WASHINGTON STATE LOCAL PUBLIC HEALTH INDICATORS

As the adjacent diagram shows, the local public health indicators represent only part of the health information picture, drawing from only a small share of the wealth of state and local health data that are now available. In addition, Washington's counties differ in their demographic mix, economic environment, and other factors that contribute to health status. Local level variation in the indicators will reflect differences in these underlying conditions. The data collected through the local public health indicators will contribute over time to our knowledge base of the health of all Washington's communities.

Creating the List of Indicators Rationale for Indicators List of Indicators How to Navigate the Site

 

CREATING THE LIST OF INDICATORS Back to the top >> The local public health indicators list is the work of the state's Public Health Indicators workgroup. The workgroup has been meeting since 2006 to identify a set of local public health indicators that could be used to help measure health status and determinants of health in Washington's 35 local public health jurisdictions. The workgroup recognized that the health of every community occurs within a unique socio-demographic context that determines, in part, the nature of its health problems and the ability of public health programs to address them. The workgroup’s first task was to identify criteria that would direct selection of the indicators. These criteria were used as guiding principles to ensure that the selected measures would be relevant across Washington's diverse communities and that the reported data would be valid, reliable, and accessible. The panel determined that each of the indicators, to the extent possible, should: Measure an important aspect, result, or outcome of public health's work. Be population-based or generalizable to populations as a whole. Be measurable ─ that is, defined in standard and specific terms. Represent data that are feasible (and not too expensive) to collect. Be actionable ─ the public health system can implement activities to improve performance against the measure. Be reportable for at least 80% of local health jurisdictions, meeting requirements regarding sample size, margin of error and completeness. Measure either health determinants or status. Be measurable over time to determine trends. Link to and be consistent with local, state, and national measures (such as Healthy People 2010). Be measurable for population sub-groups (age, gender, race, etc.) to identify disparities across groups. Be understandable and not require extensive explanation. Be based on data of appropriate validity. The workgroup approved the final set of 32 indicators in June 2007. Certain indicators that were desired by the workgroup were limited by the data available. Other indicators of public health significance, but low in incidence for the majority of local health jurisdictions, were not included on the indicator list but will continue to be monitored. The local public health indicators website was launched in November 2007. At that time data were available and reported for 27 of the 32 indicators. In October 2009, the website was updated for the first time, including data on 31 of the 32 indicators.  The plan is to update the indicator data every two years. The Public Health Indicators workgroup reviews the indicators and data definitions and makes changes as needed. The latest update is being rolled out the end of 2011 as the data becomes available. There will be 35 indicators posted this time with 4 new measures that were added by the workgroup.   RATIONALE FOR INDICATORS Back to the top >> The Public Health Indicators workgroup ─ part of the Washington State Public Health Improvement Partnership ─ selected 35 local public health indicators to measure community-based results and outcomes of the state' s public health system. The indicators are a mix of health status and health determinants. They measure six key aspects of public health: Community Context, Communicable Disease, Prevention and Health Promotion, Maternal and Child Health, Access to Care, and Environmental Health.   Following is the list of indicators by category, and a brief statement of the rationale and data source for each one. The Technical Notes provide more detailed information about each indicator.   