Transcript HEALTH STATISTICS - UBC Library Data Services

Population Health Surveys at STC
Prepared for: B.C. Research Data Centre
Date: Nov. 15, 2000
Why Health Information
Matters
$80 billion a year on health care
How do we improve the health of the
population
Why are some healthier than others
The most critical contributors to health are
not health related -- social status, control
over work, education (CPRN)
National Population Health
Survey (NPHS)
longitudinal survey of 17,276
households and 2,300 residents of
institutions
first cycle in 1994, continuing every 2
years
Cycle 4, transition to only longitudinal
Self perceived health - a longitudinal and
cross sectional analysis. Aged 65 +
Table 2
Self perceived health in 1994/95 % Self perceived health 1998/99
‘000
%
Total
2,590
100
77
23
Excellent,
very good,
good
Fair, poor
2,030
79
85
15
560
21
46
54
Excellent, very good,
good
Fair, poor
Percentage of household population aged 65 or older in 1994/95 entering home
care by 1996/97, by selected characteristics
Chart 7
NPHS: Household Longitudinal
Respondents (Full)
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
1994/95
1996/97
1998/99
2000/01e
Chart 6
NPHS
Institutions - results after 3 cycles
NPHS: Residents of Health Institutions
100%
80%
non-resp
60%
dead
40%
resp.hhld
resp.inst
20%
0%
1994/95 1996/97 1999 (p.) 2001(e.)
5
Opportunities to improve health
information
Health Information Roadmap: a four-year action
plan to strengthen Canada’s health information
system;
 Creation of Canadian Community Health Survey
(CCHS)
 Person oriented database
NPHS and CCHS - A More
Robust Survey Program
NPHS
– longitudinal
– sample of 17,276
households
– national and provincial
level estimates
CCHS
– cross-sectional
– sample of 130,00
respondents
– national, provincial and
sub provincial level
estimates
1994-1999
HEALTHSURVEYS
NPHS Household
NPHS North
NPHS Institutions
Longitudinal &X-sectional
(Provinces)
Longitudinal &X-sectional
(Territories)
Longitudinal &X-sectional (-C3)
(Provincial Health Institutions)
Since 2000
HEALTH SURVEYS
NPHS Household
NPHS North
Longitudinal
(Provinces)
Longitudinal
(Territories)
11/9/2001
8
NPHS Institutions
CCHS
Longitudinal
Cross-sectional
(Prov. Hlth Institutions) (Provinces + Territories)
3
The Canadian Community
Health Survey
Objectives
Estimates at the community health region
level
Flexibility to enhance and vary content to
meet unique regional and provincial needs
– regular data collection
– timely data release
Canadian Community Health Survey Cycles and Components
Cycle/
Component
Content
Sample
Collection
1.1
27 Common core + 23 Optional modules
130,000
Sept. 00 - Oct. 01
1.2
Mental disorders, well-being + common core
repeated
30,000
Jan. – Dec. 2002
2.1
Common core + Optional modules expanded
130,000
Jan. – Dec. 2003
2.2
Nutrition, dietary recall, psychosocial
determinants, fruit and vegetable consumption,
food insecurity + common core
Potential supplement for physical measures
30,000
Jan –Dec. 2004
3.1
Common core + Optional modules expanded
130,000
Jan. – Dec. 2005
3.2
????
30,000
Jan. – Dec. 2006
Canadian Community Health Survey
Design
2000/2001
– Sample size -- 130,000, stratified by health region
– Questionnaire content
• 30 minutes for priority items
• 10 minutes of optional items selected by health regions
• standard socio-economic items
– Estimates for health regions, provinces and Canada
2001/2002
– Sample size -- 30,000
– Proposed focused study on mental health and wellbeing
CCHS - Year 1 Survey
Sample Frames
Area frame (computer-assisted personal interview)
– 94,000 households from the LFS structure
• 78,000 households with 1 person selected
• 16,000 households with 2 persons selected
RDD frame (computer-assisted telephone interview)
– 20,000 households with 1 person selected
these figures will be boosted before going in the field
Common Content
 Alcohol
 Alcohol dependence / abuse
 Blood pressure check
 Breastfeeding
 Chronic condition
 Contacts with mental health
professionals
 Exposure to second hand smoke
 Food insecurity
 Fruit & vegetable consumption
 General health
 Health care utilization
 Health status - SF36
 Health Utility Index (HUI)
 Height / Weight
 Injuries
 Mammography
 PAP smear test
 Physical activities
 PSA test
 Restriction of activities
 Smoking
 Tobacco alternatives
 Two-week disability
 Household composition & housing
 Income
 Labour force
 Socio-demographic characteristics
 Administration
Optional Content
 Breast examinations
 Breast self examinations
 Changes made to improve health
 Child & adult stressors (traumas)
 Dental visits
 Depression
 Distress
 Driving under influence
 Drug use
 Eye examinations
 Flu shots
 Home care
 Mastery
 Mood
 Ongoing problems
 Physical check-up
 Recent life events
 Sedentary activities
 Self-esteem
 Sexual behaviours
 Smoking cessation aids
 Social support
 Spirituality
 Suicidal thoughts and attempts
 Use of protective equipment
 Work stress
CCHS – Cycle 1.1
Province
NFLD
PEI
NS
NB
QUE
ONT
MAN
SASK
ALB
BC
Pop. Size
Preliminary Counts
No. Health Regions
551K
135K
909K
738K
7,139K
10,714K
1,114K
990K
2,697K
3,725K
CANADA 29,000K
6
2
6
7
16
37
11
11
17
20
4,026
3,617
5,226
5,039
22,759
38,910
8,443
8,062
14,499
18,218
133
130,917
Pop. Size
Territories:
YUK
NWT
NUN
* Preliminary numbers, November 2001
# Records*
25,000
36,000
22,000
# Records *
791
985
342
Status of Collection CCHS 1.1
Collection completed Nov 3, 2001;
National response rate 85%;
Projected provincial response rates of at least
80%;
Achieved target of more than 130,000 records.
