From Alice_Rarig@health.state.ak.us Wed Oct 30 11:04:21 2002 Received: from mailscan2.cac.washington.edu (mailscan2.cac.washington.edu [140.142.33.16]) by lists.u.washington.edu (8.12.1+UW01.12/8.12.1+UW02.09) with SMTP id g9UJ4EFD075912 for ; Wed, 30 Oct 2002 11:04:14 -0800 Received: FROM mxu4.u.washington.edu BY mailscan2.cac.washington.edu ; Wed Oct 30 11:04:14 2002 -0800 Received: from as-jnu2e.state.state.ak.us (as-jnu2e.health.state.ak.us [146.63.177.19]) by mxu4.u.washington.edu (8.12.1+UW01.12/8.12.1+UW02.09) with ESMTP id g9UJ4Dg3008723 for ; Wed, 30 Oct 2002 11:04:13 -0800 Received: by AS-JNU2E with Internet Mail Service (5.5.2653.19) id <40SH2B2G>; Wed, 30 Oct 2002 10:02:06 -0900 Message-ID: <32E2EFC59090D611A4AA00065B3DB9B979400A@AS-JNU3E> From: "Rarig, Alice" To: "'waphgis@u.washington.edu'" Subject: RE: waphgis: deprivation index Date: Wed, 30 Oct 2002 10:01:49 -0900 MIME-Version: 1.0 X-Mailer: Internet Mail Service (5.5.2653.19) Content-Type: multipart/alternative; boundary="----_=_NextPart_001_01C28046.CD01D2B0" This message is in MIME format. Since your mail reader does not understand this format, some or all of this message may not be legible. ------_=_NextPart_001_01C28046.CD01D2B0 Content-Type: text/plain; charset="iso-8859-1" I developed a health status index, dependency ratio, and scale based on per capita income (also a seasonal population scoring approach) specifically for the use of the Denali Commission in ranking Alaskan communities for these several dimensions as they considered "need" for PRIMARY HEALTH CARE clinics and services. It is described in their report (Volume II) of a year ago. I thought it was critical to use health status indicators and other measures that had a clear role in predicting or reflecting need for primary care. Without a context, any "index" can be created and mis-used to characterize communities or counties or states in ways that can be harmful. I do not like "scorecards" because they obscure rather than enlighten by combining factors that are often unrelated. If you truly want an aggregated picture showing the cumulative effects or scores of some particular variables about a "place" it is very important to remember what you have piled into the composite, to make sense of the result. For the Denali Commission, we used county-level data for part of the picture (the Health Status Score), and CDP-specific data where we had it for the census measures. The per capita income measure was challenged by one community because that community had high incomes in 1989, but had crashed in the meantime. I was able to show that county-level data on personal income in the course of the decade indicated this community had languished but still ranked high in the state - its relative ranking had scarcely shifted - so it would not gain or lose "points" with the Denali Commission process despite the feeling that they were economically worse off than ten years earlier. Generally for each of the indices in the Denali Commission model, communities had points assigned according to the quintile of their rank. Thus the scoring was less sensitive to the precise rank order. More points were given to health status score (a county-level score) than to "seasonality" - in accordance with the emphasis the Steering Committee wanted to give to the elements. "Community readiness" to undertake a project was a qualitative assessment element that was also important to the process. I see that the Denali Commission has done what appears to be an update of my approach - see the website http://www.denali.gov/ and go to Health Care Facilities and then Distressed Community Criteria & Surrogate Standard! I'll have to read it over myself to see how it looks! Colleagues in Community Health and EMS Section of the Alaska Division of Public Health (I'm manager of the DPH Data and Evaluation Unit) have been the main staff support (for the primary care assessments) and contacts in DPH for the Denali Commission. I look forward to hearing from others about other "applications" using census indicators and health status measures (appropriately, we hope) to support program decisions or planning. Alice J. Rarig, MA, MPH, PhD Manager, Data and Evaluation Unit Division of Public Health Alaska Department of Health and Social Services PO Box 110618 Juneau, AK 99811-0618 (907) 465 1285 phone (907) 465 8637 fax -----Original Message----- From: HealthMaps [mailto:healthmaps@attbi.com] Sent: Wednesday, October 30, 2002 8:30 AM To: WAPHGIS Subject: waphgis: deprivation index I am interested in developing a "deprivation" index, something along the lines of one that is used in the UK, ( see http://www.avon.nhs.uk/phnet/PHinfo/understanding.htm#Deprivation ) but for US census data. Can anyone suggest recent bibliography on this topic? Clearly this is a research interest for sociologists, demographers and geographers, but I am not familiar with their literature in this area. Any ideas about development of a deprivation index with US Census data? Something similar to the UK site's could be made with recent census data, but has there been much use of such an index in public health? Pros/cons? Thanks, Richard E Hoskins PhD MPH Spatial Epidemiology Unit WA State Dept of Health 1102 Quince Street Olympia, WA 98504-7812 richard.hoskins@doh.wa.gov GMT -8 to join WAPHGIS: send email to listproc@u.washington.edu with the following request: subscribe WAPHGIS Your Name new on-line GIS, geography & health journal: http://www.ij-healthgeographics.com/start.asp ------_=_NextPart_001_01C28046.CD01D2B0 Content-Type: text/html; charset="iso-8859-1" Content-Transfer-Encoding: quoted-printable

