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Abstract
Introduction: Participatory action research methods like Photovoice are uniquely equipped to identify structural determinants of health based on lived experiences of how they influence proximal and distal population health outcomes. This study uses Photovoice data to examine how structural determinants impact community health needs.
Methods: Qualitative thematic analysis used focus group discussion data (25 transcripts) from four Kentucky counties that embedded Photovoice into their local health department community health assessment processes. Coded excerpts were examined for ways in which participants' community health concerns reflected structural issues rather than individual health behaviors.
Results: Participants perceived issues such as houselessness, food insecurity, and transportation as resulting from structural factors beyond the scope of local public health departments. Rather than individual interventions to improve health, participants often discussed the need for system changes in health promotion. The findings show that while local organizations can contribute to addressing health disparities, violence prevention and health promotion require larger policy decisions to reduce health disparities.
Conclusion: Highlighting the roots of health disparity as lived and understood by community members through Photovoice may indicate specific areas where cross-sector engagement and government intervention is most critical to improve community health outcomes.
Document Type
Article
Publication Date
2026
Digital Object Identifier (DOI)
https://doi.org/10.3389/fpubh.2026.1737022
Funding Information
The author(s) declared that financial support was received for this work and/or its publication. This work was funded by contracts between the University of Kentucky College of Public Health and the Montgomery County Health Department, Clark County Health Department, Lexington-Fayette County Health Department, and Oldham County Health Department. This research was also supported by a National Institute on Drug Abuse R36 dissertation award (R36DA061317). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, National Institute on Drug Abuse, or the contributing local health departments.
Repository Citation
Booty, Marisa; Culbertson, Madelyne G.; Taylor, Mason; Heise, Dakota; Stone, Heather; Kommer, Katherine Leanne; Gulley, Jennifer; Hart, Jeanette; Nentwick, Christina; and McGladrey, Margaret, "Applying Photovoice to uncover fundamental causes of health inequality in local health contexts" (2026). Sociology Faculty Publications. 31.
https://uknowledge.uky.edu/sociology_facpub/31
Notes/Citation Information
© 2026 Booty, Culbertson, Taylor, Heise, Stone, Kommer, Gulley, Hart, Nentwick and McGladrey. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.