CCHS 1.1 Release Line-up
Preliminary Results- Dec. 2001
Shared Files - April 2002
Official Data Release - May 2002
Analytical Results - June 2002
Public Use File - August 2002
Workshops - Fall 2002
CCHS 1.1
Products & Services
Micro Data Files for sharing partners and
researchers;
Analysis that informs the general public;
Health Indicators on-line for health region
information;
Workshops to build capacity.
Canadian Community Health Survey – File Outputs
CCHS - Master File
 Maintained by
Statistics Canada
 Record for every
respondent
 Each assigned
random ID
ID
A
B
C
D
Link
Yes
Yes
No
No
Share
Yes
No
Yes
No
Microdata Release
Committee
 Group consisting of
Statistics Canada experts
on maintaining respondent
confidentiality
Identifiable information removed
from file
 Name
 Address
 Date of Birth
 Health Card Number
 Etc.
Link
Yes
Yes
No
No
Share
Yes
No
Yes
No
ID
A
C
Link
Yes
No
Share
Yes
Yes
CCHS – Link File
 Provided by request only
 Only respondents who agree to link & share
 Contains health card and identifiable information
 Random ID provides link to share file
Linked Data
 Ministry or Statistics Canada must
approve all linkage activities
 After linkage all identifiable
information has been removed
ID
A
ID
A
Link
Yes
CCHS – Public Use Microdata File
 All respondents aggregated to a lower level of detail
 All identifying variables removed
 Age groups versus single year of age
 Health regions combined to meet minimum population
thresholds
 Other aggregations and suppressions as required
ID
A
B
C
D
CCHS - Share File
 Provided to ministries of health
 Only respondents who agree to
share information
Share
Yes
Ministry of Health Administrative
Data
 Data maintained by ministry of
health
 Contains health card information
ID
A
Link
Yes
Share
Yes
Link
Yes
Share
Yes
Organization of Electronic Data
Canadian Statistics
Free
Canada Level Detail
Health Region
information
in the Community
Profile
Free, Simple
Cansim II
Data Warehouse
$ for Download
Health Indicators
Free
Detailed Health Region
Information
Linked Sample Data Structure
person i
person j
t
t+2
t+4
personal interview content (socio-demographic,
disability, etc. + info for other family members)
health care service encounter (e.g. hospital inpatient stay; date, diagnosis, procedures, etc.)
attributes of person’s geographic neighbourhood
t+6
Mental Health &
Well-Being
Objectives
1. Determine prevalence rates of selected mental disorders to
study adequacy of health care;
2. Juxtapose access and utilisation of mental health services
with respect to perceived needs;
3. Assess the disability associated with mental health
problems to individuals and society.
CCHS 1.2 Study
Methodology
Face to face interview;
Sample of 30,000 individuals, aged 15
years and older;
Based on WHO non clinical approach, that
profiles disorders depending on symptoms,
duration and severity, (ICD10, DSM IV).
Content:
Mental Illness & Problems
 Depression
 Mania
 Panic disorder
 Social phobia
 Agoraphobia
 Generalised anxiety disorder
 Suicidal thoughts & attempts
 Eating troubles & behaviours
 Gambling
 Alcohol dependence
 Illicit drugs use & dependence
 Utilization of mental health
services
 Medication Use
Content:
General Information
 General health
 Restriction of activities
 Chronic illness
 Well-being and satisfaction with
life
 Spirituality
 Demographics
 Smoking
 Social Support
 Distress
 Stress, Work Stress
 Labour force activity
 Income
Surveying Challenges
Balance between individual privacy and
informed research;
keeping abreast of emerging issues;
collecting increasingly sophisticated
information e.g. mental health, physical
measures, dietary recall
CCHS
Questionnaire Content and Sample Design
Information is available on the Statistics Canada
Web Site.
www.statcan.ca
nphs-ensp@statcan
cchs-escc@statcan