Community Health Assessment for Population Health Improvement
Targeting care and effective planning for improving population health requires good information about current health status and the factors that will influence that health status. This report identifies the metrics – the population health outcomes and important risk and protective factors – that, taken together, can describe the health of a community and drive action. Selection of these metrics is based on a systematic review of professional and academic judgment over the past three decades. The report identifies 42 metrics, broadly categorized as those characterizing the status of health outcomes or health determinants. This report also contains links to and descriptions of existing sources of indicators for these metrics. The majority of the 42 metrics have indicators available at the level of metropolitan statistical area, county, or sub-county (census tract, census block groups).
A population health framework is used to organize the metrics of health outcomes and determinants. Outcomes were categorized as mortality or morbidity. Social determinants were organized into the following categories: health care, personal behaviors, demographics and the social environment, and the physical environment. These indicators can be used to make comparisons across populations, promote collaboration between organizations conducting assessments, assist in establishing a shared understanding of the factors that influence health, and help to galvanize residents to work collaboratively to improve community health.