These health indicators include county, regional and state level data on a variety
of health, environmental and social topics. These data are used in Colorado’s Health Assessment and Planning System (CHAPS).
CHAPS is a standard process created to help local public health agencies meet assessment
and planning requirements. These indicators are useful for anyone who needs Colorado
health data for a community health assessment or for other research purposes.
These indicators are organized based on the Health Equity Model (click above to view),
which takes into account a wide range of factors that influence health. This model
groups the social determinants of health into:
- Life course perspective: how populations are impacted differently
during the various stages of life
- Social determinants of health: societal influence, such as economic
opportunity, physical environment and social factors that play critical roles in
the length and quality of life
- Health factors: components of health behaviors and conditions,
mental health and access, utilization and quality of health care
- Population health outcomes: measures of quality of life, morbidity,
mortality and life expectancy
Colorado Health Data Interpretation
Guide
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Introduction
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Colorado Health Data Interpretation Guide
This guide has been developed as part of Colorado Health Assessment and Planning
System (CHAPS) to assist public health agencies in analyzing and interpreting the
data collected through the Community Health Assessment (Phase III of CHAPS).
Community assessment is the regular and systematic collection, analysis and dissemination
of information on the health of the community, including statistics on health status,
awareness of community health needs and strengths, and the utilization of available
expertise to understand this information.
This guide focuses on the indicators selected specifically to facilitate standardized
health assessment across all jurisdictions in Colorado. The indicators are organized
according to a Health Equity Model. A link to the guide will also be included
with the data output to assist with data interpretation.
Each section in this guide reflects a component of the model and includes questions
to consider when analyzing data, a list of the selected indicators, links to the
indicator website, and data sources for other indicators. This is not a complete
list of indicators nor are any of the indicators required. There are
many other indicators to consider from local data sources, special studies, state
agencies and federal agencies.
General Questions to Consider for All Indicators
- How has this indicator been changing? Is it getting better or worse?
- Do the trends seem reflective of the age profile of the county? Of the racial/ethnic
diversity of the county? Of the poverty rates in the county? Of other factors?
- How does your county compare on this indicator to other communities (regional neighbors,
other counties, the state, nation)? How does it compare to the Healthy People 2020
objective?
- When comparing the range of your county’s confidence limits (lower and upper
values), does the range overlap with the communities’ ranges you are comparing
too? If not, what does this statistical significance mean for your county?
- What could the statistical difference (whether significant or not) tell you about
the relationship this indicator has with your neighbors, region or state? If there
is a significant difference, what does this mean OR what could it mean if it’s
not statistically significant?
- Are there subpopulations in your county that may have an impact on this indicator?
Is there programming to address these needs? Are there ways to measure the effectiveness
of programming already in place? Do any of the neighboring counties in your region
have programs or resources for addressing these needs?
- If there is no data available for your county on this indicator, is there other
data available that is related or similar in content that could serve as this data
point? Is it appropriate to use the regional value in the absence of your county
value?
- How does the impact of this indicator compare to the impact of other indicators
you are assessing? Is it statistically significant? Does the significance have a
greater impact on public health in your community compared to other statistically
significant indicators?
- What are the resources available for addressing this in the community? Who could
be the community partners in addressing this issue? Will there be more or less community
(nonprofit, political, business, etc) support around this topic? What other areas
of the community will be impacted by addressing this need?
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Community Description
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Community Description
General Questions to Consider
- How has this indicator been changing? Is it getting better or worse?
- How does your county compare on this indicator to other communities (regional neighbors, other counties, the state, and nation)? How does it compare to the Healthy People 2020 objective?
- When comparing the range of your county’s confidence limits (lower and upper values), does the range overlap with the communities’ ranges you are comparing too? If not, what does this statistical significance mean for your county?
- What could the statistical difference (whether significant or not) tell you about the relationship this indicator has with your neighbors, region or state? If there is a significant difference, what does this mean OR what could it mean if it’s not statistically significant?
- How does the impact of this indicator compare to the impact of other indicators you are assessing? Is it statistically significant? Does the significance have a greater impact on public health in your community compared to other statistically significant indicators?
- What are the resources available for addressing this in the community? Who could be the community partners in addressing this issue? Will there be more or less community (nonprofit, political, business, etc) support around this topic? What other areas of the community will be impacted by addressing this need?
Indicator-Specific Questions to Consider
Population & Community Characteristics
- How does your population differ from the state by age, race, and gender? Where are the greatest variations?
- Is your population increasing or decreasing? Are there any specific populations that are increasing or decreasing?
- What are your county’s largest age groups? Are there large variations that are likely to impact health or the need for certain types of health promotion and disease prevention activities?
- Do the data suggest special needs in certain areas, such as child care, family planning or geriatrics?
- What unique health concerns or experiences might lesbian, gay and bisexual populations in your community have? Are health services in your community prepared to adequately and appropriately serve the needs of lesbians, gays, bisexuals, and their families?
- Are the foreign languages spoken in your community the same for both the spoken language indicator and the linguistic isolation indicator?
- Does your population contain a high percentage of those who are linguistically isolated (e.g., don’t speak English very well)? Does your county contain a population that speaks another language you were unaware existed in your geographic area? Is this unique to your county or where are these languages spoken elsewhere in the state? What implications does this have for service delivery?
- Does your county contain populations living in group quarters? If so, who makes up this population in your community and what are some of their specific community health needs? Who is responsible for providing these services?
