This page provides definitions for common public health assessment and epidemiology
concepts. It also serves as an index to additional resources on the NM-IBIS system.
10 Essential Public Health Services
The 10 Essential Public Health Services
were developed in 1994 by the U.S. Public Health Service and include services such
as "Monitor health status," "Diagnose and investigate health problems," and
"Mobilize community partnerships."
For more
information, see CDC's
National
Public Health Performance Standards Program Website.
A.S.T.H.O.
The Association of State and Territorial Health Officers (ASTHO) is the
national nonprofit organization representing public health agencies in the United
States, the U.S. Territories, and the District of Columbia. ASTHO's voting membership
includes the chief health officials for each U.S. state and territory. ASTHO members
formulate and influence sound public health policy and promote excellence in state-based
public health practice.
ASTHO Website. See also
N.A.C.C.H.O..
Advocacy
Advocacy refers to organized efforts to change or
influence policies.
See also
Policy.
Age-adjusted Rate
Age-specific Birth Rate
The age-specific birth rate is the number of live births in a specific age
group of women per 1,000 women in that age group in the population.
The teen birth rate is considered an age-specific birth rate.
Age-specific Birth Rates for New Mexico
can be calculated using the
Birth Data Custom Query section of the NM-IBIS Website. See also
Crude Birth Rate.
Age-specific Rate
An age-specific rate is a
rate in which both the numerator (number of events)
and denominator (number in population at risk) are limited to a specific age group.
It is calculated by dividing the total number of health events for the specific age group of
interest by the total population in that age group.
[more on age-specific rates...]
Artifact
An artifact is any representation in data, such as choice of methodology, or observational or data entry errors, that would
cause a datum to misrepresent its true value.
Assessment
Assessment is the regular and systematic
collection, assembly, analysis, and dissemination of information about the
health of a community. Public health assessment, policy development and
assurance of access to quality health care are considered the three core functions of
government in public health. (Institute of Medicine (1988) The Future of Public Health,
National Academies Press.)
See also
Community Health Assessment.
Attributable Fraction
The theoretical proportion of the rate or number of cases of an adverse
health outcome that can be attributed to a given risk factor.
Bridged-Race
Data collected using the 1997 OMB standard for collection of race and ethnicity information are
not directly comparable to those that were collected using the 1977 standard. To permit trend
analysis, a methodology was developed to "bridge" population estimates that were collected using
the 1997 standard back to the categories used in the 1977 standard.
[more on race and ethnicity measurement...] C.S.T.E.
CSTE stands for "Council of State and Territorial Epidemiologists."
CSTE is a professional organization for public health epidemiologists.
Visit the CSTE Website
for more information.
Cause / Cause-and-Effect
There is philosophical debate about
the meaning of 'cause,' but for a working definition in epidemiology, we can
use a definition from Rothman and Greenland,
Causation and Causal Inference in Epidemiology, "...a cause of a specific disease
event [is] an antecedent event, condition, or characteristic that was necessary
for the occurrence of the disease at the moment it occurred, given that other
conditions are fixed."
Choropleth Map
Choropleth maps display data for predefined geographic areas. The areas on a
choropleth map are shaded or patterned to reflect values of a variable such
as population density or birth rate.
[more on NM-IBIS Choropleth Maps...]
Coefficient of Variation (CV)
Community Action Teams
Community action teams are generally task forces or
committees established to plan and implement activities that address a particular health priority.
They may include health council members as well as other community stakeholders.
Community Health Assessment
Community health assessment is a process of identifying and
quantifying the needs, conditions, and resources of communities with respect to health and health care.
Community health assessment processes include gathering secondary or published data and primary data
(locally-generated data through surveys, focus groups, interviews, or other means); analyzing and
interpreting the data; and establishing priorities for community health improvement.
See also
Assessment.
Community Health Status Indicators
Having a common set of core health status measures can help communities conduct health
assessments and identify priority health issues. The 46 Community Health Status Indicators (CHSIs)
provide consistent and comparable health assessment information for New Mexico Department of Health
and our community partners to work collaboratively to improve community health.
[more on New Mexico CHSIs...]
