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Taking a closer look: New study examines health data at sub-county level

Written by April Houston, MSW, MPH, Communications Assistant, Institute for Public Health

Your zip code can mean more than your genetic code when it comes to your personal health. In the St. Louis area, that message was clearly articulated through the For the Sake of All project. Unfortunately, it is often not possible to see variations in population health indicators and outcomes beyond the county level.

A recent publication in the Journal of Public Health Management and Practice titled Measuring Subcounty Differences in Population Health Using Hospital and Census-Derived Data Sets: The Missouri ZIP Health Rankings Project is looking to change that by providing measures of population health at the subcounty level. Elna Nagasako, MD, PhD, MPH of the Washington University School of Medicine was lead author on the report, aided by Sarah Gehlert, PhD, MA, MSW of the Brown School and Siteman Cancer Center, Min Lian, MD, PhD, also of the School of Medicine, and Mat Reidhead and Brian Waterman from the Missouri Hospital Association. The researchers set out to learn if local-level primary data from hospitals, widely available in most areas, could supplement census data to provide a more thorough picture of population health and possible disparities among areas and neighborhoods within the same county.

Currently, County Health Rankings (CHR) collects county-level health data from more than twenty national data sources, making their findings available to public health experts and anyone else who might be interested in designing research studies, programs, or policies to address community health problems or health disparities. Dr. Nagasako received a CHR grant to fund this proof-of-concept study, and found that combining local census and hospital data was useful as a supplement to county-level data and can provide a more detailed picture of health factors and outcomes within communities in Missouri.

Subcounty variation in health factors and outcomes in rural Franklin County, Missouri

The research team consulted with an advisory board that included members working in different healthcare-related fields to ensure that the study’s approach had maximum utility to a variety of stakeholders. Board members included: Kevin Everett, PhD of University of Missouri Healthcare, Karley King, MPH, MBA of BJC HealthCare, Matthew Kuhlenbeck, MHA of Missouri Foundation for Health, Jon Mooney, MS of the Springfield-Greene County Health Department, and Leslie Porth, PhD, MPH of the Missouri Hospital Association. Dr. Gehlert served as the board chair.

According to Dr. Nagasako, the team wanted to make sure they were asking the right questions and serving needs in the community. “We wanted to know, for folks that are out there working on these types of problems, what kinds of things help you in your work? What kinds of things do you not see that would be useful?”

The team will continue to ask questions as they move on to the next step of their process – sharing the data they’ve generated. “Our future work will include making these results publicly available using an interactive platform, evaluating their use in meeting data needs of Missouri stakeholders, and evaluating performance of this method on successive years of data, as well as potentially in other states, and with the inclusion of additional data sources for domains not readily captured in hospital and census-derived data sets.”

For more details on this study, review the full publication online.