A public health approach to health needs assessment at the interface of primary care and community development: findings from an action research study

Abstract

This paper describes how a health needs assessment of a specified community was conducted using action research. The study involved local people and a multiagency steering group, within a primary health care setting. Community development approaches were applied because of the potential it has to address some of the fundamental issues that lead to poor health. A multimethod approach was used to gather data using quantitative and qualitative approaches. Six focus groups, with varying sections of the community, were used to elicit community perceptions of their health needs. Data triangulation was used in order to identify differences and similarities in each of the methods. The outcomes identified disparities in health needs between the areas assesseddue to differences in socio-economic variances. One area experienced a greater level of deprivation using the Jarman index. The most common forms of ill health in the community were heart disease, cerebrovascular disease, asthma and diabetes. The assessment identified a need for more health promotional work to be carried out by health care professionals, i.e., annual health checks. A number of outcomes confirmed the existence of well-known difficulties in accessing health care, such as difficulties with physical distance to secondary care services, as well as the length of the waiting time at the outpatient departments. It was also apparent that there was a poor understanding of primary health care services and the role and function of the varying health care professionals, particularly amongst the ethnic minority population. The assessment highlighted a number of issues, including obvious benefits, which may accrue from this process for primary care groups and primary care trusts in identifying the health needs of their local populations and subsequent development of the health improvement programmes with the health authority. The discussion raises issues concerning the impact that these changes have on collaboration between varying professional groups and users of services in the planning and delivery of services in order to reduce inequality in health.