{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T06:16:58Z","timestamp":1783664218485,"version":"3.55.0"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p>Public health agencies routinely conduct community health assessments, yet many jurisdictions continue to face challenges translating population health data into coordinated action that addresses structural determinants of health, health equity, and public health infrastructure needs. These challenges became increasingly visible during the COVID-19 pandemic and highlight the need for community-centered approaches that align public health, healthcare systems, and community partnerships across sectors. This Policy and Practice Review presents a community-centered framework for translating local population health data into coordinated, equity-oriented population health strategy. Using Shelby County, Tennessee, a large urban county in the southern United States, as an illustrative case, the analysis synthesizes publicly available datasets, community health needs assessments, and institutional reports to align local priorities, governance structures, and cross-sector operational strategies within a unified implementation approach. The framework organizes population health priorities into five domains: chronic disease prevention, maternal and child health equity, HIV and sexual health, behavioral health and substance use, and violence prevention and community safety. Across domains, the framework emphasizes shared measurement, data integration, community partnerships, trust, and cross-sector accountability as foundational components of sustainable population health improvement. Although not an implementation evaluation, this review offers a practical approach for jurisdictions seeking to strengthen public health infrastructure, operationalize equity-centered decision-making, and move from fragmented programs toward coordinated population health action responsive to evolving community needs.<\/jats:p>","DOI":"10.3389\/fpubh.2026.1879850","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T05:39:52Z","timestamp":1783661992000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["From data to action: a community-centered framework for translating community health assessment into coordinated public health strategy"],"prefix":"10.3389","volume":"14","author":[{"given":"Diego R.","family":"Hijano","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, St. Jude Children's Research Hospital","place":["Memphis, TN, United States"]},{"name":"Department of Pediatrics, University of Tennessee Health Science Center","place":["Memphis, TN, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1177\/00333549141291S206","article-title":"The social determinants of health: it's time to consider the causes of the causes","volume":"129","author":"Braveman","year":"2014","journal-title":"Public Health Rep"},{"key":"B2","volume-title":"How are Income and Wealth Linked to Health and Longevity?","author":"Woolf","year":"2015"},{"key":"B3","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1146\/annurev-publhealth-031210-101218","article-title":"The social determinants of health: coming of age","volume":"32","author":"Braveman","year":"2011","journal-title":"Annu Rev Public Health."},{"key":"B4","unstructured":"\u201cBoard on global health; institute of medicine; national academies of sciences e, and medicine,\u201d\n          \n          A Framework for Educating Health Professionals to Address the Social Determinants of Health.\n          \n          2016"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1227","DOI":"10.2105\/AJPH.2017.303823","article-title":"The public health practitioner of the future","volume":"107","author":"Erwin","year":"2017","journal-title":"Am J Public Health."},{"key":"B6","article-title":"Washington, DC: National Academies Press","year":"2011"},{"key":"B7","unstructured":"Improving public health system performance through multiorganizational partnerships\n          \n          A116\n          \n            \n              Mays\n              GP\n            \n            \n              Scutchfield\n              FD\n            \n          \n          20950523\n          Prev Chronic Dis.\n          7\n          2010"},{"key":"B8","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1111\/1468-0009.12463","article-title":"COVID-19 and underinvestment in the public health infrastructure of the United States","volume":"98","author":"Maani","year":"2020","journal-title":"Milbank Q."},{"key":"B9","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1097\/PHH.0000000000002048","article-title":"Modernizing public health data systems and workforce capacity: the centers for disease control and prevention's public health informatics fellowship program","volume":"31","author":"Kirkcaldy","year":"2025","journal-title":"J Public Health Manag Pract."},{"key":"B10","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1377\/hlthaff.2022.01204","article-title":"Trust in US Federal, State, and local public health agencies during COVID-19: responses and policy implications","volume":"42","author":"SteelFisher","year":"2023","journal-title":"Health Aff."},{"key":"B11","unstructured":"\u201cThe future of the public's health in the 21st century,\u201d\n          \n          \n          2002"},{"key":"B12","doi-asserted-by":"publisher","first-page":"380","DOI":"10.2105\/AJPH.93.3.380","article-title":"What is population health?","volume":"93","author":"Kindig","year":"2003","journal-title":"Am J Public Health."},{"key":"B13","doi-asserted-by":"crossref","DOI":"10.31478\/201710c","article-title":"Social determinants of health 101 for health care: five plus five","volume-title":"NAM Perspectives. Discussion Paper.","author":"Magnan","year":"2017"},{"key":"B14","volume-title":"Models for Population Health Improvement by Health Care Systems and Partners: tensions and Promise on the Path Upstream: proceedings of a Workshop","year":"2021"},{"key":"B15","first-page":"36","article-title":"Collective impact","volume":"9","author":"Kania","year":"2011","journal-title":"Stanf Soc Innov Rev."},{"key":"B16","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1146\/annurev.publhealth.21.1.369","article-title":"A review of collaborative partnerships as a strategy for improving community health","volume":"21","author":"Roussos","year":"2000","journal-title":"Annu Rev Public Health."