Engaging the community to understand food needs

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Engaging the community to understand food needs

Including community stakeholders in the community health needs assessment process

Takeaways

  • Understanding the environments in which community members make food decisions as well as the availability of resources to meet daily food needs is critical to effectively address diet-related health conditions. 
  • Beyond satisfying community benefit requirements, there are a number of benefits to conducting a robust landscape assessment of existing community food resources and engaging community members during the community health needs assessment (CHNA) and health improvement planning process.
    • Leads to a more detailed understanding of community needs 
    • Identifies potential partners in order to establish or strengthen relationships to improve reach, impact and long-term sustainability of efforts 
  • There are number of ways that community organizations that address food issues can participate in the CHNA process:
    • Participate in inventorying food-related community resources 
    • Participate in interviews, surveys, and focus groups
    • Participate in community health data review and health needs prioritization 
    • Serve on the CHNA steering/advisory committee. 

This guidance brief complements the guidance brief on data sources regarding food access, food environments, and food behaviors to assist facilities in understanding healthy food access needs and opportunities in their CHNAs.
 

Understanding the built, social, and economic environments in which community members make food decisions as well as the availability of resources to meet daily food needs is critical to effectively address rising rates of diet-related health conditions. Efforts to improve healthy food access and promote healthier community food environments can have a significant impact on population health outcomes. 

For these reasons, understanding the community food environment and landscape of community food resources is an essential component of any community health needs assessment and health improvement planning process. 
 

Federal requirements to engage the community in the CHNA process

Community benefit regulations specify that a hospital’s written community health needs assessment (CHNA) report must include a description of the community resources potentially available to address the significant health needs identified. 

Community benefit regulations also instruct hospitals to take community input into account when identifying and prioritizing significant health needs and identifying resources potentially available to address those needs. 

After completing the needs assessment, hospitals are required to develop an “implementation strategy” that describes how the hospital will use its resources and assets of the local community to address prioritized health needs. 

Conducting a robust assessment of existing community food system resources and engaging community stakeholders in this process, as well as in needs identification and prioritization and in implementation strategy development, provides an opportunity to satisfy multiple community benefit obligations.
 

According to 2016 national survey findings, obesity was identified as a priority health need in more than 70 percent of CHNAs, while food insecurity or healthy food access was identified as a health need in 13 percent of CHNAs. Identifying existing community resources that address food access, healthy eating, food insecurity, healthy food production and distribution, and other food system-related matters is critical for the majority of hospitals to fulfill community benefit requirements. 

Beyond satisfying community benefit requirements, there are a number of benefits to conducting a robust landscape assessment of existing community food organizations and resources and engaging community food system stakeholders in the CHNA process, such as: 

  • Leads to a more detailed understanding of community needs and underlying determinants of health 
  • Increases likelihood of success by engaging community as partners in assessment and strategy development process thereby increasing sense of buy-in and ownership
  • Increases knowledge of existing community food resources
  • Helps avoid duplication or re-creating programs and services
  • Reveals gaps, areas of need, and opportunities to strengthen current assets
  • Identifies potential allies and partners in order to establish or strengthen relationships to help improve reach, impact and long-term sustainability of efforts 
  • Illuminates opportunities to align with existing community efforts or bring groups and organizations together for greater synergy
  • Strengthens health improvement efforts through increased alignment, coordination or collaboration
  • Develops more effective and appropriate strategies and approaches by consulting experts in the field with years of experience addressing food system issues

Recommended practices

Getting to know what’s out there: Conducting a robust landscape assessment

Various strategies and techniques exist for conducting a landscape assessment of existing community food resources. Inventorying community resources could be as simple as a group of stakeholders gathering to discuss and list community food assets including programs, services, and resources, as well as identifying gaps or weaknesses. 

Seeking out local groups or agencies with expertise such as county extension services, a local food policy council or food coalition, the local public health department, a university partner, city planners and sustainability managers, or others can be valuable to identify if a food system assessment or mapping effort already exists, or to consider partnering to conduct or commission a robust community food assessment. 

Community food assessments can be scaled up to become valuable as a standalone tool and resource for the community. Assessments may use formal instruments to compile specific food environment and food security-related data to provide a comprehensive view of the food system relative to community health. 

