Data Counts
Healthy King County Coalition
April 9, 2015
Marguerite Ro, DrPH, MPH
Nadine Chan, PhD, MPH
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Purpose
 Using data effectively
 Determining what data you need
 Finding data on the populations we care about
 Q&A
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Using data effectively
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Why are you looking for data and
who is your audience?
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Why?
Who?
Grant proposal
Funders
Advocacy
Elected officials, policymakers, media, general
public
Monitoring / Performance management
Agency heads, program and service staff,
governing boards or committees
Research
Subject matter experts
100% of applicants (n=11)
who were funded used data
effectively:
• Demographic
characteristics
• Data articulate need
• Link data to proposed
project
Based on analysis of 54 applications from
community organizations for funding for
policy/system change projects.
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From a grant reviewer’s perspective
 Comparisons are important
 Tying data to your logic model/theory of change
 Need to link data to strategies
 Use forecasting - what would the curve look like if you
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didn’t do anything?
Have you done a recent literature search?
Evidence-based? Are there supporting studies?
Cost per person
Use appendices – not too much!
From a policymaker’s perspective
 Is the data compelling, reliable, and understandable?
Do:
 Present information in a short, easily digestible form.
 Use language that a non-specialist can understand.
 Summarize the information, and present clear arguments
for a particular course of action.
Don’t:
 Oversell your data (e.g. don’t imply causality without proof)
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How much data do your audiences
need?
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What data do you need
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What do you need the data to do?
 Demonstrating need
 Showing that you have a solution
 Forecasting what will happen if a problem is not addressed
 Measuring progress, impact, or outcomes
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What message will the data deliver?
 Scope – what is the magnitude of the problem? what is the
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landscape?
Cost – what is the cost of the problem to the community and
various sectors?
Quality – are there issues of accessibility, availability, or
affordability?
Equity – are there disparities or inequities in resources or
outcomes?
Impact – what is the impact of an applied strategy or
intervention?
Telling your story
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Credit: Tiffany Manuel, PhD, Vice President for Knowledge, Impact & Strategy
Start with the basic
elements of good storytelling:
not always the data
points.
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Credit:
Credit:Tiffany
TiffanyManuel,
Manuel,PhD,
PhD,Vice
VicePresident
Presidentfor
forKnowledge,
Knowledge,Impact
Impact&&Strategy
Strategy
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Credit: Tiffany Manuel, PhD, Vice President for Knowledge, Impact & Strategy
Social Math
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Credit: Tiffany Manuel, PhD, Vice President for Knowledge, Impact & Strategy
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Credit: Tiffany Manuel, PhD, Vice President for Knowledge, Impact & Strategy
Social Math in Action
Over 100,000 adults live with diabetes in King County. That’s
enough to fill CentuyLink Football Stadium 1.5 times.
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Social Math with Solutions
Over 300,000 adults are
obese in King County. That’s
enough players for 5 soccer
matches a day in each of the
1000 King County soccer
fields (if they were safe and
accessible) and an additional
200 soccer fields.
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Measuring Progress: Result, indicator,
strategy, and performance measure
Guidance by Mark Friedman, author of “Trying Hard is Not Good
Enough: how to produce measurable improvements for customers
and communities”
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Result (or outcome or goal)
 Population condition of well-being
 For children, adults, families and communities
 Stated in plain language
 Results are conditions that voters and tax-payers can
understand
 Examples: healthy children, children ready for school, children
succeeding in school, strong families, elders living in the community
with dignity, a safe community, clean environment
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Indicator (or benchmark)
 A measure that helps quantify the achievement of a result
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Strategy
 A coherent collection of actions that has a reasoned chance of
improving results
 Made of the best thinking of what works or likely to work
 Can operate at both the population and performance levels
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Performance measure
 A measure of how well the program, agency, or service
system is working
 How much did we do?
 How well did we do it?
 Is anyone better off?
