community-level data on social determinants and health ...stakeholder strategy for health equity and...

Community-level Data on Social Determinants and Health Outcomes

The material that accompanies this working document was produced through a data inventory undertakenby Community Science, Inc., for the National Partnership for Action to End Health Disparities (NPA) led bythe Office of Minority Health in the Office of the Assistant Secretary for Health (OMH/OASH). The goals ofthe inventory were to: 1) assess and document the community-level data (i.e., data that can bedisaggregated by city, county, neighborhood, or zip code) available from state agencies and organizationson social determinants and health outcomes; and 2) share this information with NPA community partners(e.g., Regional Health Equity Councils [RHECs]) to make it easier for them to know what data are availableand how to access the data.

The inventory primarily focuses on state sources because:

Data for the current year from national sources (e.g., U.S. Census Bureau) are generally notavailable until several years later;

Data from state sources are likely to be available sooner and are frequently available for measuresthat are not usually included in national data sources;

An inventory of state sources is a more manageable task than an inventory of data from the largenumber of counties, cities, and other local jurisdiction that may also collect and store data.

The inventory started with the social determinants of health and health outcomes included in the NationalStakeholder Strategy for Health Equity and in the Centers for Disease Control and Prevention’s (CDC) HealthDisparities and Inequalities Report.1 Community Science and OMH/OASH discussed and prioritized the listof social determinants of health and health outcomes to be included in the inventory (see list at the end ofthis narrative). For each measure, information was sought about the smallest geographic unit and mostrecent year for which data were available and whether or not the data can be disaggregated by race,ethnicity, gender, age, disability status, primary language, and sexual orientation and gender identity.

Community Science attempted to locate the data through contacts with State government staff andthrough searching the World Wide Web. Community Science recognizes that the search may not besufficiently thorough to surface data that were not easily available, and welcomes information aboutadditional state sources that should be included in the accompanying materials. For questions or to shareinformation about additional state sources, please contact Abigail Baum, Community Science, 301-519-0722, ext. 121 or [email protected]. Community Science is also working with OMH/OASHto determine other critical social determinants of health and health outcome measures that should beexplored.

While the inventory focused on state sources, it would be helpful for NPA partners to also have informationabout certain key national sources; the accompanying material includes this information.

1 CDC Morbidity and Mortality Weekly Report, Supplement, Vol. 60, January 14, 2011

List of Measures Sought

Social Determinants of Health

EducationEducational Attainment

High school graduation ratesHigh school dropout ratesHighest level of education that an individual has completed# of diploma recipients, # of other high school completersHigh school equivalency recipientsAveraged freshman graduation rates% of persons aged 16-19 years not enrolled, not high school graduatesPost-secondary education enrollment/plans

JobsLabor Market Turnover

Unemployment ratesUnderemployment ratesLabor force participation rates

Access to Health CareScreening Rates

% of early periodic screenings (Early Periodic Screening, Diagnosis and Treatment (EPSDT) as defined inthe Medicaid program)

% of people reporting receiving colorectal cancer screeningsImmunizations Rates

% of people reporting influenza vaccination coverage% of children aged 19-35 months completely immunized

Distribution of Health Care ProvidersTotal number of nonfederal MD/DOs in primary careTotal number of nonfederal MD/DOs in family practiceTotal number of nonfederal MD/DOs in general practiceTotal number of nonfederal MD/DOs in internal medicineTotal number of nonfederal MD/DOs in OB/GYNTotal number of nonfederal MD/DOs in pediatric primary care practiceTotal # of oral health care providersTotal # of mental/ behavioral health care providersProvider-to-population ratios - mental/behavioral health care servicesMeasures of availability of services for older adults

Interpreter Training/Certification% of interpreters certified by training entities that comply with the codes of ethics and standards for

training and practiceRace/Ethnicity of Provider Staff-to-Population Ratios

Race/ethnicity staff-to-population ratios for primary careRace/ethnicity staff-to-population ratios for family practiceRace/ethnicity staff-to-population ratios for general practiceRace/ethnicity staff-to-population ratios for pediatric practiceRace/ethnicity staff-to-population ratios for internal medicineRace/ethnicity staff-to-population ratios for OB/GYNRace/ethnicity staff-to-population ratios for medical and surgical subspecialties

Health Outcomes

Mortality and DiseaseInfant/Maternal mortalityCardiovascular diseaseCancerHIV/AIDSDiabetesChronic lower-respiratory diseaseKidney diseaseArthritis

