Community development in health promotion: empowerment or regulation?

Community development is a concept that currently has wide appeal in public health policy. It has become a central element of population-based health promotion strategies that purport to involve community groups in determining the form and purpose of resources for advancing the community's health. It has been variously claimed that community development empowers individuals and groups, leads to greater commitment by the community and consumers to change, strengthens community values, promotes greater local accountability in use of resources, and redresses inequalities in health. However, the meanings and implications of community development remain obscure. This paper examines the multiple and conflicting discourses of community development, and suggests that the rhetoric of community development has tended not to be matched by the reality of practice. It concludes that health promoters need to be much more critical in their assessment of the approach, and to clarify the use of basic terminology such as 'community' and 'empowerment', if their actions are to contribute to effective long-term change.