COLLECTING AND MANAGING DATA FOR THE COMMUNITY HEALTH

COLLECTING AND MANAGING DATA FOR THE COMMUNITY HEALTH ASSESSMENT Bobby D. Schmidt, M. Ed. – Moderator Michelle L. Cook, Ph. D(c), M. P. H. – BRFSS Coordinator Christopher Webb, M. P. H. – Research Specialist Ann Barnett, M. S. – GIS Analyst

COLLECTING AND MANAGING DATA FOR THE COMMUNITY HEALTH ASSESSMENT Goal: Improve the ability of LHD’s to collect and manage data for the CHA.

Collecting and Managing Data for the Community Health Assessment Objectives • List multiple types of data that inform a CHA • Cite national, state and local sources that provide data for CHA • Analyze and organize the information available in small, medium and large LHD settings • Prioritize the data to be used in the CHA

Collecting and Managing Data for the Community Health Assessment Common Elements • Develop an assessment plan • Engage the community and local public health system partners • Define the population • Identify community health status indicators

Collecting and Managing Data for the Community Health Assessment Common Elements • Collect data on indentified community health status indicators • Analyze the data • Summarize the key findings • Report results back to the community and public health system partners

Collecting and Managing Data for the Community Health Assessment Data Profile Characteristics • Health Status Indicators of the Population • Community Priorities • Determinants of Health • Access and Resources • Health Disparities • Health Outcomes

Community Health Assessment Topics Demography General Health Chronic Conditions Health Behaviors Preventive Health Infectious Diseases Mental Health Substance Abuse Safety & Injury Aging & Disability Infant & Child Health Maternal Health Workforce Facilities Transportation

Demography Potential Indicators Possible Data Sources • Population by gender, • 2010 U. S. Census • • • Texas State Data Center • • • race/ethnicity, age Population migration Unemployment Median household income Level of education Families with children under 18 living below the federal poverty guidelines Single female-headed families with children under 18 living below poverty Marriages and divorces Community Investment Reports • American Community Survey • Texas Health Currents • Vital Statistics • Texas Health Data • Texas Department of Insurance

General Health Potential Indicators Fair or Poor General Health Poor Mental Health Poor Physical Health Births Overall Mortality Health Care Coverage CHIP Medicaid TANF – Temporary Assistance to Needy Families • SNAP • • • Possible Data Sources • Behavioral Risk Factor Surveillance System • Vital Statistics • Texas Health Data • HHSC

Chronic Conditions Potential Indicators • • • High blood pressure High cholesterol Asthma Diabetes Cardiovascular Disease Cancer Obesity/Overweight Kidney Disease Vision Impairment Arthritis Alzheimer’s Disease Possible Data Sources • Behavioral Risk Factor Surveillance System • Texas Health Data • Preventable Hospitalizations • Other Hospital Discharge Data • Cancer Registry

Health Behaviors Potential Indicators Possible Data Sources • Physical Activity • Behavioral Risk Factor • Fruit & Vegetable Surveillance System • Department of Public Safety Consumption • Cigarette Consumption* • Smokeless Tobacco Consumption* • Binge Drinking* • Heavy Drinking* • Drinking & Driving*

Preventive Health Potential Indicators Possible Data Sources • Annual Checkup • Behavioral Risk Factor • Cancer Screenings Surveillance System • UTMB Texas Smoke-Free Ordinance Database • Dental Visits • HIV Testing • Policies related to secondhand smoke • Immunizations

Infectious Diseases Potential Indicators • Diseases by County • Rabies • HIV / AIDS • West Nile Virus • Whooping Cough • Mortality Possible Data Sources • DSHS Infectious Disease Control Unit • HIV/STD Program • Texas Health Data • Vital Statistics

Mental Health Potential Indicators Possible Data Sources • Mental Health & • DSHS Mental Health & Substance Abuse Services (Admissions) • State behavioral health infrastructure Substance Abuse Decisions Support • Texas Mental Health Transformation

Substance Abuse Potential Indicators • Cigarette Consumption • Smokeless Tobacco Consumption • Binge Drinking • Heavy Drinking • Drinking & Driving Possible Data Sources • Behavioral Risk Factor Surveillance System

Safety & Injury Potential Indicators • Crashes and injuries • Mortality • Unintentional injuries • Drownings • • • Seatbelt Use Drinking & Driving Falls Firearms Family Violence Hate Crime Report causes of injury by trauma service area Poisonings Adult Protective Services Fires Claims Possible Data Sources • Texas Department of • • • Transportation Vital Statistics Texas Health Data Behavioral Risk Factor Surveillance System Department of Public Safety DSHS Environmental Epi & Injury Surveillance Texas Poison Center Network Department of Family & Protective Services Texas Department of Insurance TDI Claims

