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The research goal was to describe local health department community health improvement plans and hospital implementation strategies, assessing the extent to which they address the social determinants of health. In 2014, we used a grounded theory approach to conceptualize the extent of social determinant efforts in a purposive sample of improvement plans and implementation strategies (N = 12) taken from the community health assessment database pilot project (N = 502). We developed the Community Health Improvement Matrix (CHIM), categorizi