Community Health Assessment (CHA)
A Community Health Assessment (CHA) is conducted to provide an understanding of the state of health in a community and the social factors contributing to and influencing health in the area. The assessment will be used as a guide for development of community health improvement strategies. The periodic updating of assessments reflects changes in health status and factors over time and helps ensure ongoing improvement efforts are based on the current needs of the community. Metro Public Health facilitated the 2013 Community Health Assessment process for Nashville-Davidson County.
For 2019, Metro Public Health Department, Saint Thomas Health, Vanderbilt University Medical Center, Metro Social Services, Matthew Walker Comprehensive Health Center, ConnectUsHealth and the Healthy Nashville Leadership Council forged a collaborative relationship to partner with community residents and stakeholders to understand the current health needs of Davidson County, Tennessee. This updated assessment of unmet health needs will provide a basis for addressing the health of the county, and act as a reference for each of the partnering organizations’ community health improvement plan/implementation strategy to ensure alignment with the community needs.
2018 Community Health Assessment Report
Community Health Improvement Plan (CHIP)
A Community Health Improvement Plan is an action-oriented plan outlining the priority community health issues based on the Mobilizing for Action through Planning and Partnerships (MAPP) community health assessment. The Healthy Nashville Community Health Improvement Plan outlines how these issues will be addressed, including strategies and measures to ultimately improve the health of Nashville by achieving our vision:A Healthy Nashville has a culture of compassion and well-being where all people belong, thrive, and prosper.
Thousands of Nashvillians participated in the visioning, assessment and strategy development processes that resulted in this Community Health Improvement Plan. The Mobilizing for Action through Planning and Partnerships process utilized the mayoral appointed Healthy Nashville Leadership Council as the Steering Committee, and Metro Public Health Department, Saint Thomas Health, Vanderbilt University Medical Center, Metro Social Services, Matthew Walker Comprehensive Health Center, ConnectUsHealth joined together to form a Core Team which was responsible for convening and guiding the process. The Community Health Assessment for Nashville Report details the assessment process, and its results, and can be found this page.
The 2020-2022 Healthy Nashville Community Health Improvement Plan (CHIP) presents five key systems issues for the community to address during the next three years. These issues were elicited from a rigorous community health assessment process using the Mobilizing for Action through Planning and Partnerships framework for community health improvement. The Mobilizing for Action through Planning and Partnerships assessments served as the foundation for informing the development of the priority community health issues for Nashville to address during the next three years.
Access and Coordination of Resources
Prioritizing coordination of resources between many different service providers was a necessity to many community members throughout the need’s prioritization process. “Access and Coordination of Resources” encapsulated many different types of services and resources throughout the community, not just health or clinically related. Some examples of the types of services that should be coordinated include but are not limited to social services, clinic services, housing assistance, and mental health services.
Addressing Basic Needs and Social Determinants
The need to address social determinants and to meet the basic health needs of populations in Davidson County was one of the largest issues revealed through all processes of the assessment. "Addressing Basic Needs and Social Determinants" entails many different things, including access to food, transportation, housing, and education. Failing to meet basic needs, increases the risk of development of chronic diseases and worse health outcomes. Primary and secondary data analysis largely stressed the importance and need to address the lack of access to basic needs across Davidson County.
Support Mental Health and Reduce Toxic Stress
Mental health and toxic stress was cited as a major issue throughout the need’s assessment process. Secondary data analysis indicates a high need for mental health services, decreasing negative stigmas of mental health, and education, prevention, and treatment of toxic stress, primarily adverse childhood experiences.
Access to Affordable Healthcare
Access and Affordability of Healthcare was a major issue, highlighted throughout the need’s assessment process. This includes insurance coverage, access to specialty providers, and insurance affordability.
The need for an equitable approach to addressing proposed health needs emerged as an issue throughout both quantitative and qualitative assessments, and by 2019 Healthy Nashville Summit attendees. The Metro Public Health Department’s 2015 Health Equity and Recommendations report define health equity as:
“[…] the societal and systematic understanding and appreciation of differences among individuals and populations; where everyone is valued and has the opportunity to achieve optimal health and well-being.
Understanding this definition, and continuing to understand complex social determinants of health, requires a systems approach when considering future health programming and interventions. This will require expanding our knowledge about what creates health, including examining policy change, finances, evidence-based programs that lead to data-driven action, community resources, and collaborative partners. Additionally, some groups are more susceptible to social disadvantages that lead to health inequities, therefore, special attention will need to be paid to:
- Children, youth or the elderly;
- Persons with disabilities;
- Ethnic or racial minorities;
- Persons experiencing homelessness;
- Persons who speak limited English;
- Low-income persons and families;
- Religious and faith communities;
- Women, and
- Persons who are lesbian, gay, bisexual, or transgender.
The success of the previously stated health needs (access and navigation of resources, mental health and toxic stress, meeting basic needs and social determinants, and access and affordability of health care) will require a health equity lens that places strategic focus on vulnerable populations and deep understanding of the complexity of some health disparities. In doing so, health leaders will need to commit to individual, organizational and community capacity-building activities and actions that will lead to more equitable outcomes.
Several community partners have already identified actions to take during the next several years to address the Community Health Improvement Plan goals. Partnership development will be an on-going process throughout the implementation of the Community Health Improvement Plan. If you are interested in getting involved in the implementation of the Community Health Improvement Plan, please send an e-mail to: HNLC@nashville.gov
In addition to the goals and objectives included in the Community Health Improvement Plan, the Healthy Nashville Leadership Council and Metro Public Health Department will continue to seek opportunities to partner, convene and participate in initiatives that support the five priority issues for the community.