Making Sense of a Vague Category of Public Action, “Public Health”: A Case Study in a Poor Community North of Paris
Based on fieldwork in a poor community north of Paris, this paper focuses on intermediaries in charge of "public health" local policies, either in the local public sector or in non-profit organizations. Neither health specialists nor social workers, these actors, mostly women, are “project managers.” They work at an intermediate level, between senior officials and subordinate employees. The aim of this article is to study how they contribute to defining “public health” programs in the context of welfare State reforms and of the “territorialization” of public policies. It analyzes the positions and the dispositions of these intermediaries who have unclear missions and hybrid skills. It shows how unstable working conditions impact the way they implement public health policies at the local level. The use of numbers allows them to give coherence to their practices and to deal with uncertain funding. In doing so they embrace the managerial forces promoted by the new public management and the city policies, while criticizing them. They can secure their position and activities, thus continuing their commitment to “empower” residents.