Resources for Sustainable Local Communities
-- Part Four
In this part of our continuing series devoted to identifying and describing important resources on the topic, "sustainable local communities;" we will focus on human health, one of the many interdependent elements of community sustainability.
Because health is such a highly valued human condition and because it is deeply impacted by local communities, it is no surprise that over the past century communities in the U.S. have devoted major attention to this topic. Initially cities sought to prevent the spread of disease through activities like water treatment, sewage systems, slum clearance and provision of specific health services like clinics for the diagnosis and prevention of venereal disease.
"Since the mid-1980s, a broader conception of public health has been adopted by municipal governments in Europe, and North America "(Roseland, 1998, p.153) as well as in other parts of the world. What has become known as the "healthy communities movement" began in 1984 in Toronto, Canada at a health conference called, "Healthy Toronto 2000." There Dr. Leonard Duhl presented a paper titled, "Healthy Cities," and it catalyzed thinking and action. For example, Ilona Kickbusch, of the World Health Organization's European Office was in attendance and introduced this idea into Europe where it first developed before spreading to Canada and Australia before it caught on in the U.S. With the support of the World Health Organization which recognized that "the fundamental conditions and resources for health are peace, shelter, education, food, income, a stable ecosystem, sustainable resources, social justice and equity," this movement has now grown to involve over 1,000 communities throughout the world where major and intensive community change work focused on health is now occurring. In 1993, over 1400 participants from more than 50 countries attended the first global conference on Healthy Cities and Communities which was held in California. The "healthy communities/healthy cities" movement is seen by many to grow out of the increasing and rapid urbanization which is happening throughout the world and which is accompanied by urban problems along with diminishing top-down control within specialized municipal bureaucracies.
While the origins and issue emphases of the healthy communities movement and the sustainable communities movements are different, there are several similarities between the two approaches. Even with its broad and systemic understanding of the community antecedents of human health, projects in the "healthy communities tradition" tend to focus more narrowly on human health while local sustain-ability projects tend to focus more on the interaction between the natural environment and the economy. Having said this, I strongly believe that local sustainability projects can learn a great deal from the older and highly effective work which focuses on improving human health in local communities. Therefore this article focuses on resources from the healthy cities/healthy communities movement.
Mark Roseland an analyst, practitioner, teacher and author on community sustainability, has recognized the importance of health within community sustainability projects and what can be learned from "healthy communities" projects. His analysis of these projects has led him to conclude that the healthy communities approach is based on four main ideas (Roseland, 1998):
1. "wide community participation" Like sustainability projects these efforts seek to involve people from all walks of life. Both approaches frequently use dialogue and consensus based processes to assist community representatives to envision a desired future for their community.2. "multi-or inter-sectorial involvement" Both approaches see the necessity of involving experts from government, business and the third sector of non-profit and citizen organizations in cooperative and collaborative efforts to improve the community on the dimensions which each approach emphasizes.
3. "local government commitment" The "healthy communities" approach places greater emphasis on broad local government involvement than does the "community sustainability" approach. Though within this latter tradition many specific community's projects do involve local government but other projects rely more heavily on grassroots based initiatives.
4. "healthy public policy" Often the key to improved health is legislative change as opposed to adding new services. The "local sustainability" tradition gives greater attention to the natural environment and the local economy but in doing so is very cautious about merely adding new specialized services as opposed to altering existing services as supplemented by increased responsibility taken by individual citizens and local private, governmental and non-profit organizations
Leonard Duhl one of the founder's of the healthy communities movement in a 1993 interview said about the commonalities among healthy community projects in different cities: "… you have to start someplace. You have to begin to look at it in an ecological and systemic way. You have to involve people. You have to start thinking of values of equity and participation. Beyond that, you can start wherever you want." He understands that the health care industry has to be a partner in the process but not in charge of it. He goes on in this interview to say, "The concept is universally applicable, but the way it is applied is dependent upon the local scene. Sometimes it's around a health system or a health department. Sometimes it's social service or a business." In summary he says, "This is a revolution in our thinking, a paradigm shift that says unless we think systemically, ecologically, multidisciplinarily, multisectorily, we are not dealing with the core questions." (Healthcare Forum Journal, May-June 1993).
