Putting the Community into Putting the Community into Community HealthCommunity Health

F. Douglas Scutchfield, MDF. Douglas Scutchfield, MDBosomworth ProfessorBosomworth Professor

UK College of Public HealthUK College of Public Health

““There is a tide in the affairs of men, which There is a tide in the affairs of men, which when taken at its flood, leads on to when taken at its flood, leads on to fortune. fortune. Omitted all the voyages of their life are Omitted all the voyages of their life are bound in shallows and misery”bound in shallows and misery”

ShakespeareShakespeare

Public JudgmentPublic Judgment

““The state of highly developed public The state of highly developed public opinion that exists once people have opinion that exists once people have engaged an issue, considered it from all engaged an issue, considered it from all sides, understand the choices this leads sides, understand the choices this leads to, and accepts the consequences of the to, and accepts the consequences of the choices they make.” Daniel Yankelovitch choices they make.” Daniel Yankelovitch

Public JudgmentPublic Judgment Is a source of knowledge as useful and valid as Is a source of knowledge as useful and valid as

expert opinion or quantitative dataexpert opinion or quantitative data Is a process that allows citizens to deal with Is a process that allows citizens to deal with

choices they must make, moral and ethical, to choices they must make, moral and ethical, to arrive at a stable state of mental commitment to arrive at a stable state of mental commitment to an ideal.an ideal.

It determines policy choices which allow for the It determines policy choices which allow for the individual and community to move to actionindividual and community to move to action

Developing public judgment becomes a priority Developing public judgment becomes a priority to establishing health policies or programs.to establishing health policies or programs.

Types of Citizen Engagement Types of Citizen Engagement Citizen JuriesCitizen JuriesDeliberative PollingDeliberative PollingStudy circlesStudy circlesCitizen forumsCitizen forumsScenario workshopsScenario workshopsRapid and participatory rural appaisalsRapid and participatory rural appaisals

Mathews 4 Steps for Public Mathews 4 Steps for Public JudgementJudgement

Public naming of an issue, seeking a Public naming of an issue, seeking a name in the language of citzens, not name in the language of citzens, not expertsexperts

Framing the issue in the meaningful Framing the issue in the meaningful context of everyday lifecontext of everyday life

Public deliberation/forumsPublic deliberation/forumsPublic ActingPublic Acting

Citizen Voices on Pandemic Flu Choices:Citizen Voices on Pandemic Flu Choices:A Report on the Public Engagement PilotA Report on the Public Engagement PilotProject on Pandemic InfluenzaProject on Pandemic InfluenzaBernier RH and Marcuse EK. Dec. O5Bernier RH and Marcuse EK. Dec. O5

Three PremisesThree Premises

Vaccine policies formation involve public Vaccine policies formation involve public values as well as sciencevalues as well as science

Engagement of stakeholders, experts and Engagement of stakeholders, experts and THE PUBLICTHE PUBLIC is necessary is necessary

Inclusive public open dialogue produces Inclusive public open dialogue produces more supportable decisions and greater more supportable decisions and greater public trustpublic trust

PEPPPI PhasesPEPPPI Phases50 national stakeholders and consultants 50 national stakeholders and consultants

have a 2 day dialogue and deliberationhave a 2 day dialogue and deliberation100 citizens at large have a one day 100 citizens at large have a one day

dialogue and discussiondialogue and discussion3 half day sessions in MA, NE, OR with 3 half day sessions in MA, NE, OR with

citizens shown the earlier results and citizens shown the earlier results and given opportunity for feedbackgiven opportunity for feedback

Result: All AgreedResult: All AgreedAssuring the function of society should be Assuring the function of society should be

the first immunization goal (using minimum the first immunization goal (using minimum number of vaccine doses(number of vaccine doses(

Reducting individual deaths and Reducting individual deaths and hospitalizations due to Flu (protecting the hospitalizations due to Flu (protecting the most vulnerable and at risk)most vulnerable and at risk)

““I know of no safe depository of the I know of no safe depository of the ultimate powers of society but the people ultimate powers of society but the people themselves, and if we think them not themselves, and if we think them not enlighted enough to exercise their control enlighted enough to exercise their control with a wholesome discretion, the remedy with a wholesome discretion, the remedy is not to take it from them but to inform is not to take it from them but to inform their discretion by education.” their discretion by education.”

Thomas JeffersonThomas Jefferson