An innovative model of a community's capacity to act on its living conditions

In urban localities, physical and socio-economical environments are determinants of the health of urban communities. The capacity of such communities to contribute to a health promoting structuration of local space is valued as an innovative public health practice and increasingly considered part of the public health workforce. Actual conceptualisations of “community capacity” found in the public health literature are ill-fitted to reflect these realities, as they mainly refer to a community’s ability to respond to institutionally defined public health programs.

 This presentation will propose a model of a local community’s capacity to act on its living conditions which is embedded within an urban Montreal setting and sustained by an innovative theoretical framework. The study is made up of the analysis of 40 interviews realised with different actors (institutional, community, residents, elected officials) involved within collective local action aimed at modifying the living conditions of a Montreal Neighbourhood; on the observation of collective actions lead during more than a year (2006-2007), and on the examination of documents produced by these actors during this period. The study theoretically relies on the Actor Network Theory (Callon, Latour), the capability Approach (Sen), and structuration theory (Giddens).

 Results show how local communities transform their living conditions via their doings and beings, their many translation processes, given their local and external resources as much as the conversion factors, they are able to use and apply to such resources. Results also reveal major controversies resulting from unaligned top down/institutional vs local objectives vis-à-vis social determinants of health (SDH).

 Such a dynamic, systemic, urban and theoretically sustained conceptualisation of community capacity is long called for in public health to value the role of local communities in the action on the SDH, and to sustain those processes which are indicative of the growing local public health workforce.