Health Equity in Community Assessments: A Participatory Approach in Rural Virginia

A coalition of community members and human service professionals in the rural central Shenandoah Valley of Virginia has performed a community assessment every 5 years. Overreliance on quantitative surveys and hospital-based Community Health Needs Assessments resulted in earlier assessments failing to identify the needs of vulnerable populations. As the coalition approached the time for a new assessment, their priority was to develop a deeper understanding of community health needs and solutions. An extended co-learning process between coalition, community, and local academic representatives resulted in a plan to develop assessment methods and community health improvement resources suited to this goal. The coalition identified methods rooted in the social determinants of health and utilized a community-based participatory research approach to provide underserved residents the opportunity to contribute to health research and decision making and produce an assessment more reflective of their community. Resources including local interpretation and implications of the World Health Organization’s 10 Social Determinants of Health, a Healthy People 2020 community health services profile, and user-friendly access to community-based secondary data sets were developed for intervention planning. All information, resources, and implications were shared at meetings, in public announcements, and at a public forum. All data remain publicly available on the coalition’s website. Previously held beliefs regarding access to care and quality of life were substantiated through this process, enabling the coalition to better align itself with local political entities and to move forward immediately with community health improvement planning.