“NATIONAL WOMEN’S AND MINORITY HEALTH STATUS INDICATORS PROJECT”

Suzanne Haynes, Ph.D., and
Laurie Konsella, M.P.A.
Office of Women's Health, HRSA

Slide #1:

Purpose

• Prepare an easy to use database on CD with variables needed by regional, state and local health professionals
• Prepare a report synthesizing data and health status of women in each region
• Provide training and technical assistance
• Place the database on the Internet and provide a GIS capability

Slide #2:

Developmental History

• Phase 1: Identification of women’s health status indicators, data collection, report
• Phase 2: Data base development and training
• Phase 3: Updated initial database, expanded to include males, added emphasis on minority data
• Phase 4: National implementation of regional pilot (current project)

Slide #3:

Phase 1 Activities
Focus on Women’s Health

• Contractor met with RO Project Officer, other regional office staff and State Women’s Health Coordinator’s (SWHCs)
• Prepared health status indicators based on literature review
• Convened panel of physicians to review work
• Collected data from state and national sources
• Computed indicator values and assessed findings
• Drafted a report and subjected it to internal and external review
• Report printed and distributed throughout region by RO
• Piloted in Region VIII
• Funded by OWH, OPA, and ORHA
• 1999

Slide #4:

Phase 2 Activities
Focus on Women’s Health

• Contractor met with Regional Office Project Officer, SWHC’s, and state data personnel to determine database requirements
• Integrated disparate data assembled for Phase 1
• Prepared Access and Excel databases
• Held one day training session
• Piloted in Region VIII
• Funded by OWH
• 2000

Slide #5:

Phase 3 Activities
Men &Women’s Health with Emphasis on Minority Data

• Expanded to include male and additional minority data
• Broadened to include mental health data
• Developed a point-and-click front end to facilitate access to the data
• Conducted training sessions in each state
• Provided technical assistance to users
• Piloted in Region VIII
• Funded by OWH and OMH
• 2001

Phase 4 Activities

• Region by Region implementation
• Funded by OWH central office
• 2002-2004

Slide #6:

Plans for the Future

• Beginning next May/June, the database for all 10 regions will be combined and placed on the Internet
• Some restructuring of the database will take place
• A full-feature GIS tool will become available on the Internet version of the database
• Plans are in process to update the database with data as they become available

Slide #7:

OUTCOMES

• Regional Health Status Indicators book
• Regional Women’s and Minority Health Status Indicators database on CD
• On-site training: How to use the database
• National database on National Women’s Health Information Center

Slide #8:

Goals/Expectations: Purpose

• Provide tool for program staff at State and Community level to look at health status of specific populations for use in:
  • Taking “snapshots” of specific populations
  • Developing needs assessments and program goals
  • Monitoring population health status
  • Monitoring progress towards Healthy People 2010 and Steps to a HealthierUS goals

Slide #9:

Summary of Indicators

• Mortality
• Infectious and Chronic Disease
• Mental Health
• Reproductive Health
• Maternal Health
• Violence and Abuse
• Prevention
• Access to Care

Slide #10:

Indicators

• Codes & Classifications
  • Population density
  • Shortage area designations (e.g., primary care)
  • Metro status, urbanicity
  • Census codes
    
• Demographics
  • Population by race, age, gender
  • Bridge populations
  • Extensive Census statistics
  • Income/employment/disability
  • Families/households/divorce
  • Data on children (e.g., race/age, household make up, CHIP)

Slide #11:

Health Status Indicators

• Mortality (deaths, rates, age-adjusted, 3-year averages)
  • Heart disease (ischemic heart, stroke, hypertension)
  • Cancer (breast, lung, prostate, others)
  • Respiratory (CLRD, pneumonia/influenza)
  • Diabetes
  • Unintentional injuries (motor vehicle, other)
    
