10 Essential Public Health Services
The 10 Essential Public Health Services were developed in 1994 by the U.S. Public Health Service and include services such as “Monitor health status,” “Diagnose and investigate health problems,” and “Mobilize community partnerships.” For more information, see CDC’s National Public Health Performance Standards Program Website.
The Association of State and Territorial Health Officers (ASTHO) is the national nonprofit organization representing public health agencies in the United States, the U.S. Territories, and the District of Columbia. ASTHO’s voting membership includes the chief health officials for each U.S. state and territory. ASTHO members formulate and influence sound public health policy and promote excellence in state-based public health practice. ASTHO Website. See also N.A.C.C.H.O..
Advocacy refers to organized efforts to change or influence policies. See also Policy.
An age-adjusted rate is a form of a rate that controls for age effects, allowing better comparability of rates across geographic areas. Age-adjustment may also be used to control for age effects when comparing across several years of data, as the age distribution of the population changes over time. See also Direct Age Standardization and Indirect Age Standardization. [more on age-adjusted rates…]
Age-specific Fertility Rate
An age-specific fertility rate is the number of births to women in a certain age group per 1,000 women in that same age group (e.g., births to adolescent mothers per 1,000 adolescent girls of the same age in the population). See also Fertility Rate, General Fertility Rate, Birth Rate and Total Fertility Rate.
An age-specific rate is a rate in which both the numerator (number of events) and denominator (number in population at risk) are limited to a specific age group. It is calculated by dividing the total number of health events for the specific age group of interest by the total population in that age group. [more on age-specific rates…]
An artifact is any representation in data, such as choice of methodology, or observational or data entry errors, that would cause a datum to misrepresent its true value.
Assessment is the regular and systematic collection, assembly, analysis, and dissemination of information about the health of a community. Public health assessment, policy development and assurance of access to quality health care are considered the three core functions of government in public health. (Institute of Medicine (1988) The Future of Public Health, National Academies Press.) See also Community Health Assessment.
The theoretical proportion of the rate or number of cases of an adverse health outcome that can be attributed to a given risk factor.
Birth rate is the number of live births per 1,000 persons (males and females) in the population. See also Fertility Rate.
Data collected using the 1997 OMB standard for collection of race and ethnicity information are not directly comparable to those that were collected using the 1977 standard. To permit trend analysis, a methodology was developed to “bridge” population estimates that were collected using the 1997 standard back to the categories used in the 1977 standard. [more on race and ethnicity measurement…]
CSTE stands for “Council of State and Territorial Epidemiologists.” CSTE is a professional organization for public health epidemiologists. Visit the CSTE Website for more information.
Cause / Cause-and-Effect
There is philosophical debate about the meaning of ’cause,’ but for a working definition in epidemiology, we can use a definition from Rothman and Greenland, Causation and Causal Inference in Epidemiology, “…a cause of a specific disease event [is] an antecedent event, condition, or characteristic that was necessary for the occurrence of the disease at the moment it occurred, given that other conditions are fixed.”
Coefficient of Variation (CV)
See Relative Standard Error.
Community Action Teams
Community action teams are generally task forces or committees established to plan and implement activities that address a particular health priority. They may include health council members as well as other community stakeholders.
Community Health Assessment
Community health assessment is a process of identifying and quantifying the needs, conditions, and resources of communities with respect to health and health care. Community health assessment processes include gathering secondary or published data and primary data (locally-generated data through surveys, focus groups, interviews, or other means); analyzing and interpreting the data; and establishing priorities for community health improvement. See also Assessment.
Community mapping consists of the visual representation of data by geography or location, in order to link information to place. Mapping is often used to identify and locate community assets or services in relation to the populations they serve, in order to maximize access throughout a given geographic area (neighborhood, city, region, state, or nation). Other uses include identifying liquor store densities to neighborhood grocery stores and environments that encourage physical activity. Mapping provides tools for identifying, analyzing, and communicating visually the patterns that affect community health.
