Where to Search for Health Statistics and Data

When beginning to search for statistics or datasets many options are available, both free and subscription-based. As one learns to navigate these resources, one will find oneself in an “alphabet soup,” as many organizations and their resultant studies/​datasets are referred to by their acronyms. In addition, empirical research articles are also a valuable source of statistical information, and, in some cases, serve as a connection point for researchers who may need access to unpublished data.

PubMed is an essential research tool for anyone conducting medical research, be it MDs, epidemiologists, public health researchers, or geneticists. Full-text access to the majority of articles in PubMed (excluding those in PubMed Central) are facilitated by institutional subscriptions to journals and are relayed to the user using a link resolver (such as SFX). As mentioned previously, empirical research articles are a great source of very specific statistical information, and sometimes can lead to access of unpublished, raw data. Beyond PubMed, NCBI provides a set of databases, software, and downloads for genetic and chemical data. See http://www.ncbi.nlm.nih.gov/​guide/​data-software/.

ClinicalTrials.gov is a registry of publicly and privately supported clinical studies of human participants all over the world. It is a valuable resource to both clinicians and public health researchers. The registry is easy to browse by primary topic, and can be refined using additional limiters. An important thing to note about data from clinical trials is that results are not always posted. Studies with results are clearly indicated in the results list as “Has Results,” which can then be viewed in their own tab. In cases where studies have been completed but results have not been posted, information is given as to who served as the principal investigator (direct contact information not provided but name and location are given). In the United States it was only as of 2008 that results from clinical trials were provided (see http://clinicaltrials.gov/​ct2/​about-site/​history). At present, results are not required to be provided for all trials, but this may change in the future.

National Health Demographics

If one is looking for national-level health information for the United States, the best place to start is the National Center for Health Statistics (commonly referred to by its acronym, NCHS). In short, NCHS’s mission is to compile statistical information for the public in order to better their own health and to guide public health policy. NCHS collects a variety of information about the nation’s population through administrative records (such as birth, death, and medical records), surveys and interviews, direct physical exams, and laboratory testing. Surveys cover the health status of the population including illnesses (physical and mental), injuries, nutrition, pregnancy, immunizations, health hazards (such as obesity or smoking), and on the use of health services and facilities (with some cost and use information as well as manpower figures). NCHS provides prepared statistical information, access to some online analytic aggregation tools, and full dataset downloads. An important thing to note is that most public-use data files do not provide any detailed geography (Census region may be all that is available). In addition, some surveys are collected annually, but others only periodically. NCHS also provides additional services such as access to linked data (links NCHS surveys with datasets collected by other agencies), the National Death Index, and a Research Data Center to which researchers can apply to obtain restricted-use confidential data (which often does have greater geographic detail). Due to the large amount of data collected, there is often a lag of a year or more until a dataset is released for public-use.

All of the data collections listed in table 12.1 are available as raw data for use in statistical analyses but also include links to published reports on the data. NCHS provides access to aggregate statistics and online analysis tools that utilize data from these surveys as well. Some of these aggregators and tools follow.

FASTSTATS is an alphabetized topical list of quick links to statistical information on a wide range of health topics. This is a helpful place to start when one isn’t immediately aware of a particular dataset or statistical report on a particular subject. On each of the resultant topic pages, links are provided to publications that include the statistics presented, to sources of more data for deeper analysis, and to related webpages. FASTSTATS also includes a State and Territory Data subsite with a clickable map.

The Health Data Interactive is an aggregating tool that facilitates building customizable tables (by age, gender, race/​ethnicity, and geography) of national health statistics for infants, children, adolescents, adults, and older adults.

VitalStats is an interactive exploration tool for vital statistics products including tables, data files, and reports. It provides both prebuilt tables and the option to delve deeper into the data using the National Vital Statistics System online analysis tool.

The Health Indicators Warehouse (HIW) is a collaborative venture among various government agencies (such as the Centers for Medicare and Medicaid Services and the Health Resources and Services Administration) and offices within the Department of Health and Human Services. The purpose of this Internet-based warehouse is to provide a single point of access to authoritative health status and determinants at the national, state, and local level. Users can choose to select indicators based on topic, geography, or particular government initiative (such as Healthy People 2020). Once an area has been selected in which to search, the interactive filtering capacity makes it possible to further narrow indicator options (e.g., Health Risk Behaviors → Alcohol → Adults Binge Drinking [%]). The clickable “i” next to each indicator opens a metadata (source information) window. When the indicator link is clicked, an overview of how the indicator was constructed is provided. Next to the Overview is a Data tab. This view offers researchers an interactive table, chart, or map view (map when available). If a researcher wants more options for analytics, he or she can then use the Download tab to get the raw data in either an Excel or Comma Separated Values (CSV) file.

