Abstract
The global response to infectious diseases has seen a renewed interest in the use of community engagement to support research and relief efforts. From a perspective rooted in the social sciences, the concept of vulnerability offers an especially useful analytical frame for pursuing community engagement in a variety of contexts. However, few have closely examined the concept of vulnerability in community engagement efforts, leading to a need to better understand the various theories that underline the connections between the two. This literature review searched four databases (covering a total of 537 papers), resulting in 15 studies that analyze community engagement using a framing of vulnerability, broadly defined, in the context of an infectious disease, prioritizing historical and structural context and the many ways of constituting communities. The review identified historical and structural factors such as trust in the health system, history of political marginalization, various forms of racism and discrimination, and other aspects of vulnerability that are part and parcel of the main challenges faced by communities. The review found that studies using vulnerability within community engagement share some important characteristics (e.g., focus on local history and structural factors) and identified a few theoretical avenues from the social sciences which integrate a vulnerability-informed approach in community engagement. Finally, the review proposes an approach that brings together the concepts of vulnerability and community engagement, prioritizing participation, empowerment, and intersectoral collaboration.
Highlights
Infectious diseases represent a broad and persistent challenge in public health around the world
The studies included here built their framings of community engagement through a careful consideration of how individuals make up a community, and how “engaging” with those communities necessitates an approach that relies on understanding their embeddedness within specific social/historical systems and structures
This review, focusing on the cross-section between vulnerability and community engagement, proposes a unifying model to structure and evaluate processes of vulnerability reduction driven by collaboration between relevant community stakeholders in the context of infectious disease outbreaks (e.g. HIV/AIDS, Ebola Virus Disease or Covid-19)
Summary
Infectious diseases represent a broad and persistent challenge in public health around the world. With the threat of new pandemics emerging alongside other communicable and noncommunicable diseases, compounded by existing inequalities in access to quality health care, focusing on individuals and communities that are most at risk is crucial to understanding and mitigating vulnerabilities. Two subjects come to the fore here: vulnerability, a concept that can contain a multitude of factors (biological, social, or otherwise) influ encing ill health, and community engagement, a related practice or structure that seeks to utilize social networks to mitigate threats to infectious diseases. The practice of community engagement has gained attention for its promise of reaching those groups that suffer the most from disease (Southall et al, 2017; Tindana et al, 2007). What engagement means and the level of engagement during these processes and how communities are consid ered are contested by the various approaches used
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