Scouting for Health Data Advancing the Frontiers of Social Science: Opportunities and Challenges Jani Little, Executive Director Katie Genadek, Expected Administrator Scouting for Health Data Jani Little Jani.little@Colorado.edu The Rocky Mountain Federal Statistical Research Data Center (RMRDC) Jani Little Executive Director

Finding Example Projects, online sources • NCHS Publications - The NCHS RDC website provides a list of all publications that have come out of NCHS projects conducted in the RDC by dataset – http://www.cdc.gov/rdc/B6Pubeyond/Pub611.htm • Abstracts of Approved NCHS Projects—These have been extracted from Annual Reports of CES and RDC activities – http://www.colorado.edu/rocky-mountain-research-data- center/proposals Good search terms “pollution” “oil”

Finding Example Projects using the FSRDC Network •Contact your Administrator—Katie Genadek or RMRDC Director—Jani Little • We can tap into current projects that are in process throughout the system using inter-FSRDC channels Good search terms “pollution” “oil”

Some major health data sources: Survey data NHANES NHIS NSCH AHRQ Survey data MEPS-HC Health Care Survey data NAMCSs NHDS Administrative data Vital Records Linked Data Mortality Data Products Medicare Enrollment and Claims Data Medicaid Enrollment and Claims Data Social Security Benefit History Data

National Health and Nutrition Examination Survey (NHANES) Provides prevalence data on selected diseases and risk factors of U.S. Population Monitors trends in diseases, behaviors, and environmental exposures Identifies emerging public health concerns Provides national baseline information on health and nutrition

National Health and Nutrition Examination Survey (NHANES), 1999-2014 Nationally probability sample, approx. 10,000 Data collection from Mobile unit Interview—acculturation, air quality, allergies, demographics, diet, cognitive functioning, physical activity, sleep disorder, smoking, social support, weight history, family background, food security, alcohol use, bowel health, overall health, depression screening, pesticide exposure, reproductive health, exposure to chemicals, drug use, sexual behavior, etc Physical exam — hearing, body measurements, balance, blood pressure, vision, heart, etc Lab testing —blood, urine, oral rinse, etc

National Health and Nutrition Examination Survey (NHANES) Restricted Data Identifies geography below national level down to Census block Youth -- Alcohol and Drug Use, ADHD, STDs, Mental Health Disorders, Depression, Sexual Behavior

Comparing Diet Quality, Physical Activity, and Sedentary Behavior in Youth with and without ADHD Researcher: Carol Curtin - University of Massachusetts Medical School Restricted National Health and Nutrition Examination Surveys (NHANES) 2001-2004 Includes youth, ages 8-15, with and without ADHD Anthropometric, dietary and activity measures include detailed family structure categories ADHD and other behavioral health conditions assess using gold standard diagnostic

Racial Disparities in Exposure to Toxic Heavy Metals Justin Colacino, Kelly Ferguson, Shama Virani—University of Michigan Restricted National Health and Nutrition Examination Surveys (NHANES) 2003-2010 Heavy metals lab score includes cadmium, lead, mercury, arsenic. Non-Hispanic blacks significantly more likely across all age groups.

National Survey of Children’s Health National telephone survey of households with at least 1 child, N= 91,642 Demographics, Health and Functioning, Home Environment, Early Childhood Care, Developmental Screening, Adolescent School, Exercise, Emotional Difficulties Family Functioning and Parental Health Neighborhood and Community All variables restricted County and zip code geography available

Complex Families, State Family Policies, and Child Health Disparities Researchers: Justin Denney, Rachel Kimbro, Christine Percheski, Maria Perez-Patron Restricted National Survey of Children’s Health (NSCH), 2011-1012 includes detailed family structure categories Detailed child health assessments Linked with public data of state-level family and welfare policy variables

National Health Interview Survey, 1993-2015 Annual Sample that is Nationally and Regionally Representative Family, Household and Person Self-Report Data Extensive Health and Social Psychological Measures including Depression, anxiety Other Mental Health Conditions Other Emotional or Behavioral Problems

National Health Interview Survey, Restricted Data Country of Birth and Related Immigration Variables (Person File) State and Year of Birth (Person File) Industry and Occupation Codes Detailed Race and Hispanic Origin (Person File) Exact Dates (e.g., date of birth in Person File) Low levels of geography from state down to tract

Immigration Policy Enforcement and the Mental Health of Mexican Immigrant Families Researchers at Columbia University: Neeraj Kaushal; Julia Wang Local and state public deportation enforcement data Linked with Restricted National Health Interview Survey (NHIS), 1997- 2012 includes detailed health behaviors, health and mental health outcomes for Mexican immigrants Includes state and local geographic identifiers

