Overview Finding and Using Health Statistics and Data Files Soc 398: Social Inequality and Health Darlene Fichter Data Library Services, U of S Library October 4, 2007

Overview  Why use data?  Types of Data Resources in the Library and Internet: Health Surveys –Aggregate data –Public Use Microdata Files –Surveys and Products  Finding a data file  Understanding data documentation

Data Tells a Story Life expectancy at birth: by social class and sex, , England & Wales Men: 7.4 years Manual workers die earlier than others

Finding the Stories  Debunking third-world myths with the best stats you've ever seen – Hans Rosling –Global Life Expectations –How can we use this data?

Social Inequality and Health  Advances of medical practice and science have been seen as the principal causes of increased human life expectancy True False

Social Inequality and Health  Nutrition and improved living conditions are better indicator of population health True False

What are some risk factors of lower socio- economic status?  Smoking  Lack of exercise  Immoderate eating and drinking  High fat/low fiber diets  More stress - higher rates of ill health/death  Lower of levels of social support  Live or work in environments hazardous to health

Overview Part 1: Health Surveys

Health Statistics  Two main sources of data: –Special surveys by Statistics Canada –Administrative data  Collected by law – causes of death, notifiable diseases  Collected by Dept. of Health

Types of Data Files  Aggregate data files –Counts  Cases of measles in Saskatoon –Cross tabulations  Number of smokers in Saskatoon by age and sex

Table Risk of depression, by age group and sex, household population aged 12 and over, Canada (Canadian Community Health Survey) Age groupSex Probable Risk of Depression years Males3.4 Females years Males6.5 Females years Males6.1 Females years Males4.8 Females years and over Males2.3 Females4.0

Microdata File  Raw data organized in a file where the records or lines in the file are observations of a specific unit of analysis  Each record or line is one person’s responses –Time use survey – exercising, shopping, working, TV, gardening, eldercare

Cases 3 & 4 from the General Social Survey 2 Main File Sex ID

Public Use Microdata File - PUMF  Specially prepared file to minimize disclosure  “Master file” would have personal identifiers

Population Health Surveys 1  Understand the determinants of health  Collect data on  Economic  Social  Demographic  Occupational and environmental correlations  Can impact public policy development 1 Health Survey information based on Michel B. Seguin’s “Health Statistics Information on the STC website”. December 2003.

Population Surveys  NPHS – National Population Health Survey  Household, institutional, north (territories)  Geography - provincial  Products –Public Use Microdata Files (PUMF)    –Research Data Centre access     NPHS is a longitudinal survey. PUMF are not longitudinal, due to the high risk of disclosure. Inactive

NPHS  The NPHS, which relies on respondents' self- reported health information, surveys the same group of respondents every two years for up to 20 years

Population Surveys  Canadian Community Health Survey (CCHS)  Common content  Optional content  126/136 health regions, started September 2000 Year Respondents Geography 1 100,000+ Health Region, provinces, territories, Canada 2 30,000 Provinces / Canada

Canadian Community Health Survey  Cycle 1.1 – Large sample (2001)  Cycle 1.2 – Mental Health (2002)  Cycle 2.1 – Large Sample (2003)  Cycle 2.2 – Nutrition (2004)  Cycle 3.1 – Large Sample (2005)  Cycle 3.2 – Canadian Health Measures Survey (CHMS)

Article from Nutrition cycle

Health Indicators  Measures of health status, health system and factors that influence health  Based on comparable definitions  Geography –Canada –Provinces –Regionally

Health Indicators  Health Status  Health conditions, human function, well-being, deaths  Health Determinants  Health behaviours, living & working conditions, personal resources(income), environmental factors  Health System Performance  Effectiveness, accessibility, efficiency, safety …  Community/health system characteristics

Health Indicators  Many data sources –Statistics Canada  Vital statistics  Surveys –Canadian Institute for Health Information (CIHI)  Provincial ministries  Health Canada  Hospital morbidity and discharge databases, …

Health Indicators  Has the notion of “peer groups” where Health regions with similar socio-economic characteristics are grouped  Products (free) –Publication online –Tables on Statistics Canada & CIHI web sites

Health Region Boundaries  Show your results spatially Distribution gender differences in depression compared to Calgary Health Region

Comparable Health Indicators  Grew out of the First Minister’s meeting in 2000  14 areas of comparable health status and health system performance  Geography  Provincial

Comparable Health Indicators - Topics  Health Status –Live expectancy, infant mortality, low birth rate, self-reported health  Health Outcomes –Change in life expectancy, improved quality of life, reduced burden of disease, illness or injury  Quality of Service –Waiting times (selected services), patient satisfaction, Hospital readmission (selected), access to 24/7 first contact health services, home and community services, public health surveillance and protection, health promotion and disease prevention

Products  Available from Statistics Canada Web Site & CANSIM Web Site:

Other Tables  Causes of Death  Cancer Statistics

Health Canada's Notifiable Diseases Online Infectious Diseases

Residential Care Facilities  Some older tables at CIHI, prior to 1999  Custom tabulation  Online tables will be available for recent survey

