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									  CPH 711
     Week 2
September 8, 2009
   Assignment #1


Around the Room Discussion
      Actual Causes of Death,
          1993 and 2003


1st General Thoughts ????
            Data Sources
1993 Analysis – Published Articles
                1977-1993

2003 Analysis – Published Articles
                1980-2002

                Thoughts ?
Anything Missing?
    or that could cause bias??
• Unpublished studies
  * Emphasize need to always publish
• Coding of Cause
  * Missing data
  * Subjective
• Population Attributable
  Risk (PAR) calculations used
  How might this impact
• Does PAR always apply to an individual
  case/death?
Meta-Analysis
Explain potential problems
          Findings/Results

Any surprises??
• 300,00 deaths from poor diet and physical
  inactivity in 1990
• 400,000 in 2000

Thoughts on the story
           Other Thoughts

Decreases in deaths due to:
1) Alcohol consumption
   100,000 in 1990 to
    89,000 in 2000
2) Microbial agents
   90,000 1990
   75,000 2000
Increases in death from

1) Motor Vehicles
   25,000 in 1990
   43,000 in 2000
Relevance of these Analyses????

            DISCUSS
   Prevention, Chronic Diseases
                1&2

“The Neglected Epidemic”
How do you feel about the use of the term
 epidemic with Chronic Diseases and even
 Risk Behaviors??
              Worldwide:

58 million total deaths in 2005
35 million estimated to be from Chronic
  Diseases
Compare worldwide numbers with U.S.
U.S. Chronic 65%+
Worldwide Chronic 60%
        Striking Differences
              Worldwide          U.S.
CVD           30%                39%*
Cancer        13%                23%
Diabetes       2%                 4%
Accidents      9%                 5%

*Includes Heart and Cerebrovascular
Worldwide: Communicable, material,
 perinatal conditions and nutritional
 deficience 30%
            Disability Adjusted
               Life Years;
                 DALY’s

One DALY = One Lost Year of Healthy Life
           Deaths (millions)    DALYs(millions) Deaths per 100000            DALYs per 100000
           2005        2015      2005        2015 2005           2015         2005       2015

0-29 years 1-7        1-5        220        219          48         40         6320       5994
30-59 years 7           8        305        349          311        297       13304      13375
60-69 years 7           8        101        125         1911       1695       27965      26396
≥70 years   20        24          99        116         6467       6469       32457      31614
All ages    35        41         725        808          549        577       11262      11380

Table: Projected global deaths and burden of diseases (DALYs) due to chronic diseases by age, 2005
    and 2015
Interpret/Discuss
Other Interesting Findings????
• Death rates from heart disease have fallen
  up to 70% in the past 30 years in
  Australia, Canada, Japan, UK and the
  U.S.
   Preventing Chronic Diseases:
      Taking Stepwise Action
• 80% of heart disease, stroke and type 2
  diabetes are preventable
• 40% of cancers preventable
15 million (43%) of the estimated 35 million
  chronic disease deaths worldwide occur in
  individuals under the age of 70 years
Difference between Epidemiologic Surveillance
              & Epidemiologic Research
                            Surveillance                   Research


                      routine, systematic,           not routine, systematic,
Data collection       continuous                     not continuous


                      routine, systematic,           not routine, systematic,
Data analysis                                        not continuous
                      continuous


                      routine, systematic,           not routine, systematic,
Data interpretation
                      continuous                     not continuous

                                                     descriptive and
Design                usually descriptive
                                                     analytic


                      to monitor, evaluate and re-   to detect the etiology
Purpose
                      planning of health program     of disease
Translational Research
      Discussion


      3 Groups
Public Health Data Sources


            Presentation to:
    Chronic Disease Epidemiology Course
University of Kentucky College of Public Health

              September 16, 2008




                                                  42
Vital Statistics




                   43
                 Vital Statistics

• The Kentucky Office of Vital Statistics (OVS) in
  the Kentucky Department for Public Health
  records and disseminates data on the following
  vital events:
•   Birth         1911 to present
•   Death         1911 to present
•   Stillbirth    1911 to present
•   Marriage      1958 to present
•   Divorce       1958 to present
                              Birth Statistics
                        Types of information collected
OVS collects information on newborns and parents for births that occur in
Kentucky or to a Kentucky resident out of state. Types of data collected are listed
below.


