Facilitators and challenges of community action for health. Comparative analysis of four case studies in neighbourhoods of Barcelona

ABSTRACT

In a context of welfare austerity and growing inequalities many citizens ask for public sector reforms in the health sector and for community action as a relevant practice. However, analyses of community action for health are still limited to single actions. For this reason, this article analyzes community action for health as a whole process of a public intervention in the neighbourhood context, including multiple actors and actions. Based on research on four disadvantaged districts in Barcelona, we develop and apply an analytical tool that allows to identify facilitators and challenges of community action for health on three dimensions of policy: symbolic (why), substantive (what) and operational (how). In this regard, several factors emerge as key ones: generating a shared discourse on health and its assets, developing a common and integral agenda (health promotion, prevention and treatment), ensuring institutional recognition and improving participation and involvement at all times of the different agents.

KEYWORDS:

• Community action
• public policy
• health
• inequalities
• Barcelona

Acknowledgment

The authors represent the research team Salut Comunitària: María José López Medina, Nuria Calzada Lombana, Xavier Blancafort Sansó, Felipe Herrera, Glòria Muniente, Montse Petit, Maica Rodríguez-Sanz, Laia Palència and M. Isabel Pasarín.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by RecerCaixa, a programme driven by “La Caixa” in collaboration with the Catalan Association of Public Universities.

Notes on contributors

Nicolás Barbieri

Nicolás Barbieri is PhD in political science, postdoctoral researcher at the Institute of Government and Public Policies and adjunct lecturer at the Department of Political Science and Public Law, at the Universitat Autònoma de Barcelona. His main research area is institutional and policy change, (health, social services, culture).

Raquel Gallego

Raquel Gallego is PhD in Government and MSc in Public Administration and Public Policy by The London School of Economics and Political Science (LSE). She is Director of the Institute of Government and Public Policies (IGOP) of the Universitat Autònoma de Barcelona (UAB), and Professor of the Department of Political Science and Public Law of the UAB.

Ernesto Morales

Ernesto Morales is PhD in Public Policies and has developed his professional career in the promotion of community development processes and citizen participation. Currently, he is a postdoctoral researcher at the Institute of Government and Public Policies at the Universitat Autònoma de Barcelona.

Carolina Muñoz-Mendoza

Carolina Muñoz Mendoza is PhD candidate in Public Policy, researcher and lecturer at the Institute of Government and Public Policies at the Universitat Autònoma de Barcelona. Her main research area is policy analysis and evaluation (citizen approach).

Bernat Quintana Terés

Bernat Quintana Terés is social worker and MSc in Social Policy and Community Action, researcher at the Institute of Government and Public Policies at the Universitat Autònoma de Barcelona. His main research area is education and community action.