Comparison of Nonprofit Hospital Community Benefit Substance Abuse Identification and Practice Implementation in Appalachian and Non-Appalachian Counties.

Context: As substance use continues to be a public health crisis nationally, it disproportionately affects the Appalachian region.

Objectives: Our research seeks to explore whether there is a greater substance use burden in Appalachia and whether that burden is being prioritized in local hospital systems' community health needs assessments (CHNAs) and implementation strategies (ISs).

Setting: The setting for this study is the 13 states that are represented within the Appalachian region.

Equity as a Guiding Theme in Hospitals' Community Health Needs Assessments.

Introduction: This study explores the relationship between nonprofit hospitals' use of equity as a guiding theme in the development of their community health needs assessments and the level of alignment between the health needs identified in the community health needs assessment and those addressed in hospitals' implementation strategy.

Methods: Using data from a nationally representative data set of 485 nonprofit hospital community health needs assessments for the years 2018-2021, this study employed a multivariate logistic regression model to examine the association between hospitals' use of equity as a guiding theme in the community health needs assessment and binary indicators of alignment for 6 common community health needs: access to care, chronic illness, obesity, mental health, substance use, and social determinants of health.

Results: Hospitals using equity as a guiding theme in their community health needs assessment reported significantly greater alignment for 3 needs: access to care (OR=3.