Board of Scientific CounselorsBoard of Scientific CounselorsNCHS UpdateNCHS Update

September 2008September 2008

Today’s UpdateToday’s Update

• Welcome!Welcome!

• NCHS Data Users ConferenceNCHS Data Users Conference

• Other NCHS ActivitiesOther NCHS Activities

• Update on Healthiest Nation initiativeUpdate on Healthiest Nation initiative

• Budget UpdateBudget Update

New Board MembersNew Board Members

• Llewellyn Cornelius, PhD, University of Llewellyn Cornelius, PhD, University of Maryland School of Social WorkMaryland School of Social Work

• Holly Hedegaard, MD, MSPH, Colorado Holly Hedegaard, MD, MSPH, Colorado Department of Public Health and Department of Public Health and EnvironmentEnvironment

• Jose Escarce, MD, Ph.D., UCLA /RANDJose Escarce, MD, Ph.D., UCLA /RAND

• Kathleen Mullan Harris, PhD University Kathleen Mullan Harris, PhD University of North Carolina Carolina Population of North Carolina Carolina Population CenterCenter

2008 NCHS Data Users Conference2008 NCHS Data Users Conference

• August 11-13, Washington , DCAugust 11-13, Washington , DC

• Over 1,100 AttendeesOver 1,100 Attendees

• Keynote Address by Peter Orszag, PhD, Keynote Address by Peter Orszag, PhD, Director of the Congressional Budget Director of the Congressional Budget OfficeOffice

CBO’s Activities in Analyzing Health CBO’s Activities in Analyzing Health CareCare

• New Hires and Expanded StaffingNew Hires and Expanded Staffing

• New Deputy Assistant Director (Keith New Deputy Assistant Director (Keith Fontenot) in the Budget Analysis Fontenot) in the Budget Analysis DivisionDivision

• Increase in health staff agency wide Increase in health staff agency wide from 30 FTEs to 50 FTEsfrom 30 FTEs to 50 FTEs

CBO’s Uses of NCHS Data SetsCBO’s Uses of NCHS Data SetsExamplesExamples

• Comparisons of measured BMI and Comparisons of measured BMI and self-reported BMI (NHANES)self-reported BMI (NHANES)

• Estimates of Medicaid long term Estimates of Medicaid long term care costs (National Nursing Home care costs (National Nursing Home Survey)Survey)

• Analysis of the impact of increases Analysis of the impact of increases in certain chronic conditions on the in certain chronic conditions on the receipt of SSDI (NHIS)receipt of SSDI (NHIS)

Current CBO Projects Using NCHS Current CBO Projects Using NCHS Data Sets and Administrative Data Sets and Administrative

DataData• Estimating the effects of current and Estimating the effects of current and

past obesity on Medicare spendingpast obesity on Medicare spending

NHANES I Epidemiologic Follow-up NHANES I Epidemiologic Follow-up Study (20-year follow-up) linked to Study (20-year follow-up) linked to Medicare claims dataMedicare claims data

• Medicare spending with and without Medicare spending with and without health insurance prior to Medicare health insurance prior to Medicare eligibilityeligibility

NHIS data linked to Medicare claims NHIS data linked to Medicare claims datadata

CBO’s Wish List for DataCBO’s Wish List for Data

• Richer mortality Richer mortality

• Increase in longitudinal dataIncrease in longitudinal data

• Data on the social environmentData on the social environment

• Development of a single National Development of a single National Health IndicatorHealth Indicator

Current NCHS ActivitiesCurrent NCHS Activities

• Transition Planning Transition Planning

• Meeting the needs of the next Meeting the needs of the next AdministrationAdministration

• Congressional Briefing Congressional Briefing

• Briefing of Congressional staffers on Briefing of Congressional staffers on NCHS data and resources – September NCHS data and resources – September 2424thth

NHIS Paradata NHIS Paradata

• New management tool:New management tool:

• Paradata is detailed information Paradata is detailed information tracking the survey process tracking the survey process

• Potential use: Identifying interviewer Potential use: Identifying interviewer falsification by analyzing falsification by analyzing

