Reporters use county rankings for analysis
Filed under: Health data, Public health, Public records, Studies, Tools
On Feb. 17, rankings of the relative health of counties in each American state were released by the Robert Wood Johnson Foundation and the University of Wisconsin. The rankings used data from 13 distinct (mostly federal) sources, including the National Center for Health Statistics, the Census Bureau and the Dartmouth Atlas. With that data, researchers computed eight separate composite scores, which were then weighted to produce one overall score. The ratings are navigated by clicking through a national map to the state and county level. Enough clicks will even bring you to the raw data itself. The state only compares counties, not states, because data collection varies from state to state and isn’t always standardized.
It’s a combination of data, analysis and an intuitive interface, and journalists have been quick to localize the story. Many reporters reached beyond the easy numbers (”our county is 67th!”) to use the system for deeper stories.
For example, Robin Erb of the Detroit Free Press dissected the ratings process and how individual factors and disparities played into them before launching into the standard state breakdown.
Writing for Health News Florida, David Gulliver took a broader state view and considered how various socioeconomic factors played into the rankings of Florida counties. Gulliver’s analysis:
The strong-performing coastal counties, like Collier, St. John’s Sarasota, Charlotte, Palm Beach and Broward, all benefit from having heavy concentrations of retirees who have guaranteed health care access via Medicare. …
[Dr. Kevin Sherin, director of public health for Orange County] said that in Florida’s tourism and service industries, workers tend to be transient and less likely to have insurance or consistent primary care.
He noted the low-ranked counties were some of the poorest in Florida, like Union and Bradford in the rural north, and Glades and Okeechobee, with heavy populations of migrant workers. Those counties also tend to have more people who speak only Spanish, Creole or other languages.
Gulliver localized the story on a county level for his Sarasota Health News site.
In USA Today, Mary Brophy Marcus took the national view and looked for broad trends and generalizations. Marcus’ story was accompanied by a map by Frank Pompa highlighting each state’s healthiest and least healthy counties.
Survey: Nation lacking in epidemiologists
Nearly 1,500 more epidemiologists are needed nationwide to sufficiently carry out public health duties, according to a survey of state epidemiologists earlier this year.
The Council of State and Territorial Epidemiologists has released its 2009 Epidemiology Capacity Assessment (PDF), intended to report on the “epidemiology capacity of state and territorial health departments in the United States, structured around the Ten Essential Services of Public Health” in eight areas: bioterrorism/emergency response, chronic diseases, environmental health, infectious diseases, injury, maternal and child health, occupational health, and oral health.
The analysis found that there are fewer epidemiologists resulting in a reduced capacity for surveillance and epidemiology – especially in the areas of bioterrorism and emergency response. It also reveals that a number of states lack the ability to perform several of the essential services of public health, that states are lacking in the technology to conduct surveillance and that many epidemiologists with high levels of training are leaving the public health sector.
The assessment is based on an online survey filled out by state epidemiologists or their delegates between April and July of 2009.
The 122-page report includes recommendations and an in-depth examination of the workforces, the functions that are in jeopardy, the funding sources for state health departments and more.
The CSTE Web site also has a handy directory of state epidemiologists that includes e-mail addresses.
Overwhelmed sewage systems spread pathogens
Thousands of sewage systems around the country have been overwhelmed and dumped “human waste, chemicals and other hazardous materials into rivers and lakes and elsewhere,” according to Charles Duhigg in the latest installment of The New York Times series, “Toxic Waters.”
Despite more than $60 billion distributed to cities to upgrade sewer systems in the 1970s and 1980s, the Times‘ analysis of data from the Environmental Protection Agency shows that – in the past three years – more than 9,400 of the nation’s 25,000 sewage systems have violated the Clean Water Act of 1972. Fewer than one in five were fined or penalized.
Duhigg cites research that suggests as many as 20 million people a year get sick from water contaminated by bacteria and pathogens as well as a study showing that the number of children who visited one Milwaukee hospital with serious diarrhea rose when local sewers overflowed.
Related
- Paper’s investigation reveals contaminated drinking water
- Reporter finds efforts to monitor groundwater contamination leave much to be desired
The anonymous folks who test swabs for H1N1
The Baltimore Sun’s Stephanie Desmon profiled the crew of state workers laboring behind the scenes to test and identify samples of H1N1 and other strains of influenza.
Maryland is one of a dozen states testing to make sure the virus hasn’t mutated and become drug resistant. It’s labs such as these that will be the first to sound the alarm when H1N1 has returned with a vengeance, Desmon writes, and the data they forward to the CDC is crucial in the fight against flu.
Dr. Robert A Myers, deputy director of the state public health laboratory, explained some of the lab’s testing processes, saying that “I try to dispel the ‘CSI’ fact that everything takes 15 minutes.”
Flu plan includes withholding ventilators
Filed under: Government, Health policy, Hot Health Headline
Sheri Fink, M.D., of ProPublica, is reporting that state and federal officials are drawing up guidelines on who would get ventilators should there be a severe flu outbreak, including “procedures under which patients who weren’t improving would be removed from life support with or without permission of their families.”
On Thursday morning, the Institute of Medicine is expected to release guidelines to help planners create standards of care in extreme emergencies, according to Fink.
