25 Sep public health programs

Since the inception of public health programs, vital statistics have been a critical factor in the effort to improve sanitation and to control disease. Today, mortality and morbidity data are used more generally to study trends and differentials in all kinds of causes of death and illness. The availability of mortality and morbidity statistics for small geographic units has contributed uniquely to the value of these data for epidemiologic investigations, surveillance, and informatics.

List and explain at least three of the five major challenges posed by current methods of collecting morbidity data with respect to data accuracy and data reliability.

Why it is important for those collecting morbidity data to be able to ensure confidentiality for respondents, and list the legislative and administrative requirements imposed on the National Center for Health Statistics (NCHS) with respect to data confidentiality.

Morbidity and mortality statistical reporting come from, in part, coded medical data transmitted through electronic data interchange (EDI) from Health Information Management Systems (HIMS) to PHIS. These data have all been standardized under HIPAA. Explain what it means to use coded data in data collections from the HIMS and/or PHIS

Submission Details:

Write your response in a minimum of 300–400 words, providing relevant references. Apply APA standards to citation of sources. Respond to at least two students’ postings.

By the due date assigned, respond to the assigned discussion question and submit your responses to the appropriate topic in this Discussion Area.

Extra read material:

Public Health Data Collection Methods

There are numerous public health morbidity and mortality data streams. Physicians’ offices and medical facilities are primary sources of disease data. Morbidity data are also derived from public health surveillance and other scientific research. You may read more about the public health monitoring tools for multiple data streams at:

Public Health Monitoring Tools for Multiple Data Streams

A majority of the collected data comes from the diagnostic and procedurally coded data billed to Medicare, Medicaid, and insurance companies through direct data linkages with the CDC’s NCHS. The coded claims data are uploaded from the many sources into the many PHIS. This includes diagnostic data in the form of the ICD codes, procedural data in the form of ICD and Current Procedure Terminology (CPT).

Also collected and uploaded into the PHIS are demographic and socioeconomic data. The diagnostic and procedural data may be abstracted from the various PHIS data warehouse interfaces by external report writers. External report writers include the CDC’s WONDER database and report writer. You may read more about WONDER opens in new window .

To show the complexity of the PHIS, consider the Healthy People initiative, which monitors 42 health topics, double the number of health topics in Healthy People 2010. Within the Healthy People 2020 database, there are 1,413 specific health indicators under 42 topics. To collect this information requires 336 unique data sources ranging from surveys, ongoing research, and medical administrative data. Within this complex system, public health officials must maintain complete confidentiality, privacy, and security of this sensitive PHI.

You may explore the topics and objective covered by Healthy People 2020 at: 2020 Topics & Objectives – Objectives A–Z opens in new window

Burkom, H. S., Murphy, S., Coberly, J., & Hurt-Mullen, K. (2005). Public health monitoring tools for multiple data streams opens in new window.

Mortality Reporting and Disease Distribution

Reporting morbidity (disease) and mortality (death) is heavily linked to the distribution of disease. So, when informaticians report disease distribution, they must consider the disease frequencies and geographies, as well as the Epidemiologic Triad of Disease from both the epidemiological and the actual disease perspectives. There are two triads in disease distribution:

Epidemiologic Triad

Disease Perspective Triad

The Epidemiologic Triad is composed of essential characteristics important in reporting the descriptive components of disease: person, place, and time.

The graphic represents the Epidemiologic Triad.

Person: It includes age, gender, socio-economic status (education, occupation, income), marital status, ethnicity/race/genetic profiles, and behavior or habits.

Place: It includes where, i.e., a geographically restricted outbreak, or a widespread epidemic, or pandemic. Other factors of place may include temperature, humidity, mainland or offshore, urban or rural, or disease related to water, food, or air supply.

Time: It may be stable or changing, or even a point in time. It may be propagated, seasonal, secular, or combinations. Time may show the disease as clustered (epidemic) or evenly distributed (endemic).

Please continue the lecture by reading the supplemental material titled” Disease Perspective Triad”