Q. How should the Health Indicators Warehouse be cited?
A. The suggested citation is:
Centers for Disease Control and Prevention. National Center for Health Statistics. Health Indicators Warehouse. Www.healthindicators.gov. [Date of access].
Q. What is the Health Indicators Warehouse?
A. The Health Indicators Warehouse (HIW) is a user-friendly web-accessible database of pre-tabulated national, state, and local health indicators, reflecting multiple dimensions of population health, health care, and health determinants. The HIW also contains supporting descriptive data to facilitate understanding and appropriate use of the indicators, as well as links to evidence-based interventions.
Q. What data does the Warehouse contain?
A. The HIW includes indicators from:
- RWJF/UWPHI County Health Rankings (CHR);
- Community Health Status Indicators (CHSI);
- Healthy People 2020;
- Centers for Medicare & Medicaid Services (CMS) indicators (a set of community-level, Medicare utilization, sociodemographic, patient safety and quality indicators);
- Additional indicators as determined by the HHS Interagency Governance Group
All indicators in the CHSI and County Health Rankings are at the county level. Additional indicators are being added periodically.
Q. How can I access the indicator data in the Warehouse?
A. There are two major ways to access the indicator data: you can to go to the HIW website and select topic areas and specific indicators to display or print as tables, charts, or maps (when possible) OR you may download the indicator data into a spreadsheet for use in your own application. Business services are also available so that indicator data and metadata can be exposed and directly accessed by other computing systems.
Q. Does the HIW include individual level data, such as data on individual survey respondents, Medicare enrollees, health care providers, etc.?
A. No, the warehouse does not contain any individual level data. The warehouse is designed to provide summary health indicator data at a variety of geographic levels and for different populations. The indicators are constructed from individual-level data obtained from other governmental and private initiatives, and are presented at an aggregate level.
Q. What if I want to get access to the underlying data from which you created the indicators?
A. The warehouse provides users with details on the data sources for every indicator. Users can apply to those agencies and organizations through their standard approaches for requesting data access. Many micro-data sets are also available on Health.Data.gov Health Data Community.
Q. Will the warehouse include Medicare data sets like Hospital Compare?
A. The HIW contains summary health indicators at the national, state, or local level, as described above. Systems such as Hospital Compare and Nursing Home Compare contain data on individual hospitals and nursing homes and are not, therefore, included in the HIW. Those data, plus MD Compare when released, will continue to be available through the CMS website.
Warehouse Functionality and Architecture
Q. If I want to download indicators in a spreadsheet, can I do so?
A.Yes. In addition, we have selected indicators available for download in .csv format, as well as .xls and xlsx.
Q. Can I drill down to obtain indicators for important subpopulations, such as racial and ethnic and/or socioeconomic subgroups?
A. Yes, to the extent the data allow, given confidentiality constraints. Small sample sizes limit our ability to compute detailed subpopulation data at the community and other levels, even when we combine several years of data. For future versions of the warehouse, we will review the feasibility of additional subpopulation information at different levels of geography, given the constraints of the datasets. Many additions of state and county data have been made since the HIW was launched, including additional years of vital statistics and BRFSS data, as well as county-level indicators of notifiable disease rates. Medicare Indicators at the hospital referral region level have also been added over time.
Q. Can I create tables crossing multiple characteristics, such as age, gender, and race/ethnicity?
A. Because of small sample sizes, detailed breakouts that cross multiple characteristics are more feasible at the national level than at the local or even the state levels. The warehouse does not, however, allow indicators to be cross-tabulated in ways defined by individual users. The warehouse is designed to provide convenient access to indicator data which have been pre-tabulated.
Q. How can potential web service users learn more about the design?
A. The web services layer allows systems with disparate architectures and underlying technologies to gain access to the same data, either by going directly to the web services definition language (WSDL) or over a metadata exchange endpoint. There is documentation available in the “For Developers” section of the website.
Q. Are you going to use vocabularies to describe the data and the indicators and, if so, which ones?
A. All indicators will have the same descriptive information in the same format, regardless of their source. Because we are not including microdata in the Health Indicators Warehouse, the need for a common vocabulary is mitigated. Indicators without sufficient descriptions of code sets used or the methods used to define or code indicators will not be included in the HIW.
Q. How will users be able to judge the quality of the data? Will you have rigorous standards that every indicator must meet?
A. We have developed minimum statistical standards that indicators must meet. Indicator sources that do not provide sufficient descriptive information will not be able to contribute indicators to the HIW. Data that do not meet minimum standards of reliability will be suppressed. To enable users to evaluate the indicators, the warehouse provides detailed metadata, describing the definition, data sources, and limitations for each indicator and, where applicable, measures of variability.
Q. How often will you update your data? And, how will users know when an update is provided?
A. We will update the indicators as data become available. For most federal data sources, data are released annually. Updates will be posted on the HIW home page, and users will be able to subscribe to the RSS feed to receive notifications of data updates and other news.
Q. Your description of the warehouse refers to linking health data indicators to evidence-based interventions. Who decides what is evidence-based, and who will determine what gets linked?
A. Initially, we are using interventions from the Guide to Clinical Preventive Services and the Guide to Community Preventive Services. In the future, stakeholders may want us to add other interventions that are not in the Guides, but we are in the process of establishing a process for determining whether the evidence met some minimum standard for inclusion, and for communicating the strengths and weaknesses of the evidence to users.
Standardizing Indicators and Establishing Future Priorities
Q. Do you intend to keep multiple indicators for the same or similar concepts?
A. We plan to standardize indicators across indicator sets when possible. Decisions on standardization and methodological consistency will be made on an indicator by indicator basis. Stakeholders can make the case for having more than one indicator for a concept, if there are strong policy reasons to do so. For example, the HIW includes measures of health insurance at the national level from several different surveys, including the National Health Interview Survey and the Current Population Survey, and measures of obesity from each the National Health and Nutrition Examination Survey and the Behavioral Risk Factor Surveillance System surveys.
Q. How can stakeholders and users provide you with input on the indicators they would like to see in the warehouse and the services they would like it to provide?
A. We are making modifications and enhancements-including additional indicators-reflecting input from users and stakeholders. We are making improvements in display of tables and maps, and implementing more filtering by sociodemographic and other population characteristics, as well as improving formatting of downloads. We are also establishing priorities for making changes. We will use a two-stage process for the consideration of new indicators or for modifications to existing ones, involving a statistical quality review followed by a priority review. We will also consider enhancements in how indicators can be displayed or imported into other data systems. You can provide input by emailing firstname.lastname@example.org.