From Farm to Table: A Kansas Guide to Community Food Assessment provides a detailed list of common community food-related assets and indicators to consider when inventorying food system resources, as well as data resources, assessment tools, and examples.

Northwest Healthy Roots Collaborative
Adrienne harvesting sage as a part of the Healthy Roots Collaborative programming in rural Vermont. (Northwestern Medical Center)

Mapping the community food environment

Physically putting community assets on a map provides a visual aid that can increase insight and identify patterns regarding the availability of resources. This may lead to focusing on a particular neighborhood, or tailoring the intervention approach to accommodate specific environments and circumstances. 

The Maryland Food System Mapping Resource is one example of incorporating data on the food system, public health, and environment to better understand geographic patterns and community trends to inform planning, interventions, advocacy, funding, policies, and research. This food system data mapping informed an array of valuable projects, resources, and reports including a robust food environment assessment for Baltimore City. Johns Hopkins Hospital used the Mapping Baltimore City’s Food Environment report in their 2016 CHNA and to inform implementation strategies. 
 

The following resources discuss methods, tools and example assessments, all of which hospitals can draw on to incorporate community food assessment components into a community health needs assessment (CHNA):

  • The Community Food Security Assessment Toolkit, produced by the U. S. Department of Agriculture (USDA), includes a guide and series of standardized measurement tools for assessing various aspects of community food security, including components of the community food environment, community food resources, and household food security. Data collection tools include secondary data sources, focus group guides, and a food store survey instrument. 
  • Facilitator’s Guidebook Community-Based Food System Assessment and Planning provides facilitator tools and instructions for activities including developing a steering committee, defining goals, inventorying community assets, creating a baseline report, engaging a broad range of community stakeholders, hosting community meetings and more. Certain components may be useful to draw on as standalone exercises or to incorporate as elements in a CHNA. The section on “Taking Stock of Your Community Food System Assets” (pgs 21-32) could help guide an inventory of community food assets.
  • What’s Cooking in Your Food System? A Guide to Community Food Assessment provides context for the emerging field of Community Food Assessments (CFA), including an overview of the U.S. food system and community food security approach. This resource defines CFAs and benefits, presents brief case studies, outlines basic steps of an assessment, and provides detailed guidance on the CFA process from developing goals and research questions to putting the assessment to work in your community. 
  • Healthier Food Retail: Beginning the Assessment Process in Your State or Community is a report from the Centers for Disease Control (CDC) that provides a detailed overview of how to conduct an assessment of the food retail environment at the state or local level. It contains a number of useful resources and data sources, guidance on collaboration and methodology, and information on developing a successful implementation strategy after conducting the assessment. 
  • Whole Measures for Community Food Systems (Whole Measures CFS) is a values-based community-oriented tool for evaluation, planning, and dialogue geared toward organizational and community change.
  • This Community Food Assessments resource from LiveWell Colorado provides guidance and resources for getting started, navigating data collection, as well as a variety of tools to support CFA activities.

Whatever strategy or approach a hospital may take to identify and inventory stakeholder groups, organizations, and existing community food system resources, key questions to consider include: 

  • Which organizations are working on food access, healthy eating, and food insecurity issues in your community? 
  • Which groups or neighborhoods experience disproportionate rates of food insecurity and/or lack access to healthy foods, and which agencies or organizations work closely with these communities? 
  • Which organizations are involved with local food promotion or community development through food initiatives?

Types of organizations to consider when conducting a food system landscape assessment are listed below. See Making Food Systems Part of Your Community Health Needs Assessment: Practical Guidance for a more comprehensive review of organizations to consider as well as examples of how they partner with local hospitals. 
 

Potential partners for community health needs assessment

The following types of organizations can be considered potential partners when conducting a CHNA and/or conducting an inventory of community food system assets and resources: 

