Community Development Can Improve Resident Health (original) (raw)
The Healthy Community Neighborhood Initiative: Rationale and Design
Ethnicity & Disease, 2016
IntroductIon African Americans, Latinos, and adults from other racial/ethnic minority groups have higher rates and worse control of chronic conditions such as obesity, diabetes, cardiovascular disease and stroke than their White peers and face worse outcomes from these conditions. 1-5 Residence in low-income, underresourced communities is also associated with poorer chronic disease outcomes. 1,2,6-10 At the individual and the community levels, many shared mechanisms may contribute to health inequities, among them lower educational attainment and income, higher rates of deleterious health behaviors, poorer access to health care and health-promoting resources, lower quality of care, and chronic stressors. 11-14 There is limited understanding, however, of the best strategies for improving individual health outcomes and reducing health disparities in communities where physical and social conditions undermine efforts to prevent and manage chronic conditions. 15-19 An emerging literature suggests that interventions developed through community-academic partnerships have the potential to translate Objective: To describe the design and rationale of the Healthy Community Neighborhood Initiative (HCNI), a multicomponent study to understand and document health risk and resources in a low-income and minority community. Design: A community-partnered participatory research project. Setting: A low-income, biethnic African American and Latino neighborhood in South Los Angeles. Participants: Adult community residents aged >18 years. Main Outcome Measures: Household survey and clinical data collection; neighborhood characteristics; neighborhood observations; and community resources asset mapping. Results: We enrolled 206 participants (90% of those eligible), of whom 205 completed the household interview and examination, and 199 provided laboratory samples. Among enrollees, 82 (40%) were aged >50 years and participated in functional status measurement. We completed neighborhood observations on 93 street segments; an average of 2.2 (SD=1.6) study participants resided on each street segment observed. The community asset map identified 290 resources summarized in a Community Resource Guide given to all participants. Conclusions: The HCNI communityacademic partnership has built a framework to assess and document the individual, social, and community factors that may influence clinical and social outcomes in a community at high-risk for preventable chronic disease. Our project suggests that a community collaborative can use culturally and scientifically sound strategies to identify community-centered health and social needs. Additional work is needed to understand strategies for developing and implementing interventions to mitigate these disparities.
Neighborhood participation in community development: A comparison of strategic approaches
Population Research and Policy Review, 1985
This study compares the ability of community development corporations to mobilize residents of low income neighborhoods to participate in redevelopment efforts. The evidence and argument show that community development corporations have not been more successful than other types of community-based organizations in (1) the degree to which organizational leadership has been recruited from the neighborhood; (2) the type of control exercised by residents over redevelopment policy, and; (3) the degree of fiscal autonomy achieved by the organization. The policy ramifications of the findings are discussed and analyzed.
AMA Journal of Ethics
In the past few decades, scholars have begun to establish ethical principles for public health engagement. A key tension has been how to reconcile public health improvement with local autonomy in decision making so as to express respect for community members' on-theground experience. This article describes the experience of one children's hospital in learning to ethically engage a surrounding community in conversations about housing development in partnership with a local faith-based development organization. Making Neighborhoods Better In 2008, amidst the throes of economic recession, a major crossroads confronted the Nationwide Children's Hospital (NCH) in Columbus, Ohio's South Side. The hospital had decided to remain in its location of 126 years and invest more deeply in the community. The collapse of the nation's housing markets had left hundreds of vacant properties in the area just beyond the hospital's campus, and it was clear that addressing housing was key to improving pediatric health outcomes for 3 reasons: (1) housing plays a documented role in the health of children, 1 and this neighborhood had severe housing shortage; (2) outreach efforts made clear that housing was a neighborhood priority; and (3) because of instability in housing, children were moving too frequently to make school-based or neighborhood-based programs effective. Accordingly, the new hospital administration was committed to effecting change in the neighborhood.