The following are some selected resources on healthy communities change projects and other community health information which should be of interest and use to people seeking to achieve sustainable local communities:
National and International Resources
Healthy Cities/Healthy Communities
http://www.well.com/user/bbear/change.html#change1This site is part of a larger site titled "The Change Project" which in itself is very interesting and informative on the topic of "social change." Healthy Cities/Healthy Communities (HC/HC) is the work of Joe Flower, an author and consultant, who focuses on healthy community projects.This site provides an in depth introduction to exciting, contemporary understandings of health within a community context and needed changes to improve this aspect of both large and small communities. Many sub sections consist of work authored by Flower's, e.g. "An Introduction to Healthy Cities and Communities ," and "How to Create One." Other sub sections draw on the work of other individuals and organizations, e.g. "Examples from Around the World." I suggest that within this subsection that you consider studying the four case studies: Aiken, South Carolina; Bethel New Life in West Garfield Park, Chicago; Mesa County, Colorado; and Orlando, Florida. These cases draw on the work of the Healthcare Forum some of which has been done by Flowers and taken together show very clearly the diversity, complexity and ambitiousness of projects within the healthy communities movement. Still other sub sections of this site are devoted to methods, the health care industry in relation to healthy communities, interviews with outstanding practitioners working on healthy community projects and links to a few of the many other sites devoted to healthy communities.
Healthy Communities Programs
http://www.ncl.org/ncl/hci.htmThis site is the communication vehicle for a major program of the National Civic League which began in 1988 . At that time, the League was selected by the U.S. Public Health Service to develop and implement initial U.S. healthy communities work. This site is part of a much larger site which describes other programs of the League.An introduction to this site communicates their rationale for the healthy communities work they are doing. This rationale is stated in a report, "What Creates Health?" done by the League and the Health Care Forum. These organizations "found that Americans feel that 'a low crime rate' and 'a good place to bring up children' are the two most critical determinants of a healthy community. While investment in health in the U.S. is soaring, America's overall health outcomes are mediocre at best. In order to make real improvement in the health outcomes we must focus on factors that underlay health., or upstream issues. According to Mark Lelonde's Health Field Conceptual Model, health is a result of 50% lifestyle and behavior; 20% environment; and 10% medical care and access. In other words, health is a product of lifestyle and behavior, rather than state-of-the-art medical care."
One sub section of this site describes this program's services to assist healthy community projects. The services are technical assistance to communities and leadership training. In the "Healthy Communities Toolbox" sub section of the site, brief descriptions are provided for 10 of the most commonly used tools in healthy community projects. These tools are: stake holder analysis, visioning, civic index, bench marking, collaborative leadership, asset mapping, facilitation, assessment, environmental scan/situational analysis and civic journalism. I wish that more in depth information along with examples had been provided for each of these 10 important techniques.
A sub section of this site provides ordering information for the program's extensive publications (call Brandi Abeyta at 304-571-4343). One of these publications describes this program's philosophy and process approach to healthy community change efforts (The Healthy Communities Handbook, 1993, $20.00); a second publication (The Healthy Communities Directory, 1994, $20.00) contains abstracts and contact information for innovative healthy community programs throughout the U.S.; a third publication provides a listing of health-related organizations that can help with specific health and quality-of-life issues (The Healthy Communities Resource Guide, 1994 $20.00). For people ordering all three of the above described publications the price is fifty dollars. Also available from this program are: The Community Visioning and Strategic Planning Handbook (1995, $20.00) and The Civic Index: A New Approach to Improving Community Life (1993, $5.00). The latter is a ten part self-evaluation tool to help communities in planning for their future and in doing problem solving.
As an additional part of its work to create healthy communities, the League administers the Colorado Healthy Communities Initiative which involves 28 communities across this state. A five-year report on this work will be released during 1998. These specific Colorado communities are identified in a subsection of this site. One of them is Mesa County which is the subject of a case study referred to in my review of the "Healthy Cities/Healthy Communities" site.
