This community health assessment analyzes two distinct populations, the general population of Pima County, located in Southern Arizona and the patient cohort of the Health360South (H360S) project. The H360S patient cohort reside mainly in zip codes 85706, 85711, 85713, and 85756. The H360S project receives its funding through the Health Resources Services Administration (HRSA) via the Nurse Education Practice Quality and Retention (NEPQR) grant. Sally Reel, PhD, RN, FNP, FAAN, FAANP, is the Principal Investigator on the NEPQR grant. Patients in the H360S project were identified, within the Department of UAMC Family & Community Medicine Clinic, South Campus, Tucson as chronic users of emergency departments within the community. Additionally, these complex patients are at high risk for hospital admission or readmission within 30 days of hospital discharge.