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Frequently Asked Questions

How should I use the CHNA Report Tool?

We recommend that you begin with the vulnerable populations footprint tool. This will allow you to zoom to your community and identify areas where the highest percentage of individuals living in poverty and without a high school diploma are located. You can generate a Footprint Report summarizing the demographics for those areas of greatest disparity.

Next, we recommend that you run a Core Health Indicators Report for your county or counties. This report will summarize key health indicators in your region. You can explore the maps embedded within the report by clicking on them. Many of the indicators can be mapped at the sub-county level. You can download your Core Health Indicators Report into a PDF or Word document.

If you are ready to explore more indicators you can then run a Full Health Indicators Report. This is a very large and comprehensive report. Like the Core Health Indicators Report you can click on the maps to expand and interact with them, even adding more data. This report includes over 80 indicators and can be saved as PDF or Word.

Don’t forget to explore other areas of the toolkit such as the Health Indicators Map Gallery, and the other types of reports such as the Leading Health Indicators Report to see how your area stacks up against the HP2020 benchmarks.

Finally, explore the Resources page and the action examples to move from assessment to action.

 

How were the indicators selected for the CHNA Report tool?

The CHNA Workgroup has identified a focused set of health-related indicators to ensure a robust and consistent approach to CHNA. The CHNA indicator list includes over 80 indicators that together help users understand the health of a community. The indicators are organized into categories that allow the user to answer the following questions:

Demographic Data: Who lives in the community?
Key Drivers Data: Where are the areas of greatest need within the target area?
Health Outcomes Data: What are the major health issues faced by the community?
Drivers of Health Data: What is causing the health issues identified?

See a complete list of indicators here.

How often is the data in the CHNA Report tool updated?

We update data on a regular basis. If you see something that is missing or out of date please let us know.

How can I share my finished report with others?

You can print the CHNA report, or download it as a Word Document or PDF. When viewing your completed report click Download Report in the upper right-hand corner.

If you are a group member, you can also save your finished report to your collaborative group on the Commons.

Can I save or download a CHNA report?

Yes! After you have generated a report…

…select ‘Download Report’ to save a static copy of your report to your personal computer. Within the interface you may edit your report title, select your download format, and choose to download a single report page (default) or the entire report. Reports may be saved in Microsoft Word or Adobe PDF format.

Can I import local data into the CHNA Report tool?

The CHNA platform does not allow users to upload local data at this time. The purpose of this public report is to provide a common set of national indicators for service areas across the country, addressing that there is variation in the size, shape, and data availability across regions. We do recognize the value of local data for currency and specificity, and encourage users to export their reports in Microsoft WORD format. A WORD report allows you to edit the common indicator report in any way you choose, including the addition of charts and figures from local data.

Many organizations have partnered with us to create a custom report tool highlighting their unique or local data. If you are interested in creating a customized CHNA report tool for your region or organization, contact us.

 

What do the green and red numbers in my report mean?

Table figures are color coded red or green to signify an area’s performance relative to a benchmark. Green indicates more favorable performance while red indicates less favorable performance. Benchmarks vary across indicators, and represent Healthy People 2020 objectives (when directly comparable) or state averages. Figures are not color coded for indicators with no discernable positive or negative outcome (age, population density, race, etc).

In my CHNA Report, the data for my indicator is broken down by race and ethnicity in my report table, so why isn’t the data for Hispanic/Latino populations showing up in my pie chart?

Race and ethnicity are collected in most applications as two separate categories, based on methods established by the U.S. Office of Management and Budget (OMB) in 1997. By the OMB standard, the minimum race categories reported are:

1. American Indian or Alaska Native
2. Asian
3. Black or African American
4. Native Hawaiian or Other Pacific Islander
5. White

The minimum ethnicity categories are:
1. Hispanic or Latino
2. Not Hispanic or Latino

The CHNA report tool aims to provide data by race and ethnicity whenever it is available. Because race and ethnicity are two separate self-identification categories, they may be reported together, or discretely. When reported together, data may be presented in the following manner: White (Non-Hispanic); White (Hispanic); Black (Non-Hispanic); Black (Hispanic); etc. Data reported in this manner may be presented in a pie chart because the segmented population constitutes the total population of an area.

Often, the sample size for a population group with race/ethnicity together does not meet the minimum required population threshold for reported data. When reported discretely, the sample size may be adequate to display include statistics for population groups by race, independent of Hispanic origin, and for population groups by Hispanic origin, independent of race. For these indicators, only the data segmented by race constitutes the total population. Data reported for Hispanic origin is still valid, but must be excluded from the pie chart because the population overlaps the population by race.

In the CHNA report, why can’t I see race/ethnicity characteristics for some indicators?

Reports are broken down by race and ethnicity whenever that information is publically available from the source. Many sources take caution to protect sensitive data, and this often includes suppressing race/ethnicity/age information from public consumption, even when that information is collected and therefore ‘known’. Data for smaller geographic areas (like ZIP codes), and data for demographic groups which have lower populations, are less likely to be reported by race/ethnicity. As a general rule, the data behind the CHNA platform uses a minimum sample size of 30 in order to produce reliable estimates.

