Supporting a Movement for Health and Health Equity Lessons from Social Movements: Workshop Summary (2014) / Chapter Skim
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Appendix C: Considerations for Building a Population Health Movement: Five Key Debates
Appendix C: Considerations for Building a Population Health Movement: Five Key Debates
Pages 71-82
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From page 71... ...
. A corollary and equally prominent branch of research has documented persistent health disparities between population groups, especially defined along ethnic and racial lines, and has offered multiple explanations for them, ranging from accumulated day-to-day stress to institutional arrangements and public policies that result in unequal health risks (Williams et al., 2010)
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From page 72... ...
PROBLEM ONE: IDENTIFYING CONCRETE GOALS Recent calls for a population health movement are hazy on concrete objectives, and more precision is necessary concerning exactly what such a movement would try to accomplish. One useful question to ask is whether a movement would primarily be a consciousness-raising endeavor or 1 I have drawn heavily from the sociological and historical literature on social movements for this brief but have avoided grafting my discussion onto exact constructs used by the field's scholars.
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From page 73... ...
(Disagreement about objectives -- and whether concrete objectives should even exist at all -- was one reason why much of the discursive shift generated by the recent Occupy Wall Street activities did not gain as much subsequent traction as it might have in the actual policy arena.) Some considerations for identifying and assessing targets will be discussed in more detail below, but they include level (local, state, federal, global)
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From page 74... ...
These initiatives reduced and eliminated many health risks posed by the built urban environment of that period. At the same time, they were often planned and implemented in a top-down manner that ignored their human cost, as municipal officials deemed entire neighborhoods irredeemable cauldrons of disease and marked them for clearance -- a practice, known widely as "urban renewal," that targeted mostly immigrant and black neighborhoods and continued into the 1960s (Roberts, 2009)
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From page 75... ...
resonate with the public, but a more explicit linking of the two bodies of work has been lacking. Given widely held, individually centered beliefs about health in the United States and the limited exposure the population health perspective has actually gained with the larger public, careful attention to these latter aspects will be critical to the success of any future population health movement.
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From page 76... ...
For example, Franklin Roosevelt was elected and his New Deal legislation passed during the peak and heyday of the American Communist Party and labor militancy in the 1930s, which attained and public visibility and held views that made Roosevelt look relatively moderate in comparison. PROBLEM FOUR: THE DILEMMA OF SINGLE-SECTOR ADVOCACY In 1946 the Textile Workers Union of America's Solomon Barkin declared that "deficiencies in basic living conditions .
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From page 77... ...
for pushing through hallmark occupational and environmental health legislation, especially in the 1970s run-up to OSHA and the Environmental Protection Agency. The present-day environmental justice movement is an example of another multisector approach, one that unifies civil rights, environmental, and health advocates (Bullard, 1990)
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From page 78... ...
. Political support for the Vietnam War fell not only because of street agitation but also because of internal dissent within the Army and anger from congressional fiscal conservatives over the war's budgetary drain and economic consequences (Zelizer, 2007)
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CONCLUSION: POPULATION HEALTH -- PREVENTING MARGINALIZATION This brief has outlined five considerations to guide discussion on what a population health movement would look like. It urges those interested in seeing such a movement to consider goals, the nature of participation, political tenor, and strategic direction, that is, its relationship to non-health sectors and potential allies in coalitions.
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(Tapp et al., 1964) In the early 1970s, the social demographer Thomas McKeown ignited a debate on the causes of the so-called epidemiological transition in the 20th century, in which the incidence of contagious disease and mortality declined precipitously in the advanced industrial economies, and he examined the relative contribution of medical care versus other factors, including better nutrition, sanitation, public health reforms, and economic development.
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2011. How the National Prevention Council can overcome key challenges and improve Americans' health.
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From page 82... ...
2001. Dying in the city of the blues: Sickle cell anemia and the politics of race and health.
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