community asset mapping: empowering our patients and communities to health

Community Asset Mapping: Empowering our Patients and

Communities to HealthAnthony Fleg

Goals for tonight: Reflect on the service paradigm that you

and your program employ Understand the importance of the

language we use in describing our patients/communities

Understand “need-based” versus “asset-based” mapping

Begin to develop strategies for incorporating asset mapping into our projects, progams and patient care

Disclaimer My genetic conflicts of interest – mom was a drug rep

when she met dad who was a doctor hungry for her PhRMA donuts

6 years into my sobriety from PhRMA gifts and lunches (PharmFree)

3 years into my sobriety from powerpoint before tonight (PowerpointFree)

Who are we on this call? In 1-2 sentences, describe yourself and

the community you come from…no titles, school affiliations, etc

Teaching point #1 – all people and communities, when asked to describe themselves, use strengths, assets and resources

Even the most marginalized person (e.g. prisoner) and community (e.g. Indigenous, immigrant, LGBTQ) define themselves through their assets!

Compare that to our medical approach…

Mr. G is a 75yo alcoholic, diabetic male with acute hepatitis who is homeless

Community X is an inner-city, crime-ridden community in which we plan to address gang violence

Psychiatry even has a systematic way of defining people, exclusively by their deficits

Axis 1 – mental health disorders Axis 2 – personality disorders Axis 3 – medical disorders Axis 4 – social stressors

Needs mapping the dominant paradigm in medicine and public health

Needs mapping = identifying and amplifying the needs, deficits, and deficiencies of a person/community to “improve health”

What are the downstream effects of needs mapping?

Teaching point #2- what you pay attention to will grow

…pay attention to negativity, and you will actually grow the negative elements of that person or community

…pay attention to the positives, and…

Asset mapping = identifying and amplifying the assets, strengths and resources of a person/community to improve health

Who are the experts at mapping assets?

Teaching point #3 – individual patients and communities we work with are the experts in their assets

This changes the power structure and paradigm of the healing work – our communities, our patients are in control!

Asking asset-based questions

Mr. G is a 75yo alcoholic, diabetic male with acute hepatitis who is homeless

Community X is an inner-city, crime-ridden community in which we plan to address gang violence

Teaching point #4 – to do asset mapping, you must engage the ears (listening), not the mouth*

* Very hard to do after years of medical training…please attempt under adult supervision

Thought exercise – how do needs mapping and asset mapping affect our programs?

More self-reflection If you work with youth, what is the ratio

of “at-risk youth” to “youth leaders” that is used in the everyday conversation?

Are the targets of our interventions at the table, helping to plan the intervention itself

Example: medical team huddles outside patient’s room to come up with plan for the day…the expert is not even included in the conversation!

Teaching point #5 – the ethical gold standard for asset mapping is the golden rule: how would you want to be treated (as an individual or as a community member) if a health issue arose?

How to begin asset mapping

  First, allow the community/person

define themselves 

How to begin asset mapping

  Second, think in terms of assets in each of these

categories, specific to your population -Cultural

-Spiritual-Economic -Physical/environmental

-Educational -Political-Health -Human

-Social networks (formal and informal) -Community Values

Quick response Experts on teen pregnancy?

Experts in the issue of high school dropout rates?

Gang leaders – asset or deficit?

Teaching point #6 - the process of creating positive change is often more important than the product. The latter of the two is what our programs, our grants/funders pay most attention to

How to begin asset mapping

  Third – work with your

community/patient to incorporate assets/strengths/resources into your programs

Examples of asset based approaches to clinical medicine

Involve the patient in all decision-making

Motivational interviewing

Focus on strengths, and work to empower the person to build these

Example of asset-based approaches to community health

Breathe Tradition, Not Addiction campaign – incorporating traditional/ceremonial tobacco into anti-smoking efforts in Indigenous communities

“Look up to your ancestors” – a campaign in Indigenous communities to prevent SIDS

Graffiti art as a health program?

Final thoughts… Empathy, patience and listening are

the most important “technologies” you need to become good at asset mapping

Final thoughts… “You cannot build off what is not there”

(Dr. Plaza)

Final thoughts… Asset mapping requires a mentality of

service (e.g. a relationship of equals)…fixing and helping are more based on inequality

Google Naomi Remen’s piece, “In the service of life”

Offer from NHI We would be honored to assist you in the

development of your projects this year Could serve as a consultant Could help you brainstorm possibilities Possibility of connecting your work with one of

our existing programs (Youth Leading the Way project grants, Healers of Tomorrow program for youth interested in health careers)

Anthony Fleg – afleg@salud.unm.edu