We Like to be in the Tent: How charitable organizations navigate political advocacy for health equity
Dublin Core
Title
We Like to be in the Tent: How charitable organizations navigate political advocacy for health equity
Subject
Pressure groups
Electronic Resource Item Type Metadata
Journal Name
Social Science & Medicine
Volume
Vol. 380
Publication Date
2025
Publisher
Elsevier
Document Type
Journal article
Language
English
ISBN
18792987
Region
Canada
Access
Open Access
View Source
Abstract
Globally, charitable organizations vitally advocate for health equity by addressing social-structural determinants
like income inequality, housing insecurity, and systemic discrimination through political activities, coalition
building, and direct interventions. This article examines the discursive, legislative/political, and organizational
elements shaping the political activities of charities working to transform the social-structural determinants of
health and health inequity in Ontario, Canada. We conducted 28 in-depth interviews with staff from 24 charities
addressing social-structural issues, including harm reduction, mental health, disability rights, migrant justice,
housing access, and integrated social services. Drawing on Situational Analysis, our findings reveal that some
charities’ pursuit of political advocacy and activism against root causes of health inequities aligns with their
discursive framing as agents of democratization, while the reluctance and self-imposed restrictions of other
charities reflects the framing of charities as (non)compliant and (in)competent. Federal regulations and provincial political regimes continue to influence the ability of charities to challenge structural barriers, often
through funding dynamics. Organizational elements including size, scope, leadership, capacity, and budgeting
further shape political engagement around social-structural change. We argue these elements are undergirded by
neoliberal governance, leading some charities to prioritize efficiency and accountability to funders over systemic
equity and social justice, and reflect broader trends in governance that constrain civil society’s capacity to
address health inequities Despite these factors, many charities balance organizational responsibilities with
transformative aims. Supporting the democratic role of charities thus requires adequate funding, resources, and
capacity building to enable them to tackle entrenched structures of health inequity while maintaining essential
services.
like income inequality, housing insecurity, and systemic discrimination through political activities, coalition
building, and direct interventions. This article examines the discursive, legislative/political, and organizational
elements shaping the political activities of charities working to transform the social-structural determinants of
health and health inequity in Ontario, Canada. We conducted 28 in-depth interviews with staff from 24 charities
addressing social-structural issues, including harm reduction, mental health, disability rights, migrant justice,
housing access, and integrated social services. Drawing on Situational Analysis, our findings reveal that some
charities’ pursuit of political advocacy and activism against root causes of health inequities aligns with their
discursive framing as agents of democratization, while the reluctance and self-imposed restrictions of other
charities reflects the framing of charities as (non)compliant and (in)competent. Federal regulations and provincial political regimes continue to influence the ability of charities to challenge structural barriers, often
through funding dynamics. Organizational elements including size, scope, leadership, capacity, and budgeting
further shape political engagement around social-structural change. We argue these elements are undergirded by
neoliberal governance, leading some charities to prioritize efficiency and accountability to funders over systemic
equity and social justice, and reflect broader trends in governance that constrain civil society’s capacity to
address health inequities Despite these factors, many charities balance organizational responsibilities with
transformative aims. Supporting the democratic role of charities thus requires adequate funding, resources, and
capacity building to enable them to tackle entrenched structures of health inequity while maintaining essential
services.
Cataloger
Edrina Adjei-Manu
Citation
“We Like to be in the Tent: How charitable organizations navigate political advocacy for health equity,” ICMGLT Digital Library, accessed November 3, 2026, https://library.icmglt.org/items/show/839.