MICA User Group Newsletter Practice Exercise Solutions

Issue #10

You are collecting data on various death rates in Pulaski County and Missouri.  You need to report and cite these rates.  Refer to the Q&A section of this newsletter to see example citations and links to additional resources for citing sources.

  1. Use the Unintentional Injury Profile to find the state’s motor vehicle accident death rate for the 2002-2012 time period.  Write a sentence or two about this rate and provide an in-text citation.

For 2002-2012, the Missouri age-adjusted death rate from Motor Vehicle Traffic accidents was 16.7 per 100,000 residents.  This rate was based on 10,869 Missouri resident deaths (MODHSS, Unintentional Injury Profile).

Create a bibliography entry for this source.

MODHSS (Missouri Department of Health and Senior Services).  Community Data Profiles.  In Unintentional Injury Profile.  Retrieved 2014, July 1, from http://health.mo.gov/data/mica/ASPsUnintentional/header.php?cnty=929.

  1. Use the MICA datasets to find the 2010 cancer death rate for Pulaski County.

In which MICA did you find this information?    
Death MICA or Chronic Disease (Deaths) MICA

Write at least one sentence about this rate and cite it appropriately. 
Pulaski County’s 2010 age-adjusted cancer death rate was 166.2 per 100,000 residents (MODHSS, Death MICA). 

OR

Pulaski County’s 2010 age-adjusted cancer death rate was 166.2 per 100,000 residents (MODHSS, Chronic Disease MICA).

Prepare a bibliography entry for your source.

MODHSS (Missouri Department of Health and Senior Services).  MICA.  In Death MICA.  Retrieved 2014, May 19, from http://health.mo.gov/data/mica/DeathMICA/.

OR

MODHSS (Missouri Department of Health and Senior Services).  MICA.  In Chronic Disease MICA.  Retrieved 2014, May 19, from http://health.mo.gov/data/mica/ChronicDiseaseMICAs/.

 

Issue #9

As an employee of the Bates County Health Department, you are interested in changes in preventive health behaviors during recent years.  You decide to use the 2007-2011 County-Level Study (CLS) Comparison Profiles to analyze changes among Bates County residents.

  1. What is the 2011 estimated prevalence for no leisure-time physical activity?  26.7%
    What was the change in prevalence for no leisure-time physical activity between 2007 and 2011? -5.2% (or a 5.2% decrease)
    Was this change in prevalence statistically significant? No, the 2011 prevalence is not significantly different from the 2007 prevalence.

  2. What is the 2007 estimated prevalence for consumption of fruits and vegetables less than five times per day?  78.3%   
    What is the 2011 estimated prevalence?  91.9%
    What was the percentage change between these two years?  13.6% (or a 13.6% increase)
    You decide to compare the change in Bates County to the change in Missouri.  How did the state prevalence for this indicator change between 2007 and 2011?  The Missouri prevalence statistically significantly increased by 10.5% (from 77.0% in 2007 to 87.5% in 2011).
    You decide to compare the change in Bates County to the change in the Kansas City Metro Region (which includes Bates County).  How did the regional prevalence for this indicator change between 2007 and 2011? The Kansas City Metro Region prevalence significantly increased by 12.8% (from 75.0% in 2007 to 87.9% in 2011).

  3. What is the Bates County 2011 estimated prevalence for smoking not allowed in the home? 64.5%
    What was the change in prevalence for smoking not allowed in the home between 2007 and 2011?  9.5% (or a 9.5% increase)
    Was this change in prevalence statistically significant?  No, the 2011 prevalence is not statistically significantly different from the 2007 prevalence.
    In which Profile did you find this information?  County-Level Study 2007-2011 Comparison Secondhand Smoke Profile

  4. Your supervisor asks you to briefly summarize the 2007-2011 changes in the Bates County prevalence estimates for “Current cigarette smokers who made a quit attempt in past year” and “Current smokers who intend to quit in next 6 months.” The prevalence of current smokers who made a quit attempt in the past year decreased from 70.9% in 2007 to 30.5% in 2011, while the prevalence of current smokers who intend to quit in the next 6 months decreased from 79.1% to 42.9%.  The decreases for these two indicators are statistically significant and reveal meaningful decreases in prevalence between the two CLS surveys.  The Bates County Health Department may need to increase tobacco cessation efforts.

