Communities are powerful and necessary agents for defining and pursuing their health, butoutside organizations often adopt community health promotion approaches that are patronizing and top-down. Conversely, bottom-up approaches that build on and mobilize community health assets are oftencritiqued for tasking the most vulnerable and marginalized communities to use their own limited resourceswithout real opportunities for change. Taking into consideration these community health promotionshortcomings, this article asks how communities may be most effectively and appropriately supported inpursuing their health. This article reviews how community health is understood, moving from negative topositive conceptualizations; how it is determined, moving from a risk-factor orientation to socialdetermination; and how it is promoted, moving from top-down to bottom-up approaches. Building onthese understandings, we offer the concept of ‘resourcefulness’ as an approach to strengthen positivehealth for communities, and we discuss how it engages with three interrelated tensions in communityhealth promotion: resources and sustainability, interdependence and autonomy, and community diversityand inclusion. We make practical suggestions for outside organizations to apply resourcefulness as aprocess-based, place-based, and relational approach to community health promotion, arguing thatresourcefulness can forge new pathways to sustainable and self-sustaining community positive health.
