Using Local Health Information To Promote Public Health
Local health information can be a powerful vehicle for improving the health of a community. It can highlight both the existence of problems and opportunities for improvement. It can also guide local action in support of policy changes and improve programs’ effectiveness. However, efforts to expand the availability and use of local health information face major technical and institutional barriers, as well as health information privacy concerns. This paper provides an overview of current issues surrounding the availability and use of local health information, identifies barriers that hinder its use, and suggests potential solutions. Issues, barriers, and proposed solutions to improve information flow. WITH THE SUPPORT OF Robert Wood Johnson Foundation (RWJF) Turning Point funds, the Virginia Center for Healthy Communities developed an online, publicly available statewide resource providing ZIP code–level data and maps for a variety of health indicators. In Wythe County, which has an age-adjusted diabetes mortality rate more than double that of the state, business leaders, the local health department, the local hospital, and nonprofit organizations combined their visions and expertise to address this problem. Health department nurses began to screen for diabetes at health fairs, and the hospital provided classes for newly diagnosed diabetics. The Chamber of Commerce is leading a social marketing initiative complete with worksite screening, education about lowering diabetes risk, and materials for preventing and managing diabetes; the health department and the hospital are providing follow-up services.1 The Fresno County, California, public health officer used county-level data from the 2001 California Health Interview Survey (CHIS) to identify obesity, diabetes, and asthma as the most important public health issues and obtained additional resources from the county’s board of supervisors to address them. The Los Angeles County Children’s Health Initiative, a coalition of public and private groups and foundations, used CHIS data to justify and plan a new health insurance expansion program for children. In Sacramento, the Community Services Planning Council, a National Neighborhood Indicators Project (NNIP) partner, maintains an online system containing more than 150 regional indicators and provides technical assistance to data users. As these examples indicate, local-level information can be a powerful vehicle for improving health. It can highlight both the existence of problems and opportunities for improvement within a community. It can also guide local action in support of policy changes and improve programs’ effectiveness. As part of a planning effort to understand how foundations and other funders can best promote the availability and use of local health information, in April 2004 the RWJF convened a meeting of twenty-six experts in population data collection and analysis and the dissemination of local health information. Current and former officials of several state and local health departments and federal health agencies (including the Centers for Disease Control and Prevention, or CDC, the National Center for Health Statistics, or NCHS, and the Health Resources and Services Administration, or HRSA) and health advocacy and policy organizations, plus university-based researchers attended the meeting. A detailed conceptual framework based on the literature and the authors’ experience was prepared for that meeting, revised per the meeting’s recommendations, and supplemented by further expert input and literature review on relevant themes in health information privacy, community health assessment, and community indicators. This paper provides an overview of current issues surrounding the availability and use of local health information, discusses the role that public health departments play in collecting and disseminating local health information, identifies barriers that hinder its use, and suggests potential solutions to overcome them.