A DATA PRODUCT-ORIENTED APPROACH TO PROMOTING VITAL STATISTICS, INFORMING PUBLIC HEALTH ACTIVITIES, AND DEVELOPING PARTNERSHIPSKirk Bol, MSPH, Colorado Department of Public Health and Environment

2011 NAPHSIS/ NCHS Meeting

Vital Statistics In History

“But in the last fifty years the registration of vital statistics has come to signify something more important to the world that that each resident that come and departed in the ceaseless train of mortal life was ‘born on such a day and died on such another’…But to the science of hygiene and the discovery of the conditions, removable causes, factors, and laws of epidemic and other diseases, and all the disasters that imperil and waste human life, vital statistics contribute the highest influence and most practical results.” Dr. Elisha Harris, Registrar of Vital Statistics, NY, 1874

Vital Statistics In History

“Vital statistics is the science of numbers applied to the life history of communities and nations…Manifestly, vital statistics must needs be looked upon as the most influential branch of the sciences, since they affect more directly the interests and the welfare of the living people of this State.” Frederick L. Hoffman, Esq., Boston Medical

and Surgical Journal, 1900

Vital Statistics In History

“Beside the individual use made of birth and death certificates for many purposes, a wide-awake health officer can use the records if his or her vital statistics office as the very foundation upon which this health work is built.” Dr. W. A. Plecker, MD, State Registrar, VA,

1924

Uses of Vital Statistics

Describe the health of our population. Explore the factors and determinants of

health. Assess health and prioritize public health

activities in our communities.

Life Expectancy19

8019

8119

8219

8319

8419

8519

8619

8719

8819

8919

9019

9119

9219

9319

9419

9519

9619

9719

9819

9920

0020

0120

0220

0320

0420

0520

0620

0720

0820

09

66

68

70

72

74

76

78

80

82

84

75.4

79.778.9

81.9

71.9

77.4

Total

Female

Male

Source: Vital Statistics, Health Statistics Section, Colorado Department of Public Health and Environment.

Life expectancy at birth by gender: Colorado residents, 1980-2009.

Life ExpectancyA

ll R

ace

s

White/N

on-H

ispanic

White/H

ispanic

Bla

ck/A

fric

an A

meri

can

All

Race

s

White/N

on-H

ispanic

White/H

ispanic

Bla

ck/A

fric

an A

meri

can

Female Male

70

72

74

76

78

80

82

84

81.9 82

80.681.5

77.4 77.8

75.5 75.2

Source: Vital Statistics, Health Statistics Section, Colorado Department of Public Health and Environment.

Life expectancy at birth by race/ethnicity: Colorado residents, 2009.

Leading Causes of Death

0

20

40

60

80

100

120

140

160

180

200

Colorado

United States

Source: Vital Statistics, Health Statistics Section, Colorado Department of Public Health and Environment.

Age-adjusted mortality rates (per 100,000 population) for Colorado's 10 leading causes of death: Colorado and United States residents, 2009.

Age

-adj

uste

d ra

te p

er

100,

000

Premature Mortality

0

5

10

15

20

25

Total

Female

Male

Source: Vital Statistics, Health Statistics Section, Colorado Department of Public Health and Environment.

Years of potential life lost (as percent of total) before age 65: Colorado residents, 2009.

Teen Fertility

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 20090

10

20

30

40

50

60

70

80

90

54.4

35.133.0

19.9

82.7

54.5

Age 15-19

Age 15-17

Age 18-19

Teen fertility rates (births per 100,000 female population in age group): Colorado residents, 1990-2009.

Source: Vital Statistics, Health Statistics Section, Colorado Department of Public Health and Envi-ronment.

Infant Mortality

19901991

19921993

19941995

19961997

19981999

20002001

20022003

20042005

20062007

20082009

0

10

20

30

40

50

60

70

80

90

100

87.9

62.5

All causes

Congenital malformations and chromosomal abnormali-ties

Disorders related to short ges-tation and low birth weight

Sudden infant death syndrome (SIDS)

Maternal complications of pregnancy

Unintentional injuries

Assault/homicide

All other causes

Infant mortality rates (per 10,000 live births) by selected leading causes: Colorado residents, 1990-2009.

Source: Vital Statistics, Health Statistics Section, Colorado Department of Public Health and Environment.

Infant Mortality

0

50

100

150

200

250

78

51

194.5

172.5

Total

White Non-Hispanic

White Hispanic

Black

Asian

American In-dian/Alaskan Native

Infant mortality rates (per 10,000 live births) by race and ethnicity: Colorado residents, 1990-2009.

Source: Vital Statistics, Health Statistics Section, Colorado Department of Public Health and En -vironment.

Colorado Health Data Home

Colorado Health Data Home

Colorado Health Data Home

Colorado Health Data Home

Colorado Health Data Home

Topical Reports and Collaborations

Public Health Act of 2008

Requires the development and implementation of a comprehensive statewide improvement plan every 5 years

After the release of each comprehensive, statewide public health improvement plan, each county or district public health agency shall prepare a county or district public health plan

Plans are to be data driven-based on community health assessment, capacity assessment, etc.

Colorado’s Public Health Improvement Plan, 2009

Strategic recommendation #1

Ensure a comprehensive set of public health indicators, to include health status, behavioral risk, mental health, environmental health, oral health, health disparities, and social determinants of health. Measure, update, and make indicators available to local public health agencies in a timely manner to enable community health assessment and planning and the state and local levels.

Health EquityAn Explanatory Model for Conceptualizing the Social Determinants of Health

NATIONAL INFLUENCESGOVERNMENT POLICIES

U.S. CULTURE & CULTURAL NORMS

PREGNANCY

EARLY CHILDHOOD

CHILDHOOD

ADOLESCENCE

ADULTHOOD

OLDER ADULTS

LIFE COURSE HEALTH FACTORS =

QUALITY OF LIFE

MORBIDITY

MORTALITY

LIFE EXPECTANCY

POPULATIONOUTCOMES

SOCIAL DETERMINANTS OF HEALTH

ECONOMIC OPPORTUNIT

Y

PHYSICAL ENVIRONMEN

T

SOCIAL FACTORS

• Income• Employment• Education• Housing

Built Environment•Recreation•Food •Transportation

Environmental quality•Housing•Water•Air

Safety

• Participation• Social support

• Leadership• Political influence

• Organizational networks

• Violence• Racism

+

HEALTHBEHAVIORS

& CONDITIONS

MENTAL HEALTH

ACCESS , UTILIZATION & QUALITY

CARE

• Nutrition• Physical activity

• Tobacco use• Skin Cancer• Injury• Oral health• Sexual health• Obesity• Cholesterol• High Blood Pressure

• Mental health status

• Substance abuse

• Functional status

• Health insurance coverage

• Received needed care

• Provider availability

• Preventive care

Public Health’s Role in Addressing the Social Determinants of Health

•Advocating for and defining public policy to achieve health equity

•Coordinated interagency efforts

•Creating organizational environments that enable change

•Data collection, monitoring and surveillance

•Population based interventions to address health factors

•Community engagement and capacity building

Colorado’s Public Health Indicators

Colorado’s Public Health Indicators

Colorado’s Public Health Indicators

Colorado’s Public Health Indicators

Environmental Public Health Tracking

Environmental Public Health Tracking

Environmental Public Health Tracking

Environmental Public Health Tracking

Environmental Public Health Tracking

Environmental Public Health Tracking

Thank You!