Strengthening Community Health Through an Implementation Strategy
Taking Community Health Needs Assessments to the Next Level.
February 23, 2022
Woven into the fabric of our country is a desire to care for our most vulnerable. It is why people are moved to donate during the holidays, support food pantries or organize coat drives for the homeless. This care for the other is clearly demonstrated by the philanthropic engagement across our country. Americans gave almost $450 billion to charities in 2019 making it one of the best years for charitable giving.1
The nature of community benefit work appeals to a shared value system that when we lift up those who are disadvantaged, all boats rise. It is less about doing what we have to do and more about seeing a need and finding a way to address it.
The local work of organizations trying to solve community problems whether it be homelessness, hunger, or health-related conditions is vital. Our collective strength depends on it.
Community health. A mission worth pursuit.
Some thirty years ago, well before HMOs permeated the market, the pursuit of community health started to rise within non-profit hospitals. The charge started to move towards caring for the sick and simultaneously trying to improve health, in particular, preventing chronic diseases and critical sickness to keep people from having to go to the hospital.
This was not a new thought. In fact, the World Health Organization made the assertion that health is more than the absence of disease when they enacted their constitution in 1948.2 It was, however, a major shift for hospital administrators across our country who were solely focused on acute care. Throughout the 1980s and early ’90s, hospitals were still accustomed to fee-for-service care. Treating the sick was the bottom dollar.
Around this same time, the government began to revisit regulations instituted back in the 1960s that validated a hospital’s nonprofit status. These guidelines originally outlined the necessity for hospitals to institute community health needs assessments (CHNA). CHNAs gained even more traction as a mandate of the Affordable Care Act (ACA).
CHNA. Taking the first step.
Despite the necessity to fulfill the ACA mandate, many organizations began making it a focus to address the physical, economic, mental, and social impacts on health. A CHNA provides a roadmap to accomplishing this. By presenting the organization’s valuable information about the health status, needs, and barriers to health, a CHNA becomes a springboard for strategic changes to be made.
Why is this change important?
This goes back to a shared value system and the idea that improving the lives of the marginalized and disenfranchised creates a stronger footing for everyone. When the deficits in community health are not addressed, it can highly influence other facets of shared public life like safety, economic stability, population growth, and prosperity.
Thriving community health relies on the development of a systematic design that promotes equity, progress, and long-term sustainability.
Next up. Implementation planning.
Where a CHNA provides the groundwork, an Implementation Strategy Plan (ISP) puts it into motion. Taking the comprehensive analysis of community data, the ISP develops the coordinated plans, strategic partnerships, and collaborative approaches necessary for moving the needle on health equity.
But for change to occur, action is required. Evidence shows the underuse of effective health care interventions is more prevalent among underserved populations.3 Health systems need to focus on executing a comprehensive plan to improve access, remove barriers, and eliminate disparity in treatment.
By prioritizing initiatives and devoting resources to addressing the underlying factors that lead to adverse health outcomes particularly for disenfranchised populations, strides can be made in creating health equity and subsequently advancing community health.
A study by The Commonwealth Fund looking at access, prevention, quality, and health outcomes across the country identified support for an intentional and strategic approach. The analysis found that although low-income populations suffer inequalities in every state, health outcomes of those populations differed based on their state’s approach to improving community health. Top-performing states that implemented interventions like expanded insurance coverage, access, and coordination of health care services lessened the effects poverty typically has on health.4
Strategic collaborations serve as a catalyst for strengthening community health. Hospitals sit in the driver’s seat and can leverage their influence with community foundations, business leaders, and government agencies to mobilize action towards a strategic design for improved community health.
Putting our history to work
Tripp Umbach has been at the forefront of community health needs assessments since the beginning. In 1991, we completed the nation’s first CHNA for Butler Hospital in Butler, Pennsylvania. The project, a pilot program for the Veterans Health Administration (VHA), led to more than 500 assessments across the nation and internationally. Today, Tripp Umbach’s wealth of experience in community health needs assessments and implementation strategy planning is leading the way for hospitals and health systems to not only addresses their communities’ but advance their hospital’s mission. The solutions to our community health issues are within reach. Let’s pursue them together.
- Charitable giving showed solid growth, climbing to $449.64 billion in 2019, one of the highest years for giving on record, Giving USA 2020 (June 16, 2020), https://givingusa.org/giving-usa-2020-charitable-giving-showed-solid-growth-climbing-to-449-64-billion-in-2019-one-of-the-highest-years-for-giving-on-record/
- Constitution of the World Health Organization (Enacted April 7, 1948), https://www.who.int/about/governance/constitution
- Race/ethnicity, and Americans’ perceptions and experiences of over- and under-use of care: a cross-sectional study, BMC Health Services Research (October 1, 2015) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590257/
- Health care in the two Americas. Findings from the Scorecard on State Health System Performance for Low-Income Populations, The Commonwealth Fund (September 2013), commonwealthfund.org/sites/default/files/documents/___media_files_publications_fund_report_2013_sep_1700_schoen_low_income_scorecard_full_report_final_v4.pdf
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Tripp Umbach Project Director
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