Overview of the National Center for Health Statistics

National Committee on Vital and Health Statistics

Susan G. Queen

Director, Office of Planning, Budget, and Legislation National Center for Health Statistics

June 14, 2016

NCHS Mission

As the nation’s principal health statistics agency, NCHS’ mission is to provide statistical information that will guide actions and policies to improve the health of the American people

NCHS accomplishes this by the collection and dissemination of accurate, relevant, and timely data

CDC Mission As the nation’s health protection agency, CDC

saves lives and protects people from health threats

CDC accomplishes this by:

detecting and responding to new and emerging health threats

Tackling the biggest health problems causing death and disability

Promoting healthy and safe behaviors, and more…

HHS Mission

• Cabinet level Department whose mission is to enhance and protect the health and well-being of all Americans

• HHS accomplishes this by providing for effective health and human services and fostering advances in medicine, public health, and social services.

NCHS: Designated Statistical Agency

A Federal Statistical Agency* is:

an organizational unit of the Executive Branch whose activities are predominantly the collection, compilation, processing, or analysis of information for the description, estimation, or analysis of the characteristics of groups, without identifying the individuals or organizations that comprise such groups.

*Confidential Information Protection and Statistical Efficiency Act, P.L. 104-347, Section 502(7)

NCHS Data Collection Systems

• National Vital Statistics System

• National Health Interview Survey

• National Survey of Family Growth

• National Health and Nutrition Examination Survey • National Health Care Surveys

National Survey of Family Growth • Data source • In-person interview with men and women ages 15-44,

representative of noninstitutionalized civilian US population

• Data on – Reproductive health

• Fertility/infertility

• Contraception

• Pregnancy

• Sexual activity

– Family formation

• Marriage, divorce, cohabitation

National Health and Nutrition Examination Survey (NHANES)

• Data source – Standardized physical examinations, laboratory tests,personal

interviews with a nationally representative annual sample of ~5,000 persons

• Data on – Disease/condition prevalence – Nutrition – Body measures – Growth and development – Health-related behaviors – Risk factors

Current U.S. Federal Statistical System National Center for

Health Stat ist ics Bureau of National Center for Transportation Statistics Education Stat ist ics

Economic Bureau of Research Service

Labor Statistics

National Bureau of Agricultural Justice Statistics Statistics Service

Energy Census Bureau Information

Administration Nat ional Center

Bureau of for Science and Economic Analysis Engineering Stat ist ics

IRS Statistics SSA Office of Research, of Income Evaluation and Statistics

Chief Statistician OIRA/OMB

Guidance for Statistical Agencies

• OMB Statistical and Science Policy coordination

• OMB Statistical Policy Directives*

• Standards and Guidelines for Statistical Surveys**

• Committee on National Statistics established 1972

• Principles and Practices for a Federal Statistical Agency

*79 FR 71610, Dec 2, 2014 and 73 FR 12622, March 7, 2008 **71 FR 55522, Sept. 22, 2006

Principle of Independence • Functional separation from program & regulatory activities

• Authority over scope, content and frequency of data

• Authority to speak about the agency’s statistics before Congress, with congressional staff, and before public bodies

• Maintain a clear distinction between statistical information and policy interpretations of such information

• Authority to release statistical information without prior clearance by policy officials

Organizational Placement of NCHS

NCHS operates in a Department whose mission is accomplished by policy, regulatory & programmatic action

NCHS is located in an HHS Operating Division that must make recommendations, take positions, and must advocate for actions to protect the health of the nation

In HHS Operating Division, NCHS is positioned as 1 of 2 Centers under the Office of Public Health Scientific Services

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NCHS as a Statistical Agency: Secretarial Designation

1995: HHS Secretary designates the Director of NCHS to serve as Senior Advisor to the Secretary for Health Statistics; reports directly to the Secretary

Designation: NCHS Director reports directly to CDC Director on NCHS operations

Designation emphasized CDC holds NCHS “in trust” for the entire Department. Purpose: to assure that HHS has a strong, independently functioning statistics program

Budget Update FY 2016 FY 2016 funding for CDC:

• $6.27 Billion in Budget Authority; $272.6M increase over FY15

• $89 Million in PPHF funding, increase of $5M over FY 2015

FY 2016 funding for Health Statistics:

• $160.39 Million in Budget Authority; $5M increase over FY15 for improving electronic death reporting

• No PPHF funds ($12 million requested) to support NHIS sample increase or content to monitor changes in health care system

FY 2017 Budget Request

President’s Budget (PB) request for CDC $5.96 Billion

PB request for Health Statistics $160.39 Million

NCHS would maintain ongoing health and health care surveys and purchase vital registration data

No PPHF Health Statistics request made for FY 2017

Senate Appropriations Committee Report increases CDC by $186M over the PB

Senate Appropriations Committee Report cuts Health Statistics by $4.396M from the PB

Initiatives Involving Statistical Agencies Key Role for NCHS:

• New Commission on Evidence-Based Policy Making

• Sharing Administrative Data for Statistical Purposes

• Departmental Implementation of OMB Directive No. 1

• Annual Budget Requirement: identifying and sharing high value administrative data for statistical purposes

Future Focus for NCHS • Electronic health records

• Retain or improve survey response rates

• NHIS redesign to be in the field January 2018

• Continue to improve timeliness & quality of vitals

• Using administrative records and other sources of data

• Innovation and the application of new technologies

Challenges Independence of NCHS as a statistical agency

Coordination with CDC/HHS: Mission of parent agency is not the same as the mission of the statistical agency

Declining participation and response rates

Resources: balancing ongoing activities with innovation

Ensuring the relevance of NCHS’ statistical information

Questions?

Thank you