Notes from “Finding and Using Health Statistics”

From: Finding and Using Health Statistics – http://www.nlm.nih.gov/nichsr/usestats/index.html

(tutorial from…National Information Center on Health Services Research and Health Care Technology (NICHSR) )

Internet Strategies

Page 26 of 40

Using the World Wide Web to best advantage requires mastery over new types of searching that go beyond those found in printed resources.

The Internet also offers new online catalogs of health statistics material. They work like library catalogs but are focused on statistical materials. [One such resource is the Gateway to Data and Statistics of the Department of Health and Human Services.]

Search Engines

Search engines such as Google allow users to search the words within each website and use Boolean logic to find material. However, these automated facilities are not fine tuned to take advantage of the particular structure of health statistics. Because they are based on the experience of other users, search engines require an effort to focus in on particular health statistics series. They are extremely valuable in finding particular references once you know what you are looking for.

Portals

Agencies that create health statistics have invested in the creation of portals that present their data. A good first step is to focus on these for relevant material.

Searching within a Report	Page 27 of 40

At other times, the researcher’s question might lead to a search within one of these resources. Before the advent of the Internet, these kinds of searches were extremely difficult, required an in depth knowledge of the sources and usually involved contacting experts at the statistical offices where material originated. Frequently, they were the only ones who could reliably guide users to the place where they could find their answer. Because the demand for their help greatly exceeded their capacity, users often bypassed useful information and settled for the material available in standard publications. This material was sometimes not as pertinent or accurate as available information that was difficult to find.

Internet and Electronic Reports Open New Strategies

The Internet has now made it possible to discover much of this information because it added access points and made it possible to search within sources. Electronic reports that can either be downloaded from the Internet or obtained in other ways also allow for detailed searching that was not previously available.

Expand the search to web based material

Page 28 of 40

The previous examples show that traditional library methods can provide starting points in a search for health statistics publications. To be successful, the researcher must draw on material in a number of places and diverse formats.

Consequently, searchers might try to:

• Use printed reports and books as the starting point rather than the end of a search. For example, you might start with a standard compilation of health statistics—such as Health, United States. See Example for a detailed discussion of how to use Health US
• Focus on key Internet portals that provide an array of resources and finding aids. [A number of these are introduced in this course. You can find a list of them on the HSRR NLM website.]
• Use both search engines—such as Google or Google Scholar–and online catalogs of health statistics material—such as DHHS’ Gateway to Data and Statistics.

Using a Web Portal

Page 29 of 40

Specialized libraries and organizations have created web portals that make it easier to find and use health statistics. These offer key access points to health statistics.

To use them the researcher:

• Locates a website that lists relevant key sites that point to places where material is organized.
• Takes advantage of the natural structure of health statistics material. Here are some steps for this.
  • Looks for material on the websites of agencies that create it. For example, many users will start at the NCHS website.
  • Focuses on health statistics projects or surveys that address the particular topics of interest. This broad “Table of Contents” approach is a good first step but almost never finds all of the relevant material.
  • Extends the search to other material created by the agencies that managed the most relevant studies.
  • Searches can be materially enhanced by using specialized catalogs of the material. And
  • Digs beyond the apparent content of a work—represented in its title—to find material deep in its tables.

Examples of portals

Page 30 of 40

The next pages describe three examples of portals that cover health statistics.

• University of Michigan’s portal to Statistical Resources on the Web
• CDC’s listing of statistical and scientific resources maintained by its agencies
• DHHS Gateway to Data and Statistics provides an online catalog of websites that have statistical data pertaining to health.

Additional starting points

Several other portals have been built. Go here for a list of some of them.

Going to the Original Sources

Page 31 of 40

One way to find health statistics is to identify the appropriate source—the organization or agency that is likely to collect and report the information and visit their website or look for their publications.

Organizations and Health Statistics

Health statistics are the product of organizations that can conduct large scale data collection, compilation, standardization and analysis. While individual scholars and analysts make important contributions through their work, they largely rely on these institutions to collect the data and make them available.

One important approach to finding health statistics is to visit the web sites maintained by the agencies that produce them. This section introduces the producers and provides links to their main web pages.

A list of key sites can be found here

How to find the major agencies producing health statistics

Page 32 of 40

It is advantageous to approach your search for agency sources by following their organizational structure.

