Shifts in Community Health Needs Assessments: Tilting Towards a Social Determinants of Health Lens

October 17, 2016. Marlborough, MA.
Marlborough Senior Center Tai Chi class for MAPC.
© 2016 Marilyn Humphries

Shifts in Community Health Needs Assessments: Tilting Towards a Social Determinants of Health Lens

As community health needs assessments (CHNAs) are becoming more prominent, a shift
has occurred in what hospitals – and other agencies and institutions - are prioritizing.
A CHNA identifies and describes factors that affect the health of a community. The process
equips communities with a plan to prioritize and act on the community health needs, which
is typically captured in a Community Health Improvement Plan or CHIP.

Previously, most hospital-lead CHNA’s identified health needs as it mostly related to clinical
care. For example, when CHNA’s mentioned the transportation needs or barriers their patients experienced, it was in the context of community members facing transportation barriers to receive clinical care services or programming and not to their overall health. Community members were seen through the lens of ‘patient’, which missed whole parts of their lives
affected by transportation and that we know affect health such as access to healthy food
and to living wage jobs.

However, in 2019 more CHNAs in Greater Boston have identified needs of people through a social determinants of health lens. This means more hospitals are beginning to identify economic, environmental and social factors that affect their community’s health.
For instance, hospitals have begun to make the connection of how the quality and affordability of people’s homes can affect community health outcomes. Some have even gone so far as to make capital and operational investments that deepen their focus on
the social determinants identified in the CHNAs.

In this round of CHNAs, sets of hospitals have also decided to join efforts to collaboratively conduct their CHNA’s. Hospitals that participated in collaborative CHNA aimed to achieve deeper engagement with key community and organizational stakeholders, enhance alignment of priorities and use of data across hospitals, and coordinate their implementation strategies. We are seeing this same level of effort and coordination occur as other organizations – health departments and non-profits – update their needs assessments, all of which bodes well for addressing the upstream factors that keep people healthy and well.

Koi fish made out of construction netting, gloves, and air mask at Wake Up the Earth 2019

CHNAs are an important tool to inform and drive community development.

They can be a key resource for planner in Greater Boston by providing a health lens and understanding about how the economic, environmental and social factors impact people’s health outcomes.