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Examples of population accountability:
community, city, county, state, nation
 Population: all WA residents
 Population result: clean environment
 Indicators: percent of days below air quality standards, percent
of contaminated stream-miles
 Population: entire King County population
 Population result: vibrant economy
 Indicators: percent of adults unemployed
 Population: All Auburn residents
 Population result: safe community
 Indicators: violent crime rate, percent of residents who feel safe
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Examples of performance accountability:
program, agency, service system
 Program: The Peace Corps
 Performance measures: percent of countries
accepting/requesting volunteers, percent of volunteers who
complete the program
 Program: Pennsylvania Dept of Environmental Protection
 Performance measures: percent of cited industries that fully
implement clean up orders
 Program: Philadelphia Police Dept
 Performance measures: Avg response time, percent of crimes
with successful prosecution
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Steps for selecting indicators
 For each result, get input from stakeholders on indicators to consider
 Rank indicator (high, medium, low) on three criteria:
 Podium Power (communication power): is it common sense and
compelling?
 Proxy power: can it stand as a proxy for the result of interest? If this
changes, will several other related indicators change in the same way?
 Data power: is the data reliable, consistent, timely, available at the
geographic/demographic level needed?
 Specify three buckets of indicators:
 Primary/headline indicators: For each result, select 3 or 4 measures
that rise to the top in the rating process
 Secondary indicators: Include any other measures for which there is
good data
 Data development bucket: Include items ranking high in
communication and proxy power, but low in data power
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Measuring progress: Try it
What’s the connection?
• Poverty, health, and housing?
• Health and education?
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Finding the data
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Where does the data come from?
 Surveys
 Assessments
 Research / special studies
 Services / programs
 Other ???
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Healthy Youth Survey
Time: 2014 latest year, collected every other year
Who: students in grades 6, 8, 10, and 12
Topics: safety and violence, physical activity and diet, alcohol,
tobacco and other drug use, and related risk and protective
factors.
Data availability: state, county, and some cities
http://www.doh.wa.gov/DataandStatisticalReports/DataSyst
ems/HealthyYouthSurvey
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Healthy Youth Survey – Alcohol questions
Questions about the neighborhood and environment
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Healthy Youth Survey – Alcohol questions
Questions about issues related to alcohol
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Healthy Youth Survey – Alcohol questions
Questions about their individual behaviors
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Behavioral Risk Factor Surveillance
Survey (aka BRFSS)
Time: collected each year
Who: representative telephone survey collected in English and
Spanish
Topics: health-related risk behaviors, chronic health
conditions, and use of preventive surveys
Data availability: state, county, and health reporting areas
http://www.cdc.gov/brfss/index.html
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BRFSS Core
 Health Status
 Immunization
 Quality of Life
 Falls
 Health Care Access
 Seatbelt Use
 Exercise
 Drinking and Driving
 Inadequate Sleep
 Breast and Cervical Cancer
 Chronic Health Conditions
 Oral Health
 Demographics
 Tobacco Use
 Alcohol consumption
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Screening
 Prostate Cancer Screening
 Colorectal Cancer Screening
 HIV/AIDS
2013 BRFSS Modules (WA)
 Cardiovascular health
 Childhood asthma prevalence
 Mental illness & stigma
 Pre-diabetes
 Random child selection
 Sodium or Salt-related behavior
 Sugar drinks
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Pregnancy Risk Assessment Monitoring
System (PRAMS)
Time: collected monthly via mail, with phone follow-up
Who: new moms sampled from birth certificates to assure
adequate data in higher risk pops, administered in English and
Spanish
Topics: data to improve the health of mothers and infants
Data availability: state and county
http://www.cdc.gov/prams/aboutprams.htm
http://www.doh.wa.gov/DataandStatisticalReports/HealthBehaviors/PregnancyRiskAsses
smentMonitoringSystem/ForResearchers
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PRAMS Core
 Attitudes and feelings about the most recent pregnancy.
 Access, content, source, and quality of prenatal care.
 Maternal alcohol and tobacco consumption.
 Physical abuse before and during pregnancy.
 Pregnancy-related morbidity.
 Infant health care.
 Contraceptive use.
 Mother's knowledge of pregnancy-related health issues, such
as adverse effects of tobacco and alcohol; benefits of folic
acid; and risks of HIV.
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The Geography of Diabetes by Census Tract in a Large Sample
of Insured Adults in King County, Washington, 2005–2006
Adam Drewnowski, PhD, Colin D. Rehm, PhD, MPH, Anne V. Moudon, Dr es Sc, and David Arterburn, MD, MPH
Prev Chronic Dis. 2014; 11: E125. Published online 2014 Jul 24. doi: 10.5888/pcd11.140135PMCID: PMC4112927
Results
In this population of insured
adults:
 Diabetes was concentrated in
south and southeast King
County
 Diabetes prevalence ranging
from 6.9% to 21.2%
 For each 50% increase in
median home value, diabetes
prevalence was 1.2 percentage
points lower,
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What to do if quantitative data are not
available
 Proxies
 Extrapolating national or state data
 Use of qualitative data
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Extrapolating data: What is the number of Latinos with
diabetes in the community?
National data: The diabetes rate for Latinos nationally is 0.02 for age 1844, 0.143 for age 45-64, and 0.204 for age 65+
Number of Latinos with diabetes in the community =
National rates x population in your community (by the different
ages)
.02 x 30,000 (ages 18-44) = 600
.143 x 11,000 (ages 45-64) = 1,573
.203 x 2,000 (ages 65+) = 410
Next add up the various populations with diabetes:
600 + 1,573 + 410 = 2,583
There are an estimated 2,500 Latinos with diabetes in this community
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Qualitative data
 What information can context experts provide?
 What might explain the quantitative data we are seeing?
 What else is important to know that the data aren’t showing?
 What are the attitudes and beliefs of the community?
 What can we learn about why something is working or not
working?
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Sources: Qualitative Data
 Focus groups, interviews, photo voice, video, observations,
content analyses, neighborhood assessments
 Literature review
 Reports
Mapping Our Voices for Equity
http://www.mappingvoices.org/
Communitiescount.org
Reports from local initiatives
http://www.kingcounty.gov/healthservices/health/partnerships.aspx
http://www.kingcounty.gov/healthservices/health/partnerships/CPPW.aspx
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Policy landscape: King County K-12
Tobacco Related Policies, 2014
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http://www.kingcounty.gov/healthservices/health/data/PolicyTracker.aspx
Data Power or Critiquing the Data
 Credibility –Who produced the data?
 Specificity – Is the data precise for a particular population?
 Generalizability – Can you apply data from one population to
another population?
 Reliability – How was the data collected?
 Timeliness –When was it collected?
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Good or bad data?
 According to the Community Research Initiative on AIDS,
21 of 1,000 male prisoners and 35 of 1,000 female prisoners
were known to be HIV positive at the end of 1997. The rate
of confirmed AIDS was 51⁄2 times higher in the prisons than
in the general population. A study of infectious diseases
among people passing through correctional facilities in 1996
found that 17% of those released from prison were HIV
positive. Available at:
http://www.thebody.com/cria/summer00/prison.html
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Local Data Sources
 Community Health Indicators
http://www.kingcounty.gov/healthservices/health/data/indicators.aspx
 School district health profiles
http://www.kingcounty.gov/healthservices/health/data/SchoolProfiles.aspx
 City health profiles
http://www.kingcounty.gov/healthservices/health/data/CityProfiles.aspx
 Data Maps
http://www.kingcounty.gov/healthservices/health/data/maps.aspx
 Data and Reports
http://www.kingcounty.gov/healthservices/health/data.aspx
 Communities Count
www.communitiescount.org
 King County CHNA
http://www.kingcounty.gov/healthservices/health/data/kchhc.aspx
 King County Policy Tracker: Law Atlas
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http://www.kingcounty.gov/healthservices/health/data/PolicyTracker.aspx