 

Issue #8

Health Indicator

Data Source

Most Recent Rate

Time Period

Type of Rate/Constant

Stroke Mortality

Death MICA

48.5

2011

1-Year/100,000

Leading Causes of Death Profile

48.7

2001-2011

11-Year/100,000

Stroke Profile

48.7

2001-2011

11-Year/100,000

Women’s Health Profile

51.6 (females)

1999-2009

11-Year/100,000

Chronic Disease Comparisons Profile

51.6

1999-2009

11-Year/100,000

Stroke Prevalence (Adults 18 years
and older)

Stroke Profile

2.9 (Central Region rate)

2011

1-Year/100

Stroke Hospitalizations

Inpatient Hospitalization MICA

22.1

2011

1-Year/10,000

Inpatient Hospitalization Profile

23.8

2009

1-Year/10,000

Chronic Disease Comparisons Profile

26.7

2005-2009

5-Year/10,000

Stroke Profile

24.0

2007-2011

5-Year/10,000

Stroke Emergency Room Visits

Emergency Room MICA

0.3

2011

1-Year/1,000

Emergency Room Profile

0.3

2011

1-Year/1,000

Chronic Disease Comparisons Profile

0.5

2005-2009

5-Year/1,000

Stroke Profile

0.4

2007-2011

5-Year/1,000

Stroke Hospital Charges (in $)

Hospital Discharges, Charges & Days
of Care MICA

$9,356,325

2011

1-Year

Stroke Risk Factors:

 

 

 

 

Current Smoking

Stroke Profile

18.0

2007

1-Year/100

High Blood      Pressure

Stroke Profile

26.2

2007

1-Year/100

High Cholesterol

Stroke Profile

33.5

2007

1-Year/100

Halloween Costumes

Front Row:
Becca Mickels – Toddler
Whitney Coffey – The Cat in the Hat
Becky Chitima-Matsiga – Rock Bridge High School Football Player

Back Row:
Evan Mobley – Corporate Lumberjack
Andy Hunter – African Prince

 

Issue #7

Motor vehicle accident death rates are higher in rural regions compared to urban areas. Use the Leading Causes of Death Profile to answer the following questions related to Motor Vehicle Accident Deaths in Cass County and Bates County. These two counties are adjacent to each other in west-central Missouri. By some definitions Cass is considered urban while Bates is considered rural.

  1. What is the age-adjusted motor vehicle accident death rate for Cass County?
    16.6 per 100,000 population

  2. Is the Cass County rate significantly different from the state rate?
    No

  3. What is the age-adjusted motor vehicle accident death rate for Bates County?
    28.9 per 100,000 population

  4. Is the Bates County rate significantly different from the state rate?
    Yes – The Bates County rate is significantly higher than the state rate.

  5. What time period was used to calculate these rates?
    2001-2011

  6. Why was this time period used?
    A long time period was needed in order to generate statistically stable rates.  There are relatively few motor vehicle accident deaths in most counties.  For example, there were only 54 deaths in Bates County during the eleven-year time period from 2001-2011.  In Clay County, which has a larger population and is considered to be more urban, there were only 165 deaths during the eleven-year time period, or roughly 15 deaths per year.

  7. What constant was used in calculating these rates?
    These rates are per 100,000 population (residents).

  8. What DHSS tool could be used to determine if there is a statistically significant difference between Cass County and Bates County?
    The confidence intervals feature in the Death MICA can be used to determine statistical significance at either a 95% or a 99% confidence level.  If the intervals overlap, the rates are considered to be statistically similar, or not significantly different.  If the intervals do not overlap, the rates are considered to be statistically significantly different.  (The Bates County rate is significantly higher at the 95% confidence level but not at the 99% confidence level.)

    95% CI:  Bates 21.5 to 38.0 versus Cass 14.2 to 19.4
    99% CI:  Bates 19.6 to 41.1 versus Cass 13.4 to 20.3

Issue #6

You work for the Washington County Health Department and are interested in applying for a grant to prevent tobacco use and support tobacco cessation programs in your county.  Use the 2011 County-Level Study Profiles to research tobacco use in Missouri.

The answers to questions 1-3 are found on the Health and Preventative Practices Profile.

