Using Data to Improve Health Services A workshop for Community Supported Clinics

Charles Rynerson Sheila Martin April 10, 2017

Whycandatahelpyouserveyourcommunity?

WorkshopAgenda

•  ImportantsourcesofDemographicdata•  Importantsourcesofhealthdata•  CommunityProfiles:Reviewofdatapointsand

sources•  Discussionofcommunityprofiles•  Step-by-stepinstrucDonsforobtainingand

mappingsimilardata•  Brainstorminganddiscussion

INTRODUCTIONTODEMOGRAPHICDATASOURCES

CharlesRynerson

•  ShortForm•  QuesDonsaskedofallpersonsresidinginU.S.

•  Age,Gender,Race/Hispanicorigin,HouseholdrelaDonship,HousingTenure

•  100%DataProducts•  LongForm(1940-2000)

•  QuesDonsaskedofasampleof1of6HousingUnits;15%ofthepopulaDonin2000•  Economic,Social,andHousingInformaDon•  Sampledataproducts

DecennialCensus:HistoricalPerspecDve

2010Census• April1,2010

• An“actualenumeraDon”(The2010Censusaimstocount

allU.S.residents—ciDzensandnon-ciDzensalike)

• Only10ques:onsonthe2010Censusform

NOLONGFORM!

•  populaDonandhousingcountsandbasiccharacterisDcs(sex,age,race/ethnicity,householdcomposiDon,

vacant/occupiedandowner/renterunits)

2010Census:RaceandEthnicity

2000 2010 change

ACS

UsedatafromtheAmericanCommunitySurveyto

obtaindetaileddemographic,social,economic,and

housingcharacterisDcs,suchasincome,poverty,

employment,andeducaDonalabainment.

ACS

• Anongoingsurveythatprovidesdataeveryyear

• AsampleofthepopulaDon

• AllACSdataaresurveyes,mates.Tohelpyou

interpretthereliabilityoftheesDmate,the

CensusBureaupublishesamarginoferror

(MOE)foreveryACSesDmate.

SubjectsIncludedintheSurvey

ACSTopics:NotableAddiDonsandImprovements

•  Disability(newquesDonsintroduced2008)–  Hearingdifficulty–  Visiondifficulty–  CogniDvedifficulty–  Ambulatorydifficulty–  Self-caredifficulty–  Independentlivingdifficulty

•  HealthInsurance(2009)•  FieldofBachelor’sDegree(2009)

2013and2014insurancecoverage,Oregon

TotalCivilianNoninst

WithMedicaid/MeansTested

WithMedicaid/MeansTestedAlone

2013 3,893,092 3,322,210 85.3% 570,882 14.7% 662,038 475,3512014 3,931,306 3,548,645 90.3% 382,661 9.7% 897,812 667,749chg. 38,214 226,435 -188,221 235,774 192,398

U.S.CensusBureu,ACS1yearestimates,TableS2701

withInsurance noInsurance

PopulaDonThresholdsforACSEsDmates

AnnualRelease: September December

1-year estimates

5-year estimates

Areas with 65,000 + people

X X

All Geographic Areas

X

OneYearACSEsDmatesfor15OregonCounDes

FiveYearACSEsDmatesforall36OregonCounDes

Census Geography Hierarchy (with 2010 Statistical Area Criteria)

Revised 10-29-11

•  1,200 to 8,000 population (optimum 4,000) •  480 to 3,200 housing units

•  600 to 3,000 population •  240 to 1,200 housing units

Central axis describes a nesting relationship

•  Cities and towns -- incorporated •  Census Designated Places (CDPs)

Blocks are not defined by population and are the smallest geographic level

at which data are ever released (Decennial Census, not the ACS)

CensusGeography•  CensusTracts—small,relaDvelypermanentstaDsDcalsubdivisionsofacountyorequivalentarea[usually2,500-8,000people,PDXMSAavg.~4,400]

•  BlockGroups(BG)—asubdivisionofCensusTractscontainingaclusterofCensusBlocks[usually600-3,000people,opDmumsize1,500]

•  Blocks—smallestgeographicarea;boundedonallsidesbyvisiblefeatures(e.g.streets,streams,railroadtracks)andbyinvisibleboundaries(e.g.city,town,andcountylimits)

•  Place—Places,forthereporDngofcensusdata,includecensusdesignatedplaces(CDP),consolidatedciDes,andincorporatedplaces(ciDes,towns,villages,etc.).

