ABSTRACT

In 1948, the World Health Organization (WHO) issued a definition of health, which emphasised well-being:“a state of complete physical, mental and social well-being,not merely the absence of disease and infirmity.”While this definition may not seem extraordinary to us today, it indicates an alternative, positive, and holistic approach to health, which contrasts with the more negative Western concept of health as an absence of illness, related solely to the condition of the body.The emphasis on well-being encouraged the growth of the health promotion movement,which started to explore ways of promoting and sustaining health not only for individuals but also for communities. Most readers will be familiar with health promotion messages, which urge us to stop smoking, moderate our alcohol intake or eat more fresh fruit and vegetables and very few would argue with such advice. However, advocating sensible behaviour on an individual level is only part of the story: the communities in which people live or work play an equally important role. For example, people may live in areas where sub-standard housing conditions lead to health problems, or where there is inadequate public transport and few shops, making it difficult to get access to fresh food – or they may not earn enough to afford a regular supply of fruit and vegetables. Individual health and health behaviours are influenced by social structures and the nature of the communities in which people live and work. Furthermore, the concept of the healthy community is more than the aggregate of the health of individuals living in a locality. It is a multi-layered concept, in which the physical and social environments where people live or work and the community resources they have access to combine to enable mutual support.