Neighborhood Collective Efficacy: A Public Health Approach

By Felton Earls, M.D., Harvard School of Public Health

“As part of 100 Resilient Cities, New Orleans has both showcased and deepened our ability to successfully rebound after natural and manmade disasters. Through this collaboration, I am confident that New Orleans will become the global model for resilience by our city’s 300th anniversary in 2018, building resilience across all sectors and identifying the best approaches to our city’s inherited natural challenges.”
-Mayor Mitch Landrieu

The 100 Resilient Cities initiative is a project handsomely funded by the Rockefeller Foundation. The intentions are commendable, but the concept of resilience does not resonate with the historical status of African-American neighborhoods. If resilience means to “bounce back”, one might ask, bounce back to what: Jim Crowism, antebellum slavery?

A crucial aspect of a new U.S. Marshall Plan is represented by a public health approach to the quality of communal life. Since a large fraction of African Americans live in residentially segregated neighborhoods in cities, urban neighborhoods should become a focus in evaluating the impact and progress made in launching the Plan.

Addressing the physical structure of communities should be balanced with attention to their social structure and political organization. A paramount achievement in public health is the development of approaches that measure the sense of trust, confidence and security experienced by residents of a given community. A key dimension of this social organization is “collective efficacy”, defined as the belief that one’s neighbors will actively work to improve the quality of life in their communities. The measurement of this phenomenon encompasses responding to questions like: are your neighbors likely to stop a fight between teenagers, to assist an elderly person crossing the street or demand that a fire station not be moved? Strong communities have an independent and positive impact on a wide range of health conditions. For example, in neighborhoods where collective efficacy is well established, the level of violence is reduced, birth weights are improved, and rates of asthma are lower.

The Mayor of New Orleans has, in fact, witnessed significant recovery of business and commerce. Given aspiring immigrants from other parts of the country, the size of the population is trickling up to its pre-Katrina levels. But most African American communities are far from being recovered. While New Orleans, with an African American population of sixty percent, is a special case given the devastation brought on by Hurricane Katrina, the status of community life parallels that in many other cities in the South and Mid-West.

Opening a dialogue on ways of thinking about the strengths of urban communities and strategies to enhance collective efficacy is an essential aspect of ensuring that the social and political dimensions of the plan are well defined, measured and evaluated. Strengthening the collective confidence and competence of African American neighborhoods is necessary condition of improving health and well-being.