WASHINGTON STATE LOCAL PUBLIC HEALTH INDICATORS

As the adjacent diagram shows, the list represents 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 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 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 Subcommittee, with members drawn from two standing committees of Washington’s Public Health Improvement Partnership: the Key Health Indicators Committee and the Performance Management Committee. Convening in 2006, the subcommittee set out 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 subcommittee 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 subcommittee’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. 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 and margin of error. 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 or appropriate validity. The subcommittee approved the final set of 32 indicators in June 2007. The work of the indicators subcommittee is described in more detail in the Local Public Health Indicators Report. In the current reporting cycle, data are available for 27 of the 32 indicators. The website will be updated to include additional indicator data as they become available.  The anticipated schedule for reporting data on the indicators is every other year.     RATIONALE FOR INDICATORS Back to the top >> The Public Health Indicators Subcommittee—part of the Washington State Public Health Improvement Partnership—during 2006-07 selected 32 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 determinant indicators, and they measure five key aspects of public health. Following is the list of indicators and a brief statement of the rationale and data source for each one. The Technical Notes provide more detailed information about each indicator.   Communicable Disease 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 Counties report the rate of treated cases to total reported cases. (Sexually Transmitted Disease Registry) Percent of adults age 65 or older who report receiving a flu shot during the past 12 months 90% of influenza-related hospitalizations and deaths occur among people in this age group. (Behavioral Risk Factor Surveillance System—BRFSS) Percent of children who are adequately immunized Childhood immunizations have provided one of the greatest improvements in public health by controlling serious conditions such as measles, polio, diphtheria, and tetanus. (Under development—data not currently available)   Prevention and Promotion Expected years of healthy life at age 20 This is a widely used measure of quality of life. (BRFSS and Death Certificate Data) Percent of adults age 18 or older who smoked at least 100 cigarettes in their lifetime and are current smokers The number of tobacco-related deaths exceeds 430,000 per year among U.S. adults. (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 About a third of adults are not physically active at levels recommended for maintaining good health. (BRFSS) Percent of adults age 18 or older who have body mass index greater than 25 An unhealthy weight is related to many morbidity and mortality issues. (BRFSS) Percent of adults age 18 or older who report eating fruits and vegetables 5 or more times per day Consuming at least five daily servings of fruits and vegetables may prevent many cancers and possibly coronary heart disease and stroke. (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 is related to public health issues such as motor vehicle crashes and violence. (BRFSS) Percent of adults age 18 or older who have ever been told by a doctor that they have diabetes The disease is one of the top 10 causes of death and is related to unhealthy behavior, such as being overweight, inactive, and having poor nutrition. (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 associated with disability and suicide. (BRFSS)   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 has long been recognized as an important way to improve the health of mothers and to prevent adverse birth outcomes. (Birth certificate data) 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 data) Rate of live born infants per 1,000 women ages 15-17 Children of teenage mothers are more likely to be born preterm, with a low birth weight, and to die during their first year of life than children born to women who delay childbearing beyond their teen years. (Birth certificate data) Percent of live born singleton births with birth weight less than 2,500 grams Newborns with inadequate fetal growth are prone to birth asphyxia, hypoglycemia, temperature instability, infection, and circulatory problems. (Birth certificate data) 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, the single most preventable cause of disease and death in the United States, often begins in adolescence. (HYS) Percent of 10th graders in the top 5% body mass index by reported height and weight, based on CDC growth charts Extra weight acquired during adolescence may persist into adulthood and increase the risk later in life for heart disease, gall bladder disease, some types of cancer, and osteoarthritis of the weight-bearing joints. (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) 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)   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 Inadequate income or health insurance may result in health concerns not being addressed in a timely or comprehensive manner. (BRFSS) Percent of adults age 18 or older who report having a personal doctor or health care provider People who relate to a place or provider of health care (often referred to as a medical home) are more likely to seek primary health care for routine preventive services. (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 is intended to detect cancers at curable stages. (BRFSS) Percent of women age 18 or older who report receiving a Pap smear test within the past 3 years Cervical cancer screening is intended to detect cancers at curable stages. (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 past 10 years Colorectal cancer screening is intended to detect cancers at curable stages. (BRFSS) Percent of adults ages 18-64 who currently report having health care insurance Health insurance is an important determinant of health and disability status. (BRFSS) Percent of children ages 0-17 whose parents report they have health insurance Children with health insurance are more likely to have access to primary care and a variety of preventive health care services. (Under development —data not currently available)   Environmental Health Percent of solid waste facilities in substantial compliance with permit conditions Improperly operated facilities can result in vector and vermin problems and can affect ground and surface water resources. (Under development—data not currently available) 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. (Under development—data not currently available) Percent of identified on-site sewage failures with corrective action initiated within 2 weeks This is an important preventive step to correct on-site failures when first detected. (Under development—data not currently available)   Certain indicators that were desired by the subcommittee were limited by the data available.  Five public health indicators without data were kept as placeholders, realizing an investment must be made to pursue collecting and reporting this data at the local level.  Other indicators of public health significance, but low in incidence for the majority of local health jurisdictions, will continue to be monitored.     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 List of Indicators will show the 32 selected indicators in the general groups of Communicable Disease, Prevention and Health Promotion, Maternal and Child Health, Access to Care, and Environmental Health. Each of the links in Data by Indicators 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. 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. 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. Please see Technical Notes for a more detailed discussion of data sources, terms, and methods.