key elements of a community health assessment key elements of a community health assessment

For example, rather than providing an estimate of lung-cancer rates in a small community, an HIA might identify smoking rates and important sources of airborne pollutants in the communitys airshed. 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. The HIA report describes the screening process but does not provide great detail about it. Examples of Health and Behavioral Effects That Have Been Addressed Quantitatively in HIA. In practice, not all HIAs have conducted systematic literature reviews or documented review methods. Frank DA, Neault NB, Skalicky A, Cook JT, Wilson JD, Levenson S, Meyers AF, Heeren T, Cutts DB, Casey PH, Black MM, Berkowitz C. Heat or eat: The Low Income Home Energy Assistance Program and nutritional and health risks among children less than 3 years of age. The committee notes that a variety of qualitative and quantitative approaches are often used to generate predictions, but regardless of the methods used, most available guidance emphasizes the importance of considering diverse forms of evidence, a consistent and unbiased approach to selecting and interpreting evidence, and a clear and transparent description of the analytic approach (WHO 1999; Mindell et al. A community health assessment gives organizations comprehensive information about the communitys current health status, needs, and issues. Major issues and challenges for HIA development and practice are considered in Chapter 4. In other cases, it may not be possible to attribute a particular decision to the influence of an HIA (Wismar et al. Evaluation should be planned throughout the community health assessment (CHA) process to assess the impact of your strategies and progress toward your goals. In each case, it is important to determine how the standards, policies, programs, and laws bear on how health is factored into a proposal. Such reviews of the existing literature are common. Outcome evaluation requires a suitable research design, ideally an appropriate comparison group, and data from the monitoring of health outcomes or of changes in health determinants as described above. However, it appears to be increasingly accepted that HIA is carried out to inform the decision rather than to evaluate the impacts after the decision is made, and there is general agreement on the procedural steps of HIA (Harris-Roxas and Harris 2011). These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. 2008; Fredsgaard et al. Unauthorized use of these marks is strictly prohibited. Community Health Assessment and Improvement Planning - NACCHO Skip to Main NavigationSkip to Content LHD Directory Virtual Communities Toolbox Contact Us Mobilizing for Action through Planning and Partnerships (MAPP) Jobs at NACCHO Education & Events MyNACCHO Login Mobilizing for Action through Planning and Partnerships (MAPP) Jobs at NACCHO Furthermore, some policies may focus on determinants of healthfor example, economic development, transportation, or housingrather than explicitly mentioning health. The approaches taken for stakeholder involvement vary widely. Improving relationships and collaboration between stakeholders. Screening: HIA of a Residential Housing Program. A screening recommendationfor example, no further action required; no HIA, but health advice and input to be offered in an alternative way; or proceed with HIA. Using Community Health Assessments to Understand the Social This data then informs the nursing care plan. SFDPH (San Francisco Department of Public Health). In general, this approach describes effects directly related to the proposal (such as changes in air emissions) and traces them to health determinants (such as air quality) and finally to health outcomes (such as asthma). For example, U.S. priorities for improving public health are expressed in the Healthy People 2020 Program of the U.S. Department of Health and Human Services (DHHS 2010). Furthermore, impact assessments, including HIAs, may rely on proprietary business information whose disclosure is legally barred or could damage a proponents business edge or competitiveness. Logic frameworks can be used as part of stakeholder engagement to develop a shared understanding of how a project will develop and the outcomes that can be expected (Cave and Curtis 2001a,b; Cave et al. Neidell M. Information, avoidance behavior, and health: The effect of ozone on asthma hospitalizations. Some decisions to conduct HIA may depend on a specific statutory requirement or mandated procedure. Reprinted with permission; copyright 2010, International Council on Mining and Metals. Identifying data gaps and questions for future research. In those cases, the HIA team may need to rely on established principles of health promotion and disease prevention to develop approaches to minimizing or mitigating the identified effects. Suicide in young people: screening, risk assessment, and intervention In some cases, the HIA process allows a period for formal public comment on a draft of the HIA report. As discussed at the beginning of this chapter, HIAs in the United States are often conducted without a formal legal mandate and by an agency or organization that does not have decision- making authority. Cancer risk associated with exposure to hazardous chemicals. Key Elements - Kent County, Michigan Rethinking human health impact assessment. Because the biologists on the EIS team were uncertain of the degree to which subsistence harvests might be favorably or adversely affected, the HIA did not attempt to make quantitative estimates of the probability or intensity of the impact. The information generated by the HIA process needs to be organized and presented in such a way that it can be readily understood by the intended audiences and present a compelling case for recommended actions. This assessment of needs then informs a project's overall