community health status indicators (chsi) module 2 nancy allee, mls, mph, ahip deputy director,...
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Community Health Status Indicators (CHSI)
Module 2Nancy Allee, MLS, MPH, AHIP
Deputy Director, Health Sciences Libraries
University of Michigan
Webinar, January 27, 2010
Health Indicators, Part II
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Health indicators: 4-part series• Part I: “Health Indicators: Overview”• Wednesday, January 20th, 1:00pm EST
– Understand the variety of health indicators, their data sources, their key attributes, context and use – Presenter: Cheryl Wold, Wold & Associates
• Part II: “Community Health Status Indicators (CHSI)” • Wednesday, January 27th, 1:00pm EST
– Learn to navigate and use the Community Health Status Indicators (CHSI) effectively to find county-level data
– Presenter: Nancy Allee, Deputy Director, Health Sciences Libraries, University of Michigan • Part III: “Practical Approaches for Using Health Indicators” • Wednesday, February 3rd, 1:00pm EST
– Discover ways in which librarians can become more engaged with others in improving the health of their communities and become knowledgeable about ways in which CHSI data can be used in working with the public health practice community
– Presenter: Nancy Allee, Deputy Director, Health Sciences Libraries, University of Michigan • Part IV: “Examples of Important New Indicator Projects” • Date/Time: To Be Announced
– Become familiar with several important indicator efforts including State of the USA, MATCH, and two local level examples
– Presenter: Cheryl Wold, Wold & Associates
• Registration: http://www.nlm.nih.gov/nichsr/healthindicators/
Health Indicators, Part II
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Today’s presentation
Focus on: the Community Health Status Indicators
Goal: Learn to navigate and use the Community Health Status Indicators effectively to find local data
accessing searching mapping generating county-level reports
Question: How can librarians engage with the public health workforce and local communities in using health indicator resources for quality improvement?
Health Indicators, Part II
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Presenter’s backgroundNancy Allee ([email protected])
Degrees in Library Science & Public Health
MLA CE’s –Community Health Status Indicators–Evidence Based Public Health–Public Health 2.0 (Social Media)
NLM & Partners in Information Access –Chair: Public Health Training Subcommittee–Project Director: Public Health Information & Data Tutorials project & developer of Evidence Based Public Health Module
Past chair of the Public Health / Health Administration Section of the Medical Library Association
Health Indicators, Part II
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What is public health?
• Prevents epidemics and the spread of disease• Protects against environmental hazards• Prevents injuries• Promotes and encourages healthy behaviors• Responds to disasters and assists communities in recovery• Assures the quality and accessibility of health services
• Source: Public Health Functions Steering Committee, Fall 1994.
Health Indicators, Part II
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10 Essential Public Health Services• Monitor health status to identify community health problems
• Diagnose and investigate health problems and health hazards in the community
• Inform, educate, and empower people about health issues
• Mobilize community partnerships to identify and solve health problems
• Develop policies and plans that support individual and community health efforts
• Enforce laws and regulations that protect health and ensure safety
• Link people to needed personal health services and assure the provision of health care when otherwise unavailable
• Assure a competent public health and personal health care workforce
• Evaluate effectiveness, accessibility, and quality of personal and population-based health services
• Research for new insights and innovative solutions to health problems
• Source: Public Health Functions Steering Committee, Fall 1994. http://www.health.gov/phfunctions/public.htm
Health Indicators, Part II
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What is CHSI (Community Health Status Indicators)?
A collection of nationally available health indicators for counties, helping to present a “total picture” of local health.
A resource for monitoring and analyzing community health status and its determinants at the county level.
The goal of CHSI is to give local public health agencies another tool for improving their community’s health by identifying data resources and facilitating the setting of priorities.
CHSI supports the mission and goals of public health, the 10 essential public health services, Healthy People 2010 initiatives, and evidence-based policy and research.
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Partners
• Federal partners– Agency for Toxic Substances and Disease Registry (ATSDR)– Centers for Disease Control and Prevention (CDC)– Health Resources Services Administration (HRSA)– National Library of Medicine (NLM)
• Private partners– Association of State and Territorial Health Officials (ASTHO)– Johns Hopkins University Bloomberg School of Public Health– National Association of County and City Health Officials
(NACCHO)– National Association of Local Boards of Health (NALBOH)– Public Health Foundation (PHF)– Robert Wood Johnson Foundation (RWJF)
Health Indicators, Part II
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Uses of & users of CHSI and health indicators
• Uses of– Public policy– Public health
programs– Interventions– Partnerships– Research– Grants– Publications
• Users of– Public health officials– Public health workers– Librarians– Academics– Government agencies– Nonprofit
organizations– General public– Anyone with an
interest in local public health data
Health Indicators, Part II
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CHSI data sources• Air Quality Reporting System & Toxic Release Inventory
(EPA)• Behavioral Risk Factor Surveillance System (BRFSS)• Centers for Medicare & Medicaid Services • Harvard Initiative on Global Health• Infectious Diseases Reporting System (CDC)• National Vital Statistics System (CDC) • Substance Abuse and Mental Health Services
Administration (SAMHSA)• U.S. Census Bureau & Bureau of Labor Statistics -
Current Population Survey
Health Indicators, Part II
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CHSI & evidence-based decision-making
• Comparison to peer and other U.S. counties• Symbols
– Apple = favorable status– Magnifying glass = unfavorable status
Health Indicators, Part II
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What are indicators?
