Social Determinants of Health: The Community as an Empowered Partner

Let me begin by describing my own humbling attempts at community involvement through a smoking-cessation project I directed several years ago in Richmond, California. I came to the project with a dismal record in assisting people individually to quit smoking, so in the Richmond project I resolved to take a different tack; I designed the Richmond project as a community project. By having a block captain in every neighborhood in Richmond, I planned to involve the business community, the schools, and community groups. My idea was to change the climate in Richmond with regard to smoking by challenging its acceptance, its values, and its attractiveness.