Comparable Health Data Between Canada and the U.S.

1
Comparable Health Data Between Canada and the U.S.

• Many organizations such as the United Nations,
  World Health Organization and the Organization of
  Economic Cooperation and Development have noted
  the importance of internationally comparable
  statistics on health and functioning
• Such statistics are necessary to asses and
  compare the performance of national health
  systems and the health of the populations they
  serve

2
Comparable Health Data Between Canada and the U.S.

• There has been considerable interest in comparing
  health and health determinants in Canada and the
  US due to the fact that each country shares many
  similarities but has different health systems
• Previous research comparing similar survey data
  from the two countries has provided some useful
  insights and highlighted differences in certain
  health measures between Canadians and Americans.

3
Comparable Health Data Between Canada and the U.S.

• However, such comparisons are difficult to make
  and may not be completely accurate
• True differences
• vs.
• Measurement differences

4
Comparable Health Data Between Canada and the U.S.

• One of the key objectives of the joint survey is
  to produce a set of highly comparable health data
  on Canadian and U.S. populations that will enable
  researchers to better understand how the
  differing health care systems affect health care,
  health status and functional status

5
Analytical Purposes of Survey

• Methodological
• To compare the performance of 4 different
  measures of disability/restriction of activity
• International Comparisons
• To make useful and meaningful comparisons of
• The health of Canadians and Americans
• The strength of the relationships between health
  outcomes and selected determinants (including
  access to health care, insurance and
  socio-economic status)

6
Statistics on Disabilities and Activity
Limitations

• The joint survey will include 4 different
  measures of functional health -
  disability/restriction or limitation of
  activities
• In recent years many national statistical
  agencies under the impetus of the WHO and UN have
  strived to come up with internationally
  comparable disability statistics. This culminated
  at the Washington city group on disability
  statistics earlier this year.

7
Statistics on Disabilities and Activity
Limitations

• While receiving much attention internationally,
  no universally accepted set of questions have
  been found to provide effective and accurate
  results
• The joint survey will illuminate research on
  measuring disabilities/activity limitations using
  four separate sets of questions from Canada and
  the US

8
Statistics on Disabilities and Activity
Limitations

• The Canadian questions that are used in the joint
  survey employ the Health Utility Index,
  developed at Canadas McMaster University and the
  Participation and Activity Limitation Survey
  filter questions found on the Canadian Census of
  Population questionnaire.
• The US contributions to the joint survey employ
  both a form of it's own traditional measure
  Limitations of Activity and and a form of a
  Functional Limitations scale developed by
  American researchers.
• The order of these blocks of questions will be
  randomly chosen during the interview

9
Comparing Health and Health Determinants

• The resulting data from the survey will be very
  useful in assisting researchers studying
  differences in health status, health care
  utilization, the determinants of health and
  socio-economic correlates of health between the
  two countries

10
Comparing Health and Health Determinants

• In a Univariate and Bivariate framework
  researchers will be able to estimate prevalence's
  of various measures of health and health
  determinants by age and sex where possible
• Medical consultations and hospitalization
• Depression rates and contact with mental health
  professionals
• Chronic conditions such as heart disease,
  diabetes, hypertension, etc.
• Medication Use the of people using
  prescription medications in the past month

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Comparing Health and Health Determinants

• The data will also lend itself to studying more
  complex relationships
• Researchers will be able to model the
  determinants of health and compare models across
  the two countries
• socio-economic status and obesity
• insurance coverage and unmet health care needs
• Poor/fair health and health care utilisation
• Physical activity participation and other
  measures of health

12
Comparing Health and Health Determinants

• There are some limitations to the data however.
  Due to the sample size of the two survey
  populations, the analysis of certain variables
  may be restricted
• That is all variables may not have sufficient
  statistical power to provide estimates at the
  desegregated levels of both age and sex.

13
Comparing Health and Health Determinants

• However, many meaningful comparisons of selected
  health indicators can finally be made between the
  two countries
• Also researchers will be able to begin to examine
  and compare the factors (including health care
  systems) that may contribute to the level of
  health in each population

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Final Thoughts

• The harmonization of Canadian health concepts
  with those of the U.S. and the entire
  collaboration process between the two countries
  statistical agencies could potentially help
  develop a model for accepted practices worldwide
• The joint survey is a move forward in the ongoing
  quest for internationally comparable health
  statistics and hopefully will lead to further
  collaborations with the US and other countries.

15
Data Release

• Statistics Canada and the National Center for
  Health Statistics plan to release and distribute
  a Public Use Microdata File to all stakeholders
  in the fall of 2003.
• A users manual and initial publication outlining
  major findings of the survey will be also be
  released
• Information about the survey and the data will be
  made available on the STC and NCHS websites.
• Contact numbers and names to be supplied?