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Effective Community Health Assessments in King County, Washington

Solet, David PhD; Ciske, Sandra MN; Gaonkar, Rujuta MPH; Horsley, Kathryn DrPH; McNees, Molly PhD; Nandi, Parijat MPH; Krieger, James W. MD, MPH

Journal of Public Health Management and Practice: January-February 2009 - Volume 15 - Issue 1 - p 33–40
doi: 10.1097/PHH.0b013e3181903c11
Evaluating Impacts of Community Health Assessments

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

Method 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.

Findings 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.

Conclusions 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.

This article describes three examples of successful community health assessments, carried out by Public Health—Seattle & King County, with diverse strategies, which were successful in attracting new resources, forming new partnerships, and/or providing resources for program development.

David Solet, PhD, is a senior epidemiologist with the Assessment, Policy Development and Evaluation unit at Public Health—Seattle & King County, Seattle, Washington, where he supervises quantitative community health assessment activities.

Sandra Ciske, MN, is Regional Health Officer at Public Health-Seattle & King County. She has 25 years of clinical, research and management experience in diverse urban settings including 22 years in a local public health department. She has been a coauthor on numerous publications on collaboration between public health researchers and communities.

Rujuta Gaonkar, MPH, is Operations and Policy Analyst for the Coordinated School Health Mental Health Demonstration Project with the Oregon Public Health Division, Adolescent Health Section. She previously was a qualitative researcher for Public Health–Seattle & King County.

Kathryn Horsley, DrPH, is Policy and Community Assessment Consultant in Berkeley-Oakland, where she recently coauthored Alameda County's health equity report. While at Public Health–Seattle & King County, she led the first three Communities Count reports and the implementation of a county-wide system to monitor school readiness among kindergarten children.

Molly McNees, PhD, is Cultural Anthropologist with the Assessment, Policy Development and Evaluation unit at Public Health–Seattle & King County, where she leads the development of the Communities Count report and performs qualitative evaluations and assessments.

Parijat Nandi, MPH, is currently the Health and Wellness Advisor for Washington Mutual. Previously, he served as the Adolescent Pregnancy Prevention Program Manager for the Washington State Department of Health.

James W. Krieger, MD, MPH, is Chief of the Chronic Disease and Injury Prevention Section at Public Health–Seattle & King County, and Clinical Professor of Medicine and Health Services and Attending Physician at the University of Washington. He has more than 20 years of experience in epidemiology, community health assessment, public health program and policy development, community-based participatory research, and chronic disease control and prevention.

Corresponding Author: David Solet, PhD, Assessment, Policy Development and Evaluation, Public Health—Seattle & King County, 401 5th Ave, Suite 1300, Seattle, WA 98104 (

© 2009 Lippincott Williams & Wilkins, Inc.