Key sources are located on the websites of:

• The US Department of Health and Human Services
• Other Federal Agencies
• State and Local government health agencies
• Private companies

Go to the Agency Website

Page 33 of 40

If you are looking for material within the mission of a particular agency or private organization, looking at their statistics or data website can help you find it:

• The site may have the material the agency creates.
• It may link to other material and these links could identify more material
• Many agency websites also provide bibliographic resources.

Federal Government Agencies

Page 34 of 40

Agencies within and outside of the Department of Health and Human Services report statistical series that help us track and understand health.

A complete list of federal government agencies that create health statistics and related data can be found at the Department of Health and Human Services Gateway to Data and Statistics.

Department of Health and Human Services

Researchers often begin their searches by focusing on the agencies of the US Department of Health and Human Services because these agencies consider the reporting of statistical series related to health as a part of their core functions.

The following list provides links to principal web locations within the department where statistical data related to health can be located. This list is linked to the main data and statistics website of each agency.

• CDC’s National Center for Health Statistics is the principal agency of the federal government responsible for reporting health statistics. It compiles “statistical information to guide actions and policies to improve the health of our people.”
• NCHS statistical series. For Examples of NCHS data series click here.
• Agency for Healthcare Quality and Research conducts research on health care delivery and quality.  As a part of this work it conducts surveys of health care providers, insurers and the public.  For Examples of AHRQ statistical series click here.
• The Centers for Disease Control and Prevention . In addition to the extensive health statistics series compiled by its NCHS, CDC also publishes series based on active and passive surveillance.
• The Centers for Medicare and Medicaid Services Publishes statistical series that track participation in Medicare and Medicaid. It also reports on health care expenditures.
• Health Resources and Services Administration is “the primary Federal agency for improving access to health care services for people who are uninsured, isolated or medically vulnerable.” HRSA assembled statistical data to support this work and makes this data available in its warehouse.

Page 35 of 40

• The Indian Health Service Reports program statistics that track the health care and conditions of American Indians and Alaskan Natives who live on or near Indian reservations and are served by IHS.
• The National Institutes of Health publishes the statistical series of based on research conducted by its institutes and centers. This work is frequently reported in the scholarly literature. Here are some key resources that offer starting points in searches:
• National Library of Medicine HSR Information Central Data Tools and Statistics
• National Cancer Institute
• National Institute on Drug Abuse
• National Institute on Mental Health
• National Heart Lung and Blood Institute
• National Eye Institute
• National Institute on Aging
• National Institute on Alchol Abuse and Alcoholism’s Data and Statistics Page
• NIAAA’s National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)
• National Institute on Deafness and Or Communication Disorders
• Office of Applied Studies, Substance Abuse and Mental Health Services Administration

Other Federal Agencies

Page 36 of 40

Federal agencies outside of HHS also compile and report statistical data that are used to create health statistics or support analyses of health statistics.

• The Bureau of the Census provides the basic demographic information used for many of the denominators in health statistics. They also report on disability and health insurance coverage.
• The Bureau of Labor Statistics reports data on workplace injuries and safety
• The National Highway Safety Administration reports on accidents that result in injuries.

State and Local Governments

Page 37 of 40

Many state public health departments maintain statistical offices that compile statistical data for their state.

More information about state related health statistics can be found here.

For a list of state agency sites see here.

Main Features

While each state’s public health statistics are organized differently, key elements of state health data include the following.

Vital Statistics Registration

States record vital health events—such as births, death, marriages and divorces. A detailed discussion of vital statistics is included elsewhere in this course.

State health department websites frequently contain special reports of these vital events focusing on providing detailed information for the state and its counties.

Behavioral Risks

Page 38 of 40

States participate with the CDC in the conduct of the Behavioral Risk Factor Surveillance System and the Youth Risk Factor surveillance System.

Data for each state can be found on CDC’s website.

Detailed state data from this system is frequently available from the state’s Center for health statistics. See for example how North Carolina features this information.

Surveillance of Notifiable Conditions

Public health laws require providers to report cases of certain disorders to their state public health departments.

These include:

• Sexually transmitted diseases and
• Other infectious disorders—such as Tuberculosis, AIDs, Polio, and Mumps

Statistical summaries are published by CDC each week.

