Implementing Grassroots Movements to Drive Social Change and Improve Public Health

Public health initiatives often begin with big ideas. However, in order for these ideas to come into fruition and be implemented successfully, they need to start on a smaller scale, according to public health experts during a National Public Health Week Forum webcast held by the American Public Health Association. The perspectives and backgrounds of these experts varied, but their message was unified: Improving and sustaining public health comes from grassroots movements within the community.

“It’s important for us to honor the grassroots movement because that is the birthplace of public health,” said Joia Creer-Perry, MD, FACOG, founder and president of the National Birth Equity Collaborative, during her keynote address.

A notable issue gaining steam as a grassroots cause has been maternal mortality. Whereas maternal mortality rates in other developed countries have dropped in recent decades, rates have climbed in the United States. And African American women are more than 3 times more likely to die in childbirth or shortly afterward than white women.

With the goal of achieving health equity, we must first understand the roots of these inequalities that exist within our healthcare system, said Creer-Perry. While clinical factors such as eclampsia, cardiac disease, acute renal failure, and serious obstetric complications all play a role in maternal mortality, there are social factors, such as air quality and environmental status, housing, and neighborhood safety, that play just as large of a role.

Creer-Perry expressed her excitement with the growing attention paid to these social determinants and explained that to get to the social change we’re striving for, stakeholders have to listen, connect, and build trust with all patients and develop and invest in community engagement.

“If you’re not listening to the voices of the people, your data will be incomplete, and you will have poor policy,” she explained.

During a panel discussion that followed Creer-Perry’s address, Reverend Jordan Boyd, a pastor from Rockwell AME Zion Church in Charlotte, North Carolina, agreed, emphasizing the importance of centering these movements around the people in the community.

“Without understanding the dynamic of relationships and how people are connecting and how you relate to people, it won’t work,” he said. “Without understanding the value of transparency, without understanding the value of trust and being truthful and honest and open, it’s not going to work.”

Boyd and other health experts on the panel offered perspectives and stories of grassroots movements that are changing the lives of the people in their region. Boyd began by painting a picture of Charlotte. Citing a 2014 study from Harvard¹ that looked at income mobility among 50 of the largest commuting zones in the United States, he explained that someone born into poverty in Charlotte was likely to still be in poverty 30 years later. The study found that the probability that a child starting from a family in the bottom quintile of the nation’s income distribution would reach the top quintile was 4.4%.

With high rates of poverty and a high prevalence of HIV and AIDS among African Americans in the community, Jordan explained that the African American church serves as a gateway to reaching them.

“While communities change, the churches find a way to stay a part of the community and become a part of how organizations are able to tap into a community otherwise unreached,” he said.

To examplify another area also facing public health challenges, Deborah Thomas-Sims told the tale of East End, a neighborhood in Waterbury, Connecticut. With high rates of asthma, obesity, and hypertension, East End is also a food desert, explained Thomas-Sims. Working with the East End Neighborhood Revitalization Zone (NRZ), Thomas-Sims helped bring to life the East End NRZ Market & Café.

Set to open soon, the market will not only offer access to healthy foods, but it will also offer a variety of healthy living and job training programs, including dietary management services, gardening for beginners, customer service and life skills training, and violence protection and mentoring programs.

South of Connecticut, an initiative in the Brooklyn neighborhood Red Hook is focused on youth as the driver of social change. As a response to violence and disinvestment in the community, the Red Hook Initiative uses participatory action research to encourage young adults in the neighborhood to identify the issues facing their neighborhood and then materialize solutions to mitigate them, explained Javier William Lopez, chief strategic officer of Red Hook Initiative.

There need to be re-investment in the community and investment in public spaces, said Lopez. “We are working towards a campaign that puts the research into action and then into policy makers’ hands who turn it into systems change.”

Reference

Chetty R, Hendren N, Kline P, Saez E. Where is the land of opportunity? the geography of intergenerational mobility in the United States [published online June 2014]. Q J Econ. doi: 10.1093/qje/qju022.