1. Overview Finding and Using Health Statistics and Data Files Soc 398: Social Inequality and Health Darlene Fichter Data Library Services, U of S Library October 4, 2007

2. Overview  Why use data?  Types of Data Resources in the Library and Internet: Health Surveys –Aggregate data –Public Use Microdata Files –Surveys and Products  Finding a data file  Understanding data documentation

3. Data Tells a Story Life expectancy at birth: by social class and sex, 1997-99, England & Wales http://www.statistics.gov.uk/cci/nugget.asp?id=1007 Men: 7.4 years Manual workers die earlier than others

4. Finding the Stories  Debunking third-world myths with the best stats you've ever seen – Hans Rosling –Global Life Expectations –How can we use this data? http://www.ted.com/index.php/talks/view/id/92

5. Social Inequality and Health  Advances of medical practice and science have been seen as the principal causes of increased human life expectancy True False

6. Social Inequality and Health  Nutrition and improved living conditions are better indicator of population health True False

7. What are some risk factors of lower socio- economic status?  Smoking  Lack of exercise  Immoderate eating and drinking  High fat/low fiber diets  More stress - higher rates of ill health/death  Lower of levels of social support  Live or work in environments hazardous to health

8. Overview Part 1: Health Surveys

9. Health Statistics  Two main sources of data: –Special surveys by Statistics Canada –Administrative data  Collected by law – causes of death, notifiable diseases  Collected by Dept. of Health

10. Types of Data Files  Aggregate data files –Counts  Cases of measles in Saskatoon –Cross tabulations  Number of smokers in Saskatoon by age and sex

11. Table 105-0005 - Risk of depression, by age group and sex, household population aged 12 and over, Canada (Canadian Community Health Survey) Age groupSex 2000-01 Probable Risk of Depression 12-19 years Males3.4 Females9.7 20-34 years Males6.5 Females11.1 35-44 years Males6.1 Females11.3 45-64 years Males4.8 Females8.6 65 years and over Males2.3 Females4.0

12. Microdata File  Raw data organized in a file where the records or lines in the file are observations of a specific unit of analysis  Each record or line is one person’s responses –Time use survey – exercising, shopping, working, TV, gardening, eldercare

13. Cases 3 & 4 from the General Social Survey 2 Main File Sex 00003121411001198200121222222100209820012122222240112111124111212 11122050201971119710212122222252110261212043001409557204113130221 11999901978787879702221411271412400315000616611232222222221111172 6261622122226666666362120000000203202222242220000222041411011011 02111111122111000000210000000002100000000010000000000200000423300 200200100000100200 000041100110011101102122222221002009200212222222021111111231212111 21120812019381193804412222222111105220120390100750472103119101223 3520406058787870304221303420708300400001420007111222122211721575 656565555555666666656565000555500210222111111110000001111100001101 11221212211101101011000011010110000000000000000000000000000000000 0000000000000000 ID

14. Public Use Microdata File - PUMF  Specially prepared file to minimize disclosure  “Master file” would have personal identifiers

15. Population Health Surveys 1  Understand the determinants of health  Collect data on  Economic  Social  Demographic  Occupational and environmental correlations  Can impact public policy development 1 Health Survey information based on Michel B. Seguin’s “Health Statistics Information on the STC website”. December 2003.

16. Population Surveys  NPHS – National Population Health Survey  Household, institutional, north (territories)  Geography - provincial  Products –Public Use Microdata Files (PUMF)  1994-1995  1996-1997  1998-1999 –Research Data Centre access  2000-2001  2002-2003  2004-2005  2006-2007 NPHS is a longitudinal survey. PUMF are not longitudinal, due to the high risk of disclosure. Inactive

17. NPHS  The NPHS, which relies on respondents' self- reported health information, surveys the same group of respondents every two years for up to 20 years

18. Population Surveys  Canadian Community Health Survey (CCHS)  Common content  Optional content  126/136 health regions, started September 2000 Year Respondents Geography 1 100,000+ Health Region, provinces, territories, Canada 2 30,000 Provinces / Canada