International Healthy Cities Foundation
http://www.healthycities.org/cgi-bin/toc.aspFounded in 1994 as an outgrowth of the first international conference on healthy cities, this foundation describes itself as "a dynamic, interconnected web of people, organizations and networks involving many disciplines and interest groups." Its goal is increasing and enhancing Healthy Cities initiatives worldwide by means of 3 program areas: communications, resources, and training and advisory services. The foundation's offices are located in Oakland, California.They describe their web site as " a place where people interested in addressing urban and community issues along with concerns with health and quality of life issues in their communities can join and share information." They want to support Healthy Cities initiatives which "encompass all aspects of the urban world, from education to transportation, housing, economic development, communication, child and family, health planning, promotion and prevention and much more related to your community and city...As we enter the urban millennium, when the majority of the world's children will be born and raised in cities, the health and well-being of young people and of future generations will depend upon our ability to create healthier cities and communities."
If you are new to healthy communities work, I suggest you access this site's sub section, "Learning Tutorial: Overview of the Healthy Cities Movement." I found it very informative. Included in it are three distinct descriptive lists containing characteristics of Healthy Cities/Communities. One is Len Duhl's( one of the founders of this movement), a second is from the World Health Organization (a major proponent and legitimator) and the third is from the Toronto, Canada Healthy Toronto 2000 project (a pioneer project in this tradition) This tutorial also provides succinct, basic, step-by-step information about planning, beginning and fully implementing a healthy communities project.
Part of this site is an innovative library of web sites relevant to healthy cities/healthy communities. Browsing is made easy by the library being organized into 47 subject heading, e.g. "capacity building," "community economic development," "drug and alcohol abuse," "environmental justice, "healthy cities," "leadership in action," "public health," "sustainability," "youth," etc. In this library, every web site listed and linked has an attached annotation. In my experience assessing web sites, "it does not come much better" than this library.
In the part of this site titled, "Building Bridges: Stories from our Communities," you will find a list of California cities with healthy communities projects and each entry includes a brief description of the project. This sub section and one on describing individual leaders has not been updated since March 1997.
Coalition for Healthier Cities and Communities
http://www.healthycommunities.org/cgi-bin/?Mival=/indexThis web site began in February 1998 with the vision "In time, the Coalition Web site will link more than 200 organizations and 1,300 communities across the U.S. and provide quick and reliable access to thousands of pages of information. Distinguishing itself from other similar forums, the Coalition's Web site will serve as on online resource center for geographically dispersed communities to exchange success stories, best practice models, access a collective 'tool box' of process and measurement tools, and tap into a work force training bank." By the final phase of development for this web site which is scheduled for the end of 1998 site, interactive tutorial opportunities will be available to registered community organizations.The Coalition for Healthier Cities and Communities (http://www.healthycommunities.org) was founded in April 1997 as the domestic program of the International Healthy Cities Foundation to support and increase awareness for a growing U.S., nationwide grassroots healthy community movement. In the coalition are nearly 200 organizations representing health care providers, human service agencies, public health departments, community and advocacy groups, business, academic and religious institutions and federal and local governments from 1,300 communities across the U.S.
This web site is being created as a pro bono project of 7 companies which include Netscape, Hewlett-Packard Company and others. This initiative is a response to both America's Promise: The Alliance for Youth, (http://www.americas promise.org/) which seeks to address issues affecting American's 15 million at-risk youth and the Coalition's mission to be a resource for community-based efforts to improve the health and quality of life for all Americans.
In seeking to review this site, which is still under development, I found very slow response times along with an exciting menu of future options for obtaining valuable information on healthy communities projects, news about this movement for community change and a calendar of upcoming events of interest to individuals and organizations working to achieve major changes in cities and other local communities. I hope this site lives up to the promise of its ambitious vision and delivers on its scheduled completion date.
