Building Community Trust: A Rural Health Department's Journey Toward Health Equity

Rural health departments face unique challenges in advancing health equity, particularly during times of political polarization. These challenges intensified during the COVID-19 pandemic, highlighting the complex interplay between public health authorities, political dynamics, and community trust.

To document how a rural local county health department (LCHD) navigated political barriers and systemic inequities to conduct a community health assessment (CHA) during and after the COVID pandemic.

This CHA, conducted during 2021-2023, employed mixed methods data collection strategies: a bilingual community survey, listening sessions in English and Spanish, and informal interviews. Utilizing a health equity lens, the analysis focused on identifying power dynamics, systemic barriers, and community perspectives on health.

Survey data revealed differences between Hispanic and non-Hispanic respondents' health concerns and perceived barriers. Healthcare access was the only statistically significant barrier for Hispanic respondents. Lessons learned from the CHA process are provided.

The strategies employed during the CHA demonstrate how rural health departments can advance health equity while navigating complex political landscapes. Success requires careful attention to language, strategic coalition building, and persistent focus on elevating marginalized voices. The LCHD built community trust despite political resistance by modifying language around equity issues and strategic coalitions.