Data Harmonization: Current Updates

Research efforts in the future will be greatly aided by the Data Harmonization Project involving the National Association of Local Boards of Health (NALBOH), the National Association of County and City Health Officials (NACCHO), and the Association of State and Territorial Health Officials (ASTHO).  Funded by the Robert Wood Johnson Foundation, the Data Harmonization Project coordinates a variety of the mechanics of the three associations’ separate profile surveys of boards of health and health departments.  In the past, each of the associations has surveyed state and territorial health departments (ASTHO), local health departments (NACCHO), and local boards of health (NALBOH) using different survey instruments and often in different years.  In marked contrast to the extensive data available to national private health companies —especially within HMOs (Health Maintenance Organizations) with their coordinated service networks and billing systems— on services offered to clients and the resulting outcomes in terms of health, efficiency and costs, public health efforts vary greatly.  Funding, agency size, organization, governance, and services offered exhibit great diversity between states as well as between small rural and larger urban local health departments and their boards.  Likewise, while the three associations’ profile surveys provide the primary data on public health agencies, the differing methods and methodologies employed to gather these data previously have hampered efforts to link the profile surveys and begin to draw some initial perspectives on public health inputs and their corresponding population health outcomes as drawn from vital statistics data.

The Robert Wood Johnson Foundation seeks to enhance collaboration between the associations and create a single integrated dataset to be made available to the public.  To achieve this end, the associations —in collaboration with the US Centers for Disease Control and Prevention and the University of Kentucky College of Public Health— will align their survey efforts in a number of ways.  For example, all three associations will conduct a census of their respective constituent agencies over the same year:  2010.  Thus, the corresponding data will draw from agencies over the same time period. 

Similarly, the connecting element between the surveys will be service to the same jurisdiction.  Thus, the surveys will utilize the same geographic and demographic questions, and efforts have already linked local boards of health and local health departments where possible.  Such efforts are not especially easy:  rather than a one-to-one relationship, a district health department serving multiple counties may work with multiple county-level boards of health in a one-to-many relationship.  There are also instances of the reverse:  a single regional board of health overseeing multiple local health departments.  The 2010 NALBOH and NACCHO surveys seek to clarify these connections between local health agencies and boards.

Other steps to gather a timely, linkable dataset include use of the same basic survey administration methodology and the same vendor to supply the online survey portals.  Previously ASTHO and NACCHO have used a web-based survey while NALBOH has conducted a paper, mail-out survey.  In 2010 all three will use web-based surveys designed by the same vendor.  Similarly, the three associations continue through 2009 to align their surveys’ questions through uniform wording, uniform definitions of survey terms, and documentation of instances where terms or wording varies.  These efforts will allow researchers to directly compare questions or clearly understand the rationale why and how questions for similar topics vary between the surveys.  Understandably, harmonizing three surveys designed for surveying distinctly different types of agencies and reaching thousands of varying constituent agencies poses challenges, but the payoff in terms of improved research possibilities from the final integrated dataset promises great rewards.  By 2012, data on state health initiatives, local board governance issues, and local health department services should be available by jurisdiction.  The Robert Wood Johnson Foundation plans on providing it free to the public through their archiving agreement with the University of Michigan’s Inter-University Consortium for Political and Social Research.

Written by: Jeff Jones, Ph.D.

The following pages represent the initial synoptic analysis of surveys from Association of State and Territorial Health Officials (ASTHO) administered 2007 , National Association of County and City Health Officials (NACCHO) administered 2005, and National Association of Local Boards of Health (NALBOH), administered 1996. This is a side-by-side comparison of the three surveys as of 2007. This is intended to guide the researcher or practitioner who is looking to examine relationships between the three surveys for benchmarking or comparison purposes. There are two sections of this analysis.

The first section, the Activities Comparison examines questions regarding the availability of certain activities performed either by the health department/board organization or by another entity.  A closer look at the activities in this analysis allows a better knowledge of the completeness of each survey and possible inclusion, in new survey instruments, of missing factors or if comparable information is available across the various levels of public health organizations.

The second section, Question Comparison, takes an in-depth cross-sectional look at the specific questions asked by each survey regarding the structure, governance, administrative and organization issues for each respondent. This allows for cross comparisons of each respondent on key administrative variables.

Evaluation Prepared by:  Lisa J. Peterson, B.S. and Torrie T. Harris, Dr.P.H.

Current Information
ASTHO, NACCHO and NALBOH currently provide infomation on their websites about their survey materials and reports.  ASTHO maintains a Data & Analysis page where users can download their questionnaire and codebook.  NACCHO recently published the results of their 2008 National Profile of Local Health Departments.  Lastly, users can viist the NALBOH publications page to order copies of the available resources.

Surveys

Click the Images Below to Download the Attached Files

              ASTHO                   NACCHO                    NALBOH

Data Harmonization Dictionary

Synoptic Analysis