using & interpreting data in planning for healthy communities...17.2 15.2 12.1 13.7 12.6 23.2...
TRANSCRIPT
Using & Interpreting Data in Planning for Healthy Communities
Trav Ichinose, M.S., M.A.Orange County Health Care Agency
Public Health Services Health Promotion Division
Leading Causes of DeathOrange County, 2006-2008
Heart Disease27.5%
Cancer24.5%
Stroke6.5%
Lung Disease (CLRD)5.3%
Diabetes2.6%
Alzheimer's Disease4.7%
Unintentional Injury3.9%
Influenza & Pneumonia3.3%
Cirrhosis1.7%
Suicide1.6%
Hypertension1.4%
Nephritis, Nephrotic Syndrome1.1%
Parkinson's Disease1.0%
Atherosclerosis0.7%
Perinatal Conditions0.6%
Congenital Malformations
0.6%
Aortic Aneurysm
0.6%
Homicide0.5%
AIDS0.3%
OTHER11.8%
Many Factors Influence Health
Policies & Programs
Health Factors
Health OutcomesMortality (length of life - 50%)
Morbidity (quality of life - 50%)
Health Behaviors
(30%)
Clinical Care(20%)
Social & Economic
Factors(40%)
Physical Environment
(10%)
Tobacco UseDiet & Exercise
Alcohol UseSexual Behavior
Access to CareQuality of Care
EducationEmployment
IncomeFamily & Social Support
Community Safety
Environmental QualityBuilt Environment
SOURCE: County Health Rankings Model ©2012 UWPHI
13.6
910.8
17.215.2
12.113.7
12.6
23.2
20.6
17.3
21.219.6
0
5
10
15
20
25
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
*20
12*Sm
okin
g pr
eval
ence
, adu
lts (%
)
OC
CA
US
Qualitative AND QuantitativeQualitative vs. Quantitative
What makes a good quantitative indicator?
1. Important2. Understandable3. Measurable4. Valid5. Data available
6. Reliable7. Demographic detail8. Geographic detail9. Actionable10. Asset orientation
*Derived from Prevention Institute Tool for Health and Resilience in Vulnerable Environments (THRIVE).
“HEALTHY COMMUNITIES” DATA SOURCES
Critically Consuming “Healthy Communities” Indicators
• Many indicators new, newly shared, or newly purposed
• Data sources emerging, improving• Availability & standardization vary• No data are perfect…
Caveats
• Today’s discussion not comprehensive• Local jurisdictions often have the best
data• One data size does not fit all
Social and Economic Factors
Many Factors Influence Health
Policies & Programs
Health Factors
Health OutcomesMortality (length of life - 50%)
Morbidity (quality of life - 50%)
Health Behaviors
(30%)
Clinical Care(20%)
Social & Economic
Factors(40%)
Physical Environment
(10%)
Tobacco UseDiet & Exercise
Alcohol UseSexual Behavior
Access to CareQuality of Care
EducationEmployment
IncomeFamily & Social Support
Community Safety
Environmental QualityBuilt Environment
SOURCE: County Health Rankings Model ©2012 UWPHI
Social and Economic FactorsKey Data Indicators
• CDC’s Data Set Directory of Social Determinants of Health at the Local Level– http://www.cdc.gov/dhdsp/
docs/data_set_directory.pdf
Social and Economic FactorsIncome and Poverty
• Key indicator examples– Income
• Median household, per capita income
– Poverty • 100% FPL, ratio of income to poverty