A comparability ratio measures the level of agreement between ICD-9 and ICD-10 classification systems. NCHS calculated comparability ratios for 113 selected causes of death by using a double-coding exercise using 1996 death data. NCHS coded 1.8 million death certifications from 1996 first using ICD-9 and then using ICD-10. Based on that double-coding, NCHS has produced the set of Comparability Ratios for 113 Selected Causes of Death. Each ratio is an expression of the results of the comparison as a ratio of death for a cause of death by the later revision divided by the number of cause of death coded and classified by the earlier revision. To accurately portray trends that include both years 1980-1998 and 1999 on, the death counts or rates for the earlier years must be “comparability modified.” This is accomplished by multiplying the earlier death count (or rate) by the comparability ratio for that cause of death. Use comparability-adjusted mortality counts and rates only when you need to display years 1998 and earlier together with years 1999 and later. [Click here for comparability ratios for NCHS leading causes.]
The confidence interval may be thought of as the range of probable true values for a statistic. In general, as a population or sample size increases, the confidence interval gets smaller. Estimates with smaller confidence intervals are referred to as more “precise.” Less precise estimates, such as those calculated from small numbers, tend to have wide confidence intervals. Typically, the 95% confidence interval (calculated as 1.96 times the standard error of a statistic) indicates the range of values within which the statistic would fall 95% of the time if the researcher were to calculate the statistic (e.g., a percentage or rate) from an infinite number of samples of the same size drawn from the same base population. [more on confidence intervals…]
The confounding variable is a variable that is related to, and may obscure one’s view of, the variable of interest. For instance, when examining death rates across populations, the population’s age distribution can be a confounding variable because higher death rates will be found in populations with a greater proportion of persons in older age groups. In such a case, one could use an age-adjusted rate to compare the populations.
A count is simply the number of health events, such as a death or a reported disease incident, that occurred within a specified time period. [more on health event counts…]
DALY stands for “Disability Adjusted Life Years,” and is a summary measure of the impact of premature death and disability on the length and quality of life. It is defined by the World Health Organization as, “The sum of years of potential life lost due to premature mortality and the years of productive life lost due to disability.” See also Y.P.L.L., Q.A.L.Y.
The study of the amount and distribution of a disease in a specified population by person, place, and time.
The denominator is the divisor in division (for instance, where 12/3=4, the number 3 is known as the divisor, 12 is the dividend and 4 is the quotient). In public health, the denominator for a disease rate is the number of persons (or person-years) at risk, or the estimated population. For instance, for 23 deaths in a population of 15,000, the death rate would be 23/15,000, or 0.001533, or 153.3 per 100,000 population. In that example, 15,000 is referred to as the denominator. NMDOH standard population data files, NMDOH Principles for Updating Numerator and Denominator Data
Direct Age Standardization
Direct age standardization, also known as direct age adjustment, uses the observed rates in an index population and adjusts them to the age distribution of a standard population. See also Age-adjusted Rate, and Indirect Age Standardization.
See Health Disparities.
A disease or condition that is present in a community at all times but at a relatively low level.
The occurrence of more cases of a disease than would be expected in a community or region during a given time period.
Epidemiology is the study of how often disease occurs in different groups of people and why. In public health, epidemiology is also concerned with development of an appropriate response to disease in a population.
Ethnicity is a term that refers to social groups with a shared history, sense of identity, geography and cultural roots which may occur despite racial differences. Ethnicity shapes a group’s culture – food, language, music, and customs. We all have an ethnicity, but the term is often used only in reference to persons of Hispanic or Latino ethnicity versus those of non-Hispanic/Latino ethnicity. See also Race. [more on race and ethnicity measurement and coding…]
Evaluation refers to a set of tools or procedures to demonstrate or measure progress in achieving specific outcomes, goals, and objectives. Evaluation involves the systematic collection, analysis, and reporting of information to assist in planning and decision-making. Program-level evaluations measure benefits for specific populations served. Community-level evaluations measure benefits for community residents resulting from changes in community systems, organizations, neighborhoods, or networks.
Evidence-based public health practice is the careful, intentional and sensible use of current best scientific evidence in making decisions about the choice and application of public health interventions. [more on evidence-based public health practice…]
Evidence-based Community Health
Community programs, strategies, or interventions that have been shown through research or evaluation to have been effective in achieving desired health outcomes with similar populations or communities. See also Evidence-based.
See True Experiment.
