Health Promotion and Empowerment in Collaboration: Theoretical Underpinnings and Methodological Challenges when Creating a Health Equity Program in a Vulnerable Area

Abstract In Sweden, as in all other countries, there are inequalities in various areas, such as health and wealth. Research has established a social gradient in health, which means that socio-economic groups differ regarding health status. Furthermore, in many cities today there is segregation and some areas are more “socially vulnerable” than others. Some of these differences between groups and areas can be regarded as unjust and thus constitute inequities.The aim of this paper is to present the creation of a health-promotion innovation program whose purpose is to counteract health inequities in a “vulnerable” urban area in southern Sweden, and to discuss the theoretical and methodological foundations of the program. It does not, then, present any final health outcomes, but rather, gives a description of the, rather complex, initiation and launching of the program, which can in itself be seen as a kind of result.The research carried out in the program is Community-Based Participatory Research (CBPR), grounded in Participatory Action Research (PAR). The paper presents the CBPR program from its start to the present, including its rationale, and sets forth its theoretical underpinnings, i.e., ideas about place, empowerment, health promotion, “human nature,” communication and dialogue, and health equity. It closes by discussing some potential methodological and philosophical problems, namely, issues related to health equity, empowerment as a process, power relations, and community participation in the outcome evaluation.