Community health resource project: highlighting One Health resources across rural Georgia to build healthier communities

The Call for Health Care Reform and the Pediatric Nursing Shortage

ObjectiveTo provide an up-to-date overview of health assets in a global context both from a theoretical perspective and its practical applications to address health inequalities and achieve sustainable health.DesignA systematic...

The quality and access to healthcare systems depend on community health resources, infrastructure, and funding; however, a significant disparity in these resources persists globally. The effectiveness of national health systems depends on a balanced approach to health spending, access to facilities and a skilled local health workforce. What accounts for country-level differences in those critical community and societal health resources? We proposed and tested a model that leverages political and socioeconomic factors to predict various health resources and services in countries. Data, including community health training, research, and support, universal health coverage, healthcare infrastructure, and per capita health expenditure, were collected and analysed by statistical methods, like bivariate correlations and hierarchical multiple linear regressions from 105 countries. Countries with more grassroots activism, fiscal decentralisation, freedom, and globalisation and less perceived corruption and inequality had more community and societal health resources. In multivariate analyses, stronger community health training and research is associated with the globalisation index, freedom score, government fiscal decentralisation, and income inequality. The strongest predictor of health insurance coverage and hospital beds was the country's population education index, and of nurses and midwives-per-capita and health expenditures-per-capita was GDP-per-capita. These insights could guide policymaking to reduce global health inequalities.

Abstract: Justification: Within the strategy of Healthy Universities, the University of Alicante (UA) sets up a project to identify, spread, and boost health assets. It is necessary to give empirical content to Morgan and Ziglio´s proposal to use the model of assets for public health identified by the university community. Objectives: To explore the feasibility and the challenges of applying health asset mappings in the UA in order to improve health, life quality and well-being in the university community. Experience development: Training of health promoters: • Promotion of health and salutogenic theory. • Movement towards the model and strategy of health assets. Asset-Based Community Development (ABCD) Approach. • Difference between resources and assets. • Observation and dialogue techniques. • Mixed techniques: open space, TICs and mapping. • Professional skills, facilitating environment and support to get results. Methods: Achieve health asset mapping, its setting and students following John McKnight’s approach. Implementation of “what was learnt” in the UA setting: Project planning for the year 2014. Results: Development of health asset map, geolocated at the University of Alicante. The asset map was made dynamic, and connections among assets and university community necessities and participating people were studied. Dissemination using IT.

People’s health assets (HA) mapping process and design dynamization strategies for it are paramount issues for health promotion. These strategies improve the health heritage of individuals and communities as both the salutogenic model of health (SMH) and health assets model (HAM) defend. Connecting and mobilizing HA and strengthens the ‘sense of coherence’ (SOC) are both related to enhancing stress active and effective coping strategies. This study aims to describe the HA present in a population of certified nursing assistant students (n = 921) in Spain and then to explore their relationships with the SOC, the motivation to choose healthcare studies and their academic performance. A great variety of HA were identified and mapped. Findings showed that individuals with greater motivation towards self-care and ‘caring for others’ as internal HA, possessed higher SOC levels and a strong vocation for healthcare work. Differences in HA were identified according to gender, age and employment situation. Consistent connections between the care–relation factor and vocational factor with interpersonal and extrapersonal HA were reported. Evidence and results substantiated the salutogenic and asset-based approach as a proper strategy to strengthen SOC, dynamize their HA map, reinforce the sense of calling and enable Certified Nurse Assistant (CNA) students to buffer against caregiving-related stress and thrive in their profession.

Community refers to the geographical area where every people share the same geographical region, same facilities and same health care facilities. Community health refers to the in total health of the whole community people. Community health nurse are the one who is the part of community health team and played a vital role in the public health care. Who is consider as human resources for health care system. Without human resources providing health care is not possible so sufficient amount of human resources is most important as well as material resources. Health resources includes several things like drug, equipment, diagnostic tool etc. But lower income countries are having the problem of low health budget which is directly effecting the health resources and health facilities. When facilities are less, resources are minimal community health care need will be not fulfilling. It will increase morbidity and mortality ratios in the country. So, Health resources is vital for every health care which should be in a sufficient amount to promote patient condition and prevention of several communicable diseases in the low income countries. Keywords: Community, Community health, Community health nurse, Prevention, Promotion.

