Health of the Public Project at University of Iowa Conducts Rural Health Care Assessment

From 1993 to 1997, the University of Iowa, Iowa City, established a community-university partnership in rural health care and prevention that used qualitative and quantitative methods (called population-based methods) to assess the health of the population in three counties and helped those counties use the assessments to set goals and address local needs.

The project was part of the Robert Wood Johnson Foundation's (RWJF) national program Health of the Public: An Academic Challenge.

A project team of 14 faculty from the colleges of nursing, pharmacy, dentistry, medicine, and liberal arts oversaw the project, choosing North Iowa Mercy Health Center, which had a 14-county rural health network, as its community partner.

A project subcontract enabled North Iowa Mercy Health Center's Planning and Research Department to hire a community health planner to work with Health of the Public investigators and serve as the facilitator for rural communities. The University of Iowa received a variety of grants from federal, state, and private sources for dissemination, software, and project-related initiatives.

Key Results

  • North Iowa Mercy Health Center and the project team carried out an assessment of the health of the population (also called a community health assessment) in Franklin, Palo Alto, and Howard counties, Iowa.

    Results of each survey were presented to advisory councils set up by the project in each county, and subsequently to a town meeting in each county for discussion and prioritization of primary care and prevention goals. The project reported local response to the assessment in two counties:
    • Franklin County:
      • Developed a mission statement and specific project goals based on the assessment findings.
      • Secured a grant from the Iowa Department of Public Health to hire a care coordinator to assist primary care providers caring for the elderly and chronically ill.
      • Developed a series of parenting and babysitting classes in several school districts.
      • Expanded an existing substance abuse prevention program throughout the county.
    • Palo Alto County:
      • Developed a mission statement and specific project goals based on the assessment findings.
      • Secured grants for a breast and cervical cancer detection program and a health promotion program for tobacco use prevention and education.
      • Converted an older hospital ambulance into a volunteer-driven, wheelchair-accessible van to help meet transportation needs.
      • Surveyed schools regarding drug and alcohol use.
  • In a follow-up evaluation by the Health of the Public project, both counties credited Health of the Public with providing key health data that supported grant applications and with improving communication and collaboration among community groups.
  • The Health of the Public project developed several new databases and published The Iowa Health Fact Book, covering secondary health outcome and health provider data by county.
  • Health of the Public faculty tracked the development of community health courses and modules and also provided consultation to academic health center administrators. This included the development of a rural health policy report Provision of Comprehensive Health Care to Rural Iowans in the 21st Century, which included a descriptive epidemiological assessment of rural health outcomes.

The Iowa Department of Public Health provided funding for dissemination of The Iowa Health Fact Book and Provision of Comprehensive Health Care to Rural Iowans in the 21st Century.

One investigator, James E. Rohrer, PhD, wrote Planning for Community-Oriented Health Systems, a text based on the community-oriented primary care model, incorporating elements and examples from the Health of the Public project. The community assessment process was also presented at national meetings.