Prioritization: How to Go From 20 Community Needs to 5
The data collection isn’t the hardest part of a CHA. Usually, it’s deciding what to do with the data!
By the time most teams finish gathering data and community input for a Community Health Assessment, they're not short on problems — they're drowning in them. Chronic disease, housing instability, maternal health gaps, behavioral health access, food insecurity, and transportation barriers, you name it. Issues tend to be many, all backed by data but not all able to be tackled by a single health department at one time.
This is where a lot of CHAs quietly lose their way. Prioritization gets treated as a formality instead of what it should be: the decision that determines where staff time, grant dollars, and community trust get spent for the next three years.
Why Prioritization Goes Wrong
Before getting into how to do it well, it's worth naming where it usually goes off track:
When a vocal board member or community group ends up steering priorities more than the data does
When momentum (usually carried over from the last cycle) picks the priority instead of need
When everything makes the list — because having ten priorities isn't a strategy
When the community process happens after the decision-making
None of these are failures of effort, but rather of process. Luckily, a defensible prioritization method fixes that.
A Framework for Scoring Community Needs
Rather than relying on instinct or momentum, successful departments score each candidate need against a consistent set of criteria. Five tend to cover what actually matters:
Magnitude. How many people in the community are affected? A need touching 40% of residents carries different weight than one touching 2%.
Severity. How serious are the consequences of inaction? Mortality and disability tend to outweigh discomfort or inconvenience.
Disparity. Is this need distributed unevenly across race, income, geography, or age? Needs that concentrate harm in specific populations deserve extra weight, even at a lower overall magnitude.
Feasibility. Does the community realistically have the resources, partners, and political will to move the needle in the next three years? A crucial need with no plausible path forward may still need to be named, just not made a top action priority.
Community concern. How much does this matter to the people who live here? Data can miss what residents experience daily, and a need the community consistently raises deserves real weight even if it doesn't top the statistical rankings.
Score each need on a simple 1-5 scale across all five criteria, using both the quantitative data and the community input gathered earlier in the CHA process. The scores won't make the decision for you, but they replace feelings with something a board, funder, or skeptical partner can actually see.
Running the Prioritization Session
The framework works best if the room is set up right. Have participants score candidate needs independently before any discussion — comparing scores afterward surfaces disagreement early rather than letting the first voice in the room set the tone. Community members should be part of the actual scoring conversation, not just a data source feeding it from a prior survey. When the group lands on a final list, it's worth explicitly separating "important" from "actionable this cycle" — a need can be significant and still not make the top five if the community isn't positioned to act on it yet. And whatever the group decides, document the reasoning, not just the result. When the priority list gets challenged later — and it will — "here's the data and criteria we used" is a far stronger answer than "the committee decided."
How Many Priorities Is the Right Number?
Most CHAs land somewhere between three and eight. That range reflects a real tradeoff: fewer priorities, and the assessment risks looking like it ignored real problems; more than that, and the CHIP that follows ends up spread so thin that nothing gets the staff time or funding to actually move.
A useful gut check: if a priority doesn't have an obvious owner and a plausible first action, it's probably not ready to be one of your top picks yet, even if it scored well.
The Bottom Line
Prioritization is where a CHA either becomes a real plan or a shelf document. A consistent scoring framework won't remove judgment from the process, and it shouldn't. But it gives that judgment structure, offers the community a real seat in the decision, and ensures you have a defensible answer the next time someone asks why a particular need made the list and another one didn't.