Introduction to Health Data Using Online Resources: AskCHIS

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Introduction to Health Data using
Online Resources:
AskCHIS Workshop
Health DATA Program:
Data. Advocacy. Training. Assistance.
June 2012
Agenda
I.
Introduction
II.
Overview: Understanding Data and Developing & Answering
Data Questions
III.
Modules 1-3: Accessing Data from the AskCHIS Online Data
Query System
IV.
Practice with AskCHIS
V.
Evaluation & Conclusion
California Health Interview Survey

CHIS is the nation's largest state health survey

More than 50,000 Californians - including adults, teenagers and
children - are surveyed every 2 years by CHIS

Conducted by the UCLA Center for Health Policy Research,
located within the UCLA School of Public Health, in
collaboration with the California Department of Public Health
and the Department of Health Care Services


Center for Health Policy Research’s mission: improve and maintain
the public’s health by advancing health policy research, public service,
community partnership and education
Health DATA program exists to make data easy and understandable
to a wide range of health advocates through trainings, workshops
and technical assistance.
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion
CHIS Case Studies

Both California Governor Schwarzenegger's office and
Democratic legislators used CHIS data to develop health care
reform proposals. Governor Schwarzenegger also held a press
conference at UCLA in which he cited a cornerstone CHIS
publication - The State of Health Insurance in California - as
important evidence of the need for health care reform.

More than a dozen First 5 county commissions - created by
California voters to direct tobacco tax revenues to promote
early childhood development - have used CHIS data to
develop new public-private expansion programs for children
ineligible for private insurance, Medi-Cal or Healthy Families. In
most cases, CHIS has been the only data source available.
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion
Goals and Objectives

To train and provide technical assistance to those who
plan to use CHIS to increase their capacity to obtain and
apply health and social data

Upon completion of this training, you will be able to:


Identify relevant and appropriate data sources to answer data
questions
Increase knowledge and skills to use the AskCHIS data
reporting system and computer tools to access, interpret and
apply CHIS data
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion
Overview

Distinguish between different data types

Identify the type of data CHIS provides

Review how to evaluate data sources

Review benefits and limitations of CHIS data

Develop and Answer Data Questions
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion
Data Types

Quantitative data


Qualitative data


Textual/words, often descriptions- An individual’s account of her
experience at a healthcare facility
Primary data


Numerical- # of healthcare facilities in a city
Collected and analyzed directly by individuals, communities and
researchers
Secondary data

Collected and provided by a third party such as a non-profit,
university or government agency
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion
Evaluating Data
Credibility
Timeliness
Reliability
Specificity
Generalizability
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion
Benefits and Limitations
CHIS CAN:

Provide data for California
counties

Compare information
between counties and the
state

Compare information
across ethnic groups

Compare data over time
(2001-2009)
CHIS CANNOT:

Provide data before 2001

Provide data on nonCalifornia households
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion
Health and Migration - What can
CHIS data provide?

Citizenship and Immigration status:


Years Lived in the US


Up to 1 year
2 to 4 years
5 to 9 years
10 to 11 years
12 to 14 years
15 or more years
Country of Birth


U.S. born citizen
Naturalized citizen
Non-citizen
United States
Mexico
Central America
Other Latin America
Asia and Pacific Islands
Europe
Other
Informational available for respondent and respondent’s mother and father
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion
Develop and Answer Data Questions

Identify a question that can be answered using data


Identify appropriate data types and sources


Quantitative vs. Qualitative; Primary vs. Secondary
Identify stakeholders that can help answer the data question


Consider the population, location and pervasiveness of a specific
community health issue when developing a data question
Connect with stakeholders that work with community of interest
Present the Data

Present data in a simple and consistent manner- tables, charts and
graphs are very helpful
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion
Brainstorm Activity
Select Your Own Question:
How does health status differ amongst Californians with
different types of immigration status.
Community
Health Issue
Data
Question
Data Types
Needed
Data
Stakeholders
Data
Presentation
Example:
What percentage of children ages 0-12 are covered by
Medi-Cal?
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion
Modules
1.
Introduction to AskCHIS
Developing a Data Query
2.
Executing Queries and Retrieving Data
3.
Additional Features
Interpreting and Presenting AskCHIS Data
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion
AskCHIS

Online data query system that allows you to access
specific health information from CHIS

CHIS information can also be accessed via:

Data Access Center located at the UCLA Center for Health
Policy Research


Email: [email protected]
Public Use Files available on the AskCHIS website
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion
AskCHIS: www.chis.ucla.edu
1. Log-in to AskCHIS (or register)
2. Select a Geographic Area
3. Select a Main Topic
4. Select a Compare By Group
5. Select a Population for your Results
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion
Developing the Query: Topics

AskCHIS topic fact sheet


Data Dictionary


Online at: http://www.chis.ucla.edu/main/PUF/default.asp
Questionnaires


Online at:
http://www.chis.ucla.edu/pdf/respondent_topics_2009.pdf
Online at: http://www.chis.ucla.edu/questionnaires.html
AskCHIS Keyword Search

Online at:
http://www.chis.ucla.edu/main/DQ3/topic.asp?page=first (click
on AskCHIS, then Main Topic)
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion
Worksheet 1(Appendix, B-19)

Step 1: What question are you trying to answer?