Selected Indicators Website: Colorado Health Data website
Population Characteristics
Total Population
Population change over time
Population by gender
Population by age groups
Population by race/ethnicity
Population by spoken language
Percent of adults aged 18+ years who identify themselves as lesbian, gay, or bisexual
Community Characteristics
Population enrolled in school by grade (Age 3+ years)
Number and percent of households that are linguistically isolated
Population in group living quarters
Additional Resources and other data sources
US Census County Quick Facts
Colorado State Demography Office
CDC National Vital Statistics System
CDC National Behavioral Risk Factor Surveillance System
DHHS Actions to Improve Health for LGBT Communities
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Economic Opportunity
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Economic Opportunity
General Questions to Consider
- How has this indicator been changing? Is it getting better or worse?
- How does your county compare on this indicator to other communities (regional neighbors, other counties, the state, nation)?
- When comparing the range of your county’s confidence limits (lower and upper values), does the range overlap with the communities’ ranges you are comparing too? If not, what does this statistical significance mean for your county?
- Are there subpopulations in your county that may have an impact on this indicator? Is there programming to address these needs? Are there ways to measure the effectiveness of programming already in place? Do any of the neighboring counties in your region have programs or resources for addressing these needs?
- If there is no data available for your county on this indicator, is there other data available that is related or similar in content that could serve as this data point? Is it appropriate to use the regional value in the absence of your county value?
- How does the impact of this indicator compare to the impact of other indicators you are assessing? Is it statistically significant? Does the significance have a greater impact on public health in your community compared to other statistically significant indicators?
- What are the resources available for addressing this in the community? Who could be the community partners in addressing this issue? Will there be more or less community (nonprofit, political, business, etc) support around this topic? What other areas of the community will be impacted by addressing this need?
Indicator-Specific Questions to Consider
Income
- Do the data show that your county has households with income above the poverty level and received food stamps? What economic, cultural, etc factors could be driving this to occur?
- Considering the age distribution in your county, how might this contribute to the percent of households receiving food stamps? Percent receiving free and reduced school lunches?
Employment
- What recent events in your community may have impacted the unemployment rates? What businesses opened or closed their doors recently? How large are the main industries of employment in your area?
- Is unemployment in your area seasonally impacted by agriculture, tourism, etc?
Education
- What do the data suggest about the level of education in your adult population? How could this impact the perspective your community members have about healthy living?
- When analyzing the high school drop out rate for your county, what other data is important to consider? (Age distribution, spoken language/linguistic isolation, eligibility for free and reduced lunch, etc.)
- When considering the outcomes for school proficiency in your county, how does public health play a role? What areas of public health would directly or indirectly impact the proficiency of school children?
Housing
- How much of household income is being spent on rent/mortgage in your county? How might this be related to the median home value of your county?
- What is the distribution of renter and owner-occupied housing units? If there is a larger renter-occupied population, how might this impact healthy housing indicators in your community? (See Physical Enivornment)
Selected Indicators Website: Colorado Health Data website
Income
- Percent of population below poverty level
- Percent of children (<18 yrs old) below poverty level
- Median household income
- Percent of households that received food stamps in the past 12 months
- Percent of households that received food stamps in the past 12 months with an adult 60+ yrs old
- Percent of households that received food stamps in the past 12 months by poverty status in the past 12 months
- Percent of students eligible for free and reduced school lunch (k-12)
Employment
Education
- Percent educational attainment of adults aged 25+ years
- High school drop out rates
- High school completion rates
- Percent of fourth-grade students proficient or above in reading
- Percent of fourth-grade students proficient or above in math
- Percent of eighth-grade students proficient or above in reading
- Percent of eighth-grade students proficient or above in math
Housing
- Gross rent as a percentage of household income in the past 12 months
- Mortgage status by selected monthly owner costs as a percentage of household income in the past 12 months
- Tenure by occupied housing unit
- Median home value
Additional Resources and other data sources
US Census County Quick Facts
U.S. Bureau of Labor Statistics
U.S. Department of Labor
U.S. Department of Education
The Colorado Department of Education
No Child Left Behind Colorado State Report Cards
Colorado Department of Labor & Employment
Colorado State Demography Office- Jobs by Sector
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Physical Environment
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Physical Environment
General Questions to Consider
- How has this indicator been changing? Is it getting better or worse?
- Do the trends seem reflective of the age profile of the county? Of the racial/ethnic diversity of the county? Of the poverty rates in the county? Of other factors?
- How does your county compare on this indicator to other communities (regional neighbors, other counties, the state, nation)? How does it compare to the Healthy People 2020 objective?
- Does the confidence interval for an indicator in your county overlap with confidence intervals for the same indicator in other counties? If they do not overlap, what does that statistically significant difference mean for your county?
- What could the difference (whether significant or not) tell you about the relationship this indicator has with your neighbors, region or state? If there is a significant difference, what does this mean? What could it mean if it’s not significant?
- Are there subpopulations in your county that may have an impact on this indicator? Is there programming to address these needs? Are there ways to measure the effectiveness of programming already in place? Do any of the neighboring counties in your region have programs or resources for addressing these needs?
- If there are no data available for your county on this indicator, are there other data available that are related or similar in content that could serve as this data point? Is it appropriate to use the regional value in the absence of your county value?
- How does the impact of this indicator compare to the impact of other indicators you are assessing? Is it statistically significant? If so, does that indicator have a greater impact on community health compared to other statistically significant indicators?
- What are the resources available for addressing this in the community? Who could be the community partners in addressing this issue? Will there be more or less community (nonprofit, political, business, etc) support around this topic? What other areas of the community will be impacted by addressing this need?
Indicator-Specific Questions to Consider
Built Environment
- Do community members have sufficient space to safely walk, run or bike in your county? Do they have access to public exercise facilities? Are the data consistent with the physical activity indicators for your community?
