HRSA/MCHB 2005 FEDERAL/STATE PARTNERSHIP MEETING

PUBLIC HEALTH ACROSS THE LIFESPAN

Office of Data and Program Development

MICHAEL KOGAN: Thank you, Ann. Actually, the first thing I discovered when I walked in was somebody coming up to me and saying, “All the presentations are working well except yours. It didn’t come on.” So I’d first like to thank Carlton and Drew in the back who did such a wonderful job. There they are waving their hands. And I could have had a cow when I walked in. They told me that, but then I remembered that old story of a guy didn’t know what to do with his life and so he joins a monastic sect. And he has to take a vow of silence. He’s allowed to say two words every ten years. So ten years goes by and he comes up to the head Abbot and he says, “Bed hard,” and he returns. Another ten years pass. He comes up to the head Abbot and he says, “Food bad.” Finally, another ten years pass. He walked up to head Abbot. Head Abbot says, “Well, what do you have to say now?” He goes, “I quit.” And the Abbot says, “Well, no wonder you quit. All you’ve been doing is complaining for 30 years.”

So it’s nice to see a room of new faces out there. Actually, I can’t see anything, both because I don’t have my glasses on and because of the lights shining in my eyes. Let me -- oh, you’re not all new faces. I see Bill Holland’s head. Bill, I’m sorry about the money, I’ll get it to you by next payday, I promise. Any other new faces? Nora Wells. Yeah, I’m sorry about my behavior at the last conference. It was -- it was the wine. So without further adieu, let’s move on. I’m going to talk about the office of data and program development.

We have a number of focus areas in our office. In fact, we have so many that we have a candy bowl filled with Ritalin so people can keep track of them. Five areas are built and enhanced human resource capacity and MCH epidemiology. Built in enhanced data systems at the national, state and local levels; enhanced data and evaluation capacity within MCHB; collect and analyze data related to the MCHB strategic planning goals and MCHB program areas. And finally, we coordinate MCHB’s work on program accountability, evaluation and policy analysis. And I’m going to talk about all these in greater details. And we have a fairly small staff and they’re fairly dedicated. You can see the names. They’re actually all very competent, distinguished professionals in their areas of expertise, and almost all of them will be at the conference this week.

Now, the first area we’re going to talk about is build and enhanced human resource capacity in MCH epidemiology. I’m going to talk about a number of programs that we do in MCH epidemiology, many of which you’ll see are geared towards people at the state level. First, we have an annual series of four web-based MCH data speech providing skills building. Those could be on a number of topics; child death reviews, child obesity, prenatal care, trends in preterm birth or multiple births. A lot of people may have already tuned into those. They’re web-based. About two to 300 people tune in each time we have them. We also support and give grants to nine schools of public health to support MCH doctoral students, particularly those who use state or local data for their dissertation. This is one way we thought of to enhance the links between academia and state health departments. We also support the CDC HRSA program on state-based MCH epidemiologists using either Title V funds or other funding mechanisms. We support about 10 to 15 epidemiologists in the states. We co-sponsor the annual MCH epidemiology conference, which is primarily led by CDC. With CDC, we also sponsor training opportunities through the association with Maternal and Child Health programs at the MCH epidemiology conference for two days beforehand. And this year, the training will be on GIS training. And we provide scholarships to people in the states so if you know of somebody in the state who, in your state, who you think could use this training, please contact me or Juan Acuna at the CDC.

Now, we have other programs at MCH epidemiology such as the graduate student intern program. That is directed towards masters level students and doing the summer internship. That program has been going on for ten years. We fund about 20 students to work in state MCH or state epidemiology departments, particularly if they work with the MCH department.

There’s a new contract going on with us and CDC supporting the University of Illinois at Chicago on MCH epidemiology state assessment, and that’s trying to get at what are the essential skills that one should have in a state MCH department? You know, what should a model state MCH department look like, and what are states doing now to achieve that? It’s kind of to assess where we are in the field at this point.

In addition, a number of people in the states would talk about they either they don’t have the time or the support to publish in scientific journals. People, editors of journals say we would love to get more practice-based articles so we have a program that will help people in states write articles for scientific journals. We will help you; we could help you with data analysis, literature reviews, some of the writing. If you’re interested or have data and want to work on it, again, just contact me. And for the last four or five years, we’ve been doing the MCH training course for states and local areas we hold in different parts of the country each year. It’s about 40 students. We usually have many more people apply for that. It’s geared toward people at the mid-level in their data skills.

