Conducting a thoughtfully planned assessment of the needs, as well as the assets, in the communities and populations you serve can help guide community health improvement efforts that are logical, efficient, effective, and equitable.

Needs can be thought of as the gap between what is and what should be; and these might be experienced by an individual, a group, or an entire community. A need can span the spectrum of basic access to healthy foods or reliable transportation, all the way to something abstract like improved community cohesiveness.

Assets, or resources, are anything that can be used to improve quality of life. This might include people, organizations and institutions, the environment (built or natural), and equipment among many other examples. A bike path where people can exercise and commute, a community member who organizes a neighborhood crime watch, or a high-quality community health center are all assets that can improve quality of life, and in turn, community health.

Before embarking on a needs assessment check to see if other organizations in your community have already performed one. You may not need to conduct your own assessment, or be able to tailor your assessment based on what other organizations have already learned. “Key players” who often conduct needs assessments of their communities include:

1) State and local public health departments:


2) Hospitals and Health Systems:


3) Non-Profit Organizations:


4) Collaborative Efforts (between academic institutions, public health departments, health systems, and/or non-profit organizations):


(The Milwaukee Health Care Partnership is a public / private partnership dedicated to improving health care for underserved populations in Milwaukee County. The Partnership includes Milwaukee’s five healthcare systems, four Federally Qualified Health Centers, the Medical College of Wisconsin and the City, County and State health departments.)

(ACTIVATE (Advocacy for Children — Transformational Impact Via Action and Teamwork for Engagement) initiative, a collaboration between the Wisconsin Chapter of the American Academy of Pediatrics, the Department of Pediatrics at the University of Wisconsin School of Medicine and Public Health, the Center for Patient Partnerships at the University of Wisconsin–Madison, and the UW Health American Family Children’s Hospital)

(partnership between Affinity Health System; Aurora Health Care; Children’s Hospital of Wisconsin-Fox Valley; ThedaCare; and Health Departments of Appleton, Outagamie County, Menasha, Outagamie County, and Winnebago County)

There are a variety of reasons to perform a needs assessment:

1) Evaluating the strengths and weaknesses within a community, and creating or improving services based on this assessment. This type of needs assessment is primarily structured around how to best obtain information, opinions, and input from the community; and then how to effectively convert this information into action. This process may be broken into targeted questions which can direct the overall project. For example, the individuals or organization doing the assessment might ask themselves:

  • What is the specific purpose of the needs assessment?
  • How does this fit into my organization’s mission statement?
  • What goals are we trying to achieve with this assessment?
  • Who is the target population(s)?
  • What do we currently know about the needs and assets in the community?
  • Who should be included in this process (stakeholders)?
  • What are the best methods for collecting the data we need, and making sure it is representative of the target population?
  • How will the data from the community be used (e.g. to set a new agenda, support a new program, guide changes in service delivery or policies)?
  • What is the timeline for the needs assessment?

2) A needs assessment constructed around a known problem or potential problem facing the community (e.g. childhood obesity, poor access to health prevention services, lack of safe community spaces to gather/play, etc.) With a particular need already identified, this type of assessment centers around engaging the community and governing entities, stakeholders, businesses, advocacy groups and organizations which are potentially affected, and/or can contribute to improving the community need. Potential questions a group leading this type of needs assessment might ask themselves include:

  • What do we know about the community and its residents?
  • What do we know about the identified need/problem in this community?
  • Who are the relevant stakeholders, both those affected by the problem and those who might contribute to a solution. How will we engage them?
  • What programs and organizations already exist that are addressing this problem?
  • How will we communicate expectations, goals, and approach regarding the needs assessment with other partners?
  • Who are the potential end-users of the agenda/solution generated by the needs assessment?
  • Who will lead any interventions that result from the needs assessment?

3) An internal needs assessment within an organization which serves the community at large, is dedicated to a particular population in the community, or is currently addressing a need within the community (e.g. a clinic, hospital or health system; a non-for-profit organization, community group, etc.). This type of assessment aims to improve the efficiency or effectiveness of the organization’s activities. Potential questions the organization might ask of itself include:

  • What is the organizational culture and philosophy?
  • What is our current understanding about the needs and assets of the community/population served?
  • Is our understanding of the needs and assets in the community accurate?
  • How do the identified needs fit within our organization’s mission/purpose?
  • What reach and outcomes have we accomplished with our current interventions?
  • Are these intervention approaches evidence-based?
  • Are there new approaches we should be considering?
  • What current resources does the organization and its programs offer to address the target needs?
  • What aspects of our organization are excelling?
  • Are there particular programs or areas of the organization that would most benefit from extra investment in improvement efforts?
  • Who are our current, and potential, stakeholders?
  • Do we have within our organization the skills, experiences, and connections that will enable us to address the identified needs effectively?


These resources can be helpful when searching for data on your population, health indicator, or need of interest:



Local-level (Dane County as example)

The resources below offer additional tools for more general community health improvement efforts: