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The Public Health Knowledge Base

The Public Health Knowledge Base. Using Public Health Data Ron Bialek Public Health Foundation. Preview. Essential Public Health Services - Does anybody really use these things? Healthy People 2010 - Our nation’s prevention agenda Data and Information - The friends of public health

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The Public Health Knowledge Base

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  1. The Public Health Knowledge Base Using Public Health Data Ron Bialek Public Health Foundation MLA CE 2001

  2. Preview • Essential Public Health Services - Does anybody really use these things? • Healthy People 2010 - Our nation’s prevention agenda • Data and Information - The friends of public health • Using Data - Getting from here to there MLA CE 2001

  3. 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 MLA CE 2001

  4. Essential Public Health Services • 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 MLA CE 2001

  5. Essential Public Health Services • Evaluate effectiveness, accessibility, and quality of personal and population-based health services • Research for new insights and innovative solutions to health problems MLA CE 2001

  6. Public HealthScenario substance abuse sexually transmitted diseases pre-natal care sexual assault cardiovascular disease clinical depression domestic violence nutrition environmental hazards suicide unintended injuries family planning post-partum depression infertility HIV/AIDS TB eating disorder breast cancer communicable diseases chronic diseases cervical cancer

  7. Quality Improvement National Health Objectives Performance Standards Workforce Competencies Expenditures Research Accountability Evidence Base

  8. National Healthy People Initiative • The nation’s prevention agenda • Set of measurable objectives to improve health of Americans • A health improvement framework that states may adopt or adapt MLA CE 2001

  9. State Plans are AllCustom Made “Taking the national Healthy People framework and customizing it for local needs is one of the hallmarks of this initiative.” — Dr. David Satcher Surgeon General June 24, 1998 MLA CE 2001

  10. Significance of Healthy People 2000 • 46 states created Healthy People plans or used objectives in plans • Data systems • Community involvement • Benchmarking • Monitoring & reporting progress • Funding MLA CE 2001

  11. 6/00 Status of State* Activities *Based on PHF contact with 50 states, D.C., 3 territories

  12. Opportunities for more comprehensive plans • States and territories that have or plan to have 2010 objectives in… • Many left out these objectives in their 2000 plans (see “Chartbook”)

  13. It’s like the lotto slogan... “You can’t win if you don’t play.” MLA CE 2001

  14. New Directions for 2010 • Sustain initiative beyond the plan • Share responsibility, define accountability • Capture and evaluate action • Market achievements MLA CE 2001

  15. A Framework to Bring Together ... Policy Science Data

  16. Health indicators Denominators Demographics Assets/Services Statistical methods Comparability “Best practices” Stories Focus groups Tools Technical reports Data and Information MLA CE 2001

  17. Who needs science anyway? • Science contributes to advances in public health practice • We need to know what and how things work • Make the right choice the first time • Science influences policymakers MLA CE 2001

  18. How do we get good science?…..good data certainly help! • Health, social, and infrastructure data from communities • Sound research methods • Descriptive research and “best practices” MLA CE 2001

  19. A Dime a Day on Public Health • That’s way too much money!! • Can you prove otherwise??? MLA CE 2001

  20. Connections with Healthy People 2010 • Determining effective interventions for attaining health objectives • Identifying and learning from “best practices” • Involving the practice community in population-based research MLA CE 2001

  21. New and improved opportunities for 2010 • 10 Leading Health Indicators • Opportunities to focus systems on cross-cutting issues, data needs • Business and community partners • Partnership for a Healthy Workforce • Healthy People Consortium • Commitment to eliminate disparities • Broader players and strategies MLA CE 2001

  22. Leading Health Indicators • Physical Activity • Overweight & Obesity • Tobacco Use • Substance Abuse • Responsible Sexual Behavior • Mental Health • Injury and Violence • Environmental Quality • Immunization • Access to Health Care MLA CE 2001

  23. Tracking Healthy People 2010 DATA2010 CHSI data sets Other State/Local Sources In Healthy People 2010 Conference Edit., Vol.II Online - HP 2010 site Online, print “Chartbook” on PHF web site, HP 2010 Assistance Healthy People Data MLA CE 2001

  24. Resource Web Sites • Healthy People 2010www.health.gov/healthypeople/ • Healthy People 2010 Toolkitwww.health.gov/healthypeople/state/toolkit • State Healthy People 2010 Tool Librarywww.phf.org/HPtools/state.htm • Healthy People 2010 Partnerswww.health.gov/healthypeople/partners MLA CE 2001

  25. Community Health Status Indicators (CHSI) Reports • www.communityhealth.hrsa.gov • 3,082 reports/counties • Source information • Peer counties MLA CE 2001

  26. CHSI...Profiles County Health • Population characteristics • Vulnerable populations • Overall health • Leading causes of death • Important measures of birth and death • Environmental health • Preventive services use • Risk factors • Access to care MLA CE 2001

