Grassroots Power and the Future of Public Health

“Grassroots movements provide an opportunity for everyone to have a voice in what our society looks like – It’s at the core of what a democracy can and should be.” – Shannon Frattaroli, Johns Hopkins Bloomberg School of Public Health.

JHSPH Faculty Portraits

Interview:  Shannon Frattaroli

Shannon Frattaroli, PhD is Associate Professor at the Johns Hopkins Bloomberg School of Public Health, Center for Injury Research and Policy.  Her research on grassroots movements helps answer two critical questions:  Why are grassroots movements so important; and what is a grassroots public health movement, anyway?

This is the first in a two-part interview.  Stay tuned for Part 2, in which Dr. Frattaroli shares her insights into the successful grassroots movement for residential first sprinklers.

Grassroots Change: Tell us about your research.

Shannon Frattaroli: Grassroots movements are such an important part of public health, particularly for anyone who is interested in assuring that the public has a voice in policies that affect the public’s health.

The first work that I did had to do with gun violence. Lately I’ve been involved with the issue of residential fire sprinklers, a fantastic grassroots movement that’s been active for 30 or 40 years. I am interested in learning about how this movement took shape and evolved from the efforts of a few people in a few communities to where we are today with policies in hundreds of communities across the country that were initially advocated by people at the grassroots level. How that happens and how we can apply those lessons to other public health challenges is very important to the future of our field.

GC: What do you see as the role of grassroots movements in public health?

SF: There’s tremendous potential for grassroots movement building in public health.  Public health at its core is about the public. The public should have a voice in public health, and grassroots movements are one way for that to happen. The public has been very engaged in policy issues or problems throughout the history of public health. When people get engaged and are strategic with regard to policy change, things can happen quickly. And change can happen in a way that feels more legitimate. I think it’s where we should be moving in the future.

GC:  What does “grassroots movement” mean? How are grassroots health movements different from other types of advocacy?

SF: The defining feature of grassroots movement building is that grassroots movements have a wide popular base. It’s one of the purest forms of democracy in our country. It represents opportunities for people who care about their communities, who care about how our country works. Grassroots movements provide an opportunity for everyone to have a voice in what our society looks like – it’s at the core of what a democracy can and should be.

Advocacy organizations sometimes turn out to be more professional, and when that happens they engage less with people on the ground. Sometimes there is overlap, but not always. The distinguishing feature for me is the public involvement and invitation to people at the community level to participate, particularly in policy change.

GC: Why do you think public health advocates should care about building grassroots movements?

SF: When we think about policy formulation and figuring out what issues should be on the agenda, grassroots movements can be a voice for what’s important to the people of this country.

At the very earliest stages of the policy process, the grassroots can be important in elevating particular issues to a level where decision makers hear that this is something the public wants us to act on. In the later stages of the policy process, when we think about the details of policies, it’s valuable for the grassroots to weigh in and have a voice with regard to the different policy options. The grassroots can legitimize a particular issue and solution that’s being proposed – it gives policy makers the encouragement and knowledge that they’re supported and doing the right thing.

Another phase of the policy process that is often overlooked is implementation. Once a policy has passed, it is also important for the grassroots to be involved so that public agencies know these policies are important and that the public wants officials to pay attention to the laws that have been passed. Grassroots involvement adds legitimacy on the front end, and offers an important voice after policy adoption – it’s that public encouragement saying, “We support our government in making this policy come to life.”

“Because [elected officials] can’t know everything about the topics on which they’re asked to make decisions, grassroots involvement is an absolutely essential part of how our policy process works.”

Elected officials – the city council, state legislatures, and Congress – are asked to decide on issues that run the whole range of topics. On any given day, they may consider issues with regard to the military, banking, roads, and housing.  Because they can’t know everything about the topics on which they’re asked to make decisions, grassroots involvement is an absolutely essential part of our policy process.

GC: How can the public health community know if a particular grassroots movement has been effective or not?

SF:  By taking sure a grassroots movement has goals they’ve identified for themselves, that can be measured, and are being measured. We can encourage people who are doing grassroots work to identify measurable objectives and to be realistic about those objectives.

We also have to look not just at tangible progress along those lines, but also think about broader effects of the grassroots. What does it mean to bring together a group of people to get active on a public health issue? What benefits can come from that?  I think that there are a lot of benefits that we can hope to see on the policy end, that we can hope to see in how the media is talking about an issue, and how institutions within communities are talking about an issue.

There are a lot of things that prime a community, a state, or a country for policy change, and the grassroots can be very effective in that priming.  If we’re interested in measuring grassroots movements, we have to take those priming efforts into account in addition to the long-term goals of reducing deaths, illnesses, injuries, and enacting policies. Looking at the impacts on the dialogue and how institutions, media, and the conversation around an issue changes in response to grassroots activities is important in evaluating their impact.

GC: What’s the take-away message about the role of movement building in public health?

SF:  In public health we really need to embrace movement building and we need to embrace the grassroots. We started off by talking about the “public” in “public health,” and ultimately, one of the best ways to embrace and engage the public in public health is by engaging people through movement building.

It’s an incredibly exciting facet of our field. We can look back on the history of public health and see how we’ve won tremendous victories through grassroots movement building, and as we look ahead to what public health will look like in the future, movement building and the grassroots has to be a part of that if we’re going to be effective.

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