Needs Assessment In a Public Housing Community with Health and Aging Concerns

Background and Purpose: Community settings have a significant impact on the health, quality of life, and healthcare use (Kyle & Dunn, 2007). This investigation was based upon the Social Ecology model, which stresses the importance of the context in which the individual exists, how individuals and components of their environment interact; and the effect those interactions have on their health status, behaviors, and quality of life (Bronfenbrenner, 1989). The setting of this study, an urban public housing community of 679 residents (85% African American), disproportionately reflects the needs and concerns associated with both vulnerable and community-based groups. The University of Louisville Schools of Nursing and Social Work formed a multidisciplinary, community participatory partnership to complete a comprehensive assessment of health status and quality of life and perceptions of residents with chronic disabilities, mental health challenges, and aging concerns. The aims of the study were to identify: a) What are the key individual factors identified by residents? b) What are the key interpersonal factors identified by residents? And c) What are the key social factors identified by residents?

Methods: The research was a cross-sectional, descriptive pilot study using quantitative methods. It was approved by the University IRB. Participants volunteered for the study after reading fliers or attending information sessions. Survey methods were used to identify and explore individual, interpersonal, social, and environmental factors affecting quality of life. Demographic data, personal needs (transportation, mental healthcare, physical healthcare, housekeeping, literacy, etc.), health status, and social network information was collected. Descriptive statistics were then used to describe characteristics of the sample and correlations between demographic variables and reported individual factors. Chi square was used for categorical data. Continuous data was analyzed using comparisons between age and gender groups using t-tests. Demographic and needs data were examined for unmet needs using frequencies, percentages, and correlations between demographic characteristics and reported unmet needs. Results: Eighty-six people completed the needs assessment. Key individual factors were the lack of access to appropriate health and mental healthcare. Healthcare providers were systematically unresponsive to needs for eye care, dental care, and specialized medical care. Those who had Medicaid fared better, but there was still a high level of unmet need. Residents reported a lack of healthcare information for chronic illnesses such as diabetes. The lack of activities in the community, along with a frequent lack of social support from family were also main findings of the survey. Residents reported that the intergenerational nature of their community, and the lack of relationship between generations contributed to isolation and security concerns, especially for older residents. Conclusions and Implications: Improved understanding of the interaction of the individual within the social environment or community setting is essential to improving the health status and quality of life for those with health and aging concerns. Practitioners should have more knowledge of needs that are not being met in order to prioritize services and develop evidence-based interventions.