  • Programs that link food-insecure people to food resources (e.g. Supplemental Nutrition Assistance Program [SNAP], Women, Infants, and Children [WIC] Food and Nutrition Service, fruit and vegetable incentive programs, etc.) 
  • Food banks and pantries
  • Soup kitchens and congregate meal programs
  • Supplemental meal provision programs (e.g. summer, afterschool, and weekend meal and supplemental food “backpack” programs) 
  • Home-delivered meal programs (e.g. Meals on Wheels)
  • Food system advocacy groups (e.g. local food policy councils, food justice coalitions)
  • Community organizations involved with farmers markets, healthy food retail/store initiatives, programming that doubles the value of SNAP dollars for use on fresh foods at farmers markets 
  • Agencies that serve low-income and vulnerable communities who commonly face food insecurity and food access issues (e.g. WIC providers, social service agencies, faith-based outreach/support groups, department of aging, department of health and human services, local public health department)
  • Community agriculture groups and organizations (e.g. community gardening, urban farming programs, community supported agriculture) 
  • Food production or value-added processing community development program (e.g. community kitchens, food business incubators, food hubs)
  • Farm-to-school networks
  • Colleges, universities, and agriculture extension agencies
  • Government agencies (U.S. Department of Agriculture [USDA], USDA Food and Nutrition Services [USDA-FNS])
  • City (government) planners and sustainability managers
  • Local health foundations
     

Engaging community-based food organizations and community stakeholders

After identifying existing community food system resources as well as key stakeholders, including organizations that work on food-related issues and with low-income and minority communities, key questions include: 

  • Who is already at the table for your CHNA process? What food system stakeholder group or community is not represented? 
  • What community food assessments already exist?
  • Who would you like to be at the table to provide insight, expertise and on-the-ground experience? 
  • At what point(s) in the CHNA process would their input and expertise be most valuable? And how would you ideally like to have them participate? 

There are a variety of ways that community food organizations and stakeholders can participate in the CHNA process, each of which is discussed below.

  1. Participate in data collection
  2. Participate in community health data review and health needs prioritization
  3. Serve on the CHNA steering committee

These forms of engagement are not mutually exclusive and it is valuable to incorporate any number of the practices described below. Generally, the greater the level of community engagement, the greater the benefit. What is “best” or “right” is situation-specific and depends on the overall goals, priorities, and resources available. The wide range of strategies means there are multiple opportunities to increase community participation. 

Data collection

Community-based organizations and stakeholders that work on healthy food access, food insecurity, or other food system related initiatives can be a great resource to help develop relevant, appropriate, and effective data collection strategies. Well established community-based agencies with strong client networks can also be incredibly valuable partners for implementing a range of data collection activities. 

However, it is important to ensure a respectful and ethical approach to data extraction. Some communities may be studied frequently by universities, government agencies, hospitals, and other institutions. It is critical to utilize existing analyses in order to avoid duplication of efforts and over-burdening community members, particularly if there is little or no compensation for their vital contribution to data collection. Community members also should have access to and an active role in stewardship over this data. 

Common ways to engage community stakeholders in CHNA data collection activities include: 

  • Partner with a community coalition or agency to conduct a robust landscape assessment of community food system resources or a local food environment assessment
  • Partner with community stakeholders to host focus groups at neutral, known, and comfortable community locations; leverage the network and reputation of community organizations to recruit participants
  • Ask community members to review community survey, focus group, or interview guides to provide feedback on questions and indicators incorporated, as well as appropriateness of language utilized
  • Partner with community organizations to disseminate surveys; leverage existing networks of an organization or coalition to help increase participation and representation of low-income, minority, and historically underserved populations
  • Ask community stakeholders with food system or food access expertise to participate in a key informant interview
  • Seek input from community partners working on food system issues regarding indicators commonly used in their field to include in the CHNA, as well as recommendations regarding reputable data sources and existing datasets (national, regional and local - including a previously conducted local food environment assessment or asset mapping) 

Causes and multipliers of health conditions are nuanced. Including community organizations and stakeholders that work on food issues in data collection can help ensure the right questions are being asked in order to capture what is happening in the community, and help ensure the data collection strategies utilized will elicit robust participation from populations of interest (e.g. low-income, minority, vulnerable). 

Data review and prioritization

Including community stakeholders in the process of identifying and prioritizing health needs can help ensure accurate understanding of needs and priorities for different groups and neighborhoods in the assessment area. In addition, ensuring community stakeholders participate in needs identification and prioritization will help build community trust and buy-in, while establishing new connections and cultivating relationships that could be fruitful for implementation strategies. 