                Newborn                                       Mother
 Name                                         Name
 Gender                                       Address
 Date of Birth                                Race/ethnicity
 Race/ethnicity                               Age
 Weight/Height                                Prenatal care
 Abnormal conditions of the                   Obstetric procedures
   newborn                                    Characteristics of Labor and
 Congenital anomalies of the                     Delivery
   newborn                                    Risk factors
                                                 Smoking
                                                 Alcohol use
                  Birth Statistics
Note: Birth Certificate Change in 2004
Certain variables from previous years may not be comparable
     Changed Variables                   New Variables

Abnormal conditions of the        Mother’s height
  newborn                         Mother’s pre-pregnancy weight
Mother’s entry to prenatal care   Principal source of payment
Mother’s education                Breastfeeding
Mother’s race                     WIC status
Mother’s smoking status           Gestational and pre-pregnancy
                                     diabetes
                                  Gestational and pre-pregnancy
                                     hypertension
                                  Infertility treatments
Vital Statistics




                   47
Vital Statistics




                   48
                             Death Statistics
                        Types of information collected
Collects identifying information on deaths that occur in Kentucky or to a Kentucky
resident out of state. The types of data collected are included below.


                                                • Injury
 •   Name                                       • Underlying cause of
 •   Address                                      death (ICD-10)
 •   Age                                        • Listing for four
 •   Gender                                       contributing causes of
 •   Race/ethnicity                               death (ICD-10)
 •   Circumstances of death                          – More may be included
      – Date and Place
 • Occupation
 • Pregnancy status
                 Death Statistics
            Recent Change to Death Certificate


   On July 15, 2008 OVS issued a new version
   of the death certificate.

• Added an additional line for contributing cause of death
• Removed the following two questions on diabetes
   – 28 d. Did the deceased have diabetes?
   – 28 e. Was diabetes an immediate, underlying or
     contributing cause of or condition leading to death?
Vital Statistics




                   51
Acute exacerbation of chronic pancreatitis   3 days

Chronic pancreatitis                         2 years

Chronic alcoholism                           10 years




                                                        52
53
                Strengths
• Registration of vital events is required by
  law to ensure complete reporting for
  events that occur in state

• System is population based rather than
  relying on a sampling strategy

• Collection protocols are similar among
  states, so data are comparable.
                Limitations
• Incomplete data for births and deaths of
  KY residents that occur out of state
  (Intransfers)
  – Kentucky must rely on other states to send
    the intransfers


• Timeliness
  – Due to waiting for intransfer records and
    editing the data there can be a delay of as
    much as two years in establishing a
            Vital Statistics Data
Analysis of data by county is possible.
                           Vital Statistics Data
                  Smoking during Pregnancy by County in Kentucky, 2004


                Percentage
                     14.6 - 26.3
                     26.4 - 31.2
                     31.3 - 36.7
                     36.8 - 51.3




                                            Kentucky: 26.7%
Lowest: Oldham County, 14.6%                          Highest: Jackson County, 51.3%
 Source: Kentucky Vital Statistics Files;
 Live Birth Certificate Files, 2004
                                      Vital Statistics
                                              Resources

National Center for Health Statistics
Vital Statistics Data Query System
http://www.cdc.gov/nchs/VitalStats.htm
National Vital Statistics Reports
http://www.cdc.gov/nchs/products/pubs/pubd/nvsr/nvsr.htm


Kentucky Office of Vital Statistics
Vital Statistics Report
http://chfs.ky.gov/dph/vital/vitalstats.htm
County Health Profiles
http://www.chfs.ky.gov/dph/epi/cohealthprofiles.htm