Community Mapping
Community mapping consists of the visual representation of
data by geography or location, in order to link information to place. Mapping is often used to identify
and locate community assets or services in relation to the populations they serve, in order to maximize
access throughout a given geographic area (neighborhood, city, region, state, or nation). Other uses include
identifying liquor store densities to neighborhood grocery stores and environments that encourage physical
activity. Mapping provides tools for identifying, analyzing, and communicating visually the patterns that
affect community health.
Comparability Ratio
A comparability ratio measures the level of agreement between ICD-9 and ICD-10 classification
systems. NCHS calculated comparability ratios for 113 selected causes of death by using a double-coding
exercise using 1996 death data. NCHS coded 1.8 million death certifications from 1996 first using
ICD-9 and then using ICD-10. Based on that double-coding, NCHS has produced the set of Comparability
Ratios for 113 Selected Causes of Death. Each ratio is an expression of the results of the comparison
as a ratio of death for a cause of death by the later revision divided by the number of cause of death
coded and classified by the earlier revision. To accurately portray trends that include both years
1980-1998 and 1999 on, the death counts or rates for the earlier years must be "comparability modified."
This is accomplished by multiplying the earlier death count (or rate) by the comparability ratio for
that cause of death. Use comparability-adjusted mortality counts and rates only when you need to display
years 1998 and earlier together with years 1999 and later.
[Click here for comparability ratios for NCHS leading causes.]
Confidence Interval
The confidence interval may be thought of as the range of probable true values for a
statistic. In general, as a population or sample size increases,
the confidence interval gets smaller. Estimates with smaller confidence intervals are referred
to as more "precise." Less precise estimates, such as those calculated from
small numbers, tend to have wide confidence intervals.
Typically, the 95% confidence interval (calculated as 1.96 times the standard error of a statistic)
indicates the range of values within which the statistic would fall 95% of the time if
the researcher were to calculate the statistic (e.g., a percentage or rate) from an infinite
number of samples of the same size drawn from the same base population.
[more on confidence intervals...]
Confounding Variable
The confounding variable is a variable that is related to, and may obscure one's view of, the
variable of interest. For instance, when examining death rates across populations, the population's
age distribution can be a confounding variable because higher death rates will be found in populations
with a greater proportion of persons in older age groups. In such a case, one could use an
age-adjusted rate to compare the populations.
Count
A count is simply the number of health events, such as a death or a reported disease incident, that
occurred within a specified time period.
[more on health event counts...]
Crude Birth Rate
The crude birth rate is the number of live births per 1,000
persons (males and females) in the population.
See also
Age-specific Birth Rate.
Crude Rates
D.A.L.Y.
DALY stands for "Disability Adjusted Life Years," and is a summary
measure of the impact of premature death and disability on the length and quality of life. It is
defined by the
World Health Organization as, "The sum of years of potential
life lost due to premature mortality and the years of productive life lost
due to disability."
See also
Y.P.L.L.,
Q.A.L.Y.
Descriptive Epidemiology
The study of the amount and
distribution of a disease in a specified population by person, place,
and time.
Denominator
The denominator is the divisor in division (for instance, where 12/3=4,
the number 3 is known as the divisor, 12 is the dividend and 4 is the quotient). In public health, the denominator
for a disease rate is the number of persons (or person-years) at risk, or the estimated population. For instance,
for 23 deaths in a population of 15,000, the death rate would be 23/15,000, or 0.001533, or 153.3 per 100,000 population.
In that example, 15,000 is referred to as the denominator.
NMDOH standard population data files,
NMDOH Principles for Updating Numerator and Denominator Data
Direct Age Standardization
Disparities
Endemic
A disease or condition that is
present in a community at all times but at a relatively low level.
Epidemic
The occurrence of more cases of a disease
than would be expected in a community or region during a given time period.
Epidemiology
Epidemiology is the study of
how often disease occurs in different groups of people and why. In public
health, epidemiology is also concerned with development of an appropriate
response to disease in a population.
Ethnicity
Ethnicity is a term that refers to social groups with a shared history, sense
of identity, geography and cultural roots which may occur despite racial differences.
