Accessing and Using NCHS Data: An Overview and Demonstration of NCHS Data Access Tools

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Accessing and Using NCHS Data An Overview and
Demonstration of NCHS Data Access Tools 2006
NCHS Data Users ConferenceHands-On Session
66July 12, 2006
Ann Aikin
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Accessing NCHS Data Let Me Count the Ways
Combined Health Data Sources

• FASTATS A Z
• Reports, such as Health, U.S. and Advanced Data
• Data Warehouse
• Data Highlights
• Health E-Stats

• Beyond 20/20 Tables Health Data for All Ages and
  Trends in Health and Aging
• Healthy People DATA 2010
• CDC WONDER
• WISQARS

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Accessing NCHS Data Let Me Count the Ways
Accessing Data Sets (public use)

• ASCII Data Sets (complete public use file)
• SETS (complete public use file, with
  documentation and software to access files)
• Data Resource Center for Child and Adolescent
  Health Online Query Tool (data from two SLAITS
  surveys--National Survey of Children with Special
  Health Care Needs and National Survey of
  Children's Health)
• Research Data Center (a fee-based service that
  provides access to confidential data and data
  access for those needing assistance)

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Accessing NCHS Data Let Me Count the Ways

• Information to Help Access Data
• Listservs
• NCHS Definitions
• NCHS Survey Measures Catalog Children and
  Adolescent Mental Health Coming Soon!
• Ambulatory Care Drug Database System
• Technical Reports and Data Documentation!
• Other Published Reports, such as Series Reports

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Overview of NCHS Data Access Tools
Tool Ease Level Available
Beyond 20/20 ? ? Health Data for All Ages, Trends in Health and Aging
CDC Wonder ? ? Mortality, Natality
DATA2010 ? ? Healthy People Objectives
WISQARS ? ? Injury Data
Child and Adolescent Health Online Query Tool ? ? National Survey of Children's Health, National Survey of Children with Special Health Care Needs
SETS ? ? Selected NCHS sets Over 80 Available!
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Health Insurance Coverage

• To provide a complete picture of the uninsured
  population, the National Health Interview Survey
  (NHIS) tracks
• persons who currently lack coverage
• persons uninsured at any time in the previous
  year
• persons who have experienced lack of coverage for
  more than a year.
• Health care surveys also report health insurance
  measures, such as the National Ambulatory Care
  Survey (NAMCS), which reports expected source of
  payment from doctor visits.

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Health Insurance Coverage From the NHISLack of
Coverage

• Data are released from NHIS
• In ASCII (raw data files)
• On the Internet, as an Early Release
• In publications (forthcoming)
• In Data2010, as a Healthy People 2010 Objective
• In a customizable table on the Health Data for
  All Ages site (update to 2004 forthcoming)
• Other sources, such as Health, United States,
  FASTSTATS etc

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NHIS Early Release Percentage of persons of all
ages without health insurance coverage at the
time of interview United States, 19972005
From Early Release of Selected Estimates Based
on Data From the 2005 National Health Interview
Survey, Lack of health insurance coverage and
type of coverage, Figure 1.1.
http//www.cdc.gov/nchs/data/nhis/earlyrelease/200
606_01.pdf
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Health Insurance Coverage NHIS data in Health,
U.S.
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Health Data for All Ages also provides health
insurance statistics
In this pretabulated table, NHIS data years are
combined to make the statistics more reliable and
more useful for breakdowns by age, sex,
race/ethnicity and geography.
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Health InsuranceExpected Source of Payment from
Health Care Surveys

• Data are released from the health care surveys
• In ASCII (raw data files)
• On the Internet, as a Health E Stat
• In publications, such as Advanced Data
• Other sources, such as Trends in Health and
  Aging, Health, United States, FASTSTATS etc

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Health E-Stat Release of Doctor Visit Data
Percent Distribution of Ambulatory Care Visits by
Setting Type, According to Expected Source of
Payment, 2004
From Health E-Stat, Ambulatory Medical Care
Utilization Estimates for 2004 Accessed on
July 1, 2006.
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Prescription Drug Use
Prescription drug use is in the rise in
AmericaIn 1999-2002, 45 percent of Americans
used a prescription drug in the last month, while
18 percent used three or more and use among
seniors is much higher.
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NCHS Statistics on Prescription Drugs