Health Information from CIHI

CIHI Topics

CIHI Products  Publicly available, aggregate-level data  Analytic reports –Links to Saskatchewan report of Comparable Health Statistics with a study on measles  More detailed statistics may make a custom data request

CIHI & Graduate Students  CIHI provides health data to qualifying graduate students at no cost through the Graduate Student Data Access Program (GSDAP) Graduate Student Data Access Program

General Social Surveys –Cycle 1 to Cycle 19 –Monitor changes in the health of Canadians and to examine social support. –Cycles cover and repeat content and special focus areas – Each cycle includes general socio-economic variables

Cycle CycleYearCoreSpecial Topic 11985HealthSocial support 21986Time Use, Social MobilityLanguage 31988Personal RiskVictim services 41989Education and WorkNo focus issue 51990Family and FriendsNo focus issue 61991HealthVarious topics 71992Time UseCulture, sport and unpaid activities 81993Personal RiskAlcohol and drug use 91994Education, Work and RetirementTransition into retirement FamilyEffects of tobacco smoke

Cycle CycleYearCoreSpecial Topic Social SupportTobacco use Time UseNo focus issues Victimization Spousal violence and senior abuse and Public perception toward alternatives to imprisonment Access To and Use of Information Communication Technology Family History Social Support and Aging Social engagement Victimization Time use Since 1994, health as core topic covered in NPHS, social support expanded in 1996.

General Social Survey  20 - Family Transitions Survey –Family data collected in cycle 5, 10, 15  21 - Family, Social Support and Retirement  22 – Survey on Social networks

National Longitudinal Survey of Children and Youth (NLSCY)  Longitudinal survey designed to measure child development and well-being as children grow from infancy to childhood  Products –PUMF  Cycle 1  Cycle 2  Cycle 3  … Cycle

National Longitudinal Survey of Children and Youth (NLSCY)  Products  Cycle 1, Synthetic Files for Remote Access to the Master Files  Research Data Centre

Health and Activity Limitation Survey  Post-censual survey  Products –1991 PUMF –1996 PUMF  Participation and Activity Limitation Survey (PALS)  Participation and Activity Limitation Survey (PALS)

International  SourceOECD SourceOECD –Comparable statistics on health and health systems across OECD countries  Health status, expenditure, financing  Health care utilization  Health care coverage  Pharmaceutical  Non-medical determinants to health  Some U.S. and European data

Human Activity and The Environment 2000  Human activity and its relationship to natural systems' air, water, soil, plants and animals  Aggregate tables

Questions

Overview Part 2: Finding a Statistics and Data

Ways to Find Files 1.Library Catalogue 2.Statistics Canada Catalogue 3.Data Library Web Site 4.Web Data Extractors, i.e.IDLS 5.Talk to the Reference staff or Data Library staff

1. The Catalogue  Use it when you know the name of the survey – Canadian Community Health Survey is footnoted in the article Mental Health of Canada’s Immigrants.  Searching by a topic –Strategies  Keep it broad – “ health” not measles  Use “statistics” or “codebook”  Change the scope to “Data and GIS Files”

2. Statistics Canada Catalogue  Enter your keywords:  internet use  Look for the words public use microdata file or CANSIM Look for free access from our library

3. Data Library Web Site  Browse by subject  Health

library.usask.ca/data Topic browse

4. Very Specific Topics - Variables  Best bet  Web extractor for data files  IDLS - from Western Ontario

Data Services & GIS IDLS is listed in this section.

4. Not sure? Ask us.  U of S has access to 1,000’s files  We can:  Help you search  Check for new releases  Cut through the red tape Phone:

Overview Part 4: Data Documentation

What is Data Documentation?  Material that accompanies the data file  Information on –Methodology & sampling –Questionnaire –Record layout –Weights –Frequencies –Syntax files (spss, sas) Codebooks

Codebook  Any information on the structure, contents, and layout of a data file  Typically, it is used to refer to any or all of the accompanying documentation  It can include information on methodology, sample, record layout, questionnaire and data dictionary.

Questionnaire  Shows the survey questions in the order they were posed  Presents the response codes  Often the directions for the interviewer and skip patterns are indicated “Did they ask about x? How did they phrase the question?

Excerpt

Data Dictionary  The data dictionary describes each variable in the data file  Typical information –Variable description –Question –Universe – who was asked this question, n= – Values for the variable and the # of cases –Length of the variable – 2 characters or 25 –Position in the file – starts at column 97 –Availability (suppressed)

Values and their codes

Wrap Up  Many health surveys and products  Useful for qualitative and quantitative studies  Data Library Services  We’re here to help you locate data files  Data documentation  Save time – check to see if the variable is included  Check the sample size – will your results be statistically significant?  Find the answer – just need a frequency?

4. Ask Data Library Staff Office: 2nd Floor, Main Library  Appointments recommended  us at  Call us: Winnie Smit (7261) Chipo Kangayi (8841) Harpreet Aulakh (8841) Elise Pietroniro (2677) Rob Alary (5987) Darlene Fichter (7209)

Questions