CONTENTS

1 Bending The Trends 1
Defining Trendbenders 3
The Community in Flux4
A Movement for Healthier Communities 7
Where Is Community? 10
Why Work on Building Community? 14
The Demise of Ephesus 19
Social Entrepreneurs: Creating Community Wealth 21
A New Kind of Capital 23
Participation in the "Good Society" 26
Social Capital and the Spirit of Community 28
Great Questions for the New Century 30
Trendbending in Practice: Central Oklahoma 2020 32

2 What Creates Health ? 		37
The Real Causes of Death 40
The Social Determinants of Health 43
What the Research Tells Us 44
The Community's Challenge in Improving Health 48
The Costs of Downstrearning49
Trendbending in Practice: The Champlain Initiative 53

3 The Quantum Community: From Symptoms to Systems		59
The Quantum Paradigm and Community Health62
How the "Symptoms" Approach is Failing65
Discovering the Systems Approach 66
The Connected Community 69
Trendbending in Practice: York County, Pa. 71

4 Principles for Successful Community Change 		75
Out of the Restaurant and Into the Kitchen77
Principles of Success 78
Use a Broad Defmition of Health79
Create a Shared Vision Built on Community Values
Address Quality of Life for Everyone 84
Sample Community Vision/Shaping Our Summit, Summit County, Colo. 85
Build Diverse Citizen Participation and Community Ownership87
Focus on System Change91
Build Capacity Using Assets and Resources96
Measure Progress and Outcomes102
Guideposts to Success 103
Trendbending in Practice: Shaping Our Summit 105

5 A Model for Creating and Sustaining Positive Change		111
Creating and Managing Change 113
Sustainability and Community Change 117
Assessing Readiness; identifying choices118
Energizing Ourselves; building and equipping a leadership team 120
Early Wins; getting to work 123
Operational Structures 126
Energizing the Community; building knowledge for action 127
Setting the Direction for Change; fine-tuning our aim 131
Implementing Change; making it last134
Pitfalls to Avoid 136
Trendbending in Practice: Invemess and Palatine, Ill. 137

6 Making Connections and Producing Outcomes 		143
Life in Anyplace, USA, Versus Life in Hometown, USA144
The PROs of Hampton County, S.C. 146
The Little Valley That Roared-Roaring Fork Valley, Colo. 149
The Process of Discovery: Orlando Healthy Community Initiative154

7 Toward a Healthier Future 		159
Individual Change Agents: Connect With Those Around You 162
Community Leaders: Widen The Circle 163
Link Public Policy to Community Work and Research 166
Trendbending in Practice: Partners for Progress in Lake Forest, Ill.169
The Choice is Ours 174