Many of the draft guidelines, including those drawn up by the Veterans Health Administration, are based in part on a draft plan New York officials posted on a state web site two years ago and subsequently published in an academic journal. The New York protocol, which is still being finalized, also calls for hospitals to withhold ventilators from patients with serious chronic conditions such as kidney failure, cancers that have spread and have a poor prognosis, or “severe, irreversible neurological” conditions that are likely to be deadly.
Update
The IOM has released its report on “Standards of Care During Disaster Situations.”
EPA never tested playground material’s safety
Filed under: Government, Public health, Public records
Andrew Schneider reports on a investigation by the advocacy group Public Employees for Environmental Responsibility that found the EPA, in response to an Freedom of Information request, admitted that it “has not conducted research to evaluate children’s ‘health effects’ from tire crumb constituents,” despite their use in playgrounds and athletic fields across the country.
On his blog Cold Truth,
Schneider reports that “benzene, arsenic, cadmium, formaldehyde, lead, chromium and scores of other toxic material” is found in most waste rubber, and that long-term exposure could be harmful for children and athletes.
H1N1 will challenge public health policymakers
Filed under: Government, Health data, Health policy, Hot Health Headline
On his Cold Truth blog, Andrew Schneider questions some H1N1-related public health decisions while acknowledging the difficulties policymakers are bound to have with the fast-spreading strain of influenza. Schneider describes how the communities now coping with the some of the first large-scale H1N1 outbreaks of flu season have responded in wildly divergent ways, doing everything from canceling football games and quarantining students to allowing business to go on as usual despite what The Seattle Times said was the highest infection rate in the state.
Schneider’s point is that, given the stakes, there should probably be a standardized program for dealing with swine flu outbreaks: “If H1N1 truly poses the health risk that government experts say it does,” Schneider asks, “isn’t it time that the CDC and the public health community stop sending mixed messages and articulate a coherent, consistent policy for controlling the spread of the disease?”
Related
A consumer-oriented page in which the CDC answers common H1N1 questions
Schools gear up to offer H1N1 vaccinations
Libby Quaid and Lauran Neergaard of The Associated Press write about schools across the country that are gearing up for widespread vaccinations against swine flu.
An Associated Press review of swine flu planning suggests there are nearly 3 million students in districts where officials want to offer the vaccine once federal health officials begin shipping it in mid-October.
If swine flu vaccinations go forward - officials are awaiting study results - children will be among the first to be vaccinated. The secretary of the U.S. Department of Education has said the best place for vaccinations would be through schools and a poll found that parents agree.
A sidebar explains what schools need to do to set up vaccine-shot clinics, with advice from the National Association of County and City Health Officials.
Quaid and Neergaard run down the preparations in a number of cities throughout the country, something that reporters should be able to localize and report on in their own communities.
Glitch kept data out of Nursing Home Compare
Filed under: Government, Health data, Health journalism
Duane Schrag of the Salina (Kan.) Journal reports on problems he found in the data behind Nursing Home Compare, the federal government’s online tool to help guide consumers in judging the quality of nursing homes.
Schrag says that an area nursing home announced it was shutting down because it couldn’t comply with a state fire marshal’s requirement to replace its sprinkler system. But a check of the Nursing Home Compare data found no fire safety violations for the facility for 2007 or 2008, despite the fact that it had been cited for several fire code violations in both years.
When the Salina Journal pushed officials to explain why the deficiencies were not showing up, the Centers for Medicare & Medicaid Services discovered a software problem:
But a glitch in the software used by the federal government kept the reports from showing up in Nursing Home Compare. The software blocked more than 1,000 fire code violation reports involving Kansas nursing homes in 2006, a similar number in 2007 and almost 800 in the first six months of 2008.
Nationally, about 21,600 reports were blocked during that same period.
Officials at CMS say the software was fixed on July 23.
Schrag talked to nursing home administrators and found that most of them dispute the rankings that Nursing Home Compare assigns to them; the exception was a nursing home that had a five-star rating.
Pesticide clouds a risk for children in farming areas
The Los Angeles Times‘ Amy Littlefield reports on children, in this case in California’s San Joaquin Valley, who are sprayed with pesticide while waiting for school buses or on the buses.
There are laws and regulations in place to keep such incidents from happening but Littlefield’s opening anecdote is the third reported case in seven months. The three children were sprayed with a blend of liquid sulfur, gibberellic acid, insecticide and fertilizer.
“Children are almost like a different species in terms of how they metabolize,” said Nina Holland, the lead researcher of a UC Berkeley study that found children are more susceptible than adults to organophosphate pesticides. “We are talking about a very significant difference. We really need to look at protecting children.”
Two of the children in the latest incident say the tractor driver who was spraying the chemicals saw them but didn’t stop, a mental blow that one expert said is “as bad as the effects of the chemical or even worse.”
-
Health Journalism 2010, AHCJ's annual conference, features a world-class program with story ideas, sources, stronger reporting skills, chances to meet newsmakers and network with other journalists.
- Health and education: Covering these intersecting beats
- Reporting on the business of health care
- Health reporting resources for journalists on state and local government beats
- Shortened Lives: How location, lifestyle affect health
- Covering a complex story for the long haul
- Aging in the 21st Century: Presentations and tip sheets
- AHCJ calls for better information from Joint Commission Web site
