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ADVISORY CONCERNING ELECTRONIC CIGARETTES, THE PRACTICE OF “VAPING,” “JUULING” AND USE OF OTHER ELECTRONIC NICOTINE DELIVERY SYSTEMS OR ENDS

Data & Indicators

Having data about your community and health outcomes can help make strong arguments for change.  A variety of free data sources are available about population demographics, traffic accidents, chronic disease rates or environmental quality.  Find sources for data to use for planning, demonstrate need, establish priorities or strengthen a grant application. One way to use data is by indicator characteristics of the built environment related to health and livability.  Examples of indicators include information about place, parks, food, transportation, partnerships, schools, housing, safety and health equity.  Using indicators can be helpful as indicators allow comparison of one place or one community to another.  A checklist is available to help communities use indicators.

sidewalk construction

Why use data?

Data is information.  Data is often gathered through research, monitors, records reviews or surveys.  Analyzing data can identify trends over space and time.  Understanding trends in population health outcomes improves planning, designing, building and maintaining policies, plans, programs and projects.  Data can show these trends leading decision makers to make choices to improve public health outcomes.  

For example, asthma is a leading chronic health condition among children.  Asthma data shows that asthma causes lower quality of life and has large economic costs.  Data shows racial, income and geographic disparities exist in asthma prevalence.

All data has strengths and limitations.  Open, publicly available data is often the easiest to find and use. Much data is available in an open format.  This means it was released to be used by anyone.  Data without names or address is called de-identified data.  This data is often aggregated into a geographic area or spans a period of time.  Some data is limited to what it contains, who may use it, and for what purpose.  For example, a lot of health data is available for use, but not allowed to be repackaged for sale.

Personal health data is protected by the Health Insurance Portability and Accountability Act or HIPAA Privacy Rule.  Health data with personal identifiers such as name and address are almost always protected.  Sometimes researchers can submit a data request to apply to use data through the Tennessee Department of Health’s Internal Review Board who carefully considers what data can be shared and with whom.

Overall, data and statistics are useful for planning healthy communities and evaluating the impact of plans, policies, projects or programs and environmental changes on community health.

What is an indicator?

An indicator is something that points to an issue or a condition.  An indicator shows direction to a better or worsening condition.   Indicators should be easy to understand by people who are not experts.  Indicators need to be reliable to the information can be trusted.  Indicators are best when comparable over time.  Most people are familiar with blood pressure as an indicator of health.  Indicators can be helpful for communicating the meaning of complex data.  Indicators can also be organized.  The Tennessee Department of Health made an indicator Livable Communities Checklist which can be a great resource to start thinking about your community.  Lots of other good indicator lists and checklists are available online.

What is Public Health Tracking?

Environmental Public Health Tracking (EPHT) is the ongoing collection, integration, analysis, interpretation and dissemination of data from environmental monitoring and data from human exposure and health effects surveillance. The goal of Health Tracking is to protect communities by providing information to plan, apply and evaluate public health actions to prevent and control environmentally-related diseases. The Centers for Disease Control and Prevention’s National Environmental Public Health Tracking Network is a system of integrated health, exposure and hazard information and data from a variety of national, state and city sources.  On CDC’s EPHT Network, you can view maps, tables and charts with data about chemicals and other substances found in the environment, some chronic diseases and conditions, and the area where you live.  The Department of Health is in the early stages of building our Tennessee EPHT website. Over time, the amount of and type of data available will increase. The initial datasets available include asthmacarbon monoxide poisoningcardiovascular diseaseheat-related illnesstoxic substance incidentsradon and site-specific investigations.

Where to get health data?

Health data comes from surveys, medical procedures, and records reviews.  Some data sources are the Behavioral Risk Factor Survey which comes from telephone surveys or birth statistics which comes from the information submitted for birth certificates.   Data is available for a number of useful metrics including births, injuries, deaths, potential life lost and more. 

The Tennessee Department of Health’s Health Statistics webpage provides many of these data sets.   TDH also tracks Tennessee's Vital Signs.  These 12 metrics measure the pulse of our population's health.  Together these indicators provide an at-a-glance view of our health and prosperity.

CDC’s National Center for Environmental Health has compiled a helpful list of data resources which can be a great place to start.  CDC’s Data & Statistics webpage has information on a wide variety of health-related topics.

County Health Rankings and Roadmaps website provides tools and guidance to help improve community health.  The rankings allow counties to be compared to one another.  The Department of Health has prepared Chronic Disease Health Profiles on select indicators such as leading causes of death, heart disease and stroke, chronic lower respiratory disease, diabetes and cancer.

Where to get environmental data?

The U.S. Environmental Protection Agency has many data sources available, these cover topics including but not limited to air, climate change, health risks, pollutants and contaminants, waste and water.  The data are downloadable and available through the Environmental Dataset Gateway (EDG).  EPA’s Community-Focused Exposure and Risk Screening Tool (C-FERST) helps communities access, integrate, and interpret information and data to identify risks, prioritize issues and make decisions.

The Tennessee Department of Environment and Conservation manages a variety of databases to keep track of environmental regulatory activities, rosters and status. TDEC’s Dataviewers are available on their website.

Where to get traffic data?

