Shaping a Health Statistics Vision for the 21 st Century 2002 NCHS Data Users Conference 16 July 2002 Daniel J. Friedman, PhD Massachusetts Department of Public Health National Committee on Vital and Health Statistics

Partners, process, and products

3 Vision partners  DHHS Data Council  National Center for Health Statistics  National Committee on Vital and Health Statistics

4 Joint NCVHS, NCHS, and DHHS Data Council process for developing the 21 st century for health statistics WHO Collaborating Centres for the Classification of Diseases NAPHSIS Annual Meeting DHHS Data Council AMCHP Annual Meeting CDC Executive Leadership Launching Healthy People 2010 NCVHS 50 TH Anniversary Symposium CDC Assessment Initiative Annual Meeting National Conference On Health Statistics Association for Health Services Research Commissioned Papers Local Discussion Groups, National Academy of Sciences Workshop, 1999 Workshop Summary, 2001 Regional Public Hearings, Solicitation of Recommendations from Vision Process Participants 2001 Expert Discussion Groups, 1999 NCVHS Recommendations for Implementing the vision 2002 Shaping a vision for 21 st century health statistics, June 2000 interim report A Health Statistics Vision for the 21 st Century, final report 2002 Participant Input Reports & Papers Presentations

5 Vision components  Definitions of health statistics, uses of health statistics, and health statistics enterprise  Overarching conceptual frameworks  Model of influences on the population’s health  Health statistics cycle  Application of overarching conceptual frameworks to describe issues and gaps in U.S. health statistics  Mission of health statistics enterprise  Guiding principles for health statistics enterprise  Relationship of health statistics enterprise to National Health Information Infrastructure  NCVHS recommendations

6 Definitions and uses  Defining health statistics  Uses of health statistics  Defining health statistics enterprise

7 Defining health statistics... Numerical data that characterize the health of a population and the influences and actions that affect the health of a population.

8 Uses of health statistics 1.Creating fundamental knowledge about the health of populations and sub-populations, influences on health, and interactions among those influences 2.Developing information to guide health policy development, assessment, and evaluation 3.Generating information to guide implementation, targeting, evaluation, and refinement of health programs and other interventions for populations and personal health decisions

9 Defining health statistics enterprise... infrastructure and the activities necessary to produce health statistics.  Public and private organizations and individuals at all geopolitical levels that perform the processes of health statistics  Highly decentralized  Includes organizations that collect, analyze, and disseminate data on the health of populations and the factors that influence health

10 Defining health statistics enterprise  Focuses on the health of the population and subpopulations  Serves the public interest and generates products that are public goods  Engages in systematic and organized inquiry  Strives for scientific integrity  Involves multiple disciplines  Links U.S. health statistics activities to those of international partners

11 Overarching conceptual frameworks  Influences on the population’s health  Issues  Gaps  Health statistics cycle  Issues

12 Influences on the population's health Place & Time Cultural Context Context Built Environment Political Context Natural Environment The Population’s Health Level Distribution Disease Functional status Well-being Health Services Biological Characteristics Social Economic Population- based Health Programs Community Attributes Collective Lifestyles and Health Practices

13 Using the model to describe issues  Broad definition of health  Population health and its determinants  Data availability across geopolitical levels  Quality and quantity of data on subpopulations  Longitudinal and life cycle data  Data use, not just data availability

14 Using the model to describe gaps  Context—cultural and political  Community attributes  Social cohesion, influence, networks, support, and change  Economic attributes  Relationship between “structure, processes, and access” and “population health”  Relationship between “population-based health programs” and “population health”  Built environment  Population’s health  Disease incidence and prevalence  Functional status  Well-being

15 Health Statistics Cycle

16 Using the cycle to describe issues  Insufficient connections between users and producers of data  Lack of geographic, race/ethnic, and other detail  Lack of timeliness in making data available  Existing data difficult to find and use  Lack of resources jeopardizes major data sources  Enterprise-wide coordination and integration lacking

17 Vision for health statistics enterprise  Mission  Ten guiding principles  Role of National Health Information Infrastructure

18 Vision for U.S. health statistics enterprise: mission …efficiently provide timely, accurate, and relevant information that can be used to improve the nation’s health, including information about status of the population’s health, information to formulate and evaluate the effects of health policy, and information to manage health interventions and programs.

19 Vision for health statistics enterprise: overarching conceptual framework …helps to maintain a focus on needed data and that guides the health statistics enterprise.  Focuses on health, the population, and the community  Emphasizes distribution and level of health  Delineates major influences on health  Defines research agenda for improving the population’s health

20 Vision for health statistics enterprise: ten guiding principles 1.Enterprise-wide planning and coordination 2.Broad collaboration among data users, producers, and suppliers at local, state, and national levels 3.Rigorous policies and procedures for protecting privacy, confidentiality, and security 4.Flexibility to identify and address emergent health issues and needs 5.Use of data standards

21 Vision for health statistics enterprise: ten guiding principles 6.Sufficient detail at different levels of aggregation 7.Integrated, streamlined data collection for multiple purposes 8.Timely production of valid and reliable health statistics 9.Appropriate access to and ease of use of health statistics 10.Continuous evaluation of the completeness, accuracy, and timeliness of health statistics and the ability of the health statistics enterprise to support their production

22 Vision for health statistics enterprise: National Health Information Infrastructure  21 st century health statistics enterprise must be viewed within context of the NHII  Data standards should mirror NHII  NHII provides conceptual framework and ultimately tools to transform vision into reality

23 Vision for health statistics enterprise: National Health Information Infrastructure The heart of the vision for the NHII is sharing information and knowledge appropriately so it is available to people when they need it to make the best possible health decisions.

24 Vision for health statistics enterprise: National Health Information Infrastructure The set of technologies, standards, applications, systems, values, and laws that support all facets of individual health, health care, and public health NOT (NOT!) a centralized database Connects distributed health information in the framework of a secure network with strict confidentiality protections

25 P e r s o n a l H e a l t h D i m e n s i o n H e a l t h c a r e P r o v i d e r D i m e n s i o n P o p u l a t i o H e a l t h D i m e n s i o n n

26 NCVHS recommendations

27 NCVHS recommendations  Recommendations for achieving the ten guiding principles (30)  Recommendations for moving toward the adoption of the overarching conceptual framework (6)  Recommendations pertain to  Data access and use (3)  Data set development (11)  Data standards (4)  Enterprise structure (3)  Evaluation (2)  Policy (4)  Research agenda (6)  Training (2)

28 NCVHS recommendations  Priority recommendations for building and integrating the “hub” of the health statistics enterprise  Priority recommendations  #1: Reconstituted NCHS  #2: national Health Statistics Planning Board  #3: state Health Statistics Planning Boards  #4: Graduate, in-service, and continuing education in all elements of the health statistics cycle

29 Vision for health statistics enterprise: next steps  Disseminate Vision  Develop health statistics enterprise-wide planning process  Hold planning and implementation hearings and meetings

Contacts Dan Friedman Ed Hunter Gib Parrish st century vision for health statistics URL: 30