From Data to Action

Data Resources

Data from Neighborhood Health Partnerships (NHP) is a valuable tool that is meant to complement your experience and knowledge of your local community. Resources on this page can help you get started in understanding what data is and understanding the data used by NHP.

Data in Our Reports

The data used in the reports comes from multiple sources including the Wisconsin Collaborative for Healthcare Quality (WCHQ), the U.S. Census Bureau American Community Survey (ACS), and the Wisconsin Behavioral Risk Factor Survey (BRFS).

The Wisconsin Collaborative for Healthcare Quality (WCHQ) is a voluntary collaborative of 35 health systems, 325 medical clinics and more than 150 dentists, representing about 65% of the primary care providers in Wisconsin. WCHQ members publicly report health outcome and care measures on the WCHQ website and work on quality improvement teams to improve the quality and affordability of healthcare and promote health in Wisconsin. WCHQ member organizations (i.e. clinics and health systems) submit data to WCHQ that was recorded in electronic health records during primary care visits. This includes information about vaccinations, screenings for cancer and other health risk factors, and management of diabetes and heart disease. The health systems provide these data, while protecting patient confidentiality, for the NHP reports.

More information about this data source is available at the link below:

WCHQ data is used in the Health Outcome and Care Reports to report different health measures at the ZIP code level.

Limitations to WCHQ Data

  • Because the data only includes health systems that are members of WCHQ, the estimates based on these data do not reflect the entire population of the ZIP code. People living in the ZIP code who do not receive care at a WCHQ member health system are not included in these data. This includes people who get their healthcare elsewhere, those who do not have access to healthcare, and those who simply have not had a primary care visit in the last one to three years.
  • Some of the WCHQ measures rely on patients who have received a formal diagnosis. People who have conditions such as diabetes or heart disease that do not yet have a formal diagnosis are not accounted for in these measures.
  • Some of the population sizes represented in the reports are small. This means that small fluctuations in healthcare, outcomes, and behaviors could have a large impact on the measure results. For example, if the population of people included in a report is 50 people, 15 of whom are smokers, just a few people quitting smoking may have a dramatic-looking impact on your reports.
  • Health system data may include duplicate patient records if a patient receives care from more than one system.

The U.S. Census Bureau American Community Survey (ACS) is the premier source for detailed population and housing information in the U.S. It is an ongoing survey that provides information on a yearly basis about demographics, jobs, education, housing, and more for people living in the United States and Puerto Rico. More information about this data source is available at the links below:

ACS data is used in every report. In the Health Outcome and Care Reports, the data is used for population size and demographic information. The Social Determinants of Health Report uses ACS data for all the living condition measures and demographics in the reports.

The Wisconsin Behavioral Risk Factor Survey (BRFS) is part of a national system of telephone surveys that collect data from U.S. residents about their health-related risk behaviors, chronic health conditions, and use of preventive services. BRFS randomly selects cell phone and landline users to participate in the survey. More information about this data source is available at this link: Wisconsin Behavioral Risk Factor Survey - Methodology in Brief | Wisconsin Department of Health Services.

Data from the Wisconsin BRFS from 2011-2017 was used in the Health Outcome and Care Reports to calculate prevalence estimates of heart disease, hypertension and diabetes in Wisconsin ZIP codes. See the Health Outcome and Care Reports section of the FAQs on the Reports page for more information.

Health Outcome and Care Reports

Data

The primary data source for health outcome and care reports is the Wisconsin Collaborative for Healthcare Quality (WCHQ). There are currently 20+ health systems providing electronic health record data for NHP. These reports also use U.S. Census American Community Survey (ACS) data and Wisconsin Behavioral Risk Factor Survey (BRFS) data.

Measures

WCHQ publicly reports a broad and growing collection of health care performance measures. Currently, 27 measures are available for request.

Childhood Vaccinations

This measure reports the percentage of children, age 2, who receive primary care from a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system and have completed each of the following immunizations on or before their 2nd birthday: 4 Diphtheria Tetanus and Acellular Pertussis, 3 Polio, 1 Measles, Mumps and Rubella, 3 H influenza Type B, 3 Hepatitis B, 1 Chicken Pox, 4 Pneumococcal Conjugate.

