State Initiatives

From: Healthy People 2010 Tool Kit: Obtaining Baseline Measures, Setting Targets and Measuring Progress.

From State Initiatives

Obtaining Baseline Measures and Identifying Data Needs

Assessing data and data needs in order to set objectives

The Connecticut Department of Public Health responded to the year 2000 national initiative with a coordinated, internal data-oriented review of Healthy People 2000 and development of state objectives. In 1992, the Department of Public Health produced Healthy Connecticut 2000 Baseline Assessment Report, as a framework for program planning, evaluation, policy development, and assurance activities. The report originally contained 112 objectives in 18 priority areas that focused on health status and risk reduction. The Department of Public Health updated the Baseline Assessment Report in 1997 with 42 service and protection objectives. The objectives set targets for the services needed to address the health status and risk reduction objectives.

In the District of Columbia, the State Center for Health Statistics was given the task of working with Program Administrators and staff to produce a comprehensive review of progress from 1993 to 1998 toward meeting Healthy Residents Year 2000 Objectives. In January of 1999, the Progress Review was completed and released. Following the evaluation and documentation of progress, program administrators and staff working with their Advisory Board members, community-based contacts, and collaborating federal agencies developed the draft year 2010 objectives for both internal review and public comment.

In 1995 Minnesota developed objectives to improve its data systems' ability to measure progress toward the year 2000 objectives. Among these objectives, Minnesota sought to collect and disseminate data from state agencies, local agencies, health plan companies, and other health care providers. The state planned to identify significant gaps in disease prevention and health promotion data, as well as establish methods to collect and analyze health status indicators.

In Ohio, as a part of Ohio’s Public Health Plan, the Data System Work Group assisted the Healthy People Ohio (HP Ohio) Work Group by preparing a Data Inventory. The inventory specifies the data source and whether data are available for each HP Ohio objective. The Data System Work Group also identified baseline data for some of the HP Ohio objectives, and made recommendations for data collection for objectives with no data source. The HP Ohio objectives are included in the Ohio Department of Health’s data warehouse.

In South Dakota, data activities begin at the program level with programs following the grant proposal/reporting process for developing baseline measures, setting targets, and determining methods for progress measurement. Many grants, such as the Maternal and Child Health Block Grant, use Healthy People performance measures, grant-specific performance measures, and state-specific performance measures.

The Great Lakes Inter-Tribal Council of Wisconsinand the Inter-Tribal Council of Michigan serve Tribes in both states through a Cooperative Agreement Epidemiology Project (The EpiCenter). The EpiCenter developed Tribal-specific community health profiles based on health indicators by making use of Indian Health Service’s Base Line Measures, a needs assessment, and Healthy People 2000. Data in the community health profiles serve as baseline measures and descriptions of changing health status for the Tribes in the project service area.

Identifying and communicating data sources and data needs specific to the measurement of each objective in the plan

The Illinois Project for Local Assessment of Needs (IPLAN) was developed to assist local health departments to complete community health needs assessments. The system utilizes Healthy People 2000 and Healthy People 2010 objectives as reference points, where applicable, and provides over 100 state- and county-level population-based health indicators. For some indicators, community-level data are available.

Healthy New Jersey 2000 details state data needs for each goal and corresponding objectives. New Jersey expanded its list of relevant data needs beyond health status objectives. As examples, the plan calls for better patient socioeconomic and clinical outcome data, standardized definitions of certain conditions, evaluation data on prevention interventions, and economic impact data.

In Texas, through a grant from the CDC, the department received staff assistance to develop a series of on-going reports tracking state progress according to the 18 Health Status Indicators recommended by CDC in conjunction with the Healthy People 2000 initiative. The preparation of this series of reports was institutionalized within the department and is continued as an important component of its ongoing assessment of the state’s health status.

Selecting indicators based upon previously identified performance measures or benchmarks

The ColoradoStatewide Outcomes/Indicators Task Force established a defined set of measures to rate the performance of the Colorado Department of Public Health and Environment (CDPHE). Performance was measured in terms of outcomes (e.g., heart disease death rates), rather than processes (e.g., number of adults who have had their blood pressure checked). Task Force members represented public health agencies, managed care organizations, academia, and philanthropic organizations. Population-based objectives were developed to reflect the Healthy People 2000 national plan and the CDPHE budget requests.

The OregonLegislature directed all state agencies to develop performance measures with ties to the state’s indicators of well being, called Oregon Benchmarks. From 1992 through 1997, Oregon used funding from a CDC grant (Assessment Initiative) to compile valid existing data and measure their benchmarks. These results were submitted to the legislature in an annual progress report.

