Coverage, conditions and communities: Creating and using state-level health survey data in a complex system

Many private organizations and public agencies collect data on health status, conditions, service utilization, environmental factors and costs. However, much of this is proprietary, directed to areas of specific interest, restricted to narrow populations or geographical service areas, or conducted over a wide population base (e.g. national studies), thus does not allow for observing variations at local, regional or state levels. In addition, combining data from disparate sources to provide a more comprehensive understanding of population health and factors that influence it is often difficult and costly. Finally, issues of timeliness, relevance and methodology all pose limitations to use of such data for program planning and policy development. To address these issues, a group of local funders embarked on a collaborative effort to collect data on individual indicators of health status, health care access, health-related behaviors and various demographic and social/environmental factors related to health. Developed with broader community input, the 2008 survey included 4,200 randomly selected households, and is being used by public agencies, academic researchers and community-based health service providers to inform and improve public policy and community health and healthcare programs and planning. By linking information on insurance coverage, household demographics, health status, healthcare utilization and health-related behaviors with information about broader social and environmental determinants of health, this presentation discusses how collaborative, state-level health surveys can provide a more cost-effective, comprehensive and nuanced understanding of coverage, conditions and communities on population health - and their consequences in terms of cost, economic productivity and quality of life.