},{"key":"B17","doi-asserted-by":"publisher","first-page":"E78","DOI":"10.5888\/pcd14.170017","article-title":"Public health 30: a call to action for public health to meet the challenges of the 21st century","volume":"14","author":"DeSalvo","year":"2017","journal-title":"Prev Chronic Dis"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1750","DOI":"10.1001\/jama.2016.4226","article-title":"The association between income and life expectancy in the United States, 2001\u20132014","volume":"315","author":"Chetty","year":"2016","journal-title":"Jama"},{"key":"B19","unstructured":"Shelby County Tennessee USA\n          \n          2025"},{"key":"B20","unstructured":"County Data Package: Shelby County Tennessee\n          \n          2024"},{"key":"B21","unstructured":"Vital Statistics Annual Report\n          \n          2024"},{"key":"B22","unstructured":"2013"},{"key":"B23","unstructured":"Commission District Report\n          \n          2024"},{"key":"B24","unstructured":"Memphis, TN: Baptist Memorial Health Care\n          \n          \n          2023"},{"key":"B25","unstructured":"Memphis, TN: Methodist Le Bonheur Healthcare\n          \n          \n          2022"},{"key":"B26","unstructured":"Memphis, TN: OUTMemphis\n          \n          \n          2024"},{"key":"B27","unstructured":"Memphis, TN: St\n          \n          \n          2024"},{"key":"B28","unstructured":"Memphis, TN: United Way of the Mid-South\n          \n          \n          2024"},{"key":"B29","unstructured":"About Us\n          \n          2025"},{"key":"B30","unstructured":"Memphis, TN: Mid-South Food Bank\n          \n          \n          2024"},{"key":"B31","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.socscimed.2017.10.001","article-title":"Determinants of trust in the flu vaccine for African Americans and Whites","volume":"193","author":"Freimuth","year":"2017","journal-title":"Soc Sci Med"},{"key":"B32","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1056\/NEJMp2103104","article-title":"Addressing vaccine hesitancy in BIPOC communities-toward trustworthiness, partnership, and reciprocity","volume":"385","author":"Quinn","year":"2021","journal-title":"N Engl J Med"},{"key":"B33","doi-asserted-by":"publisher","first-page":"e010","DOI":"10.5334\/ijic.886","article-title":"Understanding integrated care: a comprehensive conceptual framework based on the integrative functions of primary care","volume":"13","author":"Valentijn","year":"2013","journal-title":"Int J Integr Care"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1177\/1049732305276687","article-title":"Three approaches to qualitative content analysis","volume":"15","author":"Hsieh","year":"2005","journal-title":"Qual Health Res"},{"key":"B35","unstructured":"Annual Impact Report\n          \n          2023"},{"key":"B36","doi-asserted-by":"crossref","unstructured":"Annual Report\n          \n          2024","DOI":"10.5089\/9798400279300.011"},{"key":"B37","unstructured":"Community Impact Overview: Memphis TN\n          \n          2025"},{"key":"B38","unstructured":"Violence Intervention Program (VIP)\n          \n          2024"},{"key":"B39","unstructured":"Memphis, TN: University of Tennessee Health Science Center\n          \n          \n          2024"},{"key":"B40","doi-asserted-by":"publisher","first-page":"2021","DOI":"10.31478\/202106c","article-title":"Social determinants of health 201 for health care: plan, do, study, act","author":"Magnan","year":"2021","journal-title":"NAM Perspect"},{"key":"B41","doi-asserted-by":"publisher","first-page":"1163","DOI":"10.2105\/AJPH.2013.301254","article-title":"Achieving population health in accountable care organizations","volume":"103","author":"Hacker","year":"2013","journal-title":"Am J Public Health"},{"key":"B42","doi-asserted-by":"publisher","first-page":"590","DOI":"10.2105\/AJPH.2009.185652","article-title":"A framework for public health action: the health impact pyramid","volume":"100","author":"Frieden","year":"2010","journal-title":"Am J Public Health"},{"key":"B43","doi-asserted-by":"publisher","first-page":"1852","DOI":"10.1377\/hlthaff.2011.0685","article-title":"Where health disparities begin: the role of social and economic determinants and why current policies may make matters worse","volume":"30","author":"Woolf","year":"","journal-title":"Health Aff"},{"key":"B44","unstructured":"Friends for ALL\n          \n          2025"},{"key":"B45","unstructured":"Memphis, TN: Mental Health America of the Midsouth\n          \n          \n          2025"},{"key":"B46","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1177\/0033354916662208","article-title":"The evolution of public health\u2013hospital collaboration in the United States","volume":"131","author":"Prybil","year":"2016","journal-title":"Public Health Rep"},{"key":"B47","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1016\/j.amepre.2018.01.039","article-title":"Social prescribing in the U.S. and England: emerging interventions to address patients' social needs","volume":"54","author":"Alderwick","year":"2018","journal-title":"Am J Prev Med"},{"key":"B48","volume-title":"Addressing Patients' Social Needs: an Emerging Business Case for Provider Investment","author":"Bachrach","year":"2014"},{"key":"B49","doi-asserted-by":"publisher","first-page":"821","DOI":"10.1215\/03616878-3150074","article-title":"Accountable care organizations and population health organizations","volume":"40","author":"Casalino","year":"2015","journal-title":"J Health Polit Policy Law"},{"key":"B50","volume-title":"Protecting the Public's Health From Diseases, Disasters, and Bioterrorism","year":""}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1879850\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T05:39:57Z","timestamp":1783661997000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1879850\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,10]]},"references-count":50,"alternative-id":["10.3389\/fpubh.2026.1879850"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1879850","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,10]]},"article-number":"1879850"}}