Understanding and Budgeting for Community Health Priorities

Members of the community working toward health priorities

Local governments and community healthcare services are often pressed for resources. This can lead to gaps in social safety nets that provide essential health and wellness services to residents.

To ensure all community members have access to critical health programs, it is essential to define, analyze, and prioritize community health issues and allocate funding appropriately.

What Are Community Health Priorities?

“Community health priorities” are the most pressing health needs based on the data collected within a specific community. For example, in one community, data may show that residents’ biggest public health issues are heart disease, substance abuse, and access to clean water. In another community, the primary health threats may be a lack of healthy food, depression, and diabetes.

Specific priorities will vary by city or neighborhood, but they must be addressed through a community health plan. The most effective way to fund community health plans is by implementing conscientious, priority-based budgeting at the local government level.

Before we dive into how we will pay for these critical community health services, let’s determine how to decide where to place our focus (and our funds).

Read our 2021 Annual Impact Report and learn how program-based budgeting  transformed community budgeting last year! →

How to Select Community Health Priorities

Most communities have a laundry list of health challenges that affect residents. But, as the saying goes, “When everything is a priority, nothing is a priority.” Community health is no different.

Because there will never be enough resources to support every initiative, community leaders and resident advocates conduct health needs assessments to select three to six of the highest priority health issues.

These priorities are based on criteria, such as those laid out by the American Hospital Association (AHA) Community Health Improvement network. These criteria include:

  • The magnitude of the problem
  • The severity of the problem
  • The need among vulnerable populations
  • The capacity and willingness to act on the issue
  • The ability to have a measurable impact on the issue
  • The availability of hospital and community resources
  • The existing interventions focused on the issue
  • Whether the issue is a root cause of other problems
  • The trending health concerns in the community

The process for selecting a community’s health priorities will vary by organization. However, the steps generally include:

  • Creating a committee of community stakeholders, medical professionals, and other individuals with relevant subject matter expertise.
  • Reviewing the data to determine which issues are most critical or affect the largest or most vulnerable populations, then gauging where intervention will have the most impact.
  • Evaluating community assets to identify what resources are already available and what additional resources—personnel, non-personnel, or revenue—will be needed to achieve desired outcomes.
  • Establishing priorities that consider community input, available resources, potential impact, and ramifications of not prioritizing a particular issue.

How Priority-Based Budgeting Ensures Community Health Priorities Are Adequately Funded

If community health priorities aren’t included in the budget, the making, planning, costing, and budgeting of health policies will all take place independently. This siloing of departmental operations leads to misalignment between health priorities and resource allocation.

Priority-based budgeting removes those silos by giving local government decision makers a holistic view of the budget needed to support their community’s most critical programs and services.

Unlike traditional line-item budgets that adhere to the same budget year after year and favor across-the-board cuts, priority-based budgeting looks at funding from the program level rather than the department level. This approach makes it easier to match available resources with health priorities and move away from the zero-sum game of traditional budgeting that requires someone to lose so someone else can “win.”

As we all know, the people who will feel the brunt of that loss are the residents of our communities.

Priority-Based Budgeting Empowers Community Health Initiatives

Experiential data from What Works Cities shows that when cities leverage data effectively to make decisions, they improve the quality of services they provide.

Priority-based budgeting is one way that local governments and public sector agencies can apply data to their community health improvement plan by identifying high-need programs and allocating budgets accordingly.

Whether you’re working to achieve your community health plan or focusing on other priority-driven needs in your community—such as a climate action plan or equity goals—priority-based budgeting breaks down the process into components to help you make important funding decisions.

Download our 2021 Annual Impact Report to learn how local governments utilize priority-based budgeting in their communities to align resources with needs to drive meaningful change.

Local government workers managing resources on laptop

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