Traffic data can be a measure of safety for a community.  Traffic data is collected on cars, trucks, buses, motorcycles, pedestrians and bicyclists.  Statistics about locations, injuries, fatalities, hazmat releases, time of day and distracted driving are recorded.  The Tennessee Department of Homeland Security has a Statistics and Research webpage and a Crash Data webpage with accidents, fatalities, non-motorists and other traffic safety data.  The Tennessee Highway Safety Office also has data and statistics.  The National Highway Traffic and Safety Administration has a webpage with Tennessee traffic data.  The Federal Highway Administration has great resources on their Roadway Safety Data Program webpage.  Complimentary health-focused information is available on CDC’s Motor Vehicle Safety webpage.

Where to get demographic data?

The U.S. Census Bureau is the most common source for community demographic data.  Census data is free.  Census data includes population, age, sex, race and many other characteristics.  Census data includes many measures useful to health and the built environment such as level of education, persons with disability, mean travel time to work, population per square mile and median household income.  The U.S. Census Bureau also has maps, infographics, surveys, publications and other tools available.

Where to get geographic data?

A geographic information system (GIS) is designed to manage, analyze, manipulate and visualize spatial data to understand relationships, patterns and trends.  Esri has been a standard for GIS.  Esri’s website has many options for learning about and using geographic data.  The U.S. Census presents some data using maps as well as has data available for use with mapping software.  Their Topologically Integrated Geographic Encoding and Referencing (TIGER) productscontain features such as roads, railroads, rivers, as well as legal and statistical geographic areas. The Tennessee Department of Finance and Administration has their STS-GIS Services website about geospatial technologies in state government. 

What are other data sources for data?

Data representing small land areas or low population sizes is the most useful.  It can be difficult, if not impossible, to get data at a small scale.  This local level data can be most useful for planning purposes.  Check with your local government offices such as the city or county clerk, planner, tax appraiser, property assessor or public library.  Traffic engineers, Public Works, Law Enforcement, real estate agencies and the Better Business Bureau are other possible sources for local level data.  Planning organizations such as your Metropolitan Planning Organization, Regional Planning Organization or Development District may already have data in a useable format.  Sometimes data is available from public opinion polls or surveys.  Also, consider contacting nearby academic institutions as some colleges or universities have access to data or knowledge about where to data.  Sometimes data just doesn’t exist and new data must be collected.  Any of the groups mentioned may have resources to help collect data.

What are common data limitations?

Data scale, availability and timeliness are common difficulties.   Oftentimes data is at too large of a scale, that is it represents too big of an area, to be useful whereas local level data is the most useful for planning purposes.  Another data limitation is simple frequency.  Some things are just too uncommon to have data about like sidewalks in a rural county or the number of people from a specific ethnic group in an area.  Most data is already one to three years old before it is available for use making real-time comparisons difficult.

Much of our health data will be reported by county.  For some projects, county level data will be adequate and for other projects it will be too large scale.  For something like air quality data, there are a limited number of air sampling locations.  One measurement is then put into a mathematical model to predict air quality over an area. 

Tennessee borders many states.  Many people live or work outside of Tennessee.  Anyone not a Tennessee resident who is living, working, studying or recreating here will not be represented in some data sets.  For example, an out-of-state resident whose asthma attack was treated in a Tennessee medical center will not be reported nor would a resident’s asthma attack that occurred out-of-state.

One important limitation exists with health data about from small sample sizes.  People’s personal health information is protected.  Therefore, in Tennessee we suppress all data counts less than 10 per county per year.  In areas with small populations, it will not be possible to have data on many health conditions.  This limitation may or may not exist for other types of data.

What is metadata?

Metadata is data that describes other data.  Importantly, metadata summarizes basic information about data.  As data is collected for projects, be sure to get any associated metadata files.  Metadata often describes where the data came from, what time frame the data represents, how the data was formatted, limitations with the data, who can use the data and how the data can or cannot be used.  Metadata can be important for many data sources including databases, spreadsheets, GIS files, photographs, videos and webpages.

Government partners

Tennessee Department of Health 
Special Reports: Drive your County to the Top Ten
www.tn.gov/health/health-program-areas/statistics/special-reports.html

Centers for Disease Control and Prevention (CDC)
National Environmental Public Health Tracking Network
ephtracking.cdc.gov
Community Health Status Indicators
www.cdc.gov/nccdphp/dch
Behavioral Risk Factor Surveillance System
www.cdc.gov/brfss

U.S. Department of Transportation (DOT)
National Pesdestrian and Bicycle Safety Data Clearinghouse
www.pedbikedata.org/

U.S. Environmental Protection Agency (EPA)
EnviroFacts
www3.epa.gov/enviro
EnviroAtlas
www.epa.gov/enviroatlas

National Highway Traffic Safety Administration
Website
www.nhtsa.gov

Additional resources

County Health Rankings
County Health Rankings & Roadmap
www.countyhealthrankings.org

America's Health Rankings
2016 Annual Report for Tennessee
www.americashealthrankings.org/explore/2016-annual-report/state/TN

American Association of Retired Persons (AARP) 
Livability Index
livabilityindex.aarp.org

Community Commons
Data, tools, and stories to improve communities and inspire change
www.communitycommons.org

Helpful documents