query: is organizing good for your health

colist at comm-org.utoledo.edu colist at comm-org.utoledo.edu
Wed Feb 25 09:06:47 CST 2004

[ed:  thanks to Howard for contributing an international perspective to 
the discussion.]

From: "howard sobel" <hsobel at hotmail.com>

Dear Sirs:

I have benefitted from reading many discussions here, but now feel 
compelled to contribute. Anyone who has worked in well-organized 
communities in poorly developed countries (amid the typically fatalistic 
poorly organized communities) knows effective community organization 
equates to better health. Unfortunately, documentation in this area is 
not the best. Defining effective community organization is also difficult. 
Below are a few examples of effective community organization 
improving health.

Drs. Mabel and Raj Arole ("Jamkhed" for those interested) brought to 
this very poor part of Maharashtra, community-based primary health 
care which, in large part involved empowering mothers, underclass, etc. 
through community organizing--women's clubs, farmer's clubs, village 
health workers. Through their organizing, women banded together to 
root out domestic violence; undercast and marginalized sought for, 
achieved and demanded equitable access to basic needs: water, food, 
health care, income generation, bank accounts, etc. Infant mortality 
before they arrived was 180/1000 live births (18% of infants died before 
their first birthday!). Maternal mortality was likewise awful. 20 years 
hence, infant mortality got below 20/1000. Outside Jamkhed, 
Maharashtra had the same infant mortality (180/1000) and continues 
above 50/1000 (probably many undocumented as well here; while in 
Jamkhed, the documentation system is excellent).
Daniel and Carl Taylor explore other such systems in "Just and Lasting 

Also, check out Calcutta (Sonagachi) where organized commercial sex 
workers have low HIV prevalence (few percent) compared with just 
about anywhere else in India. E.g., Mumbai CSWs have prevalence in 
excess of 50%.

This is a bit outside of the impact on health of joining an organization, 
but shows organizing an effective community-based village health 
worker (VHW) system with strong community and health system 
interaction impacts mortality. Abhay and Rani Bang (NGO= SEARCH) 
trained community-based VHWs in basic antibiotic management and 
other care. There was a strong mentoring and supervisory system put 
in place. They additionally observed infant mortality in a control 
community which continued the usual public health system.  In their 
studies (see Lancet), the intervention communities to have 1/2 the 
infant mortality of control communities.

Another aside is the "Alma Ata Declaration." This is more for reference 
where WHO recognized the effectiveness of community-based primary 
health care, of which organizing is recognized key.

Hope you find this useful,

Howard Sobel

> From: "Jennifer Flynn" <flynn at nycahn.org>
> Does anyone have any studies that say that being involved in
> community organizing (involved in civic participation, being a
> member of an organization, etc.) is good for your health?  
> Thanks.
> --Jennifer Flynn
> NYC AIDS Housing Network

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