2025 CHNA Methodology

The 2025 Community Health Needs Assessments (CHNAs) updates the prioritized community health needs identified in the 2022 CHNA reports, which focused on three areas: 

  • Social and economic factors (also known as “social determinants of health'' 
  • Barriers to accessing healthcare 
  • Health behaviors and outcomes 


The 2025 CHNA uses county-level data for the five counties in western and central Massachusetts and data for select communities when available. 

Assessment Process and Methods 

  • Review of assessments

    A review was conducted of reports published since 2022 by community and regional agencies.

  • Quantitative data collection and analysis

    Existing data were gathered and summarized from a variety of sources, including:

  • Qualitative data collection and analysis

     Primary data were collected to provide deeper insight into priority topics. Methods included: 

    • Survey and listening session with public health officials throughout Western Massachusetts;  
    • Group interviews with key informants from healthcare and service organizations 
    • Four focus groups for the Baystate Health service areas.  

    The research team coded and analyzed the transcripts to identify key themes.  

  • Use of artificial intelligence (AI)

    Use of artificial intelligence (AI): AI tools were used to aid in transcription of interviews and focus groups, to assist with making content more succinct, and to suggest simpler ways to convey complex information.

Prioritization Process

The 2025 CHNA used the 2022 priorities as a baseline and reprioritized needs based on quantitative data, qualitative data, and community feedback. In previous CHNAs, prioritized health needs were identified based on magnitude and severity, or disproportionate effects on populations that have been marginalized in the community. Data confirmed that 2022 priorities continued in 2025. Coalition members’ health equity goals and priority communities were compared to identify common themes and incorporated into the data collection plan. To ensure the CHNAs’ relevance for driving action and informing policy, a criterion was added to understand whether the focus areas aligned with major state policies, either recently enacted or under consideration. 

Priority Focus Areas

Through this process, the Coalition members identified the following priority areas for regional focus: 


Health Priorities: 

  • Maternal health 
  • Mental health and substance use 


Communities of Focus: 

  • Older adults (65+) 
  • Immigrants and refugees 
  • Young children, and their parents and caregivers

Projects

Limitations and Data Gaps

Given the limitations of time, resources, and available data, our analysis could not examine every health and community issue. Data were drawn from many sources. Each source had its own way of reporting data, which limited consistency across the reports.


Sources differed by: 

  • Most recent year of available data 
  • Geographic level (service area, town, county, state, region) 
  • Availability of racial and ethnic breakdown 
  • Reporting periods (monthly, quarterly, annual, multiple years) 
  • Use of crude versus age-adjusted data
  • Age-adjusted data account for differences in age within a population, so it’s easier to compare across communities, for example, even if one town or county has many more older adults than another. Crude data show overall rates for the entire population and are less comparable across groups and places. This report notes where crude data are used, and their limitations.


Data were limited for smaller towns where small case counts are often suppressed to protect confidentiality or due to statistical instability. These limitations particularly affected the availability of data by race and ethnicity. It is also important to consider intersectionality—the overlapping identities of residents. We were unable to explore these differences due to data limitations. Qualitative data, while extremely valuable, reflect the perspectives of a small number of key informants and residents and cannot be generalized to all populations. Finally, data collected during the first two years of the COVID-19 pandemic (2020-2021), which greatly disrupted all parts of society, may not reflect long-term trends.

Community Health Equity Survey

To advance health equity, the Massachusetts Department of Public Health conducted the Community Health Equity Survey (CHES) in 2023 and will be conducting it again in 2026. CHES intentionally focused on reaching key populations that are often underrepresented in data, such as people of color, LGBTQIA+ individuals, people living with disabilities, older adults, rural residents, and more. Because of this approach, the data provide important information not available from other data sources. However, results should be interpreted with caution, as these findings only represent those who participated in the survey and may not reflect the experiences of everyone in Massachusetts or our region.

Language Used to Describe Demographic Groups 

The Coalition and consultant team honor the unique ways that individuals and communities describe and identify themselves. For the purposes of this report, we need to use consistent language when speaking about different groups of people, knowing that terms are always evolving and changing. We use the following descriptors where possible in the text: Black, Latine, Indigenous, Asian, people/communities of color, White, LGBTQIA+. For any term we use, we know there are community members for whom that term is not their preferred way to be identified. For example, we recognize that there are differences between those who identify as Puerto Rican, Mexican, or Cuban that are not captured by the term “Latine” and differences among those who identify as Chinese, Japanese, or Korean that are not captured by “Asian.”