Overview

Finding and Using Health Statistics and Data FilesSoc 398: Social Inequality and Health

Darlene Fichter

Data Library Services, U of S Library

October 4, 2007

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 fileUnderstanding data documentation

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

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

Social Inequality and Health

Advances of medical practice and science have been seen as the principal causes of increased human life expectancy

True False

Social Inequality and Health

Nutrition and improved living conditions are better indicator of population health

True False

What are some risk factors of lower socio-economic status?

SmokingLack of exerciseImmoderate eating and drinkingHigh fat/low fiber dietsMore stress - higher rates of ill health/deathLower of levels of social supportLive or work in environments hazardous to health

Overview

Part 1: Health Surveys

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

Types of Data Files

Aggregate data files– Counts

Cases of measles in Saskatoon– Cross tabulations

Number of smokers in Saskatoon by age and sex

Table 105-0005 - Risk of depression, by age group and sex, household population aged 12 and over, Canada (Canadian Community Health Survey)

Age group Sex2000-01 Probable Risk of

Depression

12-19 years  Males 3.4

  Females 9.7

20-34 years  Males 6.5

  Females 11.1

35-44 years  Males 6.1

  Females 11.3

45-64 years  Males 4.8

  Females 8.6

65 years and over  Males 2.3

  Females 4.0

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

Cases 3 & 4 from the General Social Survey 2 Main File

Sex000031214110011982001212222221002098200121222222401121111241112121112205020197111971021212222225211026121204300140955720411313022111999901978787879702221411271412400315000616611232222222221111172626162212222666666636212000000020320222224222000022204141101101102111111122111000000210000000002100000000010000000000200000423300200200100000100200000041100110011101102122222221002009200212222222021111111231212111211208120193811938044122222221111052201203901007504721031191012233520406058787870304221303420708300400001420007111222122211721575656565555555666666656565000555500210222111111110000001111100001101112212122111011010110000110101100000000000000000000000000000000000000000000000000

ID

Public Use Microdata File - PUMF

Specially prepared file to minimize disclosure

“Master file” would have personal identifiers

Population Health Surveys1

Understand the determinants of healthCollect data on

EconomicSocialDemographic

Occupational and environmental correlationsCan impact public policy development

1 Health Survey information based on Michel B. Seguin’s “Health Statistics Information on the STC website”. December 2003.

Population Surveys

NPHS – National Population Health SurveyHousehold, institutional, north (territories)Geography - provincial

Products– Public Use Microdata Files (PUMF)

1994-19951996-19971998-1999

– Research Data Centre access2000-2001 2002-2003 2004-20052006-2007

NPHS is a longitudinal

survey. PUMF are not

longitudinal, due to the high risk of

disclosure.Inactive

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

Population Surveys

Canadian Community Health Survey (CCHS)Common contentOptional content126/136 health regions, started September 2000

Year Respondents Geography

1 100,000+ Health Region, provinces, territories, Canada

2 30,000 Provinces / Canada

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)

Article from Nutrition cycle

Health Indicators

Measures of health status, health system and factors that influence health

Based on comparable definitionsGeography

– Canada– Provinces– Regionally

Health Indicators

Health StatusHealth conditions, human function, well-being,

deathsHealth Determinants

Health behaviours, living & working conditions, personal resources(income), environmental factors

Health System PerformanceEffectiveness, accessibility, efficiency, safety …

Community/health system characteristics

Health Indicators

Many data sources– Statistics Canada

Vital statisticsSurveys

– Canadian Institute for Health Information (CIHI)Provincial ministriesHealth CanadaHospital morbidity and discharge databases, …

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

Health Region Boundaries

Show your results spatially

Distribution gender differences in depression compared to Calgary Health Region

Comparable Health Indicators

Grew out of the First Minister’s meeting in 2000

14 areas of comparable health status and health system performance

GeographyProvincial

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 injuryQuality 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

Products

Available from Statistics Canada Web Site & CANSIM

Web Site:

http://www.statcan.ca/english/freepub/82-401-XIE/01002/tables.htm

Other Tables

Causes of DeathCancer Statistics

Health Canada's Notifiable Diseases Online

Infectious Diseases http://www.phac-aspc.gc.ca/id-mi/

Residential Care Facilities

Some older tables at CIHI, prior to 1999Custom tabulationOnline tables will be available for recent

survey

Health Information from CIHI

CIHI Topics

CIHI Products

Publicly available, aggregate-level dataAnalytic reports

– Links to Saskatchewan report of Comparable Health Statistics with a study on measles