• An indicator is “a summary measure that aims to describe in a few numbers as much detail as possible about a system to help understand, compare, predict, improve, and innovate.”
• Source: – The Good Indicators Guide
http://www.apho.org.uk/resource/item.aspx?RID=44584
Health Indicators, Part II
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What are health indicators?
• A health indicator is “a characteristic of an individual, population, or environment which is subject to measurement and can be used to describe one or more aspects of the health of an individual or population.”
• Source: – Definition of Wellness web site
http://www.definitionofwellness.com/dictionary/health-indicator.html
Health Indicators, Part II
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What is the “community” in Community Health Status Indicators?
• Individual counties – data for 3,141 U.S. counties
• Peer counties– counties similar in population size and other
selected characteristics (e.g. poverty level, age distribution, density)
Health Indicators, Part II
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Some myths about health indicators• Only local indicators are relevant for local people.• Unless the data are perfect, the indicator is useless.• Measurement eliminates uncertainty and argument.• Only a few indicators are needed to understand how
a system is working.
• Source: – The Good Indicators Guide
http://www.apho.org.uk/resource/item.aspx?RID=44584
Health Indicators, Part II
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Some truths about health indicators
• Indicators only indicate – they are not the whole story.
• Indicators are ideally linked to quality improvement.– “Measurement is necessary for improvement but is
not sufficient on its own.” • David Pencheon, The Good Indicators Guide
– “I am not interested in measurement per se. I am obsessed by improvement and the role measurement has in that process.”
• Don Berwick, Institute for Healthcare Improvement
• Source: – The Good Indicators Guide
http://www.apho.org.uk/resource/item.aspx?RID=44584
Health Indicators, Part II
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CHSI health indicators
• Demographics• Summary measures of health• National leading causes of death• Measures of birth and death• Relative health importance• Vulnerable populations• Environmental health• Preventive services use• Risk factors for premature death• Access to care
Source: http://www.communityhealth.hhs.gov/Companion_Document/CHSI-Data_Sources_Definitions_And_Notes.pdf
Health Indicators, Part II
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CHSI health indicators
• Demographics– Population size– Poverty level– Population by age– Population by race/ethnicity
Health Indicators, Part II
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CHSI health indicators
• Summary measures of health– Average life expectancy– Rates of death– Self-rated health status– Average unhealthy days
Health Indicators, Part II
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CHSI health indicators
• National leading causes of death– Complications of pregnancy/birth– Birth defects– Injuries– Homicide – Cancer– Suicide– Heart disease– HIV/AIDS
Health Indicators, Part II
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CHSI health indicators
• Measures of birth and death– Birth
• Low birth weight, very low birth weight, premature births
– Death• Infant mortality, breast cancer, colon cancer,
coronary heart disease, homicide, stroke
Health Indicators, Part II
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CHSI health indicators
• Relative health importance– Highlights favorable and unfavorable health
status between peer counties and the U.S. in general
Health Indicators, Part II
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CHSI health indicators
• Vulnerable populations– Have no high school diploma– Unemployed– Severe work disability– Major depression– Recent drug use
Health Indicators, Part II
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CHSI health indicators
• Environmental health– Clean air, water, land, waste disposal– Data on infectious diseases– Standards for pollutants and toxic chemicals
Health Indicators, Part II
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CHSI health indicators
• Preventive services use– Pap tests, mammograms, colonoscopy,
vaccines
Health Indicators, Part II
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CHSI health indicators
• Risk factors for premature death– Lack of exercise– Poor nutrition– Obesity– High blood pressure– Smoking– Diabetes
Health Indicators, Part II
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CHSI health indicators
• Access to care– Number of uninsured– Number of Medicare enrollees– Number of primary care physicians– Health professional shortage areas
Health Indicators, Part II
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Peer counties
88 strata or peer groups defined in CHSI, using 5 factors:
• Frontier status
• Population size
• Poverty quartiles
• Median age
• Population density
Health Indicators, Part II
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How can I access the CHSI web site?http://www.communityhealth.hhs.gov/
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CHSI: “Home”
Health Indicators, Part II
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CHSI: “About the data”
Health Indicators, Part II
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CHSI: “Data details”
Health Indicators, Part II
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CHSI: “About the project”
Health Indicators, Part II
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CHSI: “How to use your county’s report”
Health Indicators, Part II
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CHSI: “Partners”
Health Indicators, Part II
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CHSI: “Resources”
Health Indicators, Part II
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CHSI: “Resources” cont’d
Health Indicators, Part II
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CHSI: “NLM resources”
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CHSI: Mapping & reports
Health Indicators, Part II
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CHSI sample search
Health Indicators, Part II
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Focus on Wayne County, MI
Health Indicators, Part II
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Demographics: Wayne County, MI
Health Indicators, Part II
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Summary measures of health: Wayne County, MI
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National leading causes of death: Wayne County, MI
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Measures of birth and death: Wayne County, MI
Health Indicators, Part II
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Relative health importance: Wayne County, MI
• Low Birth Wt. (<2500 g) • Very Low Birth Wt. (<1500 g) • Premature Births (<37 weeks) • Births to Women under 18 • Births to Unmarried Women • No Care in First Trimester • Infant Mortality • White non Hispanic Infant
Mortality • Black non Hispanic Infant
Mortality
• Hispanic Infant Mortality • Neonatal Infant Mortality • Post-neonatal Infant Mortality • Breast Cancer (Female) • Colon Cancer • Coronary Heart Disease • Homicide • Lung Cancer • Stroke
Unfavorable health indicators – both Peers and U.S.