State Public health departments also issue periodic summaries of Notifiable conditions.

Step 5 Assess the Results

Page 39 of 40

Once users find material, they should assess its quality and identify sources of uncertainty [error.] Statistical principles are based on the idea that all observation contains uncertainty. Identifying it increases rather than reduces its credibility.

In order to do this, users will need:

• Material about the procedures used to collect the information
• Material that documents its origins and authenticity
• A description of the data collection, compilation and processing methods used by the data creators.
• Measures of uncertainty—i.e. the results of statistical estimates that quantify the likely degree of uncertainty

Many users need to conduct their own assessment of the limits of information they use.

These kinds of users need

• Copies of the original Micro Data Sets. These are frequently released as Public Use Data sets which have been examined to be sure that the identity of the subjects—persons, providers, hospitals and payers cannot be identified.
• Each agency provides detailed information about the availability of its records for analysis. Many allow researchers who promise to protect privacy access under controlled circumstances designed to allow research but at the same time protect subject’s privacy.

Summary

Page 40 of 40

Summary of the Course
In sum, to meet the challenge of finding health statistics, researchers adopt comprehensive strategies.
These strategies:

• Are molded to fit the specific needs of a particular enquiry
• Are built on an understanding of the institutions that create health statistics and the “natural structure” of statistical work including the organizations that compile and report statistics, the studies they field, the reports they issue and the special Internet resources they present.

Searchers must focus on myriad sources. They need to adopt targeted research strategies that:

• Combine traditional library research with specialized approaches.
• Extends searchers beyond traditional printed material found in books and journals to include electronic publications, files and databases.
• Take advantage of specialized cataloging and
• Are based on an understanding of how health statistics are organized.

To read? Try public Library

Cult of the presidency: america’s dangerous devotion to executive power/ healy

Grilled pizzas and piadinas

Five years of my life: an innocent man in guantanamo

Today’s american: how free/ pubbington

Rosalind Creasy’s recipes from the garden

Martyr of the amazon: the life of Sister Dorothy Stang
The greatest gift: th courageous life and martyrdomof siter dorothy stang

yoga for arthritis: the complete guide/fishman

The forever war/Dexter Filkins (336 pages) Taliban..iraq, etc 100,000 first printing, 7 city tour

7 deadly scenarios: a military futurist explores war in the 21st century/ andrew krepinevich

Pres of teh Center for Strategic and budgetary assessments

My sister,my love: the intimate story of story of skyler rampike /Joyce Carol Oates
fictionalized JonBonet Ramset

Saving paradise: how cristianity traded love of this world for crucifixion and empire
Rita Brock

Suprised by hoe: rethinking heaven the resurrection, and the mission of the church/ NT Wright

Using Cellphones in the Classroom (Constructively)

Wired campus article

Excerpt:

1) Check the spelling/definition of a word
2) Research a topic
3) Look up reference images
4) Pull up maps (even with satellite imagery)
5) Document a science lab with built in digital camera/video
6) Fact check on the fly
7) Mail questions to the teacher that they might be embarrassed to ask
Classroom response system
9) Take quizzes
10) Record and/or listen to podcasts

[perhaps best done in group settings, not lecture...]

1. 12) Ask a librarian (via voice, IM, or SMS)
   13) receive and store library-catalog-generated text messages of call numbers for books and reserve items

   — jacqui grallo    May 7, 05:48 PM    #

Week 8 Assignment

Write about the Mashup you found on your blog

Repository 66 is a mashup of data from ROAR and OpenDOAR overlayed onto Google maps.
ROAR is a registry of open access repositories, including —

• Dspace which is an open source solution for accessing, managing, and  preserving scholarly works

Closes one to Toledo is at the University of Michigan. Deep Blue provides access to work by
the university community.

• “Eprints are open software  package for building open repositories that are compliant with the “Open Archives  Initiative Protocol for Metadata Harvesting”

  “The EPrints software is not to be confused with “eprints” (or “e-prints”), which are preprints and postprints of research journal articles…”
  [Wikipedia]

Closest is Philosophy of Science Archive in Pittsburg, a “subject repository for documents
relating to the philosophy of science, supported by the University Library and departments of
History & the Philosophy of Science and Philosophy. The repository is offered as a free service to
the philosophy of science community..”