plan and approaches by helping you identify targeted strategies and prioritize resources. Veerman J, Barendregt J, Mackenback J. Quantitative health impact assessment: Current practice and future directions. An evaluation report should be produced at the conclusion of the HIA that includes the following: Few HIA evaluation data have been published in the United States and relatively few elsewhere. The committee proposes on the basis of its review the following adaptation of the current working definition of the International Association of Impact Assessment (Quigley et al. Thank you for taking the time to confirm your preferences. The variability in the practice has evolved in the absence of widely accepted practice standards or formal regulatory or procedural requirements for HIA outside NEPA and related state laws (see Appendix A). Before There are, however, no current examples of HIAs in the United States that include outcome evaluation as described here. Mindell J, Boaz A, Joffe M, Curtis S, Birley M. Enhancing the evidence base for health impact assessment. For example, HIA reports can be disseminated in hard copy, in electronic format, at public meetings, to focus groups, or at different stages in the HIA process or policy cycle. A Review Package for Health Impact Assessment Reports of Development Projects. The discussion described pathways by which Iupiat health was likely to be affected. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Acknowledgments . Human Impact Partners then worked with groups in other states to extrapolate the findings of the national report to local jurisdictions to analyze the health effects of paid sick days. HIA recommendations take various forms, and some examples are provided below. The discussion below briefly provides definitions and key features of HIA monitoring and evaluation. It was concluded during the screening phase that an HIA would add value to project outcomes. A complete nursing health assessment requires a health professional to examine a patient in a systematic fashion, from head to toe. o Who is ultimate decision maker if the event needs to be cancelled, postponed or similar? Alternative to a proposal. Petticrew M, Cummins S, Sparks L, Findlay A. Validating health impact assessment: Prediction is difficult (especially about the future). Office of Disease Prevention and Health Promotion, US Department of Health and Human Services. Reporting: Legislation on Paid Sick Days. The report of the Healthy Families Act HIA provides a clear description of the steps in the analytic process. The phrase desktop HIA has also been used to refer to a rapid HIA that entails little or no public engagement. Retrieved fromhttps://www.chausa.org/communitybenefit/assessing-and-addressing-community-health-needs Alerting decision-makers to the more general need to focus on health in future decisions. The committee notes that in any assessment, it (more), Assessment should result in a report that. The fact, however, that the team conducting the HIA is aware of the decision context allows the assessment to be decision-relevant. In 2005, an HIA was conducted by a multidisciplinary team. Self-evaluation performed by the HIA teamfor example, against a set of process objectives or practice criteriaserves quality-assurance aims and can produce insights that will improve the field. However, because few studies have directly assessed the impact of the implementation of policies, plans, programs, or projects on health outcomes, there may be little direct evidence available with which to predict a given measures effectiveness. The Catholic Health Association defines a community health needs assessment as a systematic process involving the community to identify and analyze community health needs and assets in order to prioritize these needs, and to plan and act upon unmet community health needs. This is the key link between a health profile and a health plan. The Importance of Common Metrics for Community, Social - Health Leads Assessing alternatives in parallel with the proposal can aid decision-making by highlighting tradeoffs and actions that can be taken to achieve the desired outcome while minimizing harms. Similarly, HIAs sponsored by private nonprofit organizations may not have requirements for disclosure inasmuch as most U.S. HIAs are not done under a legal mandate that requires disclosure. These 7 components are oftentimes divided into three stages: (1) information, research, and data collection stage, (2) a prioritization and strategy design stage, and (3) an implementation and action stage. For example, in the Alaskan oil and gas HIA mentioned in Box 3-3, the HIA team drafted recommendations in collaboration with the decision-maker, the Bureau of Land Management, which formally adopted the recommendations as mitigation measures. The Association for Community Health ImprovementsCommunity Health Assessment Toolkitoffers a nine-step pathway for conducting a CHA and developing implementation strategies. It identified which areas and villages were most likely to be affected and when. The recommendations should be provided in the final HIA report and should document available supporting evidence, stakeholder input, and a health-management plan, which should do the following: If no recommendations are made in the HIA report, an explicit rationale should be provided for the decision not to include them. It characterizes health effects according to their nature, direction, intensity, magnitude, distribution, timing and duration, and likelihood. In practice, however, reporting may occur at earlier stages of the HIA process and include public meetings; meetings with decision-makers, other stakeholders, and advisers; and dissemination of interim public reports, such as a scoping summary. 