Studies show that community development approaches to health education may lead not only to improved social, economic, and health status but also to increased individual participation in health education and preventive health care activities. However, because of categorical funding restraints and philosophical issues, local health departments have rarely given control of defining project outcomes to the community. One such project was in a low-income urban neighborhood in the San Francisco Bay Area. In this Healthy Neighborhoods Project, the health department catalyzed community development and organization in a multiethnic public housing complex. As a result, an empowered community successfully advocated to improve public safety by installing street speed humps and increased street lighting. After project completion, residents initiated several additional health actions, including the removal of a neighborhood tobacco billboard. This article describes the project, which may serve as a model for other urban public health programs to explore their role in community empowerment.
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References
1.
1. Executive Office of the President: Up From Dependency (Vol. 1). Executive Office of the President, 1986.
2.
2. McKnight J: Do no harm: Policy options that met human needs. Social Policy, Summer, 1989, pp. 5-15.
3.
3. Braithwaite RL, Lythcott N: Community empowerment as a strategy for health promotion for black and other minority populations. JAMA261:282-283, 1989.
4.
4. McKnight JL: Health and empowerment. Can J Public Health76:37-38, 1985.
5.
5. Albee G: Powerlessness, Politics and Prevention. Paper presented at the meeting of the American Psychological Association, Washington, D.C., August 1986.
6.
6. Seligman M: Helplessness. San Francisco, Freeman, 1975.
7.
7. Ryan W: Preventive services in the social context: Power, pathology, and prevention, in Bloom BL, Duck DP (eds.): Preventive Services in Mental Health Programs. Boulder, CO, Western Interstate Commission for Higher Education, 1967.
8.
8. Seeman M, Seeman TE: Health behavior and personal autonomy: A longitudinal study of the sense of control in illness. J Health Soc Behav24:144-160, 1983.
9.
9. Wallerstein N: Powerlessness, empowerment, and health: Implications for health promotion programs. Am JHealth Promotion6:197-205, 1992.
10.
10. Israel BA, Schurman SJ: Social support, control, and the stress process, in Glanz K, Lewis F, Rimer B (eds.): Health Behavior and Health Education: Theory, Research and Practice. SanFrancisco, Jossey-Bass, 1990.
11.
11. House JS: Work Stress and Social Support. Reading, MA, Addison-Wesley, 1981.
12.
12. Cohen S, Evans G, Stokols D, Krantz D (eds.): Behavior, Health and Environmental Stress. New York, Plenum, 1986.
13.
13. Kasl SV, Cooper CL (eds.): Stress and Health: Issues in Research Methodology. New York, John Wiley, 1987.
14.
14. Minkler M: Improving health through community organization, in Glanz K, Lewis FM, Rimer BK (eds.): Health Behavior and Health Education: Theory, Research and Practice. San Francisco, Jossey-Bass, 1990.
15.
15. Minkler M: Ethical issues in community organization. Health Educ Monographs6(2): 198-210, 1978.
16.
16. Minkler M, Cox K: Creating critical consciousness in health: Applications of Freire's philosophy and methods to the health care setting. Int J Health Serv10(2):311-322, 1980.
17.
17. Geiger HJ: Community control: Or community conflict?Bull Natl Tuberc Respir Dis Assoc55:4-11, 1969.
18.
18. Hanson P: Citizen involvement in community health promotion: A role application of CDC's PATCH model. Intl Q of Comty Health Educ9(3):177-186, 1988-89.
19.
19. Nyswander D: The open society: Its implications for health educators. Health Educ Monographs1:3-13, 1966.
20.
20. Brown RE: Community action for health promotion: A strategy to empower individuals and communities. Int J Health Serv21(3):441-456, 1991.
21.
21. Grossman J: Health for what? Change, conflict, and the search for purpose. Pacific Health Education Reports2:51-66, 1971.
22.
22. Israel BA, Checkoway B, Schulz A, Zimmerman M: Health education and community empowerment: Conceptualizing and measuring perceptions of individual, organizational, and community control. Health Educ Q21(2):149-170, 1994.
23.
23. Lewin K: Group decision and social change, in Maccoby et al (eds.): Readings in Social Psychology (3rd ed.). New York, Holt, Rinehart & Winston, 1958.
24.
24. Freire P: Education for Critical Consciousness. New York, Seabury, 1973.
25.
25. Minkler M: Theory Into Action: Health Education in a Honduras Refugee Camp. Paper presented at the 111th annual meeting of the American Public Health Association, Dallas, November 1983.
26.
26. Wallerstein N, Bernstein E: Empowerment education: Freire's ideas adapted to health education. Health Educ Q15(4):379-394, 1988.
27.
27. Auerbach ER, Wallerstein N: ESL for Action Problem Posing at Work. Teacher's Guide. Reading, MA, Addison-Wesley, 1987.
28.
28. Arnstein SR: A ladder of citizen participation. Am Inst Plan J July, pp. 217-224, 1969.
29.
29. Eng E, Briscoe J, Cunningham A: Participation effect from water project on EPI. Soc Sci Med30(12):1349-1358, 1990.
30.
30. Leighton DC, Stone IT: Community development as a therapeutic force: A case study with measurement, in Roman PM, Trice HM (eds.): Sociological Perspectives on Community Mental Health. Philadelphia, F. A. Davis, 1974.
31.
31. Cohen S, Syme SL (eds.): Social Support and Health. Orlando, FL, Academic Press, 1985.
32.
32. Thomas PD, Goodwin JM, Goodwin JS: Effect of social support on stress-related changes in cholesterol level, uric acid level, and immune function in an elderly sample. Am J Psych142:735-737, 1985.
33.
33. McKnight J, Kretzmann J: Mapping Community Capacity. Evanston, IL, Center for Urban Affairs and Policy Research, Northwestern University, 1990.
34.
34. Demographic Research Unit: Population Estimates for California Cities and Counties 1986-1994. Sacramento, California State Department of Finance, May 1994.
35.
35. U.S. Census Bureau: 1990 Census STF3. Washington, D.C., U.S. Census Bureau, 1990.
36.
36. Tobacco Education Oversight Committee: Toward a Tobacco-Free California: A Master Plan to Reduce Californians' Use of Tobacco. Submitted to the California State Legislature, January 1991.
37.
37. Johnson CA, Sanford D: Tobacco industry response, in Independent Evaluation of Efforts to Prevent and Control Tobacco Use in California. San Diego, CA, San Diego State University, 1992.
38.
38. Robinson RG, Pertschuk M, Sutton C: Smoking and African Americans, in Samuels SE, Smith MD (eds.): Improving the Health of the Poor: Strategiesfor Prevention. Menlo Park, CA, Henry J. Kaiser Foundation, May 1992.
39.
39. Ellis GA, Reed DF, Scheider H: Mobilizing a low-income African American community around tobacco control: A force field analysis. Health Educ Q22(4):443-457, 1995.
40.
40. Kretzmann JP, McKnight JL: Building Communities From the Inside Out: A Path Toward Finding and Mobilizing a Community's Assets. Evanston, IL, Center for Urban Affairs and Policy Research, Northwestern University, 1995.
41.
41. Twiss J: California's healthy cities: Governance in action. National Civic Review86(1):81-91, 1997.
