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Community Health Assessments (often fondly referred to as CHAs) have a reputation as dense, dry, and overwhelming. On my first day as Deputy Director of the Kansas City, Missouri Health Department, I walked into my new office to see a two-inch thick printed report on my desk. The CHA was roughly 300 pages with 180 tables and figures. The data staff was amazingly thorough — the assessment was packed with everything you would ever want to know about the city. Data was organized alphabetically, for ease of reference. The problem was that no one was using it aside from a small internal team. That same team was spending hours each week fielding requests from external stakeholders for the very same data that was in the report, and yet here was an assessment that should have been making those requests irrelevant. We all knew there had to be a better way. There had to be a way to talk about health equity in KC and the social determinants of health in a way that everyone would understand.
We tried our luck with a data dashboard solution, thinking, “Making a compelling CHA for public consumption can’t be too hard, right?” We were very wrong. Just because a top-notch data team can flawlessly crunch numbers on SPSS doesn’t mean that team can weave narrative and visualizations into an interactive website that draws the public in. A do-it-yourself approach didn’t work for us, and so I had to go back with my head hung low to request more budget to try again with a new vendor. Anyone who has ever had to go back to a department director for the second chunk of funding for a new idea knows that our next version had to work better.
Enter mySidewalk and their team of data storytellers. What started as a joint experiment in a new way of communicating Public Health data eventually became a flagship solution for the company and the next step in my career journey. After creating dozens of CHAs for departments of every size, we’ve learned a few things that separate the great from the not-so-great.
This is kind of cheating, as it’s really two tips (but a list of three things is just a lot cleaner). Aside from the fact that equity is a cornerstone of PHAB standards, analyzing data by race and ethnicity is a critical responsibility of Public Health agencies. We can’t heal what we don’t reveal. But data by race and ethnicity can be tricky, especially when people of color make up a small proportion of the population and count data hides inequities. Leveraging mySidewalk’s preloaded denominators was a useful way to call out the truth while maintaining credibility.
For example, the number of Hispanic residents in KCMO without health insurance is roughly half the number of White, non-Hispanic residents. But when we add the mySidewalk denominator, it’s clear that there are massive inequities in access and uptake.
Fully understanding systemic inequities and the social determinants of health requires data we often don’t have. There’s no nationally validated, available survey on big issues like racism or social isolation. That’s why a good CHA needs to rely on innovative proxy measures found in the mySidewalk data library. Just because the perfect measure doesn’t exist, doesn’t mean a CHA can’t elevate important root causes of health inequities.
There’s no reason a CHA can’t be interesting to read. Think about the last time you saw a really cool museum exhibit. Were the pieces or artifacts arranged in alphabetical order? Likely not. They were probably arranged by theme, chronologically or some other storytelling device. Think of a CHA as a museum of health data artifacts, and put yourself in the position of the audience. This is your opportunity to clearly connect the social determinants of health with health behaviors and health outcomes. This shared belief was the deciding factor in KCMO’s decision to switch vendors for our CHA (and CHIP!) data storytelling, and the structure of that first CHA inspired all the health departments that came after.
A CHA should be simple and accessible. A PDF version of a CHA, or any health report, can be difficult to interact with for audiences with vision impairment. Certain charts can be uninterpretable to folks with color blindness. Language we use every day in the field might be incomprehensible to the average reader. A great CHA takes all of these details into account and combines compelling, easy-to-understand language with accessible data visualizations. I’m always inspired by health departments who get creative in simplicity, like KCMO’s neighbors to the West in Johnson County, KS. They made ample use of original imagery to convey complex issues and took full advantage of mySidewalk’s ability to integrate custom media.
Lastly, a great CHA is a useful tool for folks outside of a health department. A CHA shouldn’t only be an interesting story, it should be a platform for community members to make change at the local level. One of the biggest reasons we chose to transition to mySidewalk for our data storytelling was the ability to chop up data by neighborhood, city council district or custom boundary (our transit corridors were VERY popular with our audience) instantly. This made the data relevant to our various stakeholders. A great CHA provides data that can be downloaded by the reader without their having to make a formal request. When you put that power in the hands of the community, you not only free up staff time in the health department, you create a sense of ownership over a shared vision.
We are honored by the trust that Public Health departments place in our software and our people. A CHA should be a vibrant, timely and evolving foundation for community health improvement, which is why we are going all-in as a company to constantly improve our CHA solutions. We are here to stay for Public Health, and we are so excited to walk into a healthier future in partnership.
If you would like more information on our Public Health Solutions — including our CHA — check out the link below and let us know more about you. We look forward to hearing more about your community.
Dr. Sarah Martin is Vice President of Strategic Communications for mySidewalk and is responsible for developing new ways to help clients change the world. Sarah came to mySidewalk from the field of Public Health, most recently as Deputy Director for the KCMO Health Dept. Her work lives at the intersection of public policy and health outcomes, focusing on combining Public Health and Healthcare into a force to be reckoned with. Sarah received a Ph.D. and MPP in Public Policy and Economics from the Goldman School of Public Policy at UC Berkeley. She also received an MPH in Epidemiology from Cal where she specialized in methods for Social Epidemiology and Epigenetics.
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