UNDERSTANDING THE SOCIAL DETERMINANTS OF HEALTH IN UNDERSERVED COMMUNITIES: A COMMUNITY NEEDS ANALYSIS

Allison Karpyn, Ph.D.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.Biological Science