Progress Report on Health Statistic Resource Guide by onm20503

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									               Finding the Child and Adolescent Health
                                  Statistics You Want:
Overview and Instructions for the Child and Adolescent
                           Health Data Resource Guide


                                        Michael C. Biehl, MA
                                       Tina Paul, MPH, CHES
                                         M. Jane Park, MPH

                       Public Policy Analysis and Education Center
                       for Middle Childhood and Adolescent Health
                 Divisions of Adolescent Medicine and General Pediatrics,
                               Department of Pediatrics and
                             Institute for Health Policy Studies
                                      School Medicine
                          University of California, San Francisco

                                       Tel.: 415-502-4856
                                       Fax: 415-502-4858
                                 Email: policy@itsa.ucsf.edu
                           Website: http://youth.ucsf.edu/policycenter

                                            November 2003




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OVERVIEW

        This guide was created to help users locate child and adolescent health data. Our goal was to
design a tool that would help users locate health statistics among the many available health data
resources (e.g., articles, reports, & on-line databases). While there are many national data sets (e.g.,
the National Health Interview Survey, Medical Expenditure Panel Survey and the National Health
and Nutritional Examination Survey), many professionals in the health field do not have the
resources or skills to analyze these large data sets but rely instead on existing analyses. This guide is
designed to help navigate existing data on child and adolescent health statistics with a particular
emphasis on demographic breakdowns; experience with MS Excel will be helpful, as will
familiarity with health statistics and data sources.

THE PROBLEM: FINDING THE DATA YOU WANT

         Health data resources vary considerably in how they present demographic breakdowns of
their data. The following scenario illustrates the challenges of searching for data. You would like to
find the rate of asthma for United States children ages 6-11; you would also like to get these
statistics for both race/ethnicity and gender. After searching the Internet for an hour, you are able to
locate three different resources with national asthma data. A closer look at the resources reveals the
following:

           Your population of interest does not match the age groups used in the resources (one
            uses ages 0-4,5-14,15-34,35-64, >65; the second uses ages 0-4, 5-10, 11-17; and the
            third uses ages 5-14, 15-34).
           Only one of these resources presents data by gender—only for the entire age-group 0-85
            years.
           The three resources use different race/ethnicity categories (one uses White and Black;
            the second uses White, Black, and Other; the third uses Non-Hispanic-White, Non-
            Hispanic-Black, and Hispanic).


OUR SOLUTION:
THE CHILD AND ADOLESCENT DATA HEALTH RESOURCE GUIDE (“THE GUIDE”)

        Our goal in creating this guide was to make a searchable list of child and adolescent health
data resources. Specifically, we want users to be able to conduct keyword searches for specific
topics, sort information by topic, and, after sorting, compare relevant health data resources. To
achieve this, we first drafted a list of health-related topics (e.g., health care utilization, risky
behavior) and identified health data resources with data for each topic. For each resource listed, we
determined the type of data it contained (e.g., geographic scope of data, time frame of data, and
demographic factors used). The list is formatted in MSExcel, which allows the user to search, sort,
and compare the data of different resources. The list of health data resources has been compiled
over the past few years, as our staff have gathered relevant data for two major publications,
America’s Adolescents: Are They Healthy? (2003) and The Health of America’s Middle Childhood
Population (2002), as well as fact sheets and other documents. We primarily used national data for
these projects. In the following sections, we explain this guide’s structure and present detailed
instructions for use.

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What makes this guide different
        This guide is unique in that it provides specific information on multiple resources and allows
the user to "interact" with the list of resources and compare them. In addition to information about
on-line reports, this guide includes information about interactive on-line databases—databases that
allow the user to specify the type of information wanted from the data set by specific factors (e.g.,
age, gender, race/ethnicity). While we include information from over 125 sources of data, there are
several that stand out for scope and content. These include the Child Trends Data Bank
(http://www.childtrendsdatabank.org), the Federal Interagency Forum on Child and Family
Statistics (http://www.childstats.gov), and the National Center for Health Statistics
(http://www.cdc.gov/nchs). These websites provide both general and specific information on almost
any given health topic and have been enormously useful in our work.

STRUCTURE

        This guide is formatted in MSExcel and organized by health topic. The Excel file contains
three worksheets: the first worksheet lists all health data resources; the second lists interactive on-
line databases only; the third lists all other resources. For all resources listed, we also include:
Citation/Data Source, Website, Geographic Scope of Statistics (i.e., national, state, local), Time
Frame of Data, and Demographic Factors used. In the following pages, we describe each of these
areas in more detail.

