UNDERSTANDING THE SOCIAL DETERMINANTS OF HEALTH IN UNDERSERVED COMMUNITIES: A COMMUNITY NEEDS ANALYSIS
Date
2017-05
Authors
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Publisher
University of Delaware
Abstract
There is growing recognition of the critical importance of the impact of social
determinants of health – conditions that impact health status and outcomes – on
individual and community health outcomes. Yet, despite efforts to address these
issues, Delawareans living in underserved communities continue to experience poor
health outcomes. The Healthy Neighborhoods project, a partnership between
Westside Family Healthcare and the Delaware Center for Health Innovation, provides
a formal approach for organizations to collaborate in order to develop and implement
strategies that improve community health. The current project serves as a community
needs assessment for the Wilmington/Claymont neighborhood, to identify the
strengths and resources available for the residents. The target population is residents
of zip codes 19801, 19802, 19804, 19805, and 19703. Guided by the PRECEDEPROCEED model, this community needs assessment addresses the social
determinants of health by making zip-code level comparisons and considering
community perspectives. It will help communities highlight their community health
targets as well as determine the behavioral and environmental barriers that are
hindering meeting these targets.
Four distinct approaches were undertaken for this assessment. First, a
Resource Library was developed that identified all available community health
promotion activities, which were divided into several themes. Second and third,
corner store and walkability assessments were also conducted in the city of
Wilmington. Finally, a Community Profile Assessment was implemented to
understand how health promotion programs are utilized and determine the unmet need
from the community perspective. Some methodological components were included
based on the Delaware Center for Health Innovation’s framework, while I also
expanded the measures to create a more comprehensive and multi-faceted approach.
The Resource Library and Community Profile assessment both revealed that zip codes
19801 and 19805 have the worst health outcomes due to other factors such as income
and insurance, even though they are highly programmed. Corner stores in Wilmington
carry little produce, and many do not accept government-supported food assistance
programs. The walkability assessment indicated that, overall, areas in Wilmington are
walkable but still face certain physical barriers.
However, this study is not without limitations. A small convenience sample
was used, which may limit the generalizability of the findings. Additionally, while
multiple methods to understand community programs were employed, the sheer
number of programs limited my ability to fully vet each. Lastly, the Healthy
Neighborhoods project is still in its pilot phase, and thus is somewhat limited.
Regardless, the project provides a foundation for the future of the Healthy
Neighborhoods project and informs similar community health efforts, which can also
be used to make comparisons. Ultimately, understanding the social determinants of
health and social milieu from a unique community-based perspective will aid in
developing health promotion programs that will successfully meet the goals of this
initiative.
Description
Keywords
Biological Sciences, social determinants of health, undeserved communities