Bet on Organic Public Health
By Julian Johnson • August 17, 2020
This is the third and final installment of the Summer Blog Series: Making the Case for Organic Public Health. To read the first installment, please click here. To read the second installment, please click here.
Over the last three months, my time as a health justice intern at the Praxis Project has been marked with a deeper understanding surrounding the concept of organic public health. In practice, it aims to address health inequity from non-traditional pathways of public health. This centers on grassroots & community-level organization and activism advocating for reform and justice within various facets of the social conditions related to health; this includes housing, economics, education, the environment, transportation, access to food, and much more.
I have seen first-hand how grassroots organizations, both within and outside of Praxis’ network, have continued to lead the way in organic public health work. Furthermore, I have come to the conclusion that work must be done to not only redefine what we consider to be public health, but also to make structural changes to the field itself that reflect the value of both traditional and organic public health.
It continues to remain true that public health needs a publicist. However, not just one applicant should be hired.
The truth of the matter is that the job of redefining public health and bridging the gap between organic and traditional public health must fall on the shoulders of public health practitioners and advocates. WE are the publicists responsible for communicating public health and its importance to the general public as well as defining it for future generations. Practitioners, advocates, as well as federal institutions/agencies, and state & local health departments must decide whether we will opt in or out. Will we bet on organic public health and take the necessary steps to begin this important work?
Once again, it is important to note that there are in fact champions currently within traditional public health settings that center social determinants and principles of equity in their everyday work. However, we shouldn’t settle for anything except widespread adoption and understanding—not when so many lives are at stake.
Therefore, the next question we must ask ourselves is what it looks like to “bet on organic public health.”
Financial Support
There is a common adage in politics known as “power of the purse.” This references the influence that legislatures have over public policy due to the fact that they control where funding is allocated.[1] When I look at this concept within the context of public health, funders within public health have this same power in deciding how much money and resources are given to grassroots organizations vs traditional public health institutions. Unfortunately, grassroots organizations are frequently given the smallest distribution of funding. When looking at the distribution globally, the International Human Rights Funders Group (IHRFG) and Foundation Center reported in 2013 that grassroots organizations received only 2% of $2.3 billion of funds supporting human rights across 803 funders worldwide. It is also important to acknowledge that foundations within the U.S. have stepped up to the plate in the midst of COVID-19. For example, the Seattle foundation allocated $14.3 million to their COVID-19 response fund to support community-based organizations.[2] In addition, Blue Cross, Blue Shield of Minnesota set up a $750,000 fund to not only help support healthcare workers with childcare, but also appropriated funds to tackle issues related to xenophobia and homelessness.[3] The pandemic, if anything, has shown us that large foundations and companies can step up to the plate to provide funding to communities—this shouldn’t be something that only occurs during a pandemic but rather is common practice.
This unfortunately fits the pattern of larger NGOs generally receiving greater distributions of funding than grassroots community-based organizations. A fruitful discussion can’t be had around supporting grassroots organizations without addressing these funding disparities. We must call on funders of public health to do better in financially supporting grassroots organizations engaged in organic public health work. Furthermore, the onus is also on us as community members to also donate to these organizations when we have the capacity.[4]
Inclusion
Aside from financial support, betting on organic public health requires including grassroots organizations in the greater conversation(s) of community health, interventions, and general public health scholarship. Ultimately, grassroots organizations should be leading community interventions in partnership with traditional public health entities.
Community interventions can’t happen without the community.
More often than not, no one else has a better pulse on understanding community dynamics and potential responses to proposed interventions than the organizations whose work centers around serving said community. Organic public health work necessitates community involvement, help legitimize traditional public health work and ensures that it is sustainable.[5] [6]
Elevating, not replicating
Grassroots and base-building organizations haven’t just discovered organic public health like many of us. Their work and mission are ultimately rooted in it. Thus, it is not the role of traditional public health entities to take on the goal of becoming these organizations. Not only is it impossible to do, but it disrespects the tremendous importance of the work grassroots organizations have been doing in their communities for decades. Rather than emulate, it is imperative that the lines of communication are open in order to foster authentic partnership.