Fertility Rate: Live Births per 1,000 Female Population. The teen birth rate is considered an age-specific fertility rate. See also “General Fertility Rate,” the number of live births per 1,000 women of child-bearing age (15-44). Fertility Rates for New Mexico can be calculated using the Births Custom Query section of the NM-IBIS Website. See also Age-specific Fertility Rate, Birth Rate, General Fertility Rate, and Total Fertility Rate.
Fetal Mortality Rate
Fetal deaths of 16 or more weeks gestation per 1,000 deliveries. The number of deliveries consists of live births plus fetal deaths = (Total Fetal Deaths / (Total Live Births + Total Fetal Deaths)) x 1,000.
FIPS stands for Federal Information Processing Standards Codes for states, counties, and named populated places. The state FIPS code for New Mexico is 35000. New Mexico county codes are not consecutive and range from 35001 (Bernalillo) to 35061 (Valencia). List of New Mexico FIPS codes | U.S. Geological Survey FIPS Website
Fundamentals of Public Health
See Public Health, Fundamentals of.
General Fertility Rate
The general fertility rate is the number of live births per 1,000 females of childbearing age between the ages of 15-44 years. (The age range can differ, depending on the source, so it is important to note what age range is being used especially when comparing to data from other sources). Note: See also “Fertility Rate,” the number of live births per all women in the population. See also Fertility Rate, Age-specific Fertility Rate, Birth Rate and Total Fertility Rate.
Geocoding is a process that assigns each data record x and y coordinates that correspond (ultimately) to the Earth’s latitude and longitude. The geo-coordinates may then be used to locate the record on a map or in another geography (e.g., a county or census tract). [more on Geocoding…]
Gestational Age is the period of time a baby is carried in the uterus or the duration of the pregnancy, measured from the first day of the last menstrual period. Full-term gestation is considered between 37 and 42 weeks. Average Gestational age for New Mexico births can be calculated using the Births Custom Query section of the NM-IBIS Website.
A goal is a statement used in a planning process that describes a future desired state. Goals provide programmatic direction. Goals focus on ends rather than means. See also Objective and S.M.A.R.T. Objectives.
Gravidity refers to the number of times a woman has been pregnant, regardless of whether a pregnancy resulted in a live birth. For instance, a woman who was pregnant once and miscarried would be considered, “gravida 1.” See also Parity.
Health Care Reform
Health care reform generally refers to changes in the health care and public health systems that are contained in the Patient Protection and Affordable Care Act (PPAC) passed by the U.S. Congress and signed into law by President Obama on March 23, 2010. The PPAC is a complex and far-reaching piece of legislation that contains provisions to expand access to health insurance, prevent abusive practices by insurance companies, reduce the cost of health care, and support an expanded system of public health, prevention, and health promotion.
Differences in health status among distinct populations, such as racial and ethnic groups, rural vs. urban, different income groups, and populations of specific geographic areas. Health disparities generally refer to differences in health that are closely linked with social or economic disadvantage. Health disparities negatively affect groups of people who have systematically experienced greater social or economic obstacles to health. These obstacles stem from characteristics historically linked to discrimination or exclusion such as race or ethnicity, religion, socioeconomic status, gender, mental health, sexual orientation, or geographic location. Other characteristics include cognitive, sensory, or physical disability. (Adapted from Healthy People 2020, U.S. Dept. of Health and human Services)
Healthy People 2010 is an initiative of the U.S. Public Health Service that established over 400 health objectives for the Nation through a public process. The initiative also defined quantifiable measures. The objectives are to be achieved by the year 2010. They are typically used by public health organizations and programs to track progress and improve population health status. HealthyPeople2020 Website.
ICD Stands for “International Classification of Diseases.” It is a coding system maintained by the World Health Organization and the U.S. National Center for Health Statistics used to classify causes of death on death certificates and diagnoses, injury causes, and medical procedures for hospital and emergency department visits. These codes are updated every decade or so to account for advances in medical technology. Beginning in 1999, the U.S. changed over from the 9th revision (ICD-9) to the 10th revision (ICD-10) to record cause of death on death certificates. [more on ICD codes…]
Specialized ICD codes, called ICD-Oncology, or ICD-O, are used to classify cancer diagnoses by site and type (e.g., lung, breast, luekemia, lymphoma). For more on the oncology ICD codes, see the SEER (Surveillance, Epidemiology and End Results cancer registry) Website.