- What is the rate of healthy food outlets for your community compared to your neighboring counties and the state? Does the percent of adults who report having access to fresh fruits and vegetables make sense with the rate of healthy food outlets for your community?
- Are there different areas of the county that may have greater numbers of fast food restaurants and contribute more to the county rate? Are there different counties of the health region that might be contributing more to the regional rate of fast food restaurants? What are some of the social determinants that factor in to this rate?
- How do the rates of commuting to work/school by walking, biking, public transportation etc relate to the data on sufficient sidewalks/road shoulders for your county? Is your community more rural and commuting by walking or biking would not make as much sense as an urban community? How does your rate compare to those of similar urban, suburban or rural communities?
Safety
- If crime rates are higher for your community, what are some of the other social determinants of health that may be related to crime in your community?
- Do parent perceptions of child safety in the neighborhood accurately reflect what the data tell you about the safety of your community? Could there disparities among neighborhoods within your county? Where might those neighborhoods be and who are some of the community partners that could work with you to address the increased crime in those neighborhoods?
- What are some of the social determinants of health indicators that might coincide with the rate of liquor stores? Do those data align with the rate of liquor stores in your community?
Environmental Quality
- Does your community have a higher percent of private wells? Do you believe private well owners are testing water?
- Have there been annual averages or maximum concentrations of contaminants detected in the community water systems for your county that were above the EPA maximum contaminant levels? Who is responsible for water quality in your county? What are some of the health issues reported from exposures to the contaminants that were detected above MCLs in your community?
- Does the percent of population receiving optimally fluoridated water support the dental data available for your county?
- Is particulate matter or ozone an issue in your county? Whether data are available for your county or not, what are some of the indirect data that might indicative of air quality? (i.e. asthma rates, etc.)
Selected Indicators Website: Colorado Health Data website
Built Environment
Access to Recreation
- Percent with sidewalks or shoulders of the road in their neighborhood that are sufficient to safely walk, run or bike
- Percent that have access to public exercise facilities in their neighborhood
Access to Healthy Food
- Rate of healthy food outlets per 10,000 residents
- Percent who say fresh fruits, vegetables, and other healthful foods are somewhat or very available in their neighborhood
- Rate of fast food restaurants per 10,000 residents
Transportation
- Percent of workers that commute to work by biking, walking or public transportation
- Percent of children that commute to school by biking, walking or skateboarding at least one day a week
Safety
- Adult and juvenile violent crime rates
- Adult and juvenile property crime rates
- Percent of parents who feel child is usually or always safe in community/neighborhood
- Rate of liquor stores per 10,000 population
Environmental Quality
Healthy Housing
- Number of radon tests performed in households
- Percent of household radon tests that were above the EPA recommended action limit (4 piC/L)
- Number and percent of houses built before 1960 (risk for lead-based paint exposure)
Water
- Percent of residents reporting they use a private well
- Number of public water systems where the average annual or maximum concentrations of disinfection byproducts (TTHM and HAA5), nitrates and arsenic were above the EPA maximum contaminant level (MCL)
- Percent of the population served by community water systems who received optimally fluoridated water
- Percent of the population who report bottled water as their primary home drinking water source
Outdoor Air Quality
- Average annual PM 2.5 concentration
- Number of person-days PM 2.5 above standard
- Percent of days 2.5 above standard
- Number of ozone days above standard
- Number of ozone person-days above standard
Additional Resources and other data sources
CDC National Behavioral Risk Factor Surveillance System
North American Industry Classification System
U.S. Census Bureau Business Register
National Survey of Children's Health
Colorado Department of Public Safety-Office of Research and Statistics
Federal Bureau of Investigations-Uniform Crime Reporting Program
Colorado Integrated Criminal Justice Information System
CBI Crime in Colorado Reports
Colorado Environmental Public Health Tracking
HMWMD-Radiation Program, Radon Outreach
EPA Map of Radon Zones
Colorado Map of Radon Zones
Agency for Toxic Substances & Disease Registry
EPA Radon Recommendations Levels
CDPHE Watery Quality Division
EPA Safe Drinking Water Information System
Safe Drinking Water Search for the State of Colorado
EPA Water Home
EPA Local Drinking Water Information: Colorado Drinking Water
CDC Oral Health Maps
CDC My Water's Fluoride
CDC Community Water Fluoridation
CDPHE Oral Health Unit
CDPHE CO Community Water Fluoridation Program
CDPHE Oral Health in Colorado
Association of State and Territorial Dental Directors
CDPHE Air Pollution Control Division
EPA EnviroFlash
EPA Air Quality Index
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Social Factors
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Social Factors
General Questions to Consider
- How has this indicator been changing? Is it getting better or worse?
- Do the trends seem reflective of the age profile of the county? Of the racial/ethnic diversity of the county? Of the poverty rates in the county? Of other factors?
- How does your county compare on this indicator to other communities (regional neighbors, other counties, the state, nation)? How does it compare to the Healthy People 2020 objective?
- Are there subpopulations in your county that may have an impact on this indicator? Is there programming to address these needs? Are there ways to measure the effectiveness of programming already in place? Do any of the neighboring counties in your region have programs or resources for addressing these needs?
- If there are no data available for your county on this indicator, are there other data available that are related or similar in content that could serve as this data point? Is it appropriate to use the regional value in the absence of your county value?
- How does the impact of this indicator compare to the impact of other indicators you are assessing? Is it statistically significant? If so, does that indicator have a greater impact on community health compared to other statistically significant indicators?
- What are the resources available for addressing this in the community? Who could be the community partners in addressing this issue? Will there be more or less community (nonprofit, political, business, etc) support around this topic? What other areas of the community will be impacted by addressing this need?
