Community Guide to Advance Health Information

The mission of the National Library of Medicine is to advance the progress of medicine and improve public health through biomedical and health information. To support this mission, the Community Guide to Advance Health Information is an interactive resource to raise awareness of evidence-based health needs for health information outreach.

Each neighborhood, county, or region has attributes and challenges that affect the health and wellness of its population. By looking at social, economic, and environmental factors, we can identify under resourced communities and begin to understand their most pressing health information needs and concerns. Then, in collaboration with our NNLM member organizations and community partners, we can take action to improve access, use, and understanding of trustworthy information so individuals can make informed decisions about their health.

By engaging with this guide, you can:

• Interact directly with data and information from reliable and current resources
• Discover facts and stories that contribute to a community's health status
• Locate an organization to partner with for community health and wellness information

Because county governments administer public funds for libraries and schools, roads and public transportation, as well as commerce and safety, counties are a basis for looking at the local level of socioeconomic factors that determine health outcomes.

The  County Health Rankings and Roadmaps  annually reviews the data which influences health. Using a variety of national and state sources, the Robert Wood Johnson Foundation and the University of Wisconsin Public Health Institute, measure and weigh various social and economic determinants such as access to parks or recreational facilities for physical exercise; specialized clinics, and the number of health professionals to treat substance abuse; or the number of children living in poverty and receiving meal subsidies at school. The snapshot rankings have become a standard scorecard of the population health for any county in America.

The  Health Resources and Services Administration (HRSA)  is an agency of the U.S. Department of Health and Human Services (HHS). It is responsible for improving health through access to quality services, a skilled health workforce, and innovative programs.

HRSA programs provide health care to people who are geographically isolated, economically or medically vulnerable. This includes people living with HIV/AIDS, pregnant women, mothers and their families, and those otherwise unable to access high quality health care. HRSA also supports access to health care in rural areas, the training of health professionals, the distribution of providers to areas where they are needed most, and improvements in health care delivery.

HRSA is responsible for defining and recognizing  Medically Underserved Area and Medically Underserved Population . To designate an area or population as Medically Underserved, HRSA calculates and assigns a value using four demographic and health indicators as criteria. The Index of Medical Underservice (IMU) score is based on the following measurements:

• Provider per 1,000 population ratio
• Percent of the population at 100% of the Federal Poverty Level (FPL)
• Percent of population age 65 and over
• Infant Mortality Rate

The  HRSA Health Center Program  funds health centers to deliver care to the nation’s most vulnerable individuals and families, including people experiencing homelessness, agricultural workers, residents of public housing, and United States veterans.

Federally Qualified Health Centers deliver coordinated and comprehensive primary and preventive services to overcome geographic, cultural, linguistic, and other barriers. This care reduces health disparities by emphasizing care management of patients with multiple health care needs and the use of key quality improvement practices, including health information technology. You can locate a Federally Qualified Health Center for any location in the United States using their HRSA Find a Health Center map.

The Affordable Health Care Act requires public health departments, health systems, hospitals, and clinics that want to retain their tax-exempt status or want to become eligible for federal funding to conduct a community health needs assessment (CHNA) and adopt a Community Health Improvement Plan (CHIP) to identify, address, and improve population health.

Community clinics, health systems, and public health agencies often collaborate. By working together on the Community Health Needs Assessment and Improvement Plan, organizations save labor and time and create a common and shared goal, which ultimately makes a greater impact on improving the quality of health in the community.

By using the Community Health Needs Assessment and Plans, the Network of the National Library of Medicine can join evidence-based community initiatives and share resources and information to advance health information equity.

The County Health Rankings and Roadmaps obtains health data from reliable government resources such as the  Centers for Disease Control and Prevention (CDC ).

CDC’s  National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP)  helps states collect data on chronic diseases and leading health indicators through a variety of  surveillance systems . This information helps CDC understand how chronic diseases affect people and places across the United States and how well public health interventions work.