19. Canadian Community Health Survey  Cycle 1.1 – Large sample (2001)  Cycle 1.2 – Mental Health (2002)  Cycle 2.1 – Large Sample (2003)  Cycle 2.2 – Nutrition (2004)  Cycle 3.1 – Large Sample (2005)  Cycle 3.2 – Canadian Health Measures Survey (CHMS)

20. Article from Nutrition cycle

21. Health Indicators  Measures of health status, health system and factors that influence health  Based on comparable definitions  Geography –Canada –Provinces –Regionally

22. Health Indicators  Health Status  Health conditions, human function, well-being, deaths  Health Determinants  Health behaviours, living & working conditions, personal resources(income), environmental factors  Health System Performance  Effectiveness, accessibility, efficiency, safety …  Community/health system characteristics

23. Health Indicators  Many data sources –Statistics Canada  Vital statistics  Surveys –Canadian Institute for Health Information (CIHI)  Provincial ministries  Health Canada  Hospital morbidity and discharge databases, …

25. Health Indicators  Has the notion of “peer groups” where Health regions with similar socio-economic characteristics are grouped  Products (free) –Publication online –Tables on Statistics Canada & CIHI web sites

26. Health Region Boundaries  Show your results spatially Distribution gender differences in depression compared to Calgary Health Region

27. Comparable Health Indicators  Grew out of the First Minister’s meeting in 2000  14 areas of comparable health status and health system performance  Geography  Provincial

28. Comparable Health Indicators - Topics  Health Status –Live expectancy, infant mortality, low birth rate, self-reported health  Health Outcomes –Change in life expectancy, improved quality of life, reduced burden of disease, illness or injury  Quality of Service –Waiting times (selected services), patient satisfaction, Hospital readmission (selected), access to 24/7 first contact health services, home and community services, public health surveillance and protection, health promotion and disease prevention

29. Products  Available from Statistics Canada Web Site & CANSIM Web Site: http://www.statcan.ca/english/freepub/82-401-XIE/01002/tables.htm

30. Other Tables  Causes of Death  Cancer Statistics

31. Health Canada's Notifiable Diseases Online Infectious Diseases http://www.phac-aspc.gc.ca/id-mi/http://www.phac-aspc.gc.ca/id-mi/

32. Residential Care Facilities  Some older tables at CIHI, prior to 1999  Custom tabulation  Online tables will be available for recent survey

33. Health Information from CIHI

34. CIHI Topics

35. CIHI Products  Publicly available, aggregate-level data  Analytic reports –Links to Saskatchewan report of Comparable Health Statistics with a study on measles  More detailed statistics may make a custom data request

36. CIHI & Graduate Students  CIHI provides health data to qualifying graduate students at no cost through the Graduate Student Data Access Program (GSDAP) Graduate Student Data Access Program

37. General Social Surveys –Cycle 1 to Cycle 19 –Monitor changes in the health of Canadians and to examine social support. –Cycles cover and repeat content and special focus areas – Each cycle includes general socio-economic variables

38. Cycle 1 - 10 CycleYearCoreSpecial Topic 11985HealthSocial support 21986Time Use, Social MobilityLanguage 31988Personal RiskVictim services 41989Education and WorkNo focus issue 51990Family and FriendsNo focus issue 61991HealthVarious topics 71992Time UseCulture, sport and unpaid activities 81993Personal RiskAlcohol and drug use 91994Education, Work and RetirementTransition into retirement 101995FamilyEffects of tobacco smoke

39. Cycle 8 - 19 CycleYearCoreSpecial Topic 111996Social SupportTobacco use 121998Time UseNo focus issues 131999Victimization Spousal violence and senior abuse and Public perception toward alternatives to imprisonment 142000 Access To and Use of Information Communication Technology 152001Family History 162002Social Support and Aging 172003Social engagement 182004Victimization 192005Time use Since 1994, health as core topic covered in NPHS, social support expanded in 1996.