2018
other US cities. This challenge has eluded governments and private entities at all levels for decades, largely because of its immense and complex scope. As far back as the 1930s with the Chicago Area Project [1], attempts to turn areas of concentrated disadvantage into vibrant communities have failed, or at least failed to be fully successful. Recent efforts to gentrify areas to make them more vibrant have seen some success; but displace low-income residents living there, further concentrating disadvantage in other areas [2]. What is needed is a systems-based effort crossing many boundaries that is also realistic in what can be accomplished within the social, economic, and political structure of a city. An often-overlooked element of neighborhoods is that, as systems, addressing one part rarely improves the whole [3, 4]. To improve the system, a holistic and therapeutic approach is necessary to overcome decades of structural and economic disadvantage. This challenge necessitates community-based participatory partnerships, innovative thinking, and interventions addressing a variety of interconnected issues at the neighborhood level. Conceptualization of the Plan of Work to Make Urban Neighborhoods Healthy and Vibrant Successful revitalization of a neighborhood requires two simultaneous processes: 1) resources to overcome the multifaceted structural disadvantage the area and residents have experienced; and 2) a mechanism for community building among the residents. This proposal provides resources at multiple points of eight connected subsystems of health issues, structural disadvantage, and building social capacity. The foundation of these activities is the establishment of a Neighborhood Action Center (NAC), that will establish a location to coordinate program activities and provide a place for connection and action among neighborhood members. Improve health and mental health. People who live in distressed areas experience the worst kinds of health-related stress [5]. A centralized portal will provide resources for physical health, nutrition, activity, and mental health counselling and services, among others. Establishing a community health clinic within the NAC will serve as the gateway to a variety of resources and services that will improve residents' health. We will partner with the Neighborhood Association in the neighborhood(s) to identify a place for the NAC; and we will partner with the Jefferson County Department of Health and UAB Medicine for health services. Improve economic viability and self-sufficiency. Hope in the future is critical in revitalizing a neighborhood. Residents need opportunities for good jobs, within their neighborhoods, that are a part of the current economy. We propose to work with the Birmingham Business Alliance and other economic drivers in Birmingham to establish employment opportunities within the neighborhoods. We will partner with the Innovate Birmingham Regional Workforce Partnership Initiative to train local residents to work in technology and in fields in the current economy. Improve housing quality and affordability. Housing conditions strongly influence health and psychological wellbeing [6]. Living in dilapidated conditions contributes to hopelessness and feelings of unfairness. Further, hazards such as mold and lead-based paint contribute to asthma and cognitive problems [7, 8]. We propose to work with the economic partners, the Neighborhood Housing Services of Birmingham, and the Birmingham Land Bank Authority to address housing quality and affordability. This effort will help revitalize and maintain homes, rid them of health hazards, and provide resources and protection against raising taxes and rent. Improve learning and education. Children living in poverty are rarely prepared to enter school [9]. Head Start programs help; but more is needed. Research has shown that children exposed to cultural venues and learning activities (e.g. being read to at home) at an early age fare better in elementary school [10]. We will partner with the Jefferson County Committee for
A framework to extend community development measurement to health and well-being
Health affairs (Project Hope), 2014
Measurement can help community development and health practitioners align and optimize their investments and leverage additional resources to achieve shared goals. However, there is no clear guidance for reconciling the established systems for measuring community development activities and outputs-such as housing units built, jobs created, and people served-with the outcomes and impacts of health. We therefore reviewed community development measurement systems-encompassing assessment, monitoring, evaluation, and standards-and identified strategies for using those systems to support health in community development decision making. We highlight promising innovations by organizations such as the Reinvestment Fund and NeighborWorks America and place these in an ecosystem framework to illustrate opportunities for shared measurement. We then discuss policies and processes to build the ecosystem's infrastructure, balance stakeholders' priorities within the ecosystem, and use it to ...
