Before beginning my graduate studies, I assumed community health and public health were essentially the same thing. Like many people, I viewed the two terms as interchangeable and gave little thought to the distinctions between them. Coming from psychology and exercise science in my undergraduate studies, I was accustomed to viewing health through the lens of the individual. Community health has challenged that perspective by asking me to consider the families, neighborhoods, and systems that influence health long before someone becomes a patient.
What is Community Health?
According to the World Health Organization, health is “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” This definition broadened the way health has traditionally been understood by emphasizing that well-being extends beyond medical diagnoses. Community health embraces this perspective by recognizing that social relationships, environmental conditions, and access to resources are equally important determinants of health. At its core, community health is a branch of public health dedicated to improving the health and quality of life of specific populations through prevention, health promotion, education, and equitable access to resources. According to the American Hospital Association, the improvement of all these are “through addressing social, behavioral, environmental, economic and medical determinants of health in a geographically defined population.” I find this definition particularly meaningful because it highlights that improving health extends beyond medical treatment. It involves strengthening the systems, relationships, and resources that allow individuals, families, and communities to thrive. The Centers for Disease Control and Prevention identifies the social determinants of health as the conditions in which people are born, live, learn, work, play, worship, and age. These factors, including education, economic stability, healthcare access, neighborhood environments, and social support, significantly influence health outcomes. Community health professionals seek to address these upstream factors to improve health before illness occurs. This perspective is echoed by Healthy People 2030, a national framework that recognizes health as more than the absence of disease. By prioritizing health equity, prevention, and the social determinants of health, the initiative highlights the importance of creating environments where individuals and communities have the opportunity to achieve optimal health.
Ecological Systems Theory (EST)
One of the first theories that completely changed the way I thought about health was Urie Bronfenbrenner’s Ecological Systems Theory. I was first introduced to it in my community nutrition class and before learning about it, I tended to view health primarily through the individual. This framework challenged that perspective by illustrating how our families, communities, institutions, and society continuously shape our development and well-being. Urie Bronfenbrenner’s Ecological Systems Theory (EST) is a developmental framework that explains how individuals grow and develop through interconnected environmental systems, from immediate surroundings to broader cultural contexts. Individuals do not exist in isolation, rather, their health and development are shaped by the interactions between their family, community, institutions, and the larger social environment. At the center/core of the circle it’s the individual. The first system is the microsystem, which is their immediate support system—family, friends, and caregivers. Mesosystem is the connection between microsystems according to Dickens. In other words, expanding outward is the community itself: neighborhoods, schools, workplaces, healthcare organizations, and local resources that shape everyday life, i.e., community health. The third system of EST is the exosystem. Exosystem is the broader societal context, involving “formal and informal social structures likely to influence the mesosystem directly or indirectly.” (Dickens et al.) Institutions such as the education system, social service agencies, technology, public policy, and the media create conditions that shape opportunities, behaviors, and health outcomes, even when individuals are not directly involved in these settings. Macrosystem is the fourth level of EST. Macrosystems involve culture, societal impacts and other various systems that impact an individual. Dickens et al. states “socioeconomic status exerts maco-level influence on an individual.” An individual from a lower SE status may not have the resources or opportunities someone from a higher SE status might obtain. The last system of Ecological System Theory is the Chronosystem. This is the outermost circle and the chronosystem represents public health, which examines health on a broader scale through regional, national, and global populations. Dickens et al. explains interventions at this level are designed to strengthen preparedness by equipping communities and public health organizations to respond effectively to future public health emergencies such as global pandemics and other outbreaks. What I appreciate most about this framework is that it illustrates how health is shaped by far more than individual choices. Despite the differences individuals have among each other, we are all interconnected via the intricate levels of systems.
Community Health in Practice
What surprised me most was how community health shifts the focus from treating illness (clinical medicine) to understanding the environments in which people live. It asks questions beyond What disease does this person have? Instead, it asks: Do they have access to healthcare? Safe housing? Nutritious food? Reliable transportation? Social support? Educational opportunities? Community health recognizes that these social, economic, behavioral, and environmental factors play a significant role in shaping health outcomes. By understanding the unique strengths and challenges within a community, professionals can develop interventions that are more responsive, equitable, and sustainable.
To better understand community health, imagine two communities with similar populations, age distributions, and genetic backgrounds. In the first community, residents have access to sidewalks and parks that encourage physical activity, grocery stores offering affordable and nutritious food, reliable public transportation, quality schools, and nearby healthcare facilities. Community organizations provide health education programs, social support, and recreational opportunities that foster connection and well-being. Now imagine a second community where these resources are scarce or nonexistent. Sidewalks are absent, healthy food options are limited, public transportation is unreliable, healthcare services are difficult to access, and opportunities for education and employment are fewer. Although the individuals living in both communities may share similar biological characteristics, their health outcomes are likely to differ considerably.