  1. What is the Washington County prevalence of current cigarette smoking?  36.4%
    Is the Washington County prevalence statistically significantly different from the state prevalence?  Yes – significantly higher

  2. What is the Central Region (which includes Washington County) prevalence of current cigarette smoking?  22.5%
    Is the Central Region prevalence statistically significantly different from the state prevalence?  No

  3. Use the Download Indicator Data column (available only on the Missouri Profile) to determine which region has the highest current cigarette smoking prevalence.  Southeastern Region (27.5%)
    Which region has the lowest prevalence?  St. Louis Metro Region (20.0%)
    Which county/city has the highest prevalence of current cigarette smoking? Pemiscot County (45.5%)
    Which has the lowest? Scotland County (8.4%)

The answers to questions 4-6 are found on the Tobacco Use Profile.

  1. What is the Washington County prevalence of former cigarette use?  22.1%
    Is the Washington County prevalence statistically significantly different from the state prevalence?  No

  2. What is the Washington County prevalence of smokeless tobacco use?  7.2%
    Is the Washington County prevalence statistically significantly different from the state prevalence?  No

  3. What are the Washington County prevalence rates for belief that smoking cigarettes causes the following conditions?

Condition

Prevalence Rate

Heart attack

76.5%

Colon cancer

36.1%

Stroke

67.5%

Low-birth weight

78.4%

Impotence

41.5%

Visit http://health.mo.gov/data/mica/MICA/solutions.html to check the solution.

Issue #5

You are researching the use of caesarean sections in Missouri.  You would like to determine which mothers are at highest risk for a caesarean delivery.  Use the Birth MICA to complete the following tables and determine which demographics groups are at significantly higher risk for caesarean deliveries based on 2009 data.

 

Number

Rate

95% Confidence Interval

Whites

20,494

32.3

31.9 to 32.6

African Americans

3,967

32.9

32.1 to 33.8

American Indians/Alaskan Natives

107

30.1

25.5 to 35.0

Asians/Native Hawaiians/Pacific Islanders

677

33.7

31.6 to 35.8

Groups at significantly higher risk:

None – The confidence intervals overlap.

 

Number

Rate

95% Confidence Interval

Hispanic

1,184

27.6

26.3 to 29.0

Non-Hispanic

24,310

32.6

32.3 to 33.3

Group at significantly higher risk:

Non-Hispanics, when compared to Hispanics

 

Number

Rate

95% Confidence Interval

10-14

20

27.0

18.2 to 38.1

15-17

509

21.5

19.9 to 23.2

18-19

1,527

24.9

23.9 to 26.0

20-24

6,300

28.7

28.1 to 29.3

25-29

7,612

32.0

31.4 to 32.6

30-34

6,039

36.9

36.2 to 37.7

35-39

2,865

41.9

40.8 to 43.1

40+

643

46.7

44.1 to 49.4

All Ages

25,517

32.4

32.0 to 32.7

Groups at significantly higher risk:

Ages 30+ are at significantly higher risk than the overall state population.

 

Number

Rate

95% Confidence Interval

Married

15,656

33.6

33.2 to 34.0

Not married

9,858

30.6

30.1 to 31.1

Group at significantly higher risk:

Married women, when compared to not married women

Issue #4

  1. Highest - Madison -170.9       Lowest – Lewis – 17.4
  2. Yes to both
  3. No, CI’s overlap
  4. Saline (2709)
  5. Crawford
  6. Open Wounds and Strains and Sprains

Issue #3

Use the Birth MICA to answer the following questions related to premature births in Jackson County and the Kansas City metropolitan area.

  1. Using the 2008 and 2009 data years, what is the premature birth rate for Jackson County?  12.2% of live births (or 12.2 per 100 live births  What is the rate for the State of Missouri? 12.6% of live births (or 12.6 per 100 live births)
  2. Use 95% confidence intervals to determine if the difference between your answers to Question 1 represents a statistically significant difference.  Is the Jackson County rate significantly higher than, significantly lower than, or not significantly different from the State of Missouri rate?  The Jackson County and State of Missouri rates are not significantly different.
  3. Now calculate the premature birth rate using the same time period for a region that includes Jackson, Cass, Clay and Platte Counties.  What is the rate?  11.8% of live births (or 11.8 per 100 live births)  Is this rate significantly higher than, significantly lower than, or not significantly different from the state rate at a 95% confidence level?  This rate is significantly lower than the state rate.
  4. If we change the confidence level to 99%, does that change the answer to Question 3?  If so, how?  No
  5. Now use the Kansas City ZIP Code option on the Birth MICA to determine which ZIP Code in the range from 64011 through 64030 had the highest number of premature births for 2008-2009.  64030 (109)  Do you get the same answer if you look for the ZIP Code with the highest rate of premature births?  If the answer is not the same, which ZIP Code has the highest rate?  No – 64024 (15.5%)

