3 Improving Health through Community Organization and Community Building: Perspectives from Health Education and Social Work
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3 Improving Health through Community Organization and Community Building Perspectives from Health Education and Social Work MEREDITH MINKLER NINA WALLERSTEIN 37 Although health education and social work professionals have developed and adapted numerous approaches and change strategies in recent years, the principles and methods loosely referred to as community organizing remain a central method of practice. We define community organizing as the process by which community groups are helped to identify common problems or change targets, mobilize resources, and develop and implement strategies to reach their collective goals. The newer and related concept of community building is viewed here not so much as a “strategic framework” as an orientation to community through which people who identify as members engage together in building community capacity rather than “fixing problems” through the application of specific and externally driven strategies (see chapter 5).1 Implicit in both these definitions is the concept of empowerment, classically defined by Rappaport (1984) as an enabling process through which individuals or communities take control over their lives and environments. Indeed, we argue that without empowerment that enhances community competence or problemsolving ability, community organizing is not taking place. Strict definitions of community organization suggest that the needs or problems should be identified by groups within the community, and not by an outside organization or change agent. Thus, while a public health or social work professional may help mobilize a community around HIV/AIDS prevention or access to mental health services, he or she can’t be said to be doing community organizing in the pure sense unless the community itself has identified this as a key area for organizing (see chapter 7). Community organization is important in fields like health education and social work partially because it reflects one of their fundamental principles, that of “starting where the people are” (Nyswander 1956). The public health professional , social worker, or urban and regional planner who begins with the community ’s felt needs will more likely be successful in the change process, and in fostering true community ownership of programs and actions. Community organizing also is important in light of evidence that social participation itself can be significant in improving perceived control, empowerment, individual coping capacity, health behaviors, and health status (Marmot 2009; Kegler et al. 2009; Wallerstein 2006). Finally, the heavy accent being placed on community partnerships , coalitions, and community-based health initiatives by government agencies , philanthropic organizations, and nongovernmental organizations (NGOs) both in North America and globally (Corburn 2009; Diers 2006; Fawcett et al. 2010; USDHHS 2011) suggests the need for further refining theory, methods, and measurement techniques. Following a brief historical grounding, the chapter covers concepts of community, community organization and community building models, and several key theories and topical areas in these fields, each of which will be explored more deeply in later chapters. Community Organization and Community Building in Historical Perspective The term community organization was coined by American social workers in the late 1800s in reference to their efforts to coordinate services for newly arrived immigrants and the poor. Yet as Garvin and Cox (2001) pointed out, although community organization is often seen as the offspring of the settlement house movement, several important milestones should by rights be included in any history . Prominent are (1) African American efforts in the post-Reconstruction period to salvage newly won rights that were rapidly slipping away; (2) the Populist movement , which began as an agrarian revolution and became a multisectoral coalition and a major political force; and (3) the labor movement of the 1930s and 1940s, which taught the value of forming coalitions around issues, the importance of full-time professional organizers, and the use of conflict as a means of bringing about change (Garvin and Cox 2001). Within the field of social work, early approaches to community organization stressed collaboration and consensus as communities were helped to self-identify and to increase their problem-solving ability (DeFilippis et al. 2010; Garvin and Cox 2001). By the 1950s, however, a new brand of community organization was gaining popularity that stressed confrontation and conflict strategies for social change. Most closely identified with Saul Alinsky (1969, 1972), social action organizing emphasized redressing power imbalances by creating dissatisfaction with the status quo among the disenfranchised, building community-wide identification, and helping members devise winnable goals and nonviolent conflict strategies as a means to bring about change (Miller 2009; Rothman 2008; see chapter 4). MEREDITH MINKLER AND NINA WALLERSTEIN 38 From the late 1950s on, strategies and tactics of community...


Subject Headings

  • Health promotion.
  • Community health services -- Citizen participation.
  • Community organization.
  • Community development.
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