restricted access 8 Building Partnerships between Local Health Departments and Communities: Case Studies in Capacity Building and Cultural Humility
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130 8 Building Partnerships between Local Health Departments and Communities Case Studies in Capacity Building and Cultural Humility GALEN ELLIS SHERYL WALTON The path toward effective partnerships between local health departments and communities is fraught with obstacles and sometimes seemingly insurmountable challenges. It is a journey that requires great perseverance, flexibility, humility, and caring. Success is heavily dependent on the ability of organizations and individual staff to commit themselves to deeply examining their own personal and professional beliefs, behaviors, and assumptions about culture and relationships. There also is a critical need to document and disseminate findings about the outcomes of such efforts, particularly in the wake of the growing emphasis on evidence-based practice and “practice-based evidence” (Green 2006). This chapter describes and critically analyzes the Healthy Neighborhoods Project in Contra Costa County, California, and its subsequent replication in neighboring health departments and communities. We begin by reviewing the background and context in which this model was developed, using as a conceptual framework McKnight and Kretzmann’s (1990) asset-based community development (ABCD) model (see chapter 10), Lasker and her colleagues’ (2001) concept of partnerships synergy, and Tervalon and Murray-Garcia’s (1998) concept of cultural humility. Following the case study presentations, we then draw on experiences from each of these partnerships to highlight lessons learned and promising practices. Conceptual Framework Let’s put aside our preconceived notions of each other and instead each of us—the residents, the community agencies, and the health department— come to the table and offer up our varied gifts that we can pool to transform our community. —Joyce White, resident activist, city of Richmond LOCAL HEALTH DEPARTMENTS AND COMMUNITIES 131 The statement above well captures the philosophical base and value orientation of the Healthy Neighborhoods Project. Joyce’s remark also nicely reflects the grounding of the project in McKnight and Kretzmann’s (1990) ABCD model. As discussed in chapter 10, these theorists propose moving away from the “deficit mentality” at the base of much human services work to instead identify and build on individual and community assets. Whereas the traditional needs-oriented assessment approach teaches people to see themselves with special problems to be addressed by outsiders, the ABCD approach encourages community members to recognize, actively develop, and mobilize their own assets. The HNP also well reflects Lasker and her colleagues’ (2001) notion of “partnership synergy.” Building on definitions of synergy as “the power to combine the perspectives, resources, and skills of a group of people and organizations,” Lasker and her colleagues (2001) suggest that “the synergy that partners seek to achieve through collaboration is more than a mere exchange of resources. By combining the individual perspectives, resources, and skills of the partners, the group creates something new and valuable together—something that is greater than the sum of its parts” (184). Lasker and her colleagues further argue that increased creativity, comprehensive thinking, practicality, and transformative potential are unique advantages of collaboration. Without using the term, resident activist Joyce White clearly was describing the power of partnership synergy in her statement about pooling gifts to “transform our community.” A final component of the Healthy Neighborhoods Project’s conceptual framework lies in the concept of cultural humility. As noted in chapters 1 and 3, Tervalon and Murray-Garcia (1998) originally used this term primarily in reference to race and ethnicity, noting that although we can never become truly competent in another’s culture, we can engage openly, acknowledging the limitations of our understanding and seeking to broaden that understanding. Building on this approach, we describe cultural humility as the ability to listen both to persons from other cultures and to our own internal dialogue. When we do that, we discover how easily we discount another’s truth when it passes through our own cultural lens. But cultural humility also includes understanding and addressing the impacts of professional cultures, which tend to be highly influenced by white, western, patriarchal belief systems, as these help shape interactions between health departments and local communities. As suggested in this and other chapters, sharing power can be an important outcome of having and demonstrating cultural humility in such contexts. Linking the concepts of cultural humility, ABCD and partnership synergy provides an overarching hypothesis that partnerships will be improved and longer-term health and social outcomes more easily achieved in low-income communities of color when (1) residents are engaged in and driving community development; (2) critical public health capacities of government staff are increased, particularly with respect to cultural...


Subject Headings

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