What does the meter next to my indicator’s report table describe?

The meter is a graphic which visually compares service area performance for a given indicator to the indicator’s benchmark value. The meter also compares service area performance to the US average, when available. In the graphic, the needle represents the service area value, and is colored red or green depending on performance relative to the indicator benchmark. The gold arc within the meter always represents the benchmark value, which is either a state average or a Health People 2020 objective. When data is available, the total US average is also displayed as an arc in the meter. The US average is always color-coded in blue.

How can I make the report map larger and view the map data?

When viewing your report, click the link located below the inset map labeled “View larger map”. A new page will open containing the full map viewer. Your indicator data loaded and the map will center to your report area location.

Why is the American Community Survey used for the CHNA Report demographics rather than the Census 2010?

The American Community Survey was selected for the majority of the demographic indicators in this report because the data are regularly updated. Census 2010 was selected to report total population because the specific population breakdowns required are only available in the 2010 Census.

What is the difference between the Core Health Indicators Report and the Full Health Indicators Report?

The Core Health Indicators Report includes a subset of indicators to get you started. Once you’ve examined the Core Health Indicators Report you might check out the Full Health Indicators Report to view all 80+ indicators available in the tool.

What is the Leading Health Indicators Report?

This report incorporates a small set of indicators which are measurable against health targets established in the Healthy People 2020 (HP 2020) initiative.

What is HP2020?

Click here to learn more about the Healthy People 2020 (HP 2020) initiative.

Why are some HP2020 indicators not included in the benchmark report?

CHNA indicators are only included in the benchmark reports when the methodology used to calculate the statistic *exactly matches* the Healthy People 2020 data methodology. This typically requires that CHNA reports draw their data from the same source as HP 2020, or at a minimum use the same data processing techniques. Because the CHNA tool provides the most-current, most-granular data available for each indicator, this often resulted in incomparable statistics.

For example, the HP 2020 objective AHS-1Increase the proportion of persons with health insurance uses national-level data from the Centers for Disease Control and Prevention (CDC), National Health Interview Survey (NHIS) to determine the nation’s baseline statistic and target objective. The CHNA platform reports the same statistic – percentage of total population with health insurance – but using public use micro area (PUMA) level results from the U.S. Census Bureau’s American Community Survey (ACS). While the NHIS provides just one statistic to represent the nation (83.2 percent of persons had medical insurance in 2008), ACS data can be broken out for smaller geographic areas within a state or county, to provide a better picture of local area health. Because data collection techniques yield different across the datasets, the CHNA indicator is not benchmarked to the HP 2020 objective.

Is it possible to see how indicators in my area compare to the HP2020 benchmarks?

Yes! When viewing the core indicators or full report you will notice the indicators are benchmarked to HP2020 whenever possible. In cases where the indicators are comparable the font color will change to red (indicating a number more negative than the HP2020 benchmark) or green (indicating a number more positive than the HP2020 benchmark).

If you only want to see those indicators that are NOT meeting the HP2020 benchmarks then open your report and click “Modify Report” in the upper right-hand corner. Then, check the box under Limit Options that says “Use the Benchmark report to see indicators compared with HP2020 benchmarks.” Click View Report to return to your report.

What are Vulnerable Populations?

Vulnerable populations can be identified by socio-economic status, race, ethnicity, geography, gender, age, disability status, risk status related to sex and gender, and other populations identified to be at-risk for health disparities.

What is a Vulnerable Populations Footprint?

Two key social determinants, poverty and education, have a significant impact on health outcomes. Those that live in poverty and have low educational attainment are often identified as vulnerable populations. The tool allows you to automatically see the Vulnerable Populations Footprint (VPF) area for your community.

Vulnerable Populations Footprint (VPF)— The VPF tool within Community Commons maps percent of residents in poverty and those with low educational attainment as a resource in identifying the communities most in need. Areas in red depict overlap of high poverty and low educational attainment. Thresholds for percent impacted can be modified.

What is the purpose of the Vulnerable Populations Footprint tool?

The vulnerable populations footprint tool is a compact mapping and reporting platform that identifies geographic areas with high rates of poverty and low educational attainment – the two indicators demonstrated to be the primary social determinants of population health. Thresholds for target area identification are adjustable, allowing the tool to be utilized in all geographic areas where regional rates may be higher or lower than the national average.

Target areas assessments are not a required part of the CHNA process; however, visualization of these areas provides an ideal starting point when assessing an area’s overall health needs. The maps and reports generated using this tool are able to be exported and can be included in the CHNA report if desired.

What are Vulnerability Thresholds?

The vulnerability population footprint tool provides the ability to change the indicator thresholds to locate vulnerable populations. This may be particularly useful in rural or other less densely populated areas. In rural areas you may want to move the threshold slider to the left, reducing the percentage of those in poverty or with no high school diploma to identify those most at risk. It can also assist you in locating the most vulnerable in a densely populated area by increasing the percent population threshold.