Extra
ICD-10
http://www.who.int/classifications/icd/en/
         Extra – Population Data
Kentucky State Data Center
http://ksdc.louisville.edu/

Office of Vital Statistics
Vital Statistics Report

U.S. Census Bureau
http://www.census.gov/

http://www.census.gov/popest
   /estimates.php
              Vital Statistics
                  Contacts

Office of Vital Statistics
Division of Epidemiology and Health
  Planning
Kentucky Department for Public Health

Paul Royce,
Registrar
502-564-3418 ex. 3568
Paul.Royce@ky.gov
Reportable Diseases




                      66
 Reportable Disease Surveillance System
• Reporting of over 70 diseases is
  required by Kentucky
  Administrative Regulation
  902 KAR:020

• Kentucky Electronic Public
  Health Records System
  (KYEPHRS) collects data on
  demographics, clinical
  symptoms, risk factors and
  outbreak associations

• Information is sent from
  hospitals, clinics, local health
  departments, private practice
  physicians and commercial
  laboratories
Reportable Disease Surveillance System

• HIV/AIDS Surveillance
  System
• STD Surveillance
  System
• Tuberculosis
  Surveillance System
• Influenza Sentinel
  Surveillance System
• Perinatal Hepatitis B
  Surveillance
    Strengths and Limitations
• Strengths
  – Required by law
  – Electronic reporting system (KYEPHRS)


• Limitations
  – Incomplete data
  – Delays in reporting
           Reportable Disease Data
           Hepatitis A Rates per 100,000 by   Kentucky County, 2005




Data Source: KYEPHRS
                    Reportable Disease Data
                         Figure 15. Kentucky AIDS Incidence Rates by Race/Ethnicity
                                      and Year of Diagnosis, 2000-2005*
                            28.1         28.4
                    30                                   26.2          24.7
 Rate per 100,000




                                                                                      23.8
                    25                                                                               18.8
                            18.4
                    20                   15.5            14.6                         18.1
                                                                        12.3
                    15                                                                                    15.9
                    10
                             3.2          3.4            4.2            3.1           3.4
                     5                                                                                2.7
                     0
                            2000        2001         2002              2003           2004           2005
                                                     Year of Diagnosis
                                   White, Not Hispanic          Black, Not Hispanic          Hispanic**


Data source: Kentucky HIV/AIDS Surveillance System. Karin
Bosh
*Includes data reported to the HIV/AIDS Surveillance Program
through December 31, 2006; Data in 2006 are provisional due to
reporting delays and are not used in trend analysis.
    Reportable Disease Surveillance
                System
• Data Access
  The fully identified data set is not available to public.
  However portions of the dataset may be available.
  Confidentiality agreements must be signed and approval
  by the Institutional Review Board may be required. Data
  by county are available.


Contact
Peggy Ellis, MPH
(502) 564-3418 ex 3572
peggya.ellis@ky.gov
 Reportable Disease Surveillance

Kentucky Reportable
  Disease Desk Reference
http://www.chfs.ky.gov/dph/diseases/


Kentucky Data
http://chfs.ky.gov/dph/epi/reportable
   diseases.htm


National Data
http://www.cdc.gov/epo/dphsi/index.
   htm
Surveys




          75
                 Kentucky BRFSS
                       Basic Information


   Behavioral Risk Factor Surveillance System
    (BRFSS) is an adult (age 18+) telephone survey
       Co-sponsored by CDC and KDPH
       Conducted in Kentucky since 1985
   Surveys households not businesses or group
    homes
   Types of Questions
     Core: Asked to all states
     Modules: Questions developed by the CDC that
      states can add
     State Added Questions: Developed by the states
BRFSS: Calls are made 6 days a week

       Kentucky BRFSS
                2008
• Goal: 625 completed interviews per month
• 5,734 attempted calls per month
• Goal : 7,500 completed interviews in 2008
       BRFSS 2008 Core Questions

