San Juan County’s Journey to Promote Health, Well-Being, and Equity
Five years into the Sentinel Communities Surveillance Project, leadership for health and well-being has been distributed across the local health system and some larger local nonprofits, in addition to some economic development organizations.
Stakeholders in San Juan County were working on several initiatives to support well-being of community residents in 2017, focused on positive health behaviors, mental health, and environmental justice, many of which have continued over the past five years. New efforts have been initiated with a focus on addressing issues across sectors such as educational attainment and economic transition. Regarding the health narrative in San Juan County over the past five years, mental health has been solidified as part of a more holistic conceptualization of health, while attempts to reimagine the local economy have also become more connected to health and well-being. Attempts to address health equity in San Juan County have continued to be challenged by ingrained racial and political tensions, though the past five years have seen the issue being addressed by a broader set of partners.
Health Priorities and Narrative
Leadership for health has been distributed across the local health system and some larger local nonprofits.
San Juan County government has become more engaged in mental health, though efforts throughout the county to coordinate with American Indian-serving organizations have not improved.
Most health promotion efforts have been focused on individual health behaviors, with an emphasis on substance use. Initiatives around environmental justice have been ongoing in parts of the county and remain the focus of health-equity-related activity.
Health Priorities and Narrative
The role of mental health has been further solidified in the health narrative and seeking help for mental health issues has become more mainstream.
A reimagining of the economy, from primarily agriculture and extraction-based to include advanced manufacturing and tourism, has inspired future-oriented thinking related to well-being.
Conversations and activity around health equity have emerged in new pockets, though the topic is still largely considered “political” and “uncomfortable” to discuss, if discussed at all.
Lessons Learned: Where is San Juan County Five Years Later?
San Juan County’s journey to promote health, well-being, and equity is one that illustrates the challenge that a lack of resources and cross-sector collaboration can present. Cultural and political divisions have also inhibited the development of shared values around health, well-being, and equity, suppressing civic engagement, and open dialogue. However, a shared commitment to improving access to mental health and the ability of the community to capitalize on its natural assets have been bright spots. Other communities can learn from San Juan County’s approaches to make these changes, as well as the challenges they 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 momentum around health, equity, and well-being influences community health narratives and decisions moving forward.
San Juan County has leveraged its informal networks and connections to culture and environmental assets to begin to establish a new vision for health and well-being in the community. However, its rurality, limited financial resources, and cultural and political tensions continue to stymie efforts.
Federal funding for health and wellness
Informal partnerships and personal connections
Cultural connection to the land
Economic transitions presenting opportunities for a new community vision
Geographic diversity and expansiveness
Cultural and political differences presenting barriers to shared dialogue
Limited philanthropic support
Lack of formal cross-sector collaboratives for health
Economic decline and population loss