Cultural Community Approaches to Health
Yesterday I participated in a very interesting small-group discussion at the Powderhorn Phillips Cultural Wellness Center (PPCWC) in south Minneapolis. The purpose of the meeting was to consider how to establish a community-based Institutional Review Board (IRB) to evaluate proposed research in communities. This is a very important issue for community-based research by research universities, one that I hope we'll make progress on.
We began, however, with an overview of the mission and philosophy of the PPCWC, presented by its very articulate Executive Director Atum Azzahir, Elder Consultant in African ways of knowing. The mission is “to unleash the power of citizens to heal themselves and to build community,” and a key statement of philosophy is
An indicator of health is engagement in healing and in community.
For cultural communities, conventional indicators of health do not adequately capture the process of what it takes to become healthy because of their exclusive focus on individual, physical indicators. While these are important to consider when discussing health, they should not be taken in isolation. They only represent one slice of the health story. Therefore, physical indicators must be part of an understanding of health together with cultural factors, such as beliefs, behaviors and lifestyle. These characterize people more holistically and affirm the role and impact of community and culture on health.
I'm struck by how integral the idea of community is to the health of individuals within that community. The contrast with the highly individual-focused ideas of most current medicine as practiced in the United States could not be greater. It's interesting to compare the PPCWC statement with that of the Center for Spirituality & Healing at the University of Minnesota:
Recognized nationally as a resource and leader in complementary therapies and healing practices, the University of Minnesota's Center for Spirituality & Healing's mission is to transform healthcare through innovative educational offerings, rigorous scientific research, inspiring outreach programs and integrative clinical services. The inspiration behind our work is the knowledge that health and well-being are enhanced when we integrate the best of complementary and conventional care.
The Center for Spirituality & Healing probably comes the closest of all University of Minnesota health enterprises to the philosophy of PPCWC, but there's still a huge gap in the individualist vs. community approaches.
The Cultural Wellness Center web site states that it "has been in the business of creating, developing, testing and implementing models that increase the effectiveness of institutions attempting to improve community health." It is partnering with a variety of "mainstream" instiutions (Hennepin County, Abbott Northwestern Hospital, the University of Minnesota, the College of Saint Catherine, the Otto Bremer Foundation) to develop and test various models.
It will be important to learn whether this culturally-specific community approach to health, partnered with the resources of modern medicine and institutions of the dominant culture, will be more successful than the not very successful standard approaches in improving health in the Powderhorn-Phllips Community.