How Change Works In Building Healthy Communities:
Four Observations

by Joe Flower


This article appeared in:
the Healthier Communities Action Kit, Module 3, published by the Healthcare Forum.
Please see our free downloading policy.


  1. Core principles + opportunities
  2. Finding a way
  3. Reputation
  4. Variety

Core principles + opportunities

The most successful partnerships for a healthier community are not the result of minutely-detailed master plans. A community lives, grows, and changes. A movement toward a healthier community must be part of that living, growing system, so it must be:

Even a thoroughly-studied and carefully-considered master plan for a healthier community put together by one institution's staff is likely to fall short of these criteria.

Instead, the partnerships that work seem to grow out of the interactions of two things: 1) a set of core principles and basic directions (such as "wellness," "strengthening community bonds," or "access for everyone"), and 2) opportunities that arise from community partners (churches, service groups); from other institutions (schools, city agencies, other healthcare institutions); from available funding; or from specific presenting problems in the community (such as lack of transportation, or high infant mortality).

Opportunities that come with partners already have some energy and connection. Opportunity that comes from available funding has energy (in the form of money) but no connections to the community yet -- the project will work only if it can attract the energies of the community, as well as funding from outside. Presenting problems can be opportunities if they are the sort of problem that excites the energies of the community -- in other words, not something that's only a problem in the community's eyes, not just in yours.

Finding a way

The richest, most fruitful community interactions seem to grow from a determination to do what needs to be done, to find a way. Over and over we hear people say, "We couldn't wait for Washington to act. We couldn't wait for the state to get it together. We had to do something here." This is an attitude that will not pass the buck, that will not give up on a problem just because the political process hasn't yielded an answer yet, or because funding organizations don't see its importance yet. It is an attitude of active patience: "We'll do what we can now, while we continually seek opportunities to do more."


"Them's that got shall get. Them's that's not shall lose." The old song is especially true of webs of community. As you build a reputation for working with the community, the community will increasingly come to you with ideas, opportunities, connections, and energy.


"Let a thousand flowers bloom." Evolving systems love variety. When you don't know exactly how to solve a problem (and we don't know how to solve these problems, that's why they are still problems), it helps to try lots of different solutions, and see which ones attract the best energy. Better to start ten small initiatives than one huge one.

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