World Health Organization's Healthy Cities Program
http://www.who.ch/peh/hlthcit/index.htmProvides a window on some healthy city work in Europe. Important parts of the site pertaining to their newsletter have not been updated since mid-1997.Examples from Different States, Provinces and Localities
South Carolina Healthy Communities Movement
http://www.state.sc.us/dhec/hcindex.htmThis site and the South Carolina initiative, is sponsored by the state's Department of Health and Environmental Control. One positive asset of this site is its background information on healthy communities which includes a succinct and definitive history and definition; statement of principles and description and rationale for the roles of interested citizens, health practitioners and the total community in achieving healthier communities. This initiative provides within South Carolina consultation and technical assistance to Healthy Communities projects, fosters the development of community partnerships, maintains and circulates resource materials, produces a quarterly newsletter and sponsors a training program.This site also contains an archive of the quarterly newsletter which began in 1994 and is ongoing. These newsletters provide good documentation of the development of South Carolina's healthy communities initiative. For example, the March 1998 issue identifies and describes many resources (e.g. funding, tools, etc.) for communities pursuing systematic, long term change projects. It also provides a calendar of relevant events along with examples of exemplary and interesting practices taking place in South Carolina communities which have healthy communities projects.
The site provides an excellent annotated list of links to other relevant sites nationally as well as within this state. Another resource of this site are the texts of key speeches from the annual meeting of South Carolina's Healthy Communities Initiative.
Ontario Healthy Communities Coalition
http://www.opc.on.ca/ohcc/This site will give you exposure to Healthy Communities work in Canada. The Coalition, established in 1991 and since 1993 funded by the Ontario Ministry of Health, is a province-wide network of community organizations and provincial associations in Ontario, Canada. Currently there are 86 communities in Ontario which have adopted the Healthy Communities process.Now the Coalition is redesigning and updating this site and in doing this maintains an additional test site (http://199.71.69.18/testing/homefrom.htm) where you can view some of the new online features which they are implementing. It is particularly valuable to visit the "Publications" sub section of the test site to learn about many available print and online resources in relation to this Canadian effort. Also the new site's sub section "Healthy Communities Projects," describes the typical steps through which Canadian local healthy community projects develop. To illustrate this information three healthy community projects are described: "Community Justice Circles" in the Byron Community Network; "Ecology Park" in Cornwall; and "Who Flung Dung?" a very unusual community consciousness raising project in Quinte. Each of these projects is very innovative and could stimulate creative thinking and planning in other communities. The new "Healthy Communities Links" provides an easy to use means of accessing rich and diverse information and other resources on healthy communities work throughout Canada along with other resources which will be familiar to individuals from the U.S. who are familiar with healthy communities work in our country.
The information provided on the history of healthy communities work will be interesting to U.S. readers because of it being framed from the perspective of the British Commonwealth and because local community projects in Ontario began in the 1980s which is much earlier than this movement in the U.S.
A distinctive feature of the Ontario Coalition's services is that they are bilingual and feature "community animators" who have expertise in community development, grassroots organization, and facilitation. They work with community groups to help them identify their existing resources as well as needs for information and skills and to provide for their training and development.
An interesting and informative feature of this site is an extensive archive of stories from local healthy communities projects which is organized within each of the 8 major regions of this very large province. It is titled, "Community Stories Index By Region."
Colorado Healthy Communities Council
http://www.kaycee.net/choc/choc.htmlThis council is comprised of representatives from communities who are participating in Colorado's Healthy Communities initiative and other organizations and communities who are engaged in and interested in this community level improvement effort. It meets quarterly in different regions of the state to identify concerns and share expertise and resources. The Council also maintains a quarterly newsletter, Pathways, and sponsors an annual meeting.Included in this site is a project index organized by the major content of each of the 28 healthy community projects taking place in Colorado with the sponsorship of the Colorado Trust. Examining the current and past projects within the Healthy Communities projects in these 28 localities, provides valuable insights on what is being worked on in this state by means of Healthy Communities initiatives.
