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Assessing
Needs and Assets
Overview
Assessing needs and assets is one of the first steps
in health planning. Needs assessments can identify priority
issues in a community and asset analyses can help to
further prioritize based on the current capacity of
a community. The use of qualitative and quantitative
data can greatly aid in the assessment of community
needs and assets. RC/EZ/ECs can utilize their local
health departments’, universities’, and other
community expertise in data collection and analysis
or tap into the numerous national sources of data such
as Community
Health Status Indicators project (CHSI) and National
Center for Health Statistics (NCHS), or needs assessment
tools such as Mobilizing
for Action through Planning and Partnerships (MAPP),
and Protocol
for Assessing Community Excellence in Environmental
Health (PACE EH). RC/EZ/ECs also can tap into the
data expertise available at the NCHS.
In addition, once the basic steering committee or advisory
group is convened, a SWOT (strengths, weaknesses, opportunities,
and threats) analysis can give a good idea of a community’s
strengths and weaknesses and the opportunities and threats
posed by local conditions.
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Stories
and Models from the field
Ogden, Utah, EC (Round I)
In the fall of each year, just before the start of
school, residents of Ogden, Utah sponsor the "Children's
Health Connection." The purpose of this event is to
increase access to care for area children. The city
of Ogden has a high population of illegal immigrants
and the need for improved access to care for children,
especially Hispanic children, has become apparent. Through
a joint effort by McKay-Dee Hospital and the Junior
League, an assessment was initially conducted by the
EC to determine areas of greatest need. The assessment
consisted of a community needs questionnaire administered
by the head start program at the Ogden Area Community
Action Agency, located in the heart of the Enterprise
Community. This facility contains the local food pantry
and is frequented by the Ogden area's needy population.
The questionnaire asked residents to identify their
four top health needs in each category. Listed categories
of need included physical, emotional, adult and family
and children's health care needs. Access to dental health
and immunizations were identified as two of the most
important areas of physical health needs. State law
requires that children have a dentist sign off on their
dental health before admission to local schools. The
EC's assessment found that children were not being enrolled
in school due to a lack of access to dental services.
In recruiting health care workers for the health fair,
the Junior League and McKay-Dee Hospital volunteers
utilized their personal networks to recruit bilingual
health care workers including physicians, dental hygienists
and even pharmacists. By the week before the event,
volunteers still had not succeeded in reaching any dentists
that would be willing to volunteer their services. According
to Telitha Greiner, a volunteer with the Junior League,
this drove them to seek out the help of retired dentists
through the local church.
Targeted towards school-aged children, the very first
two-day health fair drew more than 1000 people to a
centralized location where health care professionals
and Ogden community residents volunteered to provide
free physicals, immunizations, dental, vision, hearing,
and developmental screenings. Drugs were distributed
by volunteer pharmacists and lab work was conducted
to screen for anemia and urinary tract infections. These
screenings and services identified conditions ranging
from a tumor in a child's ear to autism and elephantitis.
Representatives from the Department of Health were available
to help eligible attendees apply for the Children's
Health Insurance Program (CHIP) and Medicaid in an effort
to insure children. In addition, the Children's Health
Connection provided basic hygienic necessities to families
with young children including distribution of diapers,
socks, underwear and haircuts. Children's activities
were sponsored to entertain the children and free book
bags and books were given out. Free food was also distributed.
The hygienists and retired dentists examined children's
teeth and filled out the appropriate forms to ensure
that the child could enroll in school. Within a year
after the Health Connection Event, volunteers had convinced
practicing dentists to accept a number of free cases.
To ensure that those covered by Medicaid would not miss
their appointment, these volunteers agreed to drive
patients to and from their appointments over the course
of the next year. Eventually, several area dentists
began accepting needy patients on a regular basis.
Over 1500 health care services were provided at the
first Children's Health Connection Event including:
- 366 - Dental Exams
- 409 - Physicals
- 348 - Hearing Screenings
- 292 - Vision Screenings
- 185 - Developmental Screenings
- 80 - Immunizations
Shortly after the event, case managers contacted the
families to coordinate follow-up care. Attendees had
been required to fill out paperwork related to liability
before entering the Health Connection. Required information
included address and the children's school information.
This facilitated the case manager's and hospital's ability
to follow up with the family. The hospital followed
up on all medical tests and referrals. Case management
follow-up from the first Children's Health Connection
resulted in 279 referrals to physicians, dentists, and
social workers.
A follow-up survey conducted by local university students
several months after the event showed that the Children's
Health Connection Event had succeeded in connecting
62.5% of attendees with a medical provider. The event
has now become an annual fair that brings in an increasing
number of volunteers and residents every year.
Implementing a Needs Assessment to Provide Comprehensive
Healthcare
Northeast Louisiana Delta Rural EC (Round I)
The Northeast Delta EC focuses on improving education,
housing, healthcare, and daycare to improve the quality
of life in the community. As part of its efforts to
provide comprehensive healthcare to its residents, the
EC is planning to implement several needs assessments.
The EC plans to develop a forum to assess current healthcare
services. The EC also plans to develop a forum on community
healthcare needs, from which it will implement recommendations.