• Alcohol Consumption      •   Health Care Access
• Asthma                   •   Health Status
• Cardiovascular Disease   •   Healthy Days
  Prevalence               •   HIV/AIDS
• Colorectal Cancer
  Screening                •   Immunization
• Demographics             •   Oral Health
• Diabetes                 •   Physical Activity
• Disability               •   Prostate Cancer Screening
• Drinking and Driving     •   Seatbelt Use
• Emotional Support and    •   Sleep
  Life Satisfaction
                           •   Tobacco Use
• Exercise
• Falls                    •   Women’s Health
            BRFSS 2008 Core Questions
                        Demographics



•   Age                       • County of Residence
•   Sex                       • Zip Code
•   Ethnicity                 • Pregnancy Status
•   Race                      • Children <18 years in
•   Marital Status              Household
•   Educational Level         • Height and Weight
•   Employment Status         • Military Service
•   Income
                  BRFSS 2008 Modules
                and State Added Questions


         Modules                  State Added
                                    Questions
•   Pre-Diabetes
•   Diabetes                •   Oral Health
•   Adult Asthma History    •   Condom Use
•   Childhood Asthma        •   Smoking Cessation
    Prevalence              •   Folic Acid
                            •   Family Planning
                            •   Osteoporosis
                            •   Colorectal Cancer
•
                     Strengthsbehaviors,
    Provides statewide data on risk
    preventive health practices and chronic disease
    prevalence that are not collected by other
    surveillance systems.

• Sample size is large enough to provide yearly
  estimates by ADD.

• Timeliness – Data are available by six months of the
  data collection year.

• Data are collected by all states and many territories.
                     Limitations
• Non-coverage bias:           BRFSS only surveys adults in
  households. Cell phones are excluded. No person would be
  surveyed who lived in any type of group setting, such as a
  nursing home, college dormitory, the military, or prison.


• Self-report bias: The BRFSS relies on self-report.
  The tendency to report a healthier lifestyle may occur.
                      BRFSS: Obesity Data
                           Prevalence of Overweight and Obesity among Kentucky Adults
                                              1985-2005 KY BRFSS,
                                                     Age 18+

             70


             60


             50
                                                                                          Percent Overweight
                                                                                          BMI ≥25
Percentage




             40
                                                                                          Percent Obese
             30                                                                           BMI ≥30

             20


             10


              0
               85


                      87


                             89


                                    91


                                           93


                                                  95


                                                         97


                                                                99


                                                                       01


                                                                              03


                                                                                     05
             19


                    19


                           19


                                  19


                                         19


                                                19


                                                       19


                                                              19


                                                                     20


                                                                            20


                                                                                   20
                                                   Year
BRFSS Data – Geographic Distribution

Smallest geographic area of analysis
 recommended
     – Area Development District
                                            Doctor Diagnosed Diabetes 2005 -
                                                        BRFSS




 Definition: Respondents who said “Yes”
 to the question, “Has a doctor ever told
 you that you have diabetes?”
  Kentucky BRFSS Data Access
• Kentucky BRFSS Web Site
    http://chfs.ky.gov/dph/epi/brfss.htm


• CDC BRFSS Web Site
    http://www.cdc.gov/brfss
Surveys




          87
Surveys




          88
                        BRFSS
                        Contacts

BRFSS Program
Division of Prevention and Quality
  Improvement
Kentucky Department for Public Health

Coordinator                    Epidemiologist
Tracey Sparks                  Yvonne Konnor, MPH
502-564-0068 ex. 3575          564-0068 ex 3529
Tracey.Sparks@ky.gov           Yvonne.Konnor@ky.gov
  Youth Risk Behavior Surveillance System (YRBS)


• In US, administered in
  typical public high schools
  since 1989

• In Kentucky, survey began
  in 1997

• Funded by the CDC, KY
  Dept. of Education and KY
  Dept. for Public Health
             Youth Risk Behavior Surveillance

•   In Kentucky, administered in the
    following years
     –   Spring 1997
     –   Spring 1999
     –   Spring 2001
     –   Spring 2003
     –   Fall 2004
     –   Spring 2007
     –   Planned Fall 2008

