The 500 Cities Project: New Data for Better Health

From the article by Oktawia wojcik on the Culture of Health Blog:

Old Colony YMCA in Brockton, Massachusetts recently discovered something startling: a single neighborhood more burdened by poor health such as asthma, high blood pressure, and elevated cholesterol than surrounding areas. Most surprising, however, was that this particular area had a lower prevalence of unhealthy behaviors like binge drinking than other locations within Brockton.

In the past, public health officials may have expended limited resources on the entire Brockton metropolitan area because they wouldn’t have been able to pinpoint the specific neighborhood facing the spike and determine why it was happening.

But since new data revealed that health behaviors were not the culprit, officials focused on partnering with regional organizations to address the social determinants of health. These include social and economic factors like unsafe streets, a lack of jobs, and limited availability of fresh, nutritious food.

Brockton’s experience illustrates how instrumental data on small geographic areas is in designing effective approaches to addressing health needs within a community. Thanks to the 500 Cities Project, a first-of-its-kind data resource from the Centers for Disease Control (CDC) and CDC Foundation, Brockton officials were able to learn about their community’s health at a level of detail never seen before: the Census tract (defined as subdivisions of a county, averaging around 4000 people). Knowing where a community thrives or suffers is essential to addressing poor health and efficiently utilizing resources to ensure everyone has the opportunity to lead healthier lives.

The 500 Cities Project

Data on the largest 500 Cities in the nation are available now, via map and data books at the 500 Cities site. But beginning March 2, an interactive website will give anyone—from public health stakeholders to curious residents—the ability to retrieve, visualize, and explore uniformly-defined city and census tract-level data for the 500 largest U.S. cities.

This collaboration between the CDC, the CDC Foundation and the Robert Wood Johnson Foundation, provides analysis of 27 chronic disease measures, health outcomes, and clinical preventive service use. The data, derived from small area estimates, will empower anyone to better see how health varies by location and plan tailored interventions.

Traditionally, public health officials were limited by health data available only at the state or county level. But a third of the U.S. population resides within cities, which are only a portion of the overall county or state population. This website finally illustrates city level information on the risk behaviors associated with illness and early death, as well as the health conditions and diseases that are the most common, costly, and preventable.

Cities chosen for the project represent the largest 497 cities in the nation by population, with three additional cities added to cover all 50 U.S. states (Burlington, Vt.; Charleston, W. Va.; and Cheyenne, Wyo.). The website, data and map books deliver timely, high-quality, small-area epidemiologic health data for cities and small areas within cities. City populations range from 42,417 (Burlington, Vt.) to 8,175,133 (New York City). Approximately a third of the nation’s population is represented in the data, which includes measurements on 5 unhealthy behaviors (e.g., current smoking), 13 health outcomes (e.g., coronary heart disease, diabetes, etc.), and 9 prevention practices (e.g., health insurance coverage, cholesterol screening, etc.). A complete list of health measures, definitions and a city list are available at the 500 Cities website.

Read the full article.

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REDCap: New Resource for Researchers at the University of South Alabama

At the April 2016 meeting of the Health Disparities Research Group, Clista Clanton, Education and Clinical Librarian Coordinator at the University of South Alabama’s Biomedical Library, introduced REDCap (Research Electronic Data Capture). This new resource provides faculty and staff at the University with a flexible, easy-to-use, and secure web-based application for capturing, using, and sharing research. The system provides various tools for building and electronically administering surveys as well as tools for managing follow-up to and incentives for study participants.

During her presentation, Ms. Clanton explained that REDCap is used and supported by an international consortium of approximately 1,800 institutional partners from around the world. This breadth of users means that REDCap provides access to survey templates and other tools to assist researchers getting started with the system.

One researcher from the Mitchell Cancer Institute described his experience with REDCap in very positive terms. He explained the ease with which his team was able to develop their surveys and distribute via email to about 1500 participants. Along with outlining how REDCap provides tools for efficient data management, he described the automation of some administrative functions such as providing incentives for study participants with emailed coupons.

REDCap is available for faculty, staff, and students of the University of South Alabama (USA), the Mitchell Cancer Institute, the USA Medical Center, and the USA Children’s & Women’s Hospital. Currently, there are 24 active REDCap users affiliated with USA with seven projects in production and another four in development.

In order to use REDCap, you must first fill out an application.  Links to the application and more information about using the system can be found on the USA REDCap informational page  and also on the USA Biomedical Library website.  Additionally, you can contact Clista Clanton the USA REDCap university contact at cclanton@southalabama.edu with any question.

Roots of Health Inequity

Roots of Health Inequity, an online-learning collaborative developed by the National Association of County and City Public Health Officials, offers participants the opportunity to explore the root causes of inequity in the distribution of disease, illness and death. Although the target audience is local public health department staff, anyone interested in these topics can participate in the free course. To encourage deep thinking about issues of health and inequity, the course content helps participants explore five critical questions:

  • Where Do We Start? Explore the relationship among changing the culture of our organizations, engaging community members, and negotiating with political pressures strategically (UNIT 1: Where Do We Start?). This unit provides Continuing Education by participating in specified activities.
  • What Are “Frames” and How Do They Influence Public Health Practice? Consider how “mental models” or “frames” influence public health work. Discuss how values, assumptions, and interests affect the capacity for addressing health inequities (UNIT 2: Perspectives on Framing).
  • What Can History Teach Us about the Role of Public Health and Public Health Practitioners? Explore the transformation of public health during the last 150 years, including the forces that advanced or limited the field (UNIT 3: Public Health History). 
  • What Are the Root Causes of Health Inequities? Examine the importance of class structure, racism, and gender inequity in the development of health inequities (Unit 4: Root Causes). 
  • What Are the Principles of Social Justice? Explore the principles of social justice and ways to influence the institutions and agencies that generate health inequity. (Unit 5: Social Justice).

A full index of course content can be downloaded from the Roots of Health Inequity website.

Study: Inequitable Use of Patient Portals May Widen Health Disparities

A recent study published in the Clinical Journal of the American Society of Nephrology, “Disparities in Electronic Health Record Patient Portal Use in Nephrology Clinics,” the sociodemographic characteristics of patients receiving care from any of four University of Pittsburgh affiliated nephrology clinics between January 2010 and December 2012. The patients included in the study had at least one follow-up visit prior to July 2013. For each of these patients, the nephrology office activated a free patient portal linked to an existing ambulatory electronic health record (EHR) and office staff members informed patients about the portal, inviting them to sign-up during the check-in process.

According to the study authors, “Enabling patients with chronic kidney disease (CKD) to easily access their medical information is a novel approach to facilitate patient engagement and activation. In other chronic disease settings, empowering patients in this fashion improves disease knowledge, enhances patient-provider communication, and increases adherence to treatment.”  

To understand the adoption of such tools by patients, the researchers viewed sociodemographic characteristics, comorbidities, clinical measurements and office visits from the EHR as well as tracking patients’ median household income. The researchers found that 39% of patients accessed the patient portal with portal adoption growing over time. However, vulnerable groups were the least likely to use the portal.

Access the study.

Read a summary of the study from Healthcare Informatics.