TABLE OF CONTENTS
|3. Indicator Category Descriptions|
IPLAN Data System provides access to essential public health data for assessment and planning purposes. The available data are collected from many different sources. Data are generally provided at the county level and, in some cases, at the community level. The system further identifies associated populations by age, race, ethnicity and gender for selected indicators.
Uses of the IPLAN Data System
The IPLAN Data System was designed initially to provide local health departments (LHDs) in Illinois with quick and easy access to data needed for community assessment and program planning. It may be used to support a variety of other activities as well, including--
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OVERVIEW OF THE IPLAN DATA SYSTEM
The IPLAN Data System provides easy access to selected public health indicators. Design features include --
Because detailed population estimates at sub-county level are not available for years after 1990, age-adjusted and age-specific rates are not available for many indicators. Crude events and events for ages 0-64 years are available.
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This section describes the seven categories of available indicators and lists the individual indicators within each category. The categories comprise nearly 100 individual indicators. For detailed indicator descriptions, click Indicator Descriptions.
Most indicators are available at the county level; fewer are available at the community level. Statistics for only some of the indicators at the county or community level can be grouped.
1.0 Demographic and Socioeconomic Characteristics
Understanding a population's age distribution, race and ethnic composition, and income characteristics is essential to identifying health needs and planning health programs. The demographic and socioeconomic indicators represent important population characteristics that can have related health attributes.
Thirteen specific indicators are included in the demographic and socioeconomic characteristics category:
1.01 Population by age and gender
1.02 Dependency indicators
1.03 Race/Ethnicity distribution
1.04 Median age
1.05 Non-high school graduates
1.06 High school drop-outs
1.08 Food stamps
1.09 Rural population
1.11 Medicaid enrollees
1.12 Single-parent household
1.13 Per capita personal income
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2.0 General Health and Access to Care Indicators
This section provides an overview of health status using
general measures of mortality, years of life lost and life
expectancy. The indicators in this section could be used, for
example, to analyze the problem of premature death in conjunction
with a detailed analysis of specific causes. General measures of
health care access included in this category also attempt to
quantify the availability and use of basic health services and
the presence of financial barriers to health care access.
Eleven specific indicators are included in the general health and access to care indicators category:
2.01 Mortality rates
2.02.01 Leading causes of mortality, ICD-9
2.02.02 Leading causes of mortality, ICD-10
2.03 Life expectancy at birth
2.04 Excess non-white deaths
2.05 Population uninsured
2.06.01 Cause-specific years of potential life lost, ICD-9
2.06.02 Cause-specific years of potential life lost, ICD-10
2.07 Percent population -- no physical past two years
2.08 Medicaid enrollees to medicaid physician vendors ratio
2.09 Advanced life support emergency care vehicles
2.10 Population residing in primary care health professional shortage area
2.11 Population with optimally fluoridated water
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3.0 Maternal and Child Health Indicators
The purpose of the maternal and child health indicators category is to provide an overview of the key components of maternal, infant and child health and the risk factors that contribute to ill health and poor outcomes. In addition to the infant mortality rate, these indicators include important measures of increased risk of death and disability, such as incidence of low birth weight, receipt of prenatal care, and genetic, metabolic and other disorders that contribute significantly to infant deaths and morbidity.
Sixteen indicators are included in the maternal and child health indicators category:
3.01 Live births
3.02 Infant mortality
3.03 Low birth weight
3.04 Mothers who smoke
3.05 Mothers who drink
3.06 Kessner index
3.07 Mothers begin prenatal in first trimester
3.08 Infants positive for cocaine
3.09.01 Leading causes of mortality (children 1-4), ICD-9
3.09.02 Leading causes of mortality (children 1-4), ICD-10
3.10 WIC: low weight for height
3.11 Teen birth rate
3.12 Percent births to teens
3.13 Child abuse/neglect
3.14 Congenital anomalies
3.15 Medicaid deliveries
3.16 Eligible children receiving early periodic screening diagnosis and treatment
3.17 Kotelchuck Index of Prenatal Care Utilization
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4.0 Chronic Disease Indicators
This section provides an overview of mortality, incidence and hospitalization rates for selected chronic diseases that reflect the influence of lifestyle-related risks. The chronic disease indicators also illustrate the prevalence of several risk factors that play an important role in the prevention and management of cardiovascular diseases, cancers, stroke, diabetes and mental health problems.
