Monitoring and Analyzing School Health and Absenteeism Data

New York City Department of Health and Mental Hygiene

ISDS Webinar – July 30, 2009

School Health Data (ASHR)• EHR set up in schools by Office of School Health (2005)

• ~ 1000 public schools in NYC on system– Predominantly Kindergarten - 8th Grade– ~700 report on any day

• Visits to school nurse – Chief complaint (drop down menu)– Coded to syndromes– Fevflu = fever and/or general achiness– *ILI = fever GE 100.4 AND cough OR sore throat

• 8000 – 9000 visits per day

• SQL server

Absenteeism Data

• Initially evaluated by NYCDOHMH in 2003– Restarted May 2009

• Data from DOE– All public schools (~1500)– Present, absent, enrollment– Data 90% complete by 4pm that afternoon

• SFTP transfer from DOE to NYCDOHMH

Active Surveillance

• May 11 – June 26, 2009

• Schools asked to call if 5 or more students with ILI seen at nurse– Continue calling to report ILI for at least 5 days

• Schools considered for closure if:– 1% ILI for 1 or more days– 2% ILI for one day

• 63 schools met closure criteria• 23 schools closed (3 to 13 days)

Current Analysis• Modeling effect of school closure on daily ILI counts. Adjusting for:

– Day of week– Week of H1N1 outbreak– Borough– School type (elementary, middle, high)– Days since meeting closure criteria– Absenteeism– Enrollment

• Estimating attributable %ILI due to school closure

• Preliminary estimates show effect due to school closure

• Currently assessing overall impact of school closure on influenza transmission