EC's First Step to Reducing Barriers is Conducting
a Survey
Bowling Green EC (Round II)
The residents of the Bowling Green Enterprise Community
are faced with low levels of educational attainment,
low skill levels, and high rates of unemployment. These
factors have translated into limited access to care
and poor health status of many of the residents. In
order to identify ways to reduce the barriers to providing
healthcare to families, the Bowling Green EC conducted
a survey of healthcare providers staff and administrators.
Community
Health Status Assessment - Miller County, GA
(Example directly from NACCHO/MAPP website)
With a population of approximately 6,000 residents,
Miller County, GA, is a small rural county, located
in the southwestern corner of Georgia. In 1997, a coalition
of community organizations and representatives in the
county embarked on a community strategic planning process
to improve the healthcare system. As part of the process,
the coalition conducted a broad-based community health
status assessment. To inform the planning process with
accurate information about the health status of Miller
County, a varied set of objective and subjective data
was collected. Because the focus of the planning process
was on the healthcare system - the local hospital, in
particular- much of the data collection focused on information
specific to health care services. The elements of the
data collection included:
- Demographic and Health Status Reports -These
included population, economic, education, employment,
health status, and crime data.
- Claritas Marketing Database Information -
Claritas, Inc., a national marketing company, develops
cluster health profiles about the lifestyle of communities
(including commonalties such as age, ethnicity, race,
education and income, consumer preferences, and neighborhood
location).
- Community Asset Mapping Results - Available
resources in Miller County were identified, including
employers, lending institutions, healthcare, churches,
civic organizations, and cultural groups.
- Community Health Assessment Survey - A survey
was distributed to learn about resident perceptions
related to: 1) the most important health issues; 2)
issues for which services were the least adequate;
and 3) the health problems of highest priority.
- Key Informant Interviews - Coalition members
conducted open-ended interviews with 70 community
residents to identify overall needs and perceived
problems.
- Telephone Opinion Survey - A randomized telephone
opinion survey to 260 Miller County residents provided
information about the quality of healthcare in the
county and perceptions about and use of the Miller
County Hospital.
- Economic Impact Study - An economic impact
study explored the direct and indirect impact the
hospital has on the community.
- Regional Asset Mapping - A study was conducted
to identify health services available within Miller
County's potential market area.
- Health Services Dollars: Patterns of Use
- This study was completed to describe how Miller
County health care needs are currently being met and
to identify opportunities for improvement. Claims
data from Medicaid, Medicare, and Merit System employees
were used.
Miller County collected a broad array of objective
and subjective data that was used for well-informed
decision making. The data collection efforts also show
how the coalition collected traditional data, but also
focused their efforts on areas important to the strategic
plan.
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Tips
for RC/EZ/ECs
- Draw from needs already identified in your RC/EZ/EC
application or annual benchmark plans.
- Involve your local health department and hospitals
- they will have valuable data to help you assess
needs.
- Define how the needs of your RC/EZ/EC may differ
from the needs of the population the health department
or hospital serves.
- Involve your local college or university for assistance
with data analysis or survey design.
- Consult with local media about what issues resonate
with the community.
- Assess your needs with likely actions in mind -
target your needs assessment so you do not get too
much information.
- Use Geographic Information Systems (GIS) for data
specific to the RC/EZ/EC - visit HUD
for Empowerment Information System; Enterprise Geographic
Information System.
- Don't forget about qualitative information - the
perception of RC/EZ/EC residents is important.
- Use your local library when researching needs,
assets, and other information.
- Use people and their skills as assets - define
needed skills and who can fill those needs.
- Think beyond the "usual suspects" as
assets.
- Market the assets of the RC/EZ/EC to outside initiatives.
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Links
EZ/EC
Health Benchmarking Demonstration Project - Lessons
Learned
Tools
and Resources From the EZ/EC Health Benchmarking Demonstration
Project
Community
Health Status Indicators Report
The Community Health Status Indicators Report (CHSI)
provides health data at the local level. Use this site
to find county data on:
- Population Characteristics
- Four summary Measures of Health
- Leading Causes of Death
- Measures of Birth and Death
- Vulnerable Populations
- Environmental Health
- Preventive Services Use
- Risk Factors for Premature Death
- Access to Care
National Center
for Health Statistics
The National Center for Health Statistics is the Federal
Government's principal vital and health statistics agency.
NCHS data systems include data on vital events as well
as information on health status, lifestyle and exposure
to unhealthy influences, the onset and diagnosis of
illness and disability, ant the use of healthcare.
National Association
of Health Data Organizations
The National Association of Health Data Organizations
(NAHDO) is the "premier national health information
organization dedicated to improving healthcare through
collection, analysis, dissemination, and use of healthcare
data."
Morbidity and
Mortality Weekly Report
"The Morbidity and Mortality Weekly Report (MMWR) Series
is prepared by the Centers for Disease Control and Prevention
(CDC). The data in the weekly MMWR are provisional,
based on weekly reports to CDC by state health departments."
Community
Tool Box: Preparing a community Assessment
This section of the Community Toolbox provides
an outline for an assessment, examples of assessments,
how-to information, and other resources and links.
PATCH
(Planned Approach to Community Health): Collecting and
Organizing Data
This section of PATCH gives information on how
to obtain, organize, and present quantitative data (morbidity,
mortality, and behavioral) and qualitative data that
can inform the health planning process.
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