Indicator-Specific Questions to Consider
Social Network/Social Support
- What are some of the challenges for improving health for families with single parents/guardians? Are there programs or resources in your community already available to them?
Participation
- How might the registered library-user population be related to the educational data for your community? What kind of impact can libraries have on the social determinants of health?
Organizational Networks
- Is there a large or small presence of religious communities in your area? Were there any religions present in your community that you were unaware of? Are there any belief systems for the religious communities in your area that might have an influence on community health?
- Do you feel that you have a good beat on which nonprofits are present in your community? Are you aware of all those that are providing public health related services/programs? What are a few ways to increase community partners, particularly those that may impact the social determinants of health in your community?
Leadership
- Are there minority- or female-owned businesses in your community? What might be some of the influences of this leadership in your community? Can you think of ways that this could influence community health?
Political Influence
- What are the impacts of having either a politically active community or a politically inactive community? Are there political influences that are creating challenges for improving public health specifically in your community?
Violence
- How close is the child maltreatment rate in your community to the Healthy People 2020 goal of 8.5 children per 1,000 children aged < 18 yrs old? Does your agency has programs to address this? Who are some of the community partners involved in improving this for your area?
- Does your community have a disproportionate number of elderly persons? Is elder abuse a larger issue in your community? What are the programs and services available for victims and families dealing with elder abuse? As the middle-aged population currently living in your area grows older, will this become a bigger issue that will need to be addressed?
- Are there anti-bullying programs being offered to the youth? Who in the community should be responsible for this programming and does your agency have a relationship with them? How can local public health contribute to addressing violence in your community?
Selected Indicators Website: Colorado Health Data website
Social Network/Social Support
- Percent of households headed by a single adult
Participation
- Percent of population that are registered public library borrowers
Organizational Networks
- Number of religious congregations per county population
- Number of nonprofits/501c3s per county population
Leadership
- Percent of firms owned by minorities
- Percent of firms owned by women
Political Influence
- Percent of registered voters and active registered voters in previous election cycle
Violence
- Child maltreatment rates
- Elder abuse rates
- Percent of high school students who reported being bullied on school property during the past 12 months
Additional Resources and other data sources
Colorado State Library
Institute of Museum and Library Services
National Center for Education Statistics
Association of Statisticians of American Religious Bodies
Glenmary Research Center
U.S. Congregational Membership Reports
US Census County Quick Facts
Colorado Office of Economic Development and International Trade 2006 Survey of Minority- and Women-Owned Businesses in CO
U.S. Small Business Administration-Colorado Small Business Profile
U.S. Election Assistance Commission
County Election Offices
2009 Child Maltreatment Report
Child Abuse and Neglect Statistics
CDC Injury Center: Violence Prevention, Child Maltreatment
National Center on Elder Abuse
The National Center for Victims of Crime-Elder Abuse
CDC Injury Center: Violence Prevention, Elder Maltreatment
CDC YRBS
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Health Behaviors and
Conditions
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Health Behaviors and Conditions
General Questions to Consider
- How has this indicator been changing? Is it getting better or worse?
- How does your county compare on this indicator to other communities (regional neighbors, other counties, the state, nation)? How does it compare to the Healthy People 2020 objective?
- When comparing the range of your county’s confidence limits (lower and upper values), does the range overlap with the communities’ ranges you are comparing too? If not, what does this statistical significance mean for your county?
- What could the statistical difference (whether significant or not) tell you about the relationship this indicator has with your neighbors, region or state? If there is a significant difference, what does this mean OR what could it mean if it’s not statistically significant?
- Are there subpopulations in your county that may have an impact on this indicator? Is there programming to address these needs? Are there ways to measure the effectiveness of programming already in place? Do any of the neighboring counties in your region have programs or resources for addressing these needs?
- If there is no data available for your county on this indicator, is there other data available that is related or similar in content that could serve as this data point? Is it appropriate to use the regional value in the absence of your county value?
- How does the impact of this indicator compare to the impact of other indicators you are assessing? Is it statistically significant? Does the significance have a greater impact on public health in your community compared to other statistically significant indicators?
- What are the resources available for addressing this in the community? Who could be the community partners in addressing this issue? Will there be more or less community (nonprofit, political, business, etc) support around this topic? What other areas of the community will be impacted by addressing this need?
Indicator-Specific Questions to Consider
Nutrition
- Is the majority of the community eating fast food on a weekly basis? Are children or adults eating it more frequently in your community? What are the factors that may be contributing to this situation? (high number of fast food chains in the county, less access to grocery stores, etc)
- How is your community doing with fruit and vegetable consumption? If well, what programs or community dynamics support this? If not well, what are some of the barriers and what are some things ideas to address them?
Physical Activity
- Are adults more likely to be physically active or inactive in your county? Consider the built environment in your community and could this play a role in the physical activity levels reported for your area?
- How physically active are the children and adolescents in your county? Does the amount of physical activity increase, decrease or remain the same as they grow older?
- Is there an observable relationship between the percent of screen time and physical activity in your youth?
Tobacco use/exposure
- Is there a higher prevalence of current adult or teenage smokers? What kind of tobacco programming is present in your community? What impact have they had on smoking prevalence?
- Are children in your community more often reported to be exposed to second-hand smoke in the home or in the car?
Skin Cancer
- Is there an observable relationship between skin cancer rates and utilization of sun protection in the community? Who might be some community partners to work with for increasing the use of sun protection?
Injury
- Is the percentage of seniors reporting falls in your county higher than the state? How does the proportion of seniors in your population compare to the state?
- Are community members using seat belts and age-appropriate modes of restraint while riding in vehicles? What is the motor vehicle accident rate for the county? Based on both of these data points, is there a need for increased motor vehicle safety programming in your community?
