america's communities movement: investing in the civic landscape

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American Journal of Community Psycgology [ajcp] PP123-300952 April 16, 2001 11:44 Style file version Nov. 19th, 1999

American Journal of Community Psychology, Vol. 29, No. 2, 2001

America’s Communities Movement: Investingin the Civic Landscape

Tyler Norris1

Community Initiatives Inc., Boulder, Colorado

“Healthy,” “Sustainable,” “Livable,” “Safe,” “Walkable,” “Whole,” “Suc-cessful,” “Resilient,” even “Lovable” precede the word “Community” inthe name of hundreds of multisectoral coalitions across America. Althoughthese descriptors each imply special meanings and relationships, in a largersense, they are but locally determined facets of an emergent and powerfulAmerican phenomenon—the communities movement. The future of thismovement may well be to serve as a primary underpinning of our nation’sability to address its most vexing issues. Our ability to eliminate health dispar-ities, revitalize deeply struggling inner city neighborhoods and rural towns,and manage the impact of fast growth in other locales, will in great part reston the capacity of these coalitions.

To date, the breadth and impact of this movement to improve the vitalityof America’s communities has not been widely understood or documented.It falls below the radar screen of most national media. The rare politicalleader knows how to tap its power. Essays on the historic decline of civicinstitutions miss the connection with their twenty-first century successors.Academics struggle to embrace their new metrics and track their social-capital building results. Traditional institutions are only recently warmingto these nontraditional entities’ unique ability to get important work done.Civic power brokers are intrigued by the prospect of forming partnershipswith resourceful grassroots leaders who understand how to tap local assets,and demonstrate that new ways of working together are essential to address-ing the complex issues facing their communities.

1To whom correspondence should be addressed at Community Initiatives Inc., Boulder,Colorado; e-mail: [email protected].

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Across the country, this widespread and diverse array of collaborativelocal and regional partnerships creatively bridges sector, race, and class di-vision to create measurable impact. They target top community challengessuch as public safety and crime, youth development, quality jobs that paya livable wage, mobility, and access, ecosystem protection, affordable andwell-designed housing, strengthening families and redesigning local systemsof care. They are tackling the vexing issues that no single sector, institution,program or grant can address alone. And they are producing measurableimprovements in the quality of human lives. Indeed in a 1997 report, theCenters for Disease Control and Prevention credited community partner-ships with important contribution to “broad gains in the nations health.”(Stolberg, 1997.)

Broad-based community coalitions comprise the operational founda-tion of the communities movement. These coalitions typically embrace citi-zen, institutional and elected partners. Some initially form around key issuesor crises, whereas others convene geographically to improve “quality of life”generally—allowing strategic priorities to emerge from dialogue and sharedcommitment. Coalition leadership tends to be shared between multiple play-ers, and most often reflect a highly diverse cross-section of society. Partici-pation typically includes business, nonprofit, government, health care, reli-gious, media, education, and citizen leaders. Although well-known nationaland international leaders and institutions have influenced the movement,its roots are firmly planted in communities—from rural region to subrub todowntown neighborhood.

Fundamentally the communities movement is a local phenomenon, mo-bilizing innate creativity and underutilized (or misallocated) resources toinitiate and sustain positive change. As with any long-sustained social move-ment, there is no one centralized leadership group or single operational hub.Rather the nationwide movement finds spontaneous expression in hundredsof locales and forms.

HEALTHY CITIES AND COMMUNITIES—THE FUTUREFOR EVERY COMMUNITY?

Among the most successful and widespread examples of the broadercommunities movement are the many hundred local, regional, and statewideinitiatives that affiliate around the theme of “healthy communities” or“healthy cities.” Despite their aligned goal of improving health outcomes,healthy communities do not simply focus on health and medical care. Theyalso focus on jobs, education, public safety, housing, transportation, civic

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participation, and other components of community life—issues that under-pin the health and vitality of people and places.

The healthy communities movement uses health as a metaphor for abroader approach to building community. Health is a common denominatorthat cuts powerfully across lines of race, class, culture, and sector. In recentyears, this health metaphor has proved to be a gateway for citizen reengage-ment in community renewal. To begin with, the question “What is a healthycommunity?” usually elicits a clear and relevant answer, whether asked ofa business executive, a homemaker, or a child. Community coalitions acrossthe nation use an array of change models and planning processes to worktogether to achieve their vision of improved quality of life. Regardless of theapproaches taken to meet challenges, the following principles are guidingthe most successful initiatives:

In past decades, efforts to rally whole communities around issues suchas economic development or better education have met with mixed results,and tended to attract narrow involvement. The healthy communities’ ap-proach has proven itself highly effective in uniting disparate groups of peo-ple. Almost anyone can see an enlightened self-interest in working to createa healthier people in a healthier community. Citizens see the prospect ofsafer neighborhoods and better living conditions. Businesses see the poten-tial for improved productivity, a more developed workforce, and lower socialdysfunction costs. Governmental leaders see the development of communitypriorities and the cultivation of civic will. Health and social service providerssee expanded partnership on issues they cannot solve alone.

