The streams of idealism of the title of this work refer to a set of activities of community people and college students over the past decade directed toward achieving social change at the community level. Most of these efforts were attempts to improve health conditions in parts of Appalachia, Nashville, and West Tennessee, and were associated with projects of the Vanderbilt University Center for Health Services. Because health has been defined within the center as the promotion of wellbeing, not merely the absence of disease, some projects have addressed other social issues such as the need for legal counsel, better markets for small farmers, and landownership and land use. In addition to dealing with an array of issues, there has been a determined effort to address the interrelationship of these issues with health and health care. The primary concern of this book is not with the issues that the projects addressed, however important, but with the projects' function, which was to combine service-learning for students with community mobilization around various issues. We probe the role and importance of service-learning in the preparation of people for professional careers and in the pursuit of liberal arts education. We also probe the community efforts, in order to examine the premises and limits of the much-heralded American belief in the value of private effort for public improvement.