Fourteen specific indicators are included in the chronic disease indicators category:
4.01.01 Coronary heart disease mortality, ICD-9
4.01.02 Coronary heart disease mortality, ICD-10
4.02.01 Cerebrovascular disease mortality, ICD-9
4.02.02 Cerebrovascular diseases mortality, ICD-10
4.03.01 Chronic liver disease and cirrhosis mortality, ICD-9
4.03.02 Chronic liver disease and cirrhosis mortality, ICD-10
4.04.01 Breast cancer (female) mortality, ICD-9
4.04.02 Breast cancer (female) mortality, ICD-10
4.05.01 Lung cancer mortality, ICD-9
4.05.02 Lung cancer mortality, ICD-10
4.06.01 Colorectal cancer mortality, ICD-9
4.06.02 Colorectal cancer mortality, ICD-10
4.07.01 Cervical cancer (female) mortality, ICD-9
4.07.02 Cervical cancer (female) mortality, ICD-10
4.08.01 Prostate cancer (male) mortality, ICD-9
4.08.02 Prostate cancer (male) mortality, ICD-10
4.09.01 Childhood cancer (under age 15) mortality, ICD-9
4.09.02 Childhood cancer (under age 15) mortality, ICD-10
4.10 Hospitalization for alcohol dependence syndrome
4.11 Hospitalization for total psychoses
4.12 Hospitalization for diabetes
4.13 Overweight, smokers, sedentary lifestyles
4.14.01 Breast cancer age-adjusted incidence rate
4.14.02 Colorectal cancer age-adjusted incidence rate
4.14.03 Cervical cancer age-adjusted incidence rate
4.14.04 Lung cancer age-adjusted incidence rate
4.14.05 Prostate cancer age-adjusted incidence rate
4.14.06 Percent diagnosed in situ breast cancer (female)
4.14.07 Percent diagnosed at local stage colorectal cancer
4.14.08 Percent diagnosed at local stage prostate cancer
4.14.09 Percent diagnosed at late stage cervical cancer
4.14.10 Childhood cancer age-adjusted incidence rate
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5.0 Infectious Disease Indicators
The purpose of the infectious disease indicators is to present an overview of available information on the incidence of reportable infectious diseases in Illinois and to report the immunization status of Illinois children. Reportable infectious diseases have various causative agents, distribution patterns, modes of transmission, treatments and methods of control. According to the U.S. Centers for Disease Control and Prevention, the number of infectious disease cases is tremendously under-reported. Nonetheless, surveillance systems are important in detecting both the causative agents and the diseases; these systems are essential components of modern prevention and control strategies.
Eleven specific indicators are included in the infectious disease indicators category:
5.04 AIDS incidence
5.05 HIV infection
5.06 Basic series vaccinations
5.07 Haemophilus meningitis (Ages 0-2 and 0-4)
5.08 Infections by key foodborne pathogens
5.09 Vaccine preventable diseases
5.10 Hepatitis B
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6.0 Environmental, Occupational and Injury Control Indicators
This category spans a diverse set of indicators related to health factors in the areas of environmental health, occupational safety and health, and injury control.
Ten indicators are included in the environmental, occupational and injury control indicators category:
6.01 Environmental indicators
6.02 Toxic agents released into air, water, soil
6.03.01 Mortality due to motor vehicle accidents, ICD-9
6.03.02 Mortality due to motor vehicle accidents, ICD-10
6.04.01 Homicide, ICD-9
6.04.02 Homicide, ICD-10
6.05.01 Suicide, ICD-9
6.05.02 Suicide, ICD-10
6.06 Hospitalization for non-fatal head/spinal cord injuries and hip fractures
6.07 Alcohol-related motor vehicle deaths
6.08 Occupational diseases/injuries
6.09 Blood lead levels in children
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7.0 Sentinel Events
Sentinel indicators are presented for health conditions considered preventable or controllable with regular primary care. The occurrence of sentinel events can be interpreted to indicate inadequate access to primary care. In this category, the indicators are not selected separately, but instead are presented in two reports:
7.01 Sentinel Events
Infants (0-1), Hospitalization for dehydration7.02 Sentinel Events - Cancer
Children (0-17), Hospitalization for rheumatic fever
Children (0-14), Hospitalization for asthma
Adults (>=18), Tuberculosis
Adults (>=18), Hospitalization for uncontrolled hypertension
In situ Breast cancer
Late cervical cancer
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8.0 Summary Reports
The IPLAN Data System provides a quick way to generate summary reports for a county or group of counties. In a summary report, all indicators within a category are calculated:
1.99 Demographic and socioeconomic characteristics
2.99 General health and access to care indicators
3.99 Maternal and child health indicators
4.99 Chronic disease indicators
5.99 Infectious disease indicators
6.99 Environmental, occupational and injury control indicators
7.99 Sentinel events
8.99 Summary reports
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Prominent Data SourcesThis section presents a brief description of prominent data sources used to measure the indicators in the IPLAN Data System. To compile the data system, a variety of sources were used, several of which deserve special mention because of the comprehensive nature and overall relevance to the system.
