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Health
Data |
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Health data are information,
facts and figures, about the health status of a population.
To improve the health status of Hartford residents, part of
public health work involves assessing the current community
health status, so that we may identify areas of greatest need
for improvement and apply resources accordingly. We gather
information at many different levels, local, state and federal.
The collection instruments and sources used range from surveys,
such as the Hartford Health survey, which community members
complete, to vital statistics, e.g., birth records, death
records and causes of death, recorded by the State of Connecticut
Department of Public Health. The information presented below
includes tables, charts, and graphs, with a brief written
interpretation. Special reports are presented as complete
documents that may be read online, printed, or downloaded.
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Scientific Advisory
Committee |
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Community
Health Profile |
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Personnel and Acknowledgements |
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Overview |
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Profile Components |
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Scientific Advisory
Committee |
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Tara L. McLaughlin, PhD, MPE.
Acting Chairperson.
Health Outcomes Scientist, Research Administration, Hartford Hospital. |
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Georgine Burke, PhD.
Director of Research, Connecticut Children's Medical Center. |
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Gail McAvay, PhD, MS.
Senior Scientist, Qualidigm. |
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Tung Nguyen, MPH.
Epidemiologist, City of Hartford Dept of Health &
Human Services. |
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Ramon Rojano, MPH.
Director, City of Hartford Dept of Health & Human Services. |
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Merrell Singer, PhD.
Director of Research, Hispanic Health Council. |
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Ilene Staff, PhD.
Senior
Scientist, Research Administration,
Hartford Hospital. |
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Community Health Profile |
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Personnel
and Acknowledgements |
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Tara
L. McLaughlin, PhD, MPE
Health Outcomes Scientist
Research Administration, Hartford
Hospital
Tung
Nguyen, MPH
Epidemiologist, City of Hartford
Dept of Health & Human Services
Ramon
Rojano, MPH
Director, Health & Human Services,
City of Hartford Dept of Health & Human Services
Acknowledgements:
We would like to thank Eileen
O’Keefe, MD, MPH for her previous work on this profile. Also,
thanks to Hartford’s Scientific Advisory Committee
for their contributions to the creation of this profile. |
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Overview |
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A community health profile
is a set of measures that
represent the socio-demographic characteristics, physical
and social environmental factors, health status, health behavioral
risk factors, quality of life, and health resources that are
essential to the health of community residents. Through identification
of this "health profile," public health officials
can target specific
health issues, mobilize resources to address concerns, &
clarify needed public policy initiatives within the City of
Hartford. The context for
this effort includes such national efforts as The Institute
of Medicine's Committee on Using Performance Monitoring to
Improve Community Health, and the Healthy People 2000 and
Healthy People 2010 initiatives. We identify specific objectives
for developing and maintaining a community health profile.
We divide the health profile into five components:
socio-demographics, health status, chronic diseases (specifically
diabetes and hypertension), mortality and behavior risk (specifically
smoking and physical inactivity). For a more complete and
detailed discussion of Hartford's Community Health Profile,
please click here. |
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Profile
Components |
Socio-demographic
Profile
Behavioral
Risks Profile
Mortality
Diabetes
Health
Status
Hypertension
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Public
Health Reports |
Homelessness
in Hartford, CT 2002
Get
the Lead Out: Evaluating a Lead Poisoning Awareness Campaign
in Hartford, CT
The
Hartford HIV/AIDS Surveillance Report
The Hartford
Health Survey, 2003
The Hartford Health Survey, 2000
The
Hartford Health Survey, 1997
The
Hartford Homeless Health Survey 2000 Results
The
Hartford HIV/AIDS Surveillance 2000
Report
Behavioral
Risk Factor Reduction Special Report
Census and Brief Assessment of the Homeless and Supportive
Housing Populations of Hartford, CT 2004
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Committee
Reports |
Asthma
Call to Action Annual Report 2003
Asthma
Call to Action Annual Report 2002
Diabetes Call to Action 1999 - 2000 Annual
Report
Diabetes Call to Action 1998 - 1999 Annual
Report
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Introduction:
The
City of Hartford's Community Health Profile |
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This
introduction to the Community Health Profile for the City
of Hartford contains background information and descriptions
of issues, methodological and policy, that were considered
in its development. Documentation of this background, we believe,
lends context to the profile, and may guide its judicious
use.