• Fedora is an “open source software gives organizations a flexible service-oriented architecture for managing and delivering their digital content”

  Closest is MatDI.org (Materials Digital Library Pathway) in Cleveland. It is a partnership of 5 universities and NIST. It “aims to provide stewardship for content and services needed across the MS community and in particular for its targeted audience of materials undergraduate and graduate students, educators, and researchers by offering software tools ..” for data management, modeling, teaching and lab support.

• Berkely Electronic Press “publishes high quality peer-reviewed journals that offer cuting edge research quickly and at sustainable prices” in the areas of  economics, business, law, political science, health, medicine, science,and technology.

  Closest location is the Digital Commons at Wayne State University which  “is a service of the Wayne State University libraries. Research and scholarly output included here has been selected and deposited by the individual university departments and centers on campus.”

At Rollyo,

1. Type “librarianblogs” into the search box
2. Click the librarianblogs Searchroll.
3. Search for “privacy”
4. Browse the results and write something about what these bloggers said about privacy in your blog.

There is a wide range of library related issues that use the word privacy. Some deal with internet usage by the public (inside and outside the library) as they post images of others without permission and post about themselves with little regard of how it may effect them later in life, and the right to pursue knowledge (intellectual freedom). Some discuss legal and political ramificatons as the PATRIOTACTas well as philosophical underpinnings of the the role of government in individual lives (issues as surveillance and
information gathering).

Two examples…

• Librarian Net entry

….” having Google toolbar on public computers can, if the advanced mode is activated, constitute a serious privacy leak. Would a university export its user’s server logs to third parties in any other circumstance? Not without a subpoena. Is it time to call on universities, libraries and other public computing spaces to remove the Google Toolbar? I think so.”

• Annoyed Librarian entry
  “I was reminded of the value of privacy so many librarians claim to espouse while reading a post at Library Juice last week that had Rory Litwin engaging in a little revisionist history. From the LJ post: “The Council sessions of the ALA Midwinter Meeting in Seattle in January were interpreted by many as a defeat of the idea that Council should address ‘non library issues,’ [note the scare quotes] as resolutions aimed at defunding the war in Iraq and impeaching President Bush were voted down by wide margins.”" ..
  “he ALA and most librarians claim to respect the privacy of library users. And privacy is a liberal value, based on the liberal values of individual autonomy and tolerance, born in the horrors of the European wars of religion. Liberals value privacy because of the belief that people should be allowed to think and believe what they like without interference. The political claim most at odds with the liberal value of privacy is the leftist claim that the personal is the political. Privacy is the separation of the personal and the political; it is the the assertion that there is a personal sphere that is always separate from the political. Liberals believe in separating the personal and the political. Other political ideologies don’t.

  How much privacy can we have if the personal and the political (and by extension the professional) are intertwined? Not much. If you value privacy, then you will not believe that the personal is the political. You will specifically believe that the two are not identical, and that there is a separation of the two absolutely necessary for peace and justice. If you believe that the personal is the political, then you believe that what you do in private is the business of politicians. That’s exactly what leftists and “progressives” have been arguing since the 1960s, but there’s nothing “liberal” about it.”

Week 7 Assignment

Write a blog entry discussing how you felt about the experience of using YouTube and what you think about this service. Do you see any potential uses for Podcasting in the library? If so what and why?

YouTube is a mixed bag of amateur and professional clips, with varying degrees of quality. It is difficult to search, there is no thesaurus or subject approach. It is user generated, and there does not seem to be any attempt at quality control or quality collection.

Potential uses for podcasting: orientation tours, short how to guides (as database searches, resource and subject guides, recordings of library instruction sessions, added feature on staff directory page (each staff member could have an associated Youtube clip.

These uses could introduce the library and its services to patrons at their
convenience, and could assist them with their research (or at least get them started) when a librarian is not available. Youtube clips may be more easily
understood by those who find print and text resources challenging.

Week 6 assignment

Blog about the process on your personal blog for this course and share how this concept might be used in your library.

It was not clear to me at the onset how to upload images to Facebook, could not find any directions
through Facebook or the assignment. Finally figured it out through a posting.

