PolicyLab

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This year’s National Public Health Week (April 1-7) theme is all about creating the healthiest nation. The reality is public policymakers use a multitude of tools to improve the health and well-being of their communities, but the most effective public policy is rooted in evidence and informed, where possible, by local context. That’s why our interdisciplinary team at PolicyLab is excited to prepare, in partnership with the state, a county-level needs assessment that will serve as a comprehensive tool for evidence-based policymaking in Pennsylvania.

The Utility of Needs Assessments

Needs assessments are an important part of any public health policymaking process. These assessments, often conducted by government agencies or nonprofit hospitals, systematically identify gaps in resources and services for community members, areas where people are at greatest risk for poor health outcomes and disparities in factors that can protect people from things harmful to their health. Data on demographics, socioeconomic status, access to health services, health behaviors and outcomes provide a better, more complete understanding of the needs and assets of communities. Policymakers can use these assessments to identify emerging health problems, hidden or hard-to-reach populations and where people aren’t receiving services to address their needs. They can use the strengths of a community as a foundation for improving health or as a template for work in other places.

Useful needs assessments can be as simple as a report of publicly available statistics and as complex as calculations and interpretations of risk. In the simplest version, tables of data highlight communities with high rates of adverse health behaviors or outcomes, such as maternal smoking or infant mortality. More nuanced methods like risk indexes provide a look at how health determinants and behaviors interact in a community. For example, communities with a combination of high rates of opioid use disorder but few substance use treatment facilities signal a need for additional supportive public health policies or interventions.

In recent years, public health agencies have used the social determinants of health to understand health disparities between populations. This approach recognizes how the social and environmental factors—such as poverty, community violence, unemployment, air pollution and unsafe housing—can affect an individual’s health outcomes. Therefore, when needs assessments analyze social determinants of health, policymakers can use that data to identify and target upstream factors that influence health in their communities.

Another strength of needs assessments as public policy tools is their ability to shed light on emerging health problems or behavioral trends. Teen vaping, vaccine hesitancy and opioid use disorder have been growing issues in recent years. Presenting data as a trend over time allows policymakers to understand the scope and severity of new or re-emerging issues. This can illuminate hidden or stigmatized behaviors like opioid use.

Lastly, needs assessments can connect public policy to the people it impacts. Many needs assessments engage stakeholders before, during or after the data collection and analysis processes. This ensures that the indicators researchers assess reflect community priorities. Quantitative data is extremely useful but limited in its ability to communicate the relationship between factors or whether the community feels that a particular issue is a priority. Stakeholders, through town hall meetings or interviews, can inform the needs assessment with additional context about the experiences of people living in the community. In addition, community feedback and interpretation of the assessment results can aid in effectively translating findings into public policy efforts.

The 2020 Family Support Needs Assessment

In partnership with the Commonwealth of Pennsylvania Office of Child Development and Early Learning, we are conducting the 2020 Family Support Needs Assessment as a requirement of the federal Maternal, Infant and Early Childhood Home Visiting (MIECHV) program. This needs assessment will provide policymakers, state leadership, and local home visiting and family support programs with data on the maternal and child health and early education needs of communities in the Commonwealth.

In accordance with the Health Services and Resources Administration (HRSA) requirements and in an effort to provide the most comprehensive view of the home visiting and family support landscape in Pennsylvania, this assessment will include county-level risk information for multiple domains of health. In order to assess the myriad of individual, interpersonal, social and environmental factors that influence health, the domains we are focusing on include indicators of birth and child health outcomes, socioeconomic status, substance use, child maltreatment, environment and community, and child care.

Additionally, a key focus of the 2020 assessment is creating tools that are useful for state and local stakeholders. We will engage stakeholders, including administrators of local home visiting programs and early childhood advocates, to identify community-level priorities and resources. This feedback will guide the direction of the needs assessment and the dissemination of our results.

Creating a needs assessment that is useful for policymakers is critical to ensuring that public health policy decisions are based on community needs and priorities. We look forward to sharing our results once the 2020 assessment is complete. In the end, we believe this needs assessment will allow policymakers, community organizations, and home visiting and family support implementing agencies to direct their actions with data to best serve women, children and families across the state.

Deanna Marshall, MPH, is a former research associate at PolicyLab.