• Infectious Diseases
  • Hepatitis (A, B, C)
  • TB
  • Sexually Transmitted Infections
  • chlamydia
  • gonorrhea
  • syphilis
  • HIV and AIDS

Slide #12:

Health Status Indicators

• Mental Health
  • Mental disorders
  • Depression
  • Substance abuse
  • Poor mental health
  • Suicide
    
• Reproductive and Maternal Health
  • Pregnancy, fertility and birth rates
  • Pre-term and low birth weight births
  • Type of delivery
  • Prenatal care
  • Characteristics of mother (education, marital status, risk factors)
  • Births to teens and older women

Slide #13:

Health Status Indicators

• Violence and Abuse
  • Rape
  • Murder
  • Aggravated assault
  • Robbery
    
• Illness Prevention
  • Mammogram and pap smears
  • At-risk behavior in young adults
  • Sexual behavior of young adults
  • Mental health in young adults
  • Smoking/drinking
  • Oral health
  • Exercise
    
• Access to Care
  • Health facilities
  • Hospitals, by types of services
  • HHA’s, RHC’s, CMHC’s
  • Health professionals
  • MD’s, DO’s, DDS’
  • PA’s, NP’s, Chiropractors
  • Shortage areas
  • Area status

Slide #14:

Data Sources*

• National - Census, NCHS, CDC, AMA, AHA, HRSA/BHPr, FBI, ADA, CMS, NPCR
• State/Local - Epidemiologists, cancer registries, departments of public health
  A detailed listing of sources is provided on the Access Database on the CD and in the book.

Data Issues

• Small incidence
• Data availability
• Geographic level of data
• Data suppression
• Age adjustment
• ICD-9/ICD-10
• Consistency (e.g., race)

Slide #15:

Regional Book Includes:

• Text explaining key data findings
• Maps, graphs, tables, charts
• Same set of indicators as CD
• Text explaining sources and methods
• Text explaining data limitations and gaps
• Audience includes policy-makers, health care provider organizations, and non-data experts

CD Includes:

• Tutorial
• Data Tables
• Standard pre-formatted reports
• Sample queries
• Index including map of counties and reservations
• Data Sources with documentation and follow-up
• Data Methodology

Slide #16:

Data Tables

• Gender
• Age
• Race/ Ethnicity
• Health Status Indicators
• Both rates and actual incidence
• Location
• All hard-coded by FIPS (Federal Information Processing Standards)

Slide #17:

Time Frames

• Letter to State Health Offices from ASTHO, Oct. 2002
• Region V- IL, IN, MI, MN, OH, WI (First conference call, Sept. 2002, completion by June 2003)
• Region IV- AL, FL, GA, KY, MS, NC, SC, TN (Oct. 2002 – July 2003)
• Region VI- AR, LA, NM, OK, TX (Nov. 2002-August 2003)
• Region X- AK, ID, OR, WA (Dec. 2002 – September 2003)
• Region IX- AZ, CA, HI, NV, American Samoa, Guam, Marshall Islands, Micronesia, Northern Mariana Islands, Palau (Jan. 2003 – December 2003)
• Region III- DC, DE, MD, PA, VA, WV (Feb 2003 – November 2003)
• Region I- CT, MA, ME, NH, RI, VT (Mar 2003 – Jan. 2004)
• Region VII- IA, KS, MO , NE (April 2003 – Feb 2004)
• Region II- NJ, NY, PR, Virgin Islands (May 2003 – March 2004)
• Region VIII- CO, MT, ND, SD, UT, WY (June 2003 – April 2004)
• National data, internet based (June 2004)
• Updated planned but depends on appropriations

Slide #18:

Region-Specific Activities and Timeframe

• Conference call, month 1, with regional office, state women’s health, state minority health, and (optional) state data staff. Contractor provides overview of project.
• Contractor works with appropriate state staff to obtain already collected state data such as cancer registry. (Note: Contractor obtains national data from national sources)
• Contractor provides draft version of book to regional staff for review. State review optional. Month 7
• Training in each state to be completed in Month 9. State, regional, and contractor staff set-up training dates, locations, invite appropriate staff. Contractor does training and provides additional CDs.
• Month 9: Camera-ready book submitted to regional office for printing and distribution.

