Title: The Development of a Community Health Index for the State of New Jersey: An Application to Improved Service Delivery

Identifying the health care service needs among different communities is a key component of effective community health planning as it helps policy planners to distribute resources efficiently among different communities and increases access to care. It is known that socio-economic indicators are associated with health care service utilization. Therefore, this study is intended to develop a single inclusive index that represents the health care service needs of communities using socio-economic indicators. This single index can be used not just to identify the health care service need of each community but to compare the needs easily across different communities. The variables used to develop the community health index are: hospital discharge data for Medicaid, charity/self-pay; population data for families in poverty, single parent households with kids, linguistic isolation, unemployment, education less than 9th grade, non-white, age 65+, and rental population. The zip code statistics for ten variables were obtained from US census, Claritas demographic data, and NEW JERSEY Hospital Discharge data(2007-2009). The principal component analysis generated one factor solution, which explained 88% of variances for the ten variables. The factor loadings ranged from .87 to .97. The index was significantly correlated to total inpatient hospital visits(r=.80,p<.0001) and emergency department visits(r=.78, p<.0001). The index successfully differentiated high need communities from low need communities. The total number of ED visits and ACSC(Ambulatory Care Sensitive conditions) ED visits per 1000 population for the top 100 needy communities were greater by 188% and 264% respectively, than the visits for the top 100 least needy communities.