Data Deterioration and Public Health Policy

Abstract

health and human services programs while defense bud*\<sesA ~gets rose precipitously. In his litany of increases in public support for causes dear to the hearts of public healthworkers, however, one item was conspicuously missing-federal data systems. Whether he left it out of his poll or didn't think the results would be of interest is really immaterial. The fact is that the general public is not aware of what is happening to our federal data systems. Worse still, neither are many public health professionals. For most of us, it's a dusty, boring subject, best left to the statisticians and epidemiologists, while we run our important programs. And of course we assume that we can always call up statistical information when we need it. Unfortunately, that assumption may no longer be a valid one, because of the deterioration of our federal statistical programs over the past three years. At this point, it may be in order to review briefly what we use data for and what kinds of data we need. Information obtained from data systems is used for identifying problems, for prioritizing them, and then for measuring whether the solutions adopted are doing any good-in short, for planning and evaluating. State information systems are built on data received from the federal government, in particular, the census. Its population figures become what statisticians call "denominator data." The events measured in the states-births, deaths, illnesses, and so on-are the numerators. From the two, state numerators and federal denominators, we calculate rates, so that we can compare one region or town or group of citizens with another, and see who has the most pressing health needs.