For example, the CDC conducts  surveillance of chronic diseases  to:

• Better understand the extent of health risk behaviors, preventive care practices, and the burden of chronic diseases
• Monitor the progress of prevention efforts
• Help public health professionals and policymakers make more timely and effective decisions

Under the Office of the Assistant Secretary of Health and Human Services (HHS), the Office of Disease Prevention and Population Health (ODPHP) is responsible for setting the national  priorities  for preventing disease and improving the health of all Americans.

Their initiatives include establishing measurable health objectives every decade. To develop objectives that align with ODPHP, an Advisory Committee, made up of non-federal, independent subject matter experts, recommended a framework called  Healthy People 2030 .

The definition of health literacy, under Healthy People 2030, aligns with the Office of Disease Prevention and Population Health, U.S. Department of Health and Human Services initiative for a  National Action Plan to Improve Health Literacy . The definition addresses both personal health literacy and organizational health literacy:

• Personal health literacy is the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.
• Organizational health literacy is the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.

Advancing health information access, use, and understanding can help:

• A patient ask informed questions of their doctor or take prescriptions correctly
• A health system administrator recruit and hire more dental and mental health providers
• A public health nurse identify a neighborhood for a vaccination campaign

Education is a basis for finding, understanding, and using health information. The degree to which a person can read instructions, comprehend facts, and compute numbers varies. Organizations need an understanding of the education level of their patients or consumers. Then they have the responsibility to engage with plain language and cultural humility to help improve a person's understanding for health information.

The United States Census Bureau surveys communities for levels of formal education. Use the American Community Survey Table S1501 to discover educational attainment numbers for a county, race, or age. To learn more about national educational attainment statistics, read  Hanson, Melanie. “Education Attainment Statistics” EducationData.org, January 14, 2025 .

The  Affordable Health Care Act  and  Medicare and Medicaid  are federal programs to help insure that all Americans have access to preventive health services and medical treatment and procedures when needed.

87.8 percent of adults age 19 to 64 are insured for health

Just as important as reading and writing at an appropriate level or in an accessible language, knowing biology, calculating numbers, and accessing technology are needed for individuals to comprehend health information in order to be empowered to make informed decisions.

 Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all.

No matter your economic status, age, lived experience, or education, everyone experiences a need for health information. However, the ability to access, negotiate, and understand health information varies. While some people are at an advantage, others require more training and skill-building to advance health information equity.

According to the Pew Research Center, 35 percent of U.S. adults have gone online to learn about a medical condition as their de facto information resource, and a Google search retrieves more than 575 million results for “cancer” or 250 million hits for “diabetes.” That is an overwhelming amount of information!

As people rely on technology and online media for accessing health information, it is now, more important than ever that everyone has the ability to access and navigate online resources and to critically understand and evaluate the information.

It is estimated that nearly 90 percent of U.S. households subscribe to a broadband Internet service. However, households earning $20K - $75K, are less likely to have high speed access (86.2 percent) compared to income earners above $75K (96.1 percent).  U.S. Census Bureau, Bureau, 2023 American Community Survey 5-Year Estimates | Table S280 Types of Computers and Internet Subscriptions 

In the United States, approximately 24 million people live in digital deserts without broadband access, including approximately 19 million people living in rural America and 1.4 million people living on Tribal lands  ⁷  . Communities and households with limited or no internet or computer are at a disadvantage for health care services such as accessing electronic health records, scheduling medical appointments, paying bills, and enrolling for an insurance plan online. Even visiting with a health provider via telemedicine requires online access and technology skills. Not until everyone has the capacity to connect to the Internet, access a computer, or use an online service will health be equitable for all Americans.

Tips and Tools for Closing the Digital Divide is a four-part NNLM skill-building webinar series presented in collaboration with  Wisconsin Health Literacy . To help teach the skills people need for improving their digital health literacy, watch the videos, download the curriculum, and partner with a community library, school, or faith-based organization.

NNLM Region 6 has created a  collection  of selected county StoryMaps for Illinois, Indiana, Iowa, Michigan, Minnesota, Ohio, and Wisconsin. By interacting with this map, you will discover facts, view photos, and read articles that will help tell the story of a county's community health status. You also can locate a community partner to help build capacity for health information. Together we can advance health information access, use and understanding for everyone.