Within Praxis, we have developed a toolkit that helps traditional public health institutions & agencies reflect not only on how to foster organic community partnership, but also how to center health justice, racial equity, and other tenets of organic public health in their work. It is important to acknowledge that this work takes concrete planning. The following are principles that all of us—organizers and public health professionals alike—must be mindful of when engaging in this work:[7]
Act with care: it is important to establish a framework that allows for community partners to build relationships and trust.
Inclusivity: Communities that face the burden of inequity are most equipped to design interventions to address them. One must ensure that community members’ identities, values, and cultures are both recognized respected when designing potential community interventions.
Authentic community collaboration: it is important to establish a framework that holds lived experiences in equal validity with professional experiences when interacting with the community.
Sustainable Solutions: work should be community driven, build capacity/resident knowledge, increase programmatic capacity, build lasting infrastructure, and ensure respect for all.
Commitment to Transformation: We must work to establish an organizational structure that applies these principles and helps inform our work on a daily basis. Furthermore, we must work to form partnerships that allow for reflection and sharing from both parties as well as build mechanism for feedback & evaluation of progress in combatting inequity.
While we shouldn’t expect the fruits of this work to bear overnight, important seeds are being planted to help not only redefine public health as a concept but reshape it as a practice.
COVID-19 and Grassroots Organizations
There couldn’t be more of an important time to bet on organic public health and grassroots organizations than right now. Community-based organizations are stretched incredibly thin in an effort to support their communities; these communities are often low-income and communities of color, who we know systematically face a greater burden both in fatality and lack of medical resources. Organizations within these communities often are the only place where members have access to vital services and play an important role in collaboration with state & local health departments in assessing these needs.
Grassroots organizations that serve the elderly, a group most susceptible to contracting COVID-19, are facing decreases in capacity (27%) to serve their communities. Furthermore, many have had to cut staff and volunteers and have suffered with significant losses in revenue.
When looking at the impact of COVID-19 inside our own network, many organizations have had to shift their priorities during this time and have had to dedicate internal funds to various community needs such as providing relief to those who didn’t receive a stimulus package, participating in protests amidst the Movement for Black Lives, as well as set up bail funds for community activists.[8]
Now more than ever, we must “bet on organic public health.” If we didn’t know before this series, we now know its history, its significance, those who have been on the frontlines of this work, and that it is possible to make widespread systemic changes within the field of public health to intertwine tenets of both organic and traditional public health into a unified standard of practice that will help bring sustainable and community-driven work across the country.
The tides are changing. That is inarguable. But we can’t sit by and hope for a natural shift. We must be engaged and begin to do the work.
[1] Ting, Michael M. “The ‘Power of the Purse’ and Its Implications for Bureaucratic Policy-Making.” Public Choice, vol. 106, no. 3/4, 2001, pp. 243–274. JSTOR, www.jstor.org/stable/30026219
[2] Prest, M.J. “More U.S. Companies and Foundations Mobilize for Covid-19 Relief Efforts (Coronavirus Grants Roundup).” The Chronicle of Philanthropy, The Chronicle of Philanthropy, 30 Mar. 2020, www.philanthropy.com/article/More-US-Companies-and/248377.
[3] Prina, Lee-Lee. “What Are Foundations Doing In The Fight Against COVID-19? Part II.” What Are Foundations Doing In The Fight Against COVID-19? Part II | Health Affairs, 7 Apr. 2020, www.healthaffairs.org/do/10.1377/hblog20200407.974443/full/.
[4] Ioby. “Why Asking for Donations Is Community Organizing in Disguise.” Ioby, 30 Oct. 2018, blog.ioby.org/why-asking-for-donations-is-community-organizing-in-disguise/.
[5] “Grassroots Power and the Future of Public Health.” Grassroots Change, 8 Mar. 2013, grassrootschange.net/2013/03/grassroots-power-and-the-future-of-public-health/.
[6] UNHCR Innovation Service. “Grassroots Organizations Are Just as Important as Seed Money for Innovation.” Medium, UNHCR Innovation Service, 12 Mar. 2019, medium.com/unhcr-innovation-service/grassroots-organizations-are-just-as-important-as-seed-money-for-innovation-53a8af9f7a78.
[7] “Our Principles.” The Praxis Project, www.thepraxisproject.org/our-principles.
[8] The Praxis Project, Oakland (CA): 2020 Network Check-in Survey; 2020.