Improving Health in or of the Community?

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May 23, 2018
Brandn Green and Kristal Jones



Recognizing that community is both a geographic and social space, public health professionals have historically worked to improve health within the community as well as to improve the health of the community. Beginning with the first Healthy People report in 1979, community has been a central theme in public documents which outline the priorities of federal public health agencies. Over the course of four subsequent documents, the meaning of community has been fluid and evolving, and has incorporated the social determinants of health, the ecological model of influence, and broader concepts about the role of place in health outcomes. This chapter identifies the concept of community within each of these documents to provide a critical engagement with the concept of community in American public health over the past forty years. The chapter concludes that the concept of community has shifted from being the geographic location of public health interventions to being the problem for public health interventions, a distinction reflected in the contrast between making a community healthy by improving health within it or making a healthy community by improving the health of the community. Understanding the different possible conceptualizations of community within public health that have existed in the recent past and present in American public health can help practitioners and those working with local organizations to better understand the range of goals and approaches taken by those working on public health issues within communities.

Chapter in Handbook of Community Movements and Local Organizations in the 21st Century. 

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