2025 Children's of Alabmama Community Health Needs Assessment

EXECUTIVE SUMMARY

The 2025 Community Health Needs Assessment (CHNA) for Children’s of Alabama was conducted by the Public Affairs Research Council of Alabama (PARCA) in accordance with IRS and Affordable Care Act regulations. The study integrates quantitative data, survey responses, and focus group findings to identify the leading health, access, and safety challenges affecting children in Alabama.

The analysis included:

A statewide community survey ( ≈ 780 respondents) addressing perceived child health, healthcare access, and safety issues.

Four focus groups representing diverse populations: Pickens County (rural providers), Birmingham City School students, [Jefferson County students description TK], and West End (Jefferson County) caregivers. Secondary data from state and national sources, including the U.S. Census Bureau, Centers for Disease Control, Feeding America, and VOICES for Alabama’s Children . Respondents represented 58 of Alabama’s 67 counties; 55% resided in the Birmingham, Alabama, Metropolitan Statistical Area 1 (Bibb, Blount, Chilton, Jefferson, Shelby, St. Clair, and Walker), and 45% lived elsewhere. Sixty-eight percent lived in urban counties, 30% in rural.

Top Community-Identified Issues

HEALTH

Mental and Behavioral Health —Identified by 73% of respondents as a top concern, this issue dominates both survey and focus group results. Participants reported escalating youth anxiety, depression, and behavioral challenges, exacerbated by stigma and insufficient counseling services. Healthcare Access —Despite high pediatric insurance coverage (97%), many families—especially in rural counties—struggle to reach providers or afford services. Alabama’s pediatric provider shortages and transportation barriers persist statewide.

Child Abuse —Ranked third overall, confirmed by rising rates of indicated abuse/neglect reports (10.6 per 1,000 children).

Other concerns, such as childhood obesity, hunger, and accidental injury were rated lower, despite data showing continued prevalence.

ACCESS TO CARE

Ability to Pay for Care —70% of respondents identified cost as a major barrier. Nearly one in four Alabama children lives in poverty, and more than 45% of births are covered by Medicaid. Availability of Quality Services —Rural hospital and clinic closures have left many counties without pediatric providers; 80% of counties lack pediatric services.

Parent Education and Awareness —Parents often lack knowledge of available services or preventive care programs.

Transportation —A persistent obstacle, particularly in rural areas without public transit options.

These findings mirror Jefferson County Department of Public Health’s own community health improvement priorities, emphasizing affordability, transportation, and family education. 2

______________________________________ 1 OMB Bulletin No. 23-01

2 The Community Health Improvement Plan , 2020—2-2024. Jefferson County https://www.jcdh.org/ SitePages/Misc/PdfViewer?AdminUploadId=2587#:~:text=match%20at%20L1650%20Strategic%20 Issue,Term%20Target

Children’s of Alabama, 2025 CHNA

4