Role of community health centers in assessing community needs

Background: Health centers play a critical role in serving medically underserved populations.  According to the first of 19 Health Resources and Services Administration health center program requirements, Federally Qualified Health Centers (FQHCs) must assess the needs of their target population.  However, there are limited specifications regarding the process for conducting this assessment.  This presentation will describe an urban FQHC’s approach to conducting a community health needs assessment that maximized existing institutional and community resources. 

Codman Square Health Center (CSHC) is a FQHC located in an underserved neighborhood of Boston, MA where residents are disproportionately affected by several health indicators.  The health center serves over 20,000 patients each year and provides comprehensive services including primary care, urgent care, dental care, eye care, behavioral health, public health, fiscal health, fitness/wellness and youth programming through partnerships. In 2013, the health center undertook an assessment to ensure that it was addressing the most pressing health concerns of its target population.

Approach: The assessment utilized a participatory, collaborative approach to examine health in its broadest context.  Guided by the social determinants of health framework, the process included synthesizing existing data on social, economic, and health indicators among the health center’s patient population and the broader underserved community. Additionally, over 200 participants were engaged via a health center staff survey (n=133), community dialogue (n=30), four focus groups (n=39), and eleven interviews (n=12) to gauge perceptions of community needs and assets.  Participants represented multiple audiences, including health center staff and patients, the faith community, the civic community, government officials, educational leaders, social service providers, health care providers, and community leaders, among others.

Lessons Learned: While quantitative indicators provided a social and economic context of health, qualitative methods created an opportunity to hear the community voice regarding pertinent health issues.  Furthermore, qualitative research addressed limitations presented by quantitative data, such as availability, timeliness, and geographic specificity. In addition to community members, engaging health center board members and staff was crucial for subsequent planning efforts to address assessment findings.

This presentation will discuss the overall process employed by a health center to conduct a community health needs assessment, as well as identify the challenges and successes of engaging stakeholders and gathering data at the neighborhood level using limited resources.