Mark Flotow and Gary Morgan Illinois Center for Health Statistics IL Dept of Public Health

1. Publish or Perish: After 75 Years, Have State Compendiums of Vital Statistics Outlived Their Usefulness? Mark Flotow and Gary Morgan Illinois Center for Health Statistics IL Dept of Public Health 5 June, 2008 Orlando, FL

2. And the answer is . . . “Publish or Perish . . .” 5 June, 2008 . . . “MAYBE” . . . Failure to evolve is not an option . . . for continued survival

3. Past Evolution (IL examples) “Publish or Perish . . .” 5 June, 2008 1960 Characteristics: • Thin (54 pages) • Typed; includes 9 pages of text • A marvel of duplication technology

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6. Past Evolution (IL examples) “Publish or Perish . . .” 5 June, 2008 1980 Characteristics: • Thicker (184 pages), thanks to modern data processing • Mainframe-looking output, plus 14 pages of text • A marvel of cut-and-paste technology

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9. Past Evolution (IL examples) “Publish or Perish . . .” 5 June, 2008 2000 Characteristics: • Phonebook thick (318 pages), thanks to really modern data processing • PC-based output plus 47 pages of text, integrated with tables and graphs • A marvel of Y2K survival

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12. Future Evolution . . . “Publish or Perish . . .” 5 June, 2008 . . . do we need to continue to print our annual compendiums??

13. Publish? Perish the Thought . . . “Publish or Perish . . .” 5 June, 2008 The pros (and prose) of old school publishing: • Excellent desktop reference • Libraries still love them • Portable and visual • A permanent record

14. Publish? Perish the Thought . . . “Publish or Perish . . .” 5 June, 2008 The cons (and complaints) of old school publishing: • Expensive to print and distribute • S-l-o-w (layout, editorial review, duplicating, binding, etc.) • Corrections and errata are continuous issues

15. Publish? Perish the Thought . . . “Publish or Perish . . .” 5 June, 2008 The pros of Web publishing: • Cheap to produce and about nil to distribute • Not a permanent record; can be corrected, modified, replaced, deleted • Always quicker than printing (fewer production steps) • Can add extra flash and features (e.g., a hot-linked TOC)

16. Publish? Perish the Thought . . . “Publish or Perish . . .” 5 June, 2008 The cons of Web publishing: • Needs to be monitored; generally not “set and forget” (a case of higher expectations and perpetual responsibility) • In some cases, passing on costs and time of printing to consumer (i.e., collectively inefficient) • Need PC, Internet access

17. Publish? Perish the Thought . . . “Publish or Perish . . .” 5 June, 2008 What do my users need? Typical questions for which they seek answers . . . • I just need the (one) number of . . . • Tell/Give me everything you know/have about . . . • How does my area compare to the state on . . . ?

18. Publish? Perish the Thought . . . “Publish or Perish . . .” 5 June, 2008 What do my users need? Typical questions for which they seek answers (continued) • What is the rank of X ? (e.g., leading causes of death) • Can you tell me if X is going up or down during the period of . . . ? • Why does X go up and down from year to year . . . ?

19. Publish? Perish the Thought . . . “Publish or Perish . . .” 5 June, 2008 “MAYBE” Part I. - There are advantages to both print and Web publishing. - Perhaps only a minority of users need the printed version: - state offices - local health departments - libraries or other reference environs

20. And Now a Word About the Future “Publish or Perish . . .” 5 June, 2008 (If “WDQS” is “a Word”) Will Web-based Data Query Systems supplant annual vital statistics compendiums? • In terms of data or statistical tables, it is completely possible. • Think of the users who need the one number, the rank, the rates, etc.