Public Health Nursing, 2019
Community health assessment (CHA) is a core public health function described as the regular and systematic collection, analysis and evaluation of community health data, intended to monitor environmental and community health status, identify health and environmental hazards, and diagnose and investigate health problems (Institute of Medicine [IOM], 1988). It is a collaborative process identifying community assets and resources, analyzing relevant data, and prioritizing and planning public health interventions to improve population health (Bender, 2017). National U.S. standards for voluntary accreditation by the Public Health Accreditation Board (PHAB) require local, tribal, and state public health departments to conduct a CHA and to engage stakeholders in community health improvement planning (PHAB, 2013). Engagement, communication, and collaboration with communities in CHA have not been entirely successful (IOM, 2003). Community roles in CHA and health planning efforts have been limited, primarily as consultants rather than as active participants
Health & place, 2018
The health implications of urban development, particularly in rapidly changing, low-income urban neighborhoods, are poorly understood. We describe the Healthy Neighborhoods Study (HNS), a Participatory Action Research study examining the relationship between neighborhood change and population health in nine Massachusetts neighborhoods. Baseline data from the HNS survey show that social factors, specifically income insecurity, food insecurity, social support, experiencing discrimination, expecting to move, connectedness to the neighborhood, and local housing construction that participants believed would improve their lives, identified by a network of 45 Resident Researchers exhibited robust associations with self-rated and mental health. Resident-derived insights into relationships between neighborhoods and health may provide a powerful mechanism for residents to drive change in their communities.
1 A framework for community and economic development
An Introduction to Community …, 2009
Community development has evolved over the past few decades into a recognized discipline of interest to both practitioners and academicians. However, community development is defined in many different ways. Most practitioners think of community development as an outcome-physical, social, and economic improvement in a community-while most academicians think of community development as a process-the ability of communities to act collectively and enhancing the ability to do so. This chapter defines community development as both a process and an outcome and explains the relationship between the two. A related discipline, economic development, is also defined in different ways. This chapter offers a holistic definition of economic development that not only includes growing businesses and creating jobs but increases in income and standards of living as well. Economic development is also shown to be both an outcome and a process. The community and economic development chain shows the links, causal relationships, and feedback loops between community and economic development, and illustrates how success in one facilitates success in the other. Community Development Corporation Oral History Project by the Pratt Center for Community Development (www.prattcenter.net/cdcoralhistory.php). This includes one of the first CDCs in the US, the Bedford Stuyvesant Restoration Corporation in the city of New York. Evolution of the discipline continued; in 1970 two journals were established, Community Development in the UK and Community Development: Journal of the Community Development Society in North America, as well as the establishment of academic programs with an emphasis on community development (typically, a public administration, public policy or urban planning degree with a concentration available in community development). Today, there are about 4000 CDCs in the US, with most focusing on housing development. However, many also include a full range of community development activities, with about 25 percent providing a comprehensive array of housing development, homeownership programs, commercial and business development, community facilities, open space/environmental, workforce and youth programs, and planning and organizing activities (Walker 2002), Other organizations practice community development too, including public sector ones as well as private for-profit companies and other nonprofits (see Box 1.1, "Who Practices Community and Economic Development" at the end of this chapter for more information). As the variety of topics in this book attests, community development has evolved from its roots in social activism and housing to encompass a broad spectrum of processes and activities dealing with multiple dimensions of community including physical, environmental, social and economic.
2010
Distressed urban neighborhoods face challenges on multiple fronts, but most efforts to confront these problems work in isolation of one another. The New Communities Program (NCP) is an exception, helping selected Chicago neighborhoods develop partnerships to address challenges involving employment, education, housing, and safety in a comprehensive, coordinated fashion. In each community, a local intermediary brings together organizations to plan and then to implement varied improvement projects. A 10-year, $47 million MacArthur Foundation initiative developed and managed by the Local Initiatives Support Corporation of Chicago (LISC/Chicago), NCP emphasizes this relational approach by building collaborations as a "platform" for broad and sustained improvement, even as local conditions change.
