Wall

Data are Your Friends: How to Use Data to Get What You Want: 

Data are Your Friends: How to Use Data to Get What You Want Hilary K. Wall, MPH Massachusetts Department of Public Health Partnership for a Heart Healthy and Stroke Free Massachusetts January 26, 2007

Learning Objectives: 

Learning Objectives Participants should be able to: Explain common data terms relevant to community agencies and organizations List statewide surveillance datasets relevant to community agencies and organizations Use data to leverage resources

Slide3: 

"He uses statistics as a drunken man uses lampposts -- for support rather than for illumination.” - Andrew Lang

Data Terms: 

Data Terms

Age Adjustment: 

Age Adjustment Statistical procedure used to minimize the effect of age on population differences Based on 2000 US Census population “crude” numbers and rates are NOT age-adjusted Used to compare apples to apples Example – town where most people are older versus town where most people are young – need to age adjust the populations in order to determine which has the higher rate of disease

Slide6: 

2006 Massachusetts Stroke Statistics by Gender

Prevalence: 

Prevalence The proportion of individuals who have an attribute or disease in a given population at a designated point in time Example – The prevalence of diabetes in MA is 6%* means that 6% of the MA population has diabetes *age-adjusted statistic

Incidence Rate: 

Incidence Rate The number of new events that occur in a given population over a designated period of time * Example – The MA incidence rate of lung cancer in 2002 was 72** per 100,000 means that there were 72 new cases of lung cancer for every 100,000 MA residents in 2002 * usually 1 year ** age-adjusted statistic

Hospitalization Rate: 

Hospitalization Rate The number of new hospitalizations for a designated diagnosis code (ICD-9) that occur in a given population over a designated period of time Example – The MA inpatient hospitalization rate for coronary heart disease in 2002 was 602* per 100,000 = there were 602 hospitalizations for CHD for every 100,000 MA residents in 2002 *age-adjusted statistic

Mortality Rate: 

Mortality Rate aka death rate The number of people in a given population that dies from the same cause over a designated period of time Example – the 2003 mortality rate of stroke was 50* deaths per 100,000 MA residents = there were 50 deaths due to stroke for every 100,000 MA residents in 2003 *age-adjusted statistic

Relevant Data Sources: 

Relevant Data Sources

U.S. Census: 

U.S. Census Conducted every 10 years City/town fact sheet: http://factfinder.census.gov/home/saff/main.html?_lang=en Profile includes: Gender, race, age breakdowns Social (disability status), economic (income and employment status), and housing characteristics (year built, heating fuel type)

Massachusetts Mortality Data: 

Massachusetts Mortality Data Causes of death listed on a death certificate Primary and all secondary causes of death, based on ICD-10 codes By city or town Subjective data but good for death estimates Includes deaths from chronic diseases, infectious diseases, injuries, etc.

Behavioral Risk Factor Surveillance System (BRFSS): 

Behavioral Risk Factor Surveillance System (BRFSS) Random-digit-dial telephone survey with adults age 18 and older Health characteristics/behaviors and risk factors: Diabetes and related complications prevalence and disease screening Heart disease and stroke prevalence and risk factor screening Tobacco and asthma prevalence Nutrition and physical activity habits Injury information including proportion of falls, handgun ownership, and seatbelt utilization

BRFSS (cont’d): 

BRFSS (cont’d) Limited city/town level data Over-sampled from 6 areas: Fall River/New Bedford* (combined) Lowell/Lawrence* (combined) Worcester Springfield Boston The rest of Massachusetts * Will be separated in the 2007 version

BRFSS (cont’d): 

BRFSS (cont’d) No cellular phone numbers No transient populations without an address Lengthy survey (~30 minutes) Population dislike of “phone solicitation”

Hospital Discharge Data: 

Hospital Discharge Data Emergency Department (ED) visits –short-term treatment of acute events Outpatient observation stays –evaluation for hospital admission Inpatient stays –long-term treatment of acute events, surgery, and recovery

Hospital Discharge Data (cont’d): 