Adolescent Vaccinations

This measure reports the percentage of adolescents, aged 13, who receive primary care from a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system, and have had each of the following immunizations: meningococcal vaccine, tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap).

HPV Vaccination

This measure reports the percentage of adolescents, aged 15, who receive primary care from a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system, and have had two or three doses of the human papillomavirus (HPV) vaccine by their 15th birthday.

Pneumonia Vaccination

This measure reports the percentage of adults, aged 65 or older, who receive primary care from a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system, and had a pneumococcal vaccination.

Well Child Visit First 15 Months of Life

This measure reports the percentage of children, who receive primary care from a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system, and had one or more well-child visits with a primary care provider by the child’s 15-month birthday that include a health and developmental history (physical and mental), a physical exam, and health education/anticipatory guidance within the last year.

Breast Cancer Screening

This measure reports the percentage of women, aged 50-74, who receive primary care from a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system, and had a minimum of one breast cancer screening test during the two year measurement period.

Cervical Cancer Screening

This measure reports the percentage of women who receive primary care from a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system, aged 21-29 who had a minimum of one cervical cancer screening (cytology) test during the 3-year measurement period; and aged 30-64 who had a minimum of one cytology test during the 2-year measurement period or one screening cytology test and an HPV test within the last 5 years.

Chlamydia Screening in Women

This measure reports the percentage of women who are sexually active, aged 16-24, who receive primary care from a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system, and had at least one test for chlamydia within the last year.

Colorectal Cancer Screening

This measure reports the percentage of adults, aged 50-75, who receive primary care from a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system, and received a screening for colorectal cancer. This could include a colonoscopy in the past ten years, a CT colonography or flexible sigmoidoscopy in the past five years, or a stool test within the last year.

Depression Screening

This measure reports the percentage of people, aged 12 and older, who receive primary care from a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system, that were screened for clinical depression at any time within the last year using an age appropriate standardized depression screening tool.

Recommended Body Mass Index

This measure reports the percentage of adults, aged 18-85 years, who receive primary care from a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system, and had at least one Body Mass Index (BMI) test during the 12-month measurement period and the most recent BMI measurement was normal; for 18-64 years: BMI greater than or equal to 18.5 and less than 25; 65 years and older: BMI greater than or equal to 23 and less than 30.

Blood Pressure Control

This measure reports the percentage of adults with hypertension, aged 18-85, who receive primary care from a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system, and whose most recent blood pressure reading was controlled (less than 140/90 for patients under 60 years old or patients of any age with diabetes and/or chronic kidney disease (CKD); less than 150/90 for patients 60 years old and older without diabetes or CKD).

Blood Pressure Control

This measure reports the percentage of adults with heart disease, aged 18-75, who receive primary care from a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system, and whose most recent blood pressure reading within the last year was controlled to less than 140/90 mmHg.

Daily Aspirin

This measure reports the percentage of adults with heart disease, aged 18-75, who were under regular care by a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system, and were prescribed oral antiplatelet therapy, unless contraindicated, in the last year.

Statin Use

This measure reports the percentage of adults with heart disease, aged 18-75, who receive primary care from a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system, and have documented statin use at any time during the measurement period.

Tobacco-Free

This measure reports the percentage of adults with heart disease, aged 18-75, who receive primary care from a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system whose most recent tobacco status was tobacco-free.

Optimal Control

This measure reports the percentage of adults with heart disease, aged 18-75, who receive primary care from a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system, and met all of the following conditions: most recent blood pressure measurement was less than 140/90 mmHg, most recent tobacco status was tobacco-free, were prescribed daily aspirin or other antiplatelet, and used a statin.

Blood Pressure Control

This measure reports the percentage of adults with diabetes, aged 18-75, who receive primary care from a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system, whose most recent blood pressure reading within the last year was controlled to less than 140/90 mmHg.

