Studies show that health disparities are the end result of culturally ingrained health related practices. There exists a need for multisectorial involvement which directs interventions upward from the areas of greatest need. Community coalitions are self organized groups composed of socially active individuals from within the community who possess the power to create community change, particularly as it relates to change in behaviors that contribute to health disparities. The efforts of these rural grass roots coalitions mirror countless efforts worldwide among indigent and third world populations seeking to improve quality of life as well as gaining access to much needed health care services for their community. This study focuses on the work of four rural grass roots coalitions in the Black Belt region of the United States whose purpose is to eliminate health care disparities among their constituents.

This study seeks to determine processes that sustain the efforts of rural grass roots coalitions. The Community Coalition Action Theory (CCAT) was used to identify coalition processes that are most effective in creating competent sustainable community coalitions. The objectives of this study are to (1) discover how rural community coalitions identify, access and mobilize resources to eliminate health disparities in their community; (2) link founding documents, organizational structure and budget with service provision strategies developed by these organizations; (3) determine the scope of approaches aimed at community advancement through interaction with various stakeholders; and (4) examine the outcome evaluation processes, subsequent responses, and their impacts on organizational longevity.

Data collection methods included observation at coalition meetings, survey administration, review of minutes from coalition meetings, internet search, review of coalition documents, interviews with key informants, and researcher experience in the area.

Results show that each coalition is viable, and each provides its constituents with the needed strategies and techniques to reduce or eliminate health disparities in this rural black belt county. Additionally, CCAT is an effective mechanism for identifying coalition characteristics related to potential for success.