•   Students complete surveys in class
             High School (YRBS)
                     Methodology


• Sampling Frame for High Schools
  – All typical public high schools
  – Grades 9-12
• Does not include
  – Private or home schools
  – Alternative schools
  – Juvenile detention centers
  – Dropouts
• Sample Size 2007
  – Approximately 3,200
           High School (YRBS)
                  Methodology




• In 2007, 90 public high schools randomly
  selected, 72 chose to participate. 80%
  response rate
• 1 to 4 classes randomly selected in each
  school
• Weighted data: 1997, 2003, 2004, 2007
• Unweighted data: 1999, 2001
• Data are available statewide and by
  region, (Western, Eastern and Central).
  County level data are not available.
               Middle School (YRBS)
                        Methodology

• Sampling Frame for Middle Schools
  – All typical public middle schools
  – Grades 6-8
• Does not include
  –   Private or home schools
  –   Alternative schools
  –   Juvenile detention centers
  –   Dropouts
• Weighted Data
  – 2004
  – Sample Size approximately 3,000
  – Data are available statewide and by region (Western,
    Eastern and Central). County level data are not
    available.
            High School YRBS 2007
                     Topics


•   Tobacco use          •    Physical activity
•   Alcohol use          •    Body weight
•   Other drug use       •    Violence
•   Nutrition            •    Sexual behavior
•   Asthma               •    Suicide
•   Oral health          •    Family structure
•   Seat belt use        •    Demographics
           Middle School YRBS 2007
                         Topics


•   Tobacco use              •    Physical activity
•   Alcohol use              •    Body weight
•   Other drug use           •    Violence
•   Nutrition                •    Sexual behavior
•   Asthma                   •    Suicide
•   Oral health              •    Family structure
•   Bicycle helmet use       •    Sleeping habits
•   Seat belt use            •    Demographics
                                                          YRBS Data

                       Percentage of KY High School Students Who Have
                               Ever Used the Substances Listed,
                                          2007 YRBS
             100
                          72
              80
Percentage




                                         62
              60
                                                      35
              40
              20                                                      14
                                                                                     9             7              6              6
               0
                                                      a
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                    YRBS Websites
• Kentucky
   – http://www.education.ky.gov/KDE/Administrative+Resourc
     es/School+Health/Youth+Risk+Behavior+Survey.htm

• National
   – www.cdc.gov/HealthyYouth/YRBS
   – 2007 YRBS Report
      • http://www.cdc.gov/HealthyYouth/yrbs/pdf/yrbss07_m
        mwr.pdf

Contact
Stephanie Bunge
Kentucky Department of Education
Stephanie.Bunge@education.ky.gov
99
100
  Youth Tobacco Survey (YTS)
• Middle and High School students
• In Kentucky, administered by KDPH through
  a grant from the CDC
• Data collected in even number years starting
  in 2000
• Weighted Statewide Kentucky data are
  available for the following years: 2002, 2004,
  2006 and 2008.
• County level data are not available.
                  YTS Topics
• Prevalence of           • Secondhand smoke
  Tobacco Use               exposure
  –   Cigarettes          • Cessation attempts
  –   Cigars              • Role of media and
  –   Pipe                  advertising
  –   Bidis
                          • Minors’ access to
  –   Kreteks
                            tobacco
  –   Smokeless tobacco
                          • Influence of peers
                            and family related to
                            tobacco use
                              YTS Data

                   High School Lifetime Cigarette Smoking                    2004
                by Gender and Race, Kentucky 2004 and 2006                   2006




           80
           60           *       *                        70        69 67
 Percent




                63 57        64 56   62 59     63                           61
                                                    58        54                 51
           40
           20
           0
                 Total       Male    Female    White     Black     Hispanic Other

*Significant at p<.05
                                     YTS Data
                High School Students Who Think Smoke From
                     Someone Else's Cigarette is Harmful

          100
           90                          94     96
                   92           92                      88     89
           80
           70
Percent




