Building a National System of
National, State, and Local
Population Health Statistics
E. Richard Brown, PhD
UCLA Center for Health Policy Research
AcademyHealth
State Health Research and Policy Interest Group
June 26, 2010
www.healthpolicy.ucla.edu
Demand for and use of state and local
population health survey data
X Federal agencies and the Congress
f Support federal policy making, especially efforts to
address disparities
f Evaluate and monitor progress in national health
care reform
f identify and fill research gaps
X National health organizations
f Support advocacy and research on health issues
X State and local public health policy makers, program
planners, and advocates
f Levels where policy is both made and implemented
Demand for and use of state and local
population health survey data
X Data on
f Health care coverage and reform, and access to
health services
f Understanding and preventing chronic disease
f Social determinants of health
X Used in
f Health policy analysis, policy development and
advocacy
f Research on determinants of health/disease
f Seeking funding and making grants
f Service and program planning
Demand for state and local
population health survey data
X Examples of demand for population health data at
local and state levels needed
X Federal:
2002 report on “Shaping a Health Statistics Vision for
21st Century” *
fNational Committee on Vital and Health
Statistics, NCHS, and DHHS Data Council
fCalled for consistent and comparable data
across local areas, states and the nation
* Shaping a Health Statistics Vision for the 21st Century, Washington, DC: U.S. Department of
Health and Human Services, November 2002
Demand for state and local
population health survey data
X National Non-Governmental:
2002 analysis and statement by American Heart
Association *
fEmphasized importance of local and state data for
proposed national surveillance system
fNeeded for prevention and management
of heart disease and stroke
* Goff DC, Brass L, Braun LT, “Essential Features of a Surveillance System to Support the
Prevention and Management of Heart Disease and Stroke,” Circulation. 2007;115:127-155
Demand for state and local
population health survey data
X National Non-Governmental:
2009 Institute of Medicine report on “State of the
USA Health Indicators” *
f Called for development of key health
indicator data at local and state levels
coordinated with national data
* Institute of Medicine, State of the USA Health Indicators: Letter Report, Washington, DC:
National Academies Press, 2009
Demand for state and local
population health survey data
X Congress:
2010 federal health care reform legislation
echoed need for such data
f Mandates development
of key indicators
fLikely to be developed by National Academy of
Science
f Mandates that data be collected and reported at state
and local levels (“at smallest geographic level”) *
f Needed to address health disparities as well as health
system performance
* Public Laws 111-148 and111-152, “Sec. 4302. Understanding Health Disparities: Data Collection and Analysis”
Demand for state and local
population health survey data
X State and federal support for state and local health
survey data collection and use of data
f BRFSS established in 1984 and provides
statewide population health data for adults
X State demand with state/local funding:
f Some states enhanced BRFSS sample to collect
substate and/or children samples
f Some states funded own independent
state health surveys with local samples
and samples of children
f Some local jurisdictions have developed own
health surveys
Potential national system of national,
state, and local health surveys
X Federal-state – federalism model
f Federal and state funding
f Federal coordination and minimum standards to
assure comparability (e.g., key indicators)
X Potential components
f National Health Interview Survey — national and state
benchmark?
f Behavioral Risk Factor Surveillance System — as is,
or expanded to include children and local samples?
f Independent state surveys — how coordinated and
funded?
Potential national system of national,
state, and local health surveys
X How to develop system of national, state, and local
health surveys?
X How to assure comparability across component
health surveys?
X How to optimize utility of data for policy purposes at
multiple levels — federal, state and local?