The result of the Health Data Initiative (http://www.hhs.gov/​open/​initiatives/​hdi/​index.html), the DHHS has “liberated” its trove of data from multiple offices to provide wider access to health policy makers, innovators, and researchers. As of 2012, the site is still a work in progress with collections added and interface changes made quite often. The HealthData.gov site serves as a union catalog of government-produced health data. Metadata records provide links to where the data actually “lives,” which means that once someone finds something he or she wishes to access, he or she will leave the HealthData.gov site. One of the main goals of this site is to “unleash the power of private-sector innovators and entrepreneurs to utilize HHS data to create applications, products, services and features that help improve health and health care—while also helping to create jobs of the future at the same time.”12 With that being said, the site can sometimes be a bit difficult for the average user to navigate, and not as comprehensive as needed for the seasoned researcher. As the site is still reasonably new, it is likely more enhancements will be made over time to accommodate varying levels of user skills.

State and Local Health Demographics

For local and state health statistics, often the best sources of statistical information are local and state health departments. For example, the Baltimore City Health Department (http://baltimorehealth.org/​dataresearch.html) provides statistics that are especially relevant to the city’s population (the growing Hispanic population and health disparities, food security, and alcohol outlet density). The Maryland Department of State and Mental Hygiene (http://dhmh.maryland.gov/​SitePages/​Home.aspx) provides statistical reports on public health issues that are of importance in Maryland (access to care, nutrition, and food safety). To find the local health department, a simple Web search for one’s area name and health department will often yield a link. If not, one can look for one’s state health department to see if it has statistics for that local area. The National Center for Health Statistics does provide some access to state-level statistics, but most public-use datasets only provide region as a geographic variable.

This is a subset of the FASTSTATS site. Rather than organized alphabetically by topic, the user is presented with a clickable map of the United States (text links to states are also available). Once clicked, users are taken to the resultant state’s page where links are provided to publications that include birth, death, marriages and divorces, and to sources of more data available at the state level for deeper analysis (for example, the Behavioral Risk Factor Surveillance System), and a link to the state’s health department.

The Behavioral Risk Factor Surveillance System (BRFSS) collects information on health risk behaviors, preventive health practices, and health care related to chronic disease and injury. Data are collected monthly in all fifty states, Washington, DC, Puerto Rico, the U.S. Virgin Islands, and Guam, with more than 350,000 adults interviewed each year. BRFSS data are used to establish and track health objectives and legislation, identify emerging health problems, and develop and evaluate public health policies and programs. In some states, the BRFSS is the only source of timely and accurate health-based data.

State Health Facts provides timely, easy-to-use, freely accessible data on more than 700 health topics. The Kaiser Family Foundation is a nonprofit organization that focuses on major health-care issues in the United States as well as the role the U.S. plays in global health policy. The site can be browsed by topic category (such as health insurance or minority health) or by particular state. A state vs. nation or state vs. state comparison is also available.

Health Care Facilities

The Area Resource File (ARF) provides county-level information on health facilities and health professions, measures of resource scarcity, health status, health training programs, and socioeconomic and environmental characteristics. The ARF used to only be available on CD-ROM and for an 800-dollar fee. It is now freely available for download and on CD-ROM (an ASCII text file and Access Database version are available). One can also easily search the online variable database to see if it contains the information needed for analysis.

The Healthcare Cost and Utilization Project (HCUP) is a suite of health-care datasets that bring together the data collection efforts of state organizations, hospital associations, private data organizations and the federal government to create a national longitudinal information resource of patient-level health-care data. These data facilitate research on health policy issues, including cost and quality of health services, medical practice patterns, access to health-care programs, and outcomes of treatments at the national, state, and local levels. HCUP databases (which are available as formatted text datasets) include the Nationwide Inpatient Sample (NIS), the Kids’ Inpatient Database (KID), the Nationwide Emergency Department Sample (NEDS), the State Inpatient Databases (SID), the State Ambulatory Surgery Databases (SASD), and the State Emergency Department Databases (SEDD). Full datasets may be applied for, but the researcher will likely have to do that himself or herself as a formal data use agreement with signatures and project purpose is required. In addition, there is an associated cost for the data depending on what the researcher needs. HCUPnet is the freely available, online HCUP database query system which presents customizable data tables from the HCUP databases. Please note some information may be suppressed if the cell counts are too small.

The American Hospital Association’s Healthcare DataViewer offers one-stop access to AHA’s proprietary information from the AHA Annual Survey of Hospitals, IT Supplement Survey, and AHA membership data. This is a subscription-based or pay-as-you-go resource. There are some limited free queries, but the full benefit of access to this resource is in its paid services.

An essential for most medical library reference collections since 1946, the annual AHA Hospital Statistics publication (with supplemental data tables on CD) provides hospital trends on utilization, personnel, and finances for U.S. community hospitals. Trend data are provided at the national level, U.S. Census division, by state and hospital bed count brackets.

Health Care Utilization and Costs

All of the resources numbered 12.14–12.17 are also useful resources when looking for health-care costs and health-care utilization. Here are a few additional resources that can also be consulted when looking for this information.

The Medical Expenditure Panel Survey (MEPS) surveys households, their medical providers, and employers across the United States. It is the most complete source of data on the cost and use of health care and health insurance coverage. The survey also includes information on employment, health conditions, long-term care, and other specific medical service use events. Full dataset download capabilities are available for multiple years (ASCII text data with STATA, SAS, and SPSS programming statements) and customized tables can be created through an online tool, MEPSNet. Static tables are also available for quick look-up information.

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