• To find out more about drug use in America, we
  will use the following data tools
• National Survey of Childrens Health Data
  Resource Tool to find statistics on childrens
  use of prescription drugs
• Trends in Health and Aging to find statistics on
  the distribution of drug mentions in doctor
  offices
• Ambulatory Care Drug Database System to find the
  number of drug mentions for a specific drug
• WISCARS to find the number of drug-related
  adverse effect deaths

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Prescription Drug Use in SLAITS National Survey
of Childrens Health
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Prescription Drug Use in SLAITS National Survey
of Childrens Health
Child and Adolescent Health Measurement
Initiative (2005). National Survey of Childrens
Health, Data Resource Center on Child and
Adolescent Health website. Retrieved 06/30/2006
from www.nschdata.org.
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Prescription Drug Use in SLAITS National Survey
of Childrens Health
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Distribution of Drug Mentions by Patient's Age,
Sex, and Race. United States, Selected Years,
1989-2002. NAMCS, NHCS (NAD02a)
Centers for Disease Control and Prevention.
National Center for Health Statistics. Trends in
Health and Aging. http//www.cdc.gov/nchs/hdi.htm.
 June 30, 2006.
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Using WISQARS for Adverse Drug Deaths (Fatal
Injuries) Statistics
Centers for Disease Control and Prevention,
National Center for Injury Prevention and
Control. Web-based Injury Statistics Query and
Reporting System (WISQARS). June 30, 2006. 
Available from URL www.cdc.gov/ncipc/wisqars.
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Using WISQARS for Adverse Drug Deaths (Fatal
Injuries) Statistics
Step 1
For our example, we will choose All Intents
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Using WISQARS for Adverse Drug Deaths (Fatal
Injuries) Statistics
Step 2
For our example, we will choose Drugs, adverse
effects in the Adverse Effects injury category
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Using WISQARS for Adverse Drug Deaths (Fatal
Injuries) Statistics
Step 3
For our example, we will choose the default
settings for geography, race, Hispanic origin,
sex and Output Options. For years, we will
choose 1999 to 2003.
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Using WISQARS for Adverse Drug Deaths (Fatal
Injuries) Statistics
Steps 4 and 5
Under Advanced Options, we will select the age
groups 20-24 and 60-64 and we will leave the
age-adjusted default to the year 2000. We will
also select output group 1 to Age Group
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Using WISQARS for Adverse Drug Deaths (Fatal
Injuries) Statistics
Output Table
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Using the Ambulatory Care Drug Database System to
Find the Number of Drug Mentions for a Specific
Drug
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Using the Ambulatory Care Drug Database System to
Find the Number of Drug Mentions for a Specific
Drug- LOPRESSOR, a Beta Blocker Used by Heart
Patients
Step 1 Type in the name of the drug in the drug
name box. Step 2 You can also select the
2-digit) NDC Class Category 05 and the
Prescription Status of Prescription Drug.
Step 3 Select the Search Database button.
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Using the Ambulatory Care Drug Database System to
Find the Number of Drug Mentions for a Specific
Drug- LOPRESSOR, a Beta Blocker Used by Heart
Patients
In 2004, there were over 4 million drug mentions
for Lopressor. If you click any of the
highlighted words, you will bring up the drug
characteristics information.
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Using the Ambulatory Care Drug Database System to
Find the Number of Drug Mentions for a Specific
Drug- LOPRESSOR, a Beta Blocker Used by Heart
Patients
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Using CDC Wonder to Create Parkinsons Disease
Table
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Using CDC Wonder to Create Parkinsons Disease
Table
Step 1
For this example, we will leave the defaults for
area, population, and years
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Using CDC Wonder to Create Parkinsons Disease
Table
Step 2
Click the box to age-adjust to year 2000. Please
note WONDER provides more information on
age-adjustment.
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Using CDC Wonder to Create Parkinsons Disease
Table
Step 3 Selecting Cause of Death
Select the Keyword Search button and
Type in Parkinson and hit the Keyword Search
button.
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Using CDC Wonder to Create Parkinsons Disease
Table
Step 3 Selecting Cause of Death
Select G20 and G21, per NVSR 54 13 Table 9, page
29, the codes used for Parkinsons
Disease. Hit the Move Individual Codes button.
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Using CDC Wonder to Create Parkinsons Disease
Table
Steps 4 and 5
In step 4, summarize the data by Year and keep
the defaults for step 5.
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Using CDC Wonder to Create Parkinsons Disease
Table
Output table
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Cesarean Delivery Statistics Healthy People
Objectives, Health Data for All Ages, and SETS
Lowering the cesarean rate in the United States
has been a goal for the past 25 years. Separate
objectives were formulated for low-risk women
giving birth for the first time (a subset of all
women having a first birth) and for low-risk
women who had a prior cesarean birth. The
objectives set a target of 15 percent for
cesarean delivery and 63 percent for repeat
cesarean delivery.

