Transcript Building Civic Capacity, Engagement, and Action

Community Participation,
Civic Capacity & Neighborhood
Identity
Findings from Focus Groups and Written Elicitations
April 3, 2008
Commissioned by
The Center for Health Equity,
Louisville Metro Department of Public Health & Wellness
PURPOSE OF COMMISSION
• A social marketing campaign
• Increase the community participation of
west Louisville residents by …………..
• Reducing the barriers and,
• Highlighting the benefits according to
• The specific needs, values, beliefs,
practices and interests of the residents.
Investigative Framework
1. To improve health and reduce health inequities requires
changes in public policy and the arrangements in society
that support inequality.
2. If residents of the City [State, Nation] understand and
support policy goals, change and progress are more likely.
3. To change policies and societal arrangements that support
inequality communities must have the capacity to engage
civically.
4. We currently have group differences in the civic capacity of
some communities and sectors, i.e., corporations, high
income vs. low income communities, etc.
5. How do we rectify imbalances in civic participation and
civic power?
Civic Engagement
 Participation
 Formal and informal
 Social and Political
 Organized community life
 The capacity of people to organize in ways that bring
about dialogue with and/or challenge a system.
 May include individual or group acts
 Attending public meetings
 Writing a letter to the paper or government official
 Signing a petition, etc.
 Voting
 Civic engagement and participation
 Confront & organize to address community issues
 Lead to the ultimate goal of community practices for
social justice.
Civic Capacity Building
 Strengthens the ability of community
organizations and groups
– Build their knowledge, structures, systems,
people and skills so they are better able to
define and achieve their objectives
 Training, education, resource identification
and resource building, organizational and
personal development
 Promotes sustainability and strengthens
internal and external or bridging and linking
social capital
Goals Civic Engagement
– Mobilize residents to become civically
engaged
• Identify issues
• Examine issues
• Ask questions
• Organize
• Take action
• Be responsible for what they can control
MEASURING CIVIC
CAPACITY
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Political Efficacy
Social Cohesion
Social Capital
Collective Self Efficacy
How Does this Affect
Health?
Policies that Reduce
Availability of
Affordable Quality
Housing
Government
Policies
Policies that Reduce
Availability of
Financial Resources
Stress Associated
With Income and
Housing Insecurity
Direct Material
Effects of Poor
Quality
Housing
Direct Material
Effects of
Income
Health Status:
Increased Morbidity
and Mortality
Strategy and Research
• Part One
– Exploring current “landscape” of public
understanding (focus groups, written elicitations)
• Part Two
– Message development (new “lenses” on the issue
- explanations in particular)
– Message testing - evaluating effectiveness
(online, and in-person
Research Questions
• How do Louisvillians currently think about community
participation?
• What role does neighborhood identity play?
• What are the key obstacles to increasing
participation?
• Are there promising directions for moving forward?
Methods
• Focus groups
– Recorded, transcribed
• Written elicitations
• Looking for shared thinking patterns, e.g.:
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–
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Links between topics
Topics that aren’t thought about
Ideas that seem important
Differences between how we want people to
think and what they think
Subjects
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Louisville residents
Non-experts, non-activists
13 women and 7 men
9 conservative, 10 liberal, 1 moderate
12 White, 6 Black, 1 Hisp, 1 Nat.Am.
Mix of ages, educational backgrounds
From lifetime residents to newcomers
FORMAT & SUBJECTS
• Focus groups
– Six groups
– 2 hours
– Incentive $50
– Videotaped, audio
taped, transcript
• Pre-Screened
• Focus Group
questionnaire
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Homeowners
Low Income
N.E. Christian
Portland
St. Stephen’s
Youth 18-24
8
7
6
5
6
3
SUBJECTS
• Ages
– 18-24 three
– 30-50 fourteen
– > 50 eighteen
• Gender
– Female 19
– Male 16
• Home ownership
– Own
19
– Homeless
1
– Rent
13
– Unknown
2
• Race
– African American
25
– White
9
– Hispanic
1
SUBJECTS
• Education Levels
– College graduate
6
– Graduate degree
5
– High school
15
– Professional degree
1
– Some college
6
– Unknown
2
•
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•
•
•
•
•
•
Income
> $75
$50-75
$35-50
$10-15
$15-20
$20-25
$25-35
3
4
6
2
2
4
6
GROUPS
• 1 group of young adults
– Ages 18-24 African American
• 1 group from Northeast Christian
– Adults
• 1 group from St. Stephen’s
– Adults
• 1 group of adults from Portland
– White
• 2 groups of adults from W. Louisville
– African American
– Low income
– Middle income
Expert View: External Factors
External Factors
Health Outcomes
Social determinants play a key role in determining health.
