4.1 Article

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

Journal

EVALUATION AND PROGRAM PLANNING
Volume 91, Issue -, Pages -

Publisher

PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.evalprogplan.2021.102044

Keywords

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

Funding

  1. WVU Medicine Healthcare system, Morgantown, WV, USA

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This study demonstrates the utility of non-profit hospital CHNAs in monitoring complex health issues, showing the associations between adverse childhood events and various mental health conditions, highlighting the importance of CHNAs in assessing and filling gaps in community surveillance.
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 selfrated 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.

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