Community Health Needs Assessment

Community Health Needs Assessment (CHNA) is part strategic plan/part grounding rod, and provides a systematic process for determining health needs in a particular community or population and using results to spur community change. CHNA has long been best practice within the field of public health, but the process has gained momentum due to health institutions formally recognizing its importance by requiring it for nonprofit health systems. The Patient Protection and Affordable Care Act of 2010 (ACA) requires tax-exempt hospitals to do a CHNA every three years alongside stakeholders. CHNAs prompt those working to improve community health to consider local conditions—both community needs and assets, which leads to more targeted, effective community improvement planning.

Ideally, CHNAs are developed through a collaborative process (involving stakeholders from various sectors) and take into consideration present-day data, as well as historical data, in order to examine change over time and trend lines. Vulnerable populations are at risk for disparate healthcare access and outcomes because of economic, cultural, racial, or health characteristics. Examining data across different populations is important and allows you to see that people in your community have different lived experiences, resulting in different health risks and needs. If data cannot be broken out by race, for example, you’ll likely miss important differences in health needs across populations; your data won’t show health disparities. Knowing the specific health needs a population faces enables you to tailor health improvement efforts to appropriate priority populations and work to minimize disparities and promote an equitable approach to health improvement planning.

Historically, Black people and other communities of color have borne a larger burden of negative health outcomes than their white counterparts. There are myriad reasons for this, including a national legacy of systemic racism, and disparities in health care access, coverage, and quality. Careful conduction of CHNAs can serve to identify root causes of inequity with regards to health care and drive efforts to reverse these trends and improve health for all.

Due to its widespread use by local public health agencies and organizations, as well as hospitals and hospital systems, there is potential to drastically improve the healthcare landscape and advance community well-being through improving the CHNA process. In recent years, many have advocated for the integration of more non-health data into CHNA (e.g. housing data, transportation data). Adoption of a more general, well-being frame, in addition to health outcome data, acknowledges the interconnectedness of our physical health to the community conditions in which we live. Specifically, many have used the Vital Conditions for Community Well-Being framework to examine how the healthcare system can contribute to advancing community well-being outside of its traditionally clinical sphere.