Participatory Health Communication
Does public health communication always have to be a top-down model? What happens when members of the public get together and create health communication tools? How could this process engage and empower individuals while utilizing local, community-based knowledge?
Before starting my MPH at SFU, I worked as the Harm Reduction Coordinator at a Community Health Centre in Toronto. Part of my job was co-facilitating a drop-in group for woman-identified survival sex workers. One morning at group, one of the participants was telling me a story about some of the ways she and the other participants kept themselves and each other safe when they were working. I was thrilled to hear her stories and to better understand how the women I supported get through a day. I told her as much and she responded, saying: we know a lot, we really should share with other people…let’s make a zine.
From that conversation was born “Rock, Blow and All that Jazz”, a ‘zine by and for drug users and sex workers in the neighbourhood. The process of creating the ‘zine was, in many ways, just as important as our final outcome. Together we had conversations about the barriers to safety in the neighbourhood, about how and why people worked to keep themselves and each other safe, and about what could be done at a political and community level in order to enable sex workers and drug users to be safe. We also talked about the best condom flavours, the fact that you can get STIs in your eyes, growing old, board games, children, hopes and dreams. It wasn’t all serious stuff, and that was important: it helped us build relationship and strengthen community.
The process of creating the ‘zine was a form of community development and helped some of the marginalized people in our neighbourhood be heard. So the process of creating the resource in and of itself improved health in our community.
The end product was a source of pride for those who engaged in its creation. People were happy to see their art, stories, tips and ramblings turned into a product that could be shared with, and help, others in their community. And, because the ‘zine was created by members of the target audience, we didn’t have to struggle too much with making sure it was in an approachable, understandable, language. The wisdom contained in the ‘zine was far more in tune with the lived experiences of drug users and sex workers in the community than anything I would have been able to put together professionally.
It wasn’t always easy for me to put aside my own thoughts about what should go in the ‘zine. My own assumptions about the community were challenged. And in the end our funders did make some edits, which were hard for us to take as we had contributed so much of our time and spirits. But eventually we had a product which followed a key principle of harm reduction: meeting people where they’re at. And we had gone through a process which aligns with the principles of health promotion: empowering communities to make decisions which impact their health.
Some have suggested that those without specific public health ‘expertise’ should not be creating health communication materials, that public health professionals have the required skills and knowledge to create effective and meaningful health communication tools (which those without this expertise are, supposedly, lacking). Perhaps this is true in some cases. But, people with lived experience of diseases, resilience and social determinants are knowledgeable and are capable of sharing their knowledge. And, engaging in resource creation can in and of itself be a form of empowerment and community building.