Dr. Pritpal S Tamber is the Founder of the Creating Health Collaborative and the former Physician Editor of TEDMED, TED’s dedicated health event.
Dr. Tamber founded the Collaborative on the basis that most of the innovations he’d seen while with TEDMED were unlikely to have much impact on the health of people and communities living in difficult social circumstances, such as poverty or exclusion.
The Collaborative started as a blog through which Dr. Tamber shared the stories of health-focused social innovators. After a while, some of the innovators wanted to meet each other so it became a highly-curated, annual, invitation-only gathering in New York. Participants have been from the US, the UK, Canada, the Netherlands, New Zealand, and Mexico.
Dr. Tamber has codified what he has learned from the Collaborative into 12 principles.
From health care’s perspective, the 12 principles represent a framework for effective community engagement, something that is increasingly required to work on the social determinants of health. However, they go beyond considering the social needs of those that are sick – how the current work on the social determinants of health is framed – to both illustrate and overcome the deep disconnect that exists between health care and citizens, especially those enduring difficult social circumstances.
Collectively, the 12 principles describe an inclusive and participatory process:
1. Include in a community’s collective effort those who live there, those who work there, and those who deliver or support services provided there
2. Spend time understanding differences in context, goals, and power
3. Appreciate the arc of local history as part of the story of a place
4. Elicit, value and respond to what matters to community residents
5. Facilitate and support the sharing of power, including building the capacity to use it and acknowledging existing imbalances
6. Operate at four levels at the same time: individual, community, institutional and policy
7. Accept that this is long-term, iterative work
8. Embrace uncertainty, tension, and missteps as sources of success
9. Measure what matters, including the process and experience of the work
10. Build a vehicle buffered from the constraints of existing systems and able to respond to what happens, as it happens
11. Build a team capable of working in a collaborative, iterative way, including being able to navigate the tensions inherent in this work
12. Pursue sustainability creatively; it’s as much about narrative, process, and relationships as it is about resources
To make sense of the principles, Dr. Tamber spent time with leading epidemiologists. From them, he learned that while risk factors – such as poor diets, a lack of exercise or smoking – are important they account for only half of all health outcomes. The rest comes down to whether people have a sense of control over their lives. The process described by the 12 principles, Dr. Tamber learned, has the potential to foster a sense of control in communities and individuals.
To help grow the small but important field of practice linking a community’s sense of control and its health, Dr. Tamber founded a nonprofit called Bridging Health & Community (BH&C). Organized around the term ‘community agency’ – where ‘agency’ is the ability to make purposeful choices and is core to having a sense of control – BH&C held a national symposium (Community Agency & Health, Oakland, CA, May 2017) and, through 2018, partnered with The California Endowment to examine how public health might embrace community agency as part of its agenda to protect and improve health.
Dr Tamber’s work has illustrated how health care has to fundamentally renegotiate its relationship with citizens and society. Recognizing that this is hard to do, Dr Tamber is exploring how Bridging Health & Community might evolve to support leaders in health care through this renegotiation.
Dr. Tamber is the former Medical Director of Map of Medicine, a company that produced 'clinical pathways' to improve the flow of patients through health care systems. He's also the former Editorial Director for Medicine for BioMed Central, the company that disrupted academic publishing by making open access commercially sustainable. He started his career as an editor at the BMJ.
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