New life expectancy data can add context
to reporting on local health
A new data release today from the Institute for Health Metrics and Evaluation gives journalists some unique tools to help depict the health of a local population.
Emmanuela Gakidou, M.Sc., Ph.D., the director of education and training for IHME, told a Health Journalism 2010 audience that the institute was working on a project to show health information to the county level.
Just over a year later, the data allow the user to analyze life expectancy for every county in the United States and compare those numbers worldwide.
For example, the data could add context for a journalist following up on a tip from a speaker in an entirely different AHCJ event. In the recent Rural Health Journalism Workshop in St. Louis, Ellen Barnidge, Ph.D., M.P.H., of St. Louis University, discussed efforts in Missouri’s high-poverty Pemiscot County. A quick filter of the spreadsheet data shows men in that county share the same life expectancy – 68.5 – with Mauritius and Indonesia.
The data go back to 1987, allowing a journalist to look at changes over time as well for more than 3,000 counties.
Project researchers found that, while people in Japan, Canada and other nations are enjoying significant gains in life expectancy every year, most counties within the United States are falling behind.
The researchers, in collaboration with researchers at Imperial College London, found that between 2000 and 2007, more than 80 percent of counties fell in standing against the average of the 10 nations with the best life expectancies in the world, known as the international frontier.
Women have been especially affected. More than 850 counties in the U.S. have seen life expectancy remain static or go backwards for women since 1997.
The data also offers a breakdown of life expectancy by selected race – black and white – for each county.
The institute is an independent global research center at the University of Washington providing sound measurement of population health and the factors that determine health, as well as rigorous evaluation of health system and health program performance.
Study offers context for reporting on health insurance exchanges
Filed under: Health care reform, Health journalism, Studies, Tools
The first tip sheet I wrote about covering health reform was pegged to the one-year mark of the Affordable Care Act. One topic I addressed was the creation of state-based health insurance exchanges, or marketplaces. I won’t rehash that here – here’s the link to the brief – but I do want to point out a useful resource that became available just a few days after we posted that first guide.
What questions do you have about health reform and how to cover it?
Joanne Kenen is AHCJ’s health reform topic leader. She is writing blog posts, tip sheets, articles and gathering resources to help our members cover the complex implementation of health reform. If you have questions or suggestions for future resources on the topic, please send them to joanne@healthjournalism.org.
It’s an in-depth look at the two states that already do have exchanges – Utah and Massachusetts. Those states help illustrate the decisions, both practical and ideological, legislators and governors must make as to how active the exchange is going to be in shaping the local insurance market and the consumer experience.
Those exchanges are of course dramatically different – Massachusetts covers a couple of hundred thousand people, and Utah covers a couple of thousand. Massachusetts was the inspiration in many ways for the national health reform, while Utah is the model for states that want to do a lot less and rely a lot more on the free market. But the study by experts at the Georgetown University Health Policy Institute and the Center for Children and Families also found those two state exchanges also had a lot more overlap than is widely assumed.
For those of you who are writing your first story on exchanges, this report isn’t the place to start. For help with the basics, check out ideas from Sarah Kliff, a Politico health care reporter, and some background from Noam Levey, health policy reporter for the Los Angeles Times. And the Alliance for Health Reform had an event last year that explained the basics (this link includes a webcast, transcript and lots of other resources to help you get started.)
For those reporters who have been tracking the state debate over the size, shape and structure of the exchange, or following the initial phases of implementing the exchange, the Georgetown study should help provide some context for concepts that you may have heard of like “active purchaser” (an exchange that can be more discriminating about which insurers get to sell policies in the exchange and which don’t versus an “open market” (open to any health plan that wants to play.) Here’s a taste:
To many, the Massachusetts and Utah exchanges represent opposite points on a continuum of what exchanges can provide for consumers and small businesses. Yet the stereotype of Massachusetts’ exchange as an “active purchaser” and the Utah Exchange as the open market model is, in the words of one observer, “a false stereotype … perpetuated by … a media that likes simple contrasts.”
So be part of a media that goes beyond simplistic contrasts … dig in.
Covering Health Issues 6.0, coming soon to a mailbox near you*
Filed under: Health care reform, Health journalism, Member news, Tools
*Assuming you’re an AHCJ member. If you aren’t a member, then keep in mind that a free copy of each revision of the sourcebook is one of many perks you’ll gain by joining.
Thanks to a grant from the Robert Wood Johnson Foundation, the Alliance for Health Reform has released the sixth edition of its “Covering Health Issues” sourcebook. Since the fifth edition, released in 2009, editors have added loads of new content, particularly in areas related to the 2010 Affordable Care Act. The free online edition also comes with links to local stories that exemplify sourcebook-inspired reporting. If you can’t wait for your hard copy to arrive, you can also get the full book in PDF format.
As always, the book promises “fast facts, background, tips for reporters, story ideas and experts with contact information,” as well as “an extensive glossary, ideas and examples for TV and radio reporters, and links to polls on health issues.”