The purpose of this study is to estimate the risk of severe COVID-19 among individuals residing in rural, medically underserved counties compared to those living in other counties. Individual-level COVID-19 hospitalization and death data and demographic variables were downloaded from the Centers for Disease Control and Prevention. The 2013 National Center for Health Statistics Urban-Rural Classification Scheme was used to classify urban and rural counties. Health Resources and Services Administration's medically underserved area (MUA) designation was used to identify underserved counties. County-level data were drawn from the 2015-2019 American Community Survey 5-year estimates. Analytic samples included data from Minnesota and Montana in 2020. Urban-rural/MUA joint exposure categories were created: rural/MUA, rural/non-MUA, urban/MUA, urban/non-MUA. Hierarchical logistic regression models estimated associations (odds ratios and 95% confidence intervals (CI)) between rurality, MUA status, joint urban-rural/MUA status, and severe COVID-19, overall and stratified by age and state. Models were adjusted for individual- and county-level demographics. The odds of severe outcomes among those living in rural counties were 13% lower (95%CI: 0.83-0.91) than those in urban counties. The odds of severe outcomes among those living in MUA counties were 24% higher (95%CI: 1.18-1.30) than those in non-MUA counties. For joint exposure analyses, the odds of severe outcomes were highest among those living in urban/MUA counties compared to those in rural/non-MUA counties (adjusted odds ratio: 1.36, 95%CI: 1.27-1.44). In 2020, the risk of severe COVID-19 was more pronounced in urban counties and underserved areas. Results highlight the need for locality-based public health recommendations that account for rural and underserved areas and may inform future pandemic preparedness by identifying counties most in need of resources and education at various stages of the pandemic.

Background: 
 By focusing on a community’s strengths instead of its’ weaknesses, the process of asset mapping provides researchers a new way to assess community health. This process is also a useful tool for assessing health-related needs, disparities, and inequities within the communities. This paper aims to serve as a basic and surface level guide to understanding and planning for creating an asset map.
 Methods: 
 A step-by-step guideline is provided in this paper as an introduction to those interested in creating an asset map using organizational outlines and previous application in research projects.
 Results:
 To help readers better grasp asset maps, a few examples are first provided that show the application of asset maps in health research, community engagement, and community partnerships. This is followed by elaboration of the six steps involved in the creation of an asset map.
 Conclusion:
 This paper introduces researchers to the steps required to create an asset map, with examples from published literature. The intended audience includes students and researchers new to the creation of asset maps.

BackgroundWhile the demand for health services keep escalating at the grass roots or rural areas of China, a substantial portion of healthcare resources remain stagnant in the more developed cities and this has entrenched health inequity in many parts of China. At its conception, China’s Deepen Medical Reform started in 2012 was intended to flush out possible disparities and promote a more equitable and efficient distribution of healthcare resources. Nearly half a decade of this reform, there are uncertainties as to whether the attainment of the objectives of the reform is in sight.MethodsUsing a hybrid of panel data analysis and an augmented data envelopment analysis (DEA), we model human resources, material, finance to determine their technical and scale efficiency to comprehensively evaluate the transverse and longitudinal allocation efficiency of community health resources in Jiangsu Province.ResultsWe observed that the Deepen Medical Reform in China has led to an increase concern to ensure efficient allocation of community health resources by health policy makers in the province. This has led to greater efficiency in health resource allocation in Jiangsu in general but serious regional or municipal disparities still exist. Using the DEA model, we note that the output from the Community Health Centers does not commensurate with the substantial resources (human resources, materials, and financial) invested in them. We further observe that the case is worst in less-developed Northern parts of Jiangsu Province.ConclusionsThe government of Jiangsu Province could improve the efficiency of health resource allocation by improving the community health service system, rationalizing the allocation of health personnel, optimizing the allocation of material resources, and enhancing the level of health of financial resource allocation.