Incidence is the number of new cases (e.g., of disease) in a given period of time. See also Prevalence.
See “Study Population”
A health indicator is a numeric measure that depicts population health or health system status on a core public health construct.
Indirect Age Standardization
Indirect age standardization uses the observed rates in a standard population and uses the standardized mortality ratio (SMR) to adjust them to the age distribution of the index population. See also Age-adjusted Rate, and Direct Age Standardization. [more on indirect age standardization…]
Infant Mortality Rate
Infant mortality is defined as the death of an infant under one year of age. The Infant Mortality Rate is most often calculated as infant deaths in a given year per 1,000 live births in the same year (death period method). The rate may also be calculated as death of infants born in a given year per 1,000 infants born in that year (birth cohort method). See also Neonatal Mortality Rate, and Postneonatal Mortality Rate.
Occurring between decennial (every ten year) censuses. E.g., 2000-2010 intercensal population estimates are estimates that were derived for years 2000-2010, taking into account the 2010 decennial census population estimates. See also Postcensal.
The interpregnancy interval is the time (in months) between the completion of one pregnancy resulting in a live born infant and conception of the next pregnancy. Interpregnancy Interval for New Mexico births can be calculated using the Births Custom Query section of the NM-IBIS Website.
Surveillance is the systematic collection, analysis, interpretation, and dissemination of health data on an ongoing basis. Surveillance is conducted to identify potential public health threats, and to gain knowledge of the pattern of disease occurrence and risk in a community. See also Surveillance.
The Kotelchuck Index, also called the Adequacy of Prenatal Care Utilization (APNCU) Index, uses two crucial elements obtained from birth certificate data – when prenatal care began (initiation) and the number of prenatal visits from when prenatal care began until delivery (received services). The Kotelchuck index classifies the adequacy of initiation as Inadequate (received fewer than 50% of expected visits), Intermediate (50%-79%), Adequate (80%-109%), or Adequate Plus (110% of visits or more). [more on the Kotelchuck Index…]
The traditional measure of prenatal care used in New Mexico has been a modified Kessner index. Levels of prenatal care are defined by using a combination of factors: the month prenatal care began and the number of prenatal visits made. A low level of care is defined as care that begins in the third trimester with less than five or no prenatal care visits. A high level of care is defined as care that began during the first trimester (first three months) of pregnancy with nine or more prenatal care visits occurring during that period. Mid level care is defined as care that began during the first trimester with 5-8 prenatal visits, or care beginning in the fourth to sixth month of pregnancy with 5 or more visits.
Large for Gestational Age
Large for gestational age (LGA) is a term used to describe a baby who is larger than usual for the number of weeks of pregnancy. LGA babies usually have birthweights above the 90th percentile for babies of the same gestational age. This means that they weigh more than 90 percent of all other babies of the same gestational age. See also Gestational Age.
Leading Causes of Death
See “NCHS Leading Causes”
Life expectancy is the average expected number of years of life remaining from a given age, in a given population, according to the current mortality experience (age-specific death rates) of persons in the same population. Life expectancy is calculated from a table called a “Life Table.” It is most often expressed as the life expectancy from birth, but is also commonly expressed as life expectancy from age 65. [more on Life Expectancy…]
A logic model is a graphic representation or framework for understanding a program or set of activities. A logic model provides a picture of what goes into a program, what the program does, and what the results are. Logic models are useful tools for both planning and evaluation. See also Evaluation.
Mobilizing for Action through Planning and Partnerships (MAPP) is a community-driven strategic planning process for improving community health. Facilitated by public health leaders, this framework helps communities apply strategic thinking to prioritize public health issues and identify resources to address them. MAPP is not an agency-focused assessment process; rather, it is an interactive process that can improve the efficiency, effectiveness, and ultimately the performance of local public health systems. (Definition downloaded from www.naccho.org/topics/infrastructure/mapp on 8/8/2012).
