CHA Documents

This page contains documents and reports created for and by the Domain 1 Work Group in the preparation of the Community (Statewide) Health Assessment for the ADPH Public Health Accreditation project.

2015 State of Alabama Community Health Assessment

The final 2015 Alabama Community Health Assessment is now available online. If you have questions, comments or recommendations for future development, please email Carrie Allison at

CHA indicators (and updates as available) are on ADPH Health Rankings.

Michele Jones, Carrie Allison and Dale Quinney, Co-Leads

Domain 1 Work Group

  • Stacey Adams - Assistant Administrator, Public Health Area 7
  • Renae Carpenter - Director, Public Health Social Work, Bureau of Professional Support Services
  • William Duncan - Research Analyst, Bureau of Family Health Services
  • Sarah Khalidi - Epidemiologist & BRFSS Coordinator, Bureau of Health Promotion and Chronic Disease
  • Justin T. George - Director of Cancer Epidemiology, Bureau of Family Health Services
  • Jim McVay - Director, Bureau of Health Promotion and Chronic Disease
  • Sondra Reese - Chronic Disease Epidemiologist, Chronic Disease Division
  • Chris Sellers - Director of Data and Evaluation, Children's Health Insurance Program
  • Richard Rogers - HIV Surveillance and Incidence Director, Division of HIV/AIDS Prevention and Control
  • Tammie R. Yeldell - Epidemiologist Supervisor, Bureau of Family Health Services

The Community Health Assessment Developmental Process

In 2014, leadership at the Alabama Department of Public Health (ADPH) developed a team of 19 members who represented a wide array of topic areas and that included data experts for many of those fields. This team, the Domain 1 Work Group, led efforts to conduct the Community Health Assessment (CHA) for the state of Alabama. Due to the guidance from the University of Alabama at Birmingham (UAB) School of Public Health Project Team, the Domain 1 Work Group determined that the Health Issue Focused Approach was the best model to use for Alabama. The UAB Project Team provided organizational and technical support for the process. The following section will detail how the Domain 1 Work Group used the Health Focused Approach in the development of the CHA.

Step 1: Conducted a statewide online and paper copy survey of individual health care consumers. Fifty-eight known health care concerns were listed with space included for other concerns to be indicated. Respondents ranked the ten leading health care concerns in order of importance. This survey was available in English and Spanish. This was done from November 2013 through March 2014 with over 6,000 usable responses being received from all demographic components of Alabama's population. Survey responses were monitored to assure that all components of Alabama's population were adequately represented. These 58 concerns and other concerns identified through this survey were later merged with related conditions to produce 22 major conditions and ranked by seriousness as reported through the survey. View the survey questionnaire in English or Spanish.

Step 2: Conducted a statewide online and paper survey of Alabama organizations (health care and non-health care). This survey was identical to the survey of individuals described in Step 1 and was conducted during the same time frame. Over 500 Alabama organizations reflecting great diversity in mission and size participated in this survey. These 58 concerns and other concerns identified through this survey were later merged with related conditions to produce 22 major conditions and ranked by seriousness as reported through the survey.

Step 3: Each of the 11 Public Health Areas (PHAs) conducted their own public forums, surveys, etc., to identify their ten leading health concerns. The Domain 1 Work Group used personal knowledge and the listings of the top ten health care concerns identified in each of the 11 PHAs to merge related conditions into 22 major health care concerns ranked in order of severity.

Step 4: A selected group representing major interests in Alabama were identified and asked to participate in an online survey of the 22 major concerns by ranking these in order of importance to their special interest and to note other concerns that were not included among the leading 22 concerns. Special interests contacted for inclusion in this survey included: economic development, education, large employers, small hospitals, medium sized hospitals, large hospitals, public transportation, elderly residents, children/youth, the environment, the business community, manufacturing, local government, Medicaid, private health insurance, rural health interests, Native American interests, minority populations interests, Hispanic interests, emergency medical services, the Cooperative Extension System, charity clinics, local health care coalitions, health care technology, health care societies, health care institutes, the child death review program, emergency management, injury prevention, military health care, the hospital association, Federally Qualified Health Clinics, health care education, women's health, men's health, mental health care, poison control, faith based initiatives, and welfare agencies. Of the 41 entities contacted, 28 provided the requested information. View the online questionnaire that was completed by these 28 entities.

Step 5: The Domain 1 Work Group compared the major health care concerns listing developed in each of the first four steps and noted that the results from each step agreed on the top 13 concerns. The listing developed in Step 4 had the same 13 concerns included among its top 15 concerns. For this reason, the initial goal of identifying the 10 leading health care concerns was altered to include the 13 leading concerns. The Domain 1 Work Group then identified specific indicators for each of these 13 concerns that could be used to establish a baseline and to monitor progress on each major concern.

Step 6: A statewide webinar was presented on May 21, 2014; and a statewide satellite webcast was presented on July 17, 2014, to present the 13 leading health care concerns and the proposed indicators to be used in monitoring progress on each concern. Comments and suggestions concerning the selected indicators were encouraged. A special presentation of this same material was made to Medicaid officials with comments and suggestions being encouraged. This presentation was again made at a statewide meeting of special stakeholders that was held by the Domain 5 Work Group (responsible for developing the Statewide Community Health Improvement Plan) on August 20, 2014, with comments and suggestions being encouraged. Suggestions made through these presentations resulted in some changes to selected indicators.

Step 7: The final statewide CHA includes detailed data and information on each major concern and associated indicators, a comparative ranking of counties for each concern and indicator (where possible), and existing assets and resources that may be available to assist in intervention. An additional Web page will be developed to present data and information on the 13 leading concerns and on other health care concerns and issues that were not initially selected. Data and other information included on this website will be updated continuously as soon as new data becomes available. This ongoing process will involve stakeholders in the CHA Focus Group.

The 13 Leading Health Concerns Included in Alabama's Community Health Assessment

1. Access to Care
2. Mental Health and Substance Abuse
3. Poor Pregnancy Outcomes
4. Nutrition and Physical Activity
5. Circulatory Diseases (revised to Cardiovascular Diseases)
6. Sexually Transmitted Infections
7. Cancer
8. Child Abuse and Neglect
9. Diabetes
10. Geriatrics
11. Injury and Violence Prevention
12. Dental Health (revised to Oral Health)
13. Tobacco Use (revised to Cigarette Smoking)

Download additional information on each of these leading healthcare concerns, including the indicators currently being considered for establishing a baseline and monitoring future progress.

Domain 1 (Community Health Assessment) Webinars/Webcasts

CHA Work Group Assets and Resources Collection Materials

CHA Health Assets Materials - Carrie Allison, Lead

Community Health Assessment Reports and Information

Public forums and other activities were conducted in each Public Health Area with instruction to include all demographic components of the population in their service area to identify the leading health concerns in each area. In addition, several Alabama county health departments are seeking individual accreditation and are required to develop a comprehensive community health assessment for their county.

Public Health Area Health Status Indicator Reports

These reports were developed to assist in identifying leading health concerns at the Public Health Area level.

Page last updated: January 22, 2020