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Healthy community initiative participants recognize the power of local communities to make significant improvements in people's health. The movement is based on a philosophy that places equal emphasis on the process of change and the ultimate consequences of that process. Thus, there is no single model for a healthy city or community. Because each community is unique with distinct resources, cultures, and infrastructure, each community must create its own healthy community vision.

It is important that the community vision truly be shared by the community
and that it not be overly associated with any one particular group...

Creating Community Health Visions:
A Guide for Local Leaders. Institute for Alternative Futures, p. 12

Many healthy community initiatives start because a single person or organization within the community takes the initiative. More often, the initiative grows as the result of small groups gathering to discuss the community's current condition and attempting to identify strategic steps that could be pursued to improve the situation.

A. The Starting Point

A successful healthy city or community initiative relies on participation from many different players; any of the players can start a successful initiative. This diagram shows the multiple entry points to the process. Each individual or group who joins the effort brings specific resources and information that are useful for building the coalition and the vision for a healthier community.

'get in the game' graphic


Following is an example of how a Healthy Community Initiative was started in Derby, Connecticut.

Derby, Connecticut

Healthy Valley 2000 was launched through a collaborative effort of an executive staff member from Griffin Hospital and volunteers from The Valley Council of Health and Human Services Organizations (members include more than 50 organizations that provide services to the community). A Stakeholders Committee selected from this body drafted the following vision statement for the Healthy Valley 2000 initiative:

We the citizens of the Valley are committed
to a vision in which our community is
a better place to live, work, raise a family
and enjoy life.

This draft vision statement was published in four community newspapers and the initiative's monthly newsletter "2000 words" was mailed to 3,000 homes seeking reaction and input. The final draft was adopted by the Stakeholders Committee and published in the Healthy Valley 2000 Annual Report, also mailed to 3,000 homes.

Healthy Valley 2000 Priorities*
Drug Abuse
Economic Development
Alcohol Abuse
AIDS/Sexual Disease
Variety of Retail
Quality of Life

*Derby, Connecticut

The Committee also established a mission statement and selected eight priorities for the Healthy Valley 2000 Healthy Community Coalition (see above). The Healthy Valley 2000 Coalition monitors progress on those priorities.

With the launching of Healthy Valley 2000, Griffin Hospital and the community's efforts achieved consensus on improving the community's health status and quality of life.

B. Evaluating Community Needs and Assets

Before a coalition can create its vision of a healthy community, an evaluation of community needs and assets should be completed. This process is called a community assessment. A community assessment requires gathering data from libraries, local health departments, or the medical community, from interviews with business and government leaders, and from civic and government meetings. Not all the information gathered will be relevant for devising a strategy and designing programs to build a healthy community. Therefore, it's best to identify relevant information-first.

Another approach to assessing community needs is the neighborhood assets map, which focuses on mapping community resources and the resources of the institutions involved in the community effort. This approach concentrates on the assets of the community rather than on its deficiencies.

Some coalitions have organized their efforts in multiethnic and multidisciplinary task forces. Each task force examines specific topics deemed essential in its community health vision. Examples may include physical health, social justice, citizen participation, access to particular programs or services, economy, education, human enrichment, spiritual life, environment, and work. Each task force can be given the responsibility for collecting and analyzing pertinent information and making recommendations to the larger group regarding a specific issue area.

C. Creating a Vision

Visioning is the process of developing a shared picture of a healthy community. Visions encompass values, priorities, and desires. A vision is far more than a strategic plan; it is where the plan is going. A vision is an idea created and embraced by the diverse participants involved in starting a healthy community.

...Health visions state the ideal,
establish a "stretch," link explicitly to strategies,
inspire commitment, and draw out community values...

Creating Community Health Visions: A Guide for Local Leaders.
Institute for Alternative Futures, p. 3

Visioning provides an excellent framework for supporting health strategies in individual communities. In community health promotion, a vision is a picture of how a locality hopes to function in the future. The vision describes what a community would look like if it were optimally supporting health and well-being for all its residents and organizations.

