Use of large administrative data for community health assessment to inform issue prioritization at the local level

Community health assessment (CHA) is an important tool for providing data-based evidence that is necessary to drive public health policy and planning at the local level. However, such assessments can often be difficult to conduct locally, as many informative data sources are only available at the state or county level and thus, lack the precision needed to inform services targeted to sub-county populations. Beginning in 2011 with a Child and Family Health Services grant award, the Portage County Health Department was tasked with conducting a maternal and child health-focused CHA following Ohio Department of Health’s Community Health Improvement Cycle. Initial community engagement activities involving internal and external assessments, partnership building, CHA planning, and an assessment of data needs/capacity resulted in a unified vision of a comprehensive report on 50 data indicators presented separately among 12 geographical clusters of county subdivisions, when possible.  Record level geocoding and analysis of large administrative data including birth certificates, death certificates, and disease registries allowed for sub-county reporting on 31 of the 50 data indicators. The indicators were prioritized using a two-step, six-factor ranking system that balanced subjective stakeholder knowledge with objective criteria, including comparisons of sub-county data to county and state level data, when possible. Sub-county reporting afforded by the use of large administrative data ultimately played a major role in the prioritization of maternal and child health issues in Portage County and is currently being utilized to plan public health interventions that effectively target services to residents with the most need.