- What proportion of the population in the community is made up of high school students? Considering the statewide percent of teens that drink and drive, how might this injury risk impact community safety? How much education is available to students on the drinking and driving?
Sexual Health
- How does the percent of adults using effective methods of birth control in your county compare to the state? How does this relate to the measure of unintended pregnancies in your community?
- Is there an observable relationship between the teen fertility rate in your community compared to the available statewide data on teenage sexual health?
Health Conditions
- Are mothers in your community becoming pregnant at healthy weights prior to pregnancy? Are they gaining appropriate weight during pregnancy? What other maternal or infant data might be influenced by the outcomes reported for this data?
- Which life courses (adult, adolescent, or child) are most likely to be overweight or obese in the community? What programs are currently addressing this issue for any or each of the life courses? What other significant data findings for your community might be contributing, directly or indirectly, to the outcomes of this data point? (e.g., built environment, physical activity, nutrition, etc)
- What percent of adults reported high cholesterol? High blood pressure? What other data on chronic conditions might show a similar trend to this data? Do you observe a relationship between this data and the data for chronic conditions in this community?
Selected Indicators Website: Colorado Health Data website
Nutrition
- Percent of adults aged 18+ years who reported eating fast food one or more times per week
- Percent of high school students who ate fruits and vegetables 5 or more times per day
- Percent of children aged 1-14 years who ate fruit 2 or more times per day and vegetables 3 or more times per day
- Percent of children aged 1-14 years who ate fast food one or more times in the past week
- Percent of children aged 1-14 years who consumed sugar-sweetened beverages one or more times per day
Physical Activity
- Percent of adults aged 18+ years who get 30+ minutes of moderate activity per day on 5+ days/week or 20+ minutes of vigorous activity per day on 3+ days/week
- Percent of adults aged 18+ years who are physically inactive
- Percent of high school students who were physically active for a total of at least 60 minutes/day for the past 7 days
- Percent of children aged 5-14 years who were physically active for at least 60 minutes/day for the past 7 days
- Percent of children aged 1-14 years who watch TV or videos, play video games, or play on a computer for 2 hours/day or less
Tobacco use/exposure
- Percent of adults aged 18+ years who currently smoke cigarettes
- Percent of high school students who currently use cigarettes
- Percent of children aged 1-14 years who rode in a car in the past 7 days with someone who was smoking
- Percent of children aged 1-14 years live in homes where someone had smoked in the past 7 days
- Percent of women who smoked during the last three months of pregnancy
Skin Cancer
- Percent of adults aged 18+ years who always/nearly always use a method of sun protection when outside
- Percent of children aged 1-14 years who always/nearly always use a method of sun protection when outside for more than 15 minutes between 11 am and 3 pm on a sunny summer day
Injury
- Percent of adults aged 65+ years who reported having had a fall in the past 3 months
- Percent of adults aged 18+ years who reported having always used a seat belt when driving or riding in a car
- Percent of high school students who reported driving a car or other vehicle when they had been drinking alcohol
- Percent of children aged 1-14 years for whom it was reported having used the age-appropriate mode of restraint when riding a vehicle
Sexual Health
- Percent of sexually active women and men aged 18=44 years using an effective method of birth control to prevent pregnancy
- Percent of sexually active high school student using an effective method of birth control to prevent pregnancy
- Percent of high school students who have ever had sexual intercourse
- Percent of pregnancies resulting in live births that were unintended
- Fertility rates of teens aged 15-17 years
Health Conditions
- Percent of live births to mothers who were overweight or obese based on BMI before pregnancy
- Percent of live births where mothers gained an appropriate amount of weight during pregnancy according to pre-pregnancy BMI
- Percent of adults aged 18+ years who are obese
- Percent of adults aged 18+ years who are overweight or obese
- Percent of children aged 2-14 years who are obese
- Percent of children aged 2-14 years who are overweight or obese
- Percent of children aged 2-14 years who are underweight
- Percent of high school students who are obese
- Percent of high school students who are overweight
- Percent of adults aged 18+ years who have ever had cholesterol screening and been told by a health care providers that they had high blood cholesterol
- Percent of adults aged 18+ years who have ever been told by a health care provider that they had high blood pressure
Additional Resources and other data sources
CDC National Behavioral Risk Factor Surveillance System
CDC National Youth Risk Behavior Surveillance System
National Survey of Children's Health
CDC National Pregnancy Risk Assessment Monitoring System
CDC National Vital Statistics System
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Mental Health
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Mental Health
General Questions to Consider
- How does your county compare on this indicator to other communities (regional neighbors, other counties, the state, nation)? How does it compare to the Healthy People 2020 objective?
- Does the confidence interval for an indicator in your county overlap with confidence intervals for the same indicator in other counties? If they do not overlap, what does that statistically significant difference mean for your county?
- What could the difference (whether significant or not) tell you about the relationship this indicator has with your neighbors, region or state? If there is a significant difference, what does this mean? What could it mean if it’s not significant?
- Are there subpopulations in your county that may have an impact on this indicator? Is there programming to address these needs? Are there ways to measure the effectiveness of programming already in place? Do any of the neighboring counties in your region have programs or resources for addressing these needs?
- If there are no data available for your county on this indicator, are there other data available that are related or similar in content that could serve as this data point? Is it appropriate to use the regional value in the absence of your county value?
- How does the impact of this indicator compare to the impact of other indicators you are assessing? Is it statistically significant? If so, does that indicator have a greater impact on community health compared to other statistically significant indicators?
- What are the resources available for addressing this in the community? Who could be the community partners in addressing this issue? Will there be more or less community (nonprofit, political, business, etc) support around this topic? What other areas of the community will be impacted by addressing this need?