Slide #19:

Sample Results from Region V Database

• Health Status in Region V
• By and large, data are presented for the Year 2000
• An extensive database has been assembled and will be used in training sessions
• The following descriptive materials have been created with the Region V database

Slide #20:

Example: Female Population – Output

This is a screenshot image of an example output from the Region V Health Indicators database.

Slide #21:

Chart: Distribution of Region V Female Population by Race/Ethnicity, 2003

• Among the total U.S. female population in 2003,
  • 75.1% are White.
  • 12.7% are Black.
  • 0.9% are American Indian.
  • 3.8% are Asian/Pacific Islander.
  • 12.0% are Hispanic/Latino.
    
• Among the Region V female population in 2003,
  • 82.3% are White.
  • 11.5% are Black.
  • 0.5% are American Indian.
  • 2.1% are Asian/Pacific Islander.
  • 4.8% are Hispanic/Latino.

Slide #22:

Graph: Comparison of Region V Female Mortality Rates to National Values*

• Pneumonia/influenza: Region V rate is 6.3% lower than the national rate
• Alzheimer’s: Region V rate is 9.8% higher than the national rate
• Diabetes: Region V rate is 11.0% higher than the national rate
• CLRD: Region V rate is 3.7% higher than the national rate
• Stroke: Region V rate is 5.0% higher than the national rate
• Cancer: Region V rate is 5.3% higher than the national rate
• Heart Disease: Region V rate is 3.9% higher than the national rate
• All other causes: Region V rate is 4.7% higher than the national rate

Slide #23:

Percent Low Birthweight Births, 2000

• Among low birthweight births of White women in 2000,
  • 6.4% were from Illinois.
  • 6.7% were from Indiana.
  • 6.4% were from Michigan.
  • 5.7% were from Minnesota.
  • 7.0% were from Ohio.
  • 5.8% were from Wisconsin.
  • 6.4% were from Region V.
  • 6.5% were from the total U.S.
    
• Among low birthweight births of Black women in 2000,
  • 14.1% were from Illinois.
  • 12.6% were from Indiana.
  • 14.5% were from Michigan.
  • 11.0% were from Minnesota.
  • 13.1% were from Ohio.
  • 13.3% were from Wisconsin.
  • 13.6% were from Region V.
  • 13.0% were from the total U.S.
    
• Among low birthweight births of American Indian women in 2000,
  • 7.2% were from Illinois.
  • 5.0% were from Indiana.
  • 6.2% were from Michigan.
  • 6.9% were from Minnesota.
  • 7.7% were from Ohio.
  • 5.0% were from Wisconsin.
  • 6.3% were from Region V.
  • 6.8% were from the total U.S.
    
• Among low birthweight births of Asian/Pacific Islander women in 2000,
  • 8.6% were from Illinois.
  • 7.1% were from Indiana.
  • 7.1% were from Michigan.
  • 6.5% were from Minnesota.
  • 8.1% were from Ohio.
  • 6.8% were from Wisconsin.
  • 7.7% were from Region V.
  • 7.3% were from the total U.S.
    
• Among low birthweight births of Hispanic women in 2000,
  • 6.2% were from Illinois.
  • 5.3% were from Indiana.
  • 6.3% were from Michigan.
  • 5.8% were from Minnesota.
  • 7.4% were from Ohio.
  • 6.6% were from Wisconsin.
  • 6.2% were from Region V.
  • 6.4% were from the total U.S.

