A SIMPLE METHOD FOR

ANALYZING AND PRESENTING

HEALTH DATA
Charles J. Vukotich, Jr.
cvukotich@achd.net

http://info.co.allegheny.pa.us/services/achd/
• This lecture is one of series produced by the
Allegheny County Health Department (PA),
Bethlehem Health Bureau (PA) and the City
of Elizabeth Department of Health &
Human Services (NJ).

• The organizers of this project are scholars

in the Northeast Regional Public Health
Leadership Institute, Class of 2000. For
information contact: dcw01@health.state.ny
.us
• Charles J. “Chuck” Vukotich, Jr.
– Assistant Deputy Director
– 25 years in public health in a variety of
management Roles
– Carnegie Mellon University
• BS, Chemistry
• MS, Public Management and Policy, H.
John Heinz School of Public Management
and Policy
• Member of Tau Beta Pi, and Phi Kappa Phi
• Chuck Vukotich has spent many years of
his professional career applying
management tools to public health. He
developed the first program plans for the
Allegheny County Health Department. He
has worked in improving budgeting and
fiscal forecasting. He has led the
reorganization of several programs, and
participated in department wide
reorganization. He is presently working on
planning, including the applications of
MAPP, benchmarks and indicators.
 LEARNING OBJECTIVES
• To understand the importance of data for
planning and decision making.
• To understand the concept of racial and
ethic disparities.
• To understand basic concepts of data
presentation.
• To understand the basic concept of fitting a
straight line to data.
PERFORMANCE OBJECTIVES
• Know how to calculate an average.
• Know how to do a linear regression using
EXCEL.
• Know how to create a graph in EXCEL.
• Know how to determine if a racial disparity
exists.
• Know how to calculate rate of change.
 Data is Important
• Decision making, strategic Planning and
program design should be data driven.
• Data must be communicated in a way that is
understandable by all, especially members
of the community.
• This is one way to present health data using
readily available tools, basic analysis and
simple presentation.
 Look at 5 Years of Data
• A change in one year usually doesn’t mean
anything.
• Collect the 5 most current years of data and
look at this.
• Use age adjusted data, where available.
• Use rates when possible.
Has this Disease Increased or
Decreased Over 5 Years ?
16

14
Age Adjusted Rate

12

10

White
8
Black

6 Total

4
1994 1995 1996 1997 1998
Year
 Method
Health/Disease Indicators
Rate of
16
Positive rate of Change
change indicates 3.3
14
that these lines are 2.9
all increasing 6.9
Age Adjusted Rate

12

10

White
8
Black

6 Total

4
1994 1995 1996 1997 1998
Year
Regression Analysis –EXCEL Screen

Add numbers and

divide by 5, it’s
just the average.
 Regression Output
SUMMARY OUTPUT

Regression Statistics This tells how good the data fits a

Multiple R 0.884566
R Square 0.782457 straight line; think of this as a
Adjusted R Square
0.709943
Standard Error
1.299615
percent, 100% is perfect; 78% is
Observations 5 good.
ANOVA
df SS MS F Significance F
Regression 1 18.225 18.225 10.79041 0.046256
Residual 3 5.067 1.689
Total 4 23.292

Coefficients
Standard Error t Stat P-value Lower 95%Upper 95%Lower 95.0%
Upper 95.0%
Intercept 2721.14 820.3052 3.317229 0.045147 110.5603 5331.72 110.5603 5331.72
X Variable 1 -1.35 0.410974 -3.28488 0.046256 -2.65791 -0.04209 -2.65791 -0.04209

The X Variable Coefficient.

 RATE OF CHANGE

RATE OF X Variable Coefficient

CHANGE = 5 Year Average
This Rate of Change is the annual percentage
increase or decrease of the disease or condition.
A negative rate of change means that the disease
is decreasing; a positive rate means that it is
increasing.
 Plot the Data
• People like to see the data plotted out.
• It gives them a ‘feel’ for the data.
• It makes them comfortable.
• It’s easy to do using Excel.
• See screen print on next slide.
Colorectal Cancer
black
EXCEL Screen
1994 30.5
Colorectal Cancer
1995 26.3
1996 26
35
1997 26
1998 23.9
5 Year Mean 26.54 30

25
Linear rate -5.09%
change
20

HP2010 13.9
15
predicted 2010 7.64
value
10

0
1994 1995 1996 1997 1998
 Determine Disparities
• You can determine racial/ethnic disparities by
comparing the 5 year averages between groups.

(Racial/Ethnic Group Average - Overall Average)

Disparity = Overall Average

• There may be many reasons for disparities, but a

gap of 30% or greater indicates that the gap is real,
and not just from random forces.
• A DISPARITY MAY NOT EXIST.
 Can We Meet the 2010 Goal?
• We can project using regression analysis
data
Projected Intercept Coefficient +
2010 Value = (X Variable Coefficient x 2,010)
Example:
7.64 = 2,721.14 + (-1.35 x 2,010)
 Can We Meet the 2010 Goal?
• HP 2010 Goal for Colorectal Cancer is 13.9
deaths per 100,000
• Projected Value is 7.64 deaths per 100,000
• Assumes that current trend will continue.
• Projection may not be statistically valid.
• BUT, it’s a good “what-if” for strategic
purposes, but just don’t take it too seriously.
 PUT IT ALL TOGETHER
Co lo re c tal Canc e r Ag e Adjus te d De ath Rate s fo r Co lo re c tal Canc e r
(Pe r 100,000 po pulatio n)
1994 1995 1996 1997 1008 5 ye ar Rate o f
Ave rag e Chang e
To tal 21.8 23.1 22.0 19.0 18.1 20.8 -5.5
White 21.1 22.8 21.7 18.2 17.8 20.3 -5.5
Blac k 30.5 26.3 26.0 26.0 23.9 26.5 -5.1
HP 2010 Go al: 13.9 NOT MET
Ove rall g o al will be me t at c urre nt tre nd.
Rac ial Dis parity: Ye s , Blac k, Ris k 31% g re ate r

35

White
Black
30
Age Adjusted Rate

TOTAL

25

20

15
1994 1995 1996 1997 1998
Year
 PUT IT ALL TOGETHER
CAUSE OF DEATH
CAUSE OF DEATH Goal Met Currently? Goal Met in 2010? Disparity?
Heart Disease No Yes, but not Blacks Black: 18%
Stroke No Yes, overall Black: 27%
Lung Cancer No No Black: 30%
Breast Cancer Yes, but not Blacks Yes, but not Blacks Black: 20% Trend Increasing.
Colorectal Cancer No Yes, overall Black: 31%
“Goal” is Healthy People 2010 Goal.