New CEOAS-Stema partnership seeks to determine and support facets of community positive health in marginalized communities
The World Health Organization’s constitution states, “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” However, many approaches to healthcare focus on clinical medicine or hospitals, missing the massive contributions that our everyday environments play in shaping health and wellbeing – from our water sources and food systems, to economies and education, and the connections people have with each other.
Oregon State University College of Earth, Ocean, and Atmospheric Sciences Assistant Professor Laura E. R. Peters has long been interested in questions of health and well-being at the community level, particularly in extreme contexts such as Western Kenya and Andean Peru that are marginalized socially, politically, environmentally and economically. Communities the world over have unique combinations of local assets hiding in plain sight that can support collective and community health even in the midst of marginalization, and Peters’ research seeks to understand how these resources can be more effectively coordinated and stewarded by those who are most impacted by health challenges.
Peters has partnered with Stema, a global research organization based in London, United Kingdom, that focuses on disrupting standard approaches to community health and sustainable development, to address some of these questions. Stema is a registered charity in England and Wales, managing a scientific research fund in partnership with the investment fund Adeline Arts and Science.
She and Stema colleagues have developed a holistic index of “community positive health” which maps and measures the tangible and intangible determinants of collective wellbeing, from ecology and infrastructure to social support, peace and self-determination.
This work is a perfect challenge for collaboration between community leaders, academics and policymakers. Peters’ broad research goal is to examine how deeply-divided societies, including conflict and humanitarian zones, experience and act on social and environmental changes and challenges. Her Disasters in Divided Societies Lab at Oregon State focuses on preventing disasters – including those related to climate change and health – and mitigating their impacts for populations and places that are the most marginalized from power and decision-making through holistic approaches including disaster risk reduction and environmental peacebuilding. Stema’s approach to global health and sustainability brings together frontline communities, data science, research, technology and decision-making with the shared commitment to improve human and planetary health. Together, the collaboration will lay the groundwork for practical tools to support community positive health, made with and for those who are experiencing increasingly complex health challenges.
With Stema’s support and partnership, Peters has been using a variety of techniques to build the community positive health index, with the ultimate goal of finding ways to improve people’s collective ability to represent and advocate for their health. The research team’s approach is to collect data about community health by working directly with the communities as partners, seeing them as experts in their own health and self-determination. This research will serve as the basis for further data and technology-enabled approaches to supporting community health agency, decision-making and resource use.
“Health is not just the absence of disease,” Peters says. “Community positive health encompasses those qualities that make people collectively feel a sense of wellbeing, those characteristics of community, culture and situations that help them thrive.
“We are building from the theory that health is socially and ecologically determined rather than resulting solely from someone’s biology or behaviors,” she continues, “and people often cultivate collective agency to influence their health in ways that are inclusive and sustainable.”
Preliminary research conducted by Peters and Stema with Kenyan communities reveals that community positive health is defined in these communities by factors including nutrition, clean water, education and adequate local infrastructure. They state in one paper, “Crucially, these building blocks [are] underpinned by intangible community resources, such as culture, knowledge, and social cohesion.” These conclusions are based on data they collected using social science tools including discussion groups, interviews, and cognitive mapping, an activity that helps community members create visual representations of an intangible concept like community health.
Peters and colleagues contend that community positive health can be supported through “resourcefulness,” rather than resilience. “The idea of ‘resourcefulness’ carries with it the implication that these communities are already connected to a web of resources and that they have agency to control their own health,” Peters explains. “We push against the notion that communities should be resilient to the systems that harm them, and instead work for systemic change together.”
Their work aims to build theory and real-world impact through participatory action research methodologies. Peters and her Stema collaborators intend to return to Kenya to validate the community positive health index they have developed, test out the approach in another field site in Peru, and start to build technologies with long-term community partners around the world that will support improvements in community health. Their work also unites these community partners in a “translocal” community that is connected by common experiences and goals for change in how health is understood and pursued.
"Stema is catalyzing positive disruptions in global health. Converging advances in data science and participatory research are unlocking unprecedented opportunities to improve community health. We want to think creatively beyond innovations in personalized medicine and effective responses to pandemics. We are passionate about applying these evolving fields to underserved regions, to resourcefulness, and individual and community agency,” says Des Tan, Stema’s Chief Technology Officer.
Geordan Shannon, Chief Medical Officer at Stema, adds, “Stema is excited to continue its work with Laura Peters, who is a leader in peacebuilding, justice, and community and environmental health. She brings the strength of the interdisciplinary research approach of the OSU College of Earth, Ocean, and Atmospheric Sciences, as well as her own vast expertise.”
CEOAS Dean Tuba Ozkan-Haller says “We are so pleased that Laura is partnering with Stema, combining the strengths of Stema’s knowledge of innovative solutions to global health issues and Laura’s expertise in developing practices to support communities in their self-determined paths to inclusive health and safety. This work is a shining example of CEOAS’s emphasis on working towards solutions for the world’s toughest problems.”
To hear Laura talk about some of her work with Stema, watch her present at the 2024 CEOAS Earth Day panel.