Ethnicity shapes a group's culture - food, language, music, and customs. We all have
an ethnicity, but the term is often used only in reference to persons of Hispanic or Latino
ethnicity versus those of non-Hispanic/Latino ethnicity.
See also
Race.
[more on race and ethnicity measurement and coding...]
Evaluation
Evaluation refers to a set of tools or procedures to demonstrate
or measure progress in achieving specific outcomes, goals, and objectives. Evaluation involves the systematic
collection, analysis, and reporting of information to assist in planning and decision-making. Program-level
evaluations measure benefits for specific populations served. Community-level evaluations measure benefits
for community residents resulting from changes in community systems, organizations, neighborhoods, or networks.
Evidence-based
Evidence-based public health
practice is the careful, intentional and sensible use of current best
scientific evidence in making decisions about the choice and application
of public health interventions.
[more on evidence-based public health practice...]
Evidence-based Community Health
Community programs, strategies, or interventions
that have been shown through research or evaluation to have been effective in achieving desired
health outcomes with similar populations or communities.
See also
Evidence-based.
Experiment
Fetal Mortality Rate
Fetal deaths of 16 or more weeks gestation per 1,000 deliveries. The number of deliveries consists of live births plus fetal deaths = (Total Fetal Deaths / (Total Live Births + Total Fetal Deaths)) x 1,000.
FIPS Codes
Fundamentals of Public Health
General Fertility Rate
The general fertility rate is the number of live births per 1,000 females of childbearing age between the ages of 15-44 years. (The age range can differ, depending on the source, so it is important to note what age range is being used especially when comparing to data from other sources). Note: See also "Fertility Rate," the number of live births per all women in the population.
See also
Age-specific Birth Rate,
Crude Birth Rate and
Total Fertility Rate.
Geocode
Geocoding is a process that assigns each data record x and y coordinates that
correspond (ultimately) to the Earth's latitude and longitude. The geo-coordinates
may then be used to locate the record on a map or in another geography (e.g., a county
or census tract).
[more on Geocoding...]
Gestational Age
Gestational Age is the period of time a baby is carried in the uterus or
the duration of the pregnancy, measured from the first day of the last menstrual
period. Full-term gestation is considered between 37 and 42 weeks. Average Gestational age for New Mexico births
can be calculated using the
Births Custom Query section of the NM-IBIS Website.
Goal
A goal is a statement used in a planning process that describes
a future desired state. Goals provide programmatic direction. Goals focus
on ends rather than means.
See also
Objective and
S.M.A.R.T. Objectives.
Gravidity
Gravidity refers to the number of times a woman has been pregnant, regardless
of whether a pregnancy resulted in a live birth. For instance, a woman who was pregnant
once and miscarried would be considered, "gravida 1."
See also
Parity.
Health Disparities
Differences in health status among distinct populations,
such as racial and ethnic groups, rural vs. urban, different income groups, and populations of specific
geographic areas. Health disparities generally refer to differences in health that are closely linked
with social or economic disadvantage. Health disparities negatively affect groups of people who have
systematically experienced greater social or economic obstacles to health. These obstacles stem from
characteristics historically linked to discrimination or exclusion such as race or ethnicity, religion,
socioeconomic status, gender, mental health, sexual orientation, or geographic location. Other characteristics
include cognitive, sensory, or physical disability. (Adapted from Healthy People 2020, U.S. Dept. of
Health and human Services)
Health Regions, New Mexico
HealthyPeople2020
Healthy People 2010 is an initiative
of the U.S. Public Health Service that established over 400 health objectives
for the Nation through a public process. The initiative also defined quantifiable
measures. The objectives are to be achieved by the year 2010. They are typically
used by public health organizations and programs to track progress and improve
population health status.
HealthyPeople2020 Website.
ICD Codes
ICD Stands for International Classification of Diseases. It is a coding system maintained by the World Health Organization and the U.S. National Center for Health Statistics used to classify causes of death on death certificates and diagnoses, injury causes, and medical procedures for hospital and emergency department visits. These codes are updated every decade or so to account for advances in medical technology. The U.S. is currently using the 10th revision (ICD-10) to code causes of death. The 9th revision (ICD-9) is still in use for hospital and emergency department visits until October of 2015.
