Social factors that contribute to health disparities in a suburban community: A health needs assessment

Background: Nassau County, a suburban county located on Long Island, represents a dichotomy, as its residents represent the extremes on the spectrum of health. Health disparities exist within and between communities of varying socioeconomic composition, the causes of which are numerous and complex. As part of the Nassau County Department of Health’s Community Health Assessment and the Hospitals’ Community Health Needs Assessment, there was a collaborative effort to  identify the health needs of the community, as well as factors that affect health and well-being.

Methods: Key-informant interviews were conducted with 17 community based organization leaders, representing a broad spectrum of the community regarding determinants of health. Qualitative data analysis was conducted to identify emergent themes in responses.

Results: Participants overwhelmingly reported chronic disease as a primary concern, specifically obesity-related diseases, among minority populations in particular. Limited access to safe spaces hinder exercise and active-living. Participants reported a need for more preventive measures such as nutrition education and outreach in lower socioeconomic status and minority populations. Environmental justice issues, such as water quality, the built environment, and outdoor air quality, were also prevalent in low SES communities. Furthermore, limited public transportation prevents people without cars from accessing needed care.

Discussion: Both the built environment and culture of Nassau County have direct and indirect effects on the health of its inhabitants. Factors such as limited public transportation, language and cultural barriers, and a deficiency of preventive services must be addressed in order to improve the health and well-being of the population.