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Using Community Health Assessments to Understand the Social Determinants of Health in a Community

Community health assessments (CHAs) and community health needs assessments (CHNAs) can also be used as tools to assess the health of communities and to design strategies and policies to address social determinants of health (SDOH). These assessments can be used to promote change in communities based on findings, and can help engage stakeholders to address community needs.

Nonprofit hospitals are required to conduct CHNAs every three years to help identify problem areas and potential solutions for the community. According to the Centers for Disease Control and Prevention, CHAs (also known as CHNAs) are:

state, tribal, local, or territorial health assessments that identify key health needs and issues through systematic, comprehensive data collection and analysis.

Hospitals are using CHNAs to develop plans for addressing SDOH and other community needs identified. In some rural areas, hospitals have begun to work together with local public health agencies to pool resources and expertise to conduct these health assessments. By working together, hospitals and public health agencies can help create shared goals for improving health and well-being in communities.

The rural community group model (RCGM) is a model that has been used successfully by Critical Access Hospitals in North Dakota. Key elements of the model include:

  • Disseminating surveys
  • Conducting key informant interviews and focus groups
  • Incorporating county-level data on health

Small rural hospitals may lack the required resources to successfully address issues that may be identified as a result of a CHNA. Therefore, rural partnerships or funding sources can be essential for funding future work to address SDOH. In some states the State Office of Rural Health can provide leadership, funding, and technical assistance to help hospitals and local health departments complete CHNAs.

Resources to Learn More

CARES Engagement Network
Website
A national resource and network that hosts public and custom designed tools, maps, and reports that can be used by communities for conducting Community Health Needs Assessments.
Organization(s): Center for Applied Research and Engagement Systems (CARES), University of Missouri Extension

Community Health Needs Assessment
Website
Provides an example of a CHNA conducted in North Dakota. Includes individual hospital CHNA reports and implementation strategies.
Organization(s): Center for Rural Health, University of North Dakota

Community Health Needs Assessment in a Rural Setting: Foundation for a Community-Academic Partnership
Document
Discusses the process of conducting a needs assessment in a select community and perceptions from the community about health-related resources, barriers, health problems, and associated environmental factors.
Author(s): Schutte, D.L., Goris, E.D., & Rivard, J.L.
Citation: Journal of Higher Education Outreach and Engagement, 20(2), 85-108
Date: 2016

A Guide for Rural Health Care Collaboration and Coordination
Describes how rural hospitals, public health departments, and other organizations can work together to identify community health needs and develop partnerships and strategies to help address these needs.
Organization(s): Health Resources and Services Administration
Date: 08/2019

Rural Health Activities
Website
Provides insights from the research conducted by Texas A&M University Rural & Community Health Institute (RCHI) to better understand the drivers of hospital closures in Texas. Discusses five main drivers: community awareness, finances, community engagement, redefining access, and hospital board leadership.
Organization(s): Rural & Community Health Institute, Texas A&M University

THRIVE: Tool for Health & Resilience in Vulnerable Environments
Website
Discusses THRIVE, a framework designed for communities to understand community-level SDOH. Describes how THRIVE can help inform CHNAs and community health improvement planning (CHIP) processes.
Organization(s): Prevention Institute