Common opportunities to include food-related community organizations in the data review and prioritization process include: 

  • Partner with a community-based food organization to host a community event to engage key stakeholders, organizations and community members in data review, interpretation and needs prioritization. Work with the organization to identify key stakeholder groups for participation to ensure representation of the entire food system, key actors, and community.
  • Initiate or utilize an existing cross-sector community health coalition, workgroup or committee that includes food system stakeholders to interpret data and identify priority health needs.
  • Administer a survey to gather community input on needs prioritization. Partner with community food organizations and agencies that work on food issues to disseminate through their networks. 
NOW 1
Fresh produce and healthy living education opportunities are available for participants of the Nutritional Options for Wellness (NOW) program, which was founded by Spectrum Health and administered by Access of West Michigan.  (Access of West Michigan)

Steering/advisory committee

Inviting food system stakeholders to serve on the CHNA steering or advisory committee provides the opportunity for community experts to lend insight at various steps in CHNA process.

Having a community stakeholder with food system experience on the steering committee amplifies the impact of hospital investment by making connections to existing efforts, coalitions, and potential partners.

Hospital charitable grants and community benefit resources alone, while critically important, are not enough to fundamentally transform key determinants of health. A better, more sustainable opportunity is to collaborate with community partners to leverage all available resources to integrate community benefit into the fabric of the community and implement real, lasting change. 

Participation of community food organizations on the CHNA committee has significant implications for community health improvement efforts. In a 2016 national survey, 45 percent of hospitals reported including at least one food-related organization on their CHNA committee. Having a food-related organization on the CHNA committee was strongly correlated with having a community benefit program that targeted healthy food access or food insecurity.


Robust community partnerships

Deeper and ongoing engagement of the community in the CHNA process is more common as hospitals increasingly realize the value in cultivating robust community partnerships and relationships — not just to better serve their community, but to advance hospital mission and goals. 

Beyond more effective interventions and use of community benefit and charitable resources, hospitals can apply insights gained from conducting a robust landscape assessment and having strong community participation in the CHNA to improve aspects of their business model, operations, and strategic approach to population health. Community engagement is valuable to identify ripe opportunities for health care facilities to address social and environmental determinants of health through a range of “anchor institution strategies” such as local purchasing, hiring, and other strategic investments. 

Below are examples of how hospitals today are actively partnering with their community food organizations and stakeholders throughout the CHNA process.                        

Mercy Medical Center, Iowa (primary data collection activities)
Hospital and community partner example

Include a community organization working on food access or food system advocacy in primary data collection activities.


Mercy Medical Center - North Iowa (MMC-NI)

Mason City, Iowa 

Community Kitchen of North Iowa
 

Description

Mercy Medical Center - North Iowa (MMC-NI) used focus groups, interviews, and questionnaires to solicit input from individuals and community agencies serving low-income and underserved residents. 

MMC-NI partnered with Community Kitchen of North Iowa to distribute questionnaires and to conduct interviews with their clientele. 

Community Kitchen, Meals on Wheels and 17 other community agencies also participated in a community data review and needs prioritization meeting.

Highlights

“Healthy food not available” was one of four health needs identified in all of the focus groups and interviews. Obesity and diabetes were two of the top five issues identified in questionnaires. 

Diabetes, obesity, heart disease, and “healthy food not available” were four of the ten health needs to be prioritized.
 

Kaiser Permanente, Calif. (primary data collection activities)
Hospital and community partner example

Include a community organization working on food access or food system advocacy in primary data collection activities.

PGH member icon Pledge signer icon Kaiser Permanente Riverside Medical Center (KPRMC)

Riverside, Calif.

Feeding America,
Fox Farms, 
Riverside Food Co-op, 
Riverside Food Systems Alliance

 

Description

Kaiser Permanente Riverside Medical Center used key informant interviews, focus groups, and community cafés to collect primary data from diverse community-based organizations and service providers including Feeding America, Fox Farms, Riverside Food Co-op, and Riverside Food Systems Alliance. 

The hospital also hosted community forums to engage diverse community stakeholders in a participatory needs prioritization process that included data review and facilitated discussions about identified health needs. 
 

Highlights

Participation of expert community stakeholders helped lead to selection of obesity/diabetes as one of three priority health needs and underscored the role of food insecurity and healthy food access as key drivers. 

Community leaders called for greater access to fresh produce and unprocessed foods and helped identify community assets and opportunities such as local farms, school meal programs, farmers markets, existing coalitions, collaborations, and more. 

Community members offered insights in a survey about strategies to address priority health needs. Suggestions included increasing community engagement in healthy eating education recommending potential partners. 
 

