Unit 4 - Learning Journal
Community disadvantage is not a singular phenomenon but rather a complex interplay of
socioeconomic, environmental, and structural factors that restrict access to health programs and
diminish overall well-being (Lawlor et al., 2020). This unit highlights that access to community
health programs is shaped not only by individual behaviors but by broader social systems,
readiness levels, and planning capacity. This essay explores the critical factors contributing to
socially disadvantaged societies and suggests evidence-based solutions to overcome these
systemic barriers.
[Link]-economic gradient & resource limitations
○ Problem: Lower socio-economic status restricts access to food, housing,
healthcare, and education; survival needs override preventive health behaviors
(Lawlor et al., 2020).
○ Solution: Strengthen economic and social supports through income-generating
programs, food security initiatives, and social protection policies to address root
causes (Lawlor et al., 2020).
[Link] literacy and knowledge gaps
○ Problem: Limited awareness of disease prevention strategies (e.g., hygiene
practices in Mali), plus cultural and linguistic barriers in populations such as
Hispanic/Mexican communities in the U.S. (Borresen et al., 2016; Rangel Gómez
et al., 2019).
○ Solution: Enhance health literacy with culturally responsive education,
participatory approaches, and tailored messaging to local contexts (Lawlor et al.,
2020).
[Link] and engagement barriers
○ Problem: Social exclusion and lack of trust in institutions reduce participation in
health programs (Rangel Gómez et al., 2019).
○ Solution: Integrate Community Health Workers (CHWs) to provide cultural
mediation, social support, and health coaching, ensuring sustainability by offering
fair wages (Gorski et al., 2016; Hartzler et al., 2018).
[Link] institutional and leadership structures
○ Problem: Lack of coordinated governance, fragmented service delivery, and
weak leadership hinder resource mobilization and continuity of care (Lawlor et
al., 2020).
○ Solution: Build institutional capacity and cross-sector partnerships, developing
both core (data analytics, care coordination) and adjacent capabilities
(community partnerships, leadership development) (Durovich & Roberts, 2018;
Gorski et al., 2016).
[Link] community engagement
○ Problem: Top-down approaches fail to reflect community priorities, limiting
effectiveness (Sujane Kandasamy, 2020).
○ Solution: Use Collaborative Community Health Assessments (CHAs) and MAPP
models to engage communities, ensuring interventions align with actual needs
(Clayton et al., 2020; U.S. Centers for Disease Control and Prevention, 2024).
1
[Link] and environmental determinants
○ Problem: Unsafe water, poor sanitation, overcrowding, geographic isolation, and
poorly designed built environments increase disease vulnerability (Ottawa Public
Health - Santé publique Ottawa, 2018; Owsley et al., 2020).
○ Solution: Reform built environments using human-centered design to create
communities that are complete, convivial, connected, and compact, encouraging
healthier lifestyles.
[Link] readiness challenges
○ Problem: Weak leadership, low resources, and limited knowledge prevent
effective responses; low trust and civic participation impede uptake (Sujane
Kandasamy, 2020).
○ Solution: Align interventions with community readiness levels using CRM-guided
strategies, starting with awareness-building and progressing toward structured
program implementation for sustainability (Borresen et al., 2016).
Social disadvantage is a product of systemic failures in the built environment, resource
distribution, and cultural inclusivity (Lawlor et al., 2020). Overcoming these challenges requires
comprehensive planning, readiness assessment, leadership engagement, and multi-sector
collaboration (Borresen et al., 2016; Rangel Gómez et al., 2019). By integrating evidence-based
frameworks such as the Community Readiness Model and population health planning cycles,
health systems can shift from reactive service provision to proactive community empowerment
(Borresen et al., 2016).
Word Count 524:
Reference
Borresen, E., Stone, C., Boré, A., Cissoko, A., Maiga, A., Koita, O., & Ryan, E. (2016).
Assessing Community Readiness to Reduce Childhood Diarrheal Disease and Improve
Food Security in Dioro, Mali. International Journal of Environmental Research and
Public Health, 13(6), 571. [Link]
Clayton, A., Verma, P., & Pegna, S. W. (2020). MAPP Evolution Blueprint Executive
Summary. [Link]
Durovich, C. J., & Roberts, P. W. (2018). Designing a Community-Based Population
Health Model. Population Health Management, 21(1), 13–19.
[Link]
Gorski, I., Bram, J. T., Canagarajah, P., Suffian, S., & Mehta, K. (2016). How to Set Up a
Community Health Venture: Lessons from 10 Years in Kenya. International Journal for
2
Service Learning in Engineering, Humanitarian Engineering and Social
Entrepreneurship, 11(2), 72–86. [Link]
Hartzler, A. L., Tuzzio, L., Hsu, C., & Wagner, E. H. (2018). Roles and Functions of
Community Health Workers in Primary Care. The Annals of Family Medicine, 16(3),
240–245. [Link]
Lawlor, E. R., Cupples, M. E., Donnelly, M., & Tully, M. A. (2020). Implementing
community-based health promotion in socio-economically disadvantaged areas: A
qualitative study. Journal of Public Health, 42(4), 839–847.
[Link]
Ottawa Public Health - Santé publique Ottawa. (2018, March 20). My Community, My
Health (1 of 2)—YouTube. YouTube. [Link]
Owsley, K. M., Hamer, M. K., & Mays, G. P. (2020). The Growing Divide in the
Composition of Public Health Delivery Systems in US Rural and Urban Communities,
2014–2018. American Journal of Public Health, 110(S2), S204–S210.
[Link]
Rangel Gómez, M. G., López Jaramillo, A. M., Svarch, A., Tonda, J., Lara, J., Anderson,
E. J., & Rosales, C. (2019). Together for Health: An Initiative to Access Health Services
for the Hispanic/Mexican Population Living in the United States. Frontiers in Public
Health, 7, 273. [Link]
Sujane Kandasamy. (2020, September 15). START-WATCH Community Readiness
Model Survey (Intro) [Video recording]. [Link]
v=_FiRrOgAwQU
U.S. Centers for Disease Control and Prevention. (2024, May 16). Community Planning
for Health Assessment: CHA & CHIP | Public Health Gateway | CDC.
[Link]
[Link]
