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Community Health Status Indicators (CHSI) Module 2. Nancy Allee, MLS, MPH, AHIP Deputy Director, Health Sciences Libraries University of Michigan Webinar, January 27, 2010 . Health Indicators, Part II. Health indicators: 4-part series. Part I: “Health Indicators: Overview”

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community health status indicators chsi module 2
Community Health Status Indicators (CHSI)Module 2

Nancy Allee, MLS, MPH, AHIP

Deputy Director, Health Sciences Libraries

University of Michigan

Webinar, January 27, 2010

Health Indicators, Part II

health indicators 4 part series
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

today s presentation
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

presenter s background nancy allee nallee@umich edu
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

what is public health
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

10 essential public health services
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

what is chsi community health status indicators
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.

partners
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

uses of users of chsi and health indicators
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

chsi data sources
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

chsi evidence based decision making
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

what are indicators
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 Guidehttp://www.apho.org.uk/resource/item.aspx?RID=44584

Health Indicators, Part II

what are health indicators
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 sitehttp://www.definitionofwellness.com/dictionary/health-indicator.html

Health Indicators, Part II

what is the community in community health status indicators
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

some myths about health indicators
Some mythsabout 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 Guidehttp://www.apho.org.uk/resource/item.aspx?RID=44584

Health Indicators, Part II

some truths about health indicators
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 Guidehttp://www.apho.org.uk/resource/item.aspx?RID=44584

Health Indicators, Part II

chsi health indicators
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

chsi health indicators18
CHSI health indicators

Demographics

Population size

Poverty level

Population by age

Population by race/ethnicity

Health Indicators, Part II

chsi health indicators19
CHSI health indicators

Summary measures of health

Average life expectancy

Rates of death

Self-rated health status

Average unhealthy days

Health Indicators, Part II

chsi health indicators20
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

chsi health indicators21
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

chsi health indicators22
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

chsi health indicators23
CHSI health indicators

Vulnerable populations

Have no high school diploma

Unemployed

Severe work disability

Major depression

Recent drug use

Health Indicators, Part II

chsi health indicators24
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

chsi health indicators25
CHSI health indicators

Preventive services use

Pap tests, mammograms, colonoscopy, vaccines

Health Indicators, Part II

chsi health indicators26
CHSI health indicators

Risk factors for premature death

Lack of exercise

Poor nutrition

Obesity

High blood pressure

Smoking

Diabetes

Health Indicators, Part II

chsi health indicators27
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

peer counties
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

how can i access the chsi web site http www communityhealth hhs gov
How can I access the CHSI web site?http://www.communityhealth.hhs.gov/
chsi home
CHSI: “Home”

Health Indicators, Part II

chsi about the data
CHSI: “About the data”

Health Indicators, Part II

chsi data details
CHSI: “Data details”

Health Indicators, Part II

chsi about the project
CHSI: “About the project”

Health Indicators, Part II

chsi partners
CHSI: “Partners”

Health Indicators, Part II

chsi resources
CHSI: “Resources”

Health Indicators, Part II

chsi resources cont d
CHSI: “Resources” cont’d

Health Indicators, Part II

chsi mapping reports
CHSI: Mapping & reports

Health Indicators, Part II

chsi sample search
CHSI sample search

Health Indicators, Part II

focus on wayne county mi
Focus on Wayne County, MI

Health Indicators, Part II

demographics wayne county mi
Demographics: Wayne County, MI

Health Indicators, Part II

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

Relative health importance: Wayne County, MI

Unfavorable health indicators – both Peers and U.S.

Health Indicators, Part II

environmental health wayne county mi
Environmental health: Wayne County, MI

Health Indicators, Part II

access to care wayne county mi
Access to care: Wayne County, MI

Health Indicators, Part II

chsi reports
CHSI reports

Each 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

mapping
Mapping

Health Indicators, Part II

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

Peer counties: Wayne County, MI

Health Indicators, Part II

another mapping example
Another mapping example

Health Indicators, Part II

additional resources
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.

additional resources60
Additional resources

Community 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 Documentation

October 8, 2009

http://gis.cdc.gov/chsi/chsi_help.pdf

Health Indicators, Part II

upcoming webinars
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

topic for february 3rd webinar
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

contact information
Contact information

Nancy Allee

Health Sciences Libraries

University of Michigan

[email protected]

Health Indicators, Part II

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