Importance of comparable state and local health survey data for research to improve population health

Population health is the ultimate measure of how well public health institutions are serving their populations. Population health surveys provide extensive health-related information on the entire population regardless of whether they use health services. Population health data at local and state levels are needed to address disparities in health and to evaluate and monitor progress in achieving the goals of national health care reform. Numerous studies, reports and policy papers have urged local data collection. In response to this need, the CDC BRFSS program has added local estimates to its state surveillance system. In 2008, several NIH Institutes and Offices co-funded a study by UCLA to inventory statewide local health surveys across the US to identify states with comprehensive health surveys that collect data on at least one local sampling stratum. In order to harmonize population-based health surveys, an important next step is to explore whether independent and BRFSS survey leaders in states with innovative surveys can work together to coordinate state and local surveys to create a harmonized system of national, statewide and local health that can better serve the needs of local policymakers, advocates, health services researchers and better inform federal health policy. We examine data collection techniques used to accurately represent small areas and populations, and how data have been used to identify disparities and other public health issues. We further discuss how to harmonize local health surveys with each other, with other sources of local health data, and with national health data for improving population health.