From Statewide Priorities to Local Action: How Community Health Planning Works
Most people probably don't think about a community health improvement plan when they think about local government. Yet behind many of the programs, partnerships and prevention efforts happening in communities across Wisconsin is a deliberate process for understanding what residents need most and deciding where public health and its partners can make the greatest difference.
In Wisconsin, local health departments are required to regularly assess the health of their communities and involve community members and policymakers in developing a plan to address important health concerns. That plan is known as a Community Health Improvement Plan, or CHIP. But there isn't one Wisconsin CHIP.
One State. Many Local Plans.
Each local health department serves a different community. Some public health departments are part of larger county Health and Human Services departments; others operate within different local government structures. Communities also differ in population, geography, resources, partnerships and health challenges. That means each community conducts its own assessment, listens to its own residents and partners, examines its own data and establishes priorities based on what is happening locally.
Waukesha County's previous Community Health Improvement Plan covered 2022–2026 and focused on three priorities: Healthy Aging, Mental Health and Substance Use. As we prepare for the next 2027–2029 Community Health Improvement Plan, we are moving to a three-year planning cycle and once again asking an important question: What should we work on together to improve health in Waukesha County over the next three years?
Answering that question takes more than reviewing statistics. Community health planning includes examining health and demographic data, hearing directly from residents, consulting community organizations and subject-matter experts, identifying community strengths and resources, and determining where coordinated action may have the greatest impact.
This cycle, that work has also included closer collaboration with Waukesha County's local health care systems. Instead of conducting entirely separate community assessment efforts, Waukesha County Public Health and our hospital partners have worked together to gather and understand portions of the information that will inform future priorities.
Waukesha County Public Health and our local health care systems will continue to have responsibilities unique to their organizations, while also working toward identifying at least one shared health priority where coordinated action could have an even greater community impact.
Where Does Wisconsin's State Health Plan Fit?
Wisconsin conducts a similar process at the state level. The Wisconsin Department of Health Services develops a State Health Assessment (SHA) to understand health and well-being across Wisconsin and a State Health Improvement Plan (SHIP) that establishes statewide priorities and strategies for improvement.
The current Wisconsin SHIP covers 2023–2027. The relationship between the state and local plans is important, but they are not intended to be identical. The SHIP provides a statewide roadmap and can help local health departments identify data, strategies, measures and areas where local and statewide work naturally align. Local communities can adopt or adapt elements of the SHIP when they make sense locally.
At the same time, Wisconsin recognizes that communities have different strengths and different needs. A health concern that rises to the top statewide may not necessarily be the issue a particular community identifies as its highest priority. That is why local community assessment remains so important. The SHIP helps us see the statewide picture. The CHIP helps us decide what action makes sense here at home. Those plans can reinforce one another without requiring every Wisconsin community to have the same priorities or the same timeline.
Different Timelines, Shared Goals
Health planning cycles do not always line up neatly. While Waukesha County is developing its 2027–2029 CHIP, Wisconsin is currently implementing its 2023–2027 SHIP. The state released a new State Health Assessment in 2026 and has begun the process that will lead to Wisconsin's next 2028–2032 State Health Improvement Plan. Local health departments, state public health agencies, hospitals and community organizations may therefore be at different points in their planning cycles at the same time. That isn't necessarily a problem. What matters most is that organizations continue sharing information, looking for areas of alignment and responding to what current data and community voices are telling them.
In many ways, that is what community health improvement is designed to do: connect work happening at the neighborhood, county, health care system and state levels while still allowing communities to respond to their own circumstances.
A State Perspective
To help explain how these state and local planning efforts work together, we asked Julia Nagy, Population Health Improvement Strategist with the Wisconsin Department of Health Services, to share a state perspective on some of the questions residents, and even those working in public health may have about SHIPs and CHIPs.
How are the SHIP and CHIP related?
The SHIP and CHIPs are two important parts of a whole story. Together they describe the overall health and well-being status and trends affecting Wisconsinites (SHA/SHIP), as well as the local trends that may be more immediately relevant to folks’ day to day lives (CHA/CHIP).
Do local health departments have to choose priorities that align with the SHIP?
Local health departments are not expected to strictly align their priorities to the SHIP and are welcome to use it only as a framework and resource. However, when priorities are aligned local and state agencies can learn from one another, innovate together, and build partnerships that are greater than the sum of their parts.
Why do communities conduct their own assessments instead of simply adopting statewide priorities?
Even the same issue can look very different in different communities. For example, at the state level healthy housing is a priority. Within that priority one community might identify, through local assessment, that they need to focus on affordable housing and another community may find that they should focus on reducing home-based childhood lead exposure.
What would you most like Wisconsin residents to understand about community input?
A SHIP and CHIP can only be as accurate as the information it’s based on, and that information comes from people like you! If you have the capacity, engage with your health departments by completing surveys, attending focus groups, providing feedback on ongoing efforts, and more. We encourage you, your family, friends, neighbors, and others in the community to make your voices heard.
What is a misconception about SHIPs or CHIPs that you wish we explained better?
While a SHIP/CHIP may lay out an ambitious health improvement agenda, there is often little or no funding dedicated specifically to implementing the SHIP/CHIP. This means that partnerships with community leaders, governmental agencies, community-based organizations, and others are key to improving health and well-being.
Community Health Improvement Is a Shared Effort
A CHIP is not simply a Public Health Division work plan. Improving mental health, preventing substance use, helping older adults thrive, improving access to care or addressing other complex health concerns cannot be accomplished by one government department alone.
Schools, health care systems, municipalities, nonprofits, businesses, faith communities, first responders, social service organizations and residents all have knowledge and resources that can help. That is why community participation is part of the process from assessment through implementation.
The ultimate goal is not simply to publish another report. It is to use data, lived experience and community partnerships to decide where we can make a difference together, and then turn those priorities into measurable action over the next three years.
Follow the Work
Follow Waukesha County's Community Health Improvement process, review local health information and learn about opportunities to participate:
- Waukesha County CHIP: Waukesha County Community Health Improvement Plan
Learn more about Community Health Assessments and CHIPs in Wisconsin:
- Wisconsin State Health Improvement Plan (SHIP): Wisconsin State Health Plan
