Enhancing Capacity for Surveillance of Chronic Disease Risk Factors and Determinants Strategy

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Measuring the Health of the Population
Presented by Paula Stewart MD,
FRCPC Surveillance Division, CCDPC Public Health
Agency of Canada November 7, 2006
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Listening to the Population Health Surveillance

• The tracking and forecasting of any health event
  or health determinant
• through the continuous collection of high-quality
  data,
• the integration, analysis and interpretation of
  those data into surveillance products (such as
  reports, advisories, warnings)
• and the dissemination of those surveillance
  products to those who need to know.
• Surveillance products are produced for a specific
  public health purpose or policy objective.

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IDEAL SURVEILLANCE SYSTEM

Improve health of the population
Action Based on Information
Policies Programs Services
Identify need for population Information
Data Analysis/ Interpretation
Surveillance Products and Dissemination
Data Collection/ Collation
Indicator Framework
Management Coordination/Collaboration Legislation
Regulation
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Surveillance can be used to

• Plan health services gives context
• Monitor trends
• Clusters of risk factors/determinants, emerging
  issues
• Tailor policies and programs
• Complements research evidence
• Evaluate policies, programs and services
• Point to research questions

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Need to decide what to measure

• Based on programs, policies and service needs
  what do we want to change?
• Indicator framework development
• Involve key people/organizations
• Senior level committment

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PHAC chronic disease indicators

• Common framework
• Risk factor and disease-specific content
• Developed with experts and users
• Linked to public health importance, feasibility
  and quality
• SMART specific, measurable, actionable,
  relevant, timely

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Chronic Disease Indicator Framework
Health promotion and prevention programs
policies
Community, school, workplace environment
Health Status
Individual knowledge, attitude, behaviours
Management programs policies
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Healthy Living and Chronic Disease
Surveillance Potential Data Sources
Administrative Databases - recreation,
municipalities, housing, transportation, police,
justice
Primary health care (CIHI)
Electronic Health Record Databases
Community environment

• On-going Surveys
• Central (CCHS, PAM, CTUMS, CLSCY)
• Regional/local (RRFSS, RHS First Nations)

Individual and Family
Health Services
P/T Health Admin - physician billing, hospital,
lab, drugs
School, workplace, other
Insurance Databases
Cancer Registries
EAP, school, prison databases
Mortality Databases
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Using surveillance information

• Accessing data
• Analysis and interpretation
• User- friendly products and dissemination
• PHAC NCD-infobase

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Examples

• Report The Face of Mental Health and Illness in
  Canada 2006
• Many indicators
• Many data sources used
• Audience public, politicians, media, community
  organizations, NGOs, academia, health service
  providers
• Available from PHAC booth

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Figure 1-5 Ability to handle unexpected problems,
by age, Canada, 2002
Source Statistics Canada, Canadian Community
Health Survey, 2002, Mental Health and Well-being
Cycle 1.2
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Figure 1-17 Ability to handle day-to-day demands
reported as fair or poor, by income adequacy,
Canada, 2002
Source Statistics Canada, Canadian Community
Health Survey, 2002, Mental Health and Well-being
Cycle 1.2
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Figure 1-8 Proportion of students who often feel
left out or lonely, by sex and grade, Canada, 2002
Source Health Behaviour of School-Aged Children
Survey, 2002, WHO.
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Figure 1-9 Proportion of students who feel they
do not belong at their school, by sex and grade,
Canada, 2002
Source Health Behaviour of School-Aged Children
Survey, 2002, WHO.
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Figure 1-12 Most important source of feelings of
stress among adults aged 25-44 years, by sex,
Canada, 2002
Respondents may have checked more than 1 source
of stress. Source Statistics Canada, Canadian
Community Health Survey, 2002, Mental Health and
Well-being Cycle 1.2
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Summary

• Important to know what is happening in the
  population
• Decide what you want to know about
• Use existing data sources where possible
• Interpret wisely and share results
• Create an environment and a thirst for
  surveillance information