Assessment Initiative AI

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• Assessment Initiative (AI)
• And
• The NAPHSIS Training Resources
• Sukhjeet Ahuja MD, MPH

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Assessment Initiative (AI)

• Assessment Initiative is a cooperative program
  between the CDC and state health departments that
  supports the development of innovative systems
  and methods to improve the way data is used to
  provide information for public health decisions
  and policy.

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Assessment Initiative (AI)

• Through the Assessment Initiative, funded
  states work together with local health
  jurisdictions and communities to improve
• Access to data,
• Skills to accurately interpret and understand
  data, and
• Use of the data so that assessment findings
  ultimately drive public health program and policy
  decisions

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Assessment Initiative (AI)

• Began in 1992 and now in its fourth 5-year
  funding cycle
• States Funded in 2007-2012 cycle
• Arkansas
• Florida
• Illinois
• Missouri
• New Hampshire
• New Mexico
• North Carolina
• Rhode Island
• Virginia

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Assessment Initiative (AI)

• The Assessment Initiative supports work in two
  main focus areas
• Community health assessment practice
• Data dissemination systems

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Assessment Initiative (AI)

• Community health assessment practice
• Development, implementation, and evaluation of
  tools, strategies, and approaches to improve the
  capacity of local public health agencies and
  communities to conduct effective community health
  assessments
• Demonstrate how the resulting data have been used
  to affect public health programs and policies

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Assessment Initiative (AI)

• Data dissemination systems
• Implementation of electronic systems for
  user-friendly analysis and dissemination of
  public health data (i.e. Internet-based
  interactive data query systems)
• Evaluation of the effect of these systems on
  primary users

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Assessment Initiative (AI)

• NAPHSIS goals for second year out of three
  years funding cycle
• Improve the capability of states to disseminate
  health information
• Improve the consistency of use of vital
  statistics statistical measures
• Develop a more effective state health statistics
  work force

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Assessment Initiative (AI)

• Improve the capability of states to disseminate
  health information
• Objective Develop an analysis resource for the
  states
• Identify the on line state statistical reports
• Develop a topical classification system for
  categorizing the reports
• Develop a NAPHSIS web page for the statistical
  reports links
• Create the links of the state statistical reports
  on the NAPHSIS web page
• http//www.naphsis.org/index.asp?bid1141

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Statistical Report Topics

• Abortions
• Assessment
• Births
• Birth Defects
• Fetal Alcohol Syndrome
• Inadequate Prenatal Care
• Low Birth Weight
• PRAMS
• Smoking during Pregnancy
• Teen Births/Pregnancies
• Behavior Risk Factors
• Cancer Incidence
• Deaths
• Adolescent
• AIDS
• Infant
• Cancer
• Chronic Diseases
• Diabetes

• Heat Related
• Homicide
• Injuries
• Leading Causes
• Maternal
• Pneumonia and Influenza
• Smoking Related
• Suicide
• Other
• Dissolutions
• Environmental Public Health Tracking
• Head and Spinal Cord Injuries
• Marriages
• Motor Vehicle Crashes
• Vital Statistics Annual Reports
• Other

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Assessment Initiative (AI)

• 2. Improve the consistency of use of vital
  statistics statistical measures
• Objectives
• Determine key statistical measures used and
  needed for vital statistics analysis
• Create a NAPHSIS website on vital statistics
  measures

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Assessment Initiative (AI)

• Establish a NAPHSIS committee to assist with the
  project
• Contact key states and the NCHS on published
  statistical measures (NC, SC, PA, NY, and WA)
• Inventory the measures and determine if there are
  any inconsistencies
• Define measures needed but not found from key
  sources
• Post the measures, definitions and explanations
  on the web site
• Inform the NAPHSIS membership and AI states of
  the NAPHSIS website.
• Develop the web site format
• http//www.naphsis.org/index.asp?bid1205

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Statistical Measures Committee

• NAPHSIS Members
• Jerry Orris (Chair)
• Alvin Onaka
• Glenn Copeland
• Lois Haggard
• Lou Saadi
• Mark Flotow
• Meade Grigg
• Scott Fujimoto
• Garland Land
• Sukhjeet Ahuja

• NCHS Contributors
• Kenneth Kochanek
• Marian MacDorman

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Assessment Initiative (AI)

• INFANT MORTALITY RATE 
• 1. Definition
• INFANT MORTALITY RATE is the number of resident
  newborns in a specified geographic area (country,
  state, county, etc.) dying under one year of age
  divided by the number of resident live births for
  the same geographic area (for a specified time
  period, usually a calendar year).
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• 2. Calculation
• (Number of resident infant deaths/Number of
  resident live births) x 1,000
• Number of Resident Infant Deaths 1,000
• Number of Resident Live Births
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• Additional links to State/National websites with
  calculation and/or definition -
• New Mexico Glossary
• North Carolina Statistical Primer

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Assessment Initiative (AI)

• 3. Examples
• 1,300 infant deaths in 2005 among state
  residents
• 150,000 live births in 2005 to state residents
•  
• 1,300/150,000 x 1,000 8.7 infant deaths per
  1,000 live births in 2005 among state residents
•  
• Links to examples of use in ongoing published
  reports -
• National Center for Health Statistics
• State Vital Statistics
•  
• 4. Tools
• Click on the following links to access and
  download program files to assist you with
  calculating this measure.
• Excel spreadsheet file
• SAS programming code

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Assessment Initiative (AI)

• 5. Technical Notes
• An infant mortality rate (or IMR) is considered a
  primary and important indictor of a geographic
  areas (country, state, county) overall health
  status or quality of life.
• There are some concerns about the quality of
  reporting of infant mortality internationally and
  within states, especially in terms of defining a
  live birth and/or complete reporting of both
  birth and death certificates for very low birth
  weight babies.
• The IMR is usually calculated using the annual
  number of resident infants who died during a year
  in the numerator and the total annual number of
  resident live births during the same year in the
  denominator.
• By matching infant death certificates to the
  corresponding birth certificates, much more
  additional and valuable data are obtained (birth
  weight, smoking status of mother, when prenatal
  care began, etc.) for infant mortality risk
  analysis.
• In less densely populated areas, annual numbers
  of infant deaths may be small (lt10 or 20) which
  would result in an infant mortality rate
  considered to be too unstable or unreliable for
  analysis. Adding additional years (three or
  five-year average annual rates) and/or expanding
  the area to be studied should result in a larger
  number of deaths and more reliable rates for
  analysis.

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Assessment Initiative (AI)

• 3. Develop a more effective state health
  statistics work force
• Objectives
• Determine the training resources available
• Develop and implement a training plan

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Assessment Initiative (AI)

• Determine the on-line training resources
  available
• Post on-line training resources on the NAPHSIS
  web site
• Coordinate with NAHDO on roles and
  responsibilities
• Analyze with NAHDO the results of the training
  survey conducted in year 1
• Prioritize training subjects based upon need and
  available resources
• http//www.naphsis.org/index.asp?bid1161

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Assessment Initiative (AI)

• 40 Training Courses under 7 Categories
• Epidemiologic Methods
• Statistical Analysis
• Program Evaluation
• Data Management
• Data Presentation
• Grant Writing/Proposal Writing
• Other Public Health Courses

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• Questions / Comments ?
• sahuja_at_naphsis.org