Health Indicators, Part II
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Vulnerable populations: Wayne County, MI
Health Indicators, Part II
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Environmental health: Wayne County, MI
Health Indicators, Part II
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Preventive services use: Wayne County, MI
Health Indicators, Part II
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Preventive services use: infectious disease cases: Wayne County, MI
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Risk factors for premature death: Wayne County, MI
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Access to care: Wayne County, MI
Health Indicators, Part II
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CHSI reportsEach CHSI report includes data
on access and utilization of healthcare services, birth and death measures, Healthy People 2010 targets and U.S. birth and death rates, vulnerable populations, risk-factors for premature deaths, communicable diseases and environmental health.
In addition, the presentation of the data allows for comparisons of a county to its peer counties as well as U.S. rates and Healthy People 2010 targets.
Health Indicators, Part II
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Mapping
Health Indicators, Part II
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Mapping: major depression indicator
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Peer counties: Wayne County, MI
• California– Los Angeles County– Orange County– San Diego County
• Florida– Miami-Dade County– Palm Beach County
• Illinois– Cook County
• New York– Bronx County– Queens County
• Texas– Bexar County– Dallas County
Health Indicators, Part II
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Peer county comparison: major depression Wayne County, MI and Cook County, IL
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Another mapping example
Health Indicators, Part II
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Additional resources The July 2008 issue of Preventing Chronic Disease contains the
following articles that provide additional information about the Community Health Status Indicators project:
Kanarek N, Bialek R, Stanley J. Use of peer groupings to assess county public health status. Prev Chronic Dis 2008;5(3). http://www.cdc.gov/pcd/issues/2008/jul/07_0145.htm.
Metzler M, Kanarek N, Highsmith K, Bialek R, Straw R, Auston I, et al. Community Health Status Indicators Project: the development of a national approach to community health. Prev Chronic Dis 2008;5(3). http://www.cdc.gov/pcd/issues/2008/jul/07_0225.htm.
Heitgerd JL, Dent AL, Holt JB, Elmore KA, Melfi K, Stanley JM, et al. Community health status indicators: adding a geospatial component. Prev Chronic Dis 2008;5(3). http://www.cdc.gov/pcd/issues/2008/jul/07_0077.htm.
Sondik EJ. The goal of adequate data. Prev Chronic Dis 2008;5(3). http://www.cdc.gov/pcd/issues/2008/jul/07_0175.htm.
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Additional resourcesCommunity Health Status Indicators Project Working Group. Data
Sources, Definitions, and Notes for CHSI 2008. Department of Health and Human Services, Washington, DC: 2008.
http://www.communityhealth.hhs.gov/Companion_Document/CHSI-Data_Sources_Definitions_And_Notes.pdf
CHSI GIS Analyst User DocumentationOctober 8, 2009http://gis.cdc.gov/chsi/chsi_help.pdf
Health Indicators, Part II
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Upcoming webinars
• “Practical Approaches for Using Health Indicators”
• Wednesday, February 3rd, 1:00pm EST– Discover ways in which librarians can become more engaged with others in improving the
health of their communities and become knowledgeable about ways in which CHSI data can be used in working with the public health practice community
– Presenter: Nancy Allee, Deputy Director, Health Sciences Libraries, University of Michigan
• “Examples of Important New Indicator Projects”
• Date/Time: To Be Announced– Become familiar with several important indicator efforts including State of the USA, MATCH,
and two local level examples
– Presenter: Cheryl Wold, Wold & Associates
• Registration: http://www.nlm.nih.gov/nichsr/healthindicators/
Health Indicators, Part II
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Topic for February 3rd webinar
• How can librarians engage with the public health workforce and local communities in using health indicator resources for quality improvement?
• If you’d like to share your library’s experiences and project efforts successfully partnering with the public health community to improve health status: – send to [email protected]– include name & contact information and brief project
description– send by January 30 to be highlighted in upcoming
webinar
Health Indicators, Part II
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Contact information
Nancy Allee
Health Sciences Libraries
University of Michigan
Health Indicators, Part II