An Introduction to the Minnesota Epidemiological Profile

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					  An Introduction to the
Minnesota Epidemiological
         Profile

 Minnesota State Epidemiological Workgroup
                     and
    Minnesota Institute of Public Health
                Fall Forums

                                             1
                 Agenda




                What’s in     Interpreting   Activity and
Introduction
               the Profile?    the Data      Discussion




                                                            2
      Purpose of Training

  By participating in today’s session,
         you will be better able to:
• Describe the purpose, format and content
  of the MN Epi Profile
• Describe how the MN Epi Profile fits with
  the Strategic Prevention Framework
• Begin to use the MN Epi Profile to identify
  needs related to substance abuse
  prevention
                                                3
Strategic Prevention Framework
              (SPF)




                                 4
Assessment


  Needs

 Resources

 Readiness
             5
       A Shift in Thinking




“The statistical study of the distribution and
  determinants of disease in populations*.”

              *Source: www.mesotheliomafyi.com/glossary
                                                          6
A Shift in Thinking

         Applying Epidemiology to
                  Substance Abuse
                    Prevention is a
            relatively new concept




                                      7
        Ways to Use Data

Prevention professionals can use data
  to proactively identify:
• Substance use problems
• Level of capacity to address those
  problems
• Readiness of the community to implement
  prevention measures

                                            8
What does the profile provide?


• Provides
  information
  about needs
• SPF and the
  profile allow
  customized
  prevention
                                 9
  Use of the MN Epi Profile

How can the profile be
used as a tool by
prevention
professionals
at the state and
community level?




                              10
                 Agenda




                What’s in     Interpreting   Activity and
Introduction
               the Profile?    the Data      Discussion




                                                            11
      What’s in the Profile?

• Consumption
• Consequences
• Risk Factors Are Not Addressed
          Alcohol               Tobacco                 Illicit Drugs

     Students reporting any     Adults reporting       Percent of population
                                  smoking 100
         use of alcohol       cigarettes in lifetime
                                                       reporting illicit drug   Consumption
        in past 30 days        & smoke everyday         use in past 30 days

        Impaired driving      Deaths from lung         Adult prison inmates
       incidents per 1000      cancer per 1000           in MN sentenced        Consequence
           population            population              for drug offenses


             N/A                    N/A                        N/A              Risk Factors

                                                                                               12
                   Activity

• Using the Profile and your yellow worksheet, look
  up the following data for your county and for the
  state:

   12th Grade Male and Female Binge Drinking (p.150)
   12th Grade Male and Female Drinking or Using Drugs
    and Driving (p. 152)
   12th Grade Male and Female Riding With Friends
    After Using Alcohol or Drugs (p. 154)

                                                         13
                 Data Sources

• Alcohol-Related Disease       • Crash Facts and Minnesota
  Impact                          Impaired Driving Facts
• Behavioral Risk Factor        • Minnesota Dept. of Public
  Surveillance System             Health-Human and Economic
• Fatality Analysis Reporting     Cost of Alcohol Use
  System                        • Minnesota Student Survey
• MN Dept. of Corrections-      • National Survey on Drug Use
  Probation Survey and Inmate     and Health
  Profile                       • National Vital Statistics
• Smoking-Attributable            System
  Mortality, Morbidity and      • Uniform Crime Reports
  Economic Costs



                                                                14
           Census

A census is a survey of an entire
           population




                                    15
              Sample




A sample is a subset of the population
  considered representative of groups
   of people to whom results can be
              generalized
                                         16
              Surveys


A questioning or canvassing of
persons selected at random or
by quota to obtain information
  or opinions to be analyzed




                                 17
                  Rates

• A rate is the quantity, amount, or degree of
  something measured per unit of
  something else

• A percentage is a type of rate




                                                 18
            “The Rate Trap”

Page 60




                                              19
          Do the percentages add up to 100?
                    Economic Cost


Health Care Costs       Productivity
                          Impacts           Other
                                           Impacts


Alcohol Disorders          Loss of       Motor vehicle
   Treatment,           productivity       crashes
   Prevention,         due to alcohol-
    Programs           related illness




                                                         20
Economic Cost in the Profile




Page 194

                               21
Costs of Motor Vehicle Crashes




 Page 192
                             22
               Agenda




              What’s in     Interpreting Activity and
Introduction
             the Profile?     the Data   Discussion




                                                        23
       Data Interpretation

• Introduction to Basic Epidemiological
  Descriptors
   Magnitude
   Severity
   Time Trends
• Data interpretation and critical analysis


                                              24
             Magnitude

• How big is the
  problem?
• How many people are
  affected?
• What percentage of
  the population is
  affected?