I developed a health status index, dependency ratio, and scale based on per capita income (also a seasonal population scoring approach) specifically for the use of the Denali = Commission in ranking Alaskan communities for these several dimensions as they = considered "need" for PRIMARY HEALTH CARE clinics and services. It is described in their = report (Volume II) of a year ago.

 

=

I thought it was critical to use = health status indicators and other measures that had a clear role in = predicting or reflecting need for primary care. Without a context, any "index" can be created and mis-used to characterize communities or counties or states in ways that can be harmful. I do not = like "scorecards" because they obscure rather than enlighten by combining factors that = are often unrelated. If you truly want an aggregated picture showing the = cumulative effects or scores of some particular variables about a "place" it is very important to remember what you have piled into the composite, = to make sense of the result.=A0 For the = Denali Commission, we used county-level data for part of the picture (the = Health Status Score), and CDP-specific data where we had it for the census = measures. The per capita income measure was challenged by one community because = that community had high incomes in 1989, but had crashed in the meantime. I = was able to show that county-level data on personal income in the course of the = decade indicated this community had languished but still ranked high in the state - its = relative ranking had scarcely shifted - so it would not gain or lose "points" with the Denali Commission process despite the feeling that they were economically worse off than ten years earlier. =

 

=

Generally for each of the indices = in the Denali Commission model, communities had points assigned according to the = quintile of their rank. Thus the scoring was less sensitive to the precise rank order. = More points were given to health status score (a county-level score) than to = "seasonality" - in accordance with the emphasis the Steering Committee wanted to give to the elements. "Community readiness" to undertake a project was a qualitative assessment element that was also important to the = process.

=A0

I see that the Denali Commission = has done what appears to be an update of my approach - see the website http://www.denali.gov/ and go to = Health Care Facilities =A0and then Distressed Community Criteria & Surrogate Standard! I'll have to = read it over myself to see how it looks! =A0Colleagues in Community Health and EMS Section of the Alaska Division of Public = Health (I'm manager of the DPH Data and Evaluation Unit) have been the main staff = support (for the primary care assessments) and contacts in DPH for the Denali Commission.

 

=

I look forward to hearing from = others about other "applications" using census indicators and health status measures (appropriately, we hope) to support program decisions = or planning.

 

=

Alice J. Rarig, MA, MPH, PhD

Manager, Data and Evaluation Unit

Division of Public Health

Alaska Department of Health and Social Services

PO Box 110618

Juneau, AK= = 99811-0618

(907) 465 1285 phone

(907) 465 8637 fax

 

=

 

=

-----Original = Message-----
From: HealthMaps [mailto:healthmaps@attbi.com]
Sent: Wednesday, October 30, = 2002 8:30 AM
To: WAPHGIS
Subject: waphgis: = deprivation index

 

I am interested in = developing a "deprivation" index, something along the lines of one that is = used in the UK, ( see http://www.avon.nhs.uk/phnet/PHinfo/understanding.htm#Deprivation=   ) but for US census data.

 

Can anyone suggest  = recent bibliography on this topic? Clearly this is a research interest for sociologists, demographers and geographers, but I am not familiar = with their literature in this area.

 

Any ideas about = development of a deprivation index with US Census data? Something similar to the UK = site's could be made with recent census data, but has there been much use of such an = index in public health? Pros/cons?

 

Thanks, =

 

 

Richard E Hoskins PhD MPH
Spatial Epidemiology Unit
WA State Dept of Health
1102 Quince Street
Olympia, WA 98504-7812
richard.hoskins@doh.wa.gov
GMT -8
to join WAPHGIS: send  email to listproc@u.washington.edu =
with the following request:

subscribe = WAPHGIS Your Name 


new on-line GIS, geography & health journal:

 

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