There is a nexus of complex social, economic, and political factors that interact to cause ill health among the urban poor.  Because the causes of poor health are complex and varied, so are the identities of those who can help effect change for the better.  These people include but are not limited to health care providers, community residents, political activists, health educators and social service workers.

This paper discusses the postmodern conceptualization of disease, including the causes of disease, the role of subject and object, the cost of the health care industry, and the definition of disease.  This theory involves obtaining an understanding of the complex factors that come together to produce health status, and involving the members of the community in the planning and implementation of strategies to help improve health.

The philosophy of Community-Based Preventative Health Care is congruent with the postmodern conceptualization because it integrates immunization, screening for disease, and other interventions that can be made by health care providers with innovative solutions addressing the inequities in health status associated with poverty, poor housing conditions, inadequate job opportunities, powerlessness, and racism.  This is done by organizing and uniting people who are interested in improving community health.

Community nursing centers, such as the Health Annex at Myers Recreation Center utilize the principles of Community-Based Prevention to involve community residents in the planning, implementation, and evaluation of successful health promotion programs.  These centers were the most successful model of care encountered in this study.