Abstract
The purpose of this study is to perform an analysis of 51 community health needs assessments (CHNAs) qualitatively and quantitatively (mixed methods) for evidence of the presence or lack of the identification of syndemics, which is defined as two or more physiological conditions, exacerbated by a cultural factor that gives rise to a health problem. This research uses a book chapter titled, Suicide as Syndemic—physiological effects of high altitude and physiological and behavioral manifestations of mental illness, exacerbated by the Cowboy Culture as a referent. Cowboy culture is a pervasive ethos influencing community members through characteristics like independence, stoicism, and a potential for recklessness, often contributing to social isolation and a reluctance to address psychological distress. The 51 reports were uploaded into a qualitative analysis software package for coding and sorting, with the findings recorded in a spreadsheet, which was then uploaded to a quantitative statistical package. Descriptive and inferential statistics (chi-square and binomial tests of proportions) reveal no syndemics mentioned or accounted for within the reports. Furthermore, consideration of culture and weather/climate was underrepresented. The authors addressed suicide in 47 (92.2%) of the reports. Mental illness was predominantly linked to suicide; however, it was Kraepelinized with cultural and other systemic factors significantly lacking in consideration.
Keywords
Syndemic, Community Health Needs Assessment, Suicide, Suicidality, Social Determinants of Health