2006). A growing population of families that have children. The Public Health Accreditation Board defines a community health improvement plan as a long-term, systematic effort to address public health problems on the basis of the results of community health assessment activities and the community health improvement process. Monitoring should provide information that allows one to conduct the evaluations noted above. The development of recommendations should be guided by a consideration of any available evidence regarding effectiveness. Experimental evidence of welfare reform impact on clinical anxiety and depression levels among poor women. Community Health Assessment aNd Group Evaluation (CHANGE): Building a Foundation of Knowledge to . . Recommendations may be implemented through regulatory mandates or voluntary actions by stakeholders. Because any actions taken on the basis of HIA recommendations need to be implemented within a specific legal and policy context, screening needs to establish a clear description of the decision-making process and context. Program on Health Equity and Sustainability, San Francisco Department of Public Health. Conversely, to have the greatest relevance as an informational and planning document and to ensure judicious use of resources, the HIA should ultimately focus on the health effects of greatest potential importance. Bennear LS, Olmstead SM. The HIAs also changed the debate in such a way that providing paid sick days for employees began to be presented as a public-health issue rather than a labor issue. Minimum Elements and Practice Standards for Health Impact Assessment (HIA), Version 2. Would you like email updates of new search results? Another variation, rapid-appraisal HIA, has been described and in some texts includes explicit public engagement through an initial half-day workshop for stakeholders (Parry and Stevens 2001; Mindell et al. Box 3-1 provides an example of how screening on a proposal for a residential housing program was conducted. For example, there may be concerns about risks to a proponents reputation or to the viability and public acceptance of a proposed project if a report discloses important unmitigated adverse impacts or potential impacts that are uncertain or for which strong evidence does not exist. A CHA is a systematic process involving the community to identify and analyze community health needs and assets, prioritize those needs and then implement a plan to address significant unmet needs.1Upon completing the assessment, hospitals develop implementation strategies to address the significant community health needs identified in the CHA.2A community health assessment process can focus your organizations efforts around community health improvement and provide structure for addressing the determinants of health and illness in your community. Public input while recommendations are being developed helps to ensure that proposed measures are locally relevant, address context-specific factors that might render them more or less effective, and address public concerns and hopes. The baseline profile characterizes the health status of affected populations and includes trends and factors (social, economic, and environmental) known to affect health. Given the volume and breadth of decisions at the local, state, tribal, and federal levels that can potentially affect health in some way, one of the challenges for HIA practice is to determine which proposals to screen. That permits recommendations to form the basis of effective implementation and management rather than merely providing a static system without the capacity to adapt. government site. 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. What Is a Community Health Improvement Plan? The committee recommends that HIAs be publicly released and disseminated. 2001). A smaller set of related indicators was endorsed for use in monitoring key elements of community health status (CDC, 1991). Health impact assessment: A tool for healthy public policy. PMC DHHS (U.S. Department of Health and Human Services). Please enable it to take advantage of the complete set of features! It develops the scope of health effects for analysis through systematic consideration of all factors associated with the proposed action that have a potential to influence health, and it narrows the scope to effects that are judged most important for health. In many cases, the first course of action is to gather information from published literature, unpublished reports, administrative data gathered for routine monitoring purposes, and other available documents. Suicide is the fourth leading cause of death among young people worldwide and the third leading cause of death among those in the US. AHA does not claim ownership of any content, including content incorporated by permission into AHA produced materials, created by any third party and cannot grant permission to use, distribute or otherwise reproduce such third party content. The variability also reflects a lack of clear criteria that define HIA as a distinct field. To receive email updates about this page, enter your email address: We take your privacy seriously. The Affordable Care Act requires all nonprofit hospitals to complete a community health needs assessment (CHNA) process every three years. It includes the production and dissemination of written materials that document the HIA process, methods, findings, recommendations, and limitations of the analysis; and it includes the public dissemination of results through other channels, such as meetings with the public, decision-makers, and other stakeholders. Adopting a position for or against a proposal (for example, support for or opposition to a legislative proposal). BLM later considered amending the EIS to make additional public lands available for oil and gas leasing in the original 4.6-million-acre planning area. Public concern or controversy regarding health effects of the proposed decision. Issues surrounding uncertainty, literature review, and reliability and validity of