Defining Healthy Communities

November 2, 2015
By Jeremy Hegle , Senior Community Development Advisor

The definition of a two-word phrase should be straightforward, however, if you ask 10 people to define healthy communities you will likely get 10 different responses. Is it a community where residents have low cholesterol, are free from diabetes and other chronic illnesses? Is it a community where critical elements like safety, adequate housing and access to jobs all thrive? Or, does the term mean something completely different?

Health Resources in Action (HRiA), a Boston-based nonprofit, explored this question and published its results in “Defining Healthy Communities." After systematically reviewing the websites of 153 organizations engaged in healthy community initiatives, HRiA found only 11 actually defined healthy communities. Instead, most organizations focused on the process and characteristics essential to creating healthy communities. The elements most commonly referenced are shown the figure below.

Healthy Community Elements


Of the elements listed, most are commonly associated with community development, not with human health. All, however, are factors that directly affect human health. Someone living in a mold-infested apartment located far from fresh food, for example, may suffer respiratory and dietary-related illnesses. These health issues might lead to missed work, resulting in lost employment, further exacerbating the person’s physical and economic health issues. This relationship between a person's environment and health makes it clear why many of the elements on the left side of the chart above are referred to as social determinants of health. This also explains the growing interest community and health organizations have in working together to tackle shared issues.

The elements in the middle and right side of the figure speak to the degree to which community partners work together to seek, identify and address the needs of those in the community (“Healthy Community Process”). This aspect of engagement may be responsible for the lack of a single clear definition of a healthy community. It also suggests the process of identifying and addressing social determinants of health is more important to the creation of a healthy community than a specific definition.

The HRiA article suggests the following principles of a healthy community process:

  1. A broad definition of community that is multi-sectorial
  2. A broad definition of health
  3. A shared vision and shared values
  4. Community ownership
  5. Asset based
  6. Equity (equal access to opportunity)
  7. Monitoring and evaluation
  8. Sustainability
  9. Systems changes
  10. Use of evidence-based interventions while encouraging innovative practices
  11. Maximum transparency to improve community engagement and accountability
An effective healthy community process breaks down silos and allows us to think about health and community in broad terms. For positive, sustainable change we must put more emphasis on the process of identifying and addressing issues of healthy communities, rather than focusing on coming up with a narrow definition.

The Community Development Department at the Federal Reserve Bank of Kansas City works with a wide range of organizations to help strengthen communities. We recognize that, while each community is unique, lessons can be learned by exploring how other communities collaborate on healthy community initiatives. Many communities across the Tenth District are actively engaged in such initiatives. To share your community’s story, please contact Jeremy Hegle.

Healthy Community Tenets from HRiA