Step 2: Review the Topic Sources


Main topic: Health Insurance; Search by “Medi-Cal”
Step 3: Identify the health topic you are interested in and
corresponding CHIS Variable


What is the percentage of children (ages 0-12) in Los Angeles
County covered by Medi-Cal?
“Covered by Medi-Cal”- Data available for children, adolescents and
adults through 2009
Step 4: Identify a Population to be included in your results

Specify age range: 0-12
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion
1 Topic: One-way table

Table provides answer to a data query that focuses on
only ONE health topic or characteristic, aka Univariate
table

Univariate tables provide percentages, populations
estimates and confidence intervals

Interpretation: In 2009, 41.2% of children (ages 0-12)
in Los Angeles County were covered by Medi-cal.
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion
Additional Features

Compare to State


In 2009, 41.2% of children in Los Angeles County were covered
by Medi-Cal, as compared to 31.9% of children in California.
Change time period


Compare 2 years
Show Trend Line:
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion
AskCHIS: www.chis.ucla.edu
1. Log-in to AskCHIS (or register)
2. Select a Geographic Area
3. Select a Main Topic
4. Select a Compare By Group (if
applicable)
5. Select a Population for your Results
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion
2 Topics: 2-way table
(Worksheet 2: Appendix, B-21)

Table provides answer to a data query that focuses on the
distribution of one variable across the levels of a second
variable, aka Bivariate table


The distribution of children covered by Medi-Cal across
poverty levels
Interpretation: In 2009 in Los Angeles County, 86% of
children (ages 0-12) whose household income was 0-99%
FPL were covered by Medi-cal, as compared to 46.3% of
children whose household income was100-199% FPL.
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion
Bivariate Tables

Trend Line: Covered by Medi-Cal by Poverty level
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion
Unstable Estimates

Given the small size of many California Counties, data
pulled for certain health indicators can yield “statistically
unstable” results

These are marked by a red asterisk (*) in the generated tables
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion
Interpreting and Presenting Data

Switch main variable and compare by variable:



Export Data in Excel


“Transpose topic”
Interpretation: In 2009, 63.4% of children covered by Medi-Cal
had household incomes of 0-99% FPL.
Export in other formats: Excel Export
Show in bar graph, pie graph
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion
Unstable Estimates:
Worksheet 3 (Appendix, B-23)

Increase/change the geographic area


Remove Comparative categories


Try not limiting by race/ethnicity, gender or age
Use data from a larger time frame


Use statewide totals or larger counties
Combine information from a series of years
Use different indicators

Look at “Currently Insured” vs. “Type of Health Insurance
Coverage”
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion
Practice with AskCHIS
Example: Migration and
Health
All children have health coverage.
Examples of research questions:


What is the percentage of children
(ages 0-12) in Los Angeles County
covered by Medi-Cal? How does that
percentage compare to the percentage
of children covered by Medi-Cal in the
state of California?
Of children (ages 0-12) in California
that are not currently insured, what
percentage have been uninsured for the
last 12 months? What has been the
trend from 2001 to 2009?
Possible Topics:
Health Insurance: Current Coverage, Coverage
Offered, Managed Care Features,
Medication/Vision/Dental, Past Coverage, Eligibility
Health Conditions: ADD/ADHD, Asthma, Child
Development, Cholesterol, Diabetes, Heart Disease,
High Blood Pressure, Seizure Disorder/Epilepsy
Health Behaviors: Physical Activity/Exercise, Height
and Weight, Diet,Vitamin and Supplement Use, Flu
and Pneumonia Vaccines, Teen Health Education
Demographics: Age and Gender, Language,
Race/Ethnicity, Family and Marital Status, Education,
Employment, Income and Poverty, Residency in the
US
Place of Residence: Urban/Rural, Regions,
Housing/neighborhood
Child Care/Parental Involvement: Child Care,
Parenting/Parental Involvement
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion
Evaluation and Conclusion

Please complete the workshop evaluation before you leave
today:


Review the appendices in the workbook and resources at:


http://www.surveymonkey.com/s/workshopevaluation2011
www.chis.ucla.edu
Contact information:

Ashley V. Parks
Research Associate, UCLA Center for Health Policy Research
[email protected]
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion
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