Conducting a community health needs assessment in a rural Arizona town with an extremely diverse population has been, unsurprisingly, a challenge. It has also been an incredible experience and one in which I have learned about not only health issues but also the process of doing fieldwork and the importance of adapting to circumstances. Living in Winslow, Arizona, observing the place and the people in it, finding respondents willing to discuss health care, and conducting interviews have all had their challenges. They have been both academically and personally difficult and have pushed me to see different points of view, to communicate more effectively, to understand people in circumstances very unlike my own, and occasionally to accept things that are out of my control. After listening to professors lecture about how messy work in the field can be, I feel like I finally have an understanding of what that means.
After ten weeks of data collection, the picture that I have of health care in Winslow is a complex and multifaceted one. There are huge challenges faced by a rural hospital in administering quality care. The community lacks resources to support health beyond the hospital. The service population is spread out. Many of the people in it are of low socioeconomic status and have difficulty affording care or even finding the necessary transportation to make a hospital visit. The population is highly diverse with many cultural aspects that affect how care can and should be administered. It is difficult to find health care professionals willing to live and work in such a remote place. This is not an exhaustive list, but one that I hope demonstrates the hardships faced by both the community and the hospital.
This bigger picture of the difficulties of providing and receiving care is made up of individual stories that took great effort to collect. Obviously it is important to draw conclusions based on the interview data. Hopefully these conclusions can then be useful to the hospital and community in making goals and allocating resources. But I also think it is important to remember that there are individuals behind these generalizations. I spoke to people who had lost limbs due to complications of diabetes. I spoke to people who had lost loved ones, sometimes to highly preventable conditions. Individuals had a great impact on me in the course of this project, and I left Winslow with the very acute sense that I was leaving behind people who still have to deal with extremely serious health and health care issues everyday. My study may be over, but the hardships of an underserved community and an overworked hospital are not. This perspective is one of the most significant things I took away from this experience. I am very grateful to be back home where the places are familiar, where the people are known to me, and where I know what to expect. After my experiences over the summer, however, things don’t look precisely the same because, at the risk of sounding very cliche, I’m different than I was when I left.