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.
1 in 5 nursing homes pull consistently bad ratings
USA Today’s Jack Gillum crunched the numbers and found that one-fifth of U.S. nursing homes have received two consecutive poor (one- or two-star) ratings in the federal Nursing Home Compare database since its launch in 2008.
Gillum looked for homes that started with a poor rating, then received at least one more within the past year. Among other things, Gillum found that “Nearly all homes that repeatedly received few overall stars — one or two stars — were owned by for-profit corporations,” and that “the lowest-rated homes had an average of 14 deficiencies per facility.” Consistent poor-performers can be found in all 50 states.
Gillum found that one of the reasons homes weren’t improving from year to year is that they’re often given little incentive to improve their ratings unless consumers are actively using Nursing Home Compare to inform their decisions.
Medicare spokeswoman Mary Kahn says a one-star nursing home is not necessarily a terrible facility. Even the lowest-rated homes must still meet baseline Medicare conditions, she says.
…
“If homes are not motivated to get better, chances are they won’t, and you’ll wind up in homes in poor-quality purgatory,” (Larry Minnix, CEO of American Association of Homes and Services for the Aging) says. “There should be two types of homes: the excellent and the non-existent.”
Slim guide:
Covering the Health of Local Nursing Homes
Check out AHCJ’s latest volume in its ongoing Slim Guide series. This reporting guide gives a head start to journalists who want to pursue stories about one of the most vulnerable populations – nursing home residents. It offers advice about Web sites, datasets, research and other resources. After reading this book, journalists can have more confidence in deciphering nursing home inspection reports, interviewing advocacy groups on all sides of an issue, locating key data, and more. The book includes story examples and ideas.
AHCJ publishes these reporting guides, with the support of the Robert Wood Johnson Foundation, to help journalists understand and accurately report on specific subjects.
Other resources
- Aging Nation: Troublesome Health Care Issues
- Headlines an advocate for seniors would like to see
- The impact of aging upon health care
- Covering nursing homes and other issues of aging
- How will retiring boomers affect the national health agenda?
- You Can Run, but You Can’t Hide: Policy and Problems in Long-Term Care
- Biology of Aging: Sources and Resources
Airport dining proves to be a food safety challenge
Filed under: Hot Health Headline, Public health, Public records
USA Today’s Alison Young reviewed inspection reports for hundreds of restaurants at 10 airports and found a large number of critical violations, including 42 percent of the restaurants reviewed at Seattle-Tacoma and 77 percent of restaurants reviewed at Reagan National Airport.
The most common culprits? “Grab-and-go” sandwiches and related foods, which aren’t kept cold enough to ward off food-borne pathogens.
Young notes that it’s hard to pinpoint the number sickened by airport sandwiches, as it’s difficult to track foodborne illness back to a specific source even when the customers aren’t constantly boarding airplanes and taking off for all corners of the earth.
Scott Hensley, on NPR’s Shots blog, recently noted an FDA warning to a Denver kitchen that prepared thousands of meals a day for airlines:
We can sum up the findings in the LSG SkyChefs facility a few months back with a four-letter abbreviation used to describe the roaches and other insects found there: TNTC.
That stands for Too Numerous To Count.
Hensley runs down some of the other problems found there and a reaction from the company spokeswoman.
AHCJ resources
Lifting the shroud: Using multiple-cause-of-death data
Fatal Food: A study of illness outbreaks
Recent news
Loophole allows E. coli-tainted meat to be sold
Meat, dairy products transported in unsafe temperatures, overlooked by inspectors
Airlines delay testing of onboard water
Salmonella outbreak: A selection of recent stories
N.Y. school districts not meeting federal guidelines on cafeteria inspections
Private companies, not the FDA, increasingly perform food safety inspections
Web sites
Center for Infectious Disease Research & Policy
Outbreak Alert! Database
Young to report on health for USA Today
AHCJ member Alison Young has gone from The Atlanta Journal-Constitution, where she has been writing an investigative column, to USA Today, Matt Dornic reports on MediaBistro.com. 
Young, who previously covered the Centers for Disease Control and Prevention, will cover health on the paper’s national desk.
Young also is president of the Investigative Reporters and Editors’ board of directors.
USA Today matches hospital quality data, tourism
Filed under: Health data, Health journalism, Hot Health Headline
USA Today’s Steve Sternberg and Jack Gillum put a new spin on federal Hospital Compare ratings and other hospital quality data, matching the ratings, as well as data on death rates, with popular travel destinations and the locations of state parks. The reporters make the case that travelers should keep hospital quality data in mind when planning vacations.