Background
In
1995, Hartford’s Community Health Partnership declared its
goal to collaboratively assess and improve the health status
of the city’s residents by mobilizing the different community
sectors. Toward this end the Partnership identified five priority
areas. One of these priority areas was to develop a health
status database. The initial step toward development of this
database was accomplished in 1997 with the implementation
of the population-based Hartford Health Survey. The
most recent Hartford Health Survey was conducted in 200 3
and
involved 1,205 Hartford residents who responded to the 27
page, 79-question
Hartford Health
Survey 2003
booklet. This survey includes questions
directly related to health, and also addresses access to care,
satisfaction with care, social conditions, and individual
behavior. Taking these data and data from other local, state
and national sources, we have developed and continue to maintain
this Community Health Profile for the City of Hartford. This
profile is intended to be used by community members, community
organizations, health professionals, and health institutions.
We
have updated this profile to reflect the most recent Hartford
Health Survey. This updated profile includes the most current
vital statistics available (e.g. information for the Center
for Disease Control (CDC)’s Center for Health Statistics),
as well as the most recent data available from the State of
Connecticut Department of Public Health, the United States
Census, the Behavioral Risk Factor Surveillance System data
and, where appropriate, the most current institutional and
agency data.
"Community Health Profile" Defined
By
definition, a community health profile is a set of
indicators that measures sociodemographic characteristics,
physical and social environmental factors, health status,
health behavioral risk factors, quality of life, and health
resources that are crucial to the health of most communities.
Indicators, in this context, are used as markers, performance
measures, for a particular field. For example, health behavioral
risk factor indicators can include prevalence of smoking,
lack of automobile seat belt use and lack of physical activity.
We do not choose to follow every indicator in each field,
but rather we select the most appropriate indicators for our
community, taking into account the demographics and the health
needs of our specific population, and the availability of
data.
In
short, therefore, a community health profile can provide basic
information about a community’s demographics, socioeconomic
characteristics, health status, and health risks.
National
Influences
Institute of Medicine: A Community Perspective
The Institute of Medicine’s Committee
on Using Performance Monitoring to Improve Community Health
published its report in 1997(1). This committee took as one
of its core principles the broader "field model"
determinants of health, originally described by Evans and
Stoddart (2). This model takes into consideration the role
of many diverse factors on health, beyond specific disease
diagnosis and treatment. It includes the impact of the physical,
social, and economic environment, and certain individual behavior
choices that impact the health of the individual, and by extension,
the health of the community. This perspective encourages a
shift from individual patients and enrolled populations, within
institutions or health care organizations, to the community
as a whole. This community-based focus highlights a number
of important issues, particularly, the uninsured, access to
care, and the issue of responsibility of local health care
institutions to the community. This focus also demonstrates
that there are many public and private entities that can affect
the community’s health, ranging from hospitals to schools
to private industry. We use these broader determinants of
health as our framework to examine and select indicators of
the health status of our community.
Healthy People 2000
Another national focus, which
impacts the development and use of the community health profile,
is health promotion. Healthy People 2000 (3) presents a national
health promotion strategy to significantly improve the health
of the American people. It is the product of a national effort,
involving 22 working groups, includes representation from
all state health departments, almost 300 national organizations,
and the Institute of Medicine of the National Academy of Sciences.
It is under the jurisdiction of the Department of Health and
Human Services, Public Health Service. It issued its first
report in 1991. The Public Health Service periodically reviews
progress toward the year 2000 objectives. Healthy People 2000
defines three broad goals, and 319 objectives. The goals focus
on increasing the span of healthy life, reducing health disparities,
and achieving access to preventative services for everyone.
The 319 objectives are organized into 22 priority areas. Each
of the 22 priority areas is further broken down (defined)
into three sets of objectives, health status, risk reduction,
and services and protection objectives. Health status indicators
were developed in response to objective 22.1 of Healthy People
2000, "Develop a set of health status indicators appropriate
for Federal, State, and local health agencies and establish
use of the set in at least 40 States"(3).