More detailed statistics may make a custom data request

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

Cycle 1 - 10

Cycle Year Core Special Topic

1 1985 Health Social support

2 1986 Time Use, Social Mobility Language

3 1988 Personal Risk Victim services

4 1989 Education and Work No focus issue

5 1990 Family and Friends No focus issue

6 1991 Health Various topics

7 1992 Time Use Culture, sport and unpaid activities

8 1993 Personal Risk Alcohol and drug use

9 1994 Education, Work and Retirement Transition into retirement

10 1995 Family Effects of tobacco smoke

Cycle 8 - 19

Cycle Year Core Special Topic

11 1996 Social Support Tobacco use

12 1998 Time Use No focus issues

13 1999 VictimizationSpousal violence and senior abuse and Public perception toward alternatives to

imprisonment

14 2000Access To and Use of Information

Communication Technology

15 2001 Family History

16 2002 Social Support and Aging

17 2003 Social engagement

18 2004 Victimization

19 2005 Time use

Since 1994, health as core topic covered in NPHS, social support expanded in 1996.

General Social Survey 20 - 22

20 - Family Transitions Survey– Family data collected in cycle 5, 10, 15

21 - Family, Social Support and Retirement22 – Survey on Social networks

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 11996-97-Cycle 21998-99-Cycle 3… Cycle 6 2004-2005

National Longitudinal Survey of Children and Youth (NLSCY)

ProductsCycle 1, 1994-1995 - Synthetic Files for Remote

Access to the Master Files Research Data Centre

Health and Activity Limitation Survey

Post-censual surveyProducts

– 1991 PUMF– 1996 PUMF

2001 - Participation and Activity Limitation Survey (PALS)

2006 - Participation and Activity Limitation Survey (PALS)

International

SourceOECD – Comparable statistics on health and health systems

across OECD countriesHealth status, expenditure, financingHealth care utilizationHealth care coveragePharmaceuticalNon-medical determinants to health

Some U.S. and European data

Human Activity and The Environment 2000

Human activity and its relationship to natural systems' air, water, soil, plants and animals

Aggregate tables

Questions

Overview

Part 2: Finding a Statistics and Data

Ways to Find Files

1. Library Catalogue2. Statistics Canada Catalogue3. Data Library Web Site4. Web Data Extractors, i.e.IDLS5. Talk to the Reference staff or Data Library

staff

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

– StrategiesKeep it broad – “health” not measlesUse “statistics” or “codebook”

Change the scope to “Data and GIS Files”

2. Statistics Canada Catalogue

Enter your keywords: internet use

Look for the words public use microdata file or CANSIM

Look for free accessfrom our library

3. Data Library Web Site

Browse by subject Health

library.usask.ca/data

Topic browse

4. Very Specific Topics - Variables

Best betWeb extractor for data filesIDLS - from Western Ontario

Data Services & GIS

IDLS is listed in this

section.

4. Not sure? Ask us.

U of S has access to 1,000’s filesWe can:

Help you searchCheck for new releasesCut through the red tape

Phone: 966 - 5987Email: refdata@library.usask.ca

Overview

Part 4: Data Documentation

What is Data Documentation?

Material that accompanies the data fileInformation on

– Methodology & sampling– Questionnaire– Record layout– Weights– Frequencies– Syntax files (spss, sas)

Codebooks

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.

Questionnaire

Shows the survey questions in the order they were posed

Presents the response codesOften the directions for the interviewer and

skip patterns are indicated

“Did they ask about x? How did they phrase the question?

Excerpt

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)

Values and their codes

Wrap Up

Many health surveys and productsUseful for qualitative and quantitative studies

Data Library ServicesWe’re here to help you locate data files

Data documentationSave time – check to see if the variable is includedCheck the sample size – will your results be statistically

significant?Find the answer – just need a frequency?

4. Ask Data Library Staff

Office: 2nd Floor, Main LibraryAppointments recommendedEmail us at refdata@library.usask.caCall us: 966-5987

Winnie Smit (7261)

Chipo Kangayi (8841)

Harpreet Aulakh (8841)

Elise Pietroniro (2677)

Rob Alary (5987)

Darlene Fichter (7209)

Questions