The site also provides information about the membership of the Council and how to go about becoming a member including the required dues payments from members
Peak to Peak Healthy Communities Project
http://www.peaknet.org/The Peak to Peak region of Colorado is in the Front Range mountains and consists of towns along the Peak-to-Peak highway from Ward, CO. to Central City, CO. This web site is a part of this region's Healthy Communities Project. The bulk of the site which was designed as one of the implementation activities of this healthy cities projects consists of specific information for citizens of this region.Also in this site you can find this project's mission statement, history, its identification of a core problem (lack of a civic community in this region), plan for reducing this problem and descriptions of specific activities and services being offered to implement the project's plan.
Links are provided to the following other Healthy Communities projects in Colorado: Mesa County/Grand Junction, Steamboat/Yampa Valley, and Boulder County as well as to the Colorado Healthy Communities Council.
Healthy Valley 2000
http://www.Invalley.org/hv2000/This Project is the first Connecticut healthy communities project and focuses on the Lower Naugatauck Valley and its towns of Ansonia, Beacon Falls, Derby, Oxford Seymour and Shelton. This is an area of 100 square miles which has a population of 96,000. The goal of the project "is to make the Valley a better place in which to live, work, raise a family and enjoy life by measurably improving the quality of life and the health of the community and its residents." It seeks to do this by "mobilizing and engaging the community to identify and solve its problems and to build on existing strengths and resources."This project places a great emphasis on communication to all citizens through means which include: a formal Annual Report, a periodic newsletter, news releases, speaking engagements, and its own web site. This site includes rich and detailed information on the ongoing research and evaluation which supports this Healthy Communities project. Also the third annual report which covers the project's work in 1996-97 is available online at this site. You will find the sub section, "Electronic Valley," to be an interesting example of Internet use to enhance citizens' access to important information about the region within which they live.
The links provided through this site include access to the Healthy Communities projects in Meriden and Danbury Connecticut.
Other Resources on Health for Community Sustainability Projects
Rating Guide to Environmentally Healthy Metro Areas, by Robert S. Weinhold, Durango, CO.: Animas Press, 1997. (cost $19.95)
In this book 317 U.S. metropolitan areas are ranked based on their performance in 10 categories: air quality, drinking water quality, toxic releases, volume of vehicle travel, aircraft operations, manufacturing facilities, agriculture, military facilities, population density and the presence of Superfund sites. According to Kathy Cone the reviewer for The Workbook, published by the Southwest Research and Information Center, and an excellent information source for activists; "Weinhold does a good job of explaining results, defining methods, and discussing the implications of the 10 category items." (Workbook, Spring 1998, p. 33) The author spent 7 years compiling and interpreting the information in this book and based this work on the premise that we should be focusing on the cumulative effects of environmental pollution in a given locality and not merely on single sources like air, water, etc. Detroit is the only metropolitan area of Michigan which is included in this book. By the way, based on overall ratings the top three metro areas in the U.S. are 1. Auburn-Opelika, Alabama; 2. Ithaca, New York; and 3. Lewsiton-Auburn, Maine.Chemical Scorecard
http://www.scorecard.orgDuring its first week online, this unique new Internet service provided by the Environmental Defense Fund had more than two million hits. By knowing and entering your zip code you can see local sources of pollution and view their relative ranking among all major pollution sources in your state. This information is based on what is required by law to be reported to the Toxics Release Inventory and existing information about health hazards of specific chemicals. These rankings are based on the relative pollution loads and health hazards arising from each of the sites. Also this site provides information on the health effects of thousands of polluting chemicals. Users are provided multiple means for taking action in relation to what they learn including the address of each site and the name of a responsible individual to whom you could write in order to communicate your concern and seek to obtain more information such as why they are continuing to pollute and what there plans are for reducing and eliminating their pollution. I found using this site provided me excellent information about serious sources of pollution in the Grand Traverse Bay Region and elsewhere in northwestern and northern Michigan as well as other localities throughout the United States. Also for me one surprising learning from this site was: "for 81% of the chemicals being released to air, there is not enough information in the public record to assess their risks to human health."Roseland, Mark. Toward Sustainable Communities: Resources for Citizens and Their Governments, 2nd edition.. Gabriola Island, British Columbia: New Society Press, 1998.
Return to the Index of Synapse 44, Summer 1998