Conducts community health needs assessment with data collection, analysis, and priority identification. Use when assessing community health, prioritizing health needs, or planning health interventions.
Community Health Needs Assessments (CHNAs) are both a public health best practice and a legal requirement. IRS Section 501(r)(3) mandates that nonprofit hospitals conduct a CHNA every three years. PHAB accreditation requires health departments to complete a Community Health Assessment (CHA) as a prerequisite for Domain 1 compliance. The MAPP (Mobilizing for Action through Planning and Partnerships) framework — developed by NACCHO and CDC — provides the structured methodology most widely adopted by local health departments. Without a rigorous CHNA, communities cannot identify priority health needs, justify funding requests, or align interventions with actual population burden. This skill guides the complete CHNA process from planning through implementation strategy development.
Assemble a community health profile using standardized data sources:
Benchmark all indicators against state averages, national averages, and Healthy People 2030 targets.
| Data Domain | Primary Source | Geography | Update Frequency |
|---|---|---|---|
| Demographics | ACS 5-year estimates | Census tract to national | Annual |
| Mortality | NCHS/vital records | County to national | Annual (2-year lag) |
| Behavioral risk | BRFSS | State/metro | Annual |
| Youth risk | YRBSS | State | Biennial |
| Maternal/child | Vital records, Title V TVIS | State | Annual |
| Healthcare access | HRSA Area Health Resource File | County | Annual |
| Social vulnerability | CDC/ATSDR SVI | Census tract | Updated with Census |
| Food insecurity | Feeding America Map the Meal Gap | County | Annual |
| Hospital utilization | HCUP/state discharge data | State/county | Annual |
Primary data collection gives voice to community members and surfaces needs not visible in administrative datasets:
Analyze qualitative data using thematic coding. Identify convergent and divergent themes between quantitative findings and community perception.
Merge quantitative and qualitative findings into a prioritization process:
Present compiled data to the steering committee and community stakeholders.
Apply a structured prioritization method:
Select 3-5 priority health needs based on: magnitude of the problem, severity of consequences, health equity impact (disproportionate burden on underserved populations), availability of effective interventions, community readiness, and alignment with state/national priorities.
Document the prioritization rationale, including the criteria used and the stakeholder input that informed selection.
For each selected priority, document: the quantitative burden (prevalence, rate, trend), the qualitative burden (community voice, lived experience), the equity dimension (which populations are disproportionately affected), the evidence base for intervention (what works), and the community capacity to address it (existing assets, organizations, programs).
Write the CHNA report including: executive summary, community description, methods, data findings by health topic, community input summary, priority health needs, and resources available to address them.
For 501(r)(3) hospitals: prepare the accompanying Implementation Strategy (IS) that describes how the hospital plans to address each identified priority need, or explains why a need will not be addressed. The IS must be adopted by the hospital's governing body.
For health departments: the CHNA feeds directly into the Community Health Improvement Plan (CHIP), which specifies measurable objectives, evidence-based strategies, responsible partners, and timelines for each priority.
Post the CHNA report publicly (required for 501(r)(3); best practice for health departments per PHAB standards).
Plan for continuous monitoring: establish lead indicators for each priority that will be tracked annually between CHNA cycles.
Cross-sector alignment --- Align CHNA priorities with other planning processes in the community: hospital community benefit plans, United Way priorities, school district health plans, local government strategic plans, and Federally Qualified Health Center (FQHC) needs assessments. Shared priorities enable shared resources.
Steering committee included representation from underserved populations and public health expertise
Quantitative data compiled for all required health topics with sources documented
Qualitative data collected from at least 3 distinct methods (interviews, focus groups, surveys)
Data benchmarked against state, national, and Healthy People 2030 targets
Prioritization process documented with criteria and stakeholder participation
3-5 priority health needs selected with documented rationale
CHNA report written and formatted for public posting
Implementation Strategy or CHIP drafted with measurable objectives
Cross-sector alignment assessed with other community planning processes
Health equity analysis documented for each priority need with disparity ratios
Community asset inventory completed alongside need identification
CHNA meets IRS 501(r)(3) requirements if conducted by a nonprofit hospital (community input, public health expertise, public availability)
CHNA aligns with PHAB Standards and Measures Version 2022 Domain 1 if conducted by an accredited health department
MAPP 2.0 four-assessment framework applied (or equivalent methodology documented)
Data sources cited with year, geography, and methodology notes
Health equity lens applied — disparities by race/ethnicity, income, geography, and other SDOH factors highlighted for each priority
Community engagement was inclusive, not just advisory — community members had decision-making power in prioritization
SVI or equivalent composite index used to identify populations at greatest risk
Report reviewed by steering committee and community stakeholders before finalization
MAPP 2.0 (or equivalent) framework applied with all four assessments completed
Priority selection process documented with explicit equity criteria applied
Cross-sector alignment with hospital, government, and nonprofit planning processes documented
Community asset mapping completed to complement needs identification
The CHNA is a community document, not just a hospital or health department document. Genuine community ownership increases the likelihood that priorities translate into action.
Avoid data dumps. The CHNA should tell a story about community health — not merely present tables. Contextualize every data point with community voice and local relevance.
Prioritization must be transparent and inclusive. A process that produces priorities without meaningful community input will lack legitimacy and political support for implementation.
For 501(r)(3) compliance, the IRS requires that the CHNA be conducted in the tax year it is adopted, be approved by an authorized body, and be made widely available to the public. Failure to comply results in an excise tax of $50,000 per year.
When data for small populations is unavailable (e.g., tribal nations, specific immigrant communities), document the data gap explicitly and describe steps taken to gather primary data from those communities.
Update the CHNA on a three-year cycle at minimum. In rapidly changing communities (pandemic impact, economic disruption, population migration), consider interim updates.
Escalate to steering committee leadership when: community stakeholders disagree on priorities, data reveals a previously unrecognized health crisis, or available resources are insufficient to address any of the top priorities.
A CHNA that identifies needs without identifying assets is incomplete. Every community has strengths — organizations, leaders, cultural assets, natural resources — that should be mapped alongside health needs. Asset-based community development (ABCD) principles complement needs-based assessment.
Data presentation matters as much as data collection. Use data visualization (maps, infographics, comparison charts) to make findings accessible to community members, elected officials, and non-technical stakeholders. A CHNA report that only data analysts can interpret fails its primary audience.39:["$","$L41",null,{"content":"$42","frontMatter":{"name":"assessing-community-health-needs","description":"Conducts community health needs assessment with data collection, analysis, and priority identification. Use when assessing community health, prioritizing health needs, or planning health interventions.","tags":["assessment","public-health"],"metadata":{"author":"casemark","practice_areas":["Public Health","Epidemiology","Preventive Medicine"],"document_types":["Assessment Report"],"skill_modes":["Assessment"]}}}]