Expert View: External Factors
External Factors
Health Outcomes
Housing
Economic opportunity
Education
Work status
…
Diabetes
Cancer
Blood pressure
Obesity
…
Social determinants play a key role in determining health.
Actual Interpretation: Right Choices
Healthier
GROUP A
CHOICES
GROUP B
GROUP C
Character, Knowledge,
Culture, Priorities, Values
Less Healthy
Public assumes a different causal story: RIGHT CHOICES
Actual Interpretation: Right Choices
CHOICES
HEALTH
OUTCOMES
A “User-friendly” Conceptual Model: simple, easy to understand –
seems like the whole story
A Moral Model: Not just how things do work, but how they should
work – outcomes seem fair
A Limiting, Distorting Lens
HEALTH
OUTCOMES
Q: Some people say the city of Louisville should do more to close the
gap between those who are in good health and those in ill health.
What do you think?
A: I think people need to eat better, exercise more, I think that’s a big
issue here in Kentucky. The way we live. The way we eat. The way
we don’t exercise, a lot of it is [contributing] to being overweight.
Conservative African-American woman, age 64
A Limiting, Distorting Lens
HEALTH
OUTCOMES
[You] need to choose a different outlook and then from that
different outlook that will perhaps guide you towards a healthier
life ... If people understood they actually do have some amount of
power – some amount of control in their lives, then that would be
a healthier place to start – a healthier viewpoint.
Liberal white man, age 31
Note: Choices matter, but they’re not the whole story.
A Limiting, Distorting Lens
HEALTH
OUTCOMES
Q: If you had to take a guess on what groups of people in Louisville
would be healthier and what groups would be less healthy, what
do you think?
A: The couch potatoes would be less healthy.
Conservative white woman, age 71
A Limiting, Distorting Lens
HEALTH
OUTCOMES
Blacks don’t take care of themselves right. That’s why there’s
more health problems with Blacks than Whites, because they just
don’t take care of themselves right. They don’t eat right. They
don’t exercise. They don’t go to the doctor like they should.
That’s the problem with Blacks.
Conservative African-American woman, age 44
A Limiting, Distorting Lens
HEALTH
OUTCOMES
Eating habits is one of the biggest things that’s causing most of the
diabetes and stuff like that, because unfortunately the Black race
has a rich diet. It’s got a bunch of grease in it and that’s causing
cholesterol and all those stuff. Once we get educated on it we will
be able to do better.
Conservative African-American man, age 60
A Limiting, Distorting Lens
HEALTH
OUTCOMES
I think it has a lot to do with [African-American] culture. I’m
being stereotypical, but based on what I know, they are OK with
the bodies that they have. Some Black people have great bodies.
Other Black people are bigger … but they’re okay with
themselves, and I think White people have a harder image of what
they need to live up to. There’s more of a pressure on White
people, because we’re the dominant race.
Liberal White woman, age 22
A Moral Lens
Q: Do you think we as a society owe every person some kind of help for being healthy? Is
something like that a right to have?
A: No. Not as a society, because see a lot of times people cause their health problems by
the way they live.
Conservative African-American man, age 60
It’s your own personal responsibility to do what you can to improve
your health and keep yourself healthy ... If I’m going out, [if] I smoke a
lot, if I’m carrying on excess weight or if I have four or five alcoholic
drinks every day – I’m making that decision. That’s my choice, so I’m
hurting myself. I think there’s too much of people not taking
responsibility for their actions and just letting it go and thinking, well,
you know, let somebody else take care of me.
