Differences in the health of rural residents compared to their urban neighbors are startling. In Washington, for instance, rural residents are one-third more likely to die from intentional self-harm or 13 percent more likely to die from heart disease.

However, while statistics like these help guide public health policy and spending, they can hide even greater health disparities within those rural communities, said , director of the 91���� School of Public Health’s and a professor in the .

“Populations in rural areas already have suffered disproportionately from a lot of negative health outcomes,” she said. “Then on top of that, they lack the data, capacity and infrastructure to understand and better address those problems.”

Yet, some of the data rural public health officials need to better serve their communities exists but is hard to access and use. So, what gives?

To find out, Bekemeier and her colleagues at the Northwest Center embarked on the : a five-year effort to identify, gather and visualize data in four Northwest states to help rural communities more effectively address health disparities and achieve health equity.

“Rural communities in Washington, Oregon, Idaho and Alaska face high poverty and are home to large populations of Alaska Native, Native American, Latino and other residents who are often marginalized and impacted by health disparities,” explains the SHARE-NW .

The SHARE-NW project is currently in its third year. The results of the group’s in a of the Journal of the American Medical Informatics Association.

The 91���� researchers conducted phone interviews in 2018 with officials in the four Northwest states, including staff from the Alaska Native Tribal Health Consortium, the Panhandle Health District in Idaho, the Crook County Health Department in Oregon, the Wahkiakum County Health Department in Washington and 21 other rural health organizations.

“In our study with rural public health system leaders, we identified barriers to using data, such as 1) lack of easy access to timely data, 2) data quality issues specific to rural and tribal communities, and 3) the inability for rural leaders to use those data,” .

“You may have a very seemingly homogenous population on the face of it,” said Bekemeier, the study’s lead author. “But you have small population groups that are very disproportionately impacted by certain issues, and leaders in those communities may not be aware that these problems exist, let alone how deeply individuals are affected.”

For instance, one agency told the researchers: “What immediately comes to mind is our migrant farmworker community, especially with their language barriers and their temporary status in our community … It’s really hard to get the data to know who we’re looking at …”

To address this problem, SHARE-NW is building a readily accessible database and the related visualizations so local health officials can more easily talk about the makeup of their communities, identify local needs and foster data-supported decisions.

“If you have data, you can talk about what the issues are that need to be prioritized,” Bekemeier explained. “Now, we’re focusing on community-specific data for six priority areas that were common across their community health assessments.”

Those areas are: obesity, including physical activity and nutrition/food access; diabetes; tobacco; mental health, including suicide and substance abuse; violence and injury; and oral health, including access to dental care.

“We’re doing this with them,” she said of the rural health leaders. One of the key elements for creating this robust data and tool set is local participation in not only using the data, but also adding to it from their own local research.

Bekemeier added that the work done at SHARE-NW is also tied into 91����’s , a university-wide effort to solve some of the most difficult problems facing communities around the world.

“SHARE-NW is all about building community capacity and bringing information to where it is so deeply needed so that data-driven and community-engaged decisions can be made that will directly affect population-level health disparities and build health equity,” she said.

Other co-authors are , Department of Psychosocial & Community Health, 91���� School of Nursing; , assistant professor of Nursing & Healthcare Leadership, 91���� Tacoma; and India Ornelas, assistant professor of health services and , professor of health services, both in the Department of Health Services, 91���� School of Public Health.

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For more information, contact Bekemeier at bettybek@uw.edu.

The project is a sizeable challenge: Students will pour over census and public health data, interview residents, photograph neighborhoods and summarize their findings in a report. The end result will help officials in Auburn, Washington, know how to best engage and communicate with the culturally diverse populations in the city.

The neighborhoods endeavor is one of 10 initial projects in the 91����’s inaugural program, which to advance the city’s goals for livability and sustainability. The idea is to give students real-world experiences while addressing current needs identified by city leaders.

The program will formally celebrate the start of its first year at 10 a.m. Oct. 6 at wǝɫǝbʔaltxʷ – Intellectual House on the 91����’s campus in a open to all. Professors leading Livable City Year courses this fall will talk about their projects, followed by a time for Q&A.

“My students are really excited to be part of a larger initiative,” said , a 91���� assistant professor of health services who is teaching the class that will profile each Auburn neighborhood.

“They get to do something they really know will be valued and practice their professional skills to engage with each community.”

The new program is a cross-university collaboration led by faculty directors with the Department of Urban Design and Planning and with the School of Public Health, in collaboration with and , and with foundational support from the and . The program is also working with the nonprofit organization .

The projects in Auburn this fall include addressing homelessness issues, building awareness of city values, understanding wastewater discharge, managing pet waste and evaluating the success of a buy-local program. 91���� undergraduate and graduate students in six different courses spanning environmental and public health, sociology, and urban design and planning will deliver reports and recommendations to city leadership at the end of the quarter.

Sociology professor is tackling three separate projects on homelessness in Auburn with his upper-level undergraduate course on cities and neighborhood dynamics. One will assess and prioritize Auburn’s plans for addressing homelessness, and another will develop innovative strategies for understanding the size, change and distribution of the city’s homeless population.

A third project will focus on finding incentives to maintain the city’s relatively affordable older homes in the midst of expensive residential expansion.

“These are neat projects in that they allow students to work on things that are practically important, but there’s also, in a way, a ‘dream big’ element,” Crowder said. “There are great tools and resources at this university, so the more we can bring those to the community, the better off everyone will be.”

Several projects from this quarter will continue with Auburn for the rest of the academic year, and a half dozen new ones will begin winter and spring quarters. Other cities around Washington can apply to work with the 91���� through the Livable City Year program in future years.

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For more information, contact Livable City Year program manager Jennifer Davison at jnfrdvsn@uw.edu or 206-240-6903.