– Income distribution• Gini index of income inequality
• Key data resource– US Census Bureau, American Community Survey:
• http://factfinder2.census.gov
Social and Economic FactorsEducation
• Key education indicator examples– Educational attainment
• % adults 25+ with high school diploma or equivalent– Early education
• % children 3-4 years enrolled in preschool– High school graduation
• % of 9th graders graduating in 4 years• Key education data resources
– State of California Department of Education:• http://www.cde.ca.gov/ds/
– US Census Bureau, American Community Survey:• http://factfinder2.census.gov
Social and Economic FactorsHousing
• Key indicator examples– Cost, affordability
• % of renters spending 30%+ of income on housing
– Crowding• % of households with >1 occupant per room
• Key housing data resource– US Census Bureau, American Community
Survey:• http://factfinder2.census.gov
HEALTH BEHAVIORS
Many Factors Influence Health
Policies & Programs
Health Factors
Health OutcomesMortality (length of life - 50%)
Morbidity (quality of life - 50%)
Health Behaviors
(30%)
Clinical Care(20%)
Social & Economic
Factors(40%)
Physical Environment
(10%)
Tobacco UseDiet & Exercise
Alcohol UseSexual Behavior
Access to CareQuality of Care
EducationEmployment
IncomeFamily & Social Support
Community Safety
Environmental QualityBuilt Environment
SOURCE: County Health Rankings Model ©2012 UWPHI
Leading Preventable Causes of Death
0
50
100
150
200
250
300
350
400
450
500
Toba
cco
Die
t/phy
sica
l act
ivity
Alc
ohol
Mic
robi
al a
gent
s
Toxi
c ag
ents
Mot
or v
ehic
le
Fire
arm
s
Sex
ual b
ehav
ior
Illic
it dr
ug u
se
Ann
ual D
eath
s (in
100
K)
Actual Causes of Death in the United States, 2000
Leading Preventable Causes of Death
0
50
100
150
200
250
300
350
400
450
500
Toba
cco
Die
t/phy
sica
l act
ivity
Alc
ohol
Mic
robi
al a
gent
s
Toxi
c ag
ents
Mot
or v
ehic
le
Fire
arm
s
Sex
ual b
ehav
ior
Illic
it dr
ug u
se
Ann
ual D
eath
s (in
100
K)
Actual Causes of Death in the United States, 2000
Tobacco Use DataKey Indicator Resources
• Healthy People 2020, Tobacco Use– www.healthypeople.gov/
2020/
Tobacco Use DataKey Indicator Resources
• CDC’s Key Outcome Indicators for Evaluating Comprehensive Tobacco Control Programs– www.cdc.gov/tobacco/tob
acco_control_programs/surveillance_evaluation/key_outcome/index.htm
Tobacco UseKey indicators and data sources
• Key indicator examples– Past 30 day tobacco use (%)– Lifetime tobacco use (%)
• Key data sources– C-STATS
• http://www.cstats.info/– California Health Interview Survey
• http://ask.chis.ucla.edu/– California Healthy Kids Survey
• http://chks.wested.org/
Tobacco UseBuilt Environment Issues
• Community access– Concentration of tobacco licenses around schools
• % of tobacco retailers within a ¼ mile of schools
• Key data resource– California State Board of Equalization Cigarette
and Tobacco Products Licensing • http://www.boe.ca.gov/sptaxprog/cig_n_tob_prod_lic.
