Using adverse childhood experiences to explore the usefulness of community health needs assessments to monitor complex determinants of health at the local level

Shay M Daily; Angela M Dyer; Christa L Lilly; Emily A Sarkees; Thomas K Bias

doi:10.1016/j.evalprogplan.2021.102044

Using adverse childhood experiences to explore the usefulness of community health needs assessments to monitor complex determinants of health at the local level

Eval Program Plann. 2022 Apr:91:102044. doi: 10.1016/j.evalprogplan.2021.102044. Epub 2021 Nov 20.

Authors

Shay M Daily¹, Angela M Dyer², Christa L Lilly³, Emily A Sarkees², Thomas K Bias⁴

Affiliations

¹ Office of Health Affairs, Robert C. Byrd Health Sciences Center, West Virginia University, 64 Medical Center Dr., Morgantown, WV 26506, USA. Electronic address: smdaily@hsc.wvu.edu.
² Office of Health Affairs, Robert C. Byrd Health Sciences Center, West Virginia University, 64 Medical Center Dr., Morgantown, WV 26506, USA.
³ Department of Biostatistics, School of Public Health, West Virginia University, 64 Medical Center Dr., Morgantown, WV 26506, USA.
⁴ Office of Health Affairs, Robert C. Byrd Health Sciences Center, West Virginia University, 64 Medical Center Dr., Morgantown, WV 26506, USA; Department of Health Policy, Management, and Leadership, School of Public Health, West Virginia University, 64 Medical Center Dr., Morgantown, WV 26506, USA.

PMID: 34883337
DOI: 10.1016/j.evalprogplan.2021.102044

Abstract

Background: Hospital led community health needs assessments (CHNAs) are intended to help medical care organizations assess determinants of health within the communities they serve. This study demonstrates the utility of data from non-profit hospital CHNAs to monitor complex health issues such as adverse childhood events (ACEs) at the local-level.

Methods: CHNA data were collected from August to November 2019 and analyzed July 2021. A series of logistic regressions were used to analyze associations between ACEs, mental health conditions, and self-rated health from a convenience sample of 2831 adults from two regional hospitals that service five counties located in central Appalachia.

Results: ACEs were associated with increased odds of experiencing all metal health conditions after adjusting for other exposures and demographics, including: bipolar disorder (AOR: 2.42, CL: 1.78, 3.30), chronic pain (AOR: 1.61, CL: 1.438, 1.87), depression (AOR: 2.05, CL: 1.76, 2.36), PTSD (AOR: 3.83, CL: 2.95, 4.98), and poor self-rated health (AOR: 1.88, CL: 1.65, 2.15).

Conclusion: Findings suggest hospital CHNAs are a useful way to assess local data and should include factors known to antecede disease including associated risks and outcomes. CHNAs may provide an opportunity to fill important gaps in community surveillance and inform local prevention and treatment strategies.

Keywords: Adverse Childhood Experiences; Hospital led CHNAs; Local Surveillance; Mental Health; Self-Rated Health.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Adverse Childhood Experiences*
Humans
Needs Assessment
Organizations, Nonprofit
Program Evaluation
Public Health