Adverse Pregnancy Outcomes Reporting SystemThe Adverse Pregnancy Outcomes Reporting System (APORS) was created as part of the Illinois Health and Hazardous Substances Registry to guide public health policy in reducing of adverse pregnancy outcomes and in identifying and tracking children who require special services to correct and prevent developmental problems and other disabling conditions. The registry contains information on Illinois residents (including those seen in St. Louis perinatal centers) who meet specific adverse health outcome criteria. All certified Illinois hospitals are required to report to APORS.
Mandated statewide data collection began on August 1, 1988. APORS receives information from four perinatal centers in St. Louis, Missouri, that are part of the Southern Illinois Perinatal Network as well as all Illinois hospitals. A total of 32,352 newborns with adverse pregnancy outcomes are on the registry. These cases were matched with birth certificates and include infant discharge record data, maternal data and specific data from the birth certificate.
APORS cases meet one or more of the following criteria:
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Behavioral Risk Factor Surveillance System
The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing series of monthly telephone surveys using a standardized questionnaire. A combined effort of the Illinois Department of Public Health and the U.S. Centers for Disease Control and Prevention (CDC), the BRFSS is a standard method of obtaining self-reported data on health behaviors. IDPH conducts the monthly surveys and provides telephones, office space, interviewers and supplies, while CDC provides financial assistance, the questionnaire, methodology and training.
Telephone surveys are appropriate in areas where a significant portion of the population have telephone services. In Illinois, more than 92 percent of households have telephones, a percentage that is considered adequate for survey purposes.
The survey questionnaire was developed by CDC from a list of common data items used by risk factor researchers. The survey instrument, featuring approximately 55 questions, is organized into a series of modules or subject areas, such as hypertension, smoking and weight control. Although the questionnaire varies slightly from year to year, the modules remain stable.
The survey uses a random-digit dial telephone sample and respondents are randomly chosen from persons residing in the household who are 18 years of age or older. Interviews are conducted the second week of each month during weeknight, weekday and weekend survey sessions. The Illinois BRFSS completed 3,708 interviews during 1990-91. Aggregating the data from both years into one data set allowed for its stratification into five sub-state data analysis areas: Chicago; suburban Cook County; the collar counties of DuPage, Kane, Lake, McHenry and Will; urban counties, including Champaign, DeKalb, Kankakee, Kendall, McLean, Macon, Madison, Peoria, Rock Island, Sangamon, St. Clair, Tazewell and Winnebago; and rural counties, which comprise the rest of the state.
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U.S. Bureau of the Census
At the beginning of each decade, the U.S. Bureau of the Census attempts to count all the individuals living in the nation. The results of mail-in surveys and census enumerators are aggregated into increasingly larger geographic units, eventually reaching counts of cities and counties. Along with the population headcount, questions on characteristics of population and housing also are asked on the census questionnaires. The census data yield the most complete and reliable demographic figures available. Caution, however, needs to be maintained when using census data. The manner of asking census questions can present problems. For example, some questions were worded differently in earlier censuses, making the definitions of indicators different and comparisons difficult.
Race categories are imprecise concepts and can be a sensitive topic for those portrayed. Data users want the most detailed, reliable and consistent race characteristics and data, but census respondents may not provide their race for fear of discrimination or may avoid answering the census altogether. In addition, determination of race, for the most part, is made by the census respondent, so a person's self-identified race may differ from how someone else might categorize that person. Census results do not yield consistent, universally defined race data.
