Public Health Data and Science

Ali Hamade, PhD, DABTDeputy State Epidemiologist

Office of the State Public Health Director

PUBLIC HEALTH DIVISIONNew Employee Orientation

2

Modernization Framework for Data and Programs

Key Data Sources

Vital statistics (birth, death)

Reportable conditions (infectious

disease, cancer)

Surveys (BRFSS, OHT,

PRAMS)

Service receipt (immunizations,

hospital discharge, WIC)

• Indicators– Social determinants of health

• Race/ethnicity; SES; LGBTQ; urban/rural

• ACEs, poverty, homelessness– Environmental Health

• Air quality, active transportation, BLL– Prevention & Health Promotion

• Disease and condition prevalence; health risk behaviors

– Access to clinical services• Health insurance, screening

– Communicable disease control• Infectious disease reports

Updated State Health Assessment – 2018

Chart1

750060002600

Tobacco

Obesity

Alcohol & Substance Use

Tobacco

Diet/Activity Patterns

acohol and substance use

Behaviors that Kill Oregonians 2016

7,500

6,000

Sheet1

TobaccoDiet/Activity Patternsacohol and substance use

750060002600

To resize chart data range, drag lower right corner of range.

Source: 2012 CD Summary

0

2,000

4,000

6,000

8,000

10,000

12,000

AfricanAmerican

AmericanIndian/AlaskaNative

AsianAmerican

Hispanic/Latino

Multi-racial

PacificIslander

White

Rat

e pe

r 100

,000

Years of potential life lost (YPLL) before age 75Oregon, 2015–2017

Disparities in viral hepatitis, liver cancer, and mortality - OregonCondition Incidence rate:

Whites per 100,000Incidence rate: Blacks per 100,000

Chronic HBV infection, 2009–2013

2.2 39.9

Chronic HCV infection, 2009–2013

57.5 124.4

HBV-associated liver cancer, 2008–2012

0.2 1.5

HCV-associated liver cancer, 2008–2012

3.1 5.1

Mortality from HCV, 2009–2013

8.9 16.1

7

Adult cigarettes

8th-grade cigarettes

8th-grade e-cigarettes

0%

5%

10%

15%

20%

25%

Cigarette and e-cigarette use, Oregon, 1996–2017

New BRFSS weighting method began in 2010

Low SES

Not Low SES

0%

10%

20%

30%

40%

50%

Cigarette smoking by SES, Oregon, 1996–2014

New BRFSS weighting method began in 2010

Trachea, lung, and bronchus cancer mortality in Oregon 2012-2017

10

0

5

10

15

20

25

30

35

2012 2013 2014 2015 2016 2017

rate

per

100

,000

pop

ulat

ion

tobacco-related

not tobacco-related

Adult binge drinking, Oregon, 2017

Chart1

Male

Female

18-24

25-44

45-64

65+

Estimates by sex are age-adjustedSource: Oregon Behavioral Risk Factor Surveillance System

22%

14%

28%

23%

14%

6%

0.218

0.143

0.275

0.229

0.143

0.057

Adult binge drinking

Figure 1

YearEst

200114.7%

200216.3%

200315.5%

200413.2%

200513.9%

200614.1%

200715.6%

200812.8%

200915.0%

201017.3%

201117.5%

201216.2%

201317.6%

201417.4%

201517.9%

201618.1%

201718.1%

Estimates are age-adjusted

Figure 2

Male21.80%

Female14.30%

18-2427.50%

25-4422.90%

45-6414.30%

65+5.70%

Figure 3

Less than High School15.80%

College degree or more19.70%

Income

Lead hazard vulnerability mapping

• Developed to– focus outreach– education– enforcement efforts.

• Developed using data on – children under 6– pre 1980 housing– % experiencing poverty– foreign born populations

12

13

Using data to map vulnerabilities

(Enter) DEPARTMENT (ALL CAPS)(Enter) Division or Office (Mixed Case)

14

• 2015-2019 SHIP priorities– Tobacco, obesity, alcohol & substance

use– Suicide; – Oral health– Communicable diseases; immunization

• 2020-2024 SHIP priorities– Institutional bias– Adversity, trauma and toxic stress– Economic drivers of health (e.g.,

housing, living wage, food security, transportation)

– Access to equitable preventive health care

– Behavioral health (e.g., mental health, substance use)

Data to Inform State Health Improvement Plan

Questions?ali.k.hamade@state.or.us

(Enter) DEPARTMENT (ALL CAPS)(Enter) Division or Office (Mixed Case)

17

Firearm deaths by intent, 2007 ̶ 2017

18

0

5

10

15

20

25

30

35

Rat

e pe

r 1,0

00 fe

mal

es

age

15–1

7 ye

ars

Teen pregnancy (15–17 years), Oregon, 2001–2017

Adults

8th-graders

0%

5%

10%

15%

20%

25%

30%

Obesity in adults and 8th gradersOregon, 1991–2017

New BRFSS weighting method began in 2010

0

100

200

300

400

500

600

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Cas

es

Females

Males

Oregon syphilis cases by sex and year, 2008–2017

Socioeconomic Status of Oregonians

• High school graduation (2017)– 77% (US 84%, 2016)

• Poverty (2017)– Adults: 13% (US 12%) – Children: 16% (US 18%)

• Food Insecurity (2016)– Overall: 15% (US 12%)– Children: 20% (US 18%)

0%

5%

10%

15%

20%

25%

Cancer Accidents HeartDisease

Suicide LiverDisease

Diabetes PerinatalConditions

Deaths

Years of Potential LifeLost

Causes of Death and Premature Death, Oregon, 2017

Lead in water in Oregon schools

24

Public Health Data and ScienceSlide Number 2Key Data SourcesSlide Number 4Slide Number 5Slide Number 6Disparities in viral hepatitis, liver cancer, and mortality - OregonSlide Number 8Slide Number 9Trachea, lung, and bronchus cancer mortality in Oregon 2012-2017Slide Number 11Lead hazard vulnerability mapping Slide Number 13Using data to map vulnerabilitiesSlide Number 15Slide Number 16Slide Number 17Firearm deaths by intent, 2007 ̶ 2017Slide Number 19Slide Number 20Slide Number 21Socioeconomic Status of OregoniansSlide Number 23Lead in water in Oregon schools