The Morbidity and Mortality Weekly Report (MMWR) is a weekly report of state-based notifiable disease surveillance and other timely events of interest prepared and distributed by the Centers for Disease Control and Prevention (CDC). MMWR Website
The MMWR week is the week of the epidemiologic year for which the National Notifiable Diseases Surveillance System (NNDSS) disease report is assigned for the purposes of MMWR disease incidence reporting and publishing. When a notifiable disease case is reported to the state or local health department, it is assigned (coded) to an MMWR Week. Calendar Dates for MMWR Weeks (2006-2015)
Maternal Mortality Rate
Number of deaths from complications of pregnancy, childbirth, and the puerperium per 100,000 live births = (Total Maternal Deaths / Total Live Births) x 100,000.
The mean is a measure of central tendency, also called an “average.” The mean is calculated by summing the values in a set and then dividing by the number of values that are in the set. For instance, John is 30 and Mary is 38. Their mean age is (30+38)/2, or 68/2, or 34.
The median is a measure of central tendency. It is the 50th percentile, or the value for which 50% of the scores are lower and 50% of the scores are higher. The median is not sensitive to extreme values, making it a better choice than the mean as a measure of central tendency for variables with extreme values. For instance, household income has a fixed “floor” value of zero, but on the other end, there are typically a small number of extremely large values. Those extreme values will drive up the calculated value of the average or mean.
The mode is a measure of central tendency. It is the score that occurs with the greatest frequency. In other words, the most common score.
Morbidity is another term for illness. Morbidities are not deaths, and occur among the population of living persons. Examples of morbidities include Alzheimer’s disease, diabetes, and traumatic brain injury. Incidence and Prevalence are measures often used to describe the extent of morbidity in a population.
Mortality is another term for death. A mortality rate is the number of deaths due to a disease divided by the number of persons in the population.
The National Association of County and City Health Officials (NACCHO). NACCHO’s members are the 2700 local health departments across the United States. NACCHO’s mission is to be a leader, partner, catalyst, and voice for local health departments to ensure the conditions that promote health and equity, combat disease, and improve the quality and length of all lives. NACCHO Website. See also A.S.T.H.O..
N.C.H.S. Leading Causes
In order to provide a ranking standard the NCHS (National Center for Health Statistics) prepared a list of 113 selected causes of death that are reported on the death certificate. The NCHS 50 leading causes of death are taken from the list of 113. Other classification schemes are used, such as the STIPDA external causes of injury and the ICD-O causes of cancer deaths. For more information about the NCHS rankings, see the Cause of Death Ranking Vital Statistics Report. Leading causes of death for New Mexico can be calculated using the Mortality Custom Query section of the NM-IBIS Website. [list of NCHS leading causes…]
Neonatal Mortality Rate
Deaths among infants under 28 days of age per 1,000 live births = (Total Deaths Among Infants <28 Days of Age / Total Live Births) x 1,000. See also Infant Mortality Rate, and Postneonatal Mortality Rate.
The numerator is the dividend in division (for instance, where 12/3=4, the number 3 is known as the divisor, 12 is the dividend and 4 is the quotient). In public health, the numerator for a disease rate is the number of cases of, or persons with a health condition of interest. For instance, for 23 deaths in a population of 15,000, the death rate would be 23/15,000, or 0.001533, or 153.3 per 100,000 population. In that example, 23 is referred to as the numerator. See also, NMDOH Principles for Updating Numerator and Denominator Data.
An objective is a statement of an action that leads to achievement of a goal. Objectives should be specific, measurable, and time-limited. Objectives tell how to meet a goal. They focus on the means rather than the end. See also Goal and S.M.A.R.T. Objectives.
Occurrent events are those that occurred in a particular geographic area. For example, 2007 New Mexico occurrent births is the number of births that occurred in New Mexico during 2007 (regardless of the mother’s permanent residence). Reporting of vital statistics by residence is considered the standard or default for general data dissemination since it provides health status information for residents of a particular geographic area. See also Resident Events.
Outcomes are planned results, benefits, or changes that occur as a result of interventions, objectives, strategies, or activities. Outcomes may be short-term, intermediate, or long-term. Outcomes may be population-based, program-based, or community-based. See also Evaluation, and Logic Model.
A pandemic occurs when an epidemic becomes very widespread and affects a whole region, a continent, or the entire world. See also Epidemic.
Parity is the number of previous live-born infants a woman has delivered. For instance, woman who has not previously given birth is considered “nulliparous,” with parity equal to 0. See also Gravidity.
