The Importance of Community Development for Health and Well-Being

Few topics are more important to health than community development. At first, this assertion seems a wild exaggeration when considered in relation to other important contributors to health, such as high-quality medical care, healthy behavior, and good genetic stock. However, substantial evidence reveals that environmental and community forces also are important determinants of health. This observation is critical for those involved in the development of affordable housing and enhanced community facilities for people living in low-income neighborhoods. The evidence now shows that no matter how elegantly wrought a physical solution, no matter how efficiently designed a park, no matter how safe and sanitary a building, unless the people living in those neighborhoods can in some way participate in the creation and management of these facilities, the results will not be as beneficial as we might hope. It turns out that, for maximum benefit, physical improvements must be accompanied by improvements in the social fabric of the community. The French sociologist Emile Durkheim in 1897 conducted one of the earliest, and now classic, studies on the importance of the role that community social forces play in the health of the individual (Durkheim, 1951). In his work on suicide, Durkheim noted that, in conventional thinking, the causes of suicide must be found within the individual: a person's personal demons, failures, aspirations, and dashed hopes. Yet Durkheim noted that suicide rates were dramatically higher among certain groups and communities and that these differences persisted over time even as individuals entered and left those communities. To explain this difference among group rates, Durkheim argued that convention falters and one must refer to community factors. He reasoned that if different groups have different suicide rates, something about the social organization of the groups may play a role in encouraging or deterring individuals from committing suicide. This social force would not explain why particular individuals committed suicide, but it would explain why suicide rates were higher or lower in certain groups. Durkheim's research led him to conclude that the major factor affecting suicide rates was the degree of social integration of groups. Today we use terms such as " social capital " to refer to this concept that Durkheim introduced over a hundred years ago. Many years later, another classic study led to the same conclusion. In that study, Haan, Kaplan, and Camacho showed that people living in a federally designated poverty area in Community Development …