[more on ICD codes...]
ICD-O Codes
Specialized ICD codes, called ICD-Oncology, or ICD-O, are used to
classify cancer diagnoses by site and type (e.g., lung, breast, leukemia,
lymphoma).
For more on the oncology ICD codes, see the
SEER (Surveillance, Epidemiology and End Results cancer registry) Website.
Incidence
Incidence is the number of new cases
(e.g., of disease) in a given period of time.
See also
Prevalence.
Index Population
Indicator
A health indicator is a numeric measure that depicts
population health or health system status on a core public health construct.
Indirect Age Standardization
Infant Mortality Rate
Infant mortality is defined as the death of an infant under one year
of age. The Infant Mortality Rate is most often calculated as infant deaths in a given year per 1,000 live
births in the same year (death period method). The rate may also be calculated as death of infants
born in a given year per 1,000 infants born in that year (birth cohort method).
See also
Neonatal Mortality
Rate, and
Postneonatal Mortality Rate.
Intercensal
Occurring between decennial (every ten year) censuses. E.g., 2000-2010 intercensal population estimates
are estimates that were derived for years 2000-2010, taking into account the 2010 decennial census population estimates.
See also
Postcensal.
Interpregnancy Interval
The interpregnancy interval is the time (in months) between the completion of one pregnancy resulting in a live born infant and conception of the next pregnancy.
Interpregnancy Interval for New Mexico births
can be calculated using the
Births Custom Query section of the NM-IBIS Website.
Investigation
Surveillance is the systematic collection, analysis,
interpretation, and dissemination of health data on an ongoing basis. Surveillance is conducted
to identify potential public health threats, and to gain knowledge of the pattern of disease
occurrence and risk in a community.
See also
Surveillance.
Jenks Natural Breaks
The Jenks Natural Breaks method, also referred to as the Jenks Optimization method, is a
data-classification method designed identifies breaks in the ordered distribution of values that
minimizes the variance within classes and maximizes the variance between classes. The method was
developed with the intention of dividing data into relatively few data classes (seven or fewer)
for mapping purposes.
[more on NM-IBIS Choropleth Maps...]
Kotelchuck Index
The Kotelchuck Index, also called the Adequacy of Prenatal Care
Utilization (APNCU) Index, uses two crucial elements obtained from birth
certificate data - when prenatal care began (initiation) and the number of
prenatal visits from when prenatal care began until delivery (received services).
The Kotelchuck index classifies the adequacy of initiation as Inadequate (received
fewer than 50% of expected visits), Intermediate (50%-79%), Adequate (80%-109%), or
Adequate Plus (110% of visits or more).
[more on the Kotelchuck Index...]
Kessner Index
The traditional measure of prenatal care used in New Mexico has
been a modified Kessner index. Levels of prenatal care are defined by
using a combination of factors: the month prenatal care began and the
number of prenatal visits made. A low level of care is defined as care
that begins in the third trimester with less than five or no prenatal
care visits. A high level of care is defined as care that began during
the first trimester (first three months) of pregnancy with nine or more
prenatal care visits occurring during that period. Mid level care is
defined as care that began during the first trimester with 5-8 prenatal
visits, or care beginning in the fourth to sixth month of pregnancy with
5 or more visits.
Large for Gestational Age
Large for gestational age (LGA) is a term used to describe a baby who is
larger than usual for the number of weeks of pregnancy. LGA babies usually have
birthweights above the 90th percentile for babies of the same gestational age.
This means that they weigh more than 90 percent of all other babies of the same
gestational age. See also
Gestational Age.
Leading Causes of Death
Life Expectancy
Life expectancy is the average expected number of years of life remaining
from a given age, in a given population, according to the current mortality
experience (age-specific death rates) of persons in the same population.
Life expectancy is calculated from a table called a "Life Table." It is most
often expressed as the life expectancy from birth, but is also commonly
expressed as life expectancy from age 65.
[more on Life Expectancy...]
Logic Model
A logic model is a graphic representation or framework for
understanding a program or set of activities. A logic model provides a picture of what goes into a
program, what the program does, and what the results are. Logic models are useful tools for both
planning and evaluation.