•  ZCTA—AZIPCode®tabulaDonarea(ZCTA™)isastaDsDcalgeographicenDtythatapproximatesthedeliveryareaforaU.S.PostalServicefive-digitZIPCode.ZCTAsdonotpreciselydepictZIPCodedeliveryareas,anddonotincludeallZIPCodesusedformaildelivery.

CensusGeography

ResourcesforDataUsers

•  factinder.census.gov-AmericanFactFinder

•  hbp://www.census.gov/data/data-tools/cbb.html-

CensusBusinessBuilder

•  censusreporter.org

•  pdx.edu/prc–PopulaDonResearchCenter

•  portlandpulse.org

INTRODUCTIONTOHEALTHDATASOURCES

SheilaMarDn

Therearemanysourcesofhealthdata!

•  NaDonalCenterforHealthStaDsDcs,CDC•  BehavioralRiskFactorsSurveillanceSystem,CDC•  NaDonalCenterforHIV/Aids,ViralHepaDDs,STD,andTBPrevenDon

•  Claimsdata•  CensusBureau,ACSandSAHIE•  SafedrinkingwaterinformaDonsystem•  EtcetcHowdoweknowwhattouse???

EvaluaDngtheusefulnessofpotenDalhealthdata

•  Whatisthedatasource?•  Howarethedatacollected?•  Forwhatgeography?•  OverwhatDmeperiod?Whathaschanged?•  Howcurrentarethedata?Howowenaretheycollectedandwhatisthelagintheirrelease?

DatacollecDonmethods•  AdministraDverecords

– CreatedforanadministraDvepurpose•  Claimsdata,taxdata,birthanddeathrecords

•  Surveydata– UsuallycollectedspecificallytoansweraresearchquesDon

– Mayhaveproblemswithresponseratesanddatareliability

QuesDonstoaskaboutsurveydata

•  Whoisbeingsurveyed(whatistheuniverse)?•  Whatpercentageoftheuniverseissampled?•  Whatisthesamplingmethod(phone,mail,web)?

•  Whatkindofsamplingbiasmightbeintroducedbythesamplingmethod?

Keyhealthdatasources•  Vitalrecords(birthsanddeaths)

–  NaDonalCenterforHealthStaDsDcsorthestatehealthdepartment

–  Canbeusedtocalculateprematuredeath,causeofdeath,lowbirthweightbabies,teenbirths.

•  BehavioralRiskFactorSurveillanceSystem,CDC–  Phonesurveyconductedbystatestatehealthdepartments–  NaDonalsampleofabout500,000adultslivinginhouseholds(>18)

–  Setofsurveysaboutavarietyofhealthtopics–  SamplesizescanbelowforcounDes

•  Statehealthdepartments–  Diseaseincidence,etc.

OtherHealthdatasources•  CensusBureau,AmericanCommunitySurvey

–  Insuredanduninsuredbyage,sex,andrace,educaDon,andincome

– DisabilityinformaDon•  HealthResourcesandServicesAdministraDon

– HealthCenterProgramGranteeDataforFQHC’s– 2012-2015– CharacterisDcsofservicearea,paDents,services,clinicaldata,cost,etc.

Dataaggregators•  WebsitesorreportsthatproduceaspecificsetofhealthdataorindicatorsbyaggregaDngalotofdifferentsourcesofdata,Examples:– GreaterPortlandPulse(PortlandmetrocounDesonly)

– CountyHealthRankings(NaDonalcounty-leveldata)

– StateofOregon’sHealth(County-leveldata)– 500CiDesProject

ProfileReview

Discussion•  WhatcanIsayaboutmycommunitybasedonthesedata?

•  WhatotherdatawouldIliketohave?•  Howarethesedatausefulformyclinic:

– FortargeDngservices?– ForidenDfyingpartners?– ForlocaDngnewservices?

Buildingyourownprofile•  StepbystepinstrucDonsfor:

– AmericanFactinder– GreaterPortlandPulse– CountyHealthRankings– UDSMapper(ifwehaveDme)

BrainstormingandDiscussion•  WhatarethemostimportantwaysIcanthinkoftousethesedata?

•  WhatismissingthatImightneedtoknow?•  Whatotherdatamightwewanttocombinewiththesedatatolearnmore?

Contacts

•  PopulaDonResearchCenterwww.pdx.edu/prc/

•  CharlesRynersonrynerson@pdx.edu503-725-5157

•  SheilaMarDnsheilam@pdx.edu503-725-5170