Chapter Six: Community Health Assessment and Evaluation

Designing the Survey

• Determine who will conduct the survey.
• The best results are likely if those who will be conducting the survey are involved in its planning. Their observations will be sharper if they understand what they are looking for, which is most likely if they help to develop the survey.
• Whether the survey is conducted driving or walking, the ideal is to use a team or teams for which resources are available. The variety of perspectives will enrich the survey, and each team member can focus on a particular task (observation, recording, etc.), making for a more efficient survey.
• Decide on the questions the survey will answer.
• The questions will determine the scope and structure of the survey. Basic research questions (e.g., “What is the nature of the community?”) may require follow-up with secondary questions. Questions with a narrow focus (e.g., “Do most streets in the community have sidewalks?”) may not require follow-up. Some questions will have more than one part (e.g., “How, by whom, and how much are public playgrounds used?).

Training the People Who Will Conduct the Survey

• Get well acquainted with the questions, the purpose of the survey, and what it is looking for.
• Make and use a checklist to ensure that all questions have been addressed and observe all the necessary areas.
• Try to be unobtrusive. People not only act differently when they know they are being observed but also may become suspicious or hostile.
• Carry identification.
• Take notes. Take photos or videos with a camera or cell phone to remember and illustrate what has been observed.
• Work in teams and assign roles. A team should have at least one observer and at least one recorder.
• Discuss findings as the survey is conducted.
• Pay attention to safety. Be aware of the neighborhood and situation, especially while walking. If the situation does not feel safe, leave.

