Growing evidence shows that unequal distribution of wealth and power across race, class, and gender produces the differences in living conditions that are "upstream" drivers of health inequalities. Health educators and other public health professionals, however, still develop interventions that focus mainly on "downstream" behavioral risks. Three factors explain the difficulty in translating this knowledge into practice. First, in their allegiance to the status quo, powerful elites often resist upstream policies and programs that redistribute wealth and power. Second, public health practice is often grounded in dominant biomedical and behavioral paradigms, and health departments also face legal and political limits on expanding their scope of activities. Finally, the evidence for the impact of upstream interventions is limited, in part because methodologies for evaluating upstream interventions are less developed. To illustrate strategies to overcome these obstacles, we profile recent campaigns in the United States to enact living wages, prevent mortgage foreclosures, and reduce exposure to air pollution. We then examine how health educators working in state and local health departments can transform their practice to contribute to campaigns that reallocate the wealth and power that shape the living conditions that determine health and health inequalities. We also consider health educators' role in producing the evidence that can guide transformative expansion of upstream interventions to reduce health inequalities.

New Approaches for Moving Upstream How State and Local Health Departments Can Transform Practice to Reduce Health Inequalities

While formally and informally recognized as being central to community action, the research and theoretical literature provide little insight into the processes behind the emergence of community power. When power is explored, it is usually presented in a macro context where a culmination of numerous efforts results in a critical stage leading to a more equitable distribution of power. Far less often is the micro level considered. At the latter level, power is often given only a passing reference as an expected outcome of local empowerment, civic engagement, and capacity-building activities. Generally, it is implied that power naturally emerges from the presence of the latter conditions. An explanation of the processes, mechanisms, and conditions in which community power emerges or fails to emerge remains unstated. To facilitate such an understanding, we seeks to: (1) Explore the ways in which power is conceptualized at the micro level as a component of community development and social change; and (2) prov...

The Power of Community

iv ACKNOWLEDGEMENTS vi LIST OF TABLES xi LIST OF FIGURES xi

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From Property Abandonment to Predatory Equity: Writings on Financialization and Urban Space in New York City

Globalization processes are putting pressure on traditional modes of democratic social action and rendering some ineffective. How does grassroots activists’ knowledge of globalization influence their strategies for working toward community change? This article draws on a qualitative analysis of 24 in-depth interviews with activists and community organizers in the Midwestern United States to identify their perspectives on globalization, the local impacts and challenges that globalization creates, and the strategic adaptations of models for community organizing and local activism in the contemporary global era. We found that most organizers and activists are critically aware of globalization processes and the difficulties these dynamics pose for their communities. Further, they often view their locally focused work as a direct response to the demands of globalization. The findings offer a counterpoint to depictions of local social action as myopic or irrelevant for the global era.

Local Community Organizers and Activists Encountering Globalization: An Exploratory Study of their Perceptions and Adaptations

This article examines how the policy-maker’s ‘decision not to decide’ affects different levels of internal organization and how it is reflected in the residential patterns of different population groups. The article explores the dynamics of residential patterns in two case studies: the Collective behaviour of the Sylheti community along Whitechapel Road in Eastern London and the Group Action of the ‘Kol-Torah’ Community in Zangwill Street, Jerusalem, where Inner-markets activities create clear property lines around/within their boundaries and result in a similar homogeneous pattern. Identifying the main engines of organized neighbourhood change and the difficulties of planning and dealing with individuals in the housing market shed light on similar processes occurring in other city centres with diverse population groups.

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'Decision not to decide': a new challenge for planning

Much community organizing is targeted at local power‐holders—landlords, business owners, city officials For this reason, many believe that community organizing cannot make significant social change—but sometimes community organizations are able to transcend their local focus and force policy changes at the municipal, state or national level The Northwest Bronx Community Coalition's campaign against the overfinancing of neighborhood buildings by Freddie Mac is a successful example of a community organization transcending these limits This article focuses on how the Coalition solved two strategic problems particular to this campaign: the difficulty of mobilizing tenants against a distant target whose impact on their daily lives was indirect and complicated; and the difficulty of exerting influence on a far‐off, national target These are difficulties more and more community organizations will face, as the increasing chain‐store saturation of neighborhoods and globalization of our economy brings the influ

Using community power against targets beyond the neighborhood

(1993). Power, agency and structure: An examination of Steven Lukes. New Political Science: Vol. 14, No. 1, pp. 31-46.

Margaret Groarke

Papers

Using community power against targets beyond the neighborhood

Power, agency and structure: An examination of Steven Lukes