St Joseph Mercy Hospital, Mich. (primary data collection activities)
Hospital and community partner example

Include a community organization working on food access or food system advocacy in primary data collection activities.

Pledge signer iconSt Joseph Mercy Hospital - Ann Arbor

Ypsilanti, Mich.

Food Gatherers
 

Description

St Joseph Mercy Hospital - Ann Arbor conducted a key informant interview with the executive director of their local food bank, contributing expert knowledge on food insecurity in the region.
 

Highlights

Expert interview provided an overview of ongoing anti-hunger and food insecurity work in the region, helping the hospital focus on areas where they would minimize redundancy and maximize effectiveness in their implementation strategy.

Cooley Dickinson Hospital, Mass. (primary data collection activities)
Hospital and community partner example

Include a community organization working on food access or food system advocacy in primary data collection activities. 

PGH member iconPledge signer iconCooley Dickinson Hospital

Northampton, Mass.

Healthy Hampshire

Description

Cooley Dickinson Hospital partnered with Healthy Hampshire to bring together a food access advisory committee made up of professionals and residents dealing with food insecurity to conduct a community food assessment. The committee evaluated current food system conditions and developed an action plan to reduce barriers to food access.

Highlights

Cooley Dickinson used the Draft Action Plan to inform food access components of their implementation strategy.

St Joseph Health, Calif. (primary data collection activities)
Hospital and community partner example

Include a community organization working on food access or food system advocacy in primary data collection activities. 

St Joseph Health - Humboldt County 

Eureka, Calif.

First 5 Humboldt, California Center for Rural Policy
 

Descriptions

St Joseph Health - Humboldt County partnered with First 5 Humboldt to incorporate a new section on nutrition and food security into their annual survey of program participants. 

The hospital also worked with the California Center for Rural Policy to incorporate data from studies and reports on food system,  access, and  insecurity issues. The hospital utilized community assessments and reports from community partners. The Community Alliance with Family Farmers, Food for People, United Indian Health Services Elder Nutrition Program, and Area 1 Agency on Aging submitted data. 

Highlights

The hospital utilized First 5 Humboldt’s existing network and survey distribution efforts to gather nutrition and food security data from 493 survey respondents, thereby improving their understanding of the nutrition needs of vulnerable families.

Analysis of collected reports strengthened the CHNA by providing community input and relevant food systems data beyond the scope and capacity of the team’s primary data collection efforts. Data about sub-populations of interest such as senior citizens, food pantry clients, low- income children and United Indian Health Services clients was particularly valuable.

Mercy Medical Center, Iowa (health needs prioritization process)
Hospital and community partner example

Include a community organization working on food access or food system advocacy issues in the health needs prioritization process.

Mercy Medical Center

Sioux City, Iowa

Siouxland Food Bank
 

Description

After data analysis and identification of the top seven areas of need by the CHNA Planning Committee, Mercy Medical Center hosted a Community Input Meeting that engaged 20 community partner organizations, including Siouxland Food Bank. 

During facilitated workshops, meeting participants identified existing services and programs that address obesity and diet-related health needs and gaps or barriers to current programs and services.
 

Highlights

Community stakeholders pinpointed cost of healthy foods, increased food insecurity, and excessive access to unhealthy foods as root causes of obesity. Food insecurity was identified as an additional community need. 

As a result, hospital implementation plans to address obesity included financial support for a city-wide coordinator and committee focused on built environment and policy changes to promote healthy lifestyles and healthy food, as well as strategies to address the cost of healthy foods.

St. Vincent Indianapolis Hospital, Ind. (primary data collection activities)
Hospital and community partner example

Include a community organization working on food access or food system advocacy issues in the health needs prioritization process.

St. Vincent Indianapolis Hospital

Indianapolis, Ind.

Gleaners Food Bank of Indiana; Crooked Creek Community Development Corporation 
 

Description

St. Vincent Indianapolis Hospital convened more than 30 community stakeholders for data review, discussion and prioritization of health needs. 

This group process included representatives from Gleaners Food Bank of Indiana and Crooked Creek Community Development Corporation, which runs a community farmers market with a SNAP incentive program and a community garden.

