Dr. Jeri Bigbee
Purpose: The purpose of this study was to compare rural health care providers and consumers related to perceived community health assets and deficits.
Background: Historically, studies of population health have focused primarily on deficits, identifying needs and problems of the health delivery system. Recent research has also focused on identifying community health assets, including resources for joint problem solving and health promotion. Limited research, particularly from the assets perspective, has addressed rural areas and few studies have compared provider verses consumer perceptions of community assets and deficits.
Method: A descriptive comparative design was used. A convenience sample of 123 residents, including 17 providers and 106 consumers, in three rural Idaho communities were interviewed regarding community assets and deficits related to health. Responses were classified using the Typology of Community Assets for Health Promotion (Stokols, Grzywacz, McMahan, & Phillips, 2003) which includes material resources (economic, natural, human-made environmental, and technological capital) and human resources (social, moral, and human capital). Frequency of responses by category were compared between consumers and providers.
Results: In relation to community assets, the most frequent response category among providers was human capital (33.3%), specifically quality of healthcare professionals. Consumers cited the human-made environmental (25.3%) and social capital (25.3%) categories most frequently, especially hospitals and community support of healthy lifestyles. In relation to deficits, providers named the human-made environmental capital category (26.8%) most often, particularly citing the large geographical areas served by remote hospitals. The most frequent deficit category among consumers was human capital (25.6%), especially inadequate primary care and specialist providers. The only statistically significant difference between providers and consumers was in relation to the natural capital category as an asset (cited by 2.4% of providers vs. 22.4% of consumers, p = 0.004).
Implications: The results suggest that rural health care providers and consumers differ in their perceptions of community health assets and deficits. Thus, in assessing the health assets and deficits of rural communities, input from both providers and consumers is essential. This study was limited in that it included a relatively small convenience sample from only three rural communities in one state. Further research using larger samples is indicated to direct rural community nursing interventions that build on community assets.
This project was supported by the Jody DeMeyer Endowment at Boise State University.