Social change or business as usual at city hall? Examining an urban municipal government's response to neighbourhood-level health inequities

Madelaine C. Cahuas, Sarah Wakefield, Yun Peng

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


There is a renewed interest in the potential of municipal governments working collaboratively with local communities to address health inequities. A growing body of literature has also highlighted the benefits and limitations of participatory approaches in neighbourhood interventions initiated by municipal governments. However, few studies have investigated how neighbourhood interventions tackling health inequities work in real-time and in context, from the perspectives of Community Developers (CDs) who promote community participation. This study uses a process evaluation approach and semi-structured interviews with CDs to explore the challenges they face in implementing a community development, participatory process in the City of Hamilton's strategy to reduce health inequities - Neighbourhood Action. Findings demonstrate that municipal government can facilitate and suppress community participation in complex ways. CDs serve as significant but conflicted intermediaries as they negotiate and navigate power differentials between city and community actors, while also facing structural challenges. We conclude that community participation is important to bottom-up, resident-led social change, and that CDs are central to this work.

Original languageEnglish (US)
Pages (from-to)366-373
Number of pages8
JournalSocial Science and Medicine
StatePublished - May 1 2015
Externally publishedYes

Bibliographical note

Funding Information:
The authors would like to thank the City of Hamilton, the Hamilton Community Foundation and the members of the Neighbourhood Action Evaluation Team (including Suzanne Brown, James R. Dunn, Hilary Gibson-Wood, Matt Goodman, Paul Johnson, Sara Mayo, Colin McMullan, Evelyn Myrie, and Jeff Wingard) for their assistance and support. We would also like to sincerely thank the Neighbourhood Action Community Developers for their significant commitment, time and energy, as without their insights and feedback this paper would not have been possible. We are also grateful to the two anonymous reviewers who provided very helpful comments. This research was supported by a Canadian Institutes of Health Research Population Health Intervention Research ( GIR-127080 ) grant.

Publisher Copyright:
© 2014 Elsevier Ltd.


  • Canada
  • Community participation
  • Development
  • Health inequities
  • Neighbourhood interventions


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