Community Context Back to the top >> Percent of people living at or below the U.S. federal poverty level People living in poverty have poorer health status and die at younger ages than people with more financial resources. (U.S. Census Small Area Income and Poverty Estimates)   Communicable Disease Back to the top >> Rate of reported Chlamydia infections per 100,000 women ages 15–24 Reported rates of this disease are highest among young women. (Sexually Transmitted Disease Registry) Percent of reported Chlamydia infections that received treatment in women ages 15–24 A focus on investigating and treating reported cases of Chlamydia helps to limit the spread of disease and prevent recurrence. (Sexually Transmitted Disease Registry) Percent of adults age 18 or older who report receiving a flu shot during the past 12 months Flu shots are effective in reducing the number of people who get influenza, as well as influenza deaths and hospitalizations. (Behavioral Risk Factor Surveillance System – BRFSS) Percent of children ages 19–35 months with complete vaccination records on file in the Child Profile Immunization Registry (4-DTP, 3-Polio, 1-MMR, 3-Hib, 3-HepB, 1-Varicella, 4-PCV) Childhood immunizations have provided one of the greatest improvements in public health by controlling serious conditions such as measles, polio, diphtheria, and tetanus. (Child Profile Immunization Registry)   Prevention and Health Promotion Expected years of healthy life at age 20 This is a widely used measure of quality of life. (BRFSS and Death Certificate) Percent of adults age 18 or older who smoked at least 100 cigarettes in their lifetime and are current smokers Cigarette smoking is a leading cause of premature, preventable disease and death in Washington. (BRFSS) Percent of adults age 18 or older who report moderate physical activity (30 minutes a day, 5 times a week) or vigorous activity (20 minutes a day, 3 times a week) in work or leisure Physical activity improves life expectancy, functional independence, and quality of life, and reduces the risk of developing many chronic conditions. (BRFSS) Percent of adults age 18 or older who have body mass index 30 kg/m2 or higher An unhealthy weight is a leading cause of preventable, premature mortality and morbidity. (BRFSS) Percent of adults age 18 or older who report eating fruits and vegetables 5 or more times per day A nutritious diet, including sufficient consumption of fruits and vegetables, can reduce major risk factors for chronic diseases. (BRFSS) Percent of adults age 18 or older who report binge drinking (5 drinks for men; 4 drinks for women) on at least 1 occasion in last 30 days Binge drinking increases risk of morbidity and mortality from injury. (BRFSS) Percent of adults age 18 or older who have ever been told by a doctor that they have diabetes Diabetes is among the top 10 causes of death. Adult onset diabetes can be prevented through maintaining a healthy weight, being physically active, and eating a healthy diet. (BRFSS) Percent of adults age 18 or older who report 14 or more days of poor mental health in the past month Poor mental health is a major source of distress, disability, suicide and social burden. (BRFSS) Rate of hospitalization for falls per 100,000 adults age 65 or older Falls among older adults are the leading cause of injury-related hospitalizations in Washington. (Comprehensive Hospital Abstract Reporting System, Oregon Hospital Discharge Data)   Environmental Health Percent of inspected permanent food establishments with 35 or more critical violations Food service establishments with this level of violations pose the highest risk for causing food-borne outbreaks. (DOH Division of Environmental Health) Percent of identified on-site sewage failures with corrective action initiated within 2 weeks It is important to correct on-site sewage system failures when first detected to prevent surface and ground water contamination and risk to public health. (DOH Division of Environmental Health) Percent of days meeting the Washington State Department of Ecology 24-hour average healthy air goal of ≤20 ug/m3 for particulate matter 2.5 microns in diameter or less (PM2.5) Studies show that serious health effects from short term and long term exposure to PM2.5 (particulate matter of 2.5 microns or less). Those at risk from breathing PM2.5 are people with heart and lung disease, diabetes, and infants and children. The Department of Ecology has established a daily healthy air goal of 20ug/m3. However, some people can experience health effects below this level. (Washington State Department of Ecology, Washington Tracking Network).    Maternal and Child Health Percent of women giving birth who received prenatal care starting in the first trimester of pregnancy Early and continuous prenatal care long been recognized as an important way to improve the health of mothers and to prevent adverse birth outcomes. (Birth Certificate) Percent of women giving birth who smoked any time during pregnancy Tobacco smoking during pregnancy is the most important preventable cause of low birth weight. (Birth Certificate) Pregnancy rate per 1,000 women ages 15-17 Teen pregnancy rates are used to evaluate teen pregnancy prevention efforts. Teen mothers are at high risk of dropping out of high school, and children born to teenage mothers are high risk of living in poverty and suffering adverse birth outcomes. (Birth Certificate) Percent of live born singleton births with birth weight less than 2,500 grams Low birth weight is a major contributor to infant morbidity and mortality. (Birth Certificate) Percent of 10th graders who report physical activity 60 minutes a day, 5 or more days a week Some immediate effects of physical activity include building and maintaining healthy bones and lean muscles, controlling weight, reducing feelings of depression and anxiety, and promoting psychological