Moderate White woman, age 75
Response to Causal Claims
External Factors
Health Outcomes
Housing
Economic opportunity
Education
Work status
…
Diabetes
Cancer
Blood pressure
Obesity
…
Response to Causal Claims
External Factors
Health Outcomes
Housing
Economic opportunity
Education
Work status
…
Diabetes
Cancer
Blood pressure
Obesity
…
• External factors as outcomes, not causes (people create their own
poverty, racial isolation)
A lot of discrimination is self-imposed ... [Blacks] get 25 years old and they don’t have
an education, they don’t know how to speak properly. Mainstream isn’t going to take
them in, because they’re not mainstream.
Conservative White man, age 29
Response to Causal Claims
External Factors
Health Outcomes
Housing
Economic opportunity
Education
Work status
…
Diabetes
Cancer
Blood pressure
Obesity
…
• External factors as obstacles that should be overcome (many
examples of people doing fine)
You can still make a way if you try. I’ve seen people do it . . . It’s all
based on your choices.
Liberal White woman, age 30
RIGHT CHOICES Summary
• Comfort with disparities
• Resistance to Causal Claims
• Right Choices as a powerful lens with no real
competition
Where “Right Choices” Comes From
• Natural tendency to think “Little Picture”
• American emphasis on Individualism, Personal Responsibility
(to exclusion of other views)
• Reinforcement in the media
“Right Choices” in the News
• Media “tells the story” through choice of stories, language,
images, etc
• Right Choices as a natural reading, even when it’s not stated
directly
Troutman, who is nationally known for his work fighting racial
health disparities, said there are complex factors behind the problem
such as poverty, access problems and discrimination.
Jesse Penick, a 41-year-old African American getting a checkup at
the Portland clinic this week . . . cannot resist eating such foods as
pork chops and fried chicken. "It's kind of hard to eat right," he said.
Courier-Journal, 12/24/05
Opportunities
This report has so far focused on the “bad news.”
The research also suggested very promising ways of
moving forward.
Opportunities
Approaches with the potential to bring about a shift in thinking
• Health gradient
– It’s about everyone – avoids traps about groups
– Potentially a clear and concrete idea
– A totally new idea - potential for “aha!” effect?
• Very clear causal stories
– i.e. that can “compete” with Right Choices
Opportunities
• Frame social determinants as Opportunities for
health
• Convey a “Positive Vision”
– Clear, practical image of interventions that
can succeed
Opportunities
• Familiar case studies
– where it’s impossible to pin blame on
individuals
– E.g. lack of green space? lack of full service
grocery stores? Rubbertown?
Recommendations So Far
• Ask the following question about every
communication:
Does it allow people to focus on individual
choices/behaviors?
• Don’t bother focusing on disparities per se.
• Talk about practical and effective
changes/interventions
Recommendations So Far
• Make causal stories as concrete and irresistible as
possible
[email protected]
www.cullturallogic.com
Building Civic Capacity,
Engagement, and Action
What are We Dealing With?
• Many of the inequalities in health- are due to
inequalities in the social conditions in which
people live and work.
–
Valentine, et. al, PloS Medicine 2006; 3(6): e106. TH commission on the Social Determinants of Health
• Tackling these conditions- social determinants
health- underlying causes of poor health can
contribute to improving health and health equity.
Central Questions?
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•
•
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Why are you civically active?
Why are you not civically active?
What is your view of west Louisville?
What issues concern you?
– Parameters for this discussion
• Local economy
• Neighborhoods
• Your family
• Jobs, wages
• Educational opportunities
What Ideas or Theories
Do We Want To Explore?
What are their views of West Louisville?
What Issues concern them?
Why do they participate or not
participate?
Why Do Individuals Elect Not
To Participate?
 Because They Can’t……
– Legal restrictions
• Intimidation, fear, road blocks
– System makes participation/voting difficult
• Internalized powerlessness or racism
 Because They Don’t Want to…
– Will this do any good?
• Is this effective in achieving economic or non-economic benefits?
• Self-interest
• Is there a perceived benefit?
– Can I trust the people in power?
– Attitude influences participation
 Because Nobody Asked
– Mobilization Theory- participation is based on contextual cues and political
opportunities in the environment of the individual- media messages,
campaign spending, conversations with friends/neighbors, etc.
