# Presentation: 924909

## NATIONAL WOMEN’S AND MINORITY HEALTH STATUS INDICATORS PROJECT	

- 	Office on Women’s Health
- 		July 23, 2003

## 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

## 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)

## 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

## 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

- 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

- Phase 2 Activities *Focus on Women’s Health*

## 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

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

- Phase 4 Activities

- Piloted in Region VIII
- Funded by OWH and OMH
- 2001

## 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

## 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

## 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

## Summary of Indicators

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

## 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, SCHIP)

## 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

## 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

## 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

## 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)

## 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

## Data Tables

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

## 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

## 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.

## 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

## Example: Female Population - Output

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

| Populations | Region V | US Total |
| --- | --- | --- |
| Total (Pct of US Total) | 17.8% | 100% |
| Female (Pct of US Female Tot) | 17.8% | 100% |
|  - White Female  | 82.3% | 75.1% |
|  - Black Female  | 11.5% | 12.7% |
|  - AmInd Female  | 0.5% | 0.9% |
|  - A/PI Female  | 2.1% | 3.8% |
|  - Hispanic/Latino Female | 4.8% | 12.0% |

## Comparison of Region V Female  Mortality Rates to National Values*

- 2000 Age Adjusted rates

## Percent Low Birthweight Births, 2000

## Percent Females Smoking Cigarettes, *2001

- * CDC, BRFSS

## Contractor Contact 

- Colleen Goodman, MBA_cgoodman@qrs-inc.com_

- Alfred Meltzer_ameltzer@qrs-inc.com_

- Julie Kennedy_jkennedy@qrs-inc.com_

- Quality Resource Systems, Inc.Fairfax, Virginia
- (703) 352-7393

- 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

## Regional Women’s Health Coordinators

- _http://www.4woman.gov/owh/reg/_

## 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

- Thank You!

- _http://www.4woman.gov_