This Application Assignment asks you to consider the kinds of data you would use, and how you would obtain the data, for a community health assessment.
Read through the case exercise on Community Health Assessment, linked below, and complete all the questions. All the information you will need to complete this assessment exercise is provided in the Appendix at the end of the document. Save this Word document to your computer before you begin to fill out the form.
Note:Assessment is a very involved process, and you could easily spend many hours exploring this case exercise alone. However, for the purposes of this assignment, you should limit yourself to spendingno more than two hoursto complete this Application.
This Application Assignment is due byDay 7of this week.
You have completed Week 4. The course now shifts in focus to performance management. Please proceed to Week 5.
Week 4 Application: Community Health Assessment for Pitt County, North Carolina[*]
Community health assessment is key to understanding the health problems and priorities of a population. This Application Assignment outlines a process by which you can complete a health assessment of a community using indicator-based methods. You will construct a set of health indicators from a variety of domains, evaluate problems, and report on the health priorities for a community.
Sections A–C ask questions about assessment in general. Section D involves assessment of a particular county in North Carolina, information on which is provided in that section and in the Appendix.
Instructions: Save this document to your computer and complete all questions in Sections A–D below. Submit by the end of Week 4 following the submission instructions in the Week 4 Application section.
Section A: Community Health Assessment
The goal of public health is to improve the health of a population. Public health interventions such as safe water sources, immunization programs, and improved motor vehicle safety regulations account for the majority of years of life expectancy gained in the United States over the last 100 years.
A community health assessment involves obtaining and interpreting information to determine the health status of a specific community. Once community health needs are identified, public health interventions can be developed and their effectiveness evaluated using a similar approach. Information necessary for performing a community health assessment, for example data on mortality rates or behavioral risk factors such as smoking, is available from various sources.
1. How do you define community?
2. What stakeholders (groups/organizations) would you want to consult with for a community assessment?
3. What types and sources of data would you use for a community assessment?
Section B: Healthy People 2010
The Healthy People 2020 initiative is a national approach that identifies high priority health issues and establishes objectives to reduce the impact of these public health threats. To understand the significance of data on your own community, you have to be able to compare it to another standard. The questions in this section ask you about other standards that can be used.
1. How are Healthy People 2020 standards used? What are advantages and disadvantages to applying them at a local community level? (Note: you may use the Healthy People 2010 standards if the 2020 standards are not reported.)
2. What other standards (national, state, or local) can be used?
Section C: Health Indicators
For this exercise, you will use an indicator approach to develop a community health assessment. A community health assessment involves three-step feedback loop.
The first step in such an assessment involves identifying important health indicators. The second step involves matching those indicators with available data. In the third step, standards such as those explored in Section B are applied to the data gathered in the first two steps to transform it into useful information about health needs of the population.
Health indicators are measurable health outcomes, such as death rate, insurance coverage measures, immunization rates, or other data items that are relevant to the health of a community.Indicators are thoughtfully selected data points that provide useful information about the health of a community.
Note that each indicator should be:
- An important health problem.
- Prevalent or common in the community of interest.
- Measurable on a community or population basis. There should be population data on a local level that is easily available—this cannot be collected from health facilities or providers because these data sources do not apply to the entire community.
- Ideally, because we want to use a limited number of indicators, the indicator should not be redundant—not measure the same thing—as another chosen indicator.
To organize indicators, it is helpful to identify major areas of focus. For this case, we will refer to these broad categories of public health concerns asdomains. Please refer to Table 1 below for examples of domains. For each domain, an example of an indicator is provided.
Table 1: List of Domains to Assist Developing a Community Health Assessment
|Domain:||Example of an Indicator:|
(including Sexually Transmitted Diseases)
|Incidence of Gonorrhea|
|Chronic Diseases (including Cancer)||Incidence of Diabetes|
|Injury and Violence||Homicide rate|
|Maternal and Child Health||Childhood immunization rate|
|Environmental Health||Rates of Lead Poisoning|
|Access to Health Care||Rates of Uninsured|
1. How you would obtain data for these indicators. What sources might you use? Select 2 of the indicators above and provide specific sources of information on them (including URLs) for your own community or state.
Section D: Performing a Community Health Assessment
As a consultant to Pitt County Health Department, you are asked to perform a community health assessment for the county. Below is information about the county:
Pitt County is located in eastern North Carolina and has a population of 138,690 residents (2005 Census). Pitt County has been classified as urban for the first time in 2006. It and the surrounding counties are largely rural with a history of dependence on tobacco farming. Caucasians make up about 62.8% of the population, African Americans 33.6%, Hispanics 3.2%, Asians 1.1% and American Indians 0.3%. There are an estimated 6,606 migrant and seasonal workers or 5.4% of the population. About 18% or 26,000 adults in Pitt County adults have household incomes below the federal poverty level with a median per capita income of $18,243 (2000). The child poverty rate is estimated to be 21.8%. Approximately 20% of adult lack health insurance.
Pitt County contains Greenville, the largest city in eastern North Carolina with a population of 67,525 (2005). Greenville is considered the hub of eastern North Carolina. The major employers are Pitt County Memorial Hospital (PCMH), Brody School of Medicine and East Carolina University. If a state was created of all the land in North Carolina east of Interstate 95, it would be the poorest of all 50 states. In addition, it would rate 48th in terms of premature mortality. Consider these factors when evaluating populations at risk and targeting resources for public health activities.
You now embark on the steps needed to perform your assessment.
· STEP ONE: IDENTIFYING HEALTH INDICATORS
As noted earlier, the first step in a community health assessment is identifying health indicators. Develop a list of 18-20 indicators you would want to use in your assessment, identifying 3-4 indicators per domain.
Complete the column on the right in this table:
|Domain:||Indicator: (provide 3-4 per domain|
(including Sexually Transmitted Diseases)
|Chronic Diseases (including Cancer)|
|Injury and Violence|
|Maternal and Child Health|
|Access to Health Care|
· STEP TWO: MATCHING THE INDICATORS
Now that you have chosen indicators to use for a community health assessment, use the information provided in the tables below (Appendix) to match available data to your chosen indicators. In this example, residents of Pitt County constitute the community. If the Appendix does not give you the data for your indicator, you should choose another indicator (alternatively, you may seek out the data elsewhere that you need for your proposed indicator).
1. Have you matched each of your indicators to the data available in the Appendix?If not, explain how and where you got the data needed for your proposed indicator.
· STEP THREE: SETTING HEALTH PRIORITIES
Using the information gathered in the first two steps, please answer the following questions.
Note: Keep in mind that in order to plan an effective intervention program in real life, you must communicate with other constituents and stakeholders and see what they perceive to be priority health issues. Collaboration with community stakeholders in program design is critical to the success of an intervention plan. For this purposes of this assignment, however, you are reviewing the data on your own, without the input from other stakeholders.
1. Looking at this data only, what would you conclude are three priority health issues for this population? (Can be picked by how the indicator compares)
2. Choose three of your indicators. Compare them to the Healthy People 2020 Standards (or 2010 if appropriate) and provide URL(s) for the relevant Web page from Healthy People to the specific indicator.
3. How do you explain the health disparities of these indicators? (i.e., as shown by this comparison with HP?]
You have completed this Application on assessment. Submit this completed form in the Dropbox following the submission instructions in the Week 5 Application area.