Health Topic (Columns A-D)
        There are four main topics: Demographics, Access to Services, Utilization of Services and
Health Status. Within each main topic there are several subtopics (subtopic 1), with many subtopics
further categorized into a second subtopic (subtopic 2). Within the main topic of ―Health Status,‖
for example, the reader will find health data resources on the subtopic of ―Nutrition & Diet,‖
including resources under the second subtopic ―Recommended Dietary Amounts.‖ For each unique
―main topic/subtopic‖ combination, we list the resources that address that unique combination. For
example, there are two reports listed under ―Health Status/Nutrition & Diet/Recommended Dietary
Amounts.‖ Columns B-D (main topic, subtopic 1 and subtopic 2) contain over 100 different unique
topics and are organized as follows:

       Demographics (subtopics include: population, family structure, poverty, parental
        employment, childcare, and school)
       Access to Services (subtopics include insurance)
       Utilization of Health Services (subtopics include medication)
       Health Status (subtopics include: mortality, chronic illness, disability, immunizations, oral
        health, mental health, health risk behaviors, nutrition and diet, physical activity, obesity,
        violence, and victimization).

         Each unique ―main topic/subtopic‖ combination has a unique Topic Number (Column A).
The number for the unique ―main topic/subtopic1/subtopic2‖ combination of ―Health
Status/Nutrition & Diet/Recommended Dietary Amounts‖ is 42.20. We created this list of topics
based on our work developing our Center’s health documents and added other topics where other
relevant information was found. While this topic list is fairly comprehensive, it is not an exhaustive
list of all possible topics. We have limited ourselves to those topics where reliable statistics were
available, rather than create an ideal list of important topics. Below is an illustration of how the
Public Policy Analysis & Education Center for Middle Childhood & Adolescent Health, UCSF, November 2003   3
topics are formatted in the resource guide. On the following pages, we use Topic Number 42.20,
―Health Status/Nutrition & Diet/Recommended Dietary Amounts,‖ to illustrate the format of this
guide.

         A             B                       C                          D
     Topic       Main Topic            Subtopic 1               Subtopic 2
     Number
           42.10 Health Status         Nutrition & Diet         Healthy Eating Index
                 Health Status         Nutrition & Diet         Recommended Dietary
           42.20                                                Amounts
           43.00 Health Status         Physical Activity
           44.00 Health Status         Physical Education
           45.00 Health Status         Obesity
           45.00 Health Status         Obesity

Note: On the Policy Center Website, along with this guide and these instructions, there is also a
file, “List of Guide Topics” with a complete list of all the unique topics within the guide. Users may
find this to be a helpful reference.


Resource Citation & Website (Columns E & F)
        For each resource within a topic, we include the resource’s citation (or Data Source)
(Column E), and the website address containing that resource (Column F). This allows the user to
reference the resource appropriately, obtain a copy of the reference, and look for more information
within that reference. Below is an illustration of how this information is formatted in our guide.

    A      B              C…D                         E                                     F
 Topic  Main            (Subtopics Resource Citation/Data Source                     Website
 Number Topic           1 & 2)
  42.20 Health                     Centers for Disease Control and                   http://www.cdc.g
        Status                     Prevention. (2000). Youth risk                    ov/mmwr/PDF/ss
                                   behavior surveillance – United States,            /ss4905.pdf
                                   1999. MMWR 2000, 49(SS-5).
   42.20     Health                Federal Interagency Forum on Child                http://www.child
             Status                and Family Statistics [FIFCFS].                   stats.gov/ac2000/
                                   (2000). America’s children: Key                   econ4d.asp
                                   national indicators of well-being,
                                   2000. Washington, DC: U.S.
                                   Government Printing Office.


Geographic Scope of Statistics (Columns G, H & I)
        The geographic scope of the statistics refers to whether the data resource has national, state,
and local data for the specific topic. Below is an illustration of how this information is formatted in
our resource guide.

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    A        B                    C            D                    E..F        G           H         I
 Topic  Main Topic            Subtopic 1 Subtopic 2                          National     State     Local
 Number
  42.20 Health                Nutrition      Recommended                     Yes          Yes       Yes
        Status                & Diet         Dietary Amounts
  42.20 Health                Nutrition      Recommended                     Yes          No        No
        Status                & Diet         Dietary Amounts


Time Frame of Data (Columns J & K)
       The time frame columns indicate: the most current year for which data are available to the
general public (Column J); and, whether or not trend data are available, if so, for what years
(Column K). In the example below, trend data are not available for topic 42.20.

