Community Health Improvement

Community Health Assessment 2025-2030

 CHA 2025-2030  |  Roadmap to Health  |  Using MAPP 2.0  |  MAPP Timeline  |  Community Visioning  |  Prevention Agenda 2025  |  Resources 

CHA Report Cover

The 2025-2030 Tompkins County Community Health Assessment (CHA) provides an integrated, equity centered understanding of community health grounded in the New York State Prevention Agenda and social drivers of health domains. The assessment synthesizes local, state and federal surveillance data, a countywide Community Health Survey, qualitative research, and extensive community engagement to examine the conditions that shape health across five Prevention Agenda (PA) domains:

  • Economic Stability,
  • Social and Community Context,
  • Neighborhood and Built Environment,
  • Health Care Access and Quality, and
  • Education Access and Quality.

This CHA was submitted to the NYS Department of Health (DOH) in December 2025, as required.

Executive Summary

CHA Priority Areas


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CHA by Sections (fewer pages, smaller files)


Executive Summary

The 2025-2030 Tompkins County Community Health Assessment provides an integrated, equity centered understanding of community health grounded in the New York State Prevention Agenda and social drivers of health domains. Guided by Mobilizing for Action through Planning and Partnerships (MAPP) 2.0, the national community health improvement framework developed by the National Association of County and City Health Officials (NACCHO), the assessment synthesizes local, state and federal surveillance data, a countywide Community Health Survey, qualitative research, and extensive community engagement to examine the conditions that shape health across five PA domains: Economic Stability, Social and Community Context, Neighborhood and Built Environment, Health Care Access and Quality, and Education Access and Quality.

A central feature of this CHA is its commitment to collaboration. The Steering Committee provided overall direction, while the cross-sector Assessment Design Team shaped the Community Health Survey, dissemination plans, and interpretation of its findings. Cornell University’s Master of Public Health Program also supported qualitative design and analysis. Community engagement was woven throughout the process, including a countywide visioning initiative. More than 250 residents contributed visioning input and more than 1,800 completed the Community Health Survey, helping to define the values, priorities, and lived experiences that frame this assessment.

The CHA integrates data across three MAPP 2.0 assessments (Community Partner Assessment, Community Status Assessment, and the Community Context Assessment). The Community Status Assessment examines quantitative indicators drawn from local, state and federal data systems, primarily sourced from the U.S. Census, NYSDOH, and the Community Health Survey as well as other community reports and service utilization. The Community Context Assessment explores lived experiences through qualitative interviews and local existing reports. The Community Partner Assessment highlights organizational strengths, available resources, and areas where system capacity is strained or unevenly distributed. Together, these three assessments create a multi-dimensional picture of health in Tompkins County that extends beyond traditional indicators.

While specific findings appear in the body of the report, the overarching conclusion is that health in Tompkins County is primarily shaped by social and economic conditions. Across all Prevention Agenda domains: Economic Stability, Social and Community Context, Neighborhood and Built Environment, Health Care Access and Quality, and Education Access and Quality, the assessment shows an interwoven set of challenges that reflect structural conditions. At the same time, the County demonstrates strong assets of robust academic and health partnerships, a deeply engaged nonprofit sector, expanding behavioral health and crisis response initiatives, and a shared community vision centered on belonging, connection, and equitable opportunity.

This CHA forms the foundation for the 2025-2030 Community Health Improvement Plan (CHIP), which will identify shared priorities and strategies that move Tompkins County toward a healthier, more equitable future.

A visitor speaking with a woman tabling at a Juneteenth event in Ithaca, 2023

Community Health Assessment Priority Areas

The Steering Committee reviewed all PA Domains and Priorities and provided recommendations on which areas should be investigated further during the CHA process and review of data. These recommendations were used to structure the CHA and to determine what data from secondary sources would be reviewed and highlighted in the narrative. The review of existing community reports and stakeholder input were also aligned with the Priorities. Below are the thirteen chosen priorities for this CHA from the NYS Prevention Agenda:

1. Economic Stability

  • Housing Stability and Affordability
  • Poverty
  • Nutrition Security

2. Social and Community Context

  • Suicide
  • Depression
  • Primary Prevention, Substance Misuse, and Overdose Prevention
  • Tobacco/ E-cigarette Use

3. Neighborhood and Built Environment

  • Injuries and Violence

4. Health Care Access and Quality

  • Access to and Use of Prenatal Care (Promote Infant and Maternal Health)
  • Preventive Services for Chronic Disease Prevention and Control
  • Oral Health Care
  • Preventive Services (Healthy Children)

5. Education Access and Quality

  • Health and Wellness Promoting Schools
 

Roadmap to Health

 CHA 2025-2030  |  Roadmap to Health  |  Using MAPP 2.0  |  MAPP Timeline  |  Community Visioning  |  Prevention Agenda 2025  |  Resources 

CHI-Tompkins Overview

Whole Health logo markIn Tompkins County's Community Health Improvement (CHI-Tompkins) process, Whole Health partners with other community organizations to conduct ongoing community health improvement through the county Community Health Assessment (CHA) and Community Health Improvement Plan (CHIP). The process includes regular meetings of a CHI Steering Committee, continuing updates from partner organizations, and partner participation in several events, such as update and feedback activities.

Values

Our core values and objectives act as pillars in the promotion of health equity.

