New York State Health Data

Code-a-Thon

Obesity and Type 2 Diabetes

Prevention

December 13, 2013

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Webinar Housekeeping

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The Obesity and Type 2 Diabetes Epidemics

in NYS

NYS Department of Health

• Maureen Spence

• Susan Millstein

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Obesity and Type 2 Diabetes Data Sources

NYS Department of

Health

• Ian Brissette

• Trang Nguyen

• Rachael Ruberto

• Lynn Edmunds

• George Javitz

NYS Office of Parks

and Recreation

• Sally Drake

• Christina Croll

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Where Are You?

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Obesity

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• According to self-report survey data, 24.5% of

NYS adults are considered obese, and another

35.6% are overweight, impacting 8.5 million

residents.

• Obesity is significantly more prevalent among

non-Hispanic black adults (32.5%) than among

Hispanic (26.3%), non-Hispanic white (23.6%)

and other non-Hispanic adults (16.3%).

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Obesity in NYS Adults

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The rate of obesity is also higher among those

who earn an annual household income less than

$25,000 (26.8%), have less than a college

education (27.1%), or are currently living with a

disability (34.9%).

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Obesity in NYS Adults

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• In the US:

– 31.7% of children and adolescents aged 2-19 are overweight or obese.

• In NYS:

– 32% of public school students (outside NYC) are overweight or obese.

– 40% of NYC public school students ages 6-12 are overweight or obese.

– 32% of children ages 2-4 enrolled in the WIC Program are overweight or obese.

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Obesity in Adolescents and

Children

9

0

5

10

15

20

25

1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010

Pe

rce

nt

(%)

Black Hispanic White

1990-2003 (↑2.7 )

1989-2003 (↑3.9)

1989-2003 (↑3.4)

2003-2010 (↓3.6)

2003-2010 (↓2.8)

2003-2010 (↓0.6)

Source: 2010 Pediatric Nutrition Surveillance Report, table 18c

Obesity Prevalence Trends among WIC Children 2-4

Years by Race/Ethnicity

New York State, 1990-2010

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Why is Obesity a Public Health

Problem?

• Obesity can:

– Shorten lives

– Reduce quality of life

– Affect academic and work performance

– Carry an economic burden

• Racial, ethnic and income disparities are

significant

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Diabetes

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Type 2 Diabetes

• When you eat food, the body breaks down all of

the sugars and starches into glucose, which is

the basic fuel for the cells in the body.

• Insulin takes the sugar from the blood into the

cells where it can be used for energy

• In type 2 diabetes, there is too little insulin, or

the insulin that is available is not effective

• Glucose/sugar remains in the blood stream at an

elevated level (high blood sugar)

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Risk Factors for Type 2 Diabetes

• Advancing age

• Obesity

• Family history of diabetes

• Prior history of gestational diabetes

• High Blood Pressure

• Physical inactivity

• Race/ethnicity

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Portion Distortion Through the Years

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Sedentary Lifestyles

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17

AUDIENCE

POLL

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Diabetes in New York State Adults

• Approximately 1.5 million adult new Yorkers or 10.4% of the

population have been diagnosed with diabetes.

• Between 1999 and 2011, the prevalence of diagnosed diabetes

in adults in New York State (NYS) increased from 5.7% to 10.4%.

• During the same years, the prevalence of obesity in adults

increased from 17.4% to 24.5%.

• Because obesity is a leading risk factor for diabetes, the

increase in obesity prevalence translates to nearly one million

additional New Yorkers being at higher risk for developing

diabetes

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Why Do We Care?

• Diabetes affects many parts of the body and can

lead to serious complications such as blindness,

kidney damage and lower limb amputations.

• The total cost of diabetes in NYS was estimated at

$12.9 billion in 2007, including $8.7 billion in

diabetes-related medical expenditures and $4.2

billion attributed to lost productivity costs.

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Type 2 Diabetes in New York State

Youth

• No registry or other means to accurately

account for the number of children with type

2 diabetes.

• Based on national studies, we estimate there

are approximately 1,100 youths, aged 0-19,

with type 2 diabetes in NYS.

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>1.5 million with diagnosed

Diabetes

4.5 millionwith Prediabetes

Approximately 750,000 have

diabetes but don’t know it

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Prediabetes

• Blood glucose (sugar) levels that are

higher than normal but not yet high

enough to be diagnosed as diabetes.

• People with pre-diabetes are at increased

risk for developing type 2 diabetes and for

having heart disease and stroke.

• Many people are unaware that they have

pre-diabetes, because it usually has no

symptoms.

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Type 2 Diabetes Can be Delayed or

Prevented

• Weight loss of 5-7% of body weight

• Healthier food choices

• Physical activity 30 minutes a day,

most days of the week

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NYS Diabetes Prevention Program

• Lifestyle change program led by trained

coaches in community settings for people at

high risk

• Goal is to achieve 5-7% weight loss

• We have the programs, we need the

participants

• Health care providers need to diagnose,

communicate and refer

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Consequences of No Action

• One out of 3

children born in the

U.S. in the year

2000 will develop

type 2 diabetes, if

this epidemic is left

unchecked.

• This could be the

first generation of

children to not

outlive their

parents.

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How is the NYS Department of Health

Addressing the Twin Epidemics?

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Environmental Approaches

Environmental approaches promote health

and support and reinforce healthful behaviors

in schools and childcare, worksites, and

communities.

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Health Systems Approaches

Improve the clinical

environment to more

effectively deliver

quality preventive

services and help New

Yorkers more effectively

use and benefit from

those services.

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Community-Clinical LinkagesEnsuring that communities support and healthcare

providers refer patients to programs that improve the

prevention and management of chronic conditions.

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The Prevention Agenda 2013-17 is the blueprint

for state and local action to improve the health of

New Yorkers in five priority areas and to reduce

health disparities for racial, ethnic, disability,

socioeconomic and other groups who

experience them.

Prevention Agenda 2013-2017: New

York State's Health Improvement Plan

Setting the Context for Innovation:

Review of Key Data Assets

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Outline for Presentation

Defining innovation

Public health practice: epidemiology, public

health surveillance and program evaluation

Categories of data assets on Open Data NY

and Health Data NY

Demonstrations by Data Owners

Making data Open for use: API Foundry

Your Questions

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Innovation

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Defining Innovation

Innovate (verb):

To introduce

something new or

different;

To renew what exist

already;

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Data With A Purpose: Epidemiology and

Public Health Surveillance

Public Health Surveillance

Epidemiology

Data collected as part of public

health practice are done so to

understand the distribution of

disease or factors associated

with disease over time, place

and person;

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Variation… over time,

place

and person

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Public Health Program Evaluation

Evaluation is the systematic investigation of the

merit, worth or significance of an organized public

health action.

• Was the program implemented as planned?

• Did the program reach the desired segment of the

population?

• Do individuals who participate in the program experience a

health benefit?

• Is program implementation associated with a change in

population health?

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Your Mission… Should You Choose

to Accept ItUtilize Open Data

to develop an innovative

concept to help address

the twin epidemics of obesity and type 2

diabetes.

Our Aim Solution-Focused Use of Data

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Types of Data Assets on Health Data NY

Data assets that define the burden of

diabetes, obesity and related conditions

• Student Weight Status Category

• Community Health Indicators – Diabetes and

Obesity

• Prevention Agenda County Tracking Indicators

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Types of Data Assets on Health Data NY

Data assets about existing programs to

prevent obesity and type 2 diabetes…

• Women Infants and Children Program

• Child and Adult Care Food Program

• Easy Tips to Prevent Type 2 Diabetes

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