40. General Social Survey 20 - 22  20 - Family Transitions Survey –Family data collected in cycle 5, 10, 15  21 - Family, Social Support and Retirement  22 – Survey on Social networks

41. National Longitudinal Survey of Children and Youth (NLSCY)  Longitudinal survey designed to measure child development and well-being as children grow from infancy to childhood  Products –PUMF  1994-95-Cycle 1  1996-97-Cycle 2  1998-99-Cycle 3  … Cycle 6 2004-2005

42. National Longitudinal Survey of Children and Youth (NLSCY)  Products  Cycle 1, 1994-1995 - Synthetic Files for Remote Access to the Master Files  Research Data Centre

43. Health and Activity Limitation Survey  Post-censual survey  Products –1991 PUMF –1996 PUMF  2001 - Participation and Activity Limitation Survey (PALS)  2006 - Participation and Activity Limitation Survey (PALS)

44. International  SourceOECD SourceOECD –Comparable statistics on health and health systems across OECD countries  Health status, expenditure, financing  Health care utilization  Health care coverage  Pharmaceutical  Non-medical determinants to health  Some U.S. and European data

45. Human Activity and The Environment 2000  Human activity and its relationship to natural systems' air, water, soil, plants and animals  Aggregate tables

46. Questions

47. Overview Part 2: Finding a Statistics and Data

48. Ways to Find Files 1.Library Catalogue 2.Statistics Canada Catalogue 3.Data Library Web Site 4.Web Data Extractors, i.e.IDLS 5.Talk to the Reference staff or Data Library staff

49. 1. The Catalogue  Use it when you know the name of the survey – Canadian Community Health Survey is footnoted in the article Mental Health of Canada’s Immigrants.  Searching by a topic –Strategies  Keep it broad – “ health” not measles  Use “statistics” or “codebook”  Change the scope to “Data and GIS Files”

50. 2. Statistics Canada Catalogue  Enter your keywords:  internet use  Look for the words public use microdata file or CANSIM Look for free access from our library

51. 3. Data Library Web Site  Browse by subject  Health

52. library.usask.ca/data Topic browse

53. 4. Very Specific Topics - Variables  Best bet  Web extractor for data files  IDLS - from Western Ontario

54. Data Services & GIS IDLS is listed in this section.

55. 4. Not sure? Ask us.  U of S has access to 1,000’s files  We can:  Help you search  Check for new releases  Cut through the red tape Phone: 966 - 5987 Email: refdata@library.usask.ca

56. Overview Part 4: Data Documentation

57. What is Data Documentation?  Material that accompanies the data file  Information on –Methodology & sampling –Questionnaire –Record layout –Weights –Frequencies –Syntax files (spss, sas) Codebooks

58. Codebook  Any information on the structure, contents, and layout of a data file  Typically, it is used to refer to any or all of the accompanying documentation  It can include information on methodology, sample, record layout, questionnaire and data dictionary.

59. Questionnaire  Shows the survey questions in the order they were posed  Presents the response codes  Often the directions for the interviewer and skip patterns are indicated “Did they ask about x? How did they phrase the question?

60. Excerpt

61. Data Dictionary  The data dictionary describes each variable in the data file  Typical information –Variable description –Question –Universe – who was asked this question, n= – Values for the variable and the # of cases –Length of the variable – 2 characters or 25 –Position in the file – starts at column 97 –Availability (suppressed)

62. Values and their codes

63. Wrap Up  Many health surveys and products  Useful for qualitative and quantitative studies  Data Library Services  We’re here to help you locate data files  Data documentation  Save time – check to see if the variable is included  Check the sample size – will your results be statistically significant?  Find the answer – just need a frequency?

64. 4. Ask Data Library Staff Office: 2nd Floor, Main Library  Appointments recommended  Email us at refdata@library.usask.ca refdata@library.usask.ca  Call us: 966-5987 Winnie Smit (7261) Chipo Kangayi (8841) Harpreet Aulakh (8841) Elise Pietroniro (2677) Rob Alary (5987) Darlene Fichter (7209)

65. Questions