  27. CHSI...Baseline for the Next Decade • 3, 5, or 10 Year period depending on size • Year 2000 standard for age-adjustment • Period: 1988-98 MLA CE 2001

  28. CHSI...Where do the Data Come From? • National Sources • Census • NCHS • CDC • HRSA • SAMHSA • EPA • State and Local Health Departments MLA CE 2001

  29. CHSI Enumerates Vulnerable Populations • <H.S. education • Unemployed • Severe work-disability • Major depression • Recent drug use • No health insurance • Medicare eligible (elderly and disabled) MLA CE 2001

  30. Selected objectives Birth measures Infant mortality Cause-specific mortality HP 2010 target US rate Peer range Icon Favorable Unfavorable CHSI Includes HP 2010 Goals and Objectives MLA CE 2001

  31. 88 Peer groupings Average of 34 peers Peers designated using: Frontier status Population size Poverty Age composition Density CHSI...Peer Communities MLA CE 2001

  32. Relative Health Importance

  33. Some Desirable Indicators Are Not Available • Children • Indicators of children’s preventive services use — such as immunizations, dental caries, and prevalence of lead screening — must be obtained locally. MLA CE 2001

  34. CHSI… Sparks a Conversation • Discussing with Health Official • Helping to engage leaders and other members of the community • Creating a forum with the media • Providing support and resources for filling data gaps MLA CE 2001

  35. CHSI Helps Engage Several Audiences • Policy makers • Program managers and planners • Assessment and evaluation staff • Advocates and consumers • Other partners MLA CE 2001

  36. CHSI... Who’s Using It? • Local Boards of Health • Community Hospitals • U.S. Environmental Protection Agency • Anthem Alliance Health Insurance Company • Universities • General Accounting Office MLA CE 2001

  37. “Best Practices” • “Best judgment” has served us well • “Best practices” will serve us better • Rigor can be applied to determination of “best practice” • There is an immediate need to identify and communicate successful strategies MLA CE 2001

  38. The Catch You have to know the practice before you can know the best practice MLA CE 2001

  39. Determining “Best Practice” • Establish criteria • Search literature, the Internet, and query experts • Apply criteria to identify “best practices” • Analyze and synthesize information • Disseminate findings MLA CE 2001

  40. Health Improvement Progress -- Breast Cancer, 1993-97

  41. Building the Foundation: Leadership and Structure Identifying and Securing Resources Identifying and Engaging Community Partners Setting Health Priorities and Establishing Objectives Obtaining Baseline Measures, Setting Targets, and Measuring Progress Managing and Sustaining the Process Communicating Health Goals and Objectives Toolkit - 7 Action Areas MLA CE 2001

  42. Each Action Area Includes... • a brief explanation & rationale • a checklist of major activities • tips for success • national and state examples • recommended “hot picks" of resources • planning tools - easy to adapt MLA CE 2001

  43. EXAMPLES: Setting Targets... Target Setting Algorithm and Worksheets (DE) Missouri Resource Guide for Community Assessment “Tools of the Trade” data guides (PA) State Healthy People 2010 Tool Library EXAMPLES:Setting Health Priorities... • Priority Setting Options handout and presentation (DE) • Process Guidance (MD) • Facilitator “Survival Kit” and Meeting Ground Rules (IA) MLA CE 2001

  44. Mass Communication Campaign for STD Prevention Key Words - “sexually transmitted diseases” and “media”

  45. PIAPHP Home Healthy People 2010 Information Access Project ….an easy way to search PubMed to find effective strategies. • Partners in Information Access for Public Health Professionals • National Library of Medicine, National Network of Libraries of Medicine, and Public Health Foundation