– Participation influences political attitude, efficacy, and sophistication
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–
Mobilization mediates the effects of SES and attitudes on participation.
Mobilization accounts for approximately half of the decline in voter turnout since
1960.
Sidney Verba, Kay L. Schlozman, Henry Brady and Norman Nie, “Resources and Political Participation,” paper prepared for the
1991 annual meetings of the American Political Science Association
Expected Outcomes
 A report:
How people in west Louisville think about civic
participation [in comparison to…..]
A look at the issues that concern them
How they think about west Louisville
Recommended messages and activities
Preliminary ideas for a communication strategy
Preliminary ideas for evaluation
Be prepared to grow, change, and make midcourse
corrections based on our observations.
Recruitment
How & Who?
• 1 group of young adults
– Ages 18-24 African American
• 1 group of adults from Portland
– White
• 2 groups of adults from W. Louisville
– African American
– Low income
– Middle income
Deliberation
• An exchange of views
– What is my position and experience on this?
• Jointly digesting and reflecting on information, facts
• Dialogue
– Reflect on common good
– Offer reasons why others should change their
minds
• May be unable to find a common position
• Only if worldviews are incompatible
• And reasonable
THEORY
Old Theory
SES Model
Attitudes
Behavior
Resources-time, money, skills
Political Action
New Theory and Ideas
Mobilization Model
•The quality and type of participation affects another kind of participation
•SES still affects action & behaviors but we now know that ….
Participation
Mobilization
Political Attitudes & Efficacy
•Mobilization mediates the effects of SES and attitudes on participation.
•Mobilization accounts for approximately half of the decline in voter turnout since
1960.
THEORY (cont’d)
Participation
Deliberative
Discussions
Civic
Engagement
Agency
A Voice
Both externally and internally driven
Attitudes, resources – time, money skills- mobilization,
informal political discussion, etc.
Not simply voting –consider context,
kinds of actions, over what period of time
and constraints….may be organizing,
mobilizing for collective action…
Leighley, J. Attitudes, Opportunities and Incentives: A Field Essay on Political Participation, Political Research Quarterly, Vol. 48, No. 1 Mar.
1995, 181-209.
Building Civic Capacity
 Teach and demonstrate the importance of democratic
practices at the community level
 Premise: people--citizens of their own communities, can and
must be the driving force and the principal agents of change
for social justice and democratic practices
 Method:
– Format: Issue-driven
– Basis: Social change discourse & deliberation
– Community Dialogues- meetings, selected readings, deliberation,
critical thinking, scenario driven role-playing
 Evaluation- longitudinal, data-driven, with a control group
[maybe] to measure social change practices, actions, and
participation
Civic Capacity Building
 Community competence
–
Confront its own problems
 Strengthens the ability of community
organizations and groups
–
Build their knowledge, structures,
systems, people and skills so they are
better able to define and achieve their
objectives
 Training, education, resource identification
and resource building, organizational and
personal development
 Promotes sustainability and strengthens
social capital
Social Capital As a Process
Towards Community Practice
 Connections among individuals, other
communities, the government
– Intercommunity
– Intra-community
– structural
– cognitive
 One person may possess social capital
but it doesn’t take place unless there is
more than one person.
 Channels of communication with a
large number of people both inside and
outside a community.
Connect the Dots
Down Stream--------------------------Up Stream
Diabetes
Obesity
Lung Cancer
Infant Mortality
A Message
Behavioral Risk Factors
Lifestyle
Do We Care About
What They Care About?
Relationships
Public Policy Process
Self-Interests
Structural Change
Rational Public Policy Process
 Problem Identification
 Gain Agenda Status
 Policy Formulation, adoption, funding
 Policy Implementation
 Policy Evaluation Adjustment, Termination
Goals, Objectives & Theory
 To increase civic engagement – collective action and
mobilization- at the community level through the use of
dialogue, deliberation, and action.
• Redefine the factors that determine civic
participation- attitudes, SES.
• Broaden the outcomes of civic
engagement beyond simply voting.
• Motivate citizens to engage in dialogue,
group will-making and collective action
resulting in social change.