Hispanic origin refers to ethnicity; it is not a race category. Thus, a person of Hispanic origin may be of any race. Since Hispanic origin, like race, is self-reported on the census form, the census results will not yield consistent, universally defined Hispanic origin data. Some agencies or programs collect Hispanic data and treat it as belonging to a "Hispanic race." Such data, when used with census Hispanic origin population as denominators, could lead to erroneous interpretations.
For the 1980 and 1990 censuses, no attempts were made by the Census Bureau to reclassify responses on race categories that were inconsistent with other questionnaire responses. The result is a larger than usual number of persons of "other" race and a smaller number of persons classified as white or black race. Recognizing the race inconsistencies between the 1980 and earlier censuses, the Census Bureau released a modified age-race-sex (MARS) file for both 1980 and 1990 with counts of persons by age, sex and race that would be more consistent with race classification in vital statistics and other data systems. In addition, the MARS data represent an attempt to correct the original 1990 census count for age inconsistencies caused by how age was asked on the 1990 census questionnaires. It is because of these 1990 census inconsistencies that IDPH uses the MARS data for all of its applicable vital statistics calculations. MARS data from the 1990 census are reported in the demographic and socioeconomic characteristics category and are used in calculating rates in other sections of the IPLAN Data System.
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Healthy People 2000
Healthy People 2000: National Health Promotion and Disease Prevention Objectives presents a series of opportunities to dramatically cut health care costs, to prevent premature onset of disease and disability, and to help all Americans achieve healthier, more productive lives. The intent of Healthy People 2000 is to commit the nation to attain three broad goals: increase the span of healthy life for Americans, reduce health disparities among Americans, and achieve access to preventive services for all Americans.
At the local level, health professionals find guidance in the national objectives. It is a challenge to interpolate the quantification of national objectives to the local level, but this has focused greater attention on the model standards for local public health agencies. There is a highly integrated one-to-one correspondence between the Model Standards for local health agencies and the national objectives for the year 2000.
Objectives related to selected IPLAN indicators were extracted from Healthy People 2000 and incorporated into the IPLAN Data System. Year 2000 Objectives are not available for all of the indicators listed in the IPLAN Data System.
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Illinois Health Care Cost Containment Council
The aggregated hospital inpatient data used for some of the indicators come from the Illinois Health Care Cost Containment Council (IHCCCC), which tabulates Uniform Billing-82 (UB-82) hospital discharge forms for inpatients discharged from Illinois hospitals. The data available for surveillance purposes include age and sex of patient, principal diagnosis (or diagnostic related group - DRG), and ZIP code of residence. The ZIP code information is used to assign the patient to a county of residence. For areas where ZIP codes overlap county boundaries, some assignments to counties are made based on proportions of the ZIP code area in each county.
The data cover only those patients reported by Illinois hospitals and do not include Illinois residents who went to hospitals in other states. Because ZIP codes and county boundaries are not always specific, it must be noted that county level information may only approximate what the actual number of patients from that county might be. In addition, the primary diagnosis or DRG may not reflect all the health problems experienced by the patient.
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Illinois State Cancer Registry
The Illinois State Cancer Registry (ISCR) is the only database with population-based cancer incidence information for Illinois. Reporting of cancer cases is the responsibility of hospitals, laboratories and ambulatory surgical treatment centers.
The ISCR has processed cancer incidence reports since 1985, including cases of persons residing in other states who travel to Illinois for care. Case reporting of Illinois residents by Illinois hospitals is estimated by a 1990 audit to be 97 percent complete. Approximately one-half of the reporting hospitals report their cases electronically to the ISCR through available software programs.
Three of nine federal/military hospitals in Illinois report cases voluntarily. In addition, the U. S. Department of Defense provided cancer information from two additional military facilities in Illinois in September 1990. An out-of-state data exchange with Florida, Indiana, Iowa, Michigan, Missouri and Wisconsin also has been fully implemented. This separate database enhances the Illinois database by making information available on Illinois patients diagnosed or treated in another state.
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State statute requires that all vital record certificates be filed with the Illinois Department of Public Health. The records are then inspected and additional information is sought for incomplete, inconsistent or unclear certificates. The vital statistics provided in the IPLAN Data System are based on birth and death records for Illinois residents.
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