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Foundation Operations: Grantmaking-> Identifying Community Needs

What is involved in conducting a community health assessment? What do foundations do with this information?

As with any product, there are numerous options to consider and decisions to be made. There are often, however, five main components that are typically involved in a community health assessment:

  • an assessment plan,
  • a community profile,
  • a determination of the key health needs of the community,
  • estimates of the health status of the community, and
  • recommendations for action.

Grantmakers have used information from community health assessments to plan their own programming and future grantmaking, as well as to equip community members, public health leaders, and city planners with the information necessary to improve the health of the community. Both emerging and long-established health foundations use this information to make decisions about program development and the allocation of resources. For a new foundation, an assessment gives the board and staff a detailed road map of their community, informing them of its demographics, health status, existing health care services and community resources, and key health issues. A new foundation may also use key findings from an assessment to develop its strategic plan, grantmaking program, yearly budget, or staffing plan. For foundations with grantmaking experience, a new assessment provides data and perceptions that may be used to evaluate current programs, to gauge the impact made by particular grants on health status or other key health indicators, and to establish new priorities.

Before conducting an assessment, foundations typically ask themselves four basic questions: what scope should the study have, how long will it take, who should do it, and how much will it cost? The following examples describe two local foundations that have conducted health assessments in their communities:

The Birmingham Foundation, whose service area includes the south neighborhoods of Pittsburgh, Pennsylvania, funded a comprehensive community health assessment to focus its grantmaking, as well as provide relevant and thoughtful information to community groups, service providers, government representatives, planners, and others working toward a healthy community. Questions guiding the assessment process included: how is south Pittsburgh similar to and different from its surrounding community, what are its assets and challenges, and what can individuals learn from neighborhood-based data? The assessment revealed that residents were pleased with the existence of a community hospital, as well as other health centers, comprehensive mental health services, and senior centers that offered various programs. Problems in the community that were identified include: access problems, such as lack of transportation and insurance; teen pregnancy; substance abuse; and senior citizens' health problems and isolation. The executive summary of the report and information on obtaining the full report can be found on the foundation's Web site.

The Rapides Foundation, whose service area includes eleven parishes in central Louisiana, is one of the largest grantmaking organizations per capita in the southeast. In 2002, the foundation commissioned a community health assessment to build upon and update an earlier assessment that collected health-specific data and identified community needs. This latest assessment draws on data from three distinct sources:

  • community health survey: randomized telephone interviews were conducted to assess the health and behaviors of community members;
  • existing data: public health data, including statewide and nationwide risk assessments were used to complement the survey process and provide a benchmark for the survey data; and
  • community health panels: focus groups consisting of community leaders and representatives from the different communities were conducted.

Both the earlier and 2002 assessment are available on the foundation's Web site.

The Access Project is a nonprofit organization that works to strengthen community action, promote social change, and improve health, especially for those who are most vulnerable. It designs and supports community action research that advances the work of community leaders.



Brown, Prudence, Robert J. Chaskin, Ralph Hamilton, and Harold Richman,  Toward Greater Effectiveness in Community Change (New York, NY: The Foundation Center, 2003).

The Ford Foundation, “Building Community Inside Out With a Good Neighbor Committee,” GrantCraft Series (New York, NY: 2002).

The Ford Foundation, “Scanning the Landscape - Finding Out What's Going on in Your Field”, GrantCraft Series (New York, NY: 2002).

Greiff, Debbie, and Harry Snyder, Advancing Accountability: A Tool for Transparent Foundation Grantmaking (San Francisco, CA: Consumers Union of the U.S., 2000).

The Health Foundation of Greater Cincinnati, Catalyst for Change: Stories of Change and Transformation (Cincinnati, OH: 2003).

Quantum Foundation, Inc., 2002 Palm Beach County Community Health Assessment: Assessing the Health Needs of Palm Beach County (Palm Beach, FL: 2002).
















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