Community-Level Health Promotion
Communities are both structural and functional. Structurally, they have geographic and political boundaries demarcated by counties, cities, districts, neighborhoods. Functionally, communities are a place where members have a sense of identity and belonging, shared values, norms, communication and helping patterns (Green, L. & Kreuter, M., 1999). Community-level health promotion is intended to improve the health behaviors of whole populations and groups for large effect. If even a slight improvement occurs within groups or populations, the economic, quality-of-life results are often greater due to the multiplier effect across the community. Successful community-level approaches are designed to produce small changes (at often less cost) across an entire population with tremendous net gain. Simply, the community-level change program “gets a bigger bang for its buck”.
Grounded in principles of participatory democracy and social justice, community-based programs can make considerable population change. They accomplish such changes primarily by reaching larger numbers of people through mass media and multiple channels of communication, building widespread normative, economic and political support for the changes, and stimulating change in a community’s social fabric, environments and structures (Green, L. &, Kreuter, M., 1999, pg. 263-264).
Models such as PRECEDE and PROCEED (Green and Kreuter),and building social capital and social networks provide a structure for community-level health promotion that incorporates individual change theories/models and social environment interventions. The field of public health has successfully used community-level assessment, planning, implementation, evaluation for changes for many health issues (e.g., water quality, smoking reduction, safety belt use, binge drinking, childhood immunization).