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CHAPTER 8

Role of Data in Public Health

Uses of Data

Assessment of the health of a community

Raw material for research

Identification of special risk groups

Detection of new health threats

Planning of public health programs and evaluation of their success

Preparation of government budgets

Collection of Data

Local records are sources of data:

Birth certificates

Death certificates

Other vital statistics

Data is transmitted:

From local governments to states

From states to National Center for Health Statistics (NCHS is part of CDC)

Surveys are sources of data.

NCHS set up a computer system to link vital records of infants because infant mortality is an important public health issue.

The Census

Is mandated by the U.S. Constitution

Serves as the denominator for most public health data:

Age, sex, race, ethnicity

Is conducted every 10 years

Determines the political composition of the U.S. Congress

The citizenship status question excluded from 2020 census

New household categories included for 2020 census

American Community Survey is done on an ongoing basis in between censuses:

Education, housing, health insurance

Surveys

National Health Interview Survey (NHIS)

National Health and Nutrition Examination Survey (NHANES)

National Health Care Survey

Behavioral Risk Factor Surveillance Survey (BRFSS)

State-by-state, with results transmitted to NCHS

Surveys done by other government agencies

How Much Data Is Necessary?

There can never be too much data.

Data is critically important in developing surveillance systems.

Data collected is used by federal, state, and local agencies in all areas of public health.

Public health problems are defined according to available data.

Without data, experts can’t recognize when an epidemic is starting.

Accuracy and Availability of Data

Data collection is imperfect.

Census is most accurate.

Still, there are overcounts and undercounts.

Information technology increases accuracy and availability.

Public health informatics has vastly improved the accessibility of public health information for public health workers and the general public.

The CDC and most other federal and state public health agencies make information available over the Internet.

Confidentiality of Data

Governments have safeguards to protect information on individuals.

Use of data may involve removal of information identifying individuals.

Use of data requires permission granted by an institutional review board or data protection committee.

Discussion Question 1

Vital statistics are the most accurate and complete data collected on the American population, and yet there are still many errors in the information submitted.

What are some possible sources of error in records collected on births, deaths, spontaneous fetal deaths, and induced abortions?

Discussion Question 2

Why did the U.S. Census Bureau propose to use statistical sampling in conducting the year 2000 census?

Can you think of some reasons why some people might not be counted?

Discussion Question 3

Of what value to public health is information gathered by the NHIS?

NHANES?

BRFSS?

Discussion Question 4

Visit the website of the U.S. Census Bureau, www.census.gov.

What is the population of your city or town?

Is it increasing or decreasing?

How does the age distribution of your city or town compare with that of the U.S. overall?

How does the ethnic composition compare?

How does the education level of the population compare with that of the U.S. overall?

Discussion Question 5

Visit the NCHS website, www.cdc.gov/nchs.

What surveys does NCHS conduct in addition to those described in this chapter?