Post on 26-Dec-2015
transcript
Learning to Speak Epi
• Understanding terms to understand what data represent
• Don’t need to be an expert
• Know basics so you know which data are appropriate for your use
Dispelling Data Myths
• All data by the same name is equal• Rates and numbers can be used
interchangeably• Age adjustment is just epi mumbo jumbo• Morbidity and Mortality are pretty much the
same thing• Birth rate and pregnancy rate are the same
thing• Small numbers can NEVER be used
Really, these things matter, we’re not just being picky!
Review of common terms
• Community Health Assessment– A process of gathering and discussing
information from multiple and diverse sources in order to develop a deep understanding of the health of a community.
– The process culminates when assessment results are used to improve the health status of the community.
Common Terms continued
• Rate
• Frequency
• Prevalence Rate
• Incidence Rate
• Numerator
• Denominator
Making data meaningful
Data in itself is really not so meaningful, it is the interpretation and putting it into
a context that makes it relevant and meaningful.
Population and Service Data
Population• Users• People• Population Based• Patients
Utilization• Encounters• Visits• Services
Same data, different analysis
• Data can be analyzed in a variety of ways
• Most commonly used– Age– Sex– Race– Ethnicity– By cause
A closer look at data we use all the time
• Population/ Demographic data from Census or Bureau of Business and Economic Research
• Birth and Death data (Vital records) from NM OVRHS
• Youth Risk and Resiliency Survey (YRRS) and Behavioral Risk Factor Surveillance System (BRFSS) from NM DOH, Office of Epidemiology
• Hospitalization In-patient Discharge Data (HIDD) from Health Policy Commission
Population and Demographic Data
• Most common source is Census or BBER• Population based data• Usually includes general characteristics of a
population– Total count of people– Age distribution– Sex distribution– Education– Employment– Income– Languages spoken– Household characteristics– Family characteristics
Birth and Death DataVital Records
• Includes data collected via birth and death certificates through the NM OVRHS
• There are standard ways of analyzing birth and death data
Birth Data
Standard analyses of birth data• Percent of live births with:
– Low birth weight– Prenatal Care Began in 1st Trimester– Age of mother– Education level of mother
• Fertility rate• Birth rate• Infant Mortality Rate
Death Data
Standard analyses of death data
• Infant Mortality Rate
• Cause specific death rates
• Age specific death rates
• Age adjusted death rates
• Leading Causes of Death
Survey DataBRFSS and YRRS
YRRS- • school based survey, • In schools that agreed to participate• sample includes high school students who were
present that day and class period
BRFSS- • telephone survey, • sample includes people over 18 years with a land
line phone
Youth Risk and Resiliency Survey
Vehicle Safety Among NM AI/AN Youth, YRRS 2001
8.4
37.6
16.2
6.7
33.4
13.3
0
10
20
30
40
50
60
70
80
90
100
Rarely or never wears aseatbelt
Rode with drinking driverin past 30 days
Drink and drive in past30 days
Per
cen
t
NM AI/AN 2001
NM Total 2001
BRFSSCounty Level Data
• Counties must have at least 75 respondents.-Even with 75 respondents, there are limitations.
• When a county does not have 75 respondents in one year, two or more years of data can be combined.-Not all questions are asked every year.
BRFSS and Confidence Intervals
Percentage of Adults whose General Health was Fair or Poor, Luna County, Health District 3, and New Mexico, 1998-2002
16.619.9
24.1
0
10
20
30
40
Luna County Health District 3 New Mexico
Perc
enta
ge
Confidence Intervals
Percentage of Adults whose General Health was Fair or Poor, Luna County, Health District 3, and New Mexico, 1998-2002
24.1
19.916.6
0
10
20
30
40
Luna County Health District 3 New Mexico
Perc
enta
ge
Hospitalization In-Patient Discharge Data (HIDD)
• Includes data from non-federal hospitals in NM
• People admitted and discharged from hospital
Death
Hospitalization
Ambulatory
Not in any system
Trends, Trends, Trends
• What is a trend?
• How to know when to use trends?
• Using your context to determine data presentation
Trends within a population
Figure 2-4 Crude Death Rates (per 100,000) for Leading Causes of Death Among AI/AN NM
Residents
0
20
40
60
80
100
120
90-92 91-93 92-94 93-95 94-96 95-97 96-98 97-99 98-00 99-01 00-02
Three year period
Rat
e pe
r 100
,000
Accidents
Malignantneoplasms
Diseases ofheart
Diabetesmellitus
Chronic liverdisease andcirrhosis
Trends between populations
Infant Mortality Rate for NM AI/AN and All Races 1994-2002
0
5
10
15
20
1994 1995 1996 1997 1998 1999 2000 2001 2002
IMR
(p
er 1
,000
Liv
e B
irth
s)
AI/AN
All Races
Small Numbers
Concerns of the Epidemiologists• Statistical Reliability• Confidentiality
Ways to Cope• Aggregate time periods• Aggregate populations• Lose some detail• Seek counsel with an Epidemiologist
Using Data to Tell Your Story
• Purpose of your story
• Know your audience
• Find a balance between tables, graphs, and text
• Save complex details for appendix
So, I know how to use it, where do I get it?
• Data you can access on your own
• Call a DOH Epidemiologist
Data you can access on your own
Here are a few websites with data:• http://wonder.cdc.gov CDC Wonder Query death data and links to many other data on the web• http://dohewbs2.health.state.nm.us/VitalRec/ New MICA An interactive query system of birth and death data• http://www.unm.edu/~bber/BBER Population and demographic data• http://www.health.state.nm.us NMDOH Reports and link to New MICA• http://www.nmihi.com NM DOH IHI Query based health indicators• http://factfinder.census.govU.S. Census Bureau Data tables containing Census data
Call a DOH Epidemiologist
DOH Epidemiologists
District 1,Tom Scharman, 505-897-5700
District 2, Vacant (call Corazon Halasan)
District 3,Lisa Roth-Edwards 505-528-5074
District 4,Sue Champagne 505-347-2409
Community Epidemiologist, Corazon Halasan, 505-476-3676
Tribal Epidemiologist, Dawn McCusker 505-476-3073
There are many other, topic specific epidemiologists at DOH that these people can refer you too if necessary
You are NOT Alone