Data on anxiety meds, fast food and smoking will help Allegheny County target heart disease interventions

“Diseases of the heart” is the No. 1 cause of death in Allegheny County.

Maps created by ACHD using health data

Maps created by ACHD using health data

Sarah Anne Hughes

On its own, each new batch of data recently released by Allegheny County is interesting.

There’s census-tract-level information on where people are taking anxiety medication and data on establishments that have Clean Indoor Air Act exemptions, meaning people can smoke inside. Fast food establishment info includes where there’s a dollar menu.

There’s also data on obesity, poor housing conditions, traffic counts and walk scores.

But together, these datasets will help do something critical: deepen Allegheny County’s understanding of where — and why — people are dying from cardiovascular disease.

“Diseases of the heart” were the No. 1 cause of death in Allegheny County in 2013, the most recent year for which stats are available, accounting for 25.7 percent of deaths. These types of deaths have been steadily declining since 1970, but increased by more than 2 percent between 2012 and 2013.

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Allegheny County Health Department

The Robert Wood Johnson Foundation last year selected the Allegheny County Health Department to receive one of its Data Across Sectors for Health (DASH) grants. The county is using that money to form the Allegheny Data Sharing Alliance for Health, “a connected data warehouse that combines data from multiple sectors to create a more complete picture of the factors impacting the cardiovascular health of the county’s 1.2 million residents.”

A smaller group from the DASH project’s advisory coalition — which is made up of more than 75 organizations — pulled data of a “variety of different aspects,” said Allegheny County Health Department Director Karen Hacker.

“A lot of the information we’re pulling is in the public sector,” she said, “and we believe is related to cardiovascular health.”

The ACHD coalition also worked with three managed care organizations —Gateway Health Plan, Highmark Health and UPMC — to obtain data at the census-tract level on use of anxiety medication and prevalence of diabetes, hypertension and hyperlipidemia.

With the data, the University of Pittsburgh is using its platform, the Framework for Reconstructing Epidemic Dynamics (FRED), to “model how different census tracts look with regard to different cardiovascular risk factors as well as outcomes in terms of mortality,” Hacker said. “Then we’re going to look to see if any of these social determinants may actually contribute to the differences between those different census tracts. That will help us in terms of planning for interventions.”

“The fact of the matter is, we’ll never have enough resources to do everything we want to do,” she added. “We want to target [interventions] in the most appropriate place possible.”

Public use for the public good

The DASH project data was made available the Western Pennsylvania Regional Data Center’s site, where it can be downloaded and used by anyone. Civic group Code for Pittsburgh’s Thursday meeting will focus on the data.

There’s an exceptionally helpful guide that accompanies the data and details what it is and best practices for using it. The anxiety medication data, for example, represents claims from around 60 percent of the county’s insured population. This type of data, Hacker said, has its limitations, but “it’s certainly better than what we’ve had to date,” like info from the Allegheny County Health Survey.

So what does Allegheny County hope people do with the data? Hacker said they’re on board with anything that “makes things better.”

The data will be used by Pitt’s University Center for Social and Urban Research, which manages the Western Pennsylvania Regional Data Center, to help build Southwestern Pa. community profiles. Adding the data to those profiles will give residents and municipal governments “a better understanding of what’s going on in their communities from a public health perspective,” Hacker said.

“For us, the thing we’re really hoping is that this data gets used in a way that we can plan and that we can better target our efforts,” she said. “It’s information that helps us understand what’s going on in a community, but also helps us say, ‘Listen, this is where we need to do some work.’ ”

Because of the county’s limited resources, Hacker said they need “community organizations at so many levels to be focusing” on public health, as well. This data can help these groups understand where they’re needed the most.

The project also presents a holistic way to think about public health. As Hacker said, you can add green space to a community, but how do you know if it actually improves residents’ health?

DASH connects the dots between those “different sectors that we don’t usually think about,” Hacker said, like jobs, food access and transportation.

What ACHD has found thus far has not been particularly surprising, Hacker said. They already knew that some towns in the Mon Valley and other river communities are “really at a disadvantage.”

But mapping the data, while “not necessarily statistically significant,” Hacker said, does offer a visual understanding of changes like shifts in demographics.

“As a health department director, these are the things I need to be aware of,” she said.

Hacker also wants the data to “stimulate and catalyze action” in these communities. She wants people to ask themselves, what does this say about where I live? How can I make it better?

The county is already pointing people in the right direction with Live Well Allegheny, an obesity prevention and physical activity campaign. Hacker also highlighted Economic Development South’s plan to build a healthy corner store in Clairton, which recently won an UpPrize grant.

“Communities, even if they’re disadvantage, they can do things,” Hacker said. “They can plan things. They can take action.”