Assessing the public's health: community diagnosis in North Carolina.

The community diagnosis process in North Carolina has evolved over a period of years. It began in 1974 and gained great impetus during and after 1983. It serves to address the "true" health problems of the State's citizenry through the identification and communication of these problems from the local level to the State. In this "bottom-up" planning process, conducted biennially, the State health department prepares 100 county-specific health data books and an accompanying guide that advise local health department personnel on the concepts, methods, and materials of community diagnosis. The data books and guides are presented at a series of workshops to county health department personnel who subsequently analyze the data in the light of their local situations and report back to the State their county's priority health problems and strategies for solving them. This county information is then used by the State health director to determine funding requests to the legislature. In the end, it is hoped that the products of this process serve the ultimate goal of allocating resources according to priorities to meet the documented health needs of North Carolinians. "The Future of Public Health," authored by a committee of the Institute of Medicine, defines a health planning and leadership role for a local health authority that is fundamental to the protection of the community's health. Community diagnosis provides for the kind of needs assessment that is crucial to that role.