Oct 3 2013
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Grassroots Public Health and Fire Sprinklers: Mobilizing Communities for Safety

marjorie_paloma_hz_1_c Marjorie Paloma, Robert Wood Johnson Foundation

Home fires account for 85 percent of fire deaths in the United States, yet the majority of family homes lack fire sprinklers. Since the late 1970s, a grassroots movement has successfully promoted close to 400 local ordinances that mandate fire sprinklers in all new residential construction. In response, the homebuilding industry has sought out state preemption of local authority, a strategy used by other industries as well, in an effort to reduce costs and shield profits. A new study just published in the American Journal of Public Health looks at grassroots public health movements, including the one mobilized to push back against preempting residential fire sprinklers.

To learn more about how preemption can have a negative impact on public health, NewPublicHealth spoke with Marjorie Paloma, MPH, senior policy adviser and senior program officer for the Robert Wood Johnson Foundation’s Health Group, and a co-author of the new AJPH article on preemption, grassroots efforts and public health.

NewPublicHealth: How does the effort to increase installed sprinklers in the U.S. add to the conversation on the grassroots public health movement?

Marjorie Paloma: The residential fire sprinkler story illustrates the power of grassroots movements and the chilling effect preemption can have. I use power very explicitly because when you look at the residential sprinklers movement, over time, you see how much power people have when they come together and act. Families who lost someone to fire, fire officials and others came together first in local communities and then across the nation to advocate sprinklers and save lives. The new article in the American Journal of Public Health shows that over three decades, 34 states passed legislation on this — over 350 local ordinances — and I think that this example shows you the arc of a grassroots movement. This example also shows how powerful preemptive legislation is on a grassroots movement. In those two years between 2009 and 2011, 13 states passed preemptive legislation and that essentially pulled the wind out of the sails of advocates who had been working on this issue. And, it shows you how that tactic, that strategy of preemption can really deflate, thwart, and potentially kill a movement.

NPH: How does the grassroots movement intervene and explain what the impact of preemption is on movements that promote health?

Marjorie Paloma: When you’re trying to get people engaged and build a movement toward health in the community, one of the most important things that we need to do is get smart about preemption. Preemption is a tactic used by the opposition to take the energy out of a nascent movement, taking away opportunities for the community to try new things to find the best solution.  We have to be able to recognize a preemptive strategy so that when a situation arises and preemption gets on the table, we know that we have to weigh the pros and cons and understand the implications of what it means, not just on the health issue that we’re working on, but also the long-term effect for the health of that community. We need to understand what we are giving up. Acting locally affords us the opportunity to try many things to solve a problem. Preemption takes that away right now and into the future.

NPH: Regarding the sprinkler movement, what were the factors that made it a model for other similar efforts?

Marjorie Paloma: It models how people from different backgrounds and interests can come together and focus on a common cause. A lot of fire chiefs saw needless death and injuries that could have been prevented with sprinklers. The chiefs were passionate about preventing those deaths and injuries and wanted to create change. Over time, you saw their passion spread and they connected wih different groups across the country. And then that support broadened beyond fire chiefs to burn victims and others who were affected by the absence of sprinklers.   By focusing on that common cause, people were able to connect across localities and ask: how can we learn from each other?  How can we strategize and adapt accordingly.

That common cause allowed people to come together, and then the movement built up and grew into a national network of leaders who shared ideas and best practices and technical assistance. It’s really about starting locally and then building that broad local support and connecting nationally, having that understanding of what communities want to build upon is crucial.

NPH: What are some of the effective advocacy strategies that you think people need to connect with to achieve best results?

Marjorie Paloma: I’ve mentioned three already — local advocacy, a network of leaders focused on a common cause and  and broad support for the issue. Another critical strategy is  framing the issue, making it relevant to people so they can take action. That’s what happened with the fire sprinkler issue. The movement leaders lived in the community and saw the need firsthand. They framed the issue in a way that allowed the broader community to connect with and understand the issue. The movement leaders were able to create broad public support and provide clear steps for action. That support then became the pull for the local legislation to protect families from fire. Another important point is that grassroots movement building is not about pushing a piece of legislation or pushing a policy where there is no support. It really is driven by communities  and individuals pulling or demanding action, policies and laws because it is a priority for their community. That’s why  issue framing is so important — to really make sure that the issue is framed in a way that communities understand, need, and want.

NPH: What are other current public health issues that could benefit from a grassroots approach?

Marjorie Paloma: When you look at the history of the fire sprinkler movement, the advocates working on that issue area didn’t anticipate that the industry would work to preempt fire sprinkler use. And if you were to look back to some of the other public health issues, whether it’s tobacco or violence, there was a learning curve for the advocates working in those issues around preemption and knowing what that means. What this example really teaches us is that we’ve got to look across all issues that address the health and safety of a community. We’ve got to look and listen to communities to understand what they want and need and ensure that they have the ability and skills to take action.

So I think any issue that is focused on protecting the health and promoting the health of a community could benefit from grassroots. I know that’s a big, wide answer, but if you think about the air that people breathe or the water that people drink or the neighborhoods people live in — all of these could benefit from a grassroots approach. Imagine a nation in which everyone live healthy, more fulfilling lives.  To get there, we can’t use a narrow view of public health issues.  We must ask, what does it take to make where you live a healthy place to live and raise your children? That includes education, transportation, safety and everything else that’s needed to create healthy, safe, and happy communities. This will require leadership and action from every sector. All of us have a role in creating a culture of health that enables everyone in our diverse society — no matter where you live, who you live with, or what you look like — to lead healthy lives now and for generations to come.

>>Read more on lessons learned from the grassroots fire sprinkler movement, from the organization Grassroots Public Health.

Tags: Disease Prevention and Health Promotion, Grassroots Public Health, Public health law, Safety