Using and Interpreting Data

Community Health Assessment Unit

Office of Epidemiology

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