Journal of Sociology and Social Welfare, 2004
In designing and implementing community development interventions the economic status of targeted participants is a demographic characteristic worth considering. The findings from this research indicate that even within the limited economics of rural Mexican villages there are variations in economic status that affect the ways in which the outcomes of community development programs are perceived. The poorest of the poor are likely to be less satisfied with development projects than those with average or better-off economic status. This is true whether a development project uses a bottom-up approach or a top-down approach. The more participatory approach does not attenuate the relationship between economic status and satisfaction with development programs. On the contrary it may exacerbate it. (authors)
Neighbourhood development and public health initiatives: who participates?
Health Promotion International, 2012
Citizen participation in neighbourhood development is one way to promote public health and contribute to the well-being of individuals. However, some people participate while others do not. This study examines the individual characteristics of people who during the past 2 years have participated in a neighbourhood development process compared with potential and non-participants. Socio-demographic factors, perceptions and behaviour were analysed in a cross-sectional study. A questionnaire was answered by 1160 randomly chosen citizens over the age of 18 who lived in three Swedish cities. The most important single factor related to participation in neighbourhood development was prior experience of participation, such as attempting to influence city policies by contacting politicians, submitting a citizen proposal, etc. Furthermore, having frequent political discussions with neighbours was another behavioural factor that was found associated to people's participation in neighbourhood development. Among socio-demographic factors, only ethnicity was found significant after controlling for other factors; i.e. people born outside the Nordic countries were less likely to participate.
Neighborhood Effects on Health: Exploring the Links and Assessing the Evidence
Journal of Urban Affairs, 2001
This article explores the possible causal pathways through which neighborhoods might affect health and then reviews the existing evidence. Although methodological issues make the literature inconclusive, the authors offer a provisional hypothesis for how neighborhoods shape health outcomes. They hypothesize that neighborhoods may primarily influence health in two ways: first, through relatively short-term influences on behaviors, attitudes, and health-care utilization, thereby affecting health conditions that are most immediately responsive to such influences; and second, through a longer-term process of "weathering," whereby the accumulated stress, lower environmental quality, and limited resources of poorer communities, experienced over many years, erodes the health of residents in ways that make them more vulnerable to mortality from any given disease. Finally, drawing on the more extensive research that has been done exploring the effects of neighborhoods on education and employment, the authors suggest several directions for future research.
The Built Environment and Health: 11 Profiles of Neighborhood Transformation
2004
This report describes 11 projects in predominantly low income neighborhoods where local citizens mobilized private and public resources to alter their physical environments in ways that would improve the quality of life and health for their residents. Some of these changes include transforming vacant lots into community gardens, building a jogging path around a cemetery, creating beautiful murals on walls that once displayed graffiti, and reducing the number of liquor stores prevalent. As a consequence of many of the projects, the amount of walking and bicycling that the citizens engaged in increased noticeably.
The Impacts of Targeted Public and Nonprofit Investment on Neighborhood Development
2005
The authors are very grateful to the many people who assisted in the completion of this study. In particular, we would like to thank Dan Tatar of the Federal Reserve Bank of Richmond and Greta Harris of the Richmond office of LISC, whose longstanding commitment to improving the effectiveness of community-based development led them to initiate this study. Without the financial support of the Richmond Federal Reserve Bank, this study would not have been conducted. In addition, Wendy Hirsch of LISC and David Sacks of the City of Richmond's Department of Community Development gave generously of their time, retrieving, organizing and helping to interpret the data necessary for this study and patiently helping the authors understand how the city and LISC's investment processes work. We are also grateful to Frances Stanley of the Federal Reserve Bank, who helped to organize the data and who created all of the maps used in this report. Also, we would like to thank Cecilia Bingenheimer, Jennie Blizzard, Larry Cain, Cindy Elmore, Elaine Mandaleris and Jennifer Sparger for their assistance with editing and graphics. We are also very grateful to the people-real-estate developers and appraisers, lenders, public officials, nonprofit community development corporation staff and advocacy group representatives, as well as the neighborhood residents-who gave
Journal of Community Health, 2011
To describe the participatory approach used to develop ''Good For The Neighborhood'' (GFTN), a community program to improve the health of four underserved communities. A core program was developed involving a ''park and stay'' approach to impact four underserved predominately minority communities (two predominately African American, 1 predominately Latino, and the Seneca Nation of Indians). The core program includes health screenings, risk assessments, health education, and exposure to health services. An extensive tracking and evaluation system was developed to determine participation and impact on the community. Multi-methods (key informant interviews, focus groups, surveys) were implemented to gain feedback from community partners and participants as to how to adopt the program to meet the needs of the community. GFTN has been sustained for over 3 years and has reached over 3,500 predominately minority individuals in four communities with 1/3 of participants engaging regularly in the program. The program has evolved in the four communities to meet specific needs. A ''park and stay'' approach in partnership with the community has led to a strong program that community partners and residents embrace. Community ownership and social networking, including word-of-mouth from residents is essential to establishing a successful program.
