Step 3: Define the Community


Specifying the geographic focus and population characteristics determines the scope of your assessment and any implementation strategies. This includes having access to data by ZIP code, census tract or neighborhood as well as connecting with community members to truly understand their concept of community.

Key Components

Describe the geographic community
The geographic focus can include counties, cities or towns, neighborhoods, school or other governmental districts, or a collection of ZIP codes. Consider the hospital’s service area as a starting point to describe the community. In some cases, it can be beneficial to go beyond primary and secondary service areas, to areas with greater unmet health needs. Organizations that have completed a CHA can look back to see how the community was defined in earlier assessments and determine if the definition needs to change.

Identify population groups
Though the geographic focus can be broad and inclusive (e.g., all people in a defined region), hospitals can dig deeper into specific population groups relevant to the assessment’s purpose. Examples of population characteristics that can be targeted include:

It maybe be helpful to focus on populations of interest (e.g., a particular minority group assumed to be affected by health disparities) to ensure that they are represented in the overall assessment. Examples of target populations include:

Identify other organizations conducting health assessments
Nonprofit hospitals are among the many organizations that are required to assess the health needs of their communities, including, but not limited to, public health departments and social service organizations. Due to these complementary requirements and processes, collaboration with those groups is mutually beneficial. It can be mutually beneficial to partner with other local health systems or hospitals even if they have a different geographic scope than your hospital. Building on these mutual interests will ensure that priority populations such as uninsured and underinsured persons, the medically underserved, low-income populations and minority populations are included in the assessment, and will also create more meaningful opportunities to address their needs.