key elements of a community health assessment

2003; ICMM 2010). Efforts to support health-based recommendations must be carefully distinguished from biased efforts to promote a specific outcome or measure on the basis of an incomplete or inaccurately weighted comparison of favorable and unfavorable aspects of a proposal or of a predetermined political agenda. For example, if a traffic-calming infrastructure was installed on a street that had a high rate of pedestrian injury, it may be appropriate to monitor injury rates directly because changes would be expected as soon as the installation was complete. It discusses intersectionality as an emerging framework to guide research on prevention of suicide in young people and highlights several clinical and community settings that . Describes the baseline health status of the affected population with appropriate indicators, including prevalent health problems, health disparities, and social, economic, and environmental factors that affect health. Other groups have developed standard approaches to promote and evaluate practice quality, including the quality of analysis (see, for example, Fredsgaard et al. As discussed later in this section, recommendations can also establish a foundation for monitoring, and the results of the monitoring may indicate that the management strategies need to be adapted to respond to the observed outcomesa process known as adaptive management (Johnson 1999). For example, although an HIA may not be able to incorporate engineering or economic specifications for alternate routes for a proposed highway, it could discuss factors that would influence health outcomes, such as indicating that a desirable route would be, for example, 100 m from any school or elderly facility or would not be proximate to high-population-density areas with a number of vulnerable people. The findings of the HIA were covered by newspapers and Web sites in California, Maine, Massachusetts, and New Hampshire; and the HIA researchers were interviewed on radio. A complete nursing health assessment requires a health professional to examine a patient in a systematic fashion, from head to toe. The Crossings is a proposed housing development in Los Angeles that will provide 450 units in a newly rezoned residential area that needs affordable housing. Why Complete an Assessment and Improvement Plan? 2006). The committee emphasizes that the effectiveness of recommendations depends not only on the scientific validity of the interventions identified but on their relevance to the affected communitys concerns and their applicability within the regulatory or legislative framework of the proposal being considered. McHugh S, Maruca S, Lilien J, Manning A. Developing new cross-disciplinary and interagency collaborations. The characteristics and approaches of evaluation should be chosen to fit the time, resources, and data available to the HIA team. Evaluation is important for the quality of individual HIAs and for the success of the HIA field as a whole. 2005; Bhatia and Seto 2011). Practice Standards for Health Impact Assessment (HIA), Version 1. Community Health Assessment & Planning Guidebook - nmhealth.org The committee notes that qualitative social sciences and participatory-action research provide fertile ground for innovative methods for HIA. Fourth, disclosure of potential impacts may benefit industry by reducing the risk of litigation and by reducing tort liability by fulfilling requirements to warn those potentially responsible and potentially affected before the effects occur. Although less common to date, HIAs are also sometimes conducted by a decision-making agency, such as a metropolitan planning organization or a federal agency complying with NEPA. Possible Elements of a Community Team. Analyzes beneficial and adverse health effects and characterizes the changes in the indicators selected, to the extent possible, in terms of nature, direction, intensity, magnitude, distribution in the population, timing and duration, and likelihood. 2009; Bhatia et al. The programs and policies, however, may not provide any guidance on how health should be considered (see, for example, Pub. In some cases, collaboration between a health department and other agencies has resulted in the identification of appropriate proposals for screening. Failure to disclose HIA results and incomplete disclosure are not restricted to industry. However, the committee notes that no published studies in the United States have attempted to quantify the costs of undertaking an HIA across a variety of settings. Some have suggested that evaluation should be considered as outside the HIA process itself because of the need for an independent and objective perspective, particularly for impact evaluation (Bhatia et al. By examining the various components of the different assessment and planning models, we are able to identify areas for coordination, ways to maximize collaboration, and strategies to further improve community health. In general, the baseline profile focuses on health issues and health determinants that may be affected by the proposal rather than on attempting to provide a complete assessment of community health. Although a wide variety of excellent resources on community health assessment and CQI currently exist, those materials generally do not link assessment and CQI concepts and techniques in the way that is envisioned for . The top 10% of the census tracts within the study area were then identified as locations of the most vulnerable populations. Source: Adapted from BLM 2007 and Wernham 2007. Bhatia R. A Guide for Health Impact Assessment. Ensuring that the public has accurate and complete information on adverse and beneficial effects. A number of corporations and professional associations, such as the International Committee on Mining and Metals and the International Association of Oil and