From National Vital Statistics Reports, Vol. 54,
No. 4, September 22, 2005, Table 1. Cesarean
rates for first births to low-risk women by age
and race and Hispanic origin of mother United
States page 6.
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Healthy People Objectives--Cesarean Delivery
Step 1 Type in cesarean in the keyword box and
the button. The Healthy People
Objectives with the word cesarean will appear
in the objective box below. In this case, there
were two objectives with cesarean Objective
16-09a and 16-09b.
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Healthy People Objectives--Cesarean Delivery
Step 2 Choose the Submit button and the 16-09a
table with the base line year and percent, the
data years 1998-2005 and the 2010 target will
appear.
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Health Data for All Ages produces a table on
cesarean rates for low-risk women
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Customizing the Cesarean Deliveries Table for To
Show Only Prior Cesarean Deliveries
Step 1 Click on the Cesarean cell.
Step 2 Deselect the default selections by
choosing the button. Select Prior
Cesarean from the list. Choose the table button
and the table will only show prior
cesarean deliveries.
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Customizing for Specific Locations
Step 3 To further customize the table, I would
only like to look at Maryland, Washington DC, and
Virginia. To do this, you need to select
Location, deselect the defaults, and check the
appropriate boxes for the locations I want to
view. Select the table icon again to view your
selections.
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Looking at Race and Ethnicity
Step 4 To look at specific race and ethnicity,
we want to further customize our table view. To
do this, we need to physically drag and drop the
Race/Ethnicity cell into the Cesarean cell. (The
Cesarean cell the moves to the old position).
Move the cells so the order is Maternal Age,
Race/Ethnicity, Location.
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Prior Cesarean Delivery among Low-Risk Women in
Maryland, the District of Columbia, and Virginia
by Race and Ethnicity for All Ages
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Prior Cesarean Delivery among Low-Risk Women in
Maryland, the District of Columbia, and Virginia
by Race and Ethnicity for All Ages
These data can also be charted or exported. To
chart, select the chart button and then the
printer friendly button.
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Using SETS to Create a Cesarean Delivery Table
To match estimates published in our reports, such
as the Trends in Cesarean Rates for First Births
and Repeat Cesarean Rates for Low-Risk Women
United States, 1990-2003.
From National Vital Statistics Reports, Vol. 54,
No. 4, September 22, 2005, Table 1. Cesarean
rates for first births to low-risk women by age
and race and Hispanic origin of mother United
States page 6.
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Using SETS to Create a Cesarean Delivery
TableGetting Started
Step 1 Open the SETS folder and the SETS
Interface.
Step 2 Choose the correct drive, and the NCHS
folder. Step 3 Choose the Nata2003 file. Step 4
Accept the usage requirements.
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Using SETS to Create a Cesarean Delivery
TableGetting Started
Step 1 Go to file, and select Open, and Set.
Step 2 Choose the 2003 Natality File in the Data
Folderand Tabulate data.
Step 3 From the menu, go to Table and Assist.
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Using SETS to Create a Cesarean Delivery Table
Selecting only U.S. Born Residents
1. Go to Records and the choose Select. Click
Assist. 2. Double click on the empty Field box.
Add choose
3. Type foreign in the search box and choose OK.
4. Choose RESTATUS (Resident Status) from the
list and Select. Choose the ! Operator from the
pull down list and double click on the Code box
and choose 4 (FOREIGN RESIDENTS).
5. Go back to the list of Field boxes
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Using SETS to Create a Cesarean Delivery Table
Selecting only Low Risk Pregnancies
6. To look at only low risk pregnancy, we need to
select the our records

• full-term pregnancy (at least 37 completed weeks
  of gestation RGEST3, or 37 Weeks and over),
• singleton pregnancy (not a multiple pregnancy ),
• safe fetal presentation (head in a downward
  position in the birth canal).