Done properly, the process of visioning serves multiple functions:

  • Inspires action
  • Draws in more participants
  • Provides participants with a common purpose
  • Ensures sustained commitment
  • Guides the development of action steps to meet the goals articulated in the vision

Visioning requires participants to expand their thinking beyond the pressing constraints of today to come up with inspirational and far-reaching ideas for tomorrow. Generally, visioning requires several sessions or workshops, facilitated by a trained professional who is not part of the group. (See Resources for more information.)

D. Creating Successful Partnerships

The key to the healthy communities initiative lies in identifying and creating effective partnerships. Individuals, organizations, and private industry all play an integral role in a healthy community and need to be included as potential partners. Inspiring others to commit to a community movement takes talent, a passion for connection, and good management skills. Sustaining participation in a partnership is a challenge that can be met by keeping partners engaged and including their interests in the priorities.

The healthy community initiative includes the interests of various community groups. The effort must include as many individuals, groups, agencies, and businesses as possible-this is a task that no one can do alone. Everyone who comes to the table must understand that he or she has something at stake, a reason for being there. Successful coalitions ensure that all partners' interests are reflected in the priority goals.

Partnership Building

  • Define problem

  • Determine priorities

  • Set achievable goals

  • Create a shared vision

  • Maintain good flow of information

  • Leverage resources and expertise

  • Measure progress and results

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Be inclusive of ideas and goals of all partners. The steps identified in the table on partnership building may prove especially useful in creating and sustaining healthy community coalitions.

Be flexible. Flexibility is always helpful when dealing with others and helps maintain a good flow of information.

E. Obtaining Resources

Healthy communitiy initiatives require resources-both dollars and sense (expertise). Some coalitions choose to work closely and be identified with local institutions, e.g., hospitals, foundations, State agencies, local businesses, and health care providers. Some coalitions want the freedom to set their own priorities, timetables, and methodologies for bringing about change. For these coalitions, financial resources are the result of effective fundraising.

Finding ways to leverage limited resources and expertise is critical. The process appears to operate most successfully when all members of the coalition participate in defining the problems as well as assigning the resources.

Factors for Healthier Youth

"Protective factors" that may help young people be more resilient and make healthier lifestyle choices include:

  1. Perception that they are treated fairly, regardless of gender, religion, ethnic/racial group, or lifestyle.
  2. Reduced access to and discouraged use of cigarettes, alcohol and illegal drugs.
  3. Involvement in sports teams or clubs and other school activities.
  4. Clearly defined and enforced family rules.
  5. Personal safety at school.
  6. Parents available to discuss personal problems.
  7. Two-parent families.
  8. Friends with healthier lifestyles.
  9. Self-esteem and emotional well-being promoted within the family, school, and community.
  10. Aerobic exercise outside of school.

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Chico, California

Healthy Chico Kids 2000 is a collaborative, community-wide campaign to promote the highest possible level of health and well-being of Chico children and youth. This innovative initiative is guided by a volunteer board representing broad sectors of the greater Chico community. Population sectors represented on the board include youth and parents from a range of ethnic and socioeconomic backgrounds; local experts in public education, health care, public health, and alternative health care; and representatives from local businesses, churches, local government, and human service agencies.

Healthy Chico Kids 2000 has been designated a California Healthy City. Funding has been provided by a variety of local sources such as service clubs, hospitals, and physicians, as well as from outside sources such as the California Healthy Cities Project, the California Wellness Foundation, and Health Net, a California Health Maintenance Organization.

One accomplishment of Healthy Chico Kids 2000 was to develop over 270 measurable year 2000 wellness objectives for Chico children and youth, their families, and the community. The objectives span 10 categories of wellness: Nutrition, Physical Fitness, Emotional Well-Being, Social Well-Being, Living Safely, Living Lightly on The Earth, Dental Health, Substance Abuse Prevention, Responsible Sexual Behavior, and Preventive Health Care.

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