Nonprofit hospitals in California are required by state and federal law to conduct community health needs assessments (CHNAs) every three years and to use the results to develop implementation plans to improve community health. CHNAs involve measuring and understanding the health status and priority health needs of the medically underserved, low income and minority populations.

CHNAs provide valuable information for nonprofit hospitals, local officials and community partners by identifying the significant health issues in their respective service areas.  These assessments also highlight the associated drivers and services that are most needed to improve the health conditions in specific communities. Associated drivers of poor health outcomes include social and structural factors such as access to high quality, culturally sensitive care, as well as educational attainment, poverty, violence prevention and pollution.

What is the goal?

The goal is to identify the overall health status of specific communities across the Sacramento Central Valley, to understand what populations are experiencing the greatest health disparities, and to pinpoint exactly where there are higher rates of poor health outcomes. This information informs hospitals of the priority measures and resources needed to improve health conditions for people in their hospital service area.

Why is this important?

This work is important because CHNAs help hospital leadership build
 a culture of health equity in our communities and enables them to partner with community stakeholders in ways that can more effectively address the conditions, behaviors, socioeconomic and environmental factors that drive health. As a result, the Sacramento region’s nonprofit hospitals have the ability to target services within communities where it is challenging for residents to access primary and mental healthcare, healthy foods, safe places to be active, a good educational system and affordable housing. By considering a community’s health outcomes and the associated drivers to poor health, CHNAs offer clear insights to a community’s significant health needs and the measures and resources needed to improve health conditions.

How does this improve people’s lives?

CHNAs contribute significantly to the research base on economic issues in the Sacramento region, which helps identify and address the environmental issues that influence health. The data from the CHNAs examine factors related to mortality, disease and injury, risk behaviors, living conditions and social inequities, and other associated drivers—including environmental—that may influence these outcomes. Valley Vision conducts health needs assessments every three years in order to identify the communities and populations most affected by health disparities so that local stakeholders and health service providers can direct their efforts to advance health equity.

What is Valley Vision’s role?

Valley Vision has been conducting CHNAs with hospitals in the Greater Sacramento Region since 2007. The CHNA reports, authored by Valley Vision in 200720102013 and 2016, supplied critical quantitative and qualitative data collected from service providers and community members. To better serve their community, the hospitals use the information Valley Vision gathers to design health improvement implementation plans. The CHNA reports inform hospital decisions and provide community partners with valuable information to collaborate around identified health needs and assets that can improve the overall health of their communities.

In 2016, Valley Vision conducted CHNAs for Sacramento, Yolo, Placer, El Dorado, Nevada and Solano counties. Utilizing a collaborative process helped further strengthen partnerships between hospitals and other stakeholders, providing a coordinated approach to identifying priority health needs as well as opportunities to improve the health of our region. Valley Vision also provided expert research skills balanced with a strong commitment to drawing attention to critical unmet health needs.

Valley Vision used many sources of information, including population health data, key informant and focus group interviews and Geographic Information Systems (GIS) mapping to determine the most important health issues in our region. We also collected input from broad interests across the community, including hospitals, public health, community members and other stakeholders. These findings assist stakeholders in better understanding the health status of specific populations and the locations most affected by health disparities.

What was our impact?

Valley Vision delivered 17 CHNA’s to area hospitals and health systems.  The CHNA’s led to the development of specific Implementation Strategies for each of those hospitals that will drive continued improvement in community health and promote social equity in healthcare settings and systems.  


Valley Vision began working with nonprofit hospitals in the greater Sacramento region
 and across the state as early as 2007. As required by law every three years, Valley Vision has produced CHNA reports in 2007, 2010, 2013, and 2016.

Primary and secondary data collection, analysis, and report writing was completed in September for the 2016 CHNAs, which included for 15 participating hospitals in the Sacramento region and three hospitals and the Department of Public Health in Solano County. Final 2016 CHNA reports are released by the health systems at their discretion.

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