(Circulation. 1997;95:1978.)
© 1997 American Heart Association, Inc.
Articles |
Changing the Public Health Landscape Through Advocacy
Correspondence to Brian Gilpin, Office of Public Advocacy, American Heart Association, 1150 Connecticut Ave NW #810, Washington, DC 20036.
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Introduction |
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 Top Introduction |
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Advocacy created the environment for the advancement of democracy in Eastern Europe and the eventual destruction of the Berlin Wall, which served as a symbolic and physical barrier to freedom.
Potsdammer Platz, a no-man's-land created by the Berlin Wall, is now the site of ambitious building projects as East and West Berlin work to update their once neglected and outdated infrastructure and meet the 21st century as a modern, unified city, producing a dramatic change in the once dreary landscape.
Advocacy is not a new concept nor is it new to the American Heart Association, but new emphasis and priority are being given to advocacy, and it is being recognized more and more as a valuable public health tool. Advocacy is more than legislation and regulation. It can include company policies, community issues, and neighborhood projects.
Advocacy, though sometimes complex, with many possible branching components, usually contains a mix of four essential elements: grassroots mobilization; coalitions and partnerships; lobbying or influencing decision makers; and media and communications. When linked together, these components become a powerful tool for accelerating change at all levels, including Congress, state legislatures, city councils, local school boards, and our neighborhood block.
The AHA has identified advocacy as one of four key work processes that will guide its work into the 21st century. The other key work processes are generating resources, discovering/interpreting and processing science, and communicating cardiovascular science and medical and consumer health information to the general public.
The benefit of advocacy is that it can mobilize individuals from all of these areas and direct them toward the accomplishment of common objectives. Advocacy can serve as the critical link between the development of scientific knowledge and treatments and the implementation of that knowledge.
The latest treatments and appropriate care options are out of reach for thousands of heart disease and stroke patients because of some managed care policies. Some individuals do not have access to recreational facilities to engage in physical activity. The 911 emergency medical services system is still unavailable in some communities. All of these barriers to heart health can be addressed and remedied in the advocacy arena. Without the AHA's strong and forceful presence in advocacy, we will miss opportunities to make significant advances in our mission. We must be successful in the legislature as well as in the laboratory.
As the AHA realigns its work to the key work processes, there will be a shift from the traditional way of doing some things. For example, the traditional static educational programs will need to be revised so that they are tailored and linked to the broader advocacy mix to have a greater effect on community change.
Visitors to Berlin often want a small piece of the Berlin Wall as a keepsake or souvenir, for it allows them to hold in their hands a symbolic piece of freedom. Although we cannot hold freedom in our hands, we all have the power to produce change in our communities. The people of Eastern Europe now realize that all along they held in their hands the power to bring freedom to their community.
Whether we specialize in science, medicine, fund-raising, education, communications, or advocacy, we can all play a role in the advancement of public health initiatives in our communities. Indeed, we all hold in our hands the power to create change in our communities and throughout the world. However, we will never realize our potential impact on our mission if we do not broaden the scope of our advocacy activities.
The AHA's advocacy initiatives can tear down the walls that stand as barriers to the advancement of our mission. Advocacy, along with efforts in funding research and disseminating science and health information, can change the public health landscape and accelerate change, which will allow us to make great strides in reducing disability and death from cardiovascular diseases and stroke.
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