ViolenceFor violence and trauma look for homicide and suicide rates

Homicide ratesSuicide rates

Behavioral healthBinge drinkingCigarette smokingIllegal drug useSexual behavior (note that these categories were taken from the Youth Risk Behavior Surveillance SystemSurvey though we are interested in other data sources on these for different age groups if available)

Condom useAny contraceptive useForced sexual intercourse

Other measures available

Oral HealthAdults over age 18 who have visited a dentist or dental clinic in the past yearPercent of students with untreated tooth decayAdults over age 65 who have lost 6 or more teethObesity

REGION 7

Iowa

This is a list of measures for which community-level data are available from state sources. Such data were not available for the remaining measures from the initial list of 52measures included at the beginning of the packet. If you are aware of additional state sources for these measures as well as the other measures for which data were not found,please contact Abigail Baum at [email protected] or 301-519-0722, ext. 121.

MeasureFrequency of

reporting

Most recentdata collected

(as ofDecember

2011)

Smallestgeographic unit

at which data areavailable

Are data broken down by…

Website link or information on how toaccess dataGender? Race?

Hispanicorigin?

Ruralvs.

urban?Age?


Provider-to-population ratios-mental/behavioral health careservices

Appears to be aone-time report

2006Mental Health

Catchment Areahttp://www.idph.state.ia.us/hpcdp/common/pdf/workforce/mentalhealth_0306.pdf

Average freshman graduationrate

Collected every year 2010 School X X Xhttp://educateiowa.gov/index.php?option=com_docman&task=cat_view&gid=132&Itemid=1563

High school dropout rates Collected every year 2010 School Districthttp://educateiowa.gov/index.php?option=com_docman&task=cat_view&gid=132&Itemid=1563

Percentage of children aged19-35 months completelyimmunized

Collected every year 2010 Countyhttp://www.idph.state.ia.us/ImmTB/Immunization.aspx?prog=Imm&pg=ImmHome

Percentage of early periodicscreenings

Collected every year 2010

By Center forMedicaid/Medicare

Services (CMS)Agency; also

available at countylevel

Xhttp://www.idph.state.ia.us/hpcdp/epsdt_providers.asp

Percentage of people reportingreceiving colorectal cancerscreenings

Collected every 2years

2010

Mostly state,although there are

data for 5metropolitan areas,including 2 counties

X http://www.idph.state.ia.us/brfss/

Post secondary educationenrollment plans

Collected every year 2010 School Districthttp://educateiowa.gov/index.php?option=com_docman&task=cat_view&gid=132&Itemid=1563

Employment/unemploymentrates

Collected monthly 2011 Cityhttp://www.iowaworkforce.org/lmi/laborforce/locallaborforce.html

Iowa

MeasureFrequency of

reporting


(as ofDecember

2011)





Hispanicorigin?

Ruralvs.

urban?Age?

Health Outcomes

Infant/Maternal mortality-rateper 1,000

Collected every year 2009 Countyhttp://www.idph.state.ia.us/apl/vital_stats.asp

Suicide-rate per 100,000 Collected every year 2009 County Xhttp://www.idph.state.ia.us/apl/vital_stats.asp

Kansas


MeasureFrequency of

reporting


(as ofDecember

2011)





Hispanicorigin?

Ruralvs.

urban?Age?


High school dropout rates Collected every year 2009 School X X http://svapp15586.ksde.org/k12/k12.aspx

High school graduation rates Collected every year 2009 School X X http://svapp15586.ksde.org/k12/k12.aspx

Highest level of education thatan individual has completed

2009 Countyhttp://www.ipsr.ku.edu/ksdata/ksah/education/6ed15.pdf


Collected every year 2010 School X X http://svapp15586.ksde.org/k12/k12.aspx


2011 City

https://klic.dol.ks.gov/analyzer/searchAnalyzer.asp?cat=HST_EMP_WAGE_LAB_FORCE&session=LABFORCE&subsession=99&time=&geo=&currsubsessavail=&incsource=&blnStart=True

Missouri


MeasureFrequency of

reporting


(as ofDecember

2011)





Hispanicorigin?

Ruralvs.

urban?Age?



Collected monthly 2011 Cityhttp://www.missourieconomy.org/indicators/LAUS/

High school dropout rates Collected every year 2011 School X Xhttp://mcds.dese.mo.gov/Pages/default.aspx

High school graduation rates Collected every year 2011 School X X Xhttp://mcds.dese.mo.gov/Pages/default.aspx

Post-secondary educationenrollment plans

Collected every year 2011 Schoolhttp://mcds.dese.mo.gov/Pages/default.aspx

Missouri

MeasureFrequency of

reporting


(as ofDecember

2011)





Hispanicorigin?

