Data & Metrics

June 28, 2018 - Data and Metrics

June 28, 2018 at 02:00 pm

San Diego Accountable Community for Health Data and Metrics Meeting Summary

Welcome and Introductions
Kitty Bailey initiated the meeting by reviewing the agenda; workgroup members introduced themselves. The summary of the April Workgroup meeting was reviewed and accepted, and will be posted to the SD ACH website.

SD ACH Workgroup Progress Update
Kitty provided an update on the activities and progress of the other SD ACH workgroups, noting that the recent meetings have primarily focused on the SD ACH Portfolio of Interventions (POI).

Cheryl Moder discussed the status of the POI survey, which has been finalized by the Collective Action Workgroup, and will soon be distributed to ACH partners. These recipients will be asked to send out the survey link to their constituents and partners. The survey will be open for two weeks, after which the results will be examined, and prioritization of programs for inclusion in the POI will take place.

Cheryl shared the data-related survey questions, and Kitty emphasized that individuals taking the time to complete the survey will be in effect signaling a readiness to consider data sharing and adoption of shared measures for assessing health equity. The survey also facilitates greater understanding of existing programs. From the point of view of the ACH theory of change, this knowledge of programs can be used to strategically align programs and achieve a mutually reinforcing portfolio. Kitty informed the group that she has recently been in communication with a firm that has developed tools to assist in performing this alignment function. Cheryl noted that the survey will gather information on programs’ theories of change.

The Stewardship Group will review survey results, and findings will be discussed at the Stakeholder Group meeting planned for September 13.
Feedback from the May Stewardship Meeting was provided, including suggestions to explore Center for Medicare & Medicaid Services data, first responder/triage data, and to create a single document outlining challenges in availability of local data.

Priority Indicator Deep Dive: Nutrition
Alaina Dall provided an overview of existing measures for nutrition (one of the American Heart Association’s Simple 7 Measures for cardiac health) in order to allow the Workgroup to achieve resolution on which measures may be most appropriate as secondary measures to create a more complete picture of nutrition in San Diego County. The California Health Interview Survey’s (CHIS) questions regarding nutrition were used as a point of departure for this discussion. The Workgroup has previously expressed dissatisfaction with the measures available through CHIS, and up to this point has used its Fast Food measure for adults (the number of times in the past week the respondent ate fast food) and both this measure and the Fruits and Vegetables measure for youth and children.

Alaina reviewed the results of her in-depth research of data sources and indicators for nutrition, including data and reports used by organizations in San Diego County, and additional data more broadly related to nutrition. She outlined the data sources upon which recent reports produced locally for the San Diego region were drawn. This overview demonstrated how frequently these local organizations and reports draw upon CHIS data, and the challenges in discovering more compelling data sources and indicators.

Alaina provided current statistics for food security, food systems, and dietary behavior from a variety of sources. She provided data on the food insecurity rate in San Diego County, data from the Food Environment Atlas on low food access and children eligible for free/reduced lunch, and data from SANDAG about food deserts. Challenges of frequency of data collection and reporting exist with the United States Department of Agriculture’s (USDA) Food Environment Atlas. Additional sources mentioned to consider were the California Department of Education for school lunch information and the Supplemental Nutrition Assistance Program Education (SNAP-Ed).
Alaina presented food systems data including the Modified Retail Food Environment Index. The California Department of Health has recent data (2017), but challenges exist in extraction. Availability of farmers’ markets is an additional option. Members of the group suggested investigating whether Zillow or Redfin might have suitable data.

Alaina provided current data on the consumption of fruit, vegetables and sugary sodas from the Youth Risk Behavior Survey completed by 9th-12th graders in the San Diego Unified School District (which can be broken down by the five lenses of health equity). However, some Workgroup members indicated use of this data is less desirable, and also noted that it is only available for high school students.

The Workgroup discussed moving forward: which of the measures should be included on a “watch list” of secondary indicators to achieve a more comprehensive view of nutrition issues, or whether there exist other indicators the Workgroup should examine.

After an extensive discussion, the proposal to use the World Health Organization’s Three Pillars of Food Security (availability, utilization, and access) was accepted by the Workgroup as the next step forward.

Availability is a measure of healthy food availability (as measured by the Modified Retail Food Environment index, for example – the San Diego Promise Zone also uses this measure). Access indicates economic access, which may be measured using a CHIS composite for food security. Utilization indicates what foods are consumed; consumption of sugary beverages, fast food, and fruits and vegetables can be used to measure utilization. The group agreed to add consumption of sugary beverages to the secondary indicators using CHIS as the data source.

The Workgroup agreed that it would continue this effort, and work through a similar process to select measures for Wellbeing at the next meeting.

Partner Data Requests
Kitty reviewed potential data requests to be presented to SD ACH partners, and next steps for each.

San Diego Health Connect (SDHC) could be a possible data provider for Simple 7 and priority indicators, such as blood pressure, blood sugar and cholesterol, in 2019. This is based on a previous conversation with Dan Chavez, who was not in attendance at this meeting. Health systems vary in the amount of data provided to SDHC, and patients must have access to a healthcare provider, and not have opted out, in order to be included within the database. A data request to SDHC would require a high level of specificity, including data broken out by the five lenses, and should be constructed in a process including individuals with clinical expertise. Kitty proposed a small workgroup to formulate the data request. Once the specifications are decided, the SD ACH Stewardship Group will present a formal data request to the SDHC Board of Directors. The Data and Metrics Workgroup approved this plan.

Workgroup members will provide contacts for obtaining EMS data. Community Information Exchange (CIE) data will also be considered.

OSHPD data on emergency department visits, inpatient discharges, and deaths from strokes, coronary heart disease (CHD), and primary hypertension will be obtained from the County of San Diego Health and Human Services Agency. The Hospital Association of San Diego and Imperial Counties, and the San Diego State University Institute for Public Health may also assist with providing similar data.

Next Steps
The next Data and Metrics Workgroup Meeting will take place on July 26th. Members were also reminded of the upcoming ACH Community Stakeholder meeting on September 13th, 2018.

Date and Time

June 28, 2018 02:00 pm
June 28, 2018 04:00 pm

ACHs build on prior efforts to coordinate and integrate various organizations, programs and services by linking their activities together in a coherent and reinforcing portfolio of interventions across five key domains.