Through a review of the literature on the links between population health, the community sector, and community characteristics and resilience this paper explores how a vibrant and responsive community sector can enhance overall population health and ameliorate the impact and severity of health disparities for those communities most affected and identifies the key enablers or success conditions that are needed so the community sector can reduce disparities and promote population health.
1. Pervasive and systemic health disparities are a serious problem in Canada and other rich countries. For example, there is a consistent and inequitable gradient of health in which people with lower income, education or other resources have lower life expectancy, higher rates of chronic disease and poorer overall health. The basis for these disparities lies in wider structures of social and economic inequality and in access to adequate housing, nutrition, safe environments and overall social determinants of health.
2. The impact and dynamics of the social determinants of health, however, are complex and their effects are mediated and shaped by other key factors such as the effectiveness and performance of the health care system, and the characteristics of the communities in which people live. These factors mutually influence each other in shaping population health.
3. The degree to which individuals and groups experience a sense of connectedness and trust, have networks of support, and are resilient can mediate the impact of health disparities. Resilience operates at a community level as well; so the availability and depth of networks, organizations and resources within particular communities also shapes the opportunities for good health.
4. Critical to building these community capacities and resilience is the work of a vast and diverse range of community-based organizations and agencies delivering needed programs to ameliorate the harsh effects of inequalities, engaging with community members, and mobilizing policy advocacy. At best, an effective and innovative community sector can attend to local needs while working to change the broad social and economic conditions that give rise to disparities.
5. Certain conditions need to be in place for the community sector to have a positive health impact. The sector must have adequate resources (material, fiscal, and human) and favourable policy and regulatory environments. A dynamic and responsive sector also needs to establish strong working relationships based on trust, both with residents and members of the community and other organizations and partners. These relationships are strengthened by a shared vision or sense of purpose and by cross-sectoral collaborations.