Data-based
  • Effective data sharing between organizations throughout the process. Focus on evidence-based interventions, accurate assessment, inclusive collection of data, & informed evaluation.
Sustainable
  • Work towards a CHI process with dedicated funding and coordination. Equitable allocation of resources, to facilitate efficiency & longevity of the process.
Collaborative
  • Cross-sectoral alliance & power-sharing among diverse stakeholders. Intentional & meaningful community involvement throughout the CHI process.

Our Partners

Tompkins County Whole Health recognizes and extends its gratitude to the following organizations and agencies for the vital role they played in researching, organizing, and writing the 2022 CHA and CHIP. They have been true partners over a multi-year period.

Whole HealthCayuga HealthCornell MPH
Human Services CoalitionCornell MPHTC Youth Services

Office for the AgingFoodbank of the Southern TierYMCA 


Using MAPP 2.0 in the CHI Process

 CHA 2025-2030  |  Roadmap to Health  |  Using MAPP 2.0  |  MAPP Timeline  |  Community Visioning  |  Prevention Agenda 2025  |  Resources 

MAPP 2.0 Roadmap illustrationMobilizing for Action through Planning and Partnerships, MAPP

The MAPP 2.0 approach provides a scaffold for the CHA and CHIP, while centering health equity through community power and collective action.

Process

Our core values and objectives act as pillars in the promotion of health equity.

Community Partner Assessment (CPA)
  • Focus: Resources, capacity, & programs of organizations impacting the county’s health.
  • Community partners participated in both a survey and discussion group, generating themes on their ideal outcomes for a more collaborative community health improvement process, such as “creating long-term, permanent social change.”
  • CPA Report: Outcomes of the activities undertaken for this assessment(PDF, 2MB).
Community Status Assessment (CSA)
  • Focus: Health, behaviors, and identities of our county’s population.
  • A repository of secondary data indicators, intending to describe our communities current status regarding the topics included in the prevention agenda.
  • A community health survey was distributed to community members to collect primary data.
Community Context Assessment (CCA)
  • Focus: Influences, environment, and sentiments experienced by the county.
  • This assessment will be a collaboration between Civic Ensemble and students and faculty from Cornell MPH, allowing for utilization of innovative methods and engagement of the community. Methods may include focus groups, vote with your feet exercises/movement, forum theater, interviews, or listening sessions.
Assessment Design Team (ADT)
  • Purpose: Provide oversight in the development and dissemination of the three Process assessments, with a focus on the Community Status Assessment and the Community Context Assessment, particularly in the context of their cultural acceptability.

MAPP 2.0
Timeline for Activities & Engagement

 CHA 2025-2030  |  Roadmap to Health  |  Using MAPP 2.0  |  MAPP Timeline  |  Community Visioning  |  Prevention Agenda 2025  |  Resources 

A look at the timeline, 2024-2026:
’24       ’25       ’26      
Phase 1 Phase 2 Phase 3    

Phase One: Build the Community Health Improvement Foundation

January–June 2024:
  • 10 community organizations: made up the membership or the CHI steering committee
  • 2 visioning community events hosted to develop vision statement
  • 65 attendees reviewed Phase One as a participant at one of the community events.

Phase Two: Tell the Community Story

June–December 2024:
January 2025–September 2025:
  • Conduct community engaged activities for data collection
  • Share findings and prioritize issues

Phase Three: Continuously Improve the Community

October 2025–June 2026:
  • Complete the Community Health Assessment (CHA) and submit to the NYSDOH.
  • Develop the Community Health Improvement Plan (CHIP)
  • Collaborate with partners to build ongoing guidance and monitoring for key interventions.

 

CHI Tompkins Updated Timeline

CHI Timeline

Community Vision Statement

 CHA 2025-2030  |  Roadmap to Health  |  Using MAPP 2.0  |  MAPP Timeline  |  Community Visioning  |  Prevention Agenda 2025  |  Resources 

Our community visioning process went into the community for input and ideas. Completed in May 2024, the statement drew from almost 500 community responses from 15 different collection locations and events.

Community Vision Statement

“Our community is a diverse and dynamic mosaic of people across the lifespan. Shared spaces and natural beauty are central to our community, fostering care and belonging.

“We envision a community where everyone thrives, regardless of background, income, or abilities. We aspire to focus on prevention and health promotion through accessible healthcare, inclusive spaces, and resources that meet everyone’s basic needs. Our community desires collaboration, trauma-informed care, safety, resilience, environmental stewardship, and elevation of marginalized voices. We seek comprehensive well-being that encompasses physical, mental, and social needs.”


Prevention Agenda (PA) 2025-2030

 CHA 2025-2030  |  Roadmap to Health  |  Using MAPP 2.0  |  MAPP Timeline  |  Community Visioning  |  Prevention Agenda 2025  |  Resources 

What's New

Social Determinants of Health graphic, from Healthy People 2030,odphp.health.gov/healthypeopleThe Social Determinants of Health (SDOH) are integrated into the 2025-2030 PA priorities. This establishes a holistic approach to health by addressing root causes and health inequities. The Priorities (also referred to as “Domains”), now reflecting SDOH, are:

  1. Economic Stability
  2. Social and Community Context
  3. Neighborhood and Built Environment
  4. Health Care Access and Quality
  5. Education Access and Quality

 
This SDOH Framework Supports:

  • Holistic Approach
  • Addressing Root Causes
  • Health Equity
  • Intersectional Collaboration
  • Preventive Approach
  • Community Empowerment

 
PA Foundations:

  • Health Equity
  • Prevention Across the Lifespan
  • Health in All Policies
  • Local Collaboration-Building