It is Budget Season: Encouraging Public Health Liberation Theory and Practice

Mar 27

By Christopher Williams, PHL Founder

To achieve health equity, Public Health Liberation (PHL) posits that shared values and beliefs (philosophy) should broaden our understanding of causal factors (theories) and maximize the variety of tools and solutions (praxis), to include data-gathering (research) and community and student development (training). PHL resembles a “pluripotent” discipline - theoretically-rich, technically adaptive, and socially immersed. Practitioners are conversant in wide-ranging theories and worldviews needed to explain and affect the context that reproduces health inequity.

Around this time of year, federal, state, and local legislatures begin budget planning for the next fiscal year. Advocates for health equity are encouraged to seek vertical integration by conveying to their representatives the importance of aligning the five central tenets of Public Health Liberation. PHL Founder Christopher Williams recently provided District of Columbia council members with the PHL framework. It included an example on policies seeking to redevelop or gentrify the city’s most economically vulnerable district containing the highest concentration of low-income Black residents.

The message read as follows. Christopher will ask for the PHL-sponsored Health Collaborative, made up of community leaders, to review and tailor to their needs to support horizontal integration. The communication reflects best practices in political engagement - keeping messaging as succinct as possible. The Collaborative has already met with the DC Council Committee on Health to discuss budget requests. The chair indicated that she welcomes a follow-up once the mayor has released her proposed budget. The Collaborative will rely on this tool to frame their follow-up discussion.

Body of Email

“Dear Councilmember [Last Name],

You and your staff may find this budget tool useful (attached). Equity can be accelerated only if values, theories, practice, research, and training are aligned. The framework is applied to the Congress Heights Small Area Plan below. Hope this helps!

Sincerely,

Christopher Williams
PhD Candidate, Public Health
Founder, Public Health Liberation and Public Health Economy theory

https://www.accelerateusequity.com/

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Accelerating equity requires aligning values, theories, practice, research, and training. A major explanation for persistent inequity in the District is due to internal contradictions and lack of coordination within the public health economy and other sectors.

1. Values. What do my moral standards teach me about equity and justice? Does the budget reflect the moral imperative to accelerate health equity in DC? What are the District's priorities and vision for equity?

2. Theories. What theories underpin the budget - cause and effect reasoning? Do they account for all populations and externalities? Is there evidence or research to support reasoning? What are critical perspectives?

3. Practice. Based on theory and practice, how should this program or service be implemented for maximum impact? How is this likely to be implemented? Does the "practice" seek transformative change? Does the "practice" reflect values (e.g., meaningful community engagement?)

4. Research. Is there adequate research to support theories that underpin budget? Have those theories been evaluated using data in Washington, DC? Is there active research capability to deliver policy intent (e.g., improve residents' quality of life?) Is research integrating data across sectors?

5. Training Are program implementers adequately trained and resourced?

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1. Values. Ward 8 contains the city's greatest concentration of vulnerable populations - long-neglected by the District. It would be immoral to exacerbate residents' social condition due to redevelopment interest.

2. Theories. The effects of blunt planning tools as proposed in the Congress Heights Small Area Plan will reverberate well beyond the planning area. Economic vulnerability and added rent burden will mean displacement. The unlocking of Poplar Point, with SAP, will be injurious and disparate.

3. Practice. To avoid trends seen elsewhere in the District with Black displacement and demographic shifts, the District should proceed in a stepwise fashion for redevelopment in Ward 8. Ongoing monitoring should impact the rapidity and trajectory of redevelopment plans in real-time.

4. Research. Ward 8 has experienced increased poverty concentration due to eroding affordability in DC. The District has demonstrated a poor record of managing the effects of neighborhood change. Regardless of new amenities, Ward 8 is likely to see major negative impacts.

5. Training Staff are not adequately trained and resourced for effective implementation of SAP. DC health officials have minimized the major negative implications of SAP in health impact assessment. Staff and implementers should receive adequate training and seek to develop a comprehensive impact assessment based on realistic scenarios.

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