Few topics are more important to health than community development. At first, this assertion seems a wild exaggeration when considered in relation to other important contributors to health, such as high-quality medical care, healthy behavior, and good genetic stock. However, substantial evidence reveals that environmental and community forces also are important determinants of health. This observation is critical for those involved in the development of affordable housing and enhanced community facilities for people living in low-income neighborhoods. The evidence now shows that no matter how elegantly wrought a physical solution, no matter how efficiently designed a park, no matter how safe and sanitary a building, unless the people living in those neighborhoods can in some way participate in the creation and management of these facilities, the results will not be as beneficial as we might hope. It turns out that, for maximum benefit, physical improvements must be accompanied by improvements in the social fabric of the community.
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