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Relying on a Community’s Strengths to Instill a Culture of Health

Written by Natalie Orenstein on March 1, 2016

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‘Asset-based community development’ examines what a neighborhood has before determining what it needs.

A few years ago, tensions were high between local health departments and retail pharmacies in Illinois over who would be the main provider of immunizations for the local population. For the health departments, vaccinations were an important source of revenue. But their facilities were out of reach for many residents, who were unaware they existed, lacked adequate transportation, or could not leave work when they were open.

By contrast, retail pharmacies like CVS and Walgreens had neighborhood outlets and longer hours. A full 80 percent of low-income communities in the United States are within five miles of a pharmacy, according to the former director of the Illinois Department of Public Health, LaMar Hasbrouck.

Hasbrouck, now executive director of the National Association of County and City Health Officials, told this story at our Network Commons event in October. He described how he sat down with the groups, who brokered an agreement. The pharmacies would provide the immunizations, but they would make a practice of referring their patients to local health departments for more comprehensive treatment.

“The solution, as it often does, involved having the conversations,” Hasbrouck wrote in a blog post. “Building the relationship and finding how to align priorities in a way that ultimately benefited everyone.”

In a bottom-up approach to community change, residents lead development efforts.

An example of asset-based community development (ABCD), the partnership ensured that important community resources were used to their greatest potential and reaching the largest number of residents.

ABCD is a strategy that seeks to identify and assess existing resources (defined in contrast to the more traditional risk- or deficiency-based “assessments”) and use them for sustainable community development. John McKnight and John Kretzmann coined the term in their 1993 book, “Building Communities From the Inside Out: A Path Toward Finding and Mobilizing a Community’s Assets.”

The approach contrasts with traditional models, which start by identifying a community’s deficiencies. ABCD instead asks community developers to map an area’s assets, which may include buildings, parks, leadership groups, faith-based organizations, or nonprofits. Projects build on those assets, with direction from local residents, to grow a community’s social capital. The strategy relies on a bottom-up approach to community change in which residents lead development efforts and spur more participation.

An ABCD project that used public, corporate, and philanthropic funds in the Gulfton neighborhood of Houston, Texas yielded a charter school, health clinic, playground and more. Practitioners used an asset-based approach called Appreciative Inquiry, where they asked residents about the most valued parts of the neighborhood and built from there. Residents also met each other through their participation in the project.

ABCD can be particularly effective in cultivating healthy communities. The goal of Project HOPE in northeast Rochester, New York, for example, was to improve the health of the community physically, socially, and economically. The project helped residents develop a plan that included churches, schools, and local government, then put it into action on their own. Asset mapping revealed local artistic talent and identified residents interested in volunteering. Today, the community is adorned with public art and there are cleanup days to beautify the streets. Other residents formed a neighborhood council. The organizers identified a plot of land and received a grant to build a playground.

80 percent of low-income communities in the U.S. are located within five miles of a pharmacy.

Hasbrouck has written about the YMCA of America’s diabetes prevention effort, which relies on health departments to promote the program to healthcare providers, who in turn refer their patients. At-risk seniors can participate in a yearlong program where they are coached on exercise and healthy living.

Through another program in Chicago, MAPSCorps hired youth to map health resources on the city’s South Side. Doctors can then use this resource to prescribe a HealtheRx, a list of resources tailored to a patient’s condition and health needs. Patients become more aware of community assets, young people gain professional skills and employment, and businesses and organizations grow stronger.

Critics of ABCD, however, say the approach ignores systemic inequalities that can be insurmountable barriers to grassroots community building. By asking residents what they can contribute instead of what they need, these critics say, ABCD puts too much pressure and responsibility on marginalized residents.

But as we’ve written, cross-sector development can have powerful effects. We’re keeping our eye on these efforts. Get in touch if there is cross-sector work in your community that takes a bottom-up approach to promoting health. We’d love to cover it on our blog.

Top photo/Direct Relief

About the Author

Natalie Orenstein

Natalie Orenstein is staff writer at HiredPen Inc. She writes regularly about health and community development for the Build Healthy Places Network.