Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #115227

Jennifer L. Conroy, DrPH, MPH¹, Joshua Vest, MPH², Sandy Coe Simmons³, Adolfo Valadez, MD, MPH², and Jerry A. Schultz, PhD⁴. (1) Steps to a Healthier Austin, City of Austin Health and Human Services, 2800 Webberville Rd, Rm 122, Austin, TX 78702, (2) Austin / Travis County Health & Human Services Department, 15 Waller St., RBJ Building, Austin, TX 78702, (3) Research and Evaluation Dept Director, Indigent Care Collaboration, 2101 IH-35 South, Suite 500, Austin, TX 78741, (4) Work Group on Health Promotion and Community Development, Work Group on Health Promotion and Community Development, University of Kansas, 4082 Dole Center, University of Kansas, Lawrence, KS 66045, (785) 864-0533, jschultz@ku.edu

Steps to a HealthierUS is an initiative from the U.S. Department of Health and Human Services that targets physical activity, nutrition, and smoking for improvements in obesity, diabetes, and asthma.

To evaluate successes, one HP2010 Objective states: Prevent 2.5 new cases per 1000 people/year. Assessing prevention of new cases is challenging because the county does not have a diabetes registry, diabetes is not reportable by law, and utilizing single hospital systems or providers would not be generalizable to the intervention population or account for patient migration between providers.

Steps to a Healthier Austin has partnered with a unique local non-profit agency, the Indigent Care Collaboration, which maintains a community-wide electronic health history record for tracking and coordinating care for medically indigent patients in Central Texas. The ICC uploads and stores real-time medical encounters from the majority of safety-net providers in the Austin metropolitan area. These data include in-patient, out-patient and ER visit diagnostic codes, revealing the health histories of over 350,000 individuals, and reflect over 1.2 million encounters.

Selecting ICC data from safety-net providers in the Steps-Austin Intervention Area, then delimiting these data to exclude pre-existing diabetes cases, person-time comparisons can be used to calculate population-level incidence density of diabetes for indigent patients in our target area.

While incidence rates are generalizable only to patients of safety-net providers, indigent patients experience the greatest levels of disparities in health outcomes in this community, and the greatest barriers to accessing healthcare, and thus best represent our targeted population.

Learning Objectives:

• Identify new resources for tracking and monitoring community-wide health indicators.
• Recognize ways to use aggregate data from multiple sources and variable time frames to calculate disease incidence .
• Apply methods for incidence tracking in your own community.

Keywords: Evaluation, Community Research

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.