Community action success in public health: are we using a ruler to measure a sphere?

The Community Action and Public Health study explored how Ontario public health practitioners interpret and implement guidance in community action. In-depth interviews were conducted with 107 public health professionals and community members in 6 Ontario health units. This report briefly describes the study methods and presents results pertaining to the measurement of success based on interviews with 67 public health professionals. Data substantiate the view that evaluation methodologies employing quantitative measures of epidemiological outcomes inadequately capture "success" in community action, possibly attributable to an unproductive dichotomization of "process" and "outcome". Results suggest two kinds of "success": a) changes related to stated goals and targets; and b) more iterative and process-oriented changes, including necessary but often undocumented shifts in relationships, structures, social conditions and processes. In order to legitimize and validate results that might otherwise pass unrecognized, we suggest a methodology that records project "milestones" as successes in their own right.

Unemployment as an issue for public health: preliminary findings from North York.

Unemployment is a critical health care issue in Canada, an important social determinant of health and, as such, an issue of concern for public health practitioners. However, indications are that the face of unemployment is changing, creating new challenges for those in the front line of service provision. Phase one of this ongoing action research study documents changes in the unemployed populations as perceived by social service organizations, including the public health department, and the agencies' response to those changes in the city of North York. It concludes with the implications of the changes for public health practitioners.