In 1992 DPH Commissioner David Mulligan created the concept of Community Health Network Areas (CHNAs) as a way to foster cooperation and promote collaboration in public health planning among municipalities.

Cities and towns in Massachusetts were incorporated into a total of 27 Community Health Network Areas, and a mandate to participate in CHNA activities was included in all DPH contracts and Requests for Responses (RFR) documents.

Additionally, all CHNAs were required to use surveillance and other population health data for their health planning activities – a new concept at the time. DPH made this data available by CHNA region.

Since the inception of CHNAs in 1992, there have been many changes in the public health landscape in Massachusetts. For example, the Affordable Care Act requires all non-profit hospitals to perform community health assessments every three years. Hospital mergers have resulted in shifting maps of communities served by hospitals.

At the state level, DPH has adapted how we work with partners that have different municipal/regional needs for data and support. For example, DPH-funded programs such as Mass in Motion, Tobacco Prevention and Control and Substance Abuse Services work to change policies, environmental strategies, and systems at the municipal level. For many of these grant programs, collaboration between municipalities has made for a more effective use of grant resources including personnel. Municipalities may belong to the same or different groupings depending on the issue.

Changes have taken place at the local level as well. During the past decade new Board of Health districts have formed, Regional Emergency Preparedness Coalitions have come together, and Regional Planning Councils/Agencies have become key new partners in public health planning. Each of these groups have their own service area maps. In light of all of these exciting new partnerships and collaborations, it’s clear that  that one CHNA planning map  will no longer meet the ever-evolving needs of local boards of health, community agencies, and all of the other grass-roots organizations that are working tirelessly to improve the health of Massachusetts residents.

DPH is currently meeting to discuss best ways to support all of these local and regional partnerships. A DPH survey on this topic conducted in September 2013 resulted in  nearly 700 responses. Results pdf format of Summary of 2013 DPH Coalition Assessment Survey doc format of Summary of 2013 DPH Coalition Assessment Survey of the survey reinforced the value of partnerships.

  • 92% of respondents would participate in coalitions even if not required.
  • 82% participate because “the coalition is achieving important outcomes on an issue I care about”

Moving forward, DPH contracts will continue to require collaboration at the local and regional level, but allow local decision-making on the most effective form of collaboration – whether that’s participation in CHNAs, coalitions funded by DPH, federal/private funded coalitions, or other community-based coalitions working on improving health outcomes.


This information is provided by the Department of Public Health.