A policy is typically described as a principle or rule to guide decisions and achieve intended outcome(s). Policies can be written or verbal, specific or general, and can refer to actions of governmental entities, businesses, schools, institutions, or other organized bodies. See also Advocacy.
Pertaining to a general population defined by geopolitical boundaries. This population is also the denominator and/or the sampling frame. It is not based on a subset of the population, such as those enrolled in a specific program.
NMDOH standard population data files. See also Denominator.
Positive Youth Development
Positive youth development (PYD) is a comprehensive framework outlining the assets and supports that young people need in order to be successful. PYD emphasizes the importance of focusing on youths’ strengths instead of their risk factors to ensure that all youth grow up to become contributing adults. Positive youth development programs generally address diverse populations of young people, instead of focusing solely on at-risk youth (adapted from National Conference of State Legislatures).
Occurring after a decennial (every ten year) census, and prior to the following decennial census. E.g., 2001-2009 postcensal population estimates are estimates that were derived for years 2001-2009, without the benefit of the 2010 decennial census population estimates. See also Intercensal.
Postneonatal Mortality Rate
Deaths among infants aged one month (28 days) to 364 days per 1,000 live births = (Total Deaths Among Infants 28-364 Days of Age / Total Live Births) x 1,000. See also Infant Mortality Rate, and Neonatal Mortality Rate.
Prenatal care refers to healthcare visits prior to and during pregnancy. Prenatal care is recommended to detect and prevent any potential problems and ensure the healthiest possible delivery and birth. Doctors recommend that mothers-to-be see their health care provider before the 13th week of pregnancy and to go back for at least 13 visits before birth. (Go before week 13 and get 13 visits.)
A Preterm birth is a birth that occurs before the 37th week of gestation. Percentage of New Mexico births that were pre-term can be calculated using the Births Custom Query section of the NM-IBIS Website. See also Gestational Age.
Prevention (primary, secondary, tertiary)
A framework for categorizing prevention programs based on the stage of the natural history of a disease or injury: Primary prevention — An intervention implemented before there is evidence of a disease or injury. This strategy can reduce or eliminate causative risk factors (risk reduction). Secondary prevention — An intervention implemented after a disease has begun, but before it is symptomatic (screening and treatment). Tertiary prevention — An intervention implemented after a disease or injury is established. This strategy can prevent sequelae (further disability or disease).
Prevalence is the number of existing cases (e.g., of a disease or risk factor) in a given period of time. See also Incidence.
A proportion is an expression of the relationship of the magnitude of a part to the whole, and is typically expressed as a decimal fraction. For instance, the proportion “.25” indicates that the part is 25%, or one quarter, the magnitude of the whole. See also Ratio.
Public Health, Fundamentals of
Public health is “the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals” (1920, C.E.A. Winslow). Fundamentals of Public Health is a brief (two-day) course for community representatives that includes sections on the history of public health, population-based approaches to health, basic epidemiology, community health assessment, community health planning, and health disparities/social determinants of health.
QALY stands for “Quality Adjusted Life Years,” and is a summary measure of premature mortality and quality of life. It is defined by the Association for State and Territorial Health Officers as, “The combined measure of life expectancy and the quality of the remaining life years.” See also Y.P.L.L., D.A.L.Y.
Race is defined as a human population considered distinct based on physical characteristics. It is important to note, however, that race is predominantly a social construct, and that genetic science has determined that only 2 percent of our genes are ultimately responsible for the visible differences such as skin color. See also Ethnicity. [more on race and ethnicity measurement and coding…]
A rate is a special instance of a ratio in which the quantity in the numerator is also included in the denominator. In public health, the numerator is typically the number of people among whom an event occurred during a certain period of time, and the denominator is the total number of people in the population at risk for the same period of time. Rates are typically multiplied by some factor of ten so that the result is a whole number, for instance, “671 deaths per 100,000 population.” [more on health event rates…]
A ratio is a comparison between two numbers which are typically separated by a colon (:). One example is the ratio of the width to the height of a TV monitor (4:3) (read as, “four to three”). A ratio may also be expressed as a fraction, such as 4/3. See also Rate.