How were the two indicators for the Vulnerable Populations Footprint selected?

In 2011, a collaborative body of experts was convened to guide the CHNA tool and vulnerable populations footprint tool development. This group included a broad spectrum of public and private sector stakeholders at the national, state, and regional level. The group identified education and poverty as key drivers of poor health outcomes.

Learn more about the CHNA toolkit and scroll to the bottom of this page to learn about the collaborative workgroup.

Nothing is showing up in red on my Vulnerable Populations Footprint. How can I find the most vulnerable in my area?

You might need to customize the vulnerability threshold for your area. Click the Footprint Definition tool on the right side of the page to open up and customize the thresholds using the sliders. The map will automatically change.

Can I generate a report showing summary demographics of the red areas in my vulnerable populations footprint too?

Yes! Within the target area assessment tool you will notice a CHNA Target Area Report menu. Click to open the report options. You can generate a report for the entire area you are viewing on the screen, or use the draw custom report area tool to draw a shape on the map to further refine your area of interest. Once you’ve done that a window will appear prompting you to open your report. The report will open and will summarize the demographics within the red geographic areas.

Where do I find my saved footprints?

You will find your saved Vulnerable Populations Footprints in your Community Commons personal profile. You can also find them in the “My Data” section of the Community Commons map room.

Why use the Priority Intervention Area tool?

The Priority Area Intervention Tool will assist you in reviewing areas of your community that could be a priority. This easy-to-use function of Community Commons allows you to see where to focus your efforts to maximize outcomes. You simply need to type in your location (state, city, address, zip code, census tract, etc.) and the tool automatically generates a Vulnerable Population Footprint for you onto a map.

What will I get from the Priority Intervention Area tool?

When you have selected and saved your Priority Intervention Area, you will be able to download and print a short demographic report for that area. Generate reports for each of your priority intervention areas under consideration. This will allow you to more easily compare the proposed populations to be served. You may want to pay particular attention to the total number and percentages of vulnerable populations in the proposed areas. Focusing interventions in areas of greatest need can help move the needle toward achieving greater health equity.

How does the tool help identify Priority Intervention Areas?

The VPF visual shows areas that may be at most risk for health disparity, which will help you decide where community health interventions will be most appropriate. This tool then allows you select one or more areas on your map that will make up your Priority Intervention Area. You can choose to select a state, city or town, county, census tract, or school district. Once you have selected one or more areas from your map, you can save and share your Priority Intervention Area for use in the future.

Can I generate a Community Health Needs Assessment Report for my priority intervention area?

Yes! Click here or from the Community Health Improvement Landing Page, click on Community Health Needs Reports in the yellow section. This will allow you to select which area you’d like to report on. To use your Priority Intervention Area (PIA), click the radio button that says My Areas and select your desired PIA. Click View Report to explore social determinants and other health related data for your PIA.

What is the difference between my saved footprint and my saved priority intervention area?

The Vulnerable Populations Footprint (VPF) shows areas in your community that are most at risk for health disparities as defined by poverty and education attainment. Your saved Priority Intervention Area is the custom area you’ve selected from within the VPF. This is the combination of areas outlined with red hashmarks on your map.

What exactly are age-adjusted rates?

The rates of almost all causes of disease, injury, and death vary by age. Age adjustment is a technique for “removing” the effects of age from crude rates so as to allow meaningful comparisons across populations with different underlying age structures. For example, comparing the crude rate of heart disease in Florida with that of California is misleading, because the relatively older population in Florida leads to a higher crude death rate, even if the age-specific rates of heart disease in Florida and California were the same. For such a comparison, age-adjusted rates are preferable.

Age-adjusted rates are calculated by applying the age-specific rates of various populations to a single standard population. In CDC WONDER, if you choose to age-adjust rates, you must specify your standard population (or accept the default). It is good practice to specify a standard is that generally similar to the populations being compared. For example, if requesting breast cancer mortality rates for white females in Massachusetts for the period 1979-1991, you might specify “1985 Massachusetts white females” as your standard population.

How do you estimate county level indicators for areas smaller than a county?

We use an approach called the Small Area Estimate. You can learn more about our methods here.

What type of citation should I use when using Community Commons maps or reports outside the Commons?

While the website was established in 2012, we only ask you cite the date you pulled information from the Commons. If using our maps or reports, do not remove any logos that may be on them and please cite as follows:

“Courtesy: Community Commons, <www.communitycommons.org>, date_retrieved”

APA format would look more like this:

<map or report title>. Community Commons (2012). Date Retrieved, Website URL

Example:

Map of Local Food Deserts, Location, USA. Community Commons (2012). Retrieved March 18, 2015, from www.communitycommons.org

Additionally, you will find the metadata and citation information for the data sources themselves within the info area of the maps and in the footnotes of the report pages. This will be important for citing where the data came from. Keep in mind that the majority of the data in Community Commons maps and reports has been repackaged or re-analyzed based on our small area estimate methodology, so there is no need to cite the original source.

 

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