By 2006, membership has grown to more than one million in North America, with some 20 million adherents worldwide. Most Adventist members live in small towns and rural areas despite the fact that in the 1880s through 1905, the Church operate a network of city missions. Dr. John Harvey Kellogg, dean of a medical school sponsored by the Church in Battle Creek, Michigan, worked closely with Jane Addams and the settlement house movement in Chicago during this time, operating free clinics, homeless shelters and nutrition programs staffed by medical students and nursing students from the American Medical Missionary College. After 1906, when Kellogg split with the Church, the medical college was re-established in southern California and became what is today Loma Linda University.
The majority of Adventist Church members in urban congregations today are ethnic minorities. A large percentage are African Americans, with other significant portions among immigrants from the Caribbean and Latin America, Korea and the Philippines. Adventist Community Services, the faith-based charity sponsored by the Church, has an Inner City Program that funds community action projects in urban communities. A number of urban ministry organizations have been started by Adventists in the last decade: Adventist Metro Ministries in New York City, Adventist Community Development Services in Newark (NJ), Adventist Humanitarian Resource Center in Philadelphia, Adventist Community Services of Baltimore, Adventist Community Services of Greater Washington, Adventist Community Services of Greater Pittsburgh, etc. The Center for Metropolitan Ministry at Columbia Union College in Takoma Park, Maryland, serves as a research, training and resource center for Adventist and other Christian urban ministries.