What is a Community Health Needs Assessment?
“The fundamental purpose of public health is defined by three core functions: assessment, policy development, and assurance” -National Association of County & City Health Officials
Late last March, 44 volunteers went door-to-door inviting residents in Nash and Edgecombe counties to take a survey about their community’s health needs. Three hundred residents opened their doors and lent their voice on community and personal concerns of physical, mental, and nutritional health, as well as access to programs to improve health and well-being. They talked about crime and safety, access to affordable fitness opportunities, and the presence of school-based health initiatives. In the spirit of continuing to prioritize community participation, a Health Summit later this month will provide an open forum for a discussion of the survey’s findings.
Surveys such as the one implemented by the Twin Counties Health Partnership earlier this year are critical to a core function of public health: assessment. If the mission of a public health initiative is to address a disparity in health, that gap must first be identified by residents and health leaders. These kinds of survey are community health needs assessments (CHNA), and are the foundation of community-based participatory research. They are a first and critical step toward more equitable health outcomes that lead to community health improvement.
The national Public Health Accreditation Board defines a CHNA as “a systematic examination of the health status indicators for a given population that is used to identify key problems and assets in a community”. This assessment necessitates strong quantitative as well as qualitative measures that provide insight or status indicators that can be targeted. Analysis of the assessment guides the development and implementation of a community health improvement plan (CHIP), which details measurable evidence-based interventions.
Community health assessments are increasingly regulated on national and local levels. A major catalyst of this movement was a requirement in The Patient Protection and Affordable Care Act, passed in 2010, mandating all tax-exempt hospitals to conduct an assessment at least once every three years. In many states, including North Carolina, the implementation of this assessment is also a requirement of the accreditation board.
A George Washington University publication summarizes best practices for implementing CHNAs. These include:
- Multisector collaboration to address large scale social problems
- Proactive, broad, and diverse community engagement at each stage of the process (including support from leaders in health, business, education, non-profit, faith-based, and social support fields)
- An appropriate definition of community (a targeted focus with a significantly measurable impact)
- Implementation of Evidence-Based Interventions
- Rigorous Evaluation
- Use of data from diverse public and private sources
At the heart of community-centered public health work is a spirit of collaboration, a pooling of resources and knowledge, and the understanding that the health needs of a given group of people are just one facet of better understanding how these people live, and how they want to live. In the next few months, we’ll see how the programs of the Foundation use community health assessments to guide their work.