Community Asset Mapping: Empowering our Patients and Communities to Health

1. Community Asset Mapping: Empowering our Patients and Communities to Health Anthony Fleg

2. 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

3. 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)

4. Who are we on this call? • In 1-2 sentences, describe yourself and the community you come from…no titles, school affiliations, etc

5. 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!

6. 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

7. 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”

8. What are the downstream effects of needs mapping?

9. 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…

10. Asset mapping = identifying and amplifying the assets, strengths and resources of a person/community to improve health • Who are the experts at mapping assets?

11. 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!

12. 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

13. 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

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

15. 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!

16. 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?

17. How to begin asset mapping • First, allow the community/person define themselves

18. 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

19. Quick response • Experts on teen pregnancy? • Experts in the issue of high school dropout rates? • Gang leaders – asset or deficit?

20. 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

21. How to begin asset mapping • Third – work with your community/patient to incorporate assets/strengths/resources into your programs

22. 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

24. 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

25. Graffiti art as a health program?

26. Final thoughts… • Empathy, patience and listening are the most important “technologies” you need to become good at asset mapping

27. Final thoughts… • “You cannot build off what is not there” (Dr. Plaza)

28. 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”

29. 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