Center for Health Care Research and Policy, The MetroHealth System, Cleveland, Ohio, USA.
School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
Am J Community Psychol. 2023 Jun;71(3-4):437-452. doi: 10.1002/ajcp.12661. Epub 2023 Mar 22.
Healthcare systems are increasingly investing in approaches to address social determinants of health and health disparities. Such initiatives dovetail with certain approaches to neighborhood development, such as the EcoDistrict standard for community development, that prioritize both ecologically and socially sustainable neighborhoods. However, healthcare system and community development initiatives can be untethered from the preferences and lived realities of residents in the very neighborhoods upon which they focus. Utilizing the go-along approach to collecting qualitative data in situ, we interviewed 19 adults to delineate residents' community health perspectives and priorities. Findings reveal health priorities distinct from clinical outcomes, with residents emphasizing social connectedness, competing intra- and interneighborhood perceptions that potentially thwart social connectedness, and a neighborhood emplacement of agency, dignity, and self-worth. Priorities of healthcare systems and community members alike must be accounted for to optimize efforts that promote health and social well-being by being valid and meaningful to the community of focus.
医疗保健系统越来越多地投资于解决健康和健康差异的社会决定因素的方法。这些举措与某些邻里发展方法相吻合,例如社区发展的生态区标准,该标准优先考虑生态和社会可持续发展的邻里环境。然而,医疗保健系统和社区发展计划可能与他们关注的社区居民的偏好和生活现实脱节。我们利用实地收集定性数据的同行伴随方法,采访了 19 名成年人,以描绘居民的社区健康观点和优先事项。研究结果显示,健康重点与临床结果不同,居民强调社会联系,以及潜在破坏社会联系的邻里内和邻里间的竞争感知,以及邻里机构、尊严和自我价值的定位。医疗保健系统和社区成员的优先事项都必须得到考虑,以通过对关注社区具有有效性和意义来优化促进健康和社会福祉的努力。