This literature review is a discussion of asset-based approaches to community engagement. Following a literature search, we identified several asset mapping approaches: Asset-Based Community Development (ABCD); Participatory Inquiry into Religious Health Assets, Networks and Agency (PIRHANA); Community Health Assets Mapping for Partnerships (CHAMP); the Sustainable Livelihoods Approach (SLA); Planning for Real® and approaches using Geographic Information Systems (GIS). These approaches are framed by assumptions about ‘assets’, ‘needs’, and ‘community’ and their associated community engagement methods that may be influenced by dynamics related to conflict, competition and language. We conclude that asset mapping approaches derive their value from their capacities to support partnership building, consensus creation, and community agency and control.

Population-based mortality rates are important indicators of overall health status. Mortality rates may reflect underlying disparities in access to health care, quality of care, racial and geographical variations, and other socioeconomic factors associated with health. However, there is limited information on historical trends in mortality rates between older Black and White adults living in urban compared with rural communities. To examine historical trends of mortality rates among White adults compared with Black adults and among rural residents compared with urban residents by comparing sex-specific age-adjusted all-cause mortality rates between older adults of both races who reside in rural and urban counties in the US. In this county-level cross-sectional longitudinal study of US counties from January 1, 1968, to December 31, 2016, mortality data were obtained from the CDC WONDER database of the Centers for Disease Control and Prevention, and socioeconomic characteristics were obtained from the Area Health Resources Files of the US Health Resources and Services Administration. The study population included older adults (≥65 years) of Black and White ancestry living in 3131 rural and urban counties in the US. Using ordinary least squares regression analyses, race- and sex-specific trends in mortality rates with 95% CIs were examined, and trends adjusted by county-level socioeconomic characteristics using year and county fixed-effects were calculated. Data were analyzed from March 24 to May 10, 2020. Three geographic regions were examined: urban counties, rural counties adjacent to an urban county (rural-adjacent counties), and rural counties not adjacent to an urban county (rural-nonadjacent counties). All-cause age-adjusted mortality rates of Black and White adults 65 years and older. For 1968, a total of 3076 counties (19 240 437 adults ≥65 years; 11 100 000 women [57.69%]; 1 484 747 Black individuals [7.74%]) were identified; of those, 1138 counties were urban, 1018 counties were rural adjacent, and 922 counties were rural nonadjacent. For 2016, a total of 3087 counties (46 400 000 adults ≥65 years; 25 800 000 women [55.72%]; 4 447 733 Black individuals [9.60%]) were identified; of those, 1163 counties were urban, 1020 counties were rural adjacent, and 904 counties were rural nonadjacent. Between 1968 and 2016, mortality rates per 100 000 persons decreased from 9063 to 4896 deaths (46%) among White men and from 6175 to 3760 deaths (39%) among White women. During the same period, mortality rates decreased from 8801 to 5477 deaths (38%) among Black men and from 6380 to 3960 deaths (38%) among Black women. However, the racial mortality gap increased among men living in rural counties after 1980. From 1968 to 2016, the mortality rate among White men decreased from 9063 to 4751 deaths (48%) in urban counties, from 9113 to 5338 deaths (41%) in rural-adjacent counties, and from 8971 to 5229 deaths (42%) in rural-nonadjacent counties. The mortality rate among Black men during the same period decreased from 8715 to 5368 deaths (38%) in urban counties, from 8924 to 6458 deaths (28%) in rural-adjacent counties, and from 9500 to 6941 deaths (27%) in rural-nonadjacent counties. Rural and urban socioeconomic differences were associated with mortality rate disparities among both White and Black women. However, rural vs urban disparities in mortality rates among men remained significant, especially among Black men living in rural counties. Notably, the current mortality rate of Black men living in rural areas is similar to that of White men living in urban and rural areas in the mid-1980s. Understanding the intersectional factors associated with health disparities may help to inform public health and clinical interventions.