           60                                                           2004
           50
           40                                                           2006
           30
           20
           10
            0
                        Total         Never Smokers   Current Smokers
         Website and Contacts
• Kentucky
  – chfs.ky.gov/dph/ach/cd/tobaccodata.htm
• National
  – http://www.cdc.gov/tobacco

  Contact
  Division of Prevention and Quality Improvement
  Irene Centers
  502-564-7996
  Irene.Centers@ky.gov
       Data Resource Center
• National Survey of Children’s Health (NSCH)
  – Data available for survey conducted in 2003
  – Data is currently being collected for the 2007-08
    NSCH.
     • Data release scheduled for early 2009


• National Survey of Children with Special
  Health Care Needs (NS-CSHCN)
  – Data available for surveys conducted in 2001 and
    2005



• National and Statewide data are available.
                      Two Surveys
             What do they have in common?


• National Center for Health Statistics/CDC oversees sampling
  and administration

• Use SLAITS (State & Local Area Integrated Telephone
  Survey) sampling mechanism

• Designed and collected in a manner that allows valid state-
  to-state and national comparisons

• Weighted data yield prevalence estimates for non-
  institutionalized child population ages 0-17 in each state,
  and nationally
            National Survey of Children’s Health


• Conducted for the first time during 2003 – 2004

• One child randomly selected in each household subject
  of survey for a total of 102,353 interviews. In Kentucky
  the sample size is approximately 1,800.

• Information on children’s health and well-being
  collected in combination with data on child’s
  family/neighborhood context

• First time such a broad range of info collected in
  manner that allows state-to-state and national
  comparisons
Examples of available information


Getting needed preventive
       dental care
Currently using medication
for ADHD/ADD

  Child has a personal doctor or
      nurse (primary care provider)
      How do the surveys differ?

NS-CSHCN:
All CSHCN ages 0-17 in a state are the
  GROUP the question results pertain to …..

NSCH:
All children ages 0-17 in a state are the
  GROUP the question results pertain to …..
     • SELECT “SPECIAL HEALTH CARE NEEDS
       STATUS” from the COMPARE SUBGROUPS
       menu to view results for CSHCN.
                And remember:

The denominators for ALL results in both
 surveys are always CHILDREN -- never
 parents!
  – Correct: % of children ages 0-17, ages 0-5, ages
    6-17 etc.
  – Never! % of parents, families, mothers, etc. --
    even when topic is mother’s health status,
    education level….. etc.
               Websites
• Web Based Query
http://www.childhealthdata.org

• Data Sets
http://www.cdc.gov/nchs/slaits.htm
Hospitalization Data




                       118
  Hospital Inpatient Discharge Database
• Collection of records that
  each describe a single
  inpatient stay at a Kentucky
  Hospital

• Data are collected by an
  external contractor through
  an agreement with the
  Cabinet for Health and
  Family Services and the
  Kentucky Hospital
  Association beginning in
  2000.

• Claims data
        Hospital Inpatient - Data
               Collected
Demographics                Personal Identifying
 Included                     Information NOT
•   Gender                    Included
•   Age group               •   Name
•   State                   •   Address
•   County of Residence     •   Social Security Number
•   Zip Code of Residence   •   Race/ethnicity
        Hospital Inpatient - Data
                    Collected
    Hospital Stay Fields  Grouping Categories
•   Unique Hospital Identifier • Major Diagnosis
•   Admission Type               Category
•   Admission Source           • Diagnosis Related
•   Length of Stay               Group
•   Diagnosis Codes
•   Procedure Codes
•   Discharge Status
•   Total Charges
•   Payment Source
        Inpatient Data Query
• Principal Diagnosis

• All Diagnoses

• Coding based on ICD-9-CM
  http://www.cdc.gov/nchs/icd9.htm

• Data can be analyzed by county and
  hospital
                Strengths
• The hospital compliance rate is >99%

• Included data items are sufficient for
  diagnostic and outcome analysis for public
  health reporting and research

• Data can be used to illustrate regional
  hospitalization patterns and trends
                 Limitations
• Only hospital charges are listed. The actual
  amount paid by the patient, insurance, or
  Medicaid is not included.