Hightlights

Community input was integral to identifying obesity and malnutrition, access to healthy food, and awareness about healthy eating habits as top community concerns. These topics did not initially emerge as priorities through analysis of secondary data. 

Input provided by community leaders with expertise in food access during the needs prioritization convening was critical for identifying nutrition and weight as a top priority. Community input also helped identify opportunities for partnership. 
 

UMass Memorial Medical Center, Mass. (CHNA steering/advisory committee)
Hospital and community partner example

Include a community organization working on food access or food system advocacy issues on the CHNA steering/advisory committee

Pledge signer iconUMass Memorial Medical Center

Worcester, Mass.

Community Harvest Project; Worcester Food & Active Living Policy Council

Description

UMass Memorial Medical Center participated in a collaborative Community Health Assessment. Representatives from the Community Harvest Project and the Worcester Food & Active Living Policy Council served on the Advisory Committee.

Members provided key input on data collection tools and methods, identified additional stakeholders to engage, distributed the public survey assessing community health needs and strengths, and helped identify health trends, key factors, and priority health needs. 

UMass Memorial’s strategies to Promote Healthy Weight focus on “addressing food insecurity and increasing the availability of and access to affordable fresh and local fruits and vegetables for low-income residents” through promoting and supporting a variety of community-based programs and city-wide policy efforts. 
 

Highlights

Having community members with food system expertise on the committee helped ensure food-related issues and stakeholders were included in each step of the process. Data collection included local farmers market surveys, a review of community gardens and farmers markets with food assistance programs, and measures of food access and produce consumption. Community food system organizations fielded the CHA survey and participated in focus groups and interviews. 

All these forms of community input identified obesity as a priority health issue and highlighted nutrition, access to healthy food, and cost of healthy food as significant factors needing more attention.
 

The University of Vermont Medical Center, Vt. (CHNA steering/advisory committee)
Hospital and community partner example

Include a community organization working on food access or food system advocacy issues on the CHNA steering/advisory committee

PGH member iconPledge signer iconThe University of Vermont Medical Center

Burlington, Vt.

Center for Rural Studies

Description

The Center for Rural Studies (CRS) is a nonprofit research center with food systems expertise that works with communities to address social and economic development challenges. The University of Vermont Medical Center contracted with CRS to provide support to the CHNA community steering group throughout the CHNA process, including data collection and analysis, gathering community input and facilitation of needs prioritization. 
 

Highlights

The community survey conducted for UVM’s CHNA asked residents about five different aspects of access to healthy food.

Access to affordable, healthy foods was identified as a priority community health need.

Abraham Lincoln Memorial Hospital, Ill. (leverage cross-sector community participation)
Hospital and community partner example

Engage a community health coalition that includes food system stakeholders and leverage cross-sector community participation


PGH member iconAbraham Lincoln Memorial Hospital (ALMH)

Lincoln, Ill.

ALMH Community Health Collaborative

Description

To help them review data and prioritize community needs, Abraham Lincoln Memorial Hospital  relied on expertise from the ALMH Community Health Collaborative/Healthy Communities Partnership, a local 20-year-old community health coalition with 33 member organizations including representatives from: WIC Program; University of Illinois - Extension; Community Action Partnership of Central Illinois (coordinates local food pantry & Meals On Wheels) and YMCA of Lincoln, which offers healthy eating programming.
 

Highlights

This coalition was central to the CHNA process. Primary data was gathered from local community organizations that participate in the coalition. Coalition members also comprised the majority of the CHNA External Advisory Committee. 

This committee reviewed data and provided insight to help identify and prioritize community health needs  (including obesity and chronic disease management) and provided partnerships integral to implementing collaborative community health improvement strategies.
 

Union Hospital, Md. (leverage cross-sector community participation)
Hospital and community partner example

Engage a community health coalition that includes food system stakeholders and leverage cross-sector community participation

Pledge signer iconUnion Hospital

Elkton, Md.

Winbak Farm, Elkton Community Kitchen, Deep Roots, Meeting Ground

Description

Union Hospital engaged their local Community Health Advisory Committee (CHAC) to solicit input from community partners.
 
During special CHAC meetings community stakeholders helped identify and rank top health priorities and form goals and strategies for each.
 

Highlights

To broaden community representation, CHAC invited additional organizations with food system expertise to participate in meetings, including Elkton Community Kitchen; Deep Roots, which operates a food pantry and cafe offering free meals daily; Cecil County Department of Community Services, which provides a home-delivered meal program and nutrition programming; and Meeting Ground, which offers a free lunch program.