For tips on how to take advantage of this resource, scope out this video, presented by AHCJ member and NPR health reporter Julie Rovner.
Interactive models make anatomy accessible
The body imaging folks over at GE Healthymagination have teamed with Healthline networks to put together Healthline BodyMaps, a user-friendly human body navigation tool. It allows users to view a model of a male or female body in three dimensions and numerous layers (think “muscles” or “circulatory system”), and to identify specific body parts and relevant information.
This new toy isn’t as robust as Google body, a product the search behemoth rolled out late last year, but it is somewhat more accessible. Unlike Google’s product, which is fully 3D modeled using the emergent WebGL standard which calls for the latest versions of Chrome or Firefox, while BodyMaps uses Adobe’s almost-omnipresent Flash player. Its models are more limited, but also easier to navigate.
Both tools can be used to identify and link to specific body parts, which will come in handy when adding context to certain stories, but neither are embeddable enough to provide in-story illustration.
(Hat tip to ReadWriteWeb’s Curt Hopkins)
Human female musculature on Healthline BodyMaps
Human female musculature on Google bodySpreadsheet lists malpractice claims against VA
In its “FOIA Friday” feature, the Project On Government Oversight reveals a spreadsheet (XLS format) of claims against the Department of Veterans Affairs, including thousands related to medical malpractice.
The spreadsheet lists administrative claims, the first step in the VA’s process for filing claims.
Nick Schwellenbach explains more about the data:
The data provided has details on over 12,000 claims against the VA from 1989 to November 2008, although the data appears largely incomplete for the first several years. Not all of the claims are medical malpractice-related, but several thousand are. There are fields for the VA facility involved, the date the claim was received, the date of the last tort status (where the claim is in the administrative process), the date of that status, alleged negligence descriptions (none exist for non-medical malpractice tort cases), and amount paid out, if any. The spreadsheet is over two years old, so the latest tort status field may be out-of-date for many of these claims.
The spreadsheet includes 16 cases in which more than $1 million was paid out. The descriptions of the allegations are pretty vague but those 16 cases include:
- Failure To Obtain Consent or /Lack Of Informed Consent; Improper Technique; Improper Performance; Improper Management; Delay In Diagnosis; Failure To Treat; Failure To Order Appropriate Medication; Failure To Monitor; Failure To Diagnose (i.e., Concluding That Patient Has No Disease or Condit[ion)]
- Failure To Respond To Patient
- Surgical or Other Foreign Body Retained
- Unnecessary Procedure; Intubation Problem; Improperly Performed Test; Improper Management
It’s worth noting that another recent “FOIA Friday” also was related to health. It was a letter sent by the National Institutes of Health to Emory University “after the media exposed Dr. Zachary Stowe’s cozy financial relationship with GlaxoSmithKline (GSK) while also receiving NIH grants to study antidepressants like GSK’s Paxil in pregnant women.”
Berwick debuts website featuring health data
Filed under: Government, Health care reform, Health data, Health journalism, Health policy, Member news, Public health, Studies, Tools
By Susan Jaffe, Independent Journalist
From Health Journalism 2011
Journalists have a key role to play making health care safer and informing the public, Medicare chief Donald Berwick told reporters attending the annual conference of the Association of Health Care Journalists in Philadelphia on Thursday.
Donald Berwick
To help them do their job, Berwick unveiled a government website, the “Health Indicators Warehouse,” and offered a live demonstration. He said the site offers “a treasure trove of data,” including information never released before in an easily accessible form, including patient safety data, preventive health care indicators, Medicare payment claims and hospital performance at the state and hospital referral region level. Information is searchable by topic, location, health outcomes among other factors.
After highlighting well-publicized features of the Affordable Care Act, Berwick explained how the law provides tools to reduce health care costs that can also improve the quality of care.
“The best way to make care more affordable and sustainable is to make care better,” he said. “Higher quality and lower cost go together.”
To reduce health care costs, he promised continued scrutiny of Medicare Advantage plans, the government-subsidized private health plans, noting that the health law rewards top-performing plans with bonus payments. The law creates accountable care organizations, in which health care providers coordinate patient care in various medical settings. The new Center for Medicare and Medicaid Innovation “can now nurture invention around the country… that have the effect of lowering cost and raising quality.”
Berwick criticized a Republican proposal to use state block grants to replace Medicaid, the state-federal partnership that provides health insurance to low-income families.
“They are untested, they are hazardous,” he said, and could short change states during an emergency. “What happens if we issue a block grant to a state and then there’s a flu outbreak or the recession comes back? Well, you’re on your own.”
During the question and answer period, reporter Jodie Jackson of the Columbia (Mo.) Daily Tribune, had a query related to his reporting that showed a lack of communication about inspection findings between CMS, the FDA and The Joint Commission. After hearing about Jackson’s findings, Berwick said he wanted to read that series of articles.