Gas Producers, have guidance for HIA, but relatively few completed industry-led HIAs or environmental, social, and health impact assessments are available on the Internet or on public Web sites that catalog HIA activity. CDC is not responsible for the content of materials not generated by CDC. The Importance of Common Metrics for Community, Social - Health Leads Iteration during scoping and between scoping and assessment often results in additional changes in the final list of issues included in the HIA. Box 3-2 provides an example of scoping for the HIA of a proposed development in Atlanta. In practice, the categories are rarely used consistently, and a single HIA often encompasses a blend of various approaches to stakeholder engagement and participation, analytic methods, and interactions with the formal decision-making process. PMC The variability also reflects a lack of clear criteria that define HIA as a distinct field. A community health assessment (sometimes called a CHA), also known as community health needs assessment (sometimes called a CHNA), refers to a state, tribal, local, or territorial health assessment that identifies key health needs and issues through systematic, comprehensive data collection and analysis. Therefore, scoping should be thought of as a two-part process that starts with a systematic effort to identify all potentially important effects and that continues with selection of the most important and well-substantiated effects for further analysis at later stages. A summary of how stakeholders were engaged, the main issues that the stakeholders raised, and how they will be addressed or why they will not be addressed. Community Health Assessment (CHA) archived training Identifying and selecting indicators for the CHA Data Collection, Analysis and Synthesis Presenting the CHA Findings Community Health Improvement Plan (CHIP) archived training Prioritizing Issues Choosing Strategies Developing a CHIP and Implementation Plan Lifetime Effects: The High/Scope Perry Preschool Study through Age 40. This step suggests a modified version of CDC's evaluation guidelines, and may be used as a starting point to tailor an evaluation for a particular community health improvement effort, at . Mechanisms to limit bias in decision-relevant analyses further are discussed in Chapter 4. Retrieved fromhttps://www.chausa.org/communitybenefit/assessing-and-addressing-community-health-needs Program on Health Equity and Sustainability, San Francisco Department of Public Health. In Alaska, all large natural-resources development proposals are now screened for the need for HIA in a new program begun by the state health department. Federal government websites often end in .gov or .mil. Another consideration is whether the proposal is likely to place a disproportionate burden of risk on vulnerable populations in the affected community; screening proposals on this basis helps to ensure that the HIA addresses the risk factors that underlie observed disparities in the rates of illness among various populations. A smaller set of related indicators was endorsed for use in monitoring key elements of community health status (CDC, 1991). On the basis of its review of current guidance and practice, the committee recommends that scoping should result in a framework for the HIA and a written project plan that includes the following: The credibility and relevance of HIA to the decision-making process rest on a balanced and complete examination of the health risks, benefits, and tradeoffs presented by the project, policy, program, or plan being assessed. Health Impact Assessment: International Best Practice Principles. The committee notes that outcome evaluation considers the effects of the whole decision, including changes made as a result of HIA recommendations. Culturally competent care means providing care within the context of a patient's culture and beliefs. Decision-making is rarely based solely on scientific evidence but instead takes into account an array of political, economic, technical, and practical considerations. It is important for nonprofit hospitals to be knowledgeable about the Internal Revenue Services regulations for CHNAs. A variety of screening tools and algorithms are commonly used (Cole et al. Moreover, disease rates in small populations can vary substantially, and it may not be possible to calculate them reliably. For example, the Massachusetts Department of Public Health responded to citizen concerns regarding a proposed power plant by considering whether HIA would be an appropriate way to address them (McAuliffe 2009). Red Dog Mine Extension Aqqaluk Project. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. An HIA, however, might not provide any recommendations; this could occur if the HIA failed to reveal any important health effects. 2006; Jagannathan et al. The committee notes that the diversity of approaches and decision contexts imposes challenges for determining the resources required for conducting an HIA. A community health improvement plan is critical for developing policies and defining actions to target efforts that promote health. In addition, federal and state policy and accreditation requirements may be revised or implemented to better facilitate assessment and planning collaboration between health departments, hospitals, and others for the purpose of improving community health. 2023 by the American Hospital Association. Box 3-6 shows how the results of an HIA of proposals to provide paid sick days to employees were presented clearly in a report with appropriate acknowledgement of the strengths and weaknesses of the evidence. UPH (Upstream Public Health). The discussion described pathways by which Iupiat health was likely to be affected. Shortened life expectancy associated with air pollution. The fact, however, that the team conducting the HIA is aware of the decision context allows the assessment to be decision-relevant. For that reason, it is important that scoping begin with a systematic consideration of all potential effects rather than limiting consideration to a subset of issues predetermined by the teams research interests or regulatory requirements. 