predictions are discussed in greater depth in Chapter 4. The assessment phase includes two tasks. It should define the vision for the health of the community through a collaborative process and should address the gamut of strengths, weaknesses, challenges, and opportunities that exist in the community to improve the health status of that community. Or, in some cases, there may be unpublished evaluations of measures that have been implemented in similar scenarios. Developing a robust characterization of baseline health status and the social, economic, and environmental conditions important to health is a challenging aspect of HIA practice. Such programs and projects involve many agencies and entities that have authority over some aspect of planning and implementation. Health Impact Assessment: Main Concepts and Suggested Approaches-the Gothenburg Consensus Paper. Membership is variable but may include representatives of affected communities or community-based organizations, industrial proponents or business groups, public-health experts, officials involved in the decision- making process, and others who have a stake in the outcome. It is also useful to assess the political context of the proposal to be assessed and consider, for example, the major political drivers of the proposal, the arguments made by political supporters and those opposed to the proposal, and any economic or technical constraints that limit the alternatives that can be considered. It is critical for the credibility of the HIA that the measures or outcomes being promoted are grounded in full and transparent consideration of the evidence that supports and does not support the issue in question. A review of health impact assessment frameworks. Indicators may be health outcomes in some cases, whereas health determinants may be more appropriate in others. Source: SFDPH 2011. In other cases, a draft may be submitted to an internal body, such as a steering group, whose comments are incorporated into a final public version. A discussion of whether the HIA achieved its initial objectives. 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. Third, it informs government agencies and officials of potential changes in demand for services, such as health care, emergency response, and public safety; this can facilitate an appropriate response. Second, it allows findings to be reviewed and improved. Assessing the Health Impacts of Road Pricing Policy Proposals. Understanding Risk: Informing Decisions in a Democratic Society. 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. Healthy People. Finally, effects that are plausible but are not supported by available evidence include fewer hospitalizations because workers are able to receive the preventive primary care needed to maintain good health. 4 A Community Health Improvement Process - National Center for The enacted legislation is consistent with some of the recommendations of the HIA, but there were no data to evaluate whether those drafting the legislation were influenced by the recommendations; there were no interviews with legislators over the course of the legislative process (Human Impact Partners 2010). Catholic Health Association, Guide to Assessing and Addressing Community Health Needs [PDF-1.5MB], June 2013. The American Hospital Associations review of the IRSs final rules for CHNAs and implementation strategies can be foundhere. Because it will often not be practical or possible to address all direct and indirect health effects that appear theoretically possible, it is important to select issues carefully. Knowing Your Community: Community Health Assessment as a Pow - LWW Characteristics unique to the affected community may not be obvious to HIA practitioners who are outside the community. Various sources of population-health statistics at the national, state, and local levels are available. The site is secure. Any approach to determining which proposals will be screened should demonstrate a consistent rationale; should document the rationale in the HIA report; and should take account of public input. Identification of the population and vulnerable groupssuch as children, the elderly, racial or ethnic minorities, low-income people, and communities that are likely to be affected. However, it is important to note that the use of qualitative approaches in HIA should not be interpreted as implying a need for less analytic rigor. The degree to which they are systematic varies, and some authors have suggested frameworks and guidance for conducting systematic reviews (Mindell et al. CDC - Home - Community Health Assessment - STLT Gateway McHugh S, Maruca S, Lilien J, Manning A. SFCC (Federation of Swedish County Councils). Review of literature and a consideration of the social, economic, and political context of the eventual decision are also important. Final Supplemental Environmental Impact Statement. The definition also notes that recommendations should incorporate monitoring, which is essential for effective continuing management as a decision is implemented. Knowing Your Community: Community Health Assessment as a Powerful Tool Bender, Kaye PhD, RN, FAAN Author Information Journal of Public Health Management and Practice: doi: 10.1097/PHH.0000000000000599 2017 Wolters Kluwer Health, Inc. All rights reserved. 2019 Feb;22(1):25-31. doi: 10.1089/pop.2018.0049. An initial brief summary of the pathways through which health could be affected and the health effects to be addressed, including a rationale for how the effects were chosen and an account of any potential health effects that were considered but were not selected and why. In most cases, influencing decisions to protect or promote health is a central objective but by no means the sole outcome of value. The reliability and validity of predictions made in HIAs have often been questioned (Thomson 2008). Environmental, Social and Health Impact Assessment (ESHIA) Process.