Community health seeks to answer this question by examining the conditions in which people live, work, learn, and interact. It recognizes that health is influenced not only by personal choices or genetics, but also by the environments and systems that shape those choices. Access to safe neighborhoods, educational opportunities, healthcare services, nutritious food, and economic stability all contribute to an individual’s ability to achieve and maintain good health. By identifying these community-level strengths and barriers, public health professionals can develop interventions that promote healthier environments and reduce health disparities before disease occurs.
There have been numerous community-based research that demonstrate the importance of community engagement and the positive outcomes that came with it. Thompson et al. utilized community-engaged concept mapping to identify shared priorities for healthcare, research, and cancer control across communities in Kentucky. By involving both community members and representatives from statewide and local organizations, the researchers fostered collaboration and achieved a strong consensus regarding the most pressing health concerns and potential strategies for addressing them. Similarly, Keller et al. described a partnership between residents of Milwaukee’s Near West Side and Marquette University, where community members worked alongside academic researchers to define the characteristics of a healthy community. Through concept mapping, participants organized and prioritized ideas that reflected their collective experiences, ultimately creating a foundation for community-driven, strength-based interventions that aligned with local priorities.
Community Health Approach:
According to “Harnessing the Power of Community Engagement for Population Health” by Akintobi et al adapted an approach system that aids public health practitioners within communities. A defining principle of community health is the recognition that meaningful and lasting change begins with the community itself. Rather than imposing solutions from the outside, public health professionals are encouraged to first engage with communities to understand their perspectives, strengths, values, and priorities. As the authors emphasize, practitioners should “go to communities to learn their perspectives, strengths, values, and priorities,” recognizing that community members are not simply recipients of services but active partners in the planning, implementation, evaluation, and sustainability of health initiatives. Building these relationships requires time, trust, and a genuine commitment that extends beyond grant funding or research objectives.
The authors further argue that successful community health efforts depend on amplifying community voices and acknowledging their expertise throughout the research and decision-making process. This includes involving community members as collaborators, recognizing their contributions through authorship or leadership roles, and ensuring they receive appropriate compensation for their work. In addition, meaningful partnerships should extend beyond healthcare systems to include schools, faith-based organizations, businesses, social service agencies, and other local organizations that influence the social determinants of health, such as housing, employment, food security, and access to healthcare.
Ultimately, the article advocates for a strengths-based approach to community health. Rather than viewing communities as lacking resources or requiring externally developed solutions, practitioners are encouraged to recognize and build upon existing assets, local knowledge, and community leadership. By practicing cultural humility, listening with the intent to understand, and fostering trust, public health professionals can develop collaborative partnerships that produce sustainable, community-driven improvements in health and well-being.
Reflection:
As I continue my graduate studies and my career as a Family Specialist, I find myself returning to one central idea: health cannot be understood by looking at the individual alone. My colleagues and I have had conversations on this matter numerous times. An individual (youth in our setting) is shaped by families, communities, cultures, policies, and the countless social and environmental factors that influence everyday life. The habits their families, friends and communities part-take in inevitably are adopted by the youth, leading them to participate in patterns that might not be in their best favors. Although I am still growing in both my profession and this field of study, each article I read and every experience I encounter continues to reshape the way I think about health and well-being. This blog is my way of documenting that journey—not as someone who has all the answers, but as someone committed to asking meaningful questions, learning from the communities I serve, and growing into a more thoughtful practitioner and researcher. Going forward, I hope to explore topics such as health equity, social determinants of health, family systems, cultural humility, and evidence-based practice. Understanding community health is only the beginning of a much larger conversation.
References:
Akintobi TH, Bailey RE II, Michener JL. Harnessing the Power of Community Engagement for Population Health. Prev Chronic Dis 2025;22:250189. DOI: https://doi.org/10.5888/pcd22.250189.
Community Health & Well-Being | Center | AHA
Dickens C, Suarez-Balcazar Y, Allen-Meares P, Brazil E. Using Ecological Systems Theory to Enhance Community Health Literacy. Health Lit Res Pract. 2025 Jan;9(1):e29-e36. doi: 10.3928/24748307-20241126-01. Epub 2025 Feb 1. PMID: 39933535; PMCID: PMC11882101.
Keller AO, St. Arnold Bell L, Haglund K. Engaging a community–academic partnership to implement community-driven solutions. Prev Chronic Dis. 2025;22:240334.
Thompson JR, Burus T, McAfee C, Stroebel C, Brown M, Francis K, et al. . A community-engaged, mixed-methods approach to prioritizing needs in a statewide assessment of community cancer needs. Prev Chronic Dis. 2024;21:E103. PubMed:10.5888/pcd21.240183
