During the winter and spring of 1999, the St. Louis County Department of Health contracted with the National Civic League (NCL) to develop a training process to better address the core public health functions of assessment, assurance, and policy development. While working to create this training program, NCL found that the health departments that most effectively meet their core public health functions are those that have redefined how they go about trying to carry out those functions. In short, they have adopted a communityoriented approach.
Under traditional approaches to core public health functions, public health and health care experts are the active agents; they work to establish policy, determine priorities, and then ensure that a community' s health needs are being met. Under a community-oriented approach, local government, nonprofits, businesses, and citizens, as well as public health officials and experts, all play a role in meeting those functions. In other words, the whole community is involved.
While working with the St. Louis County Department of Health to adopt a holistic approach to core public health functions, we found that in addition to redefining how these functions were viewed, the health department also needed to revise many of its traditional, internal operating procedures. In attempting to implement recommendations developed during our training sessions, the department discovered that it would be necessary to help the larger St. Louis community rethink its view of the relationship with the health department. This article grew out of these lessons.
What Is Community Engagement?
Engaging a community means involving its residents, with service delivery and government institutions, in developing and implementing problem-solving activities. These activities include the core public health functions of assessment, policy development, and assurance. Engaging the community means traditional problem-solving institutions are taking a "do with" approach rather than "do to" or "do for.