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National Information Center on Health Services Research and Health Care Technology (NICHSR)

Community Health Status Indicators (CHSI): Questions and Answers

1. How were the indicators for CHSI selected?

The CHSI Project assembled an advisory panel of academic public health services researchers and local, state, and federal public health representatives who guided the development of the project’s local county reports. The indicators were carefully selected and vetted by an advisory committee of experts to essentially tell the story about the health of each county.

2. What time periods are covered by the data?

The time periods vary by the data source. Full information about the data sources and dates covered are provided in the Data Sources, Definitions and Notes for CHSI that is available from the "About the Data" webpage. Also the Data Details link within each county's CHSI report on the CHSI website provides annotations for each data source represented.

3. How up-to-date is the data and how often will it be updated?

Updates to CHSI are currently underway. Since the CHSI data is from many different sources, the goal is to make the CHSI data as up-to-date as the data source itself.

4. What is "frontier status"? Is it a rurality measure?

Frontier status is defined as fewer than 7 people per square mile. It permits the categorization of rural data into "frontier" or "non-frontier" status as designated by the Compendium of Recommendations by the National Advisory Committee on Rural Health for the Health Research and Services Administration (HRSA) data collection systems.

5. Can you elaborate on "relative health importance" and how someone determines which indicators are most important for setting priorities?

The Relative Health Importance Table creates four categories of relative concern by simply comparing one’s county rate or percent to its median of peers and to 2003 U.S. rate or percent. The table highlights favorable and unfavorable standing between one’s county, and other counties and the Nation, and points to indicators which may warrant more attention. A county's indicators in the upper left-hand box may be ripe for improvement. They are higher than 2003 U.S. rate or percent and half of the peer counties. The county compares unfavorably to both peers and the Nation for the indicators listed (i.e., a county rate higher than the median of peer county rate or percent is categorized as "unfavorable"). Conversely, indicators in the lower right-hand box of the table compare favorably to both peers and 2003 U.S. rate or percent For these indicators the county has been doing relatively well. It is important to note that though a favorable relationship currently exists, these indicators are likely to call for continued attention so that the current positive level of health status is sustained or additional progress made. The Data Details provides this description and is located on the report for each county. Simply click on the plus sign (+) by the Data Details to display this information.

6. Is this saying that 80% of premature deaths is in part attributed by poor fruit/vegetable intake? I'm trying to make sure I'm interpreting this correctly.

Few Fruits and Vegetables (under the category of Risk Factors for Premature Death) indicates the percentage of adults reporting an average fruit and vegetable consumption of less than 5 servings per day. In the example of Wayne County, Michigan, 78.4 % or roughly 80%, reported consumption of less than 5 servings of fruit and vegetables per day putting them at risk for premature deaths.

7. For very rural areas, there are lots of "NRF" statistics. Do you have any ideas of where to go for numbers on rural and small populations?

The Health Research and Services Administration (HRSA) is the lead federal agency for monitoring and improving health for rural areas and supports state offices of rural health. The HRSA programs and activities are described in this factsheet. HRSA is a good starting point. Additionally, HSR Info Central, a portal for Health Services Research information developed by the National Library of Medicine's National Information Center on Health Services Research and Health Care Technology (NICHSR), has a section of resources on Rural Health with links to major federal agencies, organizations, and associations which have programs related to rural health. Local and state health data organizations can also be helpful.