Please note RESTATUS ! 4 was selected
previously. We also need to select Detailed
Total Birth Order or RTBO 01 (first birth) to
recreate the Table 1 in the report, which only
includes first births. 7. Accept the
record selection and choose Select, when prompted.
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Using SETS to Create a Cesarean Delivery Table-
Recoding a Field

• To create the age groups used in the table, we
  need to create a recode in SETS. To do this
• Go to Recodes and Create.
• Type in the file name of your recode and save to
  your hard drive (c) and go to Recode and Assist.
• Double click on the Based on field box, and

1. Type in age and choose OK. Choose RMAGE9, or Age
   of Mother Recode 9 and choose the Select button.

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Using SETS to Create a Cesarean Delivery Table-
Creating a Recode

1. Type in a new recode name, and double click the
   first codes box (agerecode).
2. Choose codes 1 and 2 and Select. Type in an
   optional category label, such as, Under age 20
   years.
3. Double click on the second code box and choose
   code 3.

4. Continue this process until youve created 6
categories to match the ones in the publication.
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Using SETS to Create a Cesarean Delivery Table-
Creating a Recode

1. Go to Recodes and select Attach.

• 6. Your age recode will now show up in the fields
  and recodes list.

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Using SETS to Create a Cesarean Delivery Table
Step 1 Go to Table and Assist. This brings up
the Table Assistance template.
Step 2 Select your age recode and the RDELMTH
field by highlighting it and selecting the Add
button. So they appear in the Table fields box
to the right.
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Using SETS to Create a Cesarean Delivery Table
Step 3. Go to the Nesting options table (2),
leave the defaults and go to table 3, Generate
Statements.
Step 4. Choose the Generate button and go to the
Begin tabulation table (4). Select the Begin
button.
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Using SETS to Create a Cesarean Delivery Table
The table from SETS matches the table produced in
the NVSR report!
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Using SETS to Create a Cesarean Delivery Table
with our Age Recode
How would you create this table in SETS?
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In SETS, you can also browse the data.
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or chart and export your data
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or create and edit your own data sets using the
SETS Designer Kit and Editor For more
information, please see www.cdc.gov/nchs/sets.htm
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Now Its Your Turn! Can You.
Find the age-adjusted rate for Drug-Induced
Deaths (Healthy People Objective, 26-03) Using
DATA2010, create a table for Healthy People
Objective 26-03 for the District of Columbia
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Now Its Your Turn! Can You.
Can you find the percent of children (ages 0-17)
uninsured in two parent households and
mother-only households for the District of
Columbia and the US using the Data Resource
Centers National Survey of Childrens Health?
Hint Select Healthy People 2010 Goals, and Goal
1 (Access to Quality Health Services). Then
choose Objective 1-1 ( of children uninsured)
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Now Its Your Turn! Can You.
Find the death rate for Parkinsons disease?
Using Trends in Health and Aging, chart the
trends in death rates from 1981-2003. Can you
also customize the chart so it shows the trends
by sex?
Hint go to the mortality folder, and choose the
second table, Death Rates by Age, Sex, Race, and
Underlying Cause. United States, 1981-2003
(NMR03a)
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Now Its Your Turn! Can You.
Find the number of vaginal births in the District
of Columbia for 2003? For extra creditcan you
tell me how many of primary c-sections in DC
there were in 2003? What about the total number
of births to white and black mothers in DC in
2003?
Hints To create this table, you will need to use
the field STRESEXP or expanded State of
Residence. Dont forget to exclude foreign
residents before you create the table! When you
go to create the table, you will want to run a
table using the field RDELMTH or the method of
delivery recode.
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Contact Information Ann Aikin (NCHS Data Tools
Specialist)aia3_at_cdc.gov301-458-4069 Avay
Dolberry (SETS Specialist)ADolberry_at_cdc.gov919.5
41.2700 Phyllis Chappell (Beyond 20/20
Specialist)PChappell_at_cdc.gov919.541.4466Connie
Banks (Beyond 20/20 and SETS Specialist)CBanks_at_cd
c.gov919.541.3624 Susan Temple (Beyond 20/20 and
SETS Specialist)STemple_at_cdc.gov919.541.4923