Issue #2

As a health educator in Miller County, you are preparing some materials for American Heart Month.  You would like to include the prevalence of current high blood pressure in your county, because this is one of the most important risk factors for heart disease.  After reviewing the MICA suite of tools, you remember that the County-Level Study is the only source of county-specific prevalence rates for many risk factors and conditions.  Use the 2007 Health and Preventive Practices Profile to answer the following questions about current high blood pressure in Miller County and the state.

  1. What is the age-adjusted rate for current high blood pressure in Miller County?  23.6% (Use the Age-adjusted weighted percent link in the upper right corner of the screen to view age-adjusted weighted percents rather than weighted percents.)
  2. How does this rate compare to the state rate?  The Miller County rate is significantly higher than the state rate.
  3. How does it compare to the rate for the Central Region, which contains Miller County?  The Miller County rate is significantly higher than the Central Region rate.
  4. While reviewing the current high blood pressure map from the Missouri 2007 Health and Preventive Practices Profile, you notice that there are a few pockets or clusters of counties with high rates.  In general, where are these clusters located?  Use the Select a different geographical area link at the top of the screen to view the Missouri Profile.  Choose the Missouri icon in the Current high blood pressure row to view the map.  A large cluster exists in the Southeastern part of the state and extends into South Central Missouri and towards the St. Louis Metro area.  There is also a small cluster in the Central part of the state that includes only Miller County and Morgan County.
  5. From the Missouri Profile, how could you determine the number of counties that have significantly higher or significantly lower rates than the state overall?  Select either the Microsoft Excel icon or the Adobe PDF icon in the Download Indicator Data column.  Both options provide the number of interviews, the weighted (or age-adjusted weighted) percent, significance compared to the region, and significance compared to the state for every geographic area for which data are available.  In Microsoft Excel, you could sort the list by state significance to more easily determine the number of counties in each category.
  6. You want to know if the prevalence of current high blood pressure is increasing or decreasing in Miller County.  Use the 2003-2007 CLS Comparison – Health and Preventive Practices Profile to determine how the Miller County rate changed during that time period.  (NOTE:  The 2007 Miller County rate on the Comparison Profile will differ from your answer to #1.  Fewer interviews were completed in 2003, so Miller County data was combined with Camden County data to produce a more stable and reliable bi-county rate.)  What was the 2003-2007 percentage change for Camden-Miller?  3.42% increase  Was this change statistically significant, and, if so, how?  This change was not statistically significant.

Issue #1

You have been asked to write an article about methods of cataract prevention.  You decide to use the Procedures MICA to find statistics on the number of older adults who received cataract treatment.  Set up your query to determine which of the following groups of older adults underwent more cataract procedures in Missouri during 2008:  White Males, White Females, African-American Males, or African-American Females.  What settings did you use?

Step One:

Row variable Race (or Sex)

Step Two:    

Column variable Sex (or Race)

Step Three (Optional):

 

Race All Races, Ethnicity All Ethnicities, Sex All,
Age 65 and Over, Pay Source All Pay Sources, Setting All Settings

Step Four:    

Year(s) of Interest 2008

Step Five:     

Statewide/County/Cities Missouri

Step Six:      

Indicator variable Operations on the eye

Step Seven: 

Statistics to be displayed Frequencies and Rates,
Standard population 2000 Population,
Confidence intervals No Confidence Intervals

Drill-down hyperlink(s) (Optional): 

Drill down on Procedure:  Operations on the eye in the table headings to choose Lens and cataract procedures

Procedures MICA sample data image

Interpretation:  White Females had the highest number (54,990) and highest rate of lens and cataract procedures at 1,283.4 per 10,000 population.

Note:  Although most hospital data are reported using age-adjusted rates, this particular table contains crude (not age-adjusted) rates because an age-specific category (65 and Over) was selected.  Only the total population needs to be age-adjusted.