1. What is a community health assessment (CHA)?
“Assessment with a health equity perspective identifies health status and trends, but it also indicates where health differences that are the result of differences in the opportunity for health exist between population groups. This adjustment in the assessment process can disclose health differences between population groups that are addressed through changes in policy, programs, or practices.”
-- World Heath Organization, 2013
A community health assessment is…
“A balance of studies and stories”
-- Hancock and Minkler
The CHA (also called community health needs assessment or CHNA) involves data collection and analysis to describe community health status, determine priority health concerns, and identify strategies and community partners to help with implementation. The CHA is part of a larger health improvement cycle. Community agencies, teams, organizations, and partnerships use the CHA to develop implementation or improvement plans.
Conducting a Community Health Assessment using a health equity lens does the following:
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Provides insight into the community context and ensures that interventions will be designed, planned, and carried out in a way that maximizes benefits to reduce health inequities and disparities.
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Facilitates partnerships in determining where to focus and provide resources and interventions.
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Helps to create an understanding of the relationship between the social determinants and the health behaviors or outcomes of interest.
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Ensures that community voices are heard, especially those of people who are marginalized.
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Includes a focus on community assets and strengths, not deficits.
A Community Health Assessment gives agencies, teams, organizations, and partnerships information about the community’s current health status, needs, and issues. ​
2. Why conduct a community health assessment?
3. How do you conduct a community health assessment?
Resources
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Prevention Research Center in St. Louis. Evidence-based Public Health. Module 2: Community Assessment.
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Northwest Public Health Training Center. EBPH: Community Assessment.
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Rocky Mountain Public Health Training Center. Evidence-Based Public Health Online Course.
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Community Toolbox. Other Models for Promoting Community Health and Development.
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County Health Rankings and Roadmaps. Community Assessment Tools.
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NACCHO. MAPP.
Established frameworks suggest a format for conducting a Community Health Assessment that usually begins with defining the community, engaging the community and partner agencies in the assessment, collecting data, and prioritizing health concerns.
Use the following resources to help you step by step through the CHA process.
“Community” is defined a group of people with diverse characteristics who are linked by social ties, share common perspectives, and engage in joint action in geographical locations or settings. While community is often determined by geographic location such as a county or city, your community may be a group of individuals that make up a team or partnership that provides guidance or funding or individuals that are joined by culture or shared experiences. (Citation: Conducting Assessment, #3)
What is community?
4. Community health assessment process and action steps using a health equity lens.
Which agencies or community members should participate or engage in the Community Health Assessment?
“…the participation and contributions of various stakeholders are likely to produce benefits in the form of increased effectiveness and productivity by reducing duplication of effort and avoiding the imposition of solutions that are not congruent with the local culture and needs.”
---IOM, Future of Public Health in the 21st Century
Involvement of diverse partners and community members in the CHA activities will bring greater resources and skills to the process. Some groups to consider involving in the assessment include: public health, business, educators, philanthropy or funders, non-profits, community development, government, and healthcare.
Reviewing previous assessments
Reviewing previous assessments provides an overview of the methods that were used as well as which groups and community members were involved. This information may also offer important insight into health issues or concerns that may continue to persist in the community.
Consider collecting data that involves photography, interviews, videoclips, observations, and community audits. You may find alternative data from different data sources such as partner organizations or from research done outside the public health/medical field that provides important insight into the issue you are searching, such as sociology, anthropology, planning, etc.
As you collect data, consider the different populations (and sub-groups) in your community and how you are collecting data on each. These populations and subgroups maybe impacted by health issues differently. You may need to delve further into the data to better understand which sub-group is at most risk (or being impacted by the health issue) by race/ethnicity, immigration status, gender, age, and more.
For example, after collecting data on diabetes in your community, you find that Latinos have a higher incidence and prevalence of diabetes. Therefore, want to understand which Latino groups are most impacted by diabetes. You would want to collect and compare data on recent immigrants to Chicanos who have been in the U.S. for many generations. This information may be different than collecting and reviewing data on diabetes and gender differences among Latino women and men, or diabetes incidence among Latino kids, families, and working adults, or diabetes incidence or prevalence among Latino LGBTQ or straight.
Recommended data collection techniques include the collection of both quantitative (numbers) and qualitative (words) data. You may wish to gather data already collected (secondary) and new data (primary). It is important to collect data with community member input to improve knowledge and awareness regarding different health issues in the community and increase credibility.
An ideal assessment includes information on risk factors, quality of life, mortality, morbidity, community assets, activities (internal or external to the community) that may produce changes in health, social determinants of health and health inequity, and information on how well the public health system provides essential services.
Note: When collecting data, it is important to consider that there may be alternative ways to collect data. Some cultures utilize written stories or oral histories or shared cultural definitions to catalog their experiences and values. It is important to respect and respond to different methods of sharing information.
Data collection
Applying Assessment Methods to Different Types of Social Determinants from the CDC Promoting Health Equity (pages 45-47; Table 3.1)
Resources
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CDC. Promoting Health Equity: A Resource to Help Communities Address Social Determinants of Health.
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Rocky Mountain Public Health Training Center. Evidence-Based Public Health Online Course
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Northwest Public Health Training Center. Evidence-Based Public Health Online Training Series.
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Prevention Research Center in St. Louis. Evidence-Based Public Health 3-day in-person training.
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Community Toolbox. Creating and Maintaining Partnerships.
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Community Toolbox. Other Models for Promoting Community Health and Development.
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County Health Rankings and Roadmaps. Community Assessment Tools.
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NACCHO. Considering Health Equity in Community Health Improvement Planning.
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NACCHO. MAPP. http://www.naccho.org/programs/public-health-infrastructure/mapp/phase-3-the-four-assessments
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NACCHO. Social Determinants of Health in Community Health Assessment and Improvement Planning.
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Prevention Research Center in St. Louis. Evidence-Based Public Health. A Course in Chronic Disease Prevention.
A Community Health Assessment gives agencies, teams, organizations, and partnerships information about the community’s current health status, needs, and issues. ​
2. Why conduct a community health assessment?
3. How do you conduct a community health assessment?
Established frameworks suggest a format for conducting a Community Health Assessment that usually begins with defining the community, engaging the community and partner agencies in the assessment, collecting data, and prioritizing health concerns.
Use the following resources to help you step by step through the CHA process.
-
Prevention Research Center in St. Louis. Evidence-based Public Health. Module 2: Community Assessment.
-
Northwest Public Health Training Center. EBPH: Community Assessment.
-
Rocky Mountain Public Health Training Center. Evidence-Based Public Health Online Course.
-
Community Toolbox. Other Models for Promoting Community Health and Development.
-
County Health Rankings and Roadmaps. Community Assessment Tools.
-
NACCHO. MAPP.