los angeles county community health profile project: a "hot spot analysis"
DESCRIPTION
Using a variety of public data sources, we calculated the disease burden of six major clinical areas—heart disease, diabetes, pulmonary disease, cancer, HIV/AIDS and mental health—for the eight service planning areas and 26 health districts within Los Angeles County. The purpose of the project is to quantify disease "hot spots" within Los Angeles County and share our results with community stakeholders, policy makers and researchers so the data may be used to shape the design and implementation of community-driven initiatives.TRANSCRIPT
LOS ANGELES COUNTY
COMMUNITY HEALTH PROFILE
PROJECT: A “HOT SPOT ANALYSIS”
November 15, 2012 Ami M. Shah, MPH Jerry Kominski, PhD UCLA Center for Health Policy Research David Zingmond, MD PhD UCLA Division of General Internal Medicine and Health Services Research
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BACKGROUND
CTSI aims to accelerate knowledge, discoveries and research to improve health
Disparities in health and healthcare access exist. Yet, little is known about the specific geographic communities bearing a greater burdens of illness and limited access to services
Sharing knowledge and engaging in a dialogue with community stakeholders can inform data analysis and lead to evidence-based interventions to promote health equity and improve health.
RESEARCH QUESTION
1. How can investigators engage with community stakeholders to improve their analysis plan and assemble health data that are relevant and meaningful to community-based improvement efforts?
2. Where are the ‘hot spots’ of disease and preventable hospital admissions and ED encounters in Los Angeles County (LAC)?
3. What knowledge can be shared with stakeholders to inform community plans and shape community initiatives toward improved health in LAC?
METHODS
• Engage with communities, health care administrators, providers, health departments, and other stakeholders interested in the health of Los Angelinos
• Produce direct and indirect (modeled small area) estimates for 12 health indicators (disease prevalence and risk factor surveillance) based on the California Health Interview Survey (CHIS) 2009
• Produce rates (per 100,000) of inpatient admissions and ED encounters for conditions within the six CTSI core clinical domains (heart disease, diabetes, pulmonary disease, cancer, HIV/AIDs, and mental health) from the Office of Statewide Planning and Development (OSHPD). Definitions are based on AHRQ Prevention Quality Indicators (PQIs), Inpatient Quality Indicators (IQIs) and supplemented by other conditions
• Produce estimates at the Service Planning Area (SPA) and Health District levels
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community involvement
outcomes (Apr - Aug 2012)
Knowledge exchange with various stakeholders
• Community Based Organizations
• Health Care Systems
• Los Angeles County Department of Public Health
• Academic-Community Partnership (including UCLA CTSI colleagues)
Iterative analyses and feedback from researchers and other stakeholders via email, phone and meetings
Interest in increasingly more granular analysis
• Census Designated Places (CDPs) - includes 88 cities and 32 unincorporated CDPs
• 15 Los Angeles City Council Districts
• 20 Community defined neighborhoods
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health and healthcare
utilization outcomes (Apr - Aug 2012)
Analysis of secondary data sources
Substantial variation in disease prevalence across SPAs and Health Districts such as diabetes, obesity, and asthma
Identification of Health Districts with high rates of preventable hospitalizations and ER encounters for conditions such as: short-term, long-term, uncontrolled diabetes and lower extremity amputations; heart failure; and mental health disorders
Maps of environmental factors associated with poor health, such park acreage/green space and fast food outlets
Maps to visually identify “hot spots” – or areas with higher burden of disease and preventable hospitalizations as possible areas to target for interventions
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CERP AIMS ADDRESSED
Specific Aim 1: Promote and sustain bidirectional knowledge sharing between community and academia
Specific Aim 3: Drive innovation in community engagement that accelerates the volume and impact of partnered research in diverse communities
Specific Aim 4: Build health services research (HSR) methods into partnerships to accelerate design, production, and wide adoption of evidence-based practice and behavior
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TIMELINE
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Project Aims
Timeline in Months
Mar-May 2011 Jun-Aug 2011 Sept-Nov 2011 Dec-Feb 2011
AIM1: Engage community stakeholders to guide analysis plan, interpret findings and review final analysis and the report
AIM2: Develop analyses of population health and healthcare at the Health District level
AIM3: Develop analyses of disease specific hospitalizations and emergency department visits at the zip code level
AIM4: Develop a report that incorporates profiles of LAC neighborhoods and describes population health, healthcare needs and services, and hospital encounters
ADDED-VALUE FROM CTSI
FUNDING
• Improved data analysis and measurement to be relevant for community stakeholders and pertinent for local health improvement efforts
• Engagement of the research community with public health departments, local community groups, clinics, and other stakeholders in guiding data analyses
• Supported cross-disciplinary sharing of knowledge and data findings
• Encouraged continued dialogue in planning, interpreting, and presenting data on the health and healthcare of local areas
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NEXT STEPS
• Finalize data analyses and a report for CTSI
• Prepare a dissemination plan for broader knowledge sharing with community stakeholders in the form of presentations and/or short reports
• Continue engagement efforts with stakeholders to translate data findings and support the use of data in guiding the implementation of community driven initiatives
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