Healthy People 2010
Healthy People 2010 was launched in January 2000 and was updated
in June 2000 (4). Built upon the Healthy People initiatives
of the past two decades, Healthy People 2010 has two broad
goals: 1) To help individuals of all ages increase life expectancy
and improve their quality of life 2) To eliminate health disparities
among different segments of the population. The 2010 initiative
involves 28 focus areas and 467 specific objectives. Relative
to Healthy People 2000, new focus areas include impairment
and disability, and public health infrastructure.
In
Healthy People 2010, there are six topic areas identified
in which ethnic minorities experience serious health disparities;
infant mortality, diabetes, deficits in breast and cervical
screening and management, cardiovascular disease, HIV, immunization
of both children and adults. An important change in the targets
set for the population objectives in Healthy People 2010 is
that, in order to work toward eliminating health disparities,
these targets will now be identical for all population groups.
Common targets for each objective will be established for
the whole population, rather than maintaining different targets
for different ethnic groups. Further, these targets must exceed
the best rate for any particular population group at present.
Although these goals may appear unachievable, this principle
has been deemed to be too important to relinquish.
Goals of
profile development
The
ultimate goals of developing and maintaining a community
health profile (with its associated indicators) are:
1.
To
appreciate the broad range of factors that influence health
in the community
2.
To
maintain a broad strategic view of the population’s health
status
3.
To
help us best allocate our resources to improve the health
of the entire community
4.
To
facilitate both longitudinal self-comparison over time and
comparison with peer communities within the state and within
the nation as a whole.
5.
To
clarify the roles and the impact of the health department,
the private health care sector and other traditional and non-traditional
partners working to improve health within the community.
6.
To
assess the effectiveness of public health interventions.
Components
of Hartford’s Community Health Profile
Hartford’s Community Health Profile includes five components:
Socio-demographics, Health Status,
Chronic Diseases (specifically Diabetes and Hypertension),
Mortality and Behavioral Risks (specifically Smoking and
Physical Inactivity). By convention and to comply with Healthy
People 2000 and 2010 (3,4), health indicators are defined so
that a higher rate or percentage is an indication of poorer
health status. These components were initially delineated by
the City of Hartford to take into account the indicator sets
outlined by the Institute of Medicine (1) and the indicators
and targets set in Healthy People 2000 (3). We have also
considered the data presented by the Connecticut State
Department of Public Health in its publication, "Looking
Toward 2000"(5), taking into account our population’s unique
diversity, and special priorities of our own community.
Finally, our indicators may differ from national and state
because of our smaller population base, e.g. rather than
mortality we may find it more appropriate to follow disease
prevalence.
Data
Sources and Constraints
Data
are rarely available in the precise form we desire; therefore
at times concessions are made to data constraints. For each
indicator, we identify best available data. It is preferable
to assess data at the population rather than the institutional
level for development of a community health profile. "Only
at the population level is it possible to examine the effectiveness
of health promotion and disease prevention activities and
to determine whether the needs of all segments of the community
are being addressed (1). We are fortunate here in Hartford
to have data available from the Hartford Health Survey 2000,
a large population based health survey, described above. We
also use vital statistics, e.g. Center for Disease Control's
(CDC) Center for Health Statistics, data from State of Connecticut
Department of Public Health, United States Census data, Behavioral
Risk Factor Surveillance System data and, where appropriate,
institutional and agency data. We are aware that the latter
may be influenced by agenda, policy, and/or resource restrictions.
References
1.
Performance
Monitoring.
Institute of Medicine, 1997.
2.
Evans R G, Stoddart G L (1990). Producing health, consuming
health care. Social Science and Medicine, 31: 1347-
1363.
3.
U.S.
Department of Health and Human Services. Healthy People
2000: National Durch J S, Bailey L A, Stoto M A. Improving
Health in the Community: A Role for Health Promotion
and Disease Prevention Objectives. Washington D.C: U.S.
Government Printing Office, 1997.
4.
U.S.
Department of Health and Human Services. Healthy People
2010. 2nd ed. With Understanding and Improving Health
and Objectives for Improving Health. (2 vols.) Washington,
DC: U.S. Government Printing Office, November 2000.
5.
Harriman, S A. Looking Toward 2000- An Assessment
of Health Status and Health Services. Connecticut
Department of Public Health, 1999. |
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Publications
are in PDF format which requires Acrobat® Reader.
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