Seattle–King County, data are available to a relatively limited technical audience, but there are hopes to provide broad community access.

It was noted that health departments are generally a resource for essential technical and organizational services for community health assessment. They can provide the expertise and computing facilities needed to frame some indicators and to perform data management and analysis tasks. They can also help bring together the community stakeholders and help build coalitions. The discussion highlighted the different skills that technical and community organizing tasks require. It was suggested that schools of public health might make a valuable contribution by ensuring that students have training in both areas.

The growing interest in the role that health plans play in meeting community health needs was noted. They are a source of information about their members and should be able to benefit from knowing more about the factors affecting health in the community. Their collaboration in community health assessment may encourage, and be encouraged by, the development of common goals for member and community health. It was suggested that establishing common community practices in technical areas such as data standards and data interchange might promote health plan participation. An assessment of health plan performance, which might use indicators such as those provided by HEDIS, is also seen as a necessary part of these activities.

Observations to the Committee

Final remarks in this presentation highlighted several issues in monitoring community health. It was emphasized that monitoring needs to be a dynamic process and that it should promote local involvement. Indicators used for monitoring need to focus, to the extent feasible, on risk factors with interventions known to be effective. Research is needed, however, to establish the effectiveness of a much broader range of interventions. Indicators should also address not only risk factors for poor health outcomes but also factors that protect against poor outcomes. In addition, indicators should be sensitive to changes in the organization and delivery of health care services.

Some specific areas in which the committee might be helpful were noted: proposing indicators; encouraging the development of indicators for less developed domains such as environmental or social determinants of health; suggesting data standards for defining populations; providing guidance on effective presentation and dissemination of assessment results; and outlining effective processes for involving community stakeholders in monitoring. Part of the committee's contribution may be to assemble available expertise in these areas.

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