A DATA PRODUCT-ORIENTED APPROACH TO PROMOTING VITAL STATISTICS, INFORMING PUBLIC HEALTH ACTIVITIES, AND DEVELOPING PARTNERSHIPS Kirk Bol, MSPH, Colorado Department of Public Health and Environment 2011 NAPHSIS/ NCHS Meeting

Vital Statistics In History  “But in the last fifty years the registration of vital statistics has come to signify something more important to the world that that each resident that come and departed in the ceaseless train of mortal life was ‘born on such a day and died on such another’…But to the science of hygiene and the discovery of the conditions, removable causes, factors, and laws of epidemic and other diseases, and all the disasters that imperil and waste human life, vital statistics contribute the highest influence and most practical results.”  Dr. Elisha Harris, Registrar of Vital Statistics, NY, 1874

Vital Statistics In History  “Vital statistics is the science of numbers applied to the life history of communities and nations…Manifestly, vital statistics must needs be looked upon as the most influential branch of the sciences, since they affect more directly the interests and the welfare of the living people of this State.”  Frederick L. Hoffman, Esq., Boston Medical and Surgical Journal, 1900

Vital Statistics In History  “Beside the individual use made of birth and death certificates for many purposes, a wide-awake health officer can use the records if his or her vital statistics office as the very foundation upon which this health work is built.”  Dr. W. A. Plecker, MD, State Registrar, VA, 1924

Uses of Vital Statistics  Describe the health of our population.  Explore the factors and determinants of health.  Assess health and prioritize public health activities in our communities.

Life Expectancy

Leading Causes of Death

Premature Mortality

Teen Fertility

Infant Mortality

Colorado Health Data Home

Topical Reports and Collaborations

Public Health Act of 2008  Requires the development and implementation of a comprehensive statewide improvement plan every 5 years  After the release of each comprehensive, statewide public health improvement plan, each county or district public health agency shall prepare a county or district public health plan  Plans are to be data driven-based on community health assessment, capacity assessment, etc.

Colorado’s Public Health Improvement Plan, 2009 Strategic recommendation #1  Ensure a comprehensive set of public health indicators, to include health status, behavioral risk, mental health, environmental health, oral health, health disparities, and social determinants of health. Measure, update, and make indicators available to local public health agencies in a timely manner to enable community health assessment and planning and the state and local levels.

Health Equity An Explanatory Model for Conceptualizing the Social Determinants of Health NATIONAL INFLUENCES GOVERNMENT POLICIES U.S. CULTURE & CULTURAL NORMS PREGNANCY EARLY CHILDHOOD CHILDHOOD ADOLESCENCE ADULTHOOD OLDER ADULTS LIFE COURSE HEALTH FACTORS = QUALITY OF LIFE MORBIDITY MORTALITY LIFE EXPECTANCY POPULATION OUTCOMES SOCIAL DETERMINANTS OF HEALTH ECONOMIC OPPORTUNITY PHYSICAL ENVIRONMENT SOCIAL FACTORS Income Employment Education Housing Built Environment Recreation Food Transportation Environmental quality Housing Water Air Safety Participation Social support Leadership Political influence Organization al networks Violence Racism + HEALTH BEHAVIORS & CONDITIONS MENTAL HEALTH ACCESS, UTILIZATION & QUALITY CARE Nutrition Physical activity Tobacco use Skin Cancer Injury Oral health Sexual health Obesity Cholesterol High Blood Pressure Mental health status Substance abuse Functional status Health insurance coverage Received needed care Provider availability Preventive care Public Health’s Role in Addressing the Social Determinants of Health Advocating for and defining public policy to achieve health equity Coordinated interagency efforts Creating organizational environments that enable change Data collection, monitoring and surveillance Population based interventions to address health factors Community engagement and capacity building

Colorado’s Public Health Indicators

Environmental Public Health Tracking

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