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Community Health Assessment and Improvement Planning

Why community health assessments  and improvement planning processes

The fundamental purpose of public health is defined by three core functions: assessment, policy development and assurance. Community health assessments (CHAs) provide information for problem and asset identification and policy formulation, implementation, and evaluation. CHAs  also help measure how well a public health system is fulfilling its assurance function (1,2).

A CHA should be part of an ongoing broader community health improvement process. A community health improvement process uses CHA data to identify priority issues, develop and implement strategies for action, and establish accountability to ensure measurable health improvement, which are often outlined in the form of a community health improvement plan (CHIP) (3). A community health improvement process looks outside of the performance of an individual organization serving a specific segment of a community to the way in which the activities of many organizations contribute to community health improvement (3). The Public Health Accreditation Board’s (PHAB’s) voluntary, national public health department accreditation program is designed to document the capacity of a public health department to deliver the three core functions of public health and the Ten Essential Public Health Services. PHAB requires completion of a CHA and a CHIP as two of three prerequisites to accreditation program application.

Mobilizing for Action through Planning and Partnerships (MAPP)

Mobilizing for Action through Planning and Partnerships (MAPP) is a community-driven strategic planning tool for improving community health. Facilitated by public health leaders, this tool helps communities apply strategic thinking to prioritize public health issues and identify resources to address them. MAPP is not an agency-focused assessment tool; rather, it is an interactive process that can improve the efficiency, effectiveness, and ultimately the performance of local public health systems. On the webpage, users can access the entire MAPP tool, supplemental resources, and technical assistance. More »

Accreditation Prerequisites: CHAs and CHIPs

In fall 2011 the PHAB’s public health department accreditation program launched. As part of its overall intent to improve and protect the health of the public by advancing the quality and performance of public health departments, PHAB requires demonstration of ongoing community health improvement planning processes by LHDs wishing to achieve accreditation. A CHA and a CHIP are two of the three prerequisites for PHAB applications. More »

NACCHO is funding 12 LHD demonstration sites to engage in a robust community health improvement process that yields a CHA and a CHIP. Visit the CHA/CHIP project website to learn more. More »

Resource Center for Community Health Assessments and Community Health Improvement Plans

The Resource Center for Community Health Assessments and Community Health Improvement Plans provides practical, customizable tools and resources to all LHDs in a central and publicly accessible location. The CHA/CHIP resource center is intended to support LHDs and their partners in completing community health improvement processes, including the conduct of a CHA and the development of a CHIP for the purpose of improving the health of local communities. The CHA/CHIP resource center contains example high-quality CHAs and CHIPs and case studies of communities who have completed CHAs and CHIPs for accreditation preparation and more.

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Community Health Assessment and Health Reform
NACCHO is committed to helping LHDs strategically align their community health assessment efforts with other assessment initiatives such as those of non-profit hospitals. Click here for resources which provide information to help LHDs and non-profit hospitals conduct collaborative community health assessment and improvement planning processes. More »
National Public Health Performance Standards Program (NPHPSP)
The NPHPSP is designed to measure public health practices at the state and local levels. NPHPSP supports local, state, and government instruments for measurement. The local instrument, referred to as the local public health system assessment in MAPP, evaluates the capacity of local public health systems to conduct the 10 essential public health services. More »
Healthy People 2020 (HP 2020)
With fewer resources and staff, many LHDs face significant challenges in providing essential services that ensure the health and safety of their communities. The HP 2020 approach offers an evidence-based, easy-to-use tool designed to aid LHDs and other organizations in community health assessment work. NACCHO's partnership with HP 2020 is designed to support and increase the use of HP 2020 among LHDs and other organizations related to community health assessment and improvement processes.

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Community Health Status Indicators (CHSI) Project
The CHSI Project makes detailed health and demographic information about each of the nation's 3,141 counties widely available and easily accessible. County-level reports measure each county against national averages, other counties with similar demographics, and Healthy People 2010 targets. Taken as a whole, the site provides to the public the most detailed picture of health at the county level and is an invaluable resource for public health departments, policymakers, and community advocates. More »
The Assessment Protocol for Excellence in Public Health (APEXPH)

APEXPH is a flexible planning tool developed for local health officials to:

  • Assess the organization and management of the health department;
  • Provide a framework for working with community members and other organizations to assess the health status of the community; and
  • Establish the leadership role of the health department in the community.
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Course Curriculum for Performance Improvement

NACCHO's performance improvement (PI) curriculum is designed to help LHD staff implement PI practices and standards within their health departments. This curriculum will allow staff to increase internal alignment and improve effectiveness in helping LHDs to optimize their understanding of PI and recognize its value, leading to improved LHD performance and overall public health practice.

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Publications and Fact Sheets
Recommendations of Characteristics for High-Quality Community Health Assessments and Community Health Improvement Plans

The recommendations presented in the document describe the characteristics of a community health improvement process that yields a high-quality community health assessment (CHA) and community health improvement plan (CHIP), according to NACCHO. The recommendations are presented as a checklist to assist LHDs and others in tracking their efforts with particular attention to preparing for the Public Health Accreditation Board's accreditation program. Read more and visit the document here.

MAPP, NPHPSP, and Accreditation Relationship Guidance

This document explores the connections among several performance improvement processes and standards, including MAPP, the National Public Health Performance Standards Program (NPHPSP), and the PHAB's January 2009 draft accreditation standards. A general document as well as a fact sheet for local health officials is available.

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[1] Public Health Accreditation Board. Accessed 12/23/10 at
Institute of Medicine of the National Academies. (2003) The Future of the Public's Health in the 21st Century. Washington, DC: The National Academies Press.
[3] Durch J.S., Bailey L.A., & Stoto M.A. (1997). Improving Health in the Community: A Role for Performance Monitoring. Washington, DC: National Academy Press.