Berwick spoke for about 90 minutes, without a prepared text, and chatted with individual reporters for another half-hour. It was his second appearance at an AHCJ conference; in 2005, he was key-note speaker when he headed the Institute for Healthcare Improvement, a nonprofit organization dedicated to improving patient care and safety. Unlike his first visit, Berwick did not stay and join AHCJ members in watching a basketball game.
CMS releases hospital-by-hospital data on never events
Filed under: Health data, Health journalism, Hot Health Headline, Public records, Studies, Tools
About nine months after its original due date, the Centers for Medicare and Medicaid Services have overcome industry opposition and made data for hospital acquired conditions publicly available online. The data come in a 1.2 MB zip file, inside of which you’ll find a hulking 26,889-line spreadsheet.
The sheet breaks down the nation’s 4,700 or so hospitals, using Medicare fee-for-service claims from October 2008 through June 2010, based on the rates of eight different “never events,” each of which is compared with the national rate for the event in question. The hospitals can be sorted by name and state. Below, I’ve illustrated the national rates for all included HACs.
According to MedPage Today’s Emily Walker, CMS published the data to help patients make informed decisions and to help hospitals improve their quality of care. They did so, she points out, over strenuous industry objections.
The data was originally scheduled to be published in September 2010 but was met with strong resistance from hospital groups such as the American Hospital Association (AHA); the groups say that CMS never made specifics available for how it calculates the HAC rates, making “fundamental assessments of the accuracy of capturing the incidence of these conditions” impossible to conduct.
“Hospitals continue to urge CMS not to publish these data,” read a March 31 joint statement from the AHA, the Federation of American Hospitals and the Association of American Medical Colleges.
Institute launches global health data clearinghouse
Filed under: Health data, Health journalism, Public records, Tools
Last month, the University of Washington’s Institute for Health Metrics and Evaluation (about) launched the Global Health Data Exchange (or GHDx), a sort of clearinghouse for global public health data sets. At launch, the site boasted about 1,000 data sets and promised it will index and host “information about microdata, aggregated data, and research results with a focus on health-related and demographic datasets.”
The data is accompanied by visualization and GIS tools. For updates on the site, add the GHDx blog to your RSS. And, if you’re looking for a more direct connection, you can plug right into the RSS of new databases.
At present, the data is global in nature, though there are still plenty of domestic and comparative sets that will be of use to just about any U.S. reporter. Many of them will be familiar to data-heads, but it’s still handy to have it all in one place. The site will point directly to data providers when possible, and will work to provide public data for direct download. Free site registration is required before downloading.
Survey: Only half of federal agencies have better FOI procedures
Filed under: Government, Health data, Health journalism, Public records, Tools
A report from the Knight Open Government Survey found that, despite some progress, federal agencies are only halfway there when it comes to delivering on the president’s day-one promise to improve FOIA procedures and openness across the board.
There is some cause for optimism there, as last year that number was about 14 percent. For the curious, Knight also provided a full PDF of how the 90 different agencies in the survey stacked up.
But before I highlight a few health-related entries, I can’t resist pointing out the survey’s methodology section, which will help explain how the results are organized.
The 2011 Knight Open Government Survey team filed FOIA requests with the 90 federal agencies that have chief FOIA officers, asking for copies of concrete changes in their FOIA regulations, manuals, training materials, or processing guidance as a result of the “Day One” Obama memorandum, and the March 2010 White House memorandum from then-Chief of Staff Rahm Emanuel and White House Counsel Bob Bauer. The Emanuel-Bauer memo told agencies to 1) update all FOIA material, and 2) assess whether FOIA resources were adequate.
The key takeaway then is that this is a measure of administrative regulation, and not one focused on responsiveness to actual FOIA requests beyond the one used to create each data point. With that in mind, here’s how our friends at health-related agencies stack up.
Concrete action on two steps
- DEPARTMENT OF HEALTH AND HUMAN SERVICES
- OCCUPATIONAL SAFETY & HEALTH REVIEW COMM.
- DEPARTMENT OF VETERANS AFFAIRS
Concrete action on one step
- OFFICE OF NATIONAL DRUG CONTROL POLICY
- DEFENSE NUCLEAR FACILITIES SAFETY BOARD
- FEDERAL MINE SAFETY & HEALTH REVIEW COMM.
- NATIONAL SCIENCE FOUNDATION
No final response to FOIA request
- COUNCIL ON ENVIRONMENTAL QUALITY
- PUBLIC HEALTH SERVICE
No acknowledgement of FOIA request
- CHEMICAL SAFETY & HAZARD INVESTIGATION BRD.
Freedom of Information Audits and Government Transparency from Knight Foundation on Vimeo.
Resource is a fact book on older Americans
The latest version of “Profile of Older Americans: 2010,” published by the HHS Administration on Aging is available.
AHCJ member Eileen Beal, an independent journalist based in Cleveland, recommends the resource as “a great little booklet of facts and data on older Americans: health, income status, marriage status, etc.” She says it is something that reporters interested in Medicare/Medicaid and senior health care issues will want to have.
AHCJ members: What resources have you come across that your fellow journalists will find useful? Let us know in the comments below.
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