• Individual records represent single admit-
  through-discharge events; multiple admissions
  of an individual patient cannot be definitively
  identified. These data should not be used to
  measure the incidence or prevalence of a
  condition in the general population.
                                             Hospitalization Data
                                Age-adjusted Nonfatal Unintentional Injury Hospitalization Rates,
                                                    Kentucky, 2001-2003
Age-adjusted Rate per 100,000




                                500
                                         374.7      391       387.7
                                400                                     317
                                300
                                                                                           KY Prevalence
                                200                                                        HK 2010 Target
                                100
                                   0
                                         2001      2002       2003      2004        2005
                                                             Year


                                Data Source: Hospital Inpatient Discharge
                                Database Chart from Healthy Kentuckians 2010 Mid-
                                Decade Review
         Websites and Contact
National Website
http://hcupnet.ahrq.gov/

Kentucky Website
http://chfs.ky.gov/ohp/healthdata/

Contact
Kentucky Cabinet for Health and Family Services
Office of Health Policy
502-564-9592

*May be a charge for the hospitalization data set
127
128
Cancer Registry




                  133
       Kentucky Cancer Registry
                (KCR)
• All licensed health care facilities in Kentucky are required by state
  law to report all cancer cases diagnosed to the Kentucky Cancer
  Registry (KCR).
    – In 1991, all hospitals and outpatient facilities were required to report
    – In 1994, legislation was modified to include all health care facilities that
      either diagnose or treat cancer patients
    – Administered by the Markey Cancer Center at the University of
      Kentucky

• In 2000, the KCR became a part of the National Cancer Institute’s
  Surveillance, Epidemiology and End Results Program (SEER).

• Data are collected from hospitals, outpatient facilities, pathology
  laboratories, and doctors’ offices
    – May obtain data from contiguous states
    – KCR links registry data to death certificates
    KCR – Type of data collected
•   Primary site and cell type of cancer
•   Stage of disease at diagnosis
•   Date of diagnosis
•   Type of therapy
•   Vital status at date of last contact
•   Date and cause of death if applicable
•   Types of Demographics
    – Gender              - Tobacco use
    – Race/ethnicity      - Occupation
    – Date of birth       - County of
      Residence/Diagnosis
         KCR – Data Access
• KCR Website – Includes both incidence and
  mortality rates by county
  www.kcr.uky.edu

• Data sets may be available to researchers who
  submit an application to KCR and are approved
  by an internal review panel.

• Contact
  Jaclyn Nee, MPH
  859-219-0773, ext. 243
Cancer Registry




                  137
KCR Data
Injury Data Sources




                      139
          Injury Data Sources
Kentucky Injury
 Prevention and
 Research Center
 (KIPRC)

- Collaboration of
  Kentucky Dept. for
  Public Health and the
  University of Kentucky
                Injury Data Sources
• Occupational Safety and Health Surveillance Program – Surveillance
   of occupational injuries and deaths

• Fatality Assessment and Control Evaluation (FACE) – In depth study
   of occupational fatalities

• Kentucky Violent Death Reporting System – Collects data on violent
   deaths from death records, coroner reports and medical examiner reports.

• Trauma Registry – Collects trauma data from the University of Kentucky,
   University of Louisville, and Kosair Children’s Hospital.

• Crash Outcome Data Evaluation System – Combination of
   hospitalization data and the Transportation Cabinet’s CRASH database for
   motor vehicle accidents

• Traumatic Brain Injury and Spinal Cord Injury Surveillance Project –
   Trauma registry, hospital discharge and death certificate files are linked to
   produce a comprehensive data set
         Web-Based Query
• National
  – Web-based Injury Statistics Query and
    Reporting System (WISQARS)
  – http://www.cdc.gov/ncipc/wisqars/


