Incorporating local knowledge(s) in health promotion

Abstract

Historically, Western liberal democracies have defined relevant knowledge for social and economic management as that produced by experts following established professional methods. As we experience a shift from government to governance, state departments and bodies have attempted to impose their own desire for this particular form of knowledge, typically constructed as quantitative performance measures, onto their community partners. This is done in the name of accountability. Health promotion, as practiced in government health agencies, faces these same pressures to demonstrate outcomes and successes from community work. However, this article argues that, rather than blindly following these imperatives characteristic of advanced liberalism, it will be more fruitful for health promotion to explore the potential of incorporating and employing local knowledge(s). This argument is illustrated through two brief examples drawn from population health initiatives in two regional health authorities in western Canada. Persistent pressure from community members and their advocates can open up professional and bureaucratic systems to allow new forms of information to influence judgment. Local knowledge(s) offer a unique contribution to health promotion practice. It is incumbent upon practitioners and government organizations to seek ways to engage and incorporate the insights that are only thus available.

Keywords:

• health promotion
• accountability
• local knowledge
• performance measurement
• governance
• participation

Acknowledgements

The author thanks Dr. Peter Hutchison for his contributions. Also thanks to Lori Baugh Littlejohns, Dr. Penelope Hawe, Lisa Sutherland, Rose Soneff, Cathryn Wellner, and Lesley Dyck. Some of the studies reported here were funded in part by the Alberta Heritage Foundation for Medical Research, and the Interior Health Authority.