From the story, which also includes a list of poorly-rated hospitals in travel hotspots:
A USA Today analysis finds two dozen hospitals near popular travel destinations, as compiled by the National Travel Monitor, have death rates among the worst in the USA. A separate analysis shows that one of every four hospitals with high death rates for heart attack, heart failure or pneumonia — 94 of 402 — are near state parks.
Related
AHCJ Vice President Charles Ornstein, whose own hospital quality coverage has earned national recognition, recently updated his comprehensive “Road map for covering your local hospital’s quality” tip sheet with links to state-by-state resources and additional nationwide tools for journalists looking into hospital quality.
AHCJ article: Making sense of hospital quality reports
Book: Covering the Quality of Health Care: A Resource Guide for Journalists
Slim guide: Covering Hospitals: Using Tools on the Web
Free online training
On the Beat: Covering Hospitals: An innovative simulation guides you through the sources and resources you need to tackle the beat. You’ll tap into the same tools that you’ll use on the job, and you’ll have a virtual mentor to walk you through the maze of reports, statistics and sources. One story line teaches you about reporting on hospital quality
Data
Investigating hospitals: Find stories with ready-to-use Hospital Compare data: AHCJ has made it easier for journalists to compare hospitals in their regions by generating spreadsheet files from the HHS database, allowing members to compare more than a few hospitals at a time, using spreadsheet or database software. AHCJ provides key documentation and explanatory material to help you understand the data possibilities and limits.
Tip sheets
- How to cover your local hospital - Overview of many organizations that offer hospital quality ratings
- Sorting out hospital rankings
- Intro to investigating health data using spreadsheets
- Computer-assisted reporting basics: Investigating health data using spreadsheets
Reports
- Study: Hospital quality comparisons are inconsistent
- Performance data may not affect patient decisions
- GAO report on reliability of hospital quality data reported to CMS
- 2007 state quality data available
- Hospital quality resources by state
Hot Health Headlines
- Rating Hospital Heart Care
- Government releases new hospital death rates
- Mortality data and its use in quality improvement efforts
- Surgery death rates going public in U.K.
- Ranking Hospitals on Bang for the Buck
Pentagon: War takes toll on soldiers’ children too
USA Today’s Gregg Zoroya reports the results of a Pentagon survey of more than 13,000 active-duty soldiers and their spouses intended to gauge the effect of the ongoing wars in Iraq and Afghanistan upon their children.
Among the survey’s findings:
- Six in 10 say children’s fear and anxiety increase when a parent goes to war
- A majority say their children have coped well, but a quarter say they have coped poorly or very poorly
- A third say their child’s grades and behavior in school have suffered
Zoroya also reports on all the measures the military has taken to help parents cope, including family counselors, Sesame Street kits and graphic novels.
Lack of oversight contributes to Army suicides
Filed under: Government, Hot Health Headline, Studies
The Army reported that 143 active duty soldiers killed themselves in the last year, the highest number since the statistics started being kept in 1980. This year’s numbers are on track to break that unfortunate record. Gregg Zoroya of USA Today reports that an Army investigator blames at least part of this rise to a lack of day-to-day oversight by commanders accustomed to leading amidst the intensity of the battlefield rather than the less-obvious perils of the barracks.
The investigator’s solution is simple: commanders need to interact with their troops more, to keep in touch and keep their eyes out for risk factors.
Zoroya also noted another contributing factor to the climbing suicide rate:
Along with soldiers who engage in risky behaviors, McGuire says, the Army has a greater number of troops who entered the service with pre-existing anxiety or depression or who have stopped taking their behavioral medication in order to meet entrance requirements.
Soldiers concerned they may be at risk can try this online mental health self-assessment designed specifically for members of the armed services.
Study advocates evidence-based medical guidelines
In USA Today, Steve Sternberg covers a study which found that guidelines used to treat cardiac patients are often not based on conclusive research.
“There’s no doubt in my mind that the use of evidence-based medicine has improved patient care,” says Sidney Smith of the University of North Carolina-Chapel Hill, an author of the study and an expert on medical guidelines. “The trouble is, we need more evidence.”
The study’s authors, Sternberg said, advocate a strong scientific basis for every health-care decision. The American Heart Association, he reports, is starting a “Get with the Guidelines” program to encourage evidence-based treatment.
“Doctors say the study highlights a disturbing lack of scientific evidence underlying complex treatment questions, including how much aspirin to prescribe for heart attack prevention, how best to treat heart valve disease and when to choose angioplasty over bypass surgery.
Research shows that patients do best when doctors follow guidelines based on scientific evidence. This push for evidence-based medicine has come to define a new era in medical care, one in which doctors and hospitals are judged on their performance — and their grade depends partly on how true they are to medical guidelines.”
Related
-
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
