Mapping Health Assets in a Community

This groundbreaking article, “Methodology for health assets mapping in a community,” published in Gaceta Sanitaria (2013), unveils a robust and innovative methodology designed to identify and mobilize the inherent strengths within communities for health promotion. Developed within the framework of a regional strategy for community health engagement in Asturias, Spain, and connected to the Health Observatory, this approach offers a practical roadmap for initiating local health assets mapping.

Shifting Focus: From Deficit to Asset-Based Health

The methodology represents a crucial paradigm shift in public health. Rather than solely focusing on health deficits, problems, and social determinants of health, it explicitly complements the traditional “deficit” model with a salutogenic and health assets approach. This positive perspective emphasizes the “riches” of a community, aiming to understand and leverage existing resources—both formal and informal—to foster development and improve quality of life. The framework is deeply informed by theoretical models of salutogenesis, asset-based community development (ABCD), and broader community development principles. The mapping process itself is not just a data collection tool; it’s a transformative journey where citizens discover positive factors, build networks of mutual support, and collaboratively initiate projects that enhance well-being.

A Comprehensive Spectrum of Health Assets

The methodology comprehensively categorizes and identifies various types of health assets within a community:

• Individual Resources: This includes the inherent power, passion, talent, skills, experience, knowledge, time, and care contributed by community members, families, and neighbors.
• Formal Associations: Groups such as religious organizations, sports clubs, youth associations, volunteer groups, neighborhood associations, self-help groups, and patient associations, bringing vision, networks, knowledge, and influence.
• Informal Associations: Crucial networks like informal caregivers and support groups, which offer vision, networks, knowledge, influence, communal spaces, and talent.
• Physical Resources: Essential community spaces and infrastructure, including parks, educational centers, libraries, health centers, and children’s centers.
• Economic Resources: Local businesses and shops, providing financial resources, influence, and physical premises.
• Cultural Resources: Expressions of art, music, and theater, contributing vision, networks, knowledge, influence, communal spaces, and talent.
• Organizational Resources: Services from the city council, police, social workers, family doctors, and nurses, which offer financial resources, facilities, services, influence, time, power, knowledge, and leadership capacity for change.

A Structured Six-Phase Implementation

The methodology outlines a clear, step-by-step process for effective asset mapping, ensuring broad participation and sustainable impact:

1. Phase 1: Presentation to Local Agents: Local leaders (e.g., from city councils, associations) are introduced to the participation strategy, existing health indicators, social determinants of health, and the assets mapping tool. Their role is to connect with field agents.
2. Phase 2: Delimitation of Mapping: Key variables are defined, including the mapping area, population size, available resources, and subsequent actions.
3. Phase 3: Work with Field Agents: This involves presenting the work proposal to key community members who will lead the mapping process. A “driving group” is established, and “key informants” (those with deep community knowledge or representing minority groups) are identified to guide the process and decide asset localization areas.
4. Phase 4: Field Work in the Community: A dedicated group, supported by experienced community development organizations, actively locates and reflects on identified assets using a variety of participatory techniques.
5. Phase 5: Visibility on Web 2.0: Discovered assets are made visible and organized online, for example, through platforms like Asturias Actúa, using labels (e.g., sexuality, youth) to foster collaborative processes.
6. Phase 6: Transfer to Local Agents and Population: Beyond digital platforms, assets are disseminated through diverse methodologies such as community sessions, meetings, forums, and municipal publications. This phase aims to revitalize the community’s “health picture” (encompassing both deficits and assets) to catalyze change.

Empowering Techniques for Community Engagement

The methodology leverages a range of participatory techniques to explore and uncover assets, ensuring community voices are heard and valued:

• In-depth Interviews: Face-to-face conversations with key individuals to understand their perspectives, behaviors, feelings, and experiences within the community.
• Focus Groups: Moderated discussions with small, homogeneous groups to gather information on common interest topics.
• Mapping Party: Collective gatherings where community members map specific locations, encouraging widespread participation.
• Photovoice: A process of reflection and discussion using photographs of the community to describe and exchange impressions.
• Narrative Research (Storytelling): Inviting people to share their personal stories about how they have faced and overcome difficult situations.
• “Tertulias del café” (Coffee Talks): Informal conversations among small groups over coffee, facilitated by a host, to generate discussion on topics of interest, with themes collected and extracted by the whole group.

This invaluable article offers essential insights for public health practitioners, community leaders, and researchers committed to fostering healthier, more resilient communities by recognizing and building upon their inherent strengths and assets.

The six phases of the methodology

Botello and colleagues describe the method used in Asturias, Spain, as part of a regional community participation strategy linked to the Asturias Health Observatory. It is a methodological article rather than an empirical study, and it proposes six phases.

Phase 1, presentation: the strategy is presented to local agents together with health and social determinant indicators for their municipality. Phase 2, delimitation: the team defines the area, population size, available resources and the follow-up actions the mapping should feed into. Phase 3, steering group: a local group and key informants are identified. Phase 4, fieldwork: assets are identified in the community. Phase 5, publication: assets are published on a regional website and tagged by theme. Phase 6, transfer: results are returned to local agents and residents through sessions and forums.

What counts as an asset

Adapting the classification of the UK Improvement and Development Agency, the authors group assets into six types: individual residents, formal and informal associations, physical resources, economic resources, cultural resources and organisational resources. Each type calls for different techniques: in-depth interviews, focus groups, database and social media searches, informal conversations, mapping parties, photovoice, storytelling and the “tertulia del café”, in which groups of five or six people rotate between tables every 20 minutes.

Theoretical basis and lessons

The approach draws on salutogenesis, the asset model, community-based participatory research and asset-based community development. Its main contribution is to pair the usual indicators of health deficits with a view of what already keeps a community healthy. The authors note that web tools were not yet widely used by residents or health workers, so offline ways of sharing results remain necessary, and that dedicated research would be needed to confirm the method’s value. For health managers working in primary care or public health, the phases and tables offer a practical checklist for starting a local asset map.

Reference: Botello, B., Palacio, S., García, M., Margolles, M., Fernández, F., Hernán, M., Nieto, J., & Cofiño, R. (2013). Metodología para el mapeo de activos de salud en una comunidad. Gaceta Sanitaria, 27(2), 180–183.