Oxford County’s Journey to Promote Health, Well-Being, and Equity
Five years into the Sentinel Communities Surveillance Project, Oxford County still faces notable shortages in its capacity to address health and well-being.
However, a core group of dedicated individuals continue to promote public health, wellness, and apply a social determinants of health framework on a broad scale with the help of external funding. Over the past five years, the community has focused on implementing new initiatives that address high-priority areas, including substance abuse, ACEs, and mental health. With deeply entrenched rural poverty, social isolation, and a loss of employment opportunities compelled Oxford County to tackle structural barriers to health and well-being. It started to use a social determinants of health lens to address the root causes of poor health outcomes—both mental and physical. Oxford County’s attempts to address health equity over the past five years have largely remained stagnant, but there are signs of broader conversations around equity that are laying the groundwork for potential systems change beyond not only economic and education equity, but health equity as well.
Health Priorities and Narrative
Long-standing organizations committed to improving community health continue to be influential in driving health priorities.
Key initiatives that aim to advance health and well-being, established prior to 2017, have evolved and are demonstrating impact on the lives of community members.
Community members have established initiatives in other areas that influence well-being, including a local integrated food system, provision of affordable housing, and support for healthy aging.
Health Priorities and Narrative
Mental health and substance abuse remain top areas of focus, and five years later there is deeper work to address root causes of these issues.
The community is working to be more inclusive and ensure that the experiences of all community members are heard, particularly those from different socioeconomic backgrounds.
An emphasis on economic equity remains five years later.
Data capacity and assessments around health are growing in the county, with some focus on equity and root causes of health inequities.
Lessons Learned: Where is Oxford County Five Years Later?
While conversations around health equity are largely still taking place within the health sector, there is an opening to that dialogue that has evolved over the past five years. Views have changed from thinking about whether individuals have access to health insurance or are managing their chronic conditions only, and there is a stronger emphasis on social determinants of health and root causes more broadly.
Health leaders in the community have been considering collaboration differently as well, such as increasing efforts to incorporate community voice in health decision-making.
Oxford County recognizes the importance that health actions extend beyond the few individuals currently involved. The county is bringing non-health organizations to the table, but it will be important to understand the organizations’ motivations so as to sustain long-term momentum.
Other communities facing similar challenges as Oxford County with respect to an individualistic mindset, stigma around seeking support, and considerable concerns about economic inequity will benefit from reviewing how Oxford County is actively addressing those issues and working to expand the discussion of health and well-being.
Oxford County is supported by a committed group of individuals working to tackle the community’s long-term health issues and build its growing capacity for health data, but it also faces staffing shortages and burnout from individuals who have been working to influence health over the years.
A small number of committed community members have built strong connections across health-focused organizations
Significant strides have been made in the development of health data capacity
Young people have become more engaged in community-centered work
The socioeconomic composition of the community is highly stratified
Stigma around asking for help and a mindset of self-sufficiency impedes the community’s ability to help those in need
Having a small group of people focused on health can lead to burnout and staff shortages