See also
Evaluation.
M.A.P.P.
Mobilizing for Action through Planning and Partnerships (MAPP) is a community-driven
strategic planning process for improving community health. Facilitated by public health
leaders, this framework helps communities apply strategic thinking to prioritize public
health issues and identify resources to address them. MAPP is not an agency-focused
assessment process; rather, it is an interactive process that can improve the efficiency,
effectiveness, and ultimately the performance of local public health systems.
(Definition downloaded from
www.naccho.org/topics/infrastructure/mapp on 8/8/2012).
M.M.W.R.
The Morbidity and Mortality Weekly Report (MMWR) is a weekly report of
state-based notifiable disease surveillance and other timely events of
interest prepared and distributed by the Centers for Disease Control and
Prevention (CDC).
MMWR Website
M.M.W.R. Week
The MMWR week is the week of the epidemiologic
year for which the National Notifiable Diseases Surveillance System (NNDSS) disease
report is assigned for the purposes of MMWR disease incidence reporting and publishing.
When a notifiable disease case is reported to the state or local health department, it
is assigned (coded) to an MMWR Week.
Calendar Dates for MMWR Weeks (2006-2025)
Maps
Maternal Mortality Rate
Number of deaths from complications
of pregnancy, childbirth, and the puerperium per 100,000 live births = (Total
Maternal Deaths / Total Live Births) x 100,000.
Mean
The mean is a measure of central tendency, also called an "average." The mean
is calculated by summing the values in a set and then dividing by the number of
values that are in the set. For instance, John is 30 and Mary is 38. Their mean age is
(30+38)/2, or 68/2, or 34.
Median
The median is a measure of central tendency. It is the 50th percentile, or the
value for which 50% of the scores are lower and 50% of the scores are higher. The median
is not sensitive to extreme values, making it a better choice than the mean as a measure
of central tendency for variables with extreme values. For instance, household income
has a fixed "floor" value of zero, but on the other end, there are typically a small number
of extremely large values. Those extreme values will drive up the calculated value of the
average or mean.
Mode
The mode is a measure of central tendency. It is the score that occurs
with the greatest frequency. In other words, the most common score.
Morbidity
Morbidity is another term for
illness. Morbidities are not deaths, and occur among the population of
living persons. Examples of morbidities include Alzheimer's disease, diabetes,
and traumatic brain injury. Incidence and Prevalence
are measures often used to describe the extent of morbidity in a population.
Mortality
Mortality is another term for
death. A mortality rate is the number of deaths due to a disease divided by
the number of persons in the population.
N.A.C.C.H.O.
The National Association of County and City Health Officials (NACCHO). NACCHO's members
are the 2700 local health departments across the United States. NACCHO's mission
is to be a leader, partner, catalyst, and voice for local health departments
to ensure the conditions that promote health and equity, combat disease, and improve
the quality and length of all lives.
NACCHO Website. See also
A.S.T.H.O..
N.C.H.S. Leading Causes
In order to provide a ranking standard the NCHS (National Center for Health
Statistics) prepared a list of 113 selected causes of death that are reported on the death
certificate. The NCHS 50 leading causes of death are taken from the list of 113. Other classification schemes are used,
such as the STIPDA external causes of injury and the ICD-O causes of cancer deaths.
For more
information about the NCHS rankings, see the
Cause of Death Ranking Vital Statistics Report. Leading causes of death for
New Mexico can be calculated using the
Mortality Custom Query section of the NM-IBIS Website.
[list of NCHS leading causes...]
Neonatal Mortality Rate
Numerator
The numerator is the dividend in division (for instance, where 12/3=4,
the number 3 is known as the divisor, 12 is the dividend and 4 is the quotient). In public health, the numerator
for a disease rate is the number of cases of, or persons with a health condition of interest. For instance,
for 23 deaths in a population of 15,000, the death rate would be 23/15,000, or 0.001533, or 153.3 per 100,000 population.
In that example, 23 is referred to as the numerator.
See also,
NMDOH Principles for Updating Numerator and Denominator Data.