    A       B                 C                  D               E…I             J               K
 Topic  Main              Subtopic 1       Subtopic 2                      Most Current      Trend Data
 Number Topic                                                              Data
  42.20 Health            Nutrition &      Recommended                     1999              No
        Status            Diet             Dietary Amounts
  42.20 Health            Nutrition &      Recommended                     1994-1996         No
        Status            Diet             Dietary Amounts


Demographic Variables (Columns L - Q)
         Columns L-Q show how (and whether) each health data resource presents demographic
breakdowns by age, gender, race/ethnicity, family structure and poverty status. If statistics are
presented for a certain demographic variable, this guide also shows the age groups for which the
breakdowns are available. For example, if the resource presents statistics by race/ethnicity, this
guide shows the ages for which race/ethnicity breakdowns are available. The table below illustrates
how data are presented. The first resource presents race/ethnicity breakdowns for 9th, 10th, 11th, and
12th graders (Column N). Column M indicates that gender breakdowns are also available for 9th,
10th, 11th, and 12th graders. By contrast, the second resource (42.20) presents data by selected age
groups only (Column L). There are no breakdowns by gender or race/ethnicity (Columns M and N).
This guide also shows the categories used for age (Column L) and race/ethnicity (Column O). (See
list of race/ethnicity abbreviations at the end of this file.)

   A         B…K             L             M             N          O                  P             Q
 Topic                 Age              Gender       Race/       What              Family         Poverty
 Number                                              Ethnicity   Race/             Structure      Status
                                                                 Ethnicity
   42.20               Yes              Yes          Yes         WNH,              No             No
                       (9,10,11,12      (9,10,11,    (9,10,11,12 BNH, H
                       grade)           12 grade)    grade)
   42.20               Yes (2-3, 4-     No           No          (NA)              No             No
                       6, 7-10, 11-
                       14, 15-18)
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Interactive On-line Data-Base, Critical Objective Number, & Other Information (Columns R-T)
       Column R indicates whether the resource is an interactive database, and the number of
searchable levels. Column S shows other pertinent information. Finally, if the data presented
addresses one of the 21 Healthy People 2010 Critical Objectives for Adolescents and Young Adults,
Column T lists the Objective number. Since the topic used in these illustrations, Recommended
Dietary Amounts, is not a Critical Objective, Column T is blank.

   A             B…Q       R                            S                 T
   Topic                   Interactive (# of            Other Information Critical Objective
   Number                  Levels can search by)                          Number
     42.20                 Yes (4)
     42.20                                              Can download data
                           Yes (6)                      in Excel format




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INSTRUCTIONS FOR USING
      The following pages present illustrated step-by-step instructions to help orient the reader to
the MS Excel file.

Searching for Text
       After opening the file, use the following commands to search the file for certain keywords.
Figure 1 illustrates how your screen will look.
    Press the Ctrl and F keys simultaneously or go to Edit Menu and click on Find. The Find
       dialogue box will then appear.
    Enter the text you wish to find within the spreadsheet. In the illustration below, the user is
       searching for resources with statistics about asthma.
    Click the ―Find Next‖ button or press ―Enter/Return‖ on your keyboard.
    To continue searching the file, either click the ―Find Next‖ button or press ―Enter/Return‖
       again on your keyboard.
    Repeat this process until you can find no more instances of the text you are searching for.


Figure 1




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Sorting

Sorting by One Category
       To sort by one category, use the following steps:

         Go to the Data menu and click on Sort (Figure 2).
          A dialog box should appear (Figure 3). This dialog box allows you to sort by up to three
          categories (Figure 3 shows only one category). For each category, there is a pull down menu
          that allows you to select the column heading by which you want to sort.
         Select the one category you want to sort by and then click OK.
         Alternatively, you can sort by single category by clicking on the cell with the category you
          want to sort by and then clicking on the sort icon.

Executing the Sort command that is illustrated in Figure 3 will help the user locate and compare
health data resources that present information by family structure.

Figure 2




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Figure 3




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Sorting by Multiple Categories
    To sort by multiple categories, you also begin going to the Data Menu and clicking on Sort
       (Figure 2).
       A dialog box should appear. This dialog box allows you to sort by up to three categories
       (Figure 4). For each category, there is a pull down menu that allows you to select the column
       heading by which you want to sort.
    Select the three categories you want to sort by and then click OK to sort.