Blood Sugar Control

This measure reports the percentage of adults with diabetes, aged 18-75, who receive primary care from a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system, and whose most recent A1c blood sugar level was controlled to less than 8.0%.

Blood Sugar Testing

This measure reports the percentage of adults with diabetes, aged 18-75, who receive primary care from a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system, and had two or more A1c tests within the last year.

Daily Aspirin

This measure reports the percentage of adults with diabetes and heart disease, aged 18-75, who receive primary care from a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system, with documentation in their medical record of daily aspirin or other daily antiplatelet therapy within the last year.

eGFR Test

This measure reports the percentage of adults with diabetes, aged 18-75, who receive primary care from a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system, and have had an estimated glomerular filtration (eGFR) test within the last year.

Kidney Function Monitored

This measure reports the percentage of adults with diabetes, aged 18-75, who receive primary care from a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system, and were screened and/or monitored for kidney disease within the last year.

Optimal Control

This measure reports the percentage of adults with diabetes, aged 18-75, who receive primary care from a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system, and met all of the following conditions: most recent A1c test result was less than 8%, most recent blood pressure measurement was less than 140/90 mmHg, most recent tobacco status was tobacco-free, were prescribed daily aspirin or other antiplatelet for adults with heart disease, and used a statin.

Optimal Testing

This measure reports the percentage of adults with diabetes, aged 18-75, who receive primary care from a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system, and met all of the following conditions: two A1c tests performed during the last year, one kidney function test performed and/or diagnosis and treatment of kidney disease during the measurement year, and a minimum of one eGFR test annually.

Tobacco-Free

This measure reports the percentage of adults with diabetes, aged 18-75, who receive primary care from a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system, whose most recent tobacco status was tobacco-free.

Statin Use

This measure reports the percentage of adults with diabetes, aged 40-75, or those with heart disease regardless of age, who receive primary care from a Wisconsin Collaborative for Healthcare Quality (WCHQ) member health system, and have documented statin use at any time during the measurement period.

Social Determinants of Health Report

Data

The Social Determinants of Health Report uses only U.S. Census American Community Survey (ACS) data.

 

Measures

The ACS data is the premier source for detailed population and housing information in the U.S. Currently, 17 measures are included in the Sociodemographic Profile Report.

The living conditions in the Sociodemographic Profile Reports were chosen based on the Bay Area Regional Health Inequities Initiative (BARHII) framework and measures available in the ACS data.

The demographics in this report were included to show characteristics of the people living in an area.

 

 

 

 

 


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Interpreting Data in Context

Datasets—a collection of related items of data—are always incomplete. Any single dataset tells us only part of the story relating to the health of a community and the factors that shape health outcomes and care. Therefore, your data may show an inequity in a health outcome or care and leave you to interpret this inequity.

An example of one common health inequity that may be visible in NHP data is the burden of diabetes among people of color. The data in your report may show a ZIP code with a large population of people of color that has low rates of blood sugar control amongst people with diabetes. However, the NHP reports do not speak to factors that can influence the prevalence of diabetes (such as food availability or cost and access to living wage jobs) and diabetes management (such as access to culturally appropriate care and the presence of medical implicit bias).

Without recognizing the factors that shape health inequities when we use datasets, we risk drawing conclusions about communities that could be untrue and harmful. Here are suggestions to consider when interpreting NHP report data:

  1. Recognize what is and is not represented in the data
  2. Take caution not to draw conclusions from the data that might reinforce harmful and limiting stereotypes about communities
  3. Engage community knowledge and the expertise of those represented in the data
  4. Use frameworks and resources to identify contextual factors that may shape what you see in the data

For more information on the social determinants of health and tools to support data interpretation, visit our Action Tool page.

Resources for Data Literacy

There are many resources that can help you use data and create shared understanding of data among your partners. We recommend the Data Literacy modules linked below from the County Health Rankings and Roadmaps Action Center.

Frequently Asked Questions

Frequently Asked Questions (FAQs) can be found at the bottom of our Reports page.