Presentation on theme: "DECISION-MAKING SUPPORTED BY HEALTH INFORMATION: A CASE STUDY."— Presentation transcript:
DECISION-MAKING SUPPORTED BY HEALTH INFORMATION: A CASE STUDY
Real-life case (fictional… or real…) Your liaison agent informs you that additional funding will be available for the year in progress. This funding must be used for prevention projects focused on chronic diseases. You are interested in presenting a project… What do you do to respond to such a proposal?
How can you identify the best way to invest this money? What? Who? How?
1. What Defining what you mean by “chronic diseases” Long term Classics: cardiovascular, respiratory, gastrointestinal, musculoskeletal, neurological... Having an overview of the situation in terms of the chronic diseases that are a priority in your community Criteria: frequency, severity, trends…
Where can the information be found? Surveillance plan RHS Community reports Data from services Data from FNIHB and AANDC Survey among the population Survey among workers …
Data on chronic diseases… Community data from the RHS Chronic diseasesAdultsAdolescentsChildrenSeverityFrequency Asthma8.4%18.6%16.6%SFFF Chronic back pain18.1%n/a SFFF Rheumatism7.9%n/a SFF Chronic bronchitis2.0%4.8%1.3%SF Emphysema1.4%n/a SF Allergies12.4%21.0%11.4%SFFF Severe vision problems or blindness3.5%8.1%0.0%SFF Hearing loss5.2%1.4%0.0%SFF Cardiopathy2.6%n/a1.3%SSF Arterial hypertension18.8%n/a SSFFF Thyroid disorders6.0%n/a SFF Cancer2.9%0.0% SSSF Hepatic disorders other than hepatitis 1.9%0.0%n/aSF Stomach and bowel disorders10.1%6.3%n/aSFF Tuberculosis2.0%0.0% SSSF Chronic anemian/a0.0%2.3%SF Chronic ear problemsn/a 9.3%SFF Diabetes27.4%1.7%0.0%SSFFF
Data on chronic diseases… Sheet 18.104.22.168 of the health status surveillance plan The proportion of diabetic people in the general population has increased 2002: 6.9% 2008: 17%
Identified diseases Diabetes High frequency Rising trend Causes +++ complications Cardiovascular disease and arterial hypertension
Upstream of the diseases… What are the risk factors and determinants for these diseases? Are some of these shared by several diseases?
Data on the identified risk factors Smoking among those 12 years and + (sheet 22.214.171.124 of the health status surveillance plan) 2002: 71.9% 2008: 66% Community data from the RHS 49.8% of the adults, 49.3% of the adolescents and 61.4% of the children live in a smoke free environment
Data on the identified risk factors Physical activity (community data from the 2008 RHS) 43.2% of adults and 28.2% of adolescents perform less than 30 minutes of physical activity per week Frequency of moderate walking or other types of physical activity (swimming, cycling, gardening) AdultsAdolescents Rarely14.6%6.0% At least 30 minutes, at least once per week28.6%23.2% Between 30 and 59 minutes per day27.6%43.5% At least one hour per day29.2%27.3%
Data on the identified risk factors Nutrition Proportion of those 12 years and up who stated that they eat fruits and vegetables at least 5 times per day (surveillance plan, sheet 6.7.1) Vegetables: 66.3% Fruits: 65% Juice: 50% Proportion of those 12 years and up who stated that they sometimes have a nutritious and balanced diet (surveillance plan, sheet 6.7.2) 2002: 81.8% 2008: 65.3%
Data on the identified risk factors Nutrition (cont’d) Community data from the 2008 RHS Do you think your diet is nutritious and balanced? AdultsAdolescents Children Always or almost36.5%25.6% 55.6% Sometimes49.6%50.1% 40.6% Rarely13.9%24.3% 3.8%
Data on the identified risk factors Body mass index (Community data from the 2008 RHS) The vast majority of the population does not have a healthy weight. BMI category AdultsAdolescentsChildren Healthy weight18.1%40.7%34.4% Overweight24.5%38.8%27.0% Obese57.3%20.6%38.7%
2. Who The available amount is limited and you are looking to implement the most efficient interventions. Who among the people in your community would have the greatest need for these interventions? Age Gender Occupation Socioeconomic status Living environment
Socio-demographic data Breakdown of the population according to age (surveillance, sheet 126.96.36.199) 0-14 65 +15-64
Socio-demographic data Old age index (surveillance, sheet 188.8.131.52)
Socio-demographic data Education Breakdown of the adults ages 25 years and up according to education (surveillance, sheet 3.5.1) Education20022008 High school diploma not obtained61.265.6 High school diploma21.7*11.7 College diploma**n.p.*14.0 University graduate**n.p. Missing values11.91.9
Socio-demographic data Proportion of those ages 18-64 years who receive social assistance (surveillance, sheet 3.4.7) 2002: 39.6% 2008: 28% Employment rate among those ages 18 years and up (surveillance, sheet 3.2.1) 2002: 44.6% 2008: 53.8%
Socio-demographic data Average individual income (surveillance, sheet 184.108.40.206) 2002: $16 312 2008: $17 560 Average household income (surveillance, sheet 220.127.116.11) 2002: $32 350 2008: $30 882
Target groups Children and teens: improve their lifestyle (physical activity, eating habits, smoking) Focus on children from disadvantaged families Parents: provide tools Ensure that messages are understood (adjust messages according to the level of education)
3. Where and how Where can we take action? Using different models to guide your choices: Relying on: literature, experience, evaluations…
Logic model? To be refined, include the identified determinants and risk factors International factors National/regional factors Community factors Individual factors Population Prevalence of weight-related problems: obesity and excessive concern for body weight Occupation Travelling Recreation Sports Diet Body image Genetic Energy expenditure Food intake Public transportaion Security Urban planning Food availability and accessibility Advertising ans media Income Education policies Transportation policies Urbanisation policies Health policies Food policies Cultural policies Family policies Economic policies Globalization of the markets Industrialisation Media and marketing
4. Choosing Choosing the interventions to be implemented based on: Existence of effective actions: identifying them Feasibility of the intervention Resources? Time? Space? Community priority? Unwanted effects?
Conclusion Statistics and litterature are there to support planification Field knowledge is a major key in planification Combining statistics, littérature and field knoledge is a winning strategy in planification