• Respondent response time Respondent response time • Item response rate Item response rate • Adherence to protocol, for Adherence to protocol, for

example, choice of respondentexample, choice of respondent

Uses of New NHIS Paradata Uses of New NHIS Paradata

• Studying household member Studying household member

• Predicting agreement to be Predicting agreement to be interviewed based on initial interviewed based on initial doorstep responsedoorstep response

• Productivity of “n” tries to “convert” Productivity of “n” tries to “convert” a refusal a refusal

ChildStats.Gov Web PageChildStats.Gov Web Page

New Home in North CarolinaNew Home in North Carolinain Research Triangle Parkin Research Triangle Park

Healthiest Nation InitiativeHealthiest Nation InitiativeHealthiest Nation AllianceHealthiest Nation Alliance

• A new effort

• Focused on improving health through Focused on improving health through prevention prevention and protection from emerging and protection from emerging threatsthreats

• Fostering improved health through actions at Fostering improved health through actions at the “grass roots” or community level by the “grass roots” or community level by • Individuals• Community leaders• Employers• States

• Effectively applying current knowledge Effectively applying current knowledge

• Linking health to all policiesLinking health to all policies

• Valuing health and making it a priority Valuing health and making it a priority

Healthiest Nation InitiativeHealthiest Nation InitiativeHealthiest Nation AllianceHealthiest Nation Alliance

• Key PremisesKey Premises

• Health status in the United States can be Health status in the United States can be improved through more effective application improved through more effective application of current knowledgeof current knowledge

• Measurement of health is a prerequisite to Measurement of health is a prerequisite to action action

• Critical to evaluationCritical to evaluation

• NCHS role

• Expanding the measurement of healthExpanding the measurement of health•Community•Employers• Individual

FY 2009 BudgetFY 2009 Budget

• Senate, House Committees have Senate, House Committees have recommended $11M increase to $124.7M recommended $11M increase to $124.7M

• Delay expected (no change from FY 2008 is Delay expected (no change from FY 2008 is possible) possible)

• Actions taken to meet the budget Actions taken to meet the budget constraints: constraints: • Reducing by half the National Health Reducing by half the National Health

Interview Survey sample.Interview Survey sample.• Postponing the Nursing Home SurveyPostponing the Nursing Home Survey• Not fielding the National Hospital Not fielding the National Hospital

Discharge Survey in calendar year 2009, Discharge Survey in calendar year 2009, and suspending work towards the survey and suspending work towards the survey redesignredesign

• Postponing NHANES capital expendituresPostponing NHANES capital expenditures

FY 2009 BudgetFY 2009 Budget

• Actions taken to meet the budget Actions taken to meet the budget constraints: constraints:

• Vital Statistics, details now under Vital Statistics, details now under negotiation: negotiation: • Purchasing only “core items” of Purchasing only “core items” of

birth and death data from statesbirth and death data from states• Investing in infrastructure to Investing in infrastructure to

increase timeliness, quality and increase timeliness, quality and consistency of data obtained from consistency of data obtained from vital recordsvital records

FY 2010 Budget FY 2010 Budget

• Continued flat or reduced funding will Continued flat or reduced funding will necessitate further program reductionsnecessitate further program reductions

• Possible program changes: Possible program changes: • NHIS – further reductions to the NHIS NHIS – further reductions to the NHIS

sample sample

• NHANES – NHANES – • Reducing the sample size by halfReducing the sample size by half• Eliminating oversampling of minority Eliminating oversampling of minority

populationspopulations• Or removing NHANES Or removing NHANES

• Postponing Home and Hospice Survey Postponing Home and Hospice Survey (limiting data on long term care)(limiting data on long term care)

Support for FundingSupport for Funding

• Support from collaboratorsSupport from collaborators

• Support from CongressSupport from Congress

• Support from Support from Friends of NCHSFriends of NCHS

Program ProgressProgram Progress

ExamplesExamples

• Increased timeliness in every Increased timeliness in every programprogram

• High productivity – more releases High productivity – more releases and publicationsand publications

• New analysis toolsNew analysis tools

• Expanded Research Data Center Expanded Research Data Center ProgramProgram

• New publications: For example, New publications: For example, policy-oriented policy-oriented Data BriefsData Briefs