We commend Sprague Martinez et al.1 for highlighting neighborhood sanitation conditions recognized by local Black and Latino youths who then photographed these social and environmental conditions that related to their personal stress. Their experience once again demonstrates the importance of engaging community members in assessing the health of their own communities.
This rediscovery2–4 has important implications for “creating the conditions in which people can be healthy.”5 It is timely, too. For example, as a result of Internal Revenue Service regulation6 and accreditation requirements,7 nonprofit hospitals and local and state health departments must now complete community health assessment and improvement plans. Clearly, visual stories used as data are worthwhile elements of any assessment and improvement process.
In addition to hospitals and public health agencies conducting these assessments collaboratively, involving community members and community organizations incentivizes engagement and collective responsibility for outcomes. As Sprague Martinez et al. point out, communities have faced similar “nasty” situations in the past. Efforts on the part of residents to identify and voice their concerns likely resulted in political processes that were instrumental in remediating unhealthy situations.
We encourage students engaged in research to express their voices through local, state, and federal governmental processes to raise awareness of both visible and hidden upstream causes of injury, illness, and death.
While the lives of community residents are in many ways experienced as “local,” efforts to improve the public’s health may also benefit from coordinated action from all parts of the governmental public health enterprise: local, state, and federal levels.8 Law, regulation, security, protection, and financing are important local, state, and federal responsibilities; neglect of these areas by any level of government results in the conditions documented by the students and the poor outcomes present in far too many communities.
These are challenging times for local, state, and federal governmental public health agencies and for the communities they protect and keep safe. Collaboration with community partners can help make positive health outcomes more likely. Our communities will thrive as a result.
References
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