Community Health Advocacy (review)

Community Health Advocacy is a concise, well-researched overview of the topic. The first section explores the theoretical framework for community health advocacy. The authors draw on sociology, anthropology, and public health to attempt to answer the seemingly simplest and yet truly the most complex questions, "What is community?" and "What is advocacy?" The second section examines the various advocacy strategies, including grassroots activism, building coalitions, legislative advocacy, regulatory change, using the court system, and working with the media. The final section addresses evaluation of advocacy success and ethical issues.

In the preface, the authors state that their intention is "to provide both practical and theoretical guidance to health professionals and students who advocate for the protection, enhancement, and restoration of community health." And with a few exceptions, they achieve their goal. The first two chapters provide a theoretical overview, but they are, at times, perplexingly abstract. Practicing clinicians are most likely to be disconcerted by these chapters. Although the authors thoroughly describe the process of needs assessment, a description of resource assessment (an evaluation tool that reflects a community's strengths rather than weaknesses) would strengthen the presentation. The authors are fastidious about their research and scholarly attribution throughout the text, but sometimes the citation of the names of researchers distracts from the description of the process of community advocacy. There are many lists embedded in the text that would be more useful as bulleted lists or tables. The readability of the text, however, improves as the book proceeds.

Despite these minor distractions, the body of the text is rich in information. Each component of community health advocacy is well researched and well presented. Most of the text demonstrates a neat balance between providing a discussion of the community advocacy process firmly grounded in social sciences and furnishing practical instructions on the steps of the process. For example, in Chapter 7, the authors provide a quick overview of the court system (for those of us who have forgotten our high school civics) and then proceed to discuss the actual details of using a civil lawsuit as a community advocacy strategy. Similarly, Chapter 8 discusses the influence of the media on community advocacy and then gives the reader instructions for preparing a media campaign including details on creating basic tools such as a Fact Sheet and Press Kit. The real jewels of this text are the case studies. The authors have embedded multiple examples into every discussion. Each chapter concludes with an in-depth case study of how one or more organizations have successfully employed the advocacy strategy described in the chapter. The examination of Mothers Against Drunk Driving (MADD) and the AIDS Coalition to Unleash Power (ACT UP) are especially powerful. Clinicians will find this part of the text attractively familiar because clinical education relies heavily on case studies to illustrate points. Each chapter concludes with discussion questions that would be useful in a classroom setting to promote discussion and synthesis of the information provided in the text.

Health professionals and students who are seeking a degree in community oriented fields such as Master's of Public Health, Master's of Public Administration, or Masters of Public Policy will find this text most valuable. Clinicians who are engaged in community advocacy will find large chunks of the text and the case studies to be useful. Community health advocacy traditionally has been associated with poor and underserved communities. This text will be helpful to those professionals working with the poor and underserved, but its usefulness is not limited to those communities. As the authors state in their introductory paragraph, "Advocacy may be required to move beyond the status quo." Health care in every community of America, whether rich or poor, certainly needs to be dragged, coaxed, and pushed out of the status quo. Community Health Advocacy by Loue, Lloyd, and O'Shea is a valuable resource for meeting this challenge.