21. And Now a Word About the Future “Publish or Perish . . .” 5 June, 2008 Will WDQS supplant annual vital statistics compendiums? (continued) • Another question: Is the vital statistician basically a programmer, a technician or an interpreter, relative to the data? • Think of the users who need the explanations, the “hows,” the “whys”

22. And Now a Word About the Future “Publish or Perish . . .” 5 June, 2008 Will WDQS supplant annual vital statistics compendiums? (continued) • Analysis is the key component: - trend spotting - investigation (e.g., issue du jour) - summarizing results in plain prose - explaining statistical results

23. And Now a Word About the Future “Publish or Perish . . .” 5 June, 2008 Will WDQS supplant annual vital statistics compendiums? (continued) • Analysis is the key component: (cont.) - explaining statistical . . . power, calculation, limitations, appropriate application, etc. - explaining history of investigation

24. And Now a Word About the Future “Publish or Perish . . .” 5 June, 2008 Will WDQS supplant annual vital statistics compendiums? (continued) • Analysis is the key component: (cont.) - explaining history of collection - how items are measured - showing which differences are trivial versus important (i.e., significant)

25. And Now a Word About the Future “Publish or Perish . . .” 5 June, 2008 Will WDQS supplant annual vital statistics compendiums? (continued) Another devil’s advocate question: why not utilize other research statisticians, say at state universities, for VS analysis? - who are getting their hands dirty in the data? - whose job is it 24/7 (7.5/5)?

26. And Now a Word About the Future “Publish or Perish . . .” 5 June, 2008 “MAYBE” Part II. • VS need to be tied to public health policy, grant activities, local/state needs assessments, programmatic applications, etc. to be effectively used or presented, say in a VS compendium. • Analysis is your most valuable asset.

27. Um, How Do You Do That? “Publish or Perish . . .” 5 June, 2008 • Pay attention* to what your agency’s programs are using and asking for • Pay attention* to what your clients (say they) utilize in your compendium • Survey your clients, if necessary * Pay attention = serve on committees, talk to program people, scan the news, etc.

28. Um, How Do You Do That? “Publish or Perish . . .” 5 June, 2008 • Be proactive; the days of people simply coming to you because VS data are the only game in town are (long) over • Listen, liaison, link the data dots • Adapt (evolve) your VS compendium (and other products) accordingly

29. Case Study: How We Did That “Publish or Perish . . .” 5 June, 2008 • IL Program for Local Assessment of Needs (IPLAN) wanted a data tool kit for local community groups to use to assess key health indicators and determine five-year priorities for intervention • Part of LHD re-certification • Community groups’ members not data savvy, let alone public health statisticians

30. Case Study: How We Did That “Publish or Perish . . .” 5 June, 2008 • IPLAN needs (continued) • Regarding VS data, we determined: - long-term planning the focus - lots of small numbers issues for many LHDs - age-adjusted rates, for example, difficult to comprehend by users

31. Case Study: How We Did That “Publish or Perish . . .” 5 June, 2008 • IPLAN needs (continued) • Main VS response was data for the IPLAN database but we also adapted our VS compendium: - dropped YPLL - added premature mortality rates (PMR) - added multi-year averaging

32. Case Study: How We Did That “Publish or Perish . . .” 5 June, 2008 • IPLAN needs (continued) • Adapted VS compendium: (continued) - added county comparison tables - added confidence intervals for selected measures (e.g., IMR) - added explanations, such as ICD-9/10 comparison

33. “Publish or Perish . . .” 5 June, 2008 Natality example

34. “Publish or Perish . . .” 5 June, 2008 Mortality example

35. “Publish or Perish . . .” 5 June, 2008 County comparisons (PMR)

36. Case Study: How We Did That “Publish or Perish . . .” 5 June, 2008 Will County example, Heart Disease PMR: Year Deaths Deaths Crude All ages0-64RatePMRAADR 1999 941 149 194.6 33.6 291.7 2000 926 175 182.2 37.6 273.5 2001 925 142 172.3 28.8 263.0 2002 993 174 175.7 33.5 266.4 2003 972 182 163.5 33.2 246.0 2004 880 174 141.5 30.3 214.5 2005 904 185 140.9 31.2 205.7 % Change 1999-2001 to -1% +16% -19% -5% -20% == 2003-2005

37. Other Things to Keep in Mind “Publish or Perish . . .” 5 June, 2008 “MAYBE” Part III. • Don’t forget year-to-year comparability is a VS compendium strength and don’t neglect your core content. • The compendium is expected to be the “gold standard” for VS data. • VS compendiums are not necessarily meant to be the “latest news” but rather the “last word” regarding a statistical year.

38. Thank You Mark Flotow Illinois Center for Health Statistics IL Dept Public Health Springfield, IL 217.785.1064 mark.flotow@illinois.gov Web site: www.idph.state.il.us