htm
Obesity DataKey indicator resources
• Healthy People 2020, Nutrition and Weight Status; Physical Activity– www.healthypeople.gov/
2020/
Obesity DataKey indicator resources
• CDC’s Recommended Community Strategies and Measurements to Prevent Obesity in the United States– www.cdc.gov/obesity/res
ources/recommendations.html
ObesityKey Indicators and Data Sources
• Key indicator examples– Obesity prevalence (BMI >= 30)– Consumption of 5+ fruits/vegetables a day (%)– Physical inactivity (%)
• Key data sources– California Health Interview Survey
• http://ask.chis.ucla.edu/– Network for a Healthy California GIS Map Viewer:
• http://www.cnngis.org/– California Physical Fitness Test (PFT)
• http://dq.cde.ca.gov/dataquest/
NutritionBuilt Environment Issues
• Access to healthy food options• Concentration of “unhealthy” retail• Key data sources
– CDC Modified Retail Food Environment Index (mRFEI):
• http://www.cdc.gov/obesity/resources/reports.html
– USDA Food Atlas• http://www.ers.usda.gov/data-products/food-
environment-atlas
Physical ActivityBuilt Environment Issues
• Community park access– Park proximity
• % of population living within ½ mile of park
• Key data sources– California Protected Areas Database (CPAD):
http://www.calands.org/
– CDPH Healthy Communities Indicatorshttp://www.cdph.ca.gov/programs/Pages/HealthyCommunityIndicators.aspx
Many Factors Influence Health
Policies & Programs
Health Factors
Health OutcomesMortality (length of life - 50%)
Morbidity (quality of life - 50%)
Health Behaviors
(30%)
Clinical Care(20%)
Social & Economic
Factors(40%)
Physical Environment
(10%)
Tobacco UseDiet & Exercise
Alcohol UseSexual Behavior
Access to CareQuality of Care
EducationEmployment
IncomeFamily & Social Support
Community Safety
Environmental QualityBuilt Environment
SOURCE: County Health Rankings Model ©2012 UWPHI
Built Environment DataKey Indicator Resource
• EPA’s Guide to Sustainable Transportation Performance Measures– www.epa.gov/smartgro
wth/pdf/Sustainable_Transpo_Performance.pdf
Built EnvironmentUnsafe Streets – Data Resources
• Key indicator examples– Pedestrian/bicyclist injury
• Motor vehicle related pedestrian/bicyclist injuries per 100K population
• Key data sources– Statewide Integrated Traffic Records System (SWITRS):
• http://tims.berkeley.edu/index.php• http://www.chp.ca.gov/switrs/
– CDPH Healthy Communities Indicators• http://www.cdph.ca.gov/programs/Pages/HealthyCommunit
yIndicators.aspx
Built EnvironmentDesign – Data Resources
• Key indicator examples– Connectivity
• Street intersections per square mile
– Land use mix• Ratio of jobs to housing
• Key data sources– EPA Smart Location Database
• http://www.epa.gov/dced/smartlocationdatabase.htm
Built EnvironmentTransit – Data Resources
• Key indicator examples– Transit access
• % living within ½ mile of major transit stop– Frequency of transit service
• Aggregate frequency of transit service per square mile
• Key data sources– CDPH Healthy Communities Indicators
• http://www.cdph.ca.gov/programs/Pages/HealthyCommunityIndicators.aspx
– EPA Smart Location Database• http://www.epa.gov/dced/smartlocationdatabase.htm
Built EnvironmentTransportation – Data Resources
• General transportation data sources:– OCTA
• http://www.octa.net/Plans-and-Programs/GIS-Data/GIS-Data-Download/
– Southern California Association of Governments• http://gisdata.scag.ca.gov
– CalTrans Performance Measurement System• http://pems.dot.ca.gov/
Environmental QualityData Resources
• Key indicator examples– Annual number of “unhealthy days” due to ozone– Average annual PM2.5 concentration
• Key data sources– California EPA CalEnviroScreen
• http://oehha.ca.gov/ej/ces11.html
– CDPH Healthy Communities Indicators• http://www.cdph.ca.gov/programs/Pages/HealthyCom
munityIndicators.aspx
Emerging Data Sources
• California Department of Public Health Healthy Communities Indicators• http://www.cdph.ca.gov/programs/Pages/Healthy
CommunityIndicators.aspx
• California EPA CalEnviroScreen– http://oehha.ca.gov/ej/ces11.html
• EPA Smart Location Database– http://www.epa.gov/dced/smartlocationdatabase
.htm
Other Emerging Data Sources
• AskCHIS Neighborhood Edition• Orange County GIS Cloud• Orange County Health Care Agency Health
Profile• Governor’s Office of Planning and Research,
2014 General Plan Guidelines
Group Discussion
• What key data do you use and how do you use them?
• What data could you share but don’t and how could data democratization be achieved?
• What data do you need, but don’t have and what would you use them for?
THANKS
For more information:Trav Ichinose, M.S., M.A.EpidemiologistHealth Promotion DivisionOrange County Health Care [email protected]