Background Influence

Healthy community norms

Parent construct: Social cohesion

Neighborhood norms about a healthy community can be created and have immense effects.1,2,3 Poor neighborhoods often have poor health—because of toxic influences, poor food, fear of outdoor activity, and poor access to preventive care. Improving health outcomes is a major pathway for changing the odds of children and youth in ways that are not always immediately apparent.

By focusing on healthy community norms in Promise Neighborhoods, there could be significant positive impact in reducing historical disparities through small changes.

  • Poor women in America often do not breast feed their babies.4,5 Increasing the numbers of low-income pregnant mothers who breast feed4 and have good dietary intake of folic acid and fish or fish-oil can significantly increase child IQ and reduce lifetime behavior problems into the 8th year of life.6,7,8,9
  • Increasing “screen time” of children fosters many problems. Promoting “No TV” or electronic media in children’s bedrooms plus reducing total screen time of children increases academic achievement, reduces violence at school or home, and reduces obesity.10,11,12,13,14
  • Many poor people are deficient in Vitamin D. Elderly African American’s are often the primary caregivers of their grandchildren; vitamin D deficiency in elderly African Americans is highly common15 and bad for general health, and decreases important cognitive performance.15 This same vitamin D deficiency increases mood disorders among women16, which affects parenting skills.

A focus on creating healthy community norms is vital,3 since interventions focused just on individuals in poor neighborhoods often have weak effects. Thus, the Promise Neighborhood Research Consortium has accumulated a number of programs, policies, practices and evidence-based kernels that can advance healthy community norms.

Related Interventions




  1. Cubbin C, Marchi K, Lin M, Bell T, Marshall H, Miller C, et al. Is neighborhood deprivation independently associated with maternal and infant health? Evidence from Florida and Washington. Matern Child Health J 2008;12(1):61-74.  

  2. Sorensen G, Stoddard AM, Dubowitz T, Barbeau EM, Bigby J, Emmons KM, et al. The influence of social context on changes in fruit and vegetable consumption: Results of the Healthy Directions studies. American Journal of Public Health 2007;97(7):1216-27.  

  3. Maddock J, Takeuchi L, Nett B, Tanaka C, Irvin L, Matsuoka C, et al. Evaluation of a statewide program to reduce chronic disease: The Healthy Hawaii Initiative, 2000-2004. Evaluation and Program Planning 2006;29(3):293-300.  

  4. Bentley ME, Dee DL, Jensen JL. Breastfeeding among low income, African-American women: poer, beliefs and decision making. J Nutr 2003;133(1):305S-09S.  

  5. Kogan MD, Singh GK, Dee DL, Belanoff C, Grummer-Strawn LM. Multivariate analysis of state variation in breastfeeding rates in the United States. Am J Public Health 2008;98(10):1872-80.  

  6. Julvez J, Fortuny J, Mendez M, Torrent M, Ribas-Fito N, Sunyer J. Maternal use of folic acid supplements during pregnancy and four-year-old neurodevelopment in a population-based birth cohort. Paediatr Perinat Epidemiol 2009;23(3):199-206.  

  7. Helland IB, Smith L, Saarem K, Saugstad OD, Drevon CA. Maternal supplementation with very-long-chain n-3 fatty acids during pregnancy and lactation augments children's IQ at 4 years of age. Pediatrics 2003;111(1):e39-44.  

  8. Williams C, Birch EE, Emmett PM, Northstone K, Avon Longitudinal Study of P, Childhood Study T. Stereoacuity at age 3.5 y in children born full-term is associated with prenatal and postnatal dietary factors: a report from a population-based cohort study. American Journal of Clinical Nutrition 2001;73(2):316-22.  

  9. Hibbeln J, Davis JM, Steer C, Emmett P, Rogers I, Williams C, et al. Maternal seafood consumption in pregnancy and neurodevelopmental outcomes in childhood (ALSPAC study): an observational cohort study. The Lancet 2007;369(9561):578-85.  

  10. Robinson TN. Reducing children's television viewing to prevent obesity: A randomized controlled trial. 1999;282(16):1561-67.  

  11. Robinson TN, Borzekowski DLG. Effects of the SMART Classroom Curriculum to Reduce Child and Family Screen Time. Journal of Communication 2006;56(1):1-26.  

  12. Robinson TN, Wilde ML, Navracruz LC, Haydel KF, Varady A. Effects of Reducing Children's Television and Video Game Use on Aggressive Behavior: A Randomized Controlled Trial. Arch Pediatr Adolesc Med 2001;155(1):17-23.  

  13. Salmon J, Ball K, Hume C, Booth M, Crawford D. Outcomes of a group-randomized trial to prevent excess weight gain, reduce screen behaviours and promote physical activity in 10-year-old children: switch-play. International Journal of Obesity 2008;32(4):601-12.  

  14. Barr-Anderson DJ, van den Berg P, Neumark-Sztainer D, Story M. Characteristics associated with older adolescents who have a television in their bedrooms. Pediatrics 2008;121(4):718-24.  

  15. Tseng M, Giri V, Bruner DW, Giovannucci E. Prevalence and correlates of vitamin D status in African American men. BMC Public Health 2009;9:191.  

  16. Annweiler C, Schott AM, Allali G, Bridenbaugh SA, Kressig RW, Allain P, et al. Association of vitamin D deficiency with cognitive impairment in older women: cross-sectional study. Neurology 2010;74(1):27-32.