Users who sort by the columns illustrated in Figure 4 will be able to easily locate data sources that
provide state-level data on the 21 Critical Objectives and whether those sources present data by
gender.

Figure 4




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SUMMARY

         This guide is designed to serve investigators, policy analysts and others searching for child
and adolescent health data. We encourage users to adapt this guide to best meet their data needs.
Users may want to add more resources or topics to the file. People whose work focuses more
closely on disability, for example, may be aware of more health data resources that could be added
to the file. Others may focus on rural health and add a column showing which health data resources
breakdown statistics by urban/suburban/rural setting. We welcome your feedback about this guide
and would be grateful to learn how it is being used by those in the field of child and adolescent
health, as well as any additional excellent sources of data that might be useful to others. We want
this to be a document that stays current and improves as more people use it. We plan to produce an
annual supplement to this guide that will provide information on major annual reports.

        We hope this guide will save the user valuable time and illustrate how many excellent health
data resources of information are available. This effort has reaffirmed our respect for the many
organizations, agencies and people who have worked hard to make this information available for all
to use. The vision of making health statistics available at different levels (national, state, and local)
with enough specific information (age, gender, race/ethnicity, family structure, poverty, etc.) to be
useful to everyone is a daunting task. This task would not be possible without a large network of
people trying to provide this information. We thank all those individuals, centers, and institutions
that have been a part of pursuing this vision and we hope our guide is a useful contribution.

Selected Resources:

Moore KA, Brown BV, Scarupa HJ. (2003). The uses (and misuses) of social indicators:
Implications for public policy (Publication # 2003-01). Washington, D.C.: Child Trends. [Available
online at URL (11/03): http://www.childtrends.org/r_resbrief.asp]

Child Trends. (2000). Building a better system of child and family indicators. Washington, D.C.:
Author. [Available online at URL (11/03): http://www.childtrends.org/r_resbrief.asp]

Family Health Outcomes Project. (n.d.) Selecting Health Indicators for Public Health Surveillance
in a Changing Health Care Environment. San Francsico: Author. [Available online at URL (11/03):
http://www.ucsf.edu/fhop/fhophi.html]

Family Health Outcomes Project. (n.d.) Children with special health care needs (CSHCN): Issues
and options in selecting health indicators. San Francisco: Author. [Available online at URL
(11/03): http://www.ucsf.edu/fhop/fhophi.html]

Family Health Outcomes Project. (2000). Data sources & tools for measuring adolescent health
status. [Available online at URL (11/03): http://www.ucsf.edu/fhop/fhophi.html]




Public Policy Analysis & Education Center for Middle Childhood & Adolescent Health, UCSF, November 2003   11
NOTES:

1. Abbreviations used in the data guide:
Race/Ethnicity Categories:
W            White
WNH          White, non-Hispanic
B            Black
BNH          Black, non-Hispanic
Non-B        Non Black
H            Hispanic
NH           non-Hispanic
NW           non-Whites (Blacks + Others)
A            Asian
ANH          Asian, non-Hispanic
A/PI         Asian/Pacific Islander
A/PINH       Asian/Pacific Islander, non-Hispanic
PI           Pacific Islander
PINH         Pacific Islander, non-Hispanic
Haw/PI       Hawaiian/Pacific Islander
Haw/PINH Hawaiian/Pacific Islander, non-Hispanic
AI           American Indian
AINH         American Indian, non-Hispanic
AI/AN        American Indian/Alaskan Native
AI/ANNH American Indian/Alaskan Native, non-Hispanic
AI/E/A       American Indian/Eskimo/Aleut
O            Other Race
ONH          Other Race, non-Hispanic
2+Races OR More than one Race OR Multi-Race= Multiple Races
More than one Race= Multiple Races, non-Hispanic
Countries of Origin= Race/Ethnicity based on identity of Native
Country/Country Where Born
All Countries= Race/Ethnicity based on identity of Native Country/Country
Where Born
Unknown= Unknown Race/Ethnicity

SCHIP: State Children’s Health Insurance Program

Note: For racial/ethnic categories, names presented are those of the data sources used.

2. Also see topic list




Public Policy Analysis & Education Center for Middle Childhood & Adolescent Health, UCSF, November 2003   12

								
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