shaping a health statistics vision for the 21 st century 2002 nchs data users conference 16 july...

Shaping a Health Statistics Vision for the 21st Century

2002 NCHS Data Users Conference16 July 2002

Daniel J. Friedman, PhDMassachusetts Department of Public Health

National Committee on Vital and Health Statistics

Partners, process, and products

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Vision partners

DHHS Data Council National Center for Health

Statistics National Committee on Vital and

Health Statistics

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Joint NCVHS, NCHS, and DHHS Data Council process for developing the 21st century for health statistics

WHO Collaborating Centres for the Classification of

Diseases

NAPHSISAnnual Meeting

DHHS Data

Council

AMCHPAnnual Meeting

CDC Executive Leadership

Launching Healthy People

2010

NCVHS 50TH

Anniversary Symposium

CDC Assessment Initiative Annual

Meeting

National Conference On

Health Statistics

Association for Health Services

Research

Commissioned Papers

Local Discussion Groups,1999-2000

National Academy of Sciences

Workshop, 1999

Workshop Summary,

2001

Regional Public Hearings,2000-2001

Solicitation of Recommendations from

Vision Process Participants

2001

Expert Discussion Groups, 1999

NCVHS Recommendations for Implementing the

vision2002

Shaping a vision for 21st century health statistics, June 2000 interim report

A Health Statistics Vision for the 21st Century, final

report 2002 

Participant Input 

Reports & Papers 

Presentations

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Vision components

Definitions of health statistics, uses of health statistics, and health statistics enterprise

Overarching conceptual frameworks Model of influences on the population’s health Health statistics cycle

Application of overarching conceptual frameworks to describe issues and gaps in U.S. health statistics

Mission of health statistics enterprise Guiding principles for health statistics enterprise Relationship of health statistics enterprise to National

Health Information Infrastructure NCVHS recommendations

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Definitions and uses

Defining health statistics Uses of health statistics Defining health statistics

enterprise

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Defining health statistics

. . . Numerical data that characterize the health of a population and the influences and actions that affect the health of a population.

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Uses of health statistics

1. Creating fundamental knowledge about the health of populations and sub-populations, influences on health, and interactions among those influences

2. Developing information to guide health policy development, assessment, and evaluation

3. Generating information to guide implementation, targeting, evaluation, and refinement of health programs and other interventions for populations and personal health decisions

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Defining health statistics enterprise

. . . infrastructure and the activities necessary to produce health statistics.

Public and private organizations and individuals at all geopolitical levels that perform the processes of health statistics

Highly decentralized Includes organizations that collect, analyze,

and disseminate data on the health of populations and the factors that influence health

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Defining health statistics enterprise

Focuses on the health of the population and subpopulations

Serves the public interest and generates products that are public goods

Engages in systematic and organized inquiry Strives for scientific integrity Involves multiple disciplines Links U.S. health statistics activities to those of

international partners

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Overarching conceptual frameworks

Influences on the population’s health Issues Gaps

Health statistics cycle Issues

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Influences on the population's health

Place & Time

Cultural Context

Context

Built Environment

Political Context

Natural Environment

The Population’s Health Level Distribution

DiseaseFunctional statusWell-being

Health Services

Biological Characteristics Social

Economic

Population-based Health Programs

Community Attributes

Collective Lifestyles and Health Practices

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Using the model to describe issues

Broad definition of health Population health and its determinants Data availability across geopolitical levels Quality and quantity of data on subpopulations Longitudinal and life cycle data Data use, not just data availability

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Using the model to describe gaps Context—cultural and political Community attributes

Social cohesion, influence, networks, support, and change Economic attributes Relationship between “structure, processes, and access”

and “population health” Relationship between “population-based health

programs” and “population health” Built environment

Population’s health Disease incidence and prevalence Functional status Well-being

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Health Statistics Cycle

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Using the cycle to describe issues

Insufficient connections between users and producers of data

Lack of geographic, race/ethnic, and other detail Lack of timeliness in making data available Existing data difficult to find and use Lack of resources jeopardizes major data sources Enterprise-wide coordination and integration

lacking

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Vision for health statistics enterprise

Mission Ten guiding principles Role of National Health Information

Infrastructure

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Vision for U.S. health statistics enterprise: mission

…efficiently provide timely, accurate, and relevant information that can be used to improve the nation’s health, including information about status of the population’s health, information to formulate and evaluate the effects of health policy, and information to manage health interventions and programs.

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Vision for health statistics enterprise: overarching conceptual framework

…helps to maintain a focus on needed data and that guides the health statistics enterprise. Focuses on health, the population, and the

community Emphasizes distribution and level of health Delineates major influences on health Defines research agenda for improving the

population’s health

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Vision for health statistics enterprise: ten guiding principles

1. Enterprise-wide planning and coordination2. Broad collaboration among data users,

producers, and suppliers at local, state, and national levels

3. Rigorous policies and procedures for protecting privacy, confidentiality, and security

4. Flexibility to identify and address emergent health issues and needs

5. Use of data standards

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Vision for health statistics enterprise: ten guiding principles

6. Sufficient detail at different levels of aggregation

7. Integrated, streamlined data collection for multiple purposes

8. Timely production of valid and reliable health statistics

9. Appropriate access to and ease of use of health statistics

10. Continuous evaluation of the completeness, accuracy, and timeliness of health statistics and the ability of the health statistics enterprise to support their production

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Vision for health statistics enterprise: National Health Information Infrastructure

21st century health statistics enterprise must be viewed within context of the NHII

Data standards should mirror NHII NHII provides conceptual framework and

ultimately tools to transform vision into reality

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Vision for health statistics enterprise: National Health Information Infrastructure

The heart of the vision for the NHII is sharing information and knowledge appropriately so it is available to people when they need it to make the best possible health decisions.

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Vision for health statistics enterprise: National Health Information

Infrastructure

• The set of technologies, standards, applications, systems, values, and laws that support all facets of individual health, health care, and public health

• NOT (NOT!) a centralized database• Connects distributed health information

in the framework of a secure network with strict confidentiality protections

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NCVHS recommendations

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NCVHS recommendations Recommendations for achieving the ten guiding principles

(30) Recommendations for moving toward the adoption of the

overarching conceptual framework (6) Recommendations pertain to

Data access and use (3) Data set development (11) Data standards (4) Enterprise structure (3) Evaluation (2) Policy (4) Research agenda (6) Training (2)

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NCVHS recommendations

Priority recommendations for building and integrating the “hub” of the health statistics enterprise

Priority recommendations #1: Reconstituted NCHS #2: national Health Statistics Planning Board #3: state Health Statistics Planning Boards #4: Graduate, in-service, and continuing education

in all elements of the health statistics cycle

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Vision for health statistics enterprise: next steps

Disseminate Vision Develop health statistics enterprise-wide

planning process Hold planning and implementation hearings

and meetings

ContactsDan Friedman 617.624.5613 dan.friedman@state.ma.us

Ed Hunter 301.458.4100ehunter@cdc.gov

Gib Parrish 802.865.1310rparrish@cdc.gov

21st century vision for health statistics URL:http://www.ncvhs.hhs.gov/hsvision/

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