• Kentucky Injury Mortality
  – http://www.kspan.uky.edu/data.htm
DRS Data
KVDRS Data
                   Motor Vehicle Crash Fatality Rate, 2000-
                                    2004
                                          Source: Kentucky Transportation Center Crash Analysis, Table 7
Fatalities per 100 million miles traveled; state mean=1.7

     1.0 and under
     1.1-1.5
         1.6-2.5                                                                                                                                                                 Boone
                                                                                                                                                                                           Campbell

                                                                                                                                                                                      Kenton


     Over 2.5                                                                                                                                                             Gallatin                          Bracken
                                                                                                                                                                                               Pendleton
                                                                                                                                                                Carrll
                                                                                                                                                                                      Grant
                                                                                                                                                    Trimble                                                                  Mason
                                                                                                                                                                            Owen                            Robertson                                             Greenup
                                                                                                                                                                                                                                            Lewis
                                                                                                                                                                Henry                            Harrison
                                                                                                                                               Oldham
                                                                                                                                                                                                                               Fleming
                                                                                                                                                                                                               Nicholas                                       Carter         Boyd
                                                                                                                                                                                       Scott
                                                                                                                                                                         Franklin
                                                                                                                                    Jefferson            Shelby                                                                            Rowan
                                                                                                                                                                                                     Bourbon
                                                                                                                                                                                                                               Bath                         Elliott
                                                                                                                                                                             Woodford Fayette                                                                             Lawrence
                                                                                                                                                    Spencer                                                     Montgomery
                                                                                                                 Meade               Bullitt                      Anderson
                                                                                                                                                                                                            Clark                     Menifee
                                                                                                                                                                                     Jessamine                                                    Morgan
                                                                                                                                                                          Mercer                                         Powell                                         Johnson
                                                                                         Hancock
                                                                                                                                               Nelson                                                                                                                               Martin
                                                           Henderson                               Breckinridge                                                                                    Madison
                                                                             Daviess                                                                    Washington                                                  Estill               Wolfe              Magoffin
                                                                                                                          Hardin                                                        Garrard
                                            Union                                                                                                                          Boyle
                                                                                                                                                                                                                                Lee
                                                        Webster          Mclean                                                     Larue               Marion
                                                                                                                                                                                                                                                Breathitt                  Floyd
                                                                                                                                                                                    Lincoln
                                                                                        Ohio              Grayson                                                                                              Jackson         Owsley                                                        Pike
                                    Crittenden                                                                                                       Taylor                                      Rockcastle
                                                                                                                                                                                                                                                                  Knott
                                                            Hopkins                                                          Hart                                        Casey
                                                                                                                                                                                                                                                      Perry
                                                                          Muhlenberg           Butler      Edmonson                         Green
                           Livingston           Caldwell                                                                                                                                                                        Clay
                                                                                                                                                                                                            Laurel
                                                                                                                                                                                       Pulaski                                               Leslie                    Letcher
  Ballard      Mccracken                                                                                                                                Adair
                                         Lyon                                                                                          Metcalfe                  Russell
                                                                                                        Warren            Barren

    Carlisle                 Marshall                        Christian                                                                                                                                                  Knox
                                                                                       Logan                                                                                                                                                         Harlan
                                                                          Todd                                                                 Cumberland
                                                Trigg                                                                                                                       Wayne
                 Graves                                                                         Simpson           Allen
   Hickman                                                                                                                                                    Clinton                    Mccreary       Whitley                   Bell
                                                                                                                                   Monroe
                              Calloway
Fulton


                                                                                                        Prepared by: Julia F. Costich, Kentucky Injury
                                                                                                        Prevention & Research Center
 KIPRC Contacts and Website
Website
www.kiprc.uky.edu

Phone
859-257-4954
       My Contact Information
Sara Robeson, MA, MSPH
Kentucky Department for Public Health
Division of Epidemiology and Health Planning
275 East Main St. HS2GW-C
Frankfort, KY 40621


502-564-3418 ex 3567
Sara.Robeson@ky.gov

Link to Data Resource Guide
http://www.chfs.ky.gov/dph/DataResourceGuide.htm

								
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