John W. Hatch’s research while affiliated with University of North Carolina at Chapel Hill and other places

Strengthening communities and the roles of individuals in building community life can help prevent disease and disability and expand resources for promoting social justice. This chapter discusses addressing social injustice through community transformation and the roles that public health workers can play in this process by developing authentic partnerships with communities, recognizing and building on community strengths, and using public health approaches that address the root causes of health disparities. Communities can be strengthened in their capacity to address their health problems and the root causes of these problems. Public health workers need new skill sets and intervention strategies to assist communities in meeting the challenges that they face. A text box discusses strengthening communities in low- and middle-income countries. A second text box describes the work of a community-based foundation (the MetroWest Health Foundation) in addressing social injustice at the local level.

The aim of this book is to offer a comprehensive approach to understanding social injustice and its impact on public health. Part I explores the nature of social injustice and its adverse effects on public health. Part II describes in detail how the health of ten specific population groups is affected by social injustice. Part III explores how social injustice adversely affects health in ten different areas, ranging from infectious diseases to mental health, from prevention of assaultive violence and war, to occupational health and safety. Part IV provides an action agenda for what needs to be done to prevent social injustice and to minimize its impact on health. In sum, the book examines social injustice as a principal causative factor and as a consequence of many public health problems.

The question of the possible, proper, or desirable relationships of churches lo health and human service agencies is raised. Identifying, recruiting, and training important members of natural helping networks in the black church, who can serve as “lay health advisors” (LHA) linking and negotiating between people at risk and agency services, is one health intervention strategy for establishing a relationship between formal and informal support systems. As lay people to whom others naturally turn for advice, emotional support, and tangible aid, LHAs provide informal and spontaneous assistance. Found at many levels in a community, these persons are already helping people by virtue of their community roles, occupations, or personality traits. A lay health advisor intervention model conceptualizes the relationships between the social support functions of networks within black congregations and their expected effects on: (1) the behaviors of individuals at risk; (2) the service delivery structures of agencies; and (3) the problem solving capacities of communities. Based on this model, three types of LHA interventions are categorized in accordance with the aim of network member involvement: (1) enhancing the total network within a church; (2) cooperative problem-solving linking networks between churches; and (3) coalition building connecting networks beyond the church. An intervention example for each of these categories is provided, including a description of the target population, support provider), purpose, problems addressed, network characteristics emphasized, activities used, and role of the professional. Important lessons learned from these examples are drawn, with particular emphasis given to the issues and special interests of working with natural helping networks in black congregations.