Rhode Island’s Minority Health Information Improvement Project aimed to strengthen the state’s ability to assess and respond to the health needs of its diverse population. The project developed methods to use existing data sources to measure progress toward year 2000 objectives for racial and ethnic minority populations. Through a collaboration between the Rhode Island Health Department and the Minority Health Advisory Committee, the project published a minority health status sourcebook that established baselines and identified data gaps for minority populations.

To provide continuity with earlier statewide health improvement plans, Washingtonbased its primary health indicators on existing "performance measures" in six public health areas. Each indicator has a primary measure (e.g., the mortality rate) followed by other measures of impact and burden (e.g., hospitalization, years of potential life lost). To assist a wide range of audiences engaged in local planning and implementation, Washington compiled for each health area existing data on population risk factors, protective factors, and intervention effectiveness from research and practice.

Tracking and communicating progress toward objectives

Alaska completed two Healthy Alaskans 2000 data reports. One report was released in March 1997 which updated the health status objectives for Healthy People 2000 objective 22.1. The second report was released in December 1998 which was a complete update on all Healthy Alaskans 2000 objectives. The December 1998 report also emphasizes that data collection is the first step in public health planning and an interim step in developing a comprehensive review of Healthy Alaskans 2000.

California created individual county health status profile tables, containing 26 Healthy People health status indicators. Data for the profiles are provided by the state Center for Health Statistics, the Division of Communicable Disease Control, and the Office of AIDS of the Department of Health Services. The Demographic Research Unit and the Census Data Center of the Department of Finance provided the 1990 census data and the 1996 race/ethnic population estimates, by county, with age and sex detail.

In addition, as part of its strategy for addressing data needs, California has the Health Information and Strategic Planning Division (HISP) of the California Department of Health Services (DHS). This division takes the lead in making the DHS health data systems more integrated, accessible, and useful for policy development and program management. It also develops uniform health data systems to promote the collection of information on health status outcomes, provides technical assistance and support to local health agencies, organizes strategic planning and special initiatives in support of DHS priorities, and builds strong relationships with public health organizations and schools of public health.

In 1992 the Michigan Department of Community Health (MDCH) established a strategic planning process, which linked state-level health assessment to the identification of priorities, goals, objectives, and strategies to improve health. Healthy Michigan 2000, issued in 1993, provided a guide for improving health by the year 2000. The foundation of the plan was an assessment of not only health status and health system trends, but also the economic, demographic, public perception, and management trends likely to influence the public’s health. In 1996 Healthy Michigan 2000, Second Edition, re-affirmed the goals documented in the first edition and streamlined the objectives to reflect the areas most in need of significant emphasis or change in order to reach the goals.

Between 1992 and 1996, MDCH created an agency-wide Surveillance and Data Strategic Work Group to promote greater use of surveillance data in policy and program decision-making and to determine the data needed to monitor progress toward reaching Healthy Michigan 2000 objectives. The work group drafted a "Health Surveillance Plan" to enhance the capacity for the collection, analysis, interpretation and dissemination of information on health status, health risks, and health systems. The "Health Surveillance Plan" established variables for monitoring objectives contained in Healthy Michigan 2000, identified gaps in data and potential problems, and suggested possibility for new and enhanced data sources. The plan also recommended a set of critical health indicators as a means of communicating the overall health of the state’s population. Based on the "Health Surveillance Plan," the state initiated annual reporting on selected critical health indicators in 1996. Michigan Critical Health Indicators are linked to both key Healthy Michigan 2000 objectives and related interventions.

For its 1996 and 1999 updates to the state’s year 2000 objectives, New Jersey’s statistical and program staff assessed progress and analyzed trends. Based on their trend analysis, staff categorized each objective and sub-objective as "likely to be achieved," "unlikely to be achieved," or "uncertain."

On July 1, 1993, the North Dakota Department of Health began to assess the state’s progress toward meeting the year 2000 objectives. A point-in-time study was conducted from July 1, 1993, through March 11, 1994. The report was published in June 1994 and helped the state health department and local communities to identify high priority needs. Some of the findings included: 22 percent of the Healthy People 2000 objectives had been met, 23 percent were unmet, 5 percent were moving away from the HP 2000 target, and 49 percent had no data available.

In Utah the governor’s Office of Planning and Budget coordinates data collection and monitoring of performance measures for all state agencies, as specified in the Utah Tomorrow strategic plan. The governor’s office maintains performance measurement data in their information base. In 1995, with funding from the CDC, the Utah Department of Health, Office of Public Health Data published data to track the 18 Healthy People 2000 health status indicators by local health department district.

Washington analyzed data from local, county, state, and national sources in its 1996 statewide assessment of health status, health risks, and health systems. The state used a standard format to present data on its progress in each priority area, including analyses of time trends, geographical variation (including numerous objectives tracked at the county level), variation by age, gender, race, ethnicity, income, and education (where available).

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