  46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=PureSearch&db=PubMed&details_term=%28%28%28%28%28%28%28%22united%20states%22%5BMeSH%20Terms%5D%20AND%20%28%28%28%28%28%28%28%22education%2C%20medical%22%5BMeSH%20Major%20Topic%5D%20OR%20%22education%2C%20dental%22%5BMeSH%20Major%20Topic%5D%29%20OR%20%22education%2C%20nursing%22%5BMeSH%20Major%20Topic%5D%29%20OR%20%22education%2C%20pharmacy%22%5BMeSH%20Major%20Topic%5D%29%20OR%20%22students%2C%20health%20occupations%22%5BMeSH%20Major%20Topic%5D%29%20OR%20%22schools%2C%20public%20health%22%5BMeSH%20Major%20Topic%5D%29%20OR%20allied%20health%20personnel/education%5BMeSH%20Major%20Topic%5D%29%20OR%20physician%20assistants/education%5BMeSH%20Major%20Topic%5D%29%29%20AND%20%28%28%28%22minority%20groups%22%5BMeSH%20Major%20Topic%5D%20OR%20%22hispanic%20americans%22%5BMeSH%20Major%20Topic%5D%29%20OR%20%22blacks%22%5BMeSH%20Major%20Topic%5D%29%20OR%20%22indians%2C%20north%20american%22%5BMeSH%20Major%20Topic%5D%29%29%20AND%20%28%28%28%28%28%28%28%28%28%28%28%28%22education%22%5BMeSH%20Terms%5D%20OR%20%22curriculum%22%5BMeSH%20Terms%5D%29%20OR%20%22student%20dropouts%22%5BMeSH%20Terms%5D%29%20OR%20%22educational%20measurement%22%5BMeSH%20Terms%5D%29%20OR%20%22career%20choice%22%5BMeSH%20Terms%5D%29%20OR%20%22training%20support%22%5BMeSH%20Terms%5D%29%20OR%20%22school%20admission%20criteria%22%5BMeSH%20Terms%5D%29%20OR%20%22cultural%20diversity%22%5BMeSH%20Terms%5D%29%20OR%20%22mentors%22%5BMeSH%20Terms%5D%29%20OR%20%28affirmative%5BAll%20Fields%5D%20AND%20action%5BAll%20Fields%5D%29%29%20OR%20%22prejudice%22%5BMeSH%20Terms%5D%29%20OR%20recruitment%5BAll%20Fields%5D%29%20OR%20%22staff%20development%22%5BMeSH%20Terms%5D%29%29%20NOT%20%22patient%20education%22%5BMeSH%20Terms%5D%29%20NOT%20%22transcultural%20nursing%22%5BMeSH%20Terms%5D%29%20AND%20English%5BLang%5D%29%20AND%20%28%221996/03/24%2014.29%22%5BEDat%5D%20%3A%20%222001/03/23%2014.29%22%5BEDat%5D%29%29http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=PureSearch&db=PubMed&details_term=%28%28%28%28%28%28%28%22united%20states%22%5BMeSH%20Terms%5D%20AND%20%28%28%28%28%28%28%28%22education%2C%20medical%22%5BMeSH%20Major%20Topic%5D%20OR%20%22education%2C%20dental%22%5BMeSH%20Major%20Topic%5D%29%20OR%20%22education%2C%20nursing%22%5BMeSH%20Major%20Topic%5D%29%20OR%20%22education%2C%20pharmacy%22%5BMeSH%20Major%20Topic%5D%29%20OR%20%22students%2C%20health%20occupations%22%5BMeSH%20Major%20Topic%5D%29%20OR%20%22schools%2C%20public%20health%22%5BMeSH%20Major%20Topic%5D%29%20OR%20allied%20health%20personnel/education%5BMeSH%20Major%20Topic%5D%29%20OR%20physician%20assistants/education%5BMeSH%20Major%20Topic%5D%29%29%20AND%20%28%28%28%22minority%20groups%22%5BMeSH%20Major%20Topic%5D%20OR%20%22hispanic%20americans%22%5BMeSH%20Major%20Topic%5D%29%20OR%20%22blacks%22%5BMeSH%20Major%20Topic%5D%29%20OR%20%22indians%2C%20north%20american%22%5BMeSH%20Major%20Topic%5D%29%29%20AND%20%28%28%28%28%28%28%28%28%28%28%28%28%22education%22%5BMeSH%20Terms%5D%20OR%20%22curriculum%22%5BMeSH%20Terms%5D%29%20OR%20%22student%20dropouts%22%5BMeSH%20Terms%5D%29%20OR%20%22educational%20measurement%22%5BMeSH%20Terms%5D%29%20OR%20%22career%20choice%22%5BMeSH%20Terms%5D%29%20OR%20%22training%20support%22%5BMeSH%20Terms%5D%29%20OR%20%22school%20admission%20criteria%22%5BMeSH%20Terms%5D%29%20OR%20%22cultural%20diversity%22%5BMeSH%20Terms%5D%29%20OR%20%22mentors%22%5BMeSH%20Terms%5D%29%20OR%20%28affirmative%5BAll%20Fields%5D%20AND%20action%5BAll%20Fields%5D%29%29%20OR%20%22prejudice%22%5BMeSH%20Terms%5D%29%20OR%20recruitment%5BAll%20Fields%5D%29%20OR%20%22staff%20development%22%5BMeSH%20Terms%5D%29%29%20NOT%20%22patient%20education%22%5BMeSH%20Terms%5D%29%20NOT%20%22transcultural%20nursing%22%5BMeSH%20Terms%5D%29%20AND%20English%5BLang%5D%29%20AND%20%28%221996/03/24%2014.29%22%5BEDat%5D%20%3A%20%222001/03/23%2014.29%22%5BEDat%5D%29%29

  47. Search PubMed

  48. Access to Health Services Mary E. Ryan Food Safety Marcia Zorn Mary E. Ryan PH Infrastructure Mary E. Ryan Disability/Secondary Conditions Ron Gordner Respiratory Diseases Anne Maria Baxter Environmental Health Stacey Arnesen Lucie Chen Deena Pers Six Focus Areas/Chapters MLA CE 2001

  49. MLA CE 2001

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