Healthy communities engage people meaningfully in the work of theircommunities in ways that allow them to experience success and see tangibleresults. In the most effective partnerships—“what’s in it for me” is explicitlylinked with benefit to the commons. Only through this kind of meaningfulengagement can communities fully mobilize the willingness and capacity ofcitizens to create positive change. Although many Americans are ready toconnect with community more fully, most need to see a clear relationship be-tween their work and tangible results on issues they care about. Indeed, thisis one reason that asset-based human and community development (Benson,1997) has become a powerful feature of so many coalitions.

To support this growing nationwide movement (over 1,000 localesstrong), the U.S. Coalition for Healthy Cities and Communities (CHCC)was formed in 1996 to serve as a link to resources, a voice for policy andaction, and a force for creating and sustaining community partnerships. TheCHCC is also the U.S. link to similar networks in dozens of other nations(over 5,000 initiatives are believed to exist globally)—many spurred by theWorld Health Organization, an early developer of the healthy communities

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approach. Based in Chicago at the Health Research and Education Trustof the American Hospital Association—the CHCC itself is a broad-basedcoalition of national and regional organizations acting in service to localcoalitions. The CHCC has in recent years also developed a state’s network—with liaisons sharing promising practices and results between leaders at thecommunity and national level.

THE DETERMINANTS OF HEALTH AND WELL-BEING

As a nation, we are learning that growing a healthy community is alifelong process—one that requires our constant nurturing and vigilance.Healthy communities result from healthy choices and environments thatsupport shared responsibility. And everyone has a role to play in building ahealthier, more vibrant community.

The choices we make at home, work, school, play, and worship deter-mine most of what creates personal health and community vitality. To a greatextent it’s about how we spend our time, dollars, and talents. But it’s alsoabout how we create settings in our communities, which result in healthier,indeed wealthier communities.

Healthy communities recognize that many of the factors society has tra-ditionally tracked as “health” are more about “disease,” and only partiallyinform us as to the overall well-being of populations. Indeed a “medicalcare” focus can distract leaders from the issues that can actually make ameasurable impact in health performance. A renewed emphasis on the re-lationships between economic, social, and political factors and health statusis transforming local leaders’ perspectives on identifying the most leveragedloci of change in health improvement.

An estimate from the U.S. Department of Health and Human Servicesstates that perhaps 50% of what creates health is lifestyle and behaviorrelated, with another 20% determined by the socioeconomic and politi-cal environment. Genetic endowment comprises the next 20%, with medi-cal care services contributing only 10% to population health performance.(McGinnis & Foege, 1993)

BARRIERS TO FUTURE RESULTS

The challenge to coalitions however, is in transforming that knowledgeon the determinants of health into meaningful ground work in communities.This is compounded by a series of factors:

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• Collaboration is tough work. Participant attrition rates are high, shortand medium term outcomes are hard to measure, and organizationsare sometimes unwilling to “do business differently”;• Categorical funding streams (both from governments and founda-

tions) in practice limit community-building work that spans issuesand sectors. Communities seeking comprehensive solutions are stuckwith grants that fragment their efforts;• Incentives for health care systems to actually benefit from improved

health status are few–beyond hospital “community benefit” require-ments and mission statements defining the goal of operating with asense of value to the larger community. Most medical care providersmake more money the more treatment they perform, not necessarilyby improving health;• The very medical care and public health leaders (as well as law en-

forcement leaders) who understand the need to better address theissues that present themselves daily on the steps of their institutionsfind that priority action is required outside of their sector or domain.Just as prisons and law enforcement are only partial contributors toreducing crime—so is health care only a partial contributor to im-proving health. Both typically serve at the end of the pipeline.

Hence the call for broad-based coalitions to support inspired cross-sectoral leadership, innovative root-cause solutions, better allocation of re-sources, and more reinforcing services and strategies in attainment of sharedgoals.

Reconnecting Citizens with Civic Life—ultimately, the strength of ourdemocracy depends on it

Today, many Americans experience a gulf between heartfelt conversa-tions around their kitchen table and the formal decision-making processesin their communities. We read and hear constantly about the disaffection ofcitizens from the process of governance. We observe the institutional turfbattles and fragmentation of well-intended efforts. We too often see our re-sources spent more as fixes to the symptoms of deeper problems, and less onwhat generates health in the first place. In building communities and regionsfor this new century, many of our nations’ community partnerships need tomove beyond the symptom-oriented, “fix the problem” responses.

