Identify Community Needs and Assets
The first step in preparing to develop a community health program is identifying community needs and priorities. Conducting a community health needs assessment can help rural programs determine where and how to use limited resources to address health-related needs. Not-for-profit hospitals must perform a community health needs assessment (CHNA) every three years and accredited local health departments must perform a community health assessment and develop a Community Health Improvement Plan (CHIP) every five years. Programs can reference these resources to determine the conditions that disproportionately impact people in their community.
Rural programs can also conduct their own needs assessments to collect more tailored information through surveys, questionnaires, focus groups, public meetings, direct observations, and interviews. Secondary data sources such as vital statistics, hospital records, morbidity and mortality reports, and literature reviews also provide valuable information.
For more information on how to conduct a needs assessment, see Conducting Rural Health Research, Needs Assessments, and Program Evaluations. For more information on data sources, see Finding Statistics and Data Related to Rural Health.
Mapping community assets can also help rural communities identify needs and priorities for health programming. Asset mapping is a systematic process of cataloging key services, benefits, and resources within the community, such as individuals' skill sets, organizational resources, physical space, institutions, associations, and elements of the local economy. Asset mapping can help to:
- Identify community assets and strengths, so the project can leverage or build on existing strengths
- Ensure the intervention's relevance to community needs
- Obtain buy-in from the community
There are multiple approaches to preparing a community asset map. One approach is for the convening organization to prepare and present a draft asset map to the members of a community network for discussion and revision.
Considerations for Health Equity
When conducting a needs assessment and asset mapping, it is important to use data to understand the scope of health inequities. It is equally important to validate the data by talking with members of the community. For example, data gathered across several years may show that there has been a notable change related to health outcomes, educational attainment, or employment. Conducting a focus group with community partners or community members can help to explain the reasons why the changes have occurred. See Using Community Health Assessments to Understand the Social Determinants of Health in a Community in the Social Determinants of Health Toolkit.
Resources to Learn More
The Assessment
for Advancing Community Transformation Tool
Website
Helps communities, groups, and individuals participate together to transform health and determine what
areas can be improved. Topics address collaboration, communication, advancing equity, planning for
action, measures to improve, and sustainability.
Organization(s): Georgia Health Policy Center, Institute for Healthcare Improvement, County Health
Ranking & Roadmaps
Community Asset Mapping:
Meeting Engagement Tool
Document
Guides communities and organizations through the process of identifying and mapping community assets.
Organization(s): National Oceanic and Atmospheric Administration, Office for Coastal Management
Date: 2018
Community
Health Assessment and Improvement Planning
Website
Describes the interrelated activities of community health assessment (CHA) and community health improvement
planning process (CHIP) necessary to organize a plan and develop a partnership. Discusses sharing a community
vision and common values, collecting and analyzing data, identifying and prioritizing the issues, developing an
action plan, and implementation and evaluation.
Organization(s): National Association of County & City Health Officials
Community
Health Assessment Toolkit: Prioritize Community Health Needs and Assets
Website
Assists in identifying the most pressing community health needs based on established priority-setting
criteria, data analysis, and selection of priorities based on a process supported by contributing
participants.
Organization(s): AHA Community Health Improvement
Community Health Maps
Website
Resources to help community-based organizations identify and use low-cost mapping tools. Includes
self-paced online tutorials, reviews of mapping software, best practices, and guides on vector borne
disease surveillance, web mapping, desktop GIS and field data collection.
Organization(s): Bird's Eye View, National Library of Medicine
The
Community
Tool Box: Chapter 3 – Assessing Community Needs and Resources
Website
Offers step-by-step guidance in developing community building skills. Covers topics analyzing community
problems, determining service utilizations, conducting surveys and interviews, using public records and data,
and process development to identify community needs and resources, and set priorities.
Organization(s): University of Kansas Work Group for Community Health and
Development
County Health Rankings and Roadmaps
Website
Measures the health of nearly all counties in the U.S. and ranks them within their states to better understand
the health of a community in comparison to other communities. Rankings are calculated using county-level
measures collected from national and state data sources. In addition, guidance, tools, and resources are
provided to support community efforts.
Organization(s): Robert Wood Johnson Foundation
HealthData.gov
Website
A searchable database providing health data from a variety of
federal sources to support improvements in health.
Organization(s): U.S. Department of Health and Human Services
Assess Needs
and Resources
Website
Offers tools and resources to help identify and leverage community strengths, resources, and assets to
facilitate change.
Organization(s): County Health Rankings and Roadmaps
Processes and Outcomes of a Community-Based
Participatory Research-Driven Health Needs Assessment
Document
Explores how Community-Based Participatory Research (CBPR)-driven community health needs assessment can inform
and establish community engaged research, policy, systems and environmental change approaches, and community-led
grants and jobs creation.
Author(s): Akintobi, T. H., Lockamy, E., Goodin, L., et al.
Citation: Progress in Community Health Partnerships: Research, Education, and Action, 12(1), 139–147.
Date: 2018