A paper about evaluating community engagement as part of the public health system (South & Phillips, 2014) recognises the potential for community engagement in health to involve more than simply engaging people in planning and decision making. They suggests that community engagement can be framed in various ways:
- A delivery mechanism whereby community members deliver a standardised intervention or components for example, communication of healthy eating messages;
- A direct intervention where lay knowledge, skills and social networks are used to improve individual health for example, provision of peer support;
- Collective action on social or environmental determinants of health, often a feature of empowerment approaches;
- A means to achieve greater community influence in the health system, as part of equitable and democratic governance. (South & Phillips, 2014, p. 693)
While the definition of community engagement they provide in the opening paragraph largely focuses on decision-making, there is the potential for it to be more, particularly if we consider activities to “improve health or reduce health inequalities” in the context of social models of health.
The UK’s National Institute for Health and Care Excellence [NICE] refers to community engagement as ‘the process of getting communities involved in decisions that affect them’ including ‘the planning, development and management of services, as well as activities which aim to improve health or reduce health inequalities.’ (p. 692, emphasis added)
Looking at the latest edition of the NICE advice on community engagement to improve heath, (which is an updated version of the paper South and Phillips refer to), NICE also recognises that community engagement is relevant to more than planning and decision making.
This briefing summarises NICE’s recommendations for local authorities and partner organisations on how community engagement approaches can be used to improve the planning and delivery of all services, including those that impact on health… For the purposes of this briefing ‘community engagement’ is used as an umbrella term covering ‘community engagement’ and ‘community development’. It is about encouraging people to get directly involved in decisions that affect their wellbeing. Examples where their input will be needed include new building or housing developments, the availability of leisure services, access to housing, safe and secure neighbourhoods and employment opportunities.
Multiple terms are used to describe different approaches to community engagement, but the approaches are broadly grouped as follows:
- information provision and exchange
- delegated power
- community control. (National Institute for Health and Care Excellence, 2014, pp. 1-2, emphasis added)
While the NICE paper does have quite a focus on planning and decision making, they also recognise the that community engagement can be more.
In practice, community engagement is important in many contexts, and I think it is useful to think of community engagement in broad terms. As I’ve suggested before, I believe we can identify four types of community engagement.
- Community engagement with a focus on community development or community building
- Community participation in consultation and decision-making
- Community engagement that helps organisations, businesses etc. to improve their service delivery or to achieve their goals (e.g., some health promotion campaigns, or school engaging families and the local community to improve student outcomes)
- Community engagement as part of social change movements or as part of the work of voluntary community organisations.
Each of these broad types of community engagement have a range of associated concepts and literature associated with them. I also find it helpful to think about community engagement in terms of horizontal and vertical community engagement. Most of the four types of community engagement I suggest, involve vertical community engagement, where an organisation attempts to engage the community. But horizontal community engagement, where people are engaged within their own community, is also very important for the strength of communities.
While it is maybe tempting to define community engagement in narrow terms, one of my aims is to promote a broad definition of community engagement and the advantages of engaging communities in a wide range of contexts.
If you liked this post please follow my blog, and you might like to look at:
- An introduction to community engagement
- Definitions of community engagement
- What are social models of health?
- Types of community engagement
- 3 types of community engagement (with related concepts and literature)
- 10 things I’ve learnt about strengths-based community engagement
National Institute for Health and Care Excellence. (2014). Community engagement to improve health. Local government briefing [LGB16]. London: National Institute for Health and Care Excellence. Available from https://www.nice.org.uk/advice/lgb16/chapter/Introduction
South, J., & Phillips, G. (2014). Evaluating community engagement as part of the public health system. Journal of Epidemiology and Community Health, 68(7), 692-696. doi: 10.1136/jech-2013-203742