One of the benefits of being a WeTHRIVE!℠ community is the Community Health Assessment (CHA) conducted by Hamilton County Public Health.
In Part 1 of this story, we learned the basics of a CHA and how the WeTHRIVE! team gathers information about the community. In this post, Part 2, we’ll focus on epidemiological data and how a CHA benefits a community.
At the end of this post, you’ll find a link to a new infographic that summarizes the CHA process.
Our information comes from a conversation with three of our WeTHRIVE! team members who work on CHAs:
Tom Boeshart is a senior epidemiologist at HCPH.
Nicole Key is a WeTHRIVE! population health specialist.
Karen Schwamberger is the WeTHRIVE! community outreach contractor.
Q: What kind of epidemiological data do you use for the CHA?
Tom: Anything we can get our grubby little paws on! But really, we use a lot of data from a lot of sources to get a picture of the people who live in the community. We look at demographics like age, gender, and race. Racial residential segregation, educational attainment, income, poverty level, food access, injury and motor vehicle crash data. For actual health outcomes, we use data on access to healthcare, death rates from diseases like cancer and diabetes, rates of communicable diseases, life expectancy. We look at it all.
Q: What can data tell you about a community’s health, wellness, and vitality?
Tom: It can tell us a lot. It gives us a nice picture of what’s going on in the community, including what they are doing really well at. We take the outcomes and do a statistical comparison to the county as a whole. Is your community’s rate of a health indicator statistically significantly higher or lower than the county’s rate? This lets us look at the top ten assets and opportunities for a community, based on how they are doing compared to all of Hamilton County.
Q: Can you give us an example?
Tom: When we look at health outcomes, we’re looking at death rates, how many people died of a specific disease. A great example would be diabetes. It’s hard to get data on how many residents actually suffer from diabetes, so we have to look at the rate of residents who are dying from it. Now, correlation doesn’t prove causation, but if you have a lot of people dying from diabetes, you probably have a good chunk of people that are living with it or are undiagnosed. We compare a community’s diabetes mortality rate to Hamilton County’s rate – are you doing better or worse than the rest of the county?
Q: Does the data by itself paint the picture of a community that you’re talking about?
Tom: No, we always remind people that we can’t just look at the outcome data, in part because these outcomes are the worst of the worst. Remember, we were talking about the rate of people dying from diabetes as opposed to just living with that disease.
Karen: So to get the whole picture, we can bring in data from the Community Voice Survey and the Community Audit, too. For example, the data may show that a community has a high incidence of lung cancer. But what else is going on? Did we find a lack of tobacco-free policies through the Community Audit? In the Community Voice Survey, did residents complain about cigarette butts on the ground in parks and on sidewalks?
NICOLE: It’s the importance of considering the demographic data as well. Say, for example, we know there’s a community where lung cancer or oral cancer rates are extremely high. When we look at the demographic data, we see the community has a population that’s low income or rural or has low educational attainment, and we know that these are communities that the tobacco industry has historically targeted. This helps us find out what determinants of health exist in these communities, because they could impact the rates of lung or oral cancer as well.
Q: How do you come up with recommendations for a community?
Karen: We look at the opportunities we discovered through the data, community audit, and community survey, and then suggest recommendations for those opportunities. We really try to focus on best practices, and policy, system, and environmental changes. We’re also trying to be realistic and come up with things the community will be able to work on.
NICOLE: We’re not always asking them to move mountains. Sometimes it’s just a tweak. It’s how can we take a program that’s already in place, it’s doing well, how can you just elevate it?
Q: Any final thoughts?
Karen: It’s a lot of work, but we love it!
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