Aging & Disability Potential Indicators Possible Data Sources • Aging Well Community • American Community Assessment Toolkit • Disabilities • Indicators by age Survey • Behavioral Risk Factor Surveillance System

Infant & Child Health Potential Indicators • Low birth weight infants • Immunizations • School Health • Birth Defects • Texas Children Tested for Lead • Drug Use • Alcohol Use • Tobacco Use • Mental Health & Substance Abuse Services (Admissions) • Child Protective Services Possible Data Sources Vital Statistics Texas Health Data DSHS Immunization Branch Texas Education Agency Fitness Assessment Data DSHS Birth Defects Epi & Surveillance • DSHS Childhood Lead Poisoning Prevention • DSHS Mental Health & Substance Abuse Decisions Support • Department of Family and Protective Services • • •

Maternal Health Potential Indicators • Births to mothers <= 17 Years • Reported pregnancies, births, fetal deaths, and abortions • Onset of prenatal care within first trimester • Educational status of unmarried mothers • Family planning Possible Data Sources • Vital Statistics • Behavioral Risk Factor Surveillance System

Workforce Potential Indicators Possible Data Sources • Public Health Workforce • DSHS Health Professions • Supply & Distribution of Resource Center • DSHS Center for Nursing Workforce Studies State-Licensed Health Professions • Health Professional Shortage Areas • Medically Underserved Areas/Populations • Nursing Workforce

Facilities Potential Indicators • State Mental Health Facilities • • • Quarterly Performance Indicators Hospital Uncompensated Care Hospital Beds & Utilization Hospital Revenue Types of Hospital Services Hospital Charity Care Community Benefits Nursing Homes Long Term Care Licensed Facilities Possible Data Sources • State Mental Health Facilities • DSHS Hospital Survey Unit • DADS – Long Term Care • DSHS – Licensing & Regulation • Care. Pathways

Transportation Potential Indicators Possible Data Sources • Fatal crashes • Fatality Analysis • Crashes and injuries • By county • By cities/towns Reporting System (FARS) • Texas Department of Transportation • Texas Health Data • Behavioral Risk Factor Surveillance System • Motor vehicle deaths • Drinking & driving • Bike paths • Sidewalks

How far can you drill down? • Region • County • Zip Codes • Census Tracts • *Varies on Data Source*

U. S. Census Vital Records Types of Outcome Data Count Distribution / Percent Geospatial Types of Outcome Data BRFSS Estimates Ratio Supply & Demand Survey Data Rate Projections Mortality Incidence Forecasts

Limitations of Different Data Sources • Counts • Costly • Rates • Reporting requirements • Estimates • Sample Size • Projections • Uncertainty

Population By County in Texas, 2010

Health Information Resources • http: //www. dshs. state. tx. us/chs/info/Health-Information- Resources/

BRFSS • http: //www. dshs. state. tx. us/chs/brfss/query/brfss_form. sht m • Smoking • Mental Health

Cancer Registry • http: //www. dshs. state. tx. us/tcr/data. shtm • Breast Cancer Incidence • Colon Cancer

Texas State Data Center • http: //txsdc. utsa. edu/Index. aspx • Texas Population, 2020 • Gatesville City Population, 2010

Texas Health Currents • http: //www. dshs. state. tx. us/chs/healthcurrents/ • Cameron County High School Graduate Rate

Texas Health Data • http: //soupfin. dshs. state. tx. us/ • Cancer Mortality • Low Birth Weight Births to Bell County Residents

American Factfinder • http: //factfinder 2. census. gov/ • Population 65 years and over in Harris County with vision difficulty • Percent of households in which no one can speak English “very well” in Aransas County • How old are the houses in Texas?

STRATEGIES What data is not readily available for my city, county, etc. ?

Aggregation • Merge Years • American Community Survey (ACS) data estimates • County residents ≥ 65, 000 • 1, 3 or 5 year intervals • Multi-year improves confidence intervals • BRFSS • Merge Areas • Public Use Microarea Data (PUMA) • Based on ACS data • Aggregates tracts to 100, 000 population • Public Use Data File for 5% sample

Oversampling BRFSS • More people surveyed • population ≥ 10, 000 (adults) • Disadvantages • Cost - $64/interview • Time before data actually available

Synthetic Estimate Modeling • CDC • Obesity & diabetes using BRFSS data • Utilized by DSHS programs • Limitation – assumes community & state are similar • Census • Small Area Income & Poverty Estimates (SAIPE) • school districts, counties, and states • 1 year updates of income & poverty • combine data from administrative records, intercensal population estimates, decennial census & ACS

Synthetic Estimates cont. • Census • Small Area Health Insurance Estimates (SAHIE) • States & small counties • County level • No coverage - all ages & under 19 years old categories • Insurance - age, sex, and income categories • State level • Insurance - age, sex, race, Hispanic origin and income categories

QUESTIONS?