A larger challenge for coalitions is to serve as policy and investmentadvisors for what creates healthy people in healthy communities in the firstplace. To do this we must redefine wealth to simultaneously include a healthynatural environment, a vital economy, full participation in a rich civic life,and the well-being of all people and their families—physically, mentally, andspiritually. This role includes advancing policies and practices that create

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Table I. Design Principles for Creating and Sustaining Positive Change

A broad definition of “health” - Health is more than the absence of disease, and must bedefined broadly to include the full range of quality of life issues. Health an optimum state ofwell-being: physical, mental, emotional and spiritual. It recognizes that half of what createshealth is lifestyle and behavior related. Other major factors are genetic endowment and thesocio-economic, cultural and physical environment. Health is a by-product of a wide arrayof choices and factors—not the simply the result of a medical care intervention.

A broad definition of “community”: By using as broad a definition as possible of whatmakes up a community, individuals and partnerships can address their shared issues atthe right level, in the most fruitful way possible. Communities are based on faith,perspective, profession, as well as being determined by geographic lines.

Shared vision from community values: A community’s vision is the story of its desiredfuture. To be powerful and inspiring, a community’s vision should reflect the core values ofits diverse members. A vision is not bullet points on the wall—it is a living expression ofshared accountability to priorities.

Address quality of life for everyone: Healthy communities strive to ensure that the basicemotional, physical, and spiritual needs of everyone in the community are attended to.

Diverse citizen participation and widespread community ownership: In healthycommunities, all people take active and ongoing responsibility for themselves, theirfamilies, their property, and their community. A leaders work is to find common groundamong participants, so that everyone is empowered to take direct action for health andinfluence community directions.

Focus on “systems change”: This is about changing the way people live and worktogether. It is about how community services are delivered, how information is shared, howlocal government operates, and how business is conducted. It’s about resource allocationand decision making, not just nice projects.

Build capacity using local assets and resources: This means starting from existingcommunity strengths and successes and then investing in the enhancement of acommunity’s civic infrastructure. By developing an infrastructure that encourages health,fewer resources will need to be spent on “back end” services that attempt to fix theproblems resulting from a weak infrastructure.

Benchmark and measure progress and outcomes: Healthy communities useperformance measures and community indicators to help expand the flow of informationand accountability to all citizens, as well as revealing whether residents are heading towardor away from their stated goals. Timely, accurate information is vital to sustaining long-term community improvement.

Source: Ayre, D., Clough, G., & Norris, T. (2000). Facilitating community change. Boulder:Community Initiatives.

return on investment to all these forms of wealth and capital. The dimin-ishment of any one of these forms of wealth, eventually contributes to thedepletion of the others. (AtKisson, et al., 1997)

A CALL TO ACTION

The challenge before Americans and their coalitions today, is how toapply the learning from decades of community-building experience to the

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choices we make everyday in the settings where we live, work, play, andworship. Healthy communities call for inspired leadership and action fromevery corner of our neighborhoods and regions.

There is an increased and welcome call across the land for new levels ofinstitutional accountability for results. This requires tracking outputs morethan inputs; assuring deliverables, not simply activity; and promoting newtypes of knowledge exchange that broadly informs citizenry—not servingonly to justify the practices of the institutions issuing the data. The rapidlygrowing number of community indicator sets and local report cards (Norris,2000) tracking performance on progress toward shared vision attests to theneed for new metrics, an outcomes orientation and shared responsibility bybusiness, nonprofits, philanthropies, and governments.

But it also is about each of us as an actor in community. Aristotle de-fined a citizen as “one who participates in power”—the power to shape civicpurposes and act in alignment with values. Acting upon a shared vision forthe future is the foundation upon which a healthier community is built. Thisis the practice of local democracy and an investment in the civic landscape.

REFERENCES

AtKisson, A., Norris, T. et al. (1997). Community indicators handbook. San Francisco: Redefin-ing Progress.

Benson, P. (1998). The asset approach: Giving kids what they need to succeed. Minneapolis, MN:Search Institute.

Kretzmann, J., & McKnight, J. (1993). Building communities from the inside out: A path towardfinding and mobilizing a community’s assets. Chicago, IL: ACTA Publications.

McGinnis, J. M., & Foege, W. H. (1993) Actual causes of death in the United States. Journal ofAmerican Medical Association, 270(18), 2207–2212.

Norris, T. (2000). On practicing community capitalism/healthy, wealthy, communities. www.communityinitiatives.com

Stolberg, C. G. (1997, September 12). US life expectancy hits new high. New York Times. U.S.Coalition for Healthy Cities and Communities. www.healthycommunities.org

america's communities movement: investing in the civic landscape

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