Washtenaw County hospitals team up to assess community health needs

Trinity Health Ann Arbor, Michigan Medicine, and Chelsea Hospital are gearing up for their triennial study of what county residents need and expect from them.
Three of Washtenaw County's biggest health providers are coming together to learn what county residents need and expect from them. The Unified Needs Assessment Implementation Plan Team Engagement (UNITE) will be forming and distributing its Community Health Needs Assessment (CHNA) in order to do just that. Formerly a Washtenaw Health Initiative group, UNITE consists of Trinity Health Ann Arbor, Michigan Medicine, and Chelsea Hospital.

The federal government requires all nonprofit hospitals to conduct a CHNA every three years, with this year marking UNITE's fourth time distributing the assessment as a collective. According to Trinity Health's website, the CHNA is designed to "help communities, organizations, and local health systems identify issues that impact health in the community," and help health care providers determine what programs or resources to put funding toward in the following three years. 

Shekinah Singletery, Trinity Health director of community health and wellbeing.The assessment is distributed to the greater Washtenaw County area, which also includes Grass Lake and Stockbridge, through a traditional survey, as well as community focus groups and other meetings with community leaders and resources. 

"We will have UNITE representatives facilitating conversations so we can gain trust in the community and continue building those relationships," says Shekinah Singletery, Trinity Health director of community health and wellbeing. "It's more than just a survey."

UNITE will be working with the Washtenaw County Health Department, as well as the Southeastern Michigan Hospital Association, to best identify the root causes of common health concerns in the county, and how to best tackle them and improve general well-being in the county.

Singletery says the CHNA is a great way to "check the pulse" of the community in regards to how health systems can best serve residents.

"We go through this process of identifying needs, then shift to prioritization and addressing those needs through an implementation plan," Singletery says. "We want to elevate the voices of community leaders and community members, and understand the strengths of our community as well as its challenges or needs."

Singletery explains that the three priority needs identified by the 2021 CHNA were mental health and substance use disorders, obesity and related illnesses, and preconceptual and perinatal health. But UNITE also pays close attention to community needs even when not actively conducting a CHNA.

"We are constantly engaging our community," Singletery says. "We want to invest dollars to support those identified needs that the community has voiced as concerns."

Karen Zynda, Michigan Medicine's director of community benefit and community health needs assessment, explains that UNITE will be implementing the Community Anti-Drug Coalitions of America, or CADCA model, in its root cause analysis of health and social needs within the community. This model is designed to "emphasize the power of community coalitions to prevent substance misuse through collaborative community efforts," according to CADCA's website
Karen Zynda, Michigan Medicine's director of community benefit and community health needs assessment.
"UNITE is utilizing CADCA to help dig into the root causes of the health outcomes, behaviors, and social needs in order to understand why it is an issue in the local community," Zynda says. "This allows us to not only understand the issue at its core but it helps us to plan where UNITE can potentially target with interventions, programs, and monies."

Zynda says using the CADCA model in the past has helped UNITE identify social determinants of health to focus on, such as housing, poverty, social isolation, medical debt, incarceration, and climate change. She also says that UNITE is continuing to identify other social determinants of health to address, specifically those that emerged as a result of the COVID-19 pandemic.

"One issue that has worsened since COVID-19 is the increase in housing issues, homelessness, and the price of housing, so we're starting to see that housing is being raised as a primary issue," Zynda says. "Because social determinants of health have always been the lens we've looked at to prioritize, we want to look at health behaviors, health outcomes, and [social determinants of health] in setting our priorities for the upcoming CHNA."

Reiley Curran, Chelsea Hospital's director of community health, says UNITE seeks to engage people in the CHNA at food pantries, senior centers, civic groups, businesses, schools, libraries, and faith communities.
Chelsea Hospital's director of community health Reiley Curran
"Although the three priority needs have not changed since 2016, the context and underlying causes of those health outcomes have evolved," Curran says in an email. "I think this CHNA will look different in how the needs are framed, with a greater emphasis on community conditions, and social determinants of health that lead to the health outcomes we see at the county level."

Curran says the collaboration between UNITE's member organizations has helped establish stronger relationships between health care providers in all areas of the county, a sentiment shared by Singletery and Zynda.

"The UNITE collaboration has brought additional partners to the table, which has led to greater understanding of the needs, and puts us in a better position to address them effectively," Curran says.

"We're stronger together than separate," Zynda says. "I hope the community feels that and knows that we're out here to support them, and we want to help improve health in ways that they feel are effective."

More information on the CHNA and how to get involved through focus groups or other events, as well as more information on UNITE, can be found at the Washtenaw Health Initiative's website.

Rylee Barnsdale is a Michigan native and longtime Washtenaw County resident. She wants to use her journalistic experience from her time at Eastern Michigan University writing for the Eastern Echo to tell the stories of Washtenaw County residents that need to be heard.

All photos by Doug Coombe.
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