A Case for Investing in Academic-Community Engagement: COVID-19

Mayor Lori Lightfoot addresses issues of racial equity at a COVID-19 press conference.

The COVID-19 incidence and mortality statistics by race released this month reveal what all public health advocates predicted – that while indeed we are all in this pandemic together, communities of color will experience the burden of the impact – both in the short and long term. As with other health inequities, the COVID-19 pandemic has unveiled the systemic racism that reliably produces unfair advantage for some (i.e., the ability to adhere to health guidelines, work from home, and shelter in place) and unfair disadvantage for others (i.e., must continue to work amid increasingly hazardous conditions, sheltering in crowded housing, unable to secure stable housing).  Health inequities are rooted in social processes that structure opportunities (who must continue working) and policies that value some people over others (who has access to a regular doctor for a COVID-19 test), reliably producing differences in health outcomes. Health differences rooting in injustice requires public health practitioners and researchers find solutions by forming trusting partnership with those experiencing the phenomenon.

Scholarly community engagement involves working with, not on, communities experiencing health inequities. Community engagement acknowledges the inherent power imbalance between the academy and communities and invests in fairness, justice, participation and self-determination in the research process.

As an academic institution, we are in a uniquely powerful position. We produce knowledge that informs policies and system that structure opportunity and fairness. While UIC has a long history of engagement with communities, COVID-19 provides the opportunity to fundamentally transform the way we do scholarship as an institution such that it is firmly grounded in community priorities. This is an opportunity to change the way things have always been done—to rethink our research positionality.

Rethinking our research positionality

Public health is well positioned for and has lead past social change movements. In responding to the COVID-19 crisis public health can lead institutional transformation of the academy to produce knowledge that is rooted in community members lived experiences and solutions that address core roots of the problems.

  • Who identified the research need or research question?
  • Who owns the data?
  • Who determines how the results are framed in the dissemination and knowledge translation process?
  • Who benefits? At what costs?
  • Who is at the table? Where is the table (in the academy or in the community?) Who is impacted by this but not at the table?
  • Whose capacity needs building (the community or academy)?
  • Whose expertise is valued (the researcher or the community member)?
  • How will researchers be held accountable for having a trauma-informed, healing lens to their research?
  • Who is making the decisions and why?

Best practices for public health research and practice

Local Health Departments and other public health entities have responsibility to enact practices that address these structural drivers of health inequities. We won’t get guidance from the federal level right now.  Public health should align public health with like-minded movements committed to social justice; work with journalists, faith communities, philanthropists, politicians, social reformers, and medical providers; owning the evidence that links public policy, social conditions, and health outcomes, and propagating that information unapologetically.

  • Engage diverse stakeholders
  • Have inclusive structures that address power imbalances
  • Recognize why oppressed communities are reluctant to engage
  • Add mechanisms to build power and social capital
  • Call out “alternative facts” and oppressive actions
  • Work upstream
  • Align with social movements by providing health equity data

Principles of community engagement

  1. Be clear about the purposes or goals of the engagement effort and the populations and/or communities you want to engage
  2. Become knowledgeable about the community’s culture, economic conditions, social networks, political and power structures, norms and values, demographic trends, history, and experience with efforts by outside groups to engage it in various programs. Learn about the community’s perceptions of those initiating the engagement activities.
  3. Go to the community, establish relationships, build trust, work with the formal and informal leadership, and seek commitment from community organizations and leaders to create processes for mobilizing the community.
  4. Remember and accept that collective self-determination is the responsibility and right of all people in a community. No external entity should assume it can bestow on a community the power to act in its own self-interest.
  5. Partnering with the community is necessary to create change and improve health
  6. All aspects of community engagement must recognize and respect the diversity of the community. Awareness of the various cultures of a community and other factors affecting diversity must be paramount in planning, designing, and implementing approaches to engaging a community.
  7. Community engagement can only be sustained by identifying and mobilizing community assets and strengths and by developing the community’s capacity and resources to make decisions and take action.
  8. Organizations that wish to engage a community as well as individuals seeking to effect change must be prepared to release control of actions or interventions to the community and be flexible enough to meet its changing needs.
  9. Community collaboration requires long-term commitment by the engaging organization and its partners.

Source:  U.S. Department of Health and Human Services, 2011.

Resources

About the authors

Alexis Grant is a PhD in Community Health Sciences student at the University of Illinois at Chicago (UIC) School of Public Health and a community engagement fellow with the School’s Collaboratory for Health Justice

Jeni Hebert-Beirne, PhD, is the interim associate dean for community engagement at the UIC School of Public Health.

The Collaboratory for Health Justice at the University of Illinois at Chicago (UIC) School of Public health is dedicated to supporting faculty, students, and staff in reciprocal community engagement to improve our public health research, teaching, and practice. We strive to advance health justice—that all people would have the power and resources to have agency over their health, which requires addressing systems of oppression such as classism, racism, sexism and xenophobia. Our mission is to support academic-community partnerships by facilitating the meaningful participation of broad stakeholders; fostering representation & presence in academic settings; and providing training and technical assistance for integrating community engagement across research, teaching and practice.

References

ATSDR. CDC Principles of Community Engagement.

Jones, C. P. (2018). Toward the Science and practice of anti-racism: Launching a national campaign against racism. Ethnicity & disease28(Suppl 1), 231.

Minkler, M. (Ed.). (2005). Community organizing and community building for health. Rutgers University Press.

Wallerstein, N., Duran, B., Oetzel, J. G., & Minkler, M. (Eds.). (2017). Community-based participatory research for health: Advancing social and health equity. John Wiley & Sons.

Thomas, S. B., Quinn, S. C., Butler, J., Fryer, C. S., & Garza, M. A. (2011). Toward a fourth generation of disparities research to achieve health equity. Annual review of public health32, 399-416.

COVID-19 Hub Page