Indicator-Specific Questions to Consider
Mental Health Status
- Are there services or programs currently available to new or pregnant mothers dealing with mental health issues? Does the data support a need for these services or programs?
- How do Colorado high school students compare to the nation with regard to mental health and suicide? Are there local data available in your community on student mental health?
- How does the rate of suicide and mental health hospitalizations in your county compare to the health region and state? What are the other data that may be related to these rates? Does that data support the rates for your community?
Substance Abuse
- How does Colorado compare to the nation for high school substance abuse of alcohol and marijuana? How can you find out if this is an issue for the teenagers in your county?
- Is adult binge drinking a problem for your community? Do you observe a higher percent than the state?
- Accounting for both teenagers and adults, what does the data show about substance abuse for your county? Are there other data that you could view in order to answer that question?
Functional Status & Quality of Life
- Are more adults in your community reporting poor mental or poor physical health compared to other communities? What are some of the other data that are indicative of poor health? (i.e. diabetes, high cholesterol, asthma, etc) Does the other data support what adults are reporting for mental and physical health?
- Is there a relationship between the average number of days when health was not good and life satisfaction? How often is poor health keeping adults in your community from doing normal activities?
- Are adults in your county getting the support they need? What kinds of adult support systems/programs/services exist in your community?
Selected Indicators Website: Colorado Health Data website
Mental Health Status
- Percent of women who often or always felt down, depressed, sad or hopeless since the new baby was born (Postpartum depressive symptoms)
- Percent of women who experienced 1 or more major life stress events 12 months before delivery
- Percent of high school students who felt sad or hopeless almost every day for 2 or more weeks in a row so that they stopped doing some usual activities during the past 12 months
- Percent of high school students who seriously considered attempting suicide during the past 12 months
- Mental health hospitalizations
- Suicide hospitalizations
- Percent of parents who reported behavioral or mental health problems in children aged 1-14 years
Substance Abuse
- Percent of women who drank alcohol during the last 3 months of pregnancy
- Percent of high school students who had five or more drinks of alcohol within a couple of hours
- Percent of high school students who used marijuana one or more times during the past 30 days
- Percent of adults who reported binge drinking in past 30 days
Functional Status & Quality of Life
- Percent of adults who reported that their general health was fair or poor
- Average number of days in the past 30 days when their physical health was not good
- Average number of days in the past 30 days when their mental health was not good
- Percent of adults who usually or always get the emotional or social support they need
- Percent of adults who are satisfied or very satisfied with their life in general
- Percent of parents of children aged 1-14 years who reported that their child’s general health was fair or poor
- Average number of days of poor physical or mental health that kept them from doing usual activities, such as self-care, work, or recreation
Additional Resources and other data sources
CDC National Behavioral Risk Factor Surveillance System
CDC National Youth Risk Behavior Surveillance System
National Survey of Children's Health
CDC National Pregnancy Risk Assessment Monitoring System
CDC National Hospital Discharge Survey
Suicide Prevention Coalition of Colorado
CDPHE Suicide Prevention Resource Center
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Access, Utilization and Quality Care
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Access, Utilization and Quality Care
General Questions to Consider
- How has this indicator been changing? Is it getting better or worse?
- Do the trends seem reflective of the age profile of the county? Of the racial/ethnic diversity of the county? Of the poverty rates in the county? Of other factors?
- How does your county compare on this indicator to other communities (regional neighbors, other counties, the state, nation)? How does it compare to the Healthy People 2020 objective?
- Does the confidence interval for an indicator in your county overlap with confidence intervals for the same indicator in other counties? If they do not overlap, what does that statistically significant difference mean for your county?
- What could the difference (whether significant or not) tell you about the relationship this indicator has with your neighbors, region or state? If there is a significant difference, what does this mean? What could it mean if it’s not significant?
- Are there subpopulations in your county that may have an impact on this indicator? Is there programming to address these needs? Are there ways to measure the effectiveness of programming already in place? Do any of the neighboring counties in your region have programs or resources for addressing these needs?
- If there are no data available for your county on this indicator, are there other data available that are related or similar in content that could serve as this data point? Is it appropriate to use the regional value in the absence of your county value?
- How does the impact of this indicator compare to the impact of other indicators you are assessing? Is it statistically significant? If so, does that indicator have a greater impact on community health compared to other statistically significant indicators?
- What are the resources available for addressing this in the community? Who could be the community partners in addressing this issue? Will there be more or less community (nonprofit, political, business, etc) support around this topic? What other areas of the community will be impacted by addressing this need?
Indicator-Specific Questions to Consider
Received Need Care
- Are pregnant women in your community accessing the appropriate medical services during their pregnancies? Are the services readily available in your county?
- Are community members utilizing dental services? If they are not, what are some of the barriers in your community for accessing dental care?
Preventative Care
- Are adults accessing preventative services in your community? If not, are there challenges to accessing these services in your community?
- Are the preventative care data consistent with the health outcome data for those conditions? If not, what might be some of the reasons the data are not consistent?
Health Insurance Coverage
- Are there are large proportion of eligible children not accessing CHP+/Medicaid in your community? Why might they not be enrolling? What are the challenges to enrolling for these kids in your community? Do these challenges also apply to the eligible but not enrolled adults in your area?
- Does your community have a larger proportion of the uninsured population? Are there a larger proportion of uninsured children or adults? What are some of the factors that might play a role in this?
Provider Availability
- Which safety net providers are accessible in your community? Which are not? Are there neighboring communities that have resources that community members can utilize?
- Are the data consistent with public insurance enrollment or uninsured, preventative care services utilized, etc? Are community members able to access the services they need from the services available in the community? Are community members able to access services they need based on insurance coverage?
