6 Community, Community Development, and the Forming of Authentic Partnerships: Some Critical Reflections
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6 Community, Community Development, and the Forming of Authentic Partnerships Some Critical Reflections RONALD LABONTE 95 It is hard to be critical of community when one spends most of the day working in the stuffy cubicles of a government building or in the isolated cubbyhole offices of universities. Community represents something more positive and affirming than the bureaucratic rigidities or academic competitiveness of one’s daily working experience. It is difficult to question community’s importance when the only positive comments about frontline workers’ efforts come from small groups gathered in church basements or cluttered storefront agency meeting rooms. Yet questioning and critiquing the notion of community are precisely what I propose to do in this chapter. My concern is that an uncritical adoption of community rhetoric can, paradoxically, work against empowerment ideals that lie at the heart of many health practitioners’ intent. Let me clarify the meaning of a few key terms before proceeding. Several concepts bearing a community label are now common in the health sector, notably as in community organization, community mobilization, and community development. Different people use different terms to mean the same thing. In Canada, for example, community development is often used to describe what in the United States is called community organizing. For purposes of my argument, community organizing refers to efforts to create a new group or organization, often with the assistance of an outsider, such as a health promoter (Rothman 2008). Community mobilization describes attempts to draw together a number of such groups or organizations into concerted actions around a specific topic, issue, or event. Community development (or community organizing in the United States) incorporates both but describes a particular practice in which both practitioner and agency are committed to broad changes in the structure of power relations in society through the support they give community groups (Labonte 1996; Miller 2009). This chapter examines the continued conceptual confusion that surrounds the term community and offers five cautions about its uncritical invocation in health and social practice. Drawing in part on insights gained through my in-depth study of the Toronto Department of Public Health in the 1990s (Labonte 1996) and through more recent observations, I argue that, even though the concept of community development continues some of this confusion, the practice of community development has considerable potential for fostering self-reliance and the creation of authentic partnerships with communities. The chapter concludes by presenting nine characteristics of authentic partnerships that health educators and other social change professionals are encouraged to strive for in our practice. The Contested Meaning of Community Numerous historical developments have contributed to the conceptual prominence of community in health work. Although a detailed discussion is beyond the scope of this chapter, these factors include rising health care costs, the declining effectiveness and efficiency of medical treatment, and a growing appreciation of the role of individual and community factors in disease causation and prevention (Lalonde 1974; Cockerham 2006; Fawcett et al. 2011). As noted in earlier chapters, the centrality of community and the importance of community organizing for health were reflected in such influential documents as the Ottawa Charter for Health Promotion (World Health Organization 1986), which regarded “the empowerment of communities, their ownership and control of their own endeavors and destinies,” as the heart of the “new” health promotion. Many commentators view community as the venue for, if not the very definition of, the new health promotion practice (Robertson and Minkler 1994; Fawcett et al. 2011), a view commonly expressed by practitioners themselves (Diers 2004). But there is little agreement on what community means. As Walter and Hyde suggest in chapter 5, a general weakness of professional/institutional discourses on community has been the largely atheoretical and uncritical way in which the term has entered common usage. Initially in the health field, community was simply a reflexive adjective. In Canada, hospitals became community health centers, nurses became community health workers, state health departments became community health departments, and health promotion and health education programs became community-based efforts. In the syntax of everyday language, community ceased being a subject, a group of people acting with their own intent, and became an object (community as a “target” for health programs) or an adjective to the real subjects, which remained health institutions, which had become, by linguistic sleight of hand, community modified. The problem was not that community-enamored practitioners and their agencies did not know their grammar well. The problem was the way in which community became objectified as...



Subject Headings

  • Health promotion.
  • Community health services -- Citizen participation.
  • Community organization.
  • Community development.
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