                         25
        Magnitude
 Benefits and Limitations

                       Magnitude



 Benefits        • Good way to describe
                      the problem



                             for small
                 • Percentages
                   samples not useful
Limitations
              • Raw counts may not tell the
              whole story when comparing
                 large and small samples
                                              26
               Magnitude




 Page 35



• Counts and Percentages in the Profile
• Benefits
• Limitations

                                          27
          Magnitude

                • Using data to
Page 25
                  interpret magnitude
                   Subgroup data
                   Disparity and
                    disproportion




                                        28
            Magnitude
          Subgroup Data




                  Looking for possible
                        targeted
                  interventions within
                       subgroups
Page 47
                                         29
          Magnitude
 Disparity and Disproportion
  Gender Distribution of MSS      Gender Distribution of
        Respondents               Chewing Tobacco Users
                                     10%




51%                       49%




                         Male                   90%
                         Female
                                                           30
         Magnitude
Disparity and Disproportion
             Racial Distribution of MSS Respondents (In Percentages)
                                5.1
                      5.2

                  2.9

            4.7
                                                                       White
       1.5
                                                                       Black/AA
      4.4                                                              Native American
                                                                       Asian American/PI
                                                                       Hispanic/Latino
                                                                       Biracial
                                                                       DK/NA




                                                        76.2




                                                                                           31
         Magnitude
Disparity and Disproportion
          Racial Distribution of Meth Use (In Percentages, Used in the Last 12 Months)
                          8.37

                 6.3


           3.7
                                                                                         White
     4.3                                                                                 Black/AA
                                                                                         Native American
    2.3                                                                                  Asian American/PI
                                                                                         Hispanic/Latino
     3                                                                                   Biracial
                                                                                         DK/NA




                                                             75




                                                                                                             32
         Magnitude
Disparity and Disproportion
   All MSS                                   Meth Users
 Respondents




  Not much difference in the distributions. What does that tell us?

                                                                      33
                Activity

• Review Impaired Driving Handout Table 1.04
  (blue worksheet)
• Expect an even distribution of DUI arrests
  Sunday through Saturday
• Disproportionate number of arrests Friday -
  Sunday
• Ask why?


                                                34
Severity

    • How “bad” is the
      problem?
    • How does my
      community compare?
    • Comparison Ratios
    • Discussing
      meaningful
      differences and
      acceptable ratios
                           35
         Severity
 Benefits and Limitations

                        Severity


                  • Good way to track
 Benefits        how your community
                 compares to state and
                   national numbers



              • Meaningful differences and
Limitations       acceptable ratios are
                   subjective concepts

                                             36
          Comparison




Page 96




                       37
               Comparison

Page
 148




                                                    Ratio =
                                                   66/ 46.4
Page                                                 = 1.4
 149




       The ratio of Big Stone County : MN is 1.4
                                                              38
                  Activity

• Using the data you looked up earlier (yellow
  worksheet), calculate your local county ratios
• Divide your county’s percentage by the statewide
  percentage to find the ratio


  County Percentage               = Ratio
   State Percentage

                                                     39
    Good News…Bad News

• “Our data is lower than the state’s, so we
  don’t have a problem!”
• Keep looking at the data - what else does it
  show?
• Use other data sources, maybe use recent
  local example


                                                 40
Comparison

    • What is an
      acceptable
      comparison
      ratio?

    • What is a
      meaningful
      difference?
                    41
             Time Trends

• Reading Time Series
  Graphs
• Thinking Critically
• “Environmental”
  Causes of Trends




                           42
      Time Trends
 Benefits and Limitations

                     Time Trends

                  • Incorporates the
 Benefits           element of time

              • Good for critical analysis
                   of a community

               • Usefulness depends on
               amount of available data
Limitations
                  • Hard to evaluate
                     interventions
                                             43
          Time Trends

Page 80




                        44
                Time Trends

            Example: Drug Z Use (percentage of adults, 30 day use) 1999-2002



70


60


50


40
                                                                                      Drug Z Use
30


20


10


 0
     1999               2000                      2001                         2002

                                                                                                   45
                     Time Trends

        Example: Drug Z Use (percentage of adults, 30 day
                        use) 1990-2002

80
70
60
50
40                                                    Drug Z Use
30
20
10
 0
                                         2
                                    0
         92




                              98
                94


                       96
  90




                                         0
                                    0
       19




                                        20
              19


                     19


                            19


                                   20
19




                                                                   46
              Summary: Benefits and
                  Limitations

                  Magnitude                 Severity              Time Trends


                                                                 • Incorporates the
                                         • Good way to track
 Benefits         • Good way to         how your community
                                                                   element of time
                   describe the
                                        compares to state and
                     problem                                     • Good for critical
                                          national numbers
                                                                    analysis of a
                                                                     community

              • Percentages for small                           • Usefulness depends
                 samples not useful                                 on amount of
                                            • Meaningful
                                                                    available data
Limitations                                differences and
              • Raw counts may not
                                        acceptable ratios are
               tell the whole story                              • Hard to evaluate
                                         subjective concepts
              when comparing large                                  interventions
                and small samples
                                                                                       47
                 Agenda




                What’s in     Interpreting Activity and
Introduction
               the Profile?    the Data    Discussion




                                                          48
  Data Interpretation Activity


• Review and Discuss Information
• Calculations
• Critical Thinking
• Sharing Information




                                   49
             What’s Next

• Profile Updates
• Website
• For more information
  contact your Regional
  Prevention Coordinator
  or the Minnesota
  Institute of Public
  Health

                           50

				
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