Perceptions of health among Black adults living in a diverse urban community

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The Robert Wood Johnson Foundation's culture of health initiative advocates for making health a shared value. Health cannot be a shared value without an understanding of how health is defined and perceived. The purpose of this qualitative descriptive study was to examine community members’ perceptions of health and influencing factors, including health care services.

Design and Sample:

Data were collected through a purposive sample of nine focus groups with 52 participants who were primarily Black (94%) and female (65%). The mean age was 50 years. The average education was 14 years. Data were analyzed using inductive content analysis.


Four themes were developed: health is resilience to deal with life's challenges describes health as necessary to deal with daily challenges; external perceptions affect community identity represents perceptions that other metropolitan counties are flourishing while this county remains depressed, negatively impacting individual and community identity; structural barriers negatively impact health describes a lack of adequate resources to achieve or maintain health, as defined by the participants; and mistrust influences health-seeking behaviors reflects perceptions of differential treatment.


This study provides unique information to nurses and other health care providers about urban-residing community members’ perceptions of health and health care services. Providing a voice to residents regarding personal, family, and community health is imperative in making health a shared value to achieve the goals of population health, well-being, and equity.

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