3, Elements of a Health Impact Assessment, Improving Health in the United States: The Role of Health Impact Assessment. L 91-190, 42 U.S.C. Leventhal T, Brooks-Gunn J. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Bhatia R, Wernham A. Past Projects: Paid Sick Days Legislation. Create structural or process change. As part of the assessment phase, a set of specific indicators that can be used to describe the baseline and potential changes in health status or health determinants should be developed. HIAs are also differentiated according to whether they are integrated into an environmental impact assessment or done independently. Health impact assessment: A tool for healthy public policy. The potential for health effects to place a disproportionate burden on or substantially benefit vulnerable populations. Document No. That permits recommendations to form the basis of effective implementation and management rather than merely providing a static system without the capacity to adapt. Propose a system to verify that measures are being implemented as planned. The committee notes that each approach for gathering and interpreting data may be conducted in ways that are more or less participatory, engaging stakeholders in shaping the research questions, interpreting the findings, and developing recommendations on the basis of the findings. Gruber JB, Wang W, Quittner A, Salyakina D, McCafferty-Fernandez J. Popul Health Manag. Community health assessments use such principles as. The committees may be convened for several purposes, including providing technical guidance or peer review, ensuring adequate and fair representation of diverse interests and priorities among stakeholders, communicating the results of the HIA to decision-makers, and developing recommendations that address community needs and are compatible with the specific legal requirements of the decision- making process. 2. 2005). As discussed in greater depth in the section on scoping, it is common to convene advisory or steering committees, which can include both technical and policy experts and representatives from stakeholder groups that have an interest in the decision outcome. Centers for Disease Control and Prevention. Ibid. The local North Slope Borough governmentan agency that participated in preparing the EISconducted an HIA, which was integrated into the EIS report. Sources: Veerman et al. The results of the HIA were presented in different formats; the full report was accompanied by a summary and fact sheets. The process of describing pre-existing health issues, health disparities, and influences on health may also begin during scoping, although the full characterization of baseline health status generally takes place during assessment. Major issues and challenges for HIA development and practice are considered in Chapter 4. If the HIA is based on a thorough analysis, provides complete information so that community members are able to critique the analysis, and is conducted openly, it may provide reassurance to affected communities even if the conclusions do not support the communitys concerns. Affected populations: As the TAD constituted only a portion of the city that would be directly affected, the HIA team created the HIA study area by placing a 0.5-mile buffer around the BeltLine TAD. In some cases, the timeline and available resources will prevent collection of new data to address gaps that are identified. The specific methods used in assessment are discussed in depth in the next section. A community health improvement plan (or CHIP) is a long-term, systematic effort to address public health problems based on the results of community health assessment activities and the community health improvement process. The HIA team needed an authoritative description on which to base its assessment. A description of the proposed policy, program, plan, or project that will be the focus of the HIA, including the timeline for the decision and intervention points at which HIA information will be used. It is also common for local, state, or tribal health departments to undertake an HIA to inform another agencys decision-making. In some cases, the HIA process allows a period for formal public comment on a draft of the HIA report. International Finance Corporation Performance Standard 4 Rev -0.1, Community Health, Safety, and Security. (2015). Human Impact Partners and San Francisco Department of Public Health. II, Selected Evidence Base Breaking the Cycle, East London and the City Health Action Zone and Queen Mary. Example of a Table Used for Systematic Scoping. Ultimately, regardless of the specific tool used, the decision to conduct HIA in most cases relies on the practitioners or decision-makers judgment regarding the likelihood of impacts, the time and resources available, and the likelihood that the information produced by the HIA will be a valuable aid to decision-making. Kemm J. Bhatia R, Farhang L, Gaydos M, Gilhuly K, Harris-Roxas B, Heller J, Lee M, McLaughlin J, Orenstein M, Seto E, St Pierre L, Tamburrini AL, Wernham A, Wier M. Bhatia R, Branscomb J, Farhang L, Lee M, Orenstein M, Richardson M. Birley M. Health Impact Assessment in multinationals: A case study of the Royal Dutch/Shell Group. Chapter 2 established the rationale for examining the potential effects of decisions on health and health disparities and highlighted health impact assessment (HIA) as a potential tool for assessing the health implications of various decisions. 2017 Jul/Aug;23 Suppl 4 Suppl, Community Health Status Assessment:S14-S21.

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