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20 Using Community Organizing and Community Building to Influence Public Policy ANGELA GLOVER BLACKWELL MILDRED THOMPSON NICHOLAS FREUDENBERG JEANNE AYERS DORAN SCHRANTZ MEREDITH MINKLER 371 In public health, urban and regional planning, social work, and related fields, a hallmark of community organizing and community building lies in their commitment to action and social change. Although such action may take many forms, community builders and organizers increasingly are turning to policy approaches as among the most potent for affecting the health and well-being of communities. The rationale for an emphasis on policy in the health field is well documented . The dramatic declines in U.S. mortality rates over the past century have been attributed in large part to environmental and policy-related changes in sanitation, water supply, and food quality (McGinnis and Foege 1993; House et al. 2008). More recently, community organizing and the subsequent development of social movements in areas such as women’s rights, HIV/AIDS prevention, disability rights, and environmental and climate justice have played a crucial role in changing policies on the local through the national levels (Brown et al. 2012). Successful efforts in many parts of the country to ban smoking in public places, curb the sale of handguns, and promote healthier food environments, as well as the enactment of legislation (albeit inadequate) to clean up toxic waste, are among the many policy-related victories that took root in local community organizing and community building efforts. Finally, on a global level, the healthy cities/healthy communities movement has, since its inception, focused on broad policy-level changes as a means of helping communities realize their visions of a healthy place in which to live, work, and play (Corburn 2009; O’Neill and Simard 2006; see chapter 9). For many community residents, however, “public policy has become unfamiliar and irrelevant, complicated, inaccessible and confusing” (Blackwell and Colmenar 2000, 162). And even those who do believe in the importance of public policy often feel ineffectual in their ability to influence major decisions affecting their lives. In a similar way, professionals in health, social work, and related fields who work on the community level sometimes have been reluctant to focus on policy-related activity, which they perceive as taking place primarily “out there” on the state and national levels—levels seen as being far removed from their day-to-day community organizing efforts (Minkler and Freudenberg 2010). Confusion over the extent to which nonprofit organizations can engage in policy advocacy without jeopardizing their funding also have been cause for concern, though as Homan (2011) and others have noted, this fear is often exaggerated and not in line with actual federal or foundation grantee guidelines (see chapter 7). Despite the challenges faced, health professionals and their community partners , as well as policymakers themselves, increasingly are recognizing community organizing and community building as critical strategies for helping to effect healthy public policy. Indeed, if community building principles are taken seriously , policymaking itself may become a process of community building, with community members engaged at every step, from framing the issues to interpreting the data, discussing the options, and working for the adoption of the policy change they wish to see. We begin this chapter by offering a conceptual framework for understanding policy and policy advocacy from a community organizing and community building perspective, including a look at the key steps involved in this process. We then offer two examples demonstrating some of the many ways in which local community organizing and community-based partnership efforts have worked to influence the policymaking process. We conclude by broadening our gaze to suggest how the application of community building and community organizing principles should be an integral part of policy design. Conceptual Framework For the purposes of this chapter, policies are defined as the laws and regulations, including both formal and informal rules, “by which opportunities are framed— what is allowed, encouraged, discouraged, or prohibited” (Bell and Standish 2005, 339). As Bell and Standish go on to note, “Policies also determine the shape, size and character of communities,” including, for example, neighborhood density and population composition, and whether businesses (including polluting industries) can move in (339). As Milio (1998) has pointed out, “The intent [of policy] is to achieve a more acceptable state of affairs and, from a public health perspective, a more healthpromoting society” (15). From the perspective of health equity, policies should be designed that “[provide] all people with fair opportunities to attain their full health potential to the extent possible...


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