Selected Indicators Website: Colorado Health Data website
Received Needed Care
- Percent of mothers reporting that a doctor, nurse or other health care worker talked with them about what to do if they felt depressed during pregnancy or after delivery
- Percent of women who went for dental care during pregnancy
- Percent of adults aged 18+ years who visited the dentist for any reason within the past 12 months
- Percent of women who received adequate prenatal care
Preventative Care
- Percent of adults who report having had a flu shot in the past 12 months
- Percent of adults who report having ever had a pneumonia shot
- Percent of adults aged18+ years who have had cholesterol screening in the past 5 years
- Percent of females aged 40+ years who report having had mammogram within the last 2 years
- Percent of females aged 18+ years who report having hadPpapanicolaou smear within the last 3 years
- Percent of adults aged 50+ years who had colonoscopy within 10 years OR sigmoidoscopy within 5 years OR FOBT within the last 1 year
Health Insurance Coverage
- Number and percent of children eligible but not enrolled (EBNE) in Medicaid
- Number and percent of children eligible but not enrolled (EBNE) in CHP+
- Number and percent of working-age adults (19-64 years) eligible but not enrolled (EBNE) in Medicaid
- Number of uninsured by age
Provider Availability
- Number of safety net providers
- Percent of adults who report having one or more regular health care providers (medical home)
Additional Resources and other data sources
CDC National Pregnancy Risk Assessment Monitoring System
CDC National Behavioral Risk Factor Surveillance System
CDC National Center for Health Statistics
Overview of the Kotelchuck Adequacy of Prenatal Care Utilization Index
The Colorado Trust
Kaiser Family Foundation-State Health Facts
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Population Health Outcomes
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Population Health Outcomes
General Questions to Consider
- How has this indicator been changing? Is it getting better or worse?
- Do the trends seem reflective of the age profile of the county? Of the racial/ethnic diversity of the county? Of the poverty rates in the county? Of other factors?
- How does your county compare on this indicator to other communities (regional neighbors, other counties, the state, nation)? How does it compare to the Healthy People 2020 objective?
- Does the confidence interval for an indicator in your county overlap with confidence intervals for the same indicator in other counties? If they do not overlap, what does that statistically significant difference mean for your county?
- What could the difference (whether significant or not) tell you about the relationship this indicator has with your neighbors, region or state? If there is a significant difference, what does this mean? What could it mean if it’s not significant?
- Are there subpopulations in your county that may have an impact on this indicator? Is there programming to address these needs? Are there ways to measure the effectiveness of programming already in place? Do any of the neighboring counties in your region have programs or resources for addressing these needs?
- If there are no data available for your county on this indicator, are there other data available that are related or similar in content that could serve as this data point? Is it appropriate to use the regional value in the absence of your county value?
- How does the impact of this indicator compare to the impact of other indicators you are assessing? Is it statistically significant? If so, does that indicator have a greater impact on community health compared to other statistically significant indicators?
- What are the resources available for addressing this in the community? Who could be the community partners in addressing this issue? Will there be more or less community (nonprofit, political, business, etc) support around this topic? What other areas of the community will be impacted by addressing this need?
Indicator-Specific Questions to Consider
Quality of Life
- Are more adults in your community reporting poor mental or poor physical health compared to other communities? What are some of the other data that are indicative of poor health? (i.e. diabetes, high cholesterol, asthma, etc) Does the other data support what adults are reporting for mental and physical health?
- Is there a relationship between the average number of days when health was not good and life satisfaction? How often is poor health keeping adults in your community from doing normal activities?
- How is the reported general health of the children in your community compared to the adult’s? What is the proportion of adults and children in your community? In general, is there a particular age group or two that may need to be prioritized in the community?
Morbidity
Arthritis
- What kinds of demographics may influence the percent of adults with arthritis in your community? (Age distribution, occupational industries, etc)
Asthma
- How do the county’s asthma percentages compare with other counties, regions and the state? What are some of the environmental data that may contribute to asthma rates? How does that data compare to other counties, regions and the state?
- How does the percent of people with asthma compare between each age group? Where is the largest percent and what are some programs or policies to improve their prevalence?
Cancer
- How does the county’s rate of all invasive cancers compare to the states? Are there one or two types of cancer that may be disproportionately contributing to the rate of all invasive cancers?
- Are the males and females affected by the gender-specific cancers differently? What other data might give more insight to the gender-specific cancer rates? (Demographics, sexual health, etc)
- Can any of the data on health behaviors and conditions provide insight to the higher rates of cancer found in your community? (Example: Increased smoking rates may be associated with increased rate of lung and bronchus cancer)
Diabetes
- Are the percent of adults with diabetes consistent with the data for chronic conditions? What kinds of programs or services can be offered in the community to address diabetes?
Heart Disease and Stroke
- Does your community experience increased heart disease and stroke hospitalizations? What role or relationship with local health care providers (clinicians, hospitals, etc) could be formed to address these issues?
Oral Health
- Is there a shortage of oral health services offered in your county? Does the data support this?
- What are the data gaps, where data is missing, for your community? Are there other ways to obtain this information for your area?
Communicable Disease
- What are the rates of STIs (sexually transmitted infections) for your community? What are some of the social determinants of health that influence these rates? What does sexual health education look like in your community?
- What are the environmental conditions that might contribute to increased disease incidence in your county? (Larger mosquito population, contaminated water source, etc)
- If there is increased foodborne illness in your county, what environmental health resources are needed to address this? Is there any available information from health inspections that may be useful when considering communicable disease in your county?
Occupational Health
- Are there any high risk occupational industries in your community? Do the data show increased occupational injuries?
