LECTURE 8 (The role of data in public health)

Question 1

What is the role of Public health workers?

Answer 1

To monitor the health of a community by collecting and analysing health data called “health statistics”

Question 2

What is the function of Health statistics?

Answer 2

• To identify special risk groups
• To detect new health threats
• To plan public health programs and evaluate their success
• To prepare government budgets

Question 3

What do the statistics collected by the government serve as?

Answer 3

Raw material for research on epidemiology, environmental health, social and behavioural factors in health and for the medical care system

Question 4

What are the most basic, reliable and complete data collected?

Answer 4

Births and Deaths

Question 5

What is the state health department generally responsible for?

Answer 5

Collecting these reports and transmitting them periodically to the NCHS (National Center for Health Statistics)

Question 6

At the federal level, what does the NCHS (National Center for Health Statistics) do?

Answer 6

Collects, analyses and reports data on the health of Americans

Question 7

What is the difference between Birth certificates and Medical and health information?

Answer 7

Birth certificates = contain information supplied by the mother about the child’s family

Medical and health information = supplied by the hospital, doctor or other birth attendant

Question 8

What do birth certificates include?

Answer 8

• Names
• Addresses
• Ages
• Race
• Ethnicity
• Education levels

Question 9

What do medical and health information include?

Answer 9

• Prenatal care
• Birth weight
• Medical risk factors
• Complications of labor and delivery
• Obstetrical procedures
• Abnormalities in the new born

Question 10

What does the uncertainty of death certificates depend on?

Answer 10

A number of uncertainties depend on how well the informant knew the deceased and the circumstances of the death

Question 11

What are the causes of uncertainty in death certificates?

Answer 11

• Incorrect diagnoses (absence of autopsy -> exact cause of death not known)
• Number of conditions contribute to death -> underlying and immediate causes may be confused
• Suicide/AIDS misstated deliberately because of social stigma

Question 12

What do vital statistics include?

Answer 12

• Births and deaths
• Marriages and divorces
• Spontaneous foetal deaths
• Abortions

Question 13

Describe what the NCHS has done with infant mortality being an important health issue

Answer 13

NCHS has set up a special computer system that links vital records of infants born during a given year who died before their first birthday -> linkage allows researchers to compare information on death certificates with that on birth certificates, providing insight into factors that contribute to infant deaths

Question 14

Why are errors worrisome for public health?

Answer 14

Mortality data have such a strong influence on planning and priority setting for public health programs

Question 15

What is an Autopsy/Post-mortem examination?

Answer 15

A specialised surgical procedure used to determine the cause and manner of death

Cause of death = the medical reason explaining why a patient has passed
Manner of death = the circumstances surrounding death

Question 16

Who usually performs autopsies?

Answer 16

A specialised medical doctor called a Pathologist

[medical examiner/coroner can determine the cause of death]

Question 17

What is the advantage of autopsies?

Answer 17

Information obtained can
- improve the quality of medical care for future patients
- improve the accuracy of vital statistics

Question 18

What are the advantages of electronic information?

Answer 18

• Weekly reports of notifiable diseases from state and local health agencies are transmitted electronically to the CDC -> prompt response to new outbreaks
• Lab reports reported electronically -> Facilitate rapid identification of bacterial + viral strains causing illness in scattered locations around the country
• Databases kept up-to-date by electronic findings -> provide rapid feedback on effectiveness of new public health interventions + help detect emerging problems

Question 19

What is Public health informatics?

Answer 19

The systematic application of information and computer science and technology to public health practice, research and learning

Question 20

Who makes information available over the internet?

Answer 20

The CDC and most federal and state public health agencies

Question 21

What must happen to the data collected through the vital statistics system for it to be useful for many public health purposes?

Answer 21

It must be converted into rates -> calculations require information on number of people in the population being referred to

Question 22

What is necessary to calculate age-adjusted or age-specific rates?

Answer 22

How many people are in each age group

Question 23

What is necessary to determine sex-specific or race-specific rates?

Answer 23

How many males and females there are and how many races are in each sex and each age group

Question 24

The US constitution requires that the population of the US be counted every ________ years to determine each state’s representation in the House of Representatives

Answer 24

10 years

Question 25

What is the Census Bureau?

Answer 25

A national survey that provides data not only on the geographic distribution of the population and its sex, age, and ethnic characteristics, but also on a wide variety of social and economic characteristics, including education, housing, and health insurance status.

Question 26

What is the function of the Census Bureau?

Answer 26

• Tracks trends in the population between the decennial censuses
• Vital for the operation of the nation’s social, political, economic and industrial systems
• Essential for the practice of public health

Question 27

Why are some people missed or counted twice in the census?

Answer 27

• Missing ones = the poorest/most marginal members of the population (homeless, illegal immigrants and fugitives from the law)
• Counted twice = wealthy people who own more than one home

Question 28

Is the long form still collected in the decennial census?

Answer 28

NO

Explanation: In 2010 only short form is used for the census and the American community survey (ACS) now collects the same kind of information collected on the long form

Question 29

What is the difference between the long form and the short form?

Answer 29

Short form = asks for name, age, sex, race, ethnicity and relationship of every living in the household

Long form = asks about education, housing, employment, transportation, language, ancestry and other issues useful for governments and businesses