well-being. (Healthy Youth Survey HYS) Percent of 10th graders who report smoking cigarettes in the last 30 days Tobacco use, a leading cause of premature, preventable disease and death in Washington, often begins in adolescence. (HYS) Percent of 10th graders in the top 15% body mass index by reported height and weight, based on CDC growth charts Overweight and obese adolescents are at increased risk of adult obesity, a leading cause of preventable morbidity and mortality. (HYS) Percent of 10th graders who report alcohol consumption in the past 30 days Alcohol is often a factor in the four leading causes of death among 15–20-year-olds: vehicle crashes, homicides, suicides, and other unintentional injuries. (HYS) Percent of 10th graders who report feeling sad or hopeless almost every day for two weeks in a row over the past year Youth who report feeling sad or hopeless are at high risk of engaging in behaviors that negatively affect health. (HYS) Rate of hospitalization for unintentional injury per 100,000 children ages 0–17 Unintentional injury is a leading cause of hospitalization and mortality among children. (Comprehensive Hospital Abstract Reporting System, Oregon Hospital Discharge Data)   Access to Care Percent of adults age 18 or older who report needing to see a doctor within the past year but could not due to cost Inability to cover costs of health care may result in delays in treating health conditions, many of which have less serious consequences when treated early. (BRFSS) Percent of adults age 18 or older who report having a personal doctor or health care provider Having a personal doctor or health care provider supports prevention, early detection and treatment of disease. (BRFSS) Percent of adults age 18 or older who report visiting a dentist, dental hygienist or dental clinic within the past year Regular preventive dental care can reduce the development of disease and facilitate early diagnosis and treatment. (BRFSS) Percent of women age 50 or older who report receiving a mammogram within the past 2 years Breast cancer screening facilitates early detection and treatment of breast cancer, resulting in improved survival. (BRFSS) Percent of women age 21 or older who report receiving a Pap smear test within the past 3 years Cervical cancer screening allows for early detection and treatment of cervical cancer, resulting in improved survival. (BRFSS) Percent of adults age 50 or older who had a blood stool test in the past year, sigmoidoscopy in the past 5 years, or colonoscopy in the past 10 years Screening for colorectal cancer facilitates prevention, early detection and treatment, resulting in reduced incidence of disease and improved survival for those with colorectal cancer. (BRFSS) Percent of adults ages 18-64 who currently report having health insurance Health insurance facilitates receipt of preventive services and early diagnosis and treatment of disease. (BRFSS) Percent of children ages 0-17 whose parents report they have health insurance Health insurance facilitates receipt of preventive services and early diagnosis and treatment of disease. (BRFSS)       HOW TO NAVIGATE THE SITE Back to the top >> The local public health indicators site is designed to present local data for each of Washington' s local public health jurisdictions and to compare local data across Washington communities and with state and national averages. The Data by Indicator show the 35 selected indicators in the general groups of Community Context, Communicable Disease, Prevention and Health Promotion, Maternal and Child Health, Access to Care, and Environmental Health. Each of the links in this section leads to a chart that shows where each of Washington' s local health jurisdictions rank for that indicator, shows the state average for that indicator, and characterizes local data as better, similar, or worse than the state average. Indicators have two or three cycles of data available for review; users choose whether they want to look at baseline data (posted in 2007 for most indicators); update 1 (posted in 2009 for most indicators) or update 2 (posted in 2011). To view local data in more detail, click on Data by Jurisdiction and select an individual county or local public health jurisdiction. The list of indicators will appear again. Local data are grouped in tables consistent with the five categories listed above. Users choose which category and cycle of data they wish to view. Each table shows individual indicators, the unit of measure for the data, the year the data were collected, the most recent data, and comparisons with state and national data for that indicator. Confidence intervals are also shown. To compare data over time, click on Data Trends. The list of indicators will appear again. Choose any indicator. A table will appear that shows baseline and update data for this indicator, for each local health jurisdiction and the state as a whole. The data are shaded to indicate whether health jurisdictions and the state are doing better, similar or worse over time.  See Technical Notes for a more detailed discussion of data sources, terms, and methods.