particularly useful in bringing potential health impacts to the attention of policy makers.

A major value of this approach is its focus on considering the input of multiple stakeholders, including those who would be directly affected by the project under consideration. As changes are proposed to the built environment, communities should consider this tool for examining how proposed changes in the community would affect health issues such as access to and availability of healthful foods and opportunities for physical activity. It will be important to identify and examine natural experiments in which initiatives based on health-impact assessments could be compared to those undertaken without such an assessment.

For an overall assessment of a community’s health improvement efforts that are already underway, community health “report cards” (also termed community health assessments or health profiles) are an excellent tool, both to assess and convey progress (CDC, 1997a). A variety of approaches have been used, all with the goal of providing a concise and consistent collection of data that can be formatted for dissemination to the community. For example, state, county, and community health profiles have been developed using CDC’s Healthy Days Measures among other community performance indicators (CDC, 2004a). In addition, the Community Health Status Indicators Project (CHSI)—a collaborative effort of the Association of State and Territorial Health Officials, the National Association of County and City Health Officials (NACCHO), and the Public Health Foundation—has developed report indicators and formats for county-specific information that allows comparisons with similar “peer” counties throughout the country (NACCHO, 2004). A CHSI report contains information on behavioral risks, preventive services use, access, and summary health measures. To assist in obesity prevention efforts, community health report cards should use measures that assess the community’s progress toward encouraging good nutrition and physical activity. These measures could rate the built and social environments, local school policies and practices (Chapter 7), the community food environment, and the degree of involvement of local businesses, organizations, and other groups in supporting and participating in obesity prevention efforts.

To streamline efforts and encourage communities to engage in these types of evaluation efforts, common evaluation tools should be developed and shared, while also ensuring that evaluation tools have the flexibility to be sensitive to the needs of local communities. This is an area where it will be important to build on tools (those discussed above and others) that have already been developed. Leadership for these efforts should involve CDC, NACCHO, the American Planning Association, and other relevant organizations, including foundations such as the Robert Wood Johnson Foundation, with interests in community-based obesity prevention efforts.

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