Poster #94 - Priorities in Hospitals’ Community Health Needs Assessments: Are Youth Being Forgotten?

• In Event: Poster Session 13

Abstract

Background: For hospitals to maintain their 501 (r)(3) status, they must conduct a community health needs assessment (CHNA) every three years. In this report, they must define the community being served. Additionally, hospitals are supposed to use data to select health priorities in their community and demonstrate their ability to act on them in an implementation plan. However, it is possible that adults’ health concerns are of greater importance than youths’. CHNAs may provide valuable information on local pediatric populations, but often vary as to whether they separate out youth priorities, combine youth and adult priorities, or do not include youth priorities at all (Gruber, 2019). One national study found that when it came to examining the data, only 3% of CHNAs included primary youth data (Summers-Gabr & Cantrall, 2022). In another national study, CHNA health priorities were mainly described in terms of adult health outcomes and not age-specific (Franz et al., 2021). Together this may suggest that youth priorities are not being consistently represented. The current study aimed to understand this issue deeper by first investigating which proportion of hospitals had youth-specific priorities, then, understanding which hospitals actually collected youth data. Finally, we examined how adult and youth priorities differed by community size.

Methods: The current study extracted CHNA reports from nonprofit hospitals (n=450). The sample was stratified by USDA rural-urban continuum code, a nine-category system dividing communities by population and proximity to a metro area. Adult and youth priorities were developed through a content analysis by drawing priorities and other health categories from previous research (e.g., Franz et al., 2021). A coding protocol was created and then interrater agreement was tested on a 20% stratified random sample for the adults. Youth data was double coded because it was a smaller sample. The protocol defined 43 categories (e.g., preventative healthcare, mental health/behavioral health, and education).

Results: Out of 450 hospitals, only 287 hospitals identified any youth priorities. Of the hospitals that included youth priorities, 87 (30.30%) were categorized as urban, 128 (44.60%) in the middle of the continuum, and 72 (25.09%) as rural. Nearly all hospitals formed youth priorities through secondary youth data or by speaking with adults rather than speaking directly with youth. The most common priorities for adults and youth by community size will be discussed.

Conclusions: If CHNA reports are not better designed to highlight youth priorities, hospitals will be missing the opportunity to use community benefit dollars to improve youth health disparities. Hospitals should integrate more youth data and youth voice to better understand developmental issues in the community. Future CHNAs should make age-specific priorities. When priorities are identified without describing the target age it could be challenging for hospitals departments to form an implementation plan – also required by law to maintain a non-profit status. One solution may be to provide hospitals with a fixed list of priorities and definitions to choose from to minimize confusion and systematically track health priorities across the country.

Authors

• Avani Yaganti, Southern Illinois University School of Medicine
  Presenting Author

• Erin Ham, Southern Illinois University School of Medicine

• Jessica Cantrall, Southern Illinois University School of Medicine

• Nicole Marie Summers-Gabr, Southern Illinois University School of Medicine