Hospital Discharge Data (cont’d) City/Town specific Hospital-specific Based on billing codes (ICD-9) Primary and secondary causes including chronic conditions, injuries Underreporting of certain diagnoses

Youth Risk Behavior Surveillance System (YRBSS): 

Youth Risk Behavior Surveillance System (YRBSS) Biannual survey of grades 9-12 (randomly selected public and private schools) Health behaviors including: Tobacco use Alcohol consumption and illicit drug use Sexual behaviors and STDs Dietary behaviors Physical activity

Youth Health Survey (YHS): 

Youth Health Survey (YHS) Biannual survey of grades 6-12 (randomly selected schools) Public schools only Health behaviors including: Tobacco use Alcohol consumption and illicit drug use Extracurricular activities Dietary behaviors Physical activity Emotional status

YRBSS and YHS: 

YRBSS and YHS Not available by school or community (aggregate only) Conducted on alternate years Self-reported, voluntary responses Coordinated survey starting in 2007 every two years

Cancer Registry: 

Cancer Registry Captures all newly diagnosed cases of cancer (incidence) from all MA acute care hospitals Based on physician reporting City/town specific data (for 5 or more cases) Underreporting in border towns or cancers not diagnosed in hospitals

Leveraging Resources: 

Leveraging Resources

Data Uses for Community Agencies and Organizations: 

Data Uses for Community Agencies and Organizations Needs assessment and decision-making Grant writing Staff justification Stakeholder awareness Helps fulfill the 10 essential public health services

Specific Health Issues: 

Specific Health Issues Diabetes  BRFSS (disease, risk factor, and screening prevalence (HbA1c, foot exams, eye exams), self blood glucose monitoring), hospitalizations (amputations), mortality, MA Commission for the blind, End Stage Renal Disease Network of New England data

Elder and Disability Issues: 

Elder and Disability Issues Flu clinics  BRFSS (immunization rates, diabetes prevalence), hospitalization data Universal design  BRFSS (disability)

Violence and Injury Prevention: 

Violence and Injury Prevention Violence data BRFSS (intimate partner violence), hospitalizations (sexual assault), mortality (homicides), and Rape Crisis Center data Injury data BRFSS, hospitalizations (car and pedestrian accidents, falls) and mortality (suicides) data

Emergency Preparedness: 

Emergency Preparedness Emergency Response Plans “The need to deal with sheltering special medical need populations was and is a major gap that needs plugging.” – Frank Singleton, Director, Lowell Health Dept. in response to spring flooding  BRFSS (special populations: elderly, people with disabilities; people with chronic diseases) US Census (number of families with pets; number of people who do not speak English well)

North Adams REACH Community Health Foundation : 

North Adams REACH Community Health Foundation Compile a census profile of catchment area (demographics, poverty) Compile and publish the Children’s Health Profile (CHP) using local data Use data for grant background and needs sections e.g. Awarded a recent grant to decrease smoking rates among pregnant women because North Adams has the greatest smoking rate among pregnant women in MA (WIC data, birth certificates) e.g. Awarded a recent oral health grant due to high levels of poverty and poor oral health (census, CHP)

Lowell Community Health Center: 

Lowell Community Health Center Death Data Birth Data Hospital Data Healthy People 2010 Prevalence of Risk Race and Ethnicity Reports Health Indicators Surveillance Reports, State and National Census, Community Profile Local School Data Disease Specific Data Division of Employment/Labor Local Surveillance Reports Population Files Trend Analysis Data Urban Institute Data

Group Discussion: 

Group Discussion Examples of community agency/organization data usage? Brainstorm data for community agency/organization projects

Slide35: 

“Facts do not cease to exist because they are ignored.” - Aldous Huxley

For Additional Information: 

For Additional Information Southeastern MA – Maria Evora-Rosa, maria.evora-rosa@state.ma.us Northeastern MA – Lynda Graham-Meho, lynda.graham-meho@state.ma.us Central MA and Metro Boston – Lea Susan Ojamaa, lea.ojamaa@state.ma.us Western MA – Donna Salloom, donna.salloom@state.ma.us