“How can we assess what out what the health needs of our community really are?”

Accurately assessing a community’s actual health requirements, in terms of citizen concerns and needs, is vitally important to any community health development process. Simply put, assessment is a process of gathering and analyzing information, from both quantitative (statistical or data) sources and qualitative (empirical or public perception) sources. Assessments are essential, not only as a basis for further collaboration or goal setting, but also because funding sources usually require assessment data as documentation for loan and grant applications.

Successful assessments are based on three assumptions: 1) Those involved understand the purpose for the assessment; 2) Those involved consider the resources, both funds and people, available to conduct the assessment; and 3) Those involved agree to a plan for using the assessment’s findings.

Because there are so many methods, ranging from simple to very complex, for conducting assessments, the process of conducting a community-based assessment can seem overwhelming. It is good to bear in mind that the complexity of a given method does not necessarily equal its usefulness.

It is also encouraging to know that while professional guidance in conducting assessments is available to Texas communities, based on need, it has been proven that the average community can complete most basic assessment work itself. The sense of ownership and competency derived from this experience makes it much more likely that the community involved will translate their assessment findings into action.

Gathering and Reviewing Data
Much of the initial statistical information required for community health assessments is readily available for public research and scrutiny. Many of the references that follow assume a basic knowledge of, and access to, the Internet. Local libraries, school systems and Area Health Education Centers (AHECs) can provide assistance with Internet search capabilities. Most of the following references also list offline contact information.

As outlined in Toolbox Section Who Can Help, the Texas Department of State Health Services (DSHS) provides a wealth of statistics on health data for Texas, by state, region and county.

To access DSHS ’s online data, and print county-appropriate reports, go to their Center for Health Statistics homepage at: http://www.dshs.state.tx.us/chs

The National Civic League sponsors Healthy Communities Programs and offers a Civic Index to evaluate civic infrastructures, complete with measurement tools, sample surveys and guided processes. Order at http://www.ncl.org/publications/pubs_cs.html

For mapping and comparing health data by state, including health insurance coverage statistics, health costs, health status and minority health issues, see the Kaiser Family Foundation site at http://www.statehealthfacts.org/cgi-bin/healthfacts.cgi?

For comparative and contact information for specific hospitals and/or hospital systems within a region, try the “hospital finder” at the American Hospital Directory (AHA) at http://www.ahd.com/ The AHA directory includes basic profile and contact information for each hospital, as well as data essential to utilization of federal reimbursement programs, i.e., inpatient utilization statistics.

For by-county expenditures on health care in Texas, contact the county judge or county commissioners’ court. U.S. Census data is usually available at libraries. Other sources for data include local agricultural extension agents, local or county health departments, regional Texas Department of State Health Services (DSHS) offices, AHECs and councils of government. Other good referral sources are the state office of rural health (Office of Rural Community Affairs [ORCA]) in Austin, as introduced in Toolbox Section Who Can Help, the Texas Rural Health Association http://www.trha.org and the Texas Institute for Health Policy Research in Austin http://www.healthpolicyinstitute.org

With a little persistence, the average community can research and compile an impressive mound of quantitative data in the form of public information relating to local health needs, and depending upon the purposes meant for the research, may not need to perform their own qualitative assessments.

Conducting Community Needs Assessments
If however, more information, particularly public opinion, is needed, a community may embark on local needs assessment process. Local assessments usually include conducting surveys, by phone, mail or in person, key informant interviews, focus groups, town hall meetings and media outreach.

A summary of recommended consumer access and satisfaction items to include for assessment analysis can be derived from Consumer Survey Information in a Reforming Health Care System, a conference summary paper sponsored by the Agency for Health Care Policy and Research and The Robert Wood Johnson Foundation, 1995. Single copies are free. To order online, go to http://www.ahcpr.gov/gils/00000207.htm

The actual instrument, or format, that can be used for assessment processes varies widely. Instruments are usually tailored to fit the needs of each community, so standardized instruments or exact prototypes are difficult to find.

A basic, step-by-step community assessment guide is available for download from the federal Centers for Disease Control (CDC). It is known as the PATCH (Planned Approach To Community Health) plan. To access, go to http://www.cdc.gov/nccdphp/patch/index.htm

Another CDC standard is Measuring Healthy Days, a method of collecting health risk data through four targeted questions that measure public perceptions about their 'healthy days.' A survey of this method is found at http://www.cdc.gov/nccdphp/hrqol/pdfs/mhd.pdf

The CDC's Behavioral Risk Factor Surveillance System (BRFSS) is another standard format for assessing and gathering information on a wide variety of behaviors affecting health and chronic disease prevention. It has been used successfully by both the federal government and states to measure risk factors of populations. For an outline of the methodology, see http://www.cdc.gov/nccdphp/aag/aag_brfss.htm

To employ aspects of the federal benchmark for public health planning, Healthy People 2010, see the Healthy People 2010 Toolkit, A Field Guide to Health Planning, in downloadable PDF-format at http://www.healthypeople.gov/state/toolkit/default.htm

A nationally known, and copyrighted, model of community health improvement, which includes an assessment guide and manual is the “Community Health Improvement Partnership (CHIP)—A Rural Community Health Development Process.” Its developers, Paul McGinnis and Jim Przybilla, conduct fee-based training and community consultation. (See Resources, below, for contact information.)

For professional support in conducting community needs assessments, contact the nearest area health education center (AHEC), [information listed in Toolbox Section Who Can Help,] and ask for facilitation assistance or referral. County health departments, social welfare agencies, agricultural extension agents and some civic groups have experience in assessment activities. Community nursing or public health faculty in universities or health professional training programs also can offer expertise in assessment processes.

Another agency to contact is the local Texas Department of State Health Services (DSHS) office for possible assistance in facilitating meetings