Union Hospital also partnered with Winbak Farm to host a focus group that would reach Spanish-speaking, migrant workers with limited access to the internet (thus have difficulty completing the online CHNA survey). 
 

Genesys Regional Health System, Mich. (leverage cross-sector community participation)
Hospital and community partner example

Engage a community health coalition that includes food system stakeholders and leverage cross-sector community participation

Genesys Regional Health System

Grand Blanc, Mich.

Greater Flint Area Health Coalition
 

Description

Genesys Regional Health System collaborated with the Greater Flint Area Health Coalition (GFHC) to conduct a collaborative CHNA. The CHNA used the coalition’s existing collaborative data collection project and strong network of workgroups and community organizations to collect input from community partners, as well as engage community stakeholders in data review, needs prioritization and implementation strategy development. 
 

Highlights

Chronic disease, including diabetes and heart disease/stroke, was selected as a priority health need. Increasing vegetable consumption among students was identified as a community health improvement objective. 

Community food organizations such as Edible Flint, Flint Farmers Market, Food Bank of Eastern Michigan, and North End Soup Kitchen participated in GFHC committees or as members of the GFHC Community Network, therefore became engaged in the CHNA process. 

Healthy food access and food insecurity emerged as factors underlying a number of the top community health needs identified (obesity, diabetes, overweight). Implementation strategies include collaborative initiatives focused on improving access to and consumption of healthy foods.
 

Orange Center Elementary School’s Healthy Living Garden
Facility and staff of Orlando Health showcase plants and decorative building materials in the Healthy Living Garden space (Orlando Health)

Learn more

  • Participatory Asset Mapping is an instructional toolkit that introduces basic concepts and methods for using and applying participatory asset mapping. Stakeholders and organizations can use the tools provided, such as the Community-Engaged Mapping Facilitation Guide and Guide to Planning a Community-Engaged Mapping Event to host an activity that collects knowledge and experiences from community members about local assets. 
  • The Community Food System (CFS) tool is designed to help community food system stakeholders achieve their goals and create resilient community food systems through collaborations. This short tool includes an exercise on mapping a community food system, essential strategies for building effective partnerships, and tips for engaging diverse stakeholders. 
  • Conversations Across the Food System: A Guide to Coordinating Grassroots Community Food Assessments provides a background and overview of the process involved in coordinating a grassroots community food assessment (CFA). As opposed to more data-driven assessments, this approach focuses on conversations, asset mapping and engaging the community in a participatory process that builds capacity to help ensure efforts initiated through the CFA continue into the future. 
  • A team of regional food system specialists from across the country developed the Economics of the Local Food System: a Toolkit to Guide Community Discussion, Assessments and Choices, comprised of food system assessment principles, economic indicators, real-world project examples and practical advice. This toolkit provides guidance on conducting a community food system assessment that engages farmers, incorporates the local food production system, and helps evaluate and communicate economic impacts of local food system initiatives.
  • Local and Regional Food Systems: Community/Regional Development is an index of resources and initiatives related to local and regional food systems from Cornell University. The index includes resources related to food system assessments, spatial analysis and mapping of food systems, and more.
  • Oregon Food Bank partners with local organizations to complete community food assessments in counties throughout the state. Their website provides more than 35 examples of community food assessment reports, each of which is unique and describes their process, methods, indicators, results, tools, and resources. 
  • The Center for a Livable Future created a Community Food Assessment (CFA) tool and conducted CFAs in neighborhoods of Baltimore to gather information on local food environments, resident experiences and behaviors, community assets and areas of need. The results are used by partners to direct community efforts, inform policymakers interested in improving healthy food access, and advocate for programs and policies. This website includes examples of CFAs conducted utilizing their tool and links to the original assessment and tool utilized.
  • The report Opportunities for Increasing Access to Healthy Foods in Washington is the result of a collaborative multi-sector assessment of systems and factors that impact access to healthy foods in Washington State. The report details assessment methods, maps of key food and health indicators, community assets and barriers, promising strategies, opportunities and recommendations to improve healthy food access. Each component of the report provides useful examples to draw on to incorporate community food assessment elements into a community health needs assessment.