Outside the Cage: Exploring Everyday Interactions between Government Workers and Residents in a Place-Based Health Initiative

Abstract

This paper presents an ethnographic case study of the daily lived experience of place by government health and community workers in a place-based chronic disease initiative (PBI) located in a disadvan-taged peri-urban area in Australia. The case study focused on the place at which the PBI staff members interfaced with the community informally as opposed to the deliberate interactions described in the formal community engagement strategy. Subtle social phenomena, such as social positioning and the contrasting cultures of bureaucracy and community, generated outcomes that were the antithesis of those sought by the PBI. If these characteristics of place are not attended to during the development of PBIs, we risk rec-reating existing social divides and jeopardizing the potential of these initiatives to build community ca-pacity. This case study provides an important conceptual-theoretical understanding of the place-based ap-proach, which can augment existing empirical studies of place. The findings are also relevant for those who are exploring the physical co-location of diverse professional groups in socially disadvantaged neighbourhoods. It also exposes the inherent complexity of "place" and the futility of poorly designed bureaucratic responses.