What to Examine in a General Community Assessment Survey

• Housing. What is the age and condition of housing in the neighborhoods being surveyed? Are houses and apartment buildings kept up, or are they run-down and in need of repair? Are yards neat or overgrown?
• Other buildings. Are the buildings mostly or fully occupied? Do public and commercial buildings seem accessible to people with disabilities (ramped, street-level entries, etc.)?
• Public spaces. Are there public spaces where people can gather? Are they well kept up? Do they have seating areas, trees, and plants, attractive design, cafes or food vendors, or other features that encourage people to use the space? Who uses these spaces? Is there diversity?
• Parks. Are parks used by a variety of people? Are they well kept up? Are there sports facilities (basketball courts, soccer pitches, baseball fields, cricket pitches, etc.)? Are they used at night?
• Culture and entertainment. Are there museums, theaters, restaurants, clubs, sports stadiums, historic sites, etc.? Are they accessible to all parts of the community (centrally located, reachable by public transportation)? Do they reflect the cultures of community members?
• Streetscape. The streetscape is the environment created by streets and the sidewalks, buildings, trees, etc., that line them. Are there trees and/or plants? Are there sidewalks? Are building facades and storefronts attractive and welcoming? Are the streets and sidewalks relatively clean? Are there trash cans? Is there outdoor seating?
• Pedestrian and bicycle safety. What is the road design, traffic speed, and road/sidewalk quality? How safe is it to walk or ride? What condition are the sidewalks in? What is the physical activity level? Are there pedestrian or bicycle collisions occurring?
• Street use. Are there people on the streets at most times of the day? In the evening? How late? Do they interact with each other? Are streets and sidewalks well lit at night?
• Commercial activity. What kinds of businesses are there? Are there boarded-up or vacant storefronts? Is there a mix of large and small businesses? Are there grocery stores and supermarkets, pharmacies, and other stores that provide necessities in all parts of the community?
• Signs. What languages are business, road, and traffic signs in? Are traffic signs informative? Are there signs directing people to various parts of the community (downtown, museums, highways, etc.)?
• Industry. What kinds of industries exist in the community? Does they seem to be causing pollution?
• Land use. How much open space is there? How are residential, commercial, and industrial areas distributed? Do major roads or railroad tracks divide neighborhoods, or are they on the edges of the community?
• Infrastructure. What is the condition of roads, bridges, sidewalks, etc.? Do these conditions differ from one area of the community to another? Do all parts of the community seem to be equally served by electricity, water, phone, fiber optic, wastewater treatment, waste disposal, and other infrastructure services?
• Public transportation. Is there a functioning public transportation system? Is it well used? By whom? Does it allow relatively easy access to all parts of the community? How easy is it to navigate and use? How much does it cost? Are its vehicles energy-efficient?
• Traffic. How heavy is traffic in the community? Is it mostly commercial and industrial (vans, trucks, etc.) or mostly private cars? Is there ever gridlock? Is there much bicycle traffic? Are there bike lanes? Are there bike racks in many places?
• Environmental quality. How much usable green space is there, and is it scattered throughout the community? Is there smog or haze? Does the air smell of smoke, garbage, car exhaust, chemicals, industrial waste, etc.? Does the water in streams, ponds, lakes, etc. seem reasonably clear?
• Race/ethnicity. Who lives in the community? Are there identifiable racial and ethnic groups? Do particular groups seem to live in particular areas?
• Faith communities. What kinds of religious institutions are there? Do the institutions of one particular religion or sect dominate? Are there separate houses of worship for people of different ethnicities or races, even if they share the same faith?
• Health services. How many hospitals and clinics are there in the community? Where are they located? How big are they? How easy are they to get to?
• Community and public services. Are there identifiable community service providers and organizations in the community (mental health centers, food banks, homeless shelters, welfare offices, etc.)? Are they concentrated in a particular area? Are they easy to reach by public transportation?
• Community safety. Where are police and fire stations located? Are they in good repair? Is the community well lit at night?
• Public schools. Are schools in different neighborhoods in noticeably different states of repair? Are schools well maintained? Or in some developing countries, are there schools in the community?
• Higher education. Are there two- and four-year colleges and/or universities in the community? Where are they located? Do they seem open to the community, or do they seem self-contained and isolated?
• Political activity. Are there signs or other indications of political activity? Is it clear that political activity is allowed and/or encouraged? Are there protests or demonstrations?
• Community organizations. What evidence is there of organizations in the community? Are there service clubs (Lions, Elks, Masons, etc.)? Are there other organizations (groups centered around community issues, the environment, sports or leisure pursuits, socialization, etc.)?
• Media. Are there local media outlets such as radio and TV stations, newspapers, and internet sites devoted to local issues? Are they independent, or are they sponsored or run by governments or corporations? Where are their facilities?
• Food access. Are there markets? Fast-food restaurants? Community gardens?
• Differences among neighborhoods or areas of the community. What are the differences among different parts of the community? Are schools, stores, public and other buildings, streets, etc., in different areas in different conditions? Do some areas seem neglected whereas others are maintained?
• The “feel” of the community. What is the overall impression of the community?

Conducting a Windshield Survey

• Use a map. Google Maps or similar services are an excellent resource.
• Try to use a team of at least two. That way, one person can concentrate on driving while the other navigates and records observations. It is difficult to observe closely and drive safely at the same time.
• Drive at a moderate speed and avoid unexpected actions.
• Drive on both major and minor streets, particularly in residential neighborhoods. Get a sense of different parts of neighborhoods and different streets.
• Pull over at regular intervals to make and compare notes.
• Try to be inconspicuous.

Conducting a Walking Survey

Study a map beforehand or do a drive-through to plan. Try to work in teams of two to three.

• Two or three people walking together is a normal group, but five or six is a crowd and stands out.
• To experience the community, participate in everyday activities. Take public transportation; eat in a local restaurant; or buy something in a drugstore, supermarket, or discount store. Listen to people’s conversations and get a sense of how they interact.
• Go inside public buildings and cultural institutions.
• Sit down in a quiet place to take notes.

In Summary

Sometimes, the best survey can be a combination of walking and driving. Consider some general questions:

• What are the community’s outstanding assets?
• What seem to be the community’s biggest challenges?
• What is the most striking thing about the community?
• What is the most unexpected?
• Does the community have an aesthetic quality, either positive or negative (i.e., is it particularly beautiful or particularly ugly)?

Whether you are starting an all-encompassing campaign to eliminate poverty in the community or simply looking for good places to paint murals to stimulate community pride, a windshield or walking survey can be an excellent way to begin.