Effective community health assessments in King County, Washington

Community health assessment (CHA) is widely practiced in public health, but its effectiveness has seldom been evaluated.

We present three examples of successful CHAs, carried out by Public Health-Seattle & King County, with diverse strategies: a quantitative assessment of asthma hospitalizations; Communities Count, a set of social and health indicators paired with qualitative data; and Growing Up Healthy, an assessment using qualitative methods to provide guidance for a statewide media campaign on youth sexual abstinence.

These assessments were successful in attracting new resources, forming and sustaining new partnerships, and/or providing guidance or resources for program and policy development. They also illustrate the difficulties of evaluating the effects of CHA in at least three ways: untangling its effects from other important community and political factors; documenting outcomes that are distant in time from and indirectly related to the assessment; and cultural or political restrictions on collecting sensitive evaluation data. We suggest common characteristics of an effective assessment, potential effectiveness indicators, and evaluation strategies.

Despite barriers to documenting the relative contribution of a CHA, a set of rigorous evaluation methods needs to be developed and tested to document the benefits of a CHA in a competitive funding environment.