Lay perceptions of health and health needs

The accurate identification of need is imperative to maximise population health gains and target health inequalities. Social capital, expressed in social, psychological, economic and contextual factors, acts as a buffer in communities. The aim of this study was to determine the unexpressed health needs of a population. A needs analysis was undertaken, using Community Participatory Appraisal methodology, to determine the lay perspective in a rural village. Semi-structured face-to-face interviews with 11 adults were conducted followed by a focus group of seven adults. A questionnaire was developed and posted to 350 adults randomly selected within stratified categories from the general practice surgery list. The predominant feature of the interviews and focus group was that the divided nature of the village impinged on social cohesion and the health of the population. Of the questionnaire results 63% reported good health. Other findings were the lower educational achievement and life expectations in the social housing area, and the level of psychological distress among males, particularly in the 18 to 25 age group. Information on health needs can be determined from the lay perspective. To target a population for public health initiatives, it is important to gather data pertinent to the specific community. The study demonstrated that knowledge is held by individuals that can be used to inform direction of travel and more accurate service provision. This paper is the first of two; the first reports the research and the second describes the implementation of some of the results of the study.