Slide #24:

Percent Females Smoking Cigarettes, * 2001

• Among White females smoking cigarettes in 2001,
  • 20.3% were from Illinois.
  • 25.8% were from Indiana.
  • 24.2% were from Michigan.
  • 19.4% were from Minnesota.
  • 26.3% were from Ohio.
  • 21.9% were from Wisconsin.
  • 23.2% were from Region V.
  • 21.3% were from the total U.S.
    
• Among Black females smoking cigarettes in 2001,
  • 21.0% were from Illinois.
  • 22.6% were from Indiana.
  • 25.8% were from Michigan.
  • 25.9% were from Minnesota.
  • 23.2% were from Ohio.
  • 24.1% were from Wisconsin.
  • 23.2% were from Region V.
  • 19.6% were from the total U.S.
    
• Among Hispanic females smoking cigarettes in 2001,
  • 20.3% were from Illinois.
  • 15.6% were from Indiana.
  • 26.9% were from Michigan.
  • 20.9% were from Minnesota.
  • 26.6% were from Ohio.
  • 18.2% were from Wisconsin.
  • 21.4% were from Region V.
  • 14.5% were from the total U.S.

Slide #25:

Contractor Contact Information

• Quality Resource Systems, Inc.
  Fairfax, Virginia
  (703) 352-7393
  • Colleen Goodman, MBA
    cgoodman@qrs-inc.com
  • Alfred Meltzer
    ameltzer@qrs-inc.com
  • Julie Kennedy
    jkennedy@qrs-inc.com

Project Advisory Group

Co-Project Officers

• Suzanne Haynes, PhD - OWH Central Office
• Laurie Konsella, MPA - OWH Regional Office

Clinical Advisors

• Michelle Berlin, MD, MPH - Oregon Health & Science University
• Jean Hamilton, MD - Duke University
• Kelley Phillips, MD, MPH - Foundation for Women’s Health
• Patricia Rieker, PhD - Simmons College
• Jeffrey Weber, MD, PhD - USC/Norris Cancer Hospital

Statistical Advisor

• Mary Grace Kovar, DrPH - NORC/University of Chicago

Slide #26:

Regional Women’s Health Coordinators
http://www.4woman.gov/owh/reg/

• Region I
  • Connecticut
  • Maine
  • Massachusetts
  • New Hampshire
  • Rhode Island
  • Vermont
    
• Region II
  • New York
  • New Jersey
  • Commonwealth of Puerto Rico
  • U.S. Virgin Islands
    
• Region III
  • Delaware
  • Maryland
  • Pennsylvania
  • Virginia
  • West Virginia
  • District of Columbia
    
• Region IV
  • Alabama
  • Florida
  • Georgia
  • Kentucky
  • Mississippi
  • North Carolina
  • South Carolina
  • Tennessee
    
• Region V
  • Illinois
  • Indiana
  • Michigan
  • Minnesota
  • Ohio
  • Wisconsin
    
• Region VI
  • Arkansas
  • Louisiana
  • New Mexico
  • Oklahoma
  • Texas
    
• Region VII
  • Iowa
  • Kansas
  • Missouri
  • Nebraska
    
• Region VIII
  • Colorado
  • Montana
  • North Dakota
  • South Dakota
  • Utah
  • Wyoming
    
• Region IX
  • Arizona
  • California
  • Hawaii
  • Nevada
    
• Region X
  • Alaska
  • Idaho
  • Oregon
  • Washington

Slide #28:

For more information:

• Laurie Konsella, M.P.A.
  Regional Women’s Health Coordinator
  U.S. Public Health Service
  1961 Stout Street, Room 498
  Denver CO 80294-3538
  (303) 844-7854
  fax (303) 844-2019
  lkonsella@osophs.dhhs.gov
  
• Suzanne Haynes, Ph.D.
  Senior Advisor for Science
  DHHS Office on Women’s Health
  200 Independence Ave. S.W. Room 719E
  Washington DC 20201
  (202) 260-8420
  fax (202) 260-6537
  shaynes@osophs.dhhs.gov

http://www.4woman.gov

Thank You!