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 THE GRANTThe goal of this project is to design a data collection system that will track chronic diseases and their risk factors in US communities through multiple sources. The National Heart, Lung, and Blood Institute (NHLBI) Principal Investigators:Novel Methods of Monitoring Health DisparitiesThis project will explore disparities in chronic disease among US communities by designing a cost-effective and easily scalable data collection system to track such diseases and their accompanying risk factors using multiple data sources. Available data on health outcomes, health determinants, and quality and access to care reveal huge racial and ethnic disparities across communities in the US. Yet these disparities are only partially understood. To track these disparities in chronic diseases and the effectiveness of health policies in reducing them, national data alone are not sufficient. More clinically detailed and localized information is required to understand these disparities. Given the lack of data to analyze at the local level, pressing policy questions cannot be answered. For example, while we know the life expectancy of women is decreasing in 180 counties, we do not know what is happening to risk factors or the quality of clinical care in those communities. We cannot answer exactly how financial constraints or even the recent economic downturn affect utilization of health care. We cannot know how interventions are differentially provided or utilized across subpopulations. Understanding these disparities better and determining ways to track them cost-effectively will provide a wealth of information to policymakers nationally and locally to better target interventions, alleviate risk factors, and improve health outcomes in a way that minimizes disparities among groups. In this project, we will design a system that integrates data from household interviews, physical examinations, emergency medical services, hospital discharge databases, outpatient care databases, selective hospital chart reviews, and pharmacy records. We hope to develop methods for record linkage that allow us to trace the sequence of events for individuals from different socioeconomic contexts and risk factors through to their interactions with the health system and their health outcomes. This project represents what we hope will be a pilot for a much larger, nationally relevant system. It is important to pilot this in a relatively data-rich environment with a heterogeneous population. King County, Washington, is our pilot location, and the project will focus on three racial and ethnic groups for which there are demonstrated disparities in health outcomes nationally: white non-Hispanics; white Hispanics; and black non-Hispanics. The study is intended to resolve a series of outstanding technical measurement issues, develop operational protocols, and produce results relevant to health policy formulation. Ideally, if the system proves successful in tracking a limited set of risk factors and chronic diseases, it could be expanded to include a wider range of both and even tailored as desired for local circumstances. Additionally, and equally importantly, we will address the critical aspect of individual confidentiality and privacy. We will develop protocols for public release of the integrated chronic disease surveillance data that guarantee individual privacy but maximize the use of these data by the research and policy analysis community. CollaboratorsIHME is engaging with several key collaborators who together bring a multidisciplinary approach to the project. Collaborators at the Harvard School of Public Health will focus their efforts on assessing risk factors among different communities, such as metabolic risks, diet, and tobacco use. Collaborators at the Dartmouth Institute for Health Policy and Clinical Practice will contribute their expertise in analyzing Medicare and health expenditure data. Collaborators at Public Health – Seattle & King County will advise on how to effectively and respectfully reach individuals within King County and lend their expertise on the health services available to those communities. Together, all will advise on how best to provide information that is useful to the policy and research communities while being respectful of individuals and their privacy concerns. For more information, please contact: us@healthmetricsandevaluation.org This project is supported by award number RC2HL101759 from the National Heart, Lung, and Blood Institute, which is part of the US National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute or the National Institutes of Health. |
