26 Apr Case Study: “The Eastview Health Equity Gap—Applying SDoH and Community Assessment”
The city of Eastview (population 324,000) recently completed its Community Health Assessment (CHA). While overall health indicators appear stable, the CHA revealed significant disparities between Eastview’s west and east districts.
Key Findings from the CHA
West District (higher income):
Life expectancy: 82.4 years
High school graduation: 94%
Home ownership: 78%
Primary care access: 1 PCP per 1,300 residents
Unemployment: 3.2%
East District (lower income):
Life expectancy: 74.1 years
High school graduation: 68%
Home ownership: 42%
Primary care access: 1 PCP per 2,800 residents
Unemployment: 12.7%
Additional SDoH Data
East District has limited public transit and only one grocery store.
Childhood asthma rates in the East District are 3× higher than the West.
Violent crime rate is 2.5× higher in the East District.
27% of Eastview’s immigrant population resides in three East District neighborhoods.
Rent burden has increased 22% in five years.
Community feedback:
Residents in the East District report lack of trust in health institutions, minimal outreach, and language barriers.
Student Tasks (4–5 pages)
1. Conduct an SDoH Analysis Using Chapter 11 Frameworks
Identify which SDoH domains are most strongly influencing disparities (economic stability, education, neighborhood environment, social context, access to care).
Explain the causal pathways from these determinants to:
Life expectancy
Chronic disease patterns
Behavioral health
Health service utilization
2. Identify Priority Populations
Using the CHA data, determine two priority populations that the city of Eastview should target first.
Justify your selections using population health reasoning.
3. Evaluate the City’s CHA Process
Assess whether the CHA reflects:
Adequate community engagement
Use of both quantitative and qualitative data
Cross-sector collaboration
Cultural competence
Identification of root causes vs symptoms
What elements were missing?
4. Develop an Upstream Intervention Strategy
Propose three upstream interventions (housing, transit, language access, education, environmental safety, etc.).
For each intervention, explain:
The determinant it addresses
The expected impact on health outcomes
Which partners must be involved (public health, housing authority, schools, nonprofits, city planners)
Barriers to implementation
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