Ruralvs.

urban?Age?

Health Outcomes

Cancer-incidence-age adjustedrate per 10,000

Collected every year 2008 County http://health.mo.gov/data/index.php

Cancer-mortality-age adjustedper 100,000


Cardiovascular disease-incidence-age adjusted rateper 1,000


Cardiovascular disease-incidence-age adjusted rateper 10,000


Cardiovascular disease-mortality-age adjusted rate per100,000


Arthritis-incidence Collected every year 2009 Zip code X X X Xhttp://health.mo.gov/data/mica/ChronicDiseaseMICAs/

Binge drinking Collected every year 2009 Zip code X X X Xhttp://health.mo.gov/data/mica/ChronicDiseaseMICAs/

Cancer-incidence Collected every year 2009 Zip code X X X Xhttp://health.mo.gov/data/mica/ChronicDiseaseMICAs/

Cardiovascular disease-incidence

Collected every year 2009 Zip code X X X Xhttp://health.mo.gov/data/mica/ChronicDiseaseMICAs/

Chronic lower respiratorydisease-incidence

Collected every year 2009 Zip code X X X Xhttp://health.mo.gov/data/mica/ChronicDiseaseMICAs/

Missouri

MeasureFrequency of

reporting


(as ofDecember

2011)





Hispanicorigin?

Ruralvs.

urban?Age?

Health Outcomes

HIV/AIDS-incidence Collected every year 2010

Geographic Area(select cities andstate correctionalfacilities) or by HIV

Region

X X X X http://health.mo.gov/data/index.php

Adults over age 18 who havevisited a dentist or dental clinicin the past year

Collected every year 2010

"Region": Central,Kansas City,Northeast,Northwest,Southeast,

Southwest, St.Louis

http://health.mo.gov/data/index.php

Illegal drug use Collected every year 2011 County X Xhttp://health.mo.gov/data/CommunityDataProfiles/

Nebraska


MeasureFrequency of

reporting


(as ofDecember

2011)

Smallestgeographic unitat which dataare available



Hispanicorigin?

Ruralvs.

urban?Age?



Collected every year 2010 School District No No No No Nohttp://reportcard.education.ne.gov/20092010/School/SchoolSearch.aspx?optSearch=5&DistrictID=&CountyID=


Collected every year 2010 School District Yes Yes Yes No No

http://drs.education.ne.gov/quickfacts/Pages/StudentCharacteristics.aspx?RootFolder=%2Fquickfacts%2FEnrollment%2FGraduates%2FDistrict%20Level&FolderCTID=0x0120003F66FF8A5E32704F9BC601C48640C20D0049ABC97EFF1F6A46B84A970FDCE3BB7D&View={A429BC91-3FFC-47E1-B6

Number of diplomarecipients/number of otherhigh school completers

Collected every year 2010 School Yes Yes Yes No No

http://drs.education.ne.gov/quickfacts/Pages/StudentCharacteristics.aspx?RootFolder=%2Fquickfacts%2FEnrollment%2FGraduates%2FDistrict%20Level&FolderCTID=0x0120003F66FF8A5E32704F9BC601C48640C20D0049ABC97EFF1F6A46B84A970FDCE3BB7D&View={A429BC91-3FFC-47E1-B6

Percentage of peoplereporting influenzavaccination coverage

Collected every year 2010 Health District Yes No No No Yes http://public-dhhs.ne.gov/brfss/

Percentage of peoplereporting receiving colorectalcancer screenings


Total number of oral healthcare providers

Missing/unable todetermine

2010 Health DistrictUnable todetermine

Unableto deter-

mine

Unable todetermine

YesUnable

to deter-mine

http://dhhs.ne.gov/publichealth/Pages/dental_reports_index.aspx


Collected monthly 2011 City No No No No Nohttp://neworks.nebraska.gov/analyzer/default.asp

Nebraska

MeasureFrequency of

reporting


(as ofDecember

2011)





Hispanicorigin?

Ruralvs.

urban?Age?

Health Outcomes

Adults over age 18 who havevisited a dentist or dental clinicin the past year


Adults over age 65 who havelost 6 or more teeth


Binge drinking Collected every year 2010 Health District Yes No No No Yes http://public-dhhs.ne.gov/brfss/

Cardiovascular disease-prevalence-percent


Cigarette smoking Collected every year 2010 Health District Yes No No No Yes http://public-dhhs.ne.gov/brfss/

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