Dr. Pritpal S Tamber explores how communities can lead the pursuit of health equity.
His work began in 2013 when he was the Physician Editor of TEDMED. Through that role, he observed that innovation in health largely failed to appreciate people’s social conditions – commonly referred to as the ‘social determinants of health’. In response, he founded the Creating Health Collaborative, a highly curated meeting of innovators operating from a deep understanding of a community and its context.
The innovators in the Collaborative were clear that communities’ contexts are not accidental – they are created by policies and how those policies are translated by systems into practices. Population-level health improvement, then, is about changing policies, systems and practices.
To date, the health sector has sought to do this through research. Experts take knowledge generated through research and share it with policymakers and system leaders. Important though this is, it has largely failed to result in the radical changes needed to improve social contexts.
Communities are increasingly organizing to improve their contexts. The process involves building their power and using it to change policies, systems and practices – often described as structural change. Given that inequity stems from unjust and unfair structures, communities are effectively using their power to pursue health equity.
Dr. Tamber studies this growing movement and advises organizations in health – whether health care, public health or philanthropy – what it means for them. He looks at both empirical research and on-the-ground practices to make sense of this new frontier in structural change and health improvement – and what it means for the future of health.
At the end of 2022, Dr. Tamber published a Policy Insight article in Health Affairs summarizing almost three years of research. Together with co-authors from the California Endowment, he presented the theoretical, empirical and experiential evidence linking community power to health equity via policy change. It is one of the most comprehensive and robust analyses in the field.
Dr. Tamber began his career in clinical medicine and shifted to medical publishing, health improvement, and then health innovation. In medical publishing, he was the Editorial Director for Medicine for BioMed Central, the company that disrupted academic publishing by pioneering open access. In health improvement, he was the Medical Director of Map of Medicine, a company that produced ‘clinical pathways’ to improve the flow of patients through health care systems.
What is community? What is power? And how does community power link to health? Dr. Tamber unpacks all of this based on the work of leading theoreticians, researchers and academics. Side-stepping the rhetoric and imprecision that plagues the field, he helps population health leaders get clear on what community power is and how it might become part of a population health strategy.
How a community is engaged radically changes the types of outcomes possible. While the health sector typically focusses on clinical and service outcomes, other, more community-centric outcomes, are possible through deeper forms of engagement. As Dr. Tamber explains, these community-centric outcomes have the potential to encourage a community to understand and step into its power.
Numerous cross-sector collaborations have started to understand that the community must be a ‘partner’ in their efforts. But what does it mean for a community to become a partner? Dr. Tamber explains how the community must be seen as an ecosystem of local entities supported by a formal and informal infrastructure – and what partnering with that ecosystem means in practice.
Most people know that the future of health cannot be more health care — not only is the system only set up for repair, it is also expensive. At the same time, population health strategies have struggled to have the impact that they promise. Dr. Tamber illustrates how the future of health is a tripartite system of community power, public health, and health care – and how the second and third need the first.
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