Chapter Thirteen

Improving Health Through Community Organization and Community Building

Meredith Minkler, Nina Wallerstein, and Nance Wilson

Community organizing is the process by which community groups are helped to identify common problems or goals, mobilize resources, and develop and implement strategies to reach goals they have set collectively (Minkler and Wallerstein, 2004). The newer and related concept of community building (Blackwell and Colmenar, 2000) may be seen not as a method so much as an orientation to the ways in which people who identify as members of a shared community engage together in the process of community change (Walter, 2004).

Implicit in the definitions of both community organizing and community building is the concept of empowerment, viewed as an enabling process through which individuals or communities take control over their lives and environments (Rappaport, 1984). A multi-level construct involving "participation, control and critical awareness" (Zimmerman, 2000), empowerment embodies both social change processes and outcomes of transformed conditions (Wallerstein, 2006). Without empowerment, community organizing cannot be said to have taken place.

Community organization is important in health education, partially because it reflects one of the field's most fundamental principles, that of "starting where the people are" (Nyswander, 1956). The health education professional who begins with the community's felt needs is more likely to 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 involvement and participation can themselves be significant factors in improving perceived control, empowerment, individual coping capacity, health behaviors, and health status (Eng, Briscoe, and Cunningham, 1990; Wandersman and Florin, 2000; Link and Phelan, 2000; Wallerstein, 2006). Finally, the heavy emphasis on community partnerships and community-based health intitiatives by government agencies and foundations suggests the need for further refining theory, methods, and measurement techniques. This chapter describes the history of community organization and community building practice; examines models of community organization and community building; explores key theoretical and conceptual bases; and presents a case study to illustrate these models in practice.