UNDERSTANDING COMMUNITY RESPONSES TO CHANGES IN THE HEALTH CARE SYSTEM: A COMMUNITY FIELD PERSPECTIVE

by Kenneth E. Martin, Ph.D.,
Director, Pennsylvania Office of Rural Health
Associate Director, Northeast Regional Center for Rural Development
Penn State University
University Park, Pennsylvania

INTRODUCTION

  In his book The Rural Community in America (1991), where he describes and defends the usefulness of the community field approach, Wilkinson (1970) defines the community field as "a process of interrelated actions through which residents express their common interest in the local society." For Wilkinson, the interactional community has three essential properties: local ecology, social organization, and community action. Local ecology refers to an "organization of social life" critical for meeting individual needs as well as the ensuring the responsiveness of the local society in adapting to change. Social organization implies that the community is a "comprehensive interactional structure" that represents the needs and interests of community members. Community action arises out of the "bond of local solidarity," i.e. community members come together to pursue opportunities and solutions to local problems. This phenomenon occurs even as the individuals involved simultaneously participate in multiple special interest fields through horizontal linkages within the community and vertical linkages outside the community. For example, community residents may participate in local government activities, shop at local establishments, and work on local service organization projects while traveling outside the community for education and employment opportunities.