The ratio of the risk of disease in exposed individuals to the risk of disease in non-exposed individuals. Relative Risk = Risk in exposed ÷ Risk in non-exposed
Relative Standard Error (RSE)
Relative Standard Error, (RSE) is a measure of the statistical stability of an estimate. It is calculated as the ratio of the standard error to the point estimate (e.g. rate, average), and is often expressed as a percentage. An estimate with an RSE greater than 0.30 (30%) is generally considered unstable, and an estimate with an RSE greater than 0.50 should not be used to infer population risk. The Relative Standard Error is also known as the Coefficient of Variation. [more on reliability…]
Reliability is a property of a measurement that refers to its stability, or the degree to which measurements of identical phenomena yield identical results. In public health, we often use measures such as death rates or birth outcomes to indicate the true underlying risk of illness or disability in a population. Often such measures, when observed in small populations, are said to yield “unreliable results” because the observations tend to very considerably over repeated observations, such as from year to year. That fluctuation makes them an unreliable measure, and a poor indication of the true underlying population risk. [more on reliability…]
Resident events are those that occurred to residents of a particular geographic area. For example, 2007 New Mexico resident births is the number of births that occurred to New Mexico resident mothers during 2008 (regardless of where they occurred). Reporting of vital statistics by residence is considered the standard or default for general data dissemination since it provides health status information for residents of a particular geographic area. See also Occurrent Events.
A resiliency factor is a personal, social or environmental characteristic that is associated with a decreased risk of disease, infection or injury.
A risk factor is a personal, social or environmental characteristic that is associated with an increased risk of disease, infection or injury.
“SMART” is an acronym for objectives that are Specific (What is the specific task?), Measurable (What are the standards or parameters?), Achievable (Is the task feasible?), Realistic (Are sufficient resources available?), and Time-Bound (What are the start and end dates?). For more information, visit the CDC Healthy Youth Website. See also Objectives and Goals.
SOAP is an acronym used in clinical medicine that stands for “Subjective, Objective, Assessment and Plan.” Subjective information from the patient and Objective measurements from tests are the inputs to the clinical diagnosis, the clinician then Assesses the information to arrive at a diagnosis, and then establishes a treatment Plan. The analogy is also useful when applied to community health assessment. [more on the SOAP model…]
STIPDA stands for “State and Territorial Injury Program Directors Association.” In 2007, STIPDA published consensus recommendations for coding external cause of injury on the death certificates and hospital discharge records. See the STIPDA Consensus Recommendations.
Just as a sentinel is a person employed to keep watch for some anticipated event, sentinel public health sites are clinicians, hospitals or clinics that have agreed to watch for cases of a given disease or event and report them to the public health department. Sentinel sites are commonly used in surveillance of influenza-like illness (ILI) to track incidence of ILI in the community.
Small for Gestational Age
Small for gestational age (SGA) is a term used to describe a baby who is smaller than usual for the number of weeks of pregnancy. SGA babies usually have birthweights below the 10th percentile for babies of the same gestational age. This means that they are smaller than 90 percent of all other babies of the same gestational age. See also Gestational Age.
“Small numbers” is a term that is used to denote a population or a survey sample that is relatively small, yielding imprecise estimates for the health event of interest. “Small” is defined differently for different purposes, but in general, populations that yield 20 or fewer health events in the specific time period are generally considered small for most purposes. The precision of an estimate may be indicated by the confidence interval for the estimate. As the population size decreases, the confidence interval widens, indicating less precision, or less “confidence” with regard to how well the estimate reflects the true underlying risk in that population. A small and identifiable denominator (e.g., teen girls in Harding County) may also provide opportunities for identification of individuals represented in a dataset. To avoid invasions of individual privacy, the DOH has a “Small Numbers Reporting Rule.”
Social Determinants of Health
The social determinants of health are the circumstances in which people are born, grow up, live, work, and age, as well as the systems put in place to deal with illness. Social determinants of health are the complex, integrated, and overlapping social structures and economic systems that are responsible for most health inequities. These social structures and economic systems include the social environment, physical environment, health services, and structural and societal factors. Social determinants of health are shaped by the distribution of money, power, and resources throughout local communities, nations, and the world. (Adapted from the World Health Organization) See also Health Disparities.
Social marketing is the systematic application of marketing principles and practices, along with other concepts and techniques, to achieve specific behavioral goals for a social good. Social marketing is often applied as part of health promotion campaigns designed to change behaviors, such as reducing smoking, curbing driving while intoxicated, or increasing levels of physical activity.
Standardized Mortality Ratio (SMR)
Standardized Mortality Ratio (SMR) is a ratio between the observed number of deaths in an study population and the number of deaths that would be expected, based on the age- and sex-specific rates in a standard population and the age and sex distribution of the study population. If the ratio of observed:expected deaths is greater than 1.0, there is said to be “excess deaths” in the study population. See also Ratio. [more on the SMR…]
A statistic is a number that summarizes data. A descriptive statistic summarizes data in a limited or bounded dataset. Examples include the average age of students in a class and the percentage of employees who purchased dependent health coverage. An inferential statistic summarizes data in a sample drawn from a larger population, of which the sample is intended to be representative. Statistics calculated from the sample are used to make inferences about the population, and are typically accompanied by a confidence interval, used to suggest the precision of the statistic. Examples include the percentage of youth in a survey who smoked cigarettes, or the average body mass index among sampled persons.
A strategy is an overall approach or direction for an initiative: a set of objectives which, taken together, are likely to achieve a desired outcome. Evidence-based strategies are approaches which have been shown through research, evaluation, or experience to be likely to achieve the desired results. Promising strategies are those which are currently being tested or evaluated, with early indications that they are likely to be successful in achieving the desired results. See also Evidence-based.
The term “study population” is used to refer to the population of interest, in contrast to the “standard population” which is used to provide a basis for age standardization of rates.
Surveillance is the systematic collection, analysis, interpretation, and dissemination of health data on an ongoing basis. Surveillance is conducted to identify potential public health threats, and to gain knowledge of the pattern of disease occurrence and risk in a community. See also Investigation.
Test of Proportions
The Test of Proportions is a statistical test used to compare rates (such as a percentage or a death rate) between two independent populations (such as counties or two age groups). By “independent” we mean there is no overlap in the members of the two groups. For instance, this test would be too considered conservative to compare the same county at two different points in time. [more on the Test of Proportions…]
Total Fertility Rate
The total fertility rate is the sum of the age-specific birth rates of women in five-year age groups multiplied by five. This rate estimates the number of children a cohort of 1,000 women would bear if they all went through their childbearing years exposed to the same age-specific birth rates in effect for a particular time. See also Age-specific Fertility Rate, Birth Rate, General Fertility Rate, and Total Fertility Rate.
A trend is a view of multiple years of data so you can see how rates change over time. A trend is often shown as a simple line graph so that the trend is easily visible. Due to the changing age distribution of the population (i.e., the “aging” of the population over time) it is useful to use age-adjusted rates to compare rates over several years. The term, “secular trend” is also used to refer to trends over time.
A true experiment has the following characteristics. There must be a study group and a control group. Study participants must be randomly assigned to the study and control groups. There must be an experimenter-manipulated independent variable to which study group is exposed. Without a true experiment, it is very difficult to establish a causal relationship.
Underlying Cause of Death
Underlying cause of death is defined by the World Health Organization (WHO) as the disease or injury that initiated the train of events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury.
Validity is a property of a measurement that refers to its accuracy, or the degree to which observations reflect the true value of a phenomenon. In public health, we are lucky because the validity of most of our measures is really quite good. “Cause of death” on death certificates is certified by a physician. Survey measures have been tested to maximize validity. Birthweight is measured and reported at the birth hospital. There are some measures that we question, for instance self-reported body weight, but on the whole, the measures we use have a high degree of validity. [more on validity…]
The weighted average, or weighted mean is an average in which the data elements have been differentially weighted. Data elements with a high weight contribute more to the weighted average than do elements with a low weight. If all data components in the calculation have the same weight, it is called the arithmetic mean. In the case of age-adjusted rates for health events, a weighted mean is used to adjust, or age-standardize, health event rates for two or more populations with different age compositions.
YPLL stands for “Years of Potential Life Lost,” and is a measure of premature mortality due to one or more conditions. In New Mexico IBIS, it is calculated as the number of deaths in a population multiplied by the remaining years of life expectancy in each of 19 5-year age groups, summed across age groups. See also D.A.L.Y., Q.A.L.Y.