Early Life Mortality in the U. S. Elizabeth Lawrence, University of N Early Life Mortality in the U.S. Elizabeth Lawrence, University of N. Carolina at Chapel Hill Rick Rogers, University of Colorado Boulder 1999-2011 NHIS-LMFs 246,464 records, 734 deaths Restricted-use variables Early life deaths (ages 0-17) Exact dates (rather than quarters) Age, day, month of birth, interview, and death Detailed cause of death (beyond 10 categories) New mortality linked files, when available Geographic detail 50 states rather than 4 regions Age top coding usually at ages 85+ Quarter of birth, interview, and death may be too broad for younger ages. Some causes of death are perturbed New matches, available this fall, will first be accessible only in an RDC South generally experiences higher risk of death

Exposures to Fine Particulate Air Pollution and Respiratory Outcomes in Adults Using Two National Datasets: A Cross-sectional Study Researchers: Keeve Nachman and Jennifer Parker Datasets: NHIS, EPA Air Data System (External- Linked using geocode) --Evaluates the relationship between air pollution and asthma across race/ethnicity… --Revealed significant associations for non-Hispanic blacks but not for Hispanics and non-Hispanic whites

Medical Expenditure Panel Survey—Household Component Naoki Aizawa—University of Minnesota Asks how the ACA affects health insurance and labor markets Uses MEPS-HC with state and county FIPS codes Evaluates demand for health insurance as well as labor market impacts (changes in full time workers and part time workers, and in labor productivity).

National Ambulatory Medical Care Surveys Yuhua Bao and Yijun Pan—Cornell University Misuse and Abuse of Prescription Opioids Evaluates effectiveness of State Prescription Drug Monitory Programs (PDMP) in reducing physician prescribed opioids NAMCSs identifies patient visits for pain-related reasons resulting in opioid prescription Is trend reduced after adoption of PDMP?

National Vital Statistics System The Geography and Rise in Deaths from Despair The Geography and Decline in Teen Birth Rates Age-specific births and deaths for population projections

NCHS Surveys Linked to National Death Index (NDI) NHIS NHANES National Nursing Home Surveys (NNHS) National Home and Hospice Care Survey (NHHCS) 2007 Supplement on Aging (SOA) The Second Longitudinal Study of Aging (LSOA II)

NCHS Surveys Linked to CMS Medicare Data NHIS NHANES National Nursing Home Surveys (NNHS) National Home and Hospice Care Survey (NHHCS) 2007 The Second Longitudinal Study of Aging (LSOA II)

NCHS Surveys Linked to CMS Medicaid Data NHIS NHANES National Nursing Home Surveys (NNHS) The Second Longitudinal Study of Aging (LSOA II)

NCHS Surveys Linked to SSA Benefit History Files NHIS NHANES National Nursing Home Surveys (NNHS) The Second Longitudinal Study of Aging (LSOA II)

NCHS Proposals

Proposal Differences by Agency:   Census NCHS and AHRQ Approval % 70 nearly 100 Time to Approval 3-4 months on average less on average Benefit to Agency PPS Required Not Required Fee None $1200 min extract fee Scope Broad (max of 30 pages) Precise

Proposal Process: Write proposal – follow outline Fill out forms Create data dictionary Submit proposal to NCHS for review Work with assigned analyst https://www.cdc.gov/rdc/index.htm

Access Process NCHS Once proposal approved, request data extraction $1,200-$2,500 fee for more extensive extraction Pass on-line training Access data RDC (SSS required) Work with data extract from NCHS in RDC Output is reviewed by NCHS analyst, then emailed Disclosure review for manuscripts

Timeline for NCHS Projects Timeline dependent on agency, analyst and data you are working with Usually between 1-3 months Census approval NOT required Once approved we start SSS (1-3+ months)

Special Sworn Status SSS is authorized by Title 13 U.S.C. 23 (c) "to assist the Bureau of the Census in performing the work authorized by this title.” The Census Bureau may provide SSS to an individual When an individual has expertise or specialized knowledge that can contribute to the accomplishment of Census Bureau projects or activities or engages in a joint project with the Census Bureau; When an individual is employed by an agency/organization performing a service for the Census Bureau under contract or providing information to the Census Bureau for statistical purposes; When Federal law requires an individual to audit, inspect, or investigate Census Bureau activities.

Background Check Off-line paperwork and documentation On-line trainings and certifications Background check Submitted online and followed with interview Residential history Foreign travel Education and employment history References Fingerprinting

Useful Websites Restricted NCHS Data https://www.cdc.gov/rdc/b1datatype/dt122.htm Restricted AHRQ Data https://meps.ahrq.gov/mepsweb/data_stats/onsite_datacenter.jsp