Refugee communities face numerous health and mental health concerns both during and after resettlement. Health issues, already deteriorated by chronic poverty, malnutrition and poor living conditions, are exacerbated by acculturative challenges, such as cultural and language barriers, stigma, and lack of resources and information. Since such needs in refugee communities affect both individual and collective capacity, it is important to consider policy environment and socioecological contexts for cultural adjustment and community resources for navigating systems, rather than individual health behaviours and communication skills only. To expand our understanding of health promotion capacity and resources, a broad and context-dependent concept will be necessary. Adopting a concept of health capital, this study aims to explore the impact of community-based health workshops, while expanding and redefining the framework in the context of health promotion efforts for the refugee community in resettlement. As part of community-based participatory research, this qualitative study conducted seven focus group discussions (FGDs) with 22 Bhutanese refugees in 2014. Using a hybrid thematic analysis, themes emerged from the FGD data were organised and categorised into health capitals in ecological systems. The participants reported enhanced confidence and capacity for health promotion at individual, family and community levels. Given the interdependent coping and lifestyles of refugee communities, impacts on the participants' interactions and relations with family and community were significant, which emphasises the importance of assessment of interventions beyond an individualistic approach. The findings of this study underscore the vital role of varied forms of health capital in promoting health in the refugee community and connecting members to needed health resources and information. Health capital is an old and yet still new concept with a great potential to broaden our understanding of health resources by elaborating the impacts and interactions in individuals, family and community for health promotion.

Human resources for health in the Americas

In predominately immigrant neighborhoods, the nuances of immigrant life in the ethnic enclave have important, yet underappreciated impact on community health. The complexities of immigrant experiences are essential to unpacking and addressing the impact of acculturative processes on observed racial, ethnic, and class-based health disparities in the United States. These insights because they are largely unexplored are best captured qualitatively through academic-community research partnership. We established the participatory mixed method Little Village participatory community health assessment(CHA) to explore community health in an ethnic enclave. In this paper, we share findings from our qualitative component exploring: how do Residents in a Predominately Immigrant Neighborhood Perceive Community Health Needs and Assets in Little Village. Three major themes emerged: rich, health promoting community assets inherent in the ethnic enclave; cumulative chronic stress impacting the mental health of families and intra-familial strain; and, work and occupation as important but underappreciated community health determinants in an immigrant neighborhood. These nuanced findings enhanced our community health assessment and contributed to the development of two additional tailored CHA methods, a community member-administered Community Health Survey, and an oral history component that provided deeper insight on the community's health needs and assets, and a focus for action on work as a social determinant of health at the community level. Conducting trusted community-driven health assessments that are adaptive and flexible to capture authentic needs and assets are critical, given health consequences of the new anti-immigrant rhetoric and growing socio-political tensions and fear in immigrant neighborhoods in the United States.

BackgroundDental caries is a global public health problem with persistent inequalities. Research with a salutogenic perspective, as in, a focus on health factors, can provide important knowledge to be used in health promotion. The aim was to explore salutogenic resources among dental caries-free young adults living in vulnerable communities in South Africa.MethodsA total of 32 participants (28 females, 4 males, mean age 26.2 years) with no previous caries experience were purposively recruited from two under-resourced townships. The qualitative data from interviews were audio-recorded, transcribed, and analyzed via qualitative content analysis.ResultsThe resulting theme, A salutogenic foundation for oral health: preservation of traditions and use of personal health assets as protection against challenges, comprised two categories: (1) Individual health assets and early intergenerational learning, and (2) Ability to apply learned health strategies. Having individual health assets and tools for coping, early learning experiences by positive family influence, being exposed to healthy traditions during hardships, and the ability to apply learned health strategies were important salutogenic resources. Together, these resources formed a salutogenic foundation for oral health which enabled individuals to develop healthy routines, make healthy choices for oral health, and maintain oral health when encountering challenges and hardships.ConclusionsSalutogenic resources for oral health empowered individuals from vulnerable communities to maintain oral health. This suggests that future health promotion interventions should be considered and directed at multiple levels, targeting individual, family, community, and structural factors to promote sustainable oral health.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12903-025-06941-z.