Now, in the second area, is build and enhanced data systems at national, state and local levels. And the first thing I want to mention is the national survey of child health. And that’s a partnership we’re doing with CDC and the National Center for Health Statistics, as Peter mentioned. And we’re doing an MCHB in coordination with David Heppel’s group. David is a co-project officer on that. This is the first national survey of children since 1988. When you think about it, it’s quite amazing. A lot of states didn’t have basic data. How many kids in your state had asthma? How many kids in your state had behavioral or emotional problems? Lot of states didn’t know. What’s truly unique about this survey, it’s the first time ever where we can get state level estimates. There are 102,000 children in the survey. As you see, we collected information on a whole variety of issues, and the data became public use in April of this year. And I’ll talk a little bit more about it later.

At this time, we’re in the field now with the second national survey on children with special health care needs. Like the first one, we’re identifying 750 to 1,000 kids per state screened in as having children with special health care needs. And we gather information on their health care experiences and the needs of their families. And the survey data collection began in January of 2005. We expect to be in the field through early 2006. In addition, unlike the first survey, we will have a comparison sample of children without special health care needs.

In our office, we’re also working with the National Institute of Health, and again, David’s group, on a quadrennial survey of 15,000 children in the U.S. in grades six through ten, looking at their health behaviors. We do the U.S. component of a survey that’s standardized across 30 countries. We’ve published a lot of data from it. You might have heard about the anti-bullying campaign that MCHB does. That came out -- that originated with data from the survey showing a high percent of kids who are either bullies or are bullied. The next survey is set to begin this academic year. And again, we use a lot of this data to provide background in adolescent health behavior in support of MCHB programs.

We have a number of other programs in building data capacity. One is, we work with their division of children with special health care needs, Bonnie’s group, on integrating health information systems. But what’s the purpose of getting good data unless you can provide better services? And so this is why we’re particularly pleased with this project because it ties in our data knowledge with providing better services at division level and trying to apply it at the state level. We’re also looking at the latest statistical techniques such as multi- level modeling, and trying to design programs with four state health departments and universities, again, to foster a link between academia and state health departments, and also to try to look at new ways that we can address disparities. Again, we had the same data sets. We kept looking at the same ways. Multi-level modeling allows you to look at both the individual level, like say from vital statistics, and match them to other data sets like the census. You can look at the over-arching themes in an area in relation to some individual birth outcomes. Again, with David’s group, we support data capacity building for state and community child death review teams.

And we have a new program. Actually, it’s been ongoing for a couple of years, but we have a web-based data resource center for both the national survey of children’s health, as well as the national survey for children with special health care needs. If you write nothing else down from my talk, I’d like to you write down this website: www.childhealthdata.org. You can go to this website and you can instantly get data on your state. You don’t have to have a background in statistics at all; you can simply query the data set. You can get information on your region; you can break it down by various groups. It’s very easy to use. And it’s an invaluable resource to you all.

We also have a number of other data collection and analysis activities. We do the Healthy People 2000, Maternal and Child Health Chapter, an annual publication. We’ve been doing for about over ten years is Child Health U.S.A. Another annual publication we started a few years ago in conjunction with the Office of Women’s Health, and the division of Perinatal Systems and Healthy Start, is Women’s Health U.S.A. We also have produced chart books on adolescent health, the health of children in the U.S. compared to 30 other countries. And we produced a chart book on children with special health care needs. Some of these will be in the back here during the conference such as Child Health U.S.A. and Women’s Health U.S.A. And if you’re interested in the others, again, just contact me.

We’ve also are planning to produce chart books in the National Survey of Children’s Health, on children’s health, oral health, obesity and world health. We produce a special issue of the Maternal and Child Health Journal on state and level analyses of children with special health care needs. It’s perhaps the first journal issue ever devoted almost exclusively to state level analyses. We will have copies of this in the back during the conference. We plan to produce geographic atlases on children’s and women’s health. We also plan to produce a special issue on the results from the National Survey of Children’s Health. So again, we’re putting out a call for papers now. If you’re interested or somebody in your state is interested on doing analysis on this data set, again, please come see me or email me. And we publish in scientific journals..

And finally, for the last (inaudible) on planning policy -- look, you know, I would be crying too if I had to listen to me speak. I’m real sorry about that. I know just how you feel. Is that an adult crying? Our last (inaudible) is planning policy and evaluation activities. We work on the HRSA and MCHB strategic plans. We work on the government performance and results act plans. We work on MCHB participation in the state children’s health insurance program. And we share MCHB’s evaluation committee. We also coordinate the evaluation training; we provide assistance to MCHB programs on evaluation development and managed care issues. And we serve as a link for cross cutting MCHB by evaluation efforts.

And finally, we provide technical assistance on data analysis on an as-needed basis to you, the regional offices, to territorial health offices, whenever you ask. And so it’s been great. I really appreciate the time. Am I on time? Great. So please contact me if you have any questions. Thanks very much. I appreciate it.