PREFACE

WE WROTE THIS BOOK because we believe in people and the power they have to improve their lives as well as the world around them. People have huge reservoirs of untapped talent and vitality and are therefore capable of changing the conditions and trends that produce anything less than optimal health, safety and well being. We believed this before the events of September 11th, and the response in the aftermath of the tragedies in New York, Washington and Pennsylvania confirm it. Specifically, we believe that everyday citizens can challenge and alter any trend or pattern that is negatively impacting their lives, their loved ones or citizens in their community.

This book is about encouraging us all to draw from that deep well of human and community potential and do more to "bend the trends" of behavior and attitude that take us away from our dreams of health, safety and well being.

Our journey together as this book's authors has its roots in the healthy cities/healthy communities movement. That movement grows out of the premise that health is more than the absence of disease, and that social and environmental conditions play an important role in determining a population's health and overall quality of life.

The success of our work ultimately will be reflected in the health status of people. We work on building the capacity for change because it will bring about improvement in the health status of people. Health status is without doubt the most sensitive, reliable and powerful indicator of quality of life available to any community.

In 1988, the World Health Organization officially adopted the World Health Declaration, which states that the enjoyment of health is a fundamental right of every human being and recognizes the importance of health-promoting physical, economic, cultural environments in determining health.

With "health for all in the 21st century" as its motto, the healthy communities movement has grown for more than a decade in the United States. Citizens across the country, beginning chiefly in Boston, California, Indiana and Colorado, formed partnerships with their local hospitals, health systems, governments, businesses and nonprofit organizations to improve health and quality of life.

In 1989, the U.S. Department of Health and Human Services asked the National Civic League (NCL) to help launch a domestic initiative to improve health. Co-author Tyler Norris served as the Civic League's project director for Healthy Cities/Communities. In 1992, the Colorado Trust launched its Colorado Healthy Communities Initiative (CHCI), and asked the National Civic League to manage the project. Co-authors Darvin Ayre and Gruffie Clough, international and domestic community development and corporate consultants, were engaged to serve as facilitators in Colorado communities participating in the CHCI. The three of us, Norris, Clough and Ayre, worked in 13 of the 27 participating CHCI communities.

We were inspired by a research study conducted by the Colorado Trust, the findings of which suggested that the most effective means of improving the health of Coloradoans would be to fund efforts to engage local communities to promote health and prevent disease. A number of health-related foundations have taken a similar path, reaching beyond the medical-based model of health to create community health in a broader sense.

Our work in this field led us to understand the connections between civic life and health. We have worked to advance health in hundreds of communities by coaching, designing change processes, giving workshops and facilitating collaborative and community events. A previous publication of ours, Facilitating Community Change, captures the "how" and methodology of this work. This new book shares the importance of and the imperatives behind the work of building healthy communities.

We have now joined with Mary Pittman of the Health Research and Educational Trust, an affiliate of the American Hospital Association, to publish this book. We have worked for years with this organization, which has launched and supported numerous community initiatives to bring hospitals into closer partnership with their communities to enhance health. Mary Pittman worked with Tyler Norris to foster community sharing through the establishment of the Coalition for Healthier Cities and Communities. Through all of these experiences, we have learned the patterns and questions that emerge across America's communities that call for change.

On a more personal note, we'd like to make a confession. Like many of you, we are students of community-building work. Even as we offer expert opinions and insights in this book, we also know that there are few "final" answers. One thing we all agree on--there is no "one size fits all" or cookie-cutter approach to creating healthier communities. We know from experience that what works in one community, although it may offer lessons, doesn't always fit another. We must always be willing to challenge our assumptions and adapt what we've learned to local community conditions.

Similarly, the three of us ask ourselves the same questions that we ask our readers about how our daily actions affect the health of our communities. On a daily basis, each of us is challenged to align our personal and professional values with our behaviors and choices. We are hard-pressed to find the time to participate in our own communities and neighborhoods. We try to "walk our talk," yet still we find that some days are better than others. We attempt to balance the opportunities to earn income while still volunteering or contributing time to this important community movement. We invite you to join us in the challenge. How can we be more intentional about improving the quality of life in our communities? What can we do that will "bend the trends" that keep our communities from living up to their potential? How can we "model the way" for our friends, families, neighbors-and peers-to participate in creating healthier communities? We hope this book will serve to stimulate dialogue and action about these important questions.