Caribbean Latinos are the largest Latino group in Boston, primarily located in the Jamaica Plain (JP) neighborhood. There are various macro-level public health issues that result from the built environment in JP, factors which can create and sustain health disparities. Caribbean Latino youth are a priority group in JP, and it is important to address the causes of disparities early in life to promote good health. Presented here is an integrated research-and-action model to engage community stakeholders and researchers in designing an intervention to mitigate the negative health effects of the built environment and maximize community assets. The approach operates from a community empowerment model that allows public health practitioners, policy makers, researchers and residents to take an up-stream approach to improve health by focusing on the built environment, which is integral to community development.
Keywords: Community Based Participatory Research (CBPR); built environment; health; disparities; Caribbean Latinos
There is a growing body of literature linking the built environment to disparities in chronic disease (Jackson, 2003; Northridge, Sclar, & Biswas, 2003). The increased prevalence of chronic conditions such as diabetes, cardiovascular disease and asthma has led researchers, policy-makers and practitioners to revisit the relationship between urban planning, community development and public health (Brisbon, Plumb, Brawer, & Paxman, 2005; Northridge et al., 2003). This is particularly true given that characteristics of the built environment can: (1) result in exposure to hazardous conditions or substances: and (2) shape lifestyles and influence health behaviors, both of which contribute to the development and progression of chronic disease (Perdue, Stone, & Gostin, 2003). As health risks due to the built environment can most effectively be mitigated through community-wide interventions, public health practitioners have turned to community development approaches designed to facilitate community participation and empowerment such as community organizing, coalition development and community building (Minkler, 2006).
Drawing upon community development strategies, presented here is an integrated research-and-action model designed to engage community stakeholders, public health officials and researchers in the development of an intervention with the goal of improving the health of Caribbean Latino youth in Boston, Massachusetts. Background literature is presented, followed by an illustrative case study describing the community process employed to narrow the research focus and design the actual intervention, which is also described.
Community development refers to targeted local action aimed at improving community life (Petersen, 1994). Such strategies generally involve resource mobilization, the strengthening of community networks, coalition development, capacity building, and community resident engagement primarily through organizing and local outreach (Labonte, 1999). Working in collaboration with community residents, organizers work to change public and organizational policies that threaten the vitality of communities and proliferate inequity (Labonte, 1999). Although the original focus of community development was on social and economic empowerment and elements such as infrastructure, a focus on the social determinants of health for health improvement has brought community development approaches into the public health spotlight (Petersen, 1994). Given what is now known about the relationship between living environments, social environments and chronic disease, the inclusion of community development in public health research, practice and interventions is imperative to improve population health.
The core tenets of community development: participation, equity, collective action and empowerment, can now be found in some approaches to public health research like community-based participatory research (CBPR) (Petersen, 1994). …