Other side of the tracks: Understanding the historical, social and environmental context of health in an African American community in eastern North Carolina

Background/Purpose: Social stratification by race and class has played a significant role in shaping the economic and social context of many communities across the U.S. For example, an African American community in rural eastern North Carolina has experienced economic and social disparities as a result of living on the other side of the town's railroad tracks. The purpose of this study is to assess the impact of historical, social and environmental influences as it relates to the strengths and challenges of this community. Methods: An Action-Oriented Community Diagnosis (AOCD) was conducted in collaboration with an African American community in rural eastern North Carolina. AOCD is a Community-Based Participatory Research technique that allows researchers to identify the strengths, challenges, needs, and opportunities of a community from the perspective of community members themselves. Primary data were collected from interviews, focus groups, and field notes. Qualitative data were analyzed from the transcripts using codes that were developed from themes identified a priori by the study team, and modified in an inductive fashion to reflect themes that emerged from the data. Results/Implications: A preliminary analysis of qualitative data revealed five prominent themes: housing, employment, transportation, education, and community support and mobilization. Qualitative data suggested that much of the community's challenges are largely shaped by the town's historical, social and economic influences. Upon completion of the AOCD, future CBPR processes should include identification of important and changeable issues, and a community forum to guide and empower community members to identify, mobilize and achieve action steps.