The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #73941

Marisela Gomez, PhDMDMPH, Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, 625 N. Wolfe Street, Baltimore, MD 21205, 4102303223, mgomez@jhsph.edu and Carles Muntaner, MD PhD, Behavioral and Community Health, University of Maryland, 655 West Lombard Street, Baltimore, MD 21201.

This paper explores how the political, economic, and cultural factors of an urban community affect the power of this community to effectively advocate on its behalf. We present descriptive data on the redevelopment history, health indicators, and the political and cultural context of East Baltimore, Maryland. We show how the private institution driving redevelopment in this neighborhood affects and is affected by the political, economic, and cultural relationships in this community. Next, we present primary ethnographic data from informal/unstructured interviews, focus groups, a listening project, and in-dept key informant interviews. Our qualitative results describe a current “ government-civic society” relationship in East Baltimore that reveals the insufficient political and economic power of community residents. Data show a community with minimal political clout in its relationship with the local government or the private institution developing in their community and how this power imbalance affects its activism. Furthermore, our findings suggest that community activism cannot overcome a powerful “private institution: local government” relationship and improve the health of its residents. This framework is used to evaluate how the political, economic, and cultural context of communities determines the effectiveness of community activism and ultimately may affect the health of neighborhoods undergoing redevelopment. We conclude that political advocacy is common in epidemiology and public health. Egalitarian advocacy tends to be shunned. On the other hand, advocacy that preserves inequality or hints at minimal change is encouraged.

Learning Objectives:

• Participants will be able to:
• 1-Identify how health outcomes in a community are directly and indirectly related to political and community activism in a redevelopment process ·
• 2-Recognize the role of participatory action research in affecting community health during involuntary redevelopment
• 3-Analyze the degree to which community health research addresses or ignores political determinants of health.

Keywords: Politics, Urban Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.