Changing a Community: A Holistic View of the Fundamental Human Needs and Their Public Health Impacts
Cureus Journal of Medical Sciences, 2023
There are many approaches to changing a community to ensure it serves the people's fundamental needs. For example, enabling equitable access to critical aspects of the community, such as quality healthcare, high-quality education, and job training, is vital for promoting community safety through enhancing tolerance and respect for diversity. However, creating a community that serves the fundamental needs of the people demands a substantive investment of effort. Understanding the nature of these efforts requires discussion of community engagement, examining community networks and their role in fostering cooperative action, enhancing public safety, and identifying the structures of involvement and pertinent routes for developing community land. Understanding such efforts entails knowing the issues related to gentrification and disbandment. These hands-on possibilities can help avert the possibility of people being pushed out of their community settings. These insights further shed light on how the family unit and larger community are able to create collective unity and foster each member's responsibility in community service provision that promotes community integration. Examining how violence and other factors affect a community's collective power is necessary to determine how a community can avoid such violence and encourage positive changes at the individual and family levels to promote community cooperation and safety. Essentially, changing a community can yield significant improvements in public health. Addressing factors such as access to nutritious food, healthcare, physical activity, and social amenities and fostering social cohesion through community engagement can collectively contribute to reducing the burden of chronic diseases and promoting overall well-being. This review provides insight into crucial issues that have long plagued the societal disconnect between the local community and the leadership, policymakers, or other authoritative institutions that govern them, thus affecting the implementation of strategic social and public health initiatives. We will also explore strategies to mitigate these potential pitfalls.
The Healthy Neighborhood, Healthy Families Initiative
Pediatrics, 2018
Extreme poverty and the associated effects, such as blight, housing insecurity, and crime, have debilitating consequences on child development. Health care institutions are largely ineffective in changing those outcomes 1 child at a time. We present a case study of a hospital treating the adjacent neighborhood as a “patient” to address social determinants. The community represents a largely impoverished and housing-unstable neighborhood that underwent an assessment by community partners and treatment with a multifaceted housing intervention. Marked improvement in vacancy rates occurred, although outcome assessments for children are still being gathered. Several case learnings are presented, but the involvement and investment of pediatric health care clinicians and institutions increased the speed and size of neighborhood development after 80 years of redlining and institutional racism.
Housing Policy Debate, 2019
Governments and nonprofits routinely partner to launch place-based initiatives in distressed neighborhoods with the goal of stabilizing real estate markets, reclaiming vacant properties, abating public nuisances, and reducing crime. Public health impacts and outcomes are rarely the major policy drivers in the design and implementation of these neighborhood scale initiatives. In this article, we examine recent Health Impact Assessments in Baltimore, Maryland and Memphis, Tennessee to show how public health concepts, principles, and practices can be infused into existing and new programs and policies, and how public health programs can help to improve population health by addressing the upstream social determinants of health. We provide a portfolio of ideas and practices to bridge this classic divide of housing and health policy.