There is a flurry of education around community health needs assessments (CHNAs), with US hospitals working to meet the recent IRS requirements. The core work of a CHNA is to understand and quantify the health needs in a hospital's geographic community, which can be the first step in designing an implementation plan to improve health equity and decrease disparities in health outcomes.
CHNAs are an ideal starting point for hospitals and health systems to position themselves for financial health as payment models move toward population health. The shift in financing incentives from volume to value is refocusing provider organizations to look beyond care delivery and consider the factors that influence health.
There is growing recognition that the social determinants of health — where we live, work, and play, the food we eat, the opportunities we have to work and exercise and live in safety — drive health outcomes. Of course, there is a large role for health care to play in delivering health care services, but it is indisputable that the foundation of a healthy life lies within the community. To manage true population health — that is, the health of a community — hospitals and health systems must partner with a broad spectrum of stakeholders who share ownership for improving health in our communities.
Assessing a community's strengths and needs requires strategies and methods that are the cornerstone of the work of public health departments, community coalitions, and community organizations such as the United Way. Hospitals bring a lot to the table in the pursuit to improve population health, but they do not have to go it alone. The good news is that there is a wealth of existing resources, as community groups, public health departments, and community coalitions have been strengthening the social determinants of health for decades.
Hospitals can strengthen their ability to partner with public health, community organizations, and coalitions to carry out a variety of health improving activities, from fostering walking groups Hospitals can strengthen their ability to partner with public health, community organizations, and coalitions to carry out a variety of health improving activities, from fostering walking groups among church congregations, to converting vacant lots into food-producing community gardens, to hosting cooking classes in public housing, to leveraging municipal improvement projects as job creation for underserved neighbors.
As with any complex system, it is essential to try out small changes and learn by doing. Each community is different, and an effective platform for community health improvement will be shaped by the local context. But the core activities are the same from place to place: building will within the hospital and aligning activities, including CHNAs and community benefit, toward community health improvement, finding and engaging community stakeholders in community health improvement, and developing a portfolio of projects to improve community health.
Catherine Craig, MPA, MSW, will serve as faculty for the IHI Virtual Expedition Beyond the CHNA: Building Shared Ownership for Health in Communities, starting June 2, 2016.