- What resources are available for occupational health in your community? What community partners could work with you to address occupational health needs?
Birth Defects
- How does the community’s rate of major congenital anomalies compare to other places? Percent of low birth weight? What are other data that may give insight to this issue? (Prenatal care, preconception health, etc)
- What effective programs exist in your community to address birth defects? How can this information be shared across the entire county and with other counties experiencing increased rates?
Injury
- What are the various dynamics in your community that pose safety challenges? Does your community have lots of mountain roads or abundant wildlife that may contribute to motor vehicle accident hospitalizations? Does your community have a larger child population that might account for accidental ingestions of toxic substances resulting in hospitalizations?
- What other factors exist in your community that poses public safety challenges? (Ski/snowboard activities and rock climbing or river activities that could lead to recreational injuries) Is there a way to measure this risk?
Mortality
- What are the other data available that provide more information about infant mortality rate? Are these data consistent?
- Which communities have low infant mortality rates and what kinds of related services and programs are available?
- Are the leading causes of death and years of potential life lost (YPLL) consistent with the increased rates of disease you’ve already identified? Where are the discrepancies? What might be some of the reasons for differences between the disease data and the leading cause data?
Selected Indicators Website: Colorado Health Data website
Quality of Life
Adults
- Percent of adults who reported that their general health was fair or poor
- Average number of days in the past 30 days when their physical health was not good
- Average number of days in the past 30 days when their mental health was not good
- Percent of adults who are satisfied or very satisfied with their life in general
- Average number of days of poor physical or mental health that kept them from doing usual activities, such as self-care, work, or recreation
Children
- Percent of parents of children aged 1-14 years who reported that their child’s general health was fair or poor
Morbidity
Arthritis
- Percent of adults aged 18+ years with arthritis
Asthma
- Percent of adults aged 18+ years that currently have asthma
- Percent of high school students with asthma
- Percent of children aged 1-14 years with asthma
Cancer
- Incidence rate of invasive cancer (all sites combined) among persons of all ages
- Incidence rate of invasive cancer of the female breast among females of all ages
- Incidence rate of invasive cancer of the cervix among females of all ages
- Incidence rate of cancer of the colon and rectum among persons of all ages
- Incidence rate of cancer of the lung and bronchus among persons of all ages
- Incidence rate of invasive melanoma among persons of all ages
- Incidence rate of invasive cancer of the prostate among males of all ages
Diabetes
- Percent of adults aged 18+ years with diabetes
- Percent of women who had diabetes that started during pregnancy
Heart Disease and Stroke
- Stroke hospitalizations
- Heart disease hospitalizations
- Acute myocardial infarction hospitalizations
- Heart failure hospitalizations
- Percent of adults aged 18+ years who ever had a heart attack
- Percent of adults aged 18+ years who ever had angina or coronary heart disease
Oral Health
- Percent of adults aged 18+ years who ever lost any teeth due to decay or periodontal disease
- Percent of children aged 1-14 years with fair or poor condition of teeth
Communicable Disease
- Tuberculosis cases and incidence
- AID incidence
- HIV incidence
- Chlamydia incidence for 15-29 year olds
- Gonorrhea incidence for 15-29 year olds
- Influenza hospitalizations for 65+ year olds
- Pertussis incidence
- Hepatitis A incidence
- Hepatitis B incidence
- Campylobacter incidence
- STEC (shiga toxin producing E.coli) incidence
- Salmonella incidence
- Shigella incidence)
- West Nile Virus incidence
- Number of reported outbreaks of foodborne illness
Occupational Health
- Non-fatal Lost-time Workers’ Compensation Claims by County
- Work-related hospitalizations
Birth Defects
- Major congenital anomalies
- Percent of live births with low birth weight
Injury
- Motor vehicle accident hospitalizations
- Unintentional poisoning hospitalizations
Mortality
Infants
All
- Years of Potential Life Lost (YPLL) by age 65
- Age-adjusted ten leading causes of death
- Age-adjusted ten leading causes of YPLL
Additional Resources and other data sources
CDC National Behavioral Risk Factor Surveillance System
National Survey of Children's Health
CDC National Youth Risk Behavior Surveillance System
CDC National Program of Cancer Registries
Colorado Cancer Coalition
CDC National Pregnancy Risk Assessment Monitoring System
CDC National Hospital Discharge Survey
National Birth Defects Prevention Network
CDC National Center for Health Statistics
National Highway Traffic Safety Administration
Colorado Department of Transportation
AAPCC National Poison Data System
Rocky Mountain Poison & Drug Center (RMPDC)
RADARS System (RMPDC)
McDonnell S et al, 1998
CDC Tuberculosis
Curry International Tuberculosis Center
CDC HIV/AIDS
CDC Sexually Transmitted Diseases
Black AIDS Institute
Latino Commission on AIDS
American Social Health Association
Colorado Communicable Disease Manual
CDC Pertussis (Whooping cough)
CDC National Notifiable Diseases Surveillance System
CDC Viral Hepatitis
Colorado FoodNet-Emerging Infections Program
CDC FoodNet-Foodborne Diseases Active Surveillance Network
CDC Nationally Notifiable Infectious Conditions 2011
CDPHE West Nile Virus
US Geological Survey maps of West Nile Virus Surveillance
CDPHE Outbreak Page
CDC Foodborne Outbreak Investigations
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Additional Resources for Community Health Assessment
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Health Indicators Inventory List
Indicator List Version 2.0
Coming Soon!
Health Indicator Resources
For technical assistance and data request information please contact:
Alison Grace Bui, MPH
Public Health Data Coordinator
Vital Statistics Unit, Health Statistics Section
Colorado Department of Public Health and Environment
Phone: 303-692-2139
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