One of the drawbacks of Facebook is that it seems I cannot delete individual albums from others.

This concept might be used in our library…

• To add images to items in our library blog, as portions of Web pages when announcing
  new resources or news items (as Pubmed updates, new books [book jackets])

Week 5 Assignment

Is this the future of all software products? What do you think?

To be honest, I do not know what the future is.  All I can do is speak for myself.

As I was reading the Google Docs & Spreadsheets article the following came to mind

• The author stated that he was able to collaborate with his students from afar, after the sub
  was unable to teach the class effectively.
  In adequate communication was responsible for this situation. The plans were nowhere to
  be found. If the plans were found, the situation may never have happened.
• I fear tools as Google docs and other social networking tools will be seen as replacements for
  planning. Why plan when revisions can be made in the nick of time?  Collaborations made any time,
  anywhere make one potentially available any time, anywhere.  How does one get sufficient “down
  time” when Web based products are 24/7?

• Web based products as Google docs greatly aid in the individual producing larger and larger
  amounts of information.  But is it necessarily higher quality than the days before Web based
  software products? I understand collaboration is an answer, it is a form of quality control.
  However, I wonder where will be the time to collaborate if their is an increasing amount of
  documents written, because it is so easy to do? Will people think before they write because
  they know others will review?
• I wonder if virtual collaboration will ever replace face to face collaboration.  Just this morning
  a colleague critiqued a help sheet I was working on. Sure, he could have made the comments
  though a software product.  But I wouldn’t have seen his facial expressions, heard the tone
  of his voice, heard other comments and reflections through his years of experience, had
  a “syncronous communication”. (Web office tool collaboration is asyncronous, and could be
  slower in the long run than conferring in person ).  I found the time spent to be valuable, yes,
  a Web office tool may have been faster, but I think the meeting in person enhanced our
  professional relationship.

• What about people sharing work by others without their permission (plagiarism, invasion of privacy),
  What if Google is no more? It starts charging, gets hacked?

At the very least, software products as Google.docs should be seen to support, and not replace
face to face communications.  I think the more one is wedded to virtual forms of communication,
it replaces face to face communication….and makes one more oblivious to the humanity within
each and every person one comes in contact with during the day.

Week 4 Assignment -Step 4 (Social Bookmarking Remarks)

Create a blog post about your experience and thoughts about this tool.

De.licio.us was easy to use. I especially liked the auto fill in for tags.
I didn’t like trying to guess what tags I had used already. Going back
to the listing of tags I previously used was cumbersome and time consuming.

Nice to see comments of others, good not only for the information contained in the comments, but for potential sources of information and networking (submitter’s email, etc).

Overall, I prefer a controlled vocabulary, it aids one tremendously in finding
“things” (as articles, web pages, etc) on a topic. To be honest…I wonder
if all uncontrolled vocabulary is just going to compound the challenge of
finding relevant information…so many different words (& variant spellings)
to describe an item.

I was pleasantly surprised to see one can download from de.lico.us to EndNote.
This may be of great value, as I use EndNote to organize Web sites of note as
well as articles.

Can you see the potential of this tool for research assistance?

This can assist one in their research, whether it is a solo project, or a project done with another person or a group.

Citulike is a good example of this.
One can gather ,collect, and store bibliographic information about Web published articles.
This is basically a linear process, not unlike the old days of index cards, etc.

One can go further, though, and share and discover links among academic papers.
Through user generated tags, RSS feeds and Watchlists, users can make there findings
available to others through the Web and find out what others are collecting.

Users can create personal collections and browse collections of others.

It can complement search engines and databases in retrieving and discovering papers.

(from…Citulike: A Researcher’s Social Bookmarking Service)
Drawbacks– only as good as those who input (willingness to share in regards to content
and through time), tags chosen, and capabilities of individuals to contribute to a particular subject)

Or just as an easy way to create bookmarks that can be accessed from anywhere?

Yes, it could be used that way. In that way it would not be dissimilar to a traveling
stand alone computer…isolated from others and not in the spirit of its intent as a social
tool.

Week 3 Assignment (Social Networking..)

Social networking, I believe, is a tool which can be used to augment other forms of written and spoken communication (face to face communication [which I hear is largely body language], article publication, email, telephone conversations, blogs, etc).As in other forms of communication, the content may be perceived by the receiver as beneficial or hurtful. Social networking has the potential of reaching a wider and more diverse “audience” than other forms of communication. This is because one chooses friends based on different facets of one’s life. So, it behooves (sorry it’s early AM!) one
to keep an audience in mind, and write and select friends and other items on one’s website accordingly. And one would be wise to read other websites with a bit of compassion, and not rush to judgment.

Social network websites are in different stages of development. However, they register on my brain overwhelmingly as static. So, I have to keep reminding myself they are works in progress and the views, friends chosen, etc do not reflect 100% of the person,
institution (as a library), group, etc.

My experience with Facebook
I liked the many different options [including editing] but overall found individual Web sites to be overwhelming…and perceived as clutter…but that happens to me with quite a few subscription databases from reputable publishers in the biomedical field.

To be honest, I wonder if I would have time to keep my Facebook page current, and wonder if what I post is reflective of what I want to share. ..and if what I wantto share is of value.

Should your library have a Facebook or MySpace page?
I think this is something the reference librarians should decide as a group.Two of our librarians are 27, the other 3 including me, are 40+. This is good…different ages and also different experiences.

My gut instinct says no to Facebook/MySpace. I tend to agree with a finding in Libraries and Social Networking. The authors state that both the general public and US library directors believe the library is for learning/information and do not see the connection with social networking and libraries.

However, this may change, with current trends, including information commonsareas in academic libraries. And a few libraries have started with using these websites as places to have library related activities…some traditional, some new (as making comments, signing up for RSS feeds (as holds/checkouts), interactive art, del.icio.us tags for additional links to library catalog, instructional/informative videos, library related advice, promoted events ).

So, the question is how much does a library lead or follow? Personally, I haven’t come to terms with that.However, if a decision has a sound base, progress will be made, even if the library “changes its mind”, I think. Sound base would include patron info seeking habits and their use and perception of social networking Web sites.

Are there privacy concerns for individuals when using social networking sites?
Yes, anytime one publishes online with any personal information (even if one’s name is not included); there is the potential that the information may be used wrongfully by others or it may come back in ways unintended. Adults targeting children, bullying, job interviews (so, what else went on in that party?) and the shunning of a person due to political/religious views come to mind.

Friends by invitation only and mindful postings can address and resolve many privacy related issues. However, no combination of actions will be 100% effective. Curiosity, fear, and other human emotions are potentially very strong motivators.

How can social networking be used by MLA to connect members?
It could be used as a meeting place to discuss issues; place to share what works/doesn’t work in one’s library; networking hub to work with colleagues facing similar challenges and similar projects; place to work together on implementing objectives of MLA.

Week 2 Assignment -Step 7 (Differences between blogs and wikis)

Blogs and wikis are both social networking tools which can be used by the “owner(s)” to share information with others and receive information through their readers . They may
be published by anyone. Peer review would only take place if the owner sets it up that way. Readers would be wise to evaluate them much like they would evaluate Web pages.

• Blogs are like diaries or journals. The individual posts are written, and posted.It seems to be similar to a set of Word documents in reverse chronological order.One can scroll down to read them. Most blogs, I believe have search capabilities through a sidebar (as date, subjects created by the owner, links [including other blogs]). Blog options include the capabilitity of readers to comment on posts and the sharing of blogs among blog owners.
• Blogs are best suited when there is one owner, a fairly narrow topic is involved , and when the owner wishes to be in control of content.

• Wikkis are websites where the owners can create, organize, and revise content directly through a web browser (Firefox, Internet Explorer). The content and organization is much more fluid and user generated than blogs. (Blogs are essentially canned programs). Content may be arranged in folders, much like blogs. However the content is generally not arranged by date, largely because it is generally a work in progress, with the content constantly revised. One or more owners may be involved in one wikki. People are invited to participate on a number of editorial levels (from contributors to editors).

• Wikkis are best suited when a larger topic or subject matter as library resources. (Think thesauri and subject headings and their related narrower subject headings.) They are also useful when there are two or more contributors working together on large project that benefits from a shared memory and shared workspace (support for courses, planning/developing/supporting conferences and meetings , preparing articles for submission to journals).