Monona County’s Journey to Promote Health, Well-Being, and Equity
Monona County’s efforts have shifted with the consolidation of public health services under the authority of the local health system and transitions within local coalitions.
Regional and state organizations also provide important capacity to promote health and well-being, as do a small set of social service agencies and nonprofits. Burgess Health coordinates most of the efforts around health and well-being in the community, though local nonprofits and social services agencies also help to support healthy housing and food access, and some organizations have begun to address mental health more concertedly. Some progress has been made on walkability, and there are initiatives spearheaded by individual residents with personal interests in particular sectors, such as child care, health education, and mutual aid. For years, health has been viewed as an individual responsibility by many in Monona County, though there is a growing focus on mental health issues and access to food and recreation opportunities. Given the racially homogeneous population in Monona County, racial equity has traditionally not been a part of the conversation, although there has been somewhat more acknowledgement of income, age, and disabilities as determinants of access to resources for health over the past five years.
Baseline research started in 2016 to track community programs and initiatives. The most recent report, from 2022, provides more in-depth insights and analysis into the community's efforts to build a Culture of Health.
Health Priorities and Narrative
Burgess Health is the primary healthcare system in the county and provides public health services, while a small set of other organizations also provide healthcare services. State and regional organizations provide resources and programming via offices in Monona County and nearby counties.
The pandemic elevated food access and mental health in the community consciousness.
Health Priorities and Narrative
The perception that good health is an individual responsibility is still widespread in Monona County, and many respondents explained that residents define good health in healthcare-oriented ways.
While health equity is still not a term discussed broadly in the community, federal equity requirements, economic development goals, and concerns about transportation and mobility have sparked some discussion among stakeholders.
Lessons Learned: Where is Monona County Five Years Later?
Many of the well-being and equity priorities in Monona County—including substance use, chronic disease, and poverty—are deeply entrenched in the county. Public health leaders have been working over the past five years to establish a strategic direction within the healthcare system to address these health priorities.
The community will likely continue to be challenged by a prevailing mindset that individuals are responsible for their own health and by a hands-off, risk-averse approach on the part of local government officials.
Economic development goals that are taking root in downtown revitalization efforts and projects to improve walkability may have spill-over effects for residents with low incomes, though improving equity is not at the heart of these efforts.
Other communities can learn from Monona County’s efforts, as well as the challenges encountered, to inform their own journeys. And, as COVID-19 recovery continues, with historic funding flowing to local communities, future research could consider the ways in which momentum around health, equity, and well-being influences community health narratives and decisions moving forward.
In its efforts to improve health and well-being, Monona County has leveraged personal connections between residents and leaders in this very rural community. External resources have supplemented a lack of local funding and organizational capacity. Yet, barriers remain in the rural, aging community, particularly since leadership for public health has transitioned and local leaders face disengagement and mistrust from community residents.
Community-oriented, pitch-in culture
State and regional capacity to support local partners
Funding requirements encouraging coalition-building
Data made available by state and national partners
Dissolution of Monona County Public Health
Extreme rurality: Transportation, food access, health care providers
“Risk averse” elected officials
Denial about community challenges