Putting the Community into Community Health F. Douglas Scutchfield, MD Bosomworth Professor UK College of Public Health

“There is a tide in the affairs of men, which when taken at its flood, leads on to fortune. “There is a tide in the affairs of men, which when taken at its flood, leads on to fortune. Omitted all the voyages of their life are bound in shallows and misery” Shakespeare

Public Judgment “The state of highly developed public opinion that exists once people have engaged an issue, considered it from all sides, understand the choices this leads to, and accepts the consequences of the choices they make.” Daniel Yankelovitch

Public Judgment Is a source of knowledge as useful and valid as expert opinion or quantitative data Is a source of knowledge as useful and valid as expert opinion or quantitative data Is a process that allows citizens to deal with choices they must make, moral and ethical, to arrive at a stable state of mental commitment to an ideal. Is a process that allows citizens to deal with choices they must make, moral and ethical, to arrive at a stable state of mental commitment to an ideal. It determines policy choices which allow for the individual and community to move to action It determines policy choices which allow for the individual and community to move to action Developing public judgment becomes a priority to establishing health policies or programs. Developing public judgment becomes a priority to establishing health policies or programs.

Types of Citizen Engagement Citizen Juries Citizen Juries Deliberative Polling Deliberative Polling Study circles Study circles Citizen forums Citizen forums Scenario workshops Scenario workshops Rapid and participatory rural appaisals Rapid and participatory rural appaisals

Mathews 4 Steps for Public Judgement Public naming of an issue, seeking a name in the language of citzens, not experts Public naming of an issue, seeking a name in the language of citzens, not experts Framing the issue in the meaningful context of everyday life Framing the issue in the meaningful context of everyday life Public deliberation/forums Public deliberation/forums Public Acting Public Acting

Citizen Voices on Pandemic Flu Choices: A Report on the Public Engagement Pilot Project on Pandemic Influenza Bernier RH and Marcuse EK. Dec. O5

Three Premises Vaccine policies formation involve public values as well as science Engagement of stakeholders, experts and THE PUBLIC is necessary Inclusive public open dialogue produces more supportable decisions and greater public trust

PEPPPI Phases 50 national stakeholders and consultants have a 2 day dialogue and deliberation 50 national stakeholders and consultants have a 2 day dialogue and deliberation 100 citizens at large have a one day dialogue and discussion 100 citizens at large have a one day dialogue and discussion 3 half day sessions in MA, NE, OR with citizens shown the earlier results and given opportunity for feedback 3 half day sessions in MA, NE, OR with citizens shown the earlier results and given opportunity for feedback

Result: All Agreed Assuring the function of society should be the first immunization goal (using minimum number of vaccine doses( Assuring the function of society should be the first immunization goal (using minimum number of vaccine doses( Reducting individual deaths and hospitalizations due to Flu (protecting the most vulnerable and at risk) Reducting individual deaths and hospitalizations due to Flu (protecting the most vulnerable and at risk)

“I know of no safe depository of the ultimate powers of society but the people themselves, and if we think them not enlighted enough to exercise their control with a wholesome discretion, the remedy is not to take it from them but to inform their discretion by education.” Thomas Jefferson