Community Health Needs Assessment
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Stephen Njenga
Director of Quality Measurement and Population Health Improvement
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- 573-893-3700| ext. 1325
A community health needs assessment describes the community a hospital serves and identifies the health needs of the population.
Health improvement starts with collecting and analyzing data to guide planning and decision-making. Using both quantitative and qualitative insights, hospitals can identify community health needs, track trends, and focus resources where they will have the greatest impact.
The Patient Protection and Affordable Care Act requires nonprofit hospitals to complete a Community Health Needs Assessment (CHNA) every three years and adopt an implementation strategy to address identified needs. Together, these efforts support accountability and ongoing improvement in community health outcomes.
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MHA supports hospitals with data-informed guidance, practical resources, and proven strategies to advance community-driven health improvement. Through collaboration, shared learning, and strong data insights, hospitals can better understand local needs, strengthen partnerships, reduce disparities, and improve health outcomes across Missouri.
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MHA Resources
CHNA Templates
*Topic-specific CHNA Improvement Plan Templates can be located in the drop-down menus below.
Top Health Issues
Identified by Missouri Hospitals and Community Health Resources
In 2026, MHA continued its commitment to reviewing Community Health Needs Assessments (CHNAs) for all member hospitals required to complete this process. In the last three years ending in 2025, 69 hospitals completed their respective CHNA’s and posted on their website. MHA's comprehensive CHNA review process identified 10 priority health issues. These health issues are highly prevalent and cause significant health burdens to Missouri residents. Resources to implement successful community programs to address the issues are available below.
Top 10 Priority Health Issues
- Mental Health / Behavioral Health
- Chronic Conditions/Diseases (Diabetes, Heart Disease, Cancer, Obesity, Lung Disease)
- Access to Care / Health Care Services
- Social Determinants of Health (Food Insecurity, Housing, Poverty, Violence, Transportation)
- Substance Use /Recovery
- Needs of Older Adults / Aging Population
- Maternal and Child Health
- Health Literacy
- Community Wellness
- Health Care Workforce Availability
Key Findings
- Mental Health/Behavioral Health remains the most frequently identified priority across Missouri hospitals, appearing in over 80% of CHNAs reviewed.
- Chronic Conditions/Diseases collectively represent the second highest concern, with diabetes, heart disease, cancer, and obesity being the most cited specific conditions.
- Access to Care continues to be a critical barrier, including affordability, insurance status, and availability of health care services.
- Social Determinants of Health are increasingly recognized as foundational to community health, with food insecurity and housing instability leading SDOH concerns.
- Substance Use and Recovery often appears alongside mental health priorities, reflecting the interconnected nature of behavioral health challenges.
Topic Specific Resources
Implementation
A CHNA Implementation Plan is a systematic process involving the community that identifies and analyzes community health needs, as well as community assets and resources, to plan and act upon priority community health needs. This plan is used by health and other governmental education and human service agencies, in collaboration with community partners, to set priorities and target resources. It is critical for developing policies and defining actions to target efforts that promote health.
The implementation plan should define the vision for the health of the community through a collaborative process, and should address the gamut of strengths, weaknesses, challenges, and opportunities that exist to improve the health status of the community. Provisions under Section 501(r), added to the code by the ACA, imposes requirements on 501(c)(3) organizations that operate one or more hospital facilities (hospital organizations). These hospitals must now conduct a CHNA and adopt an implementation strategy that meets the needs identified at least once every three years. The CHNA requirements are effective for tax years beginning after March 23, 2012. In addition, hospitals must complete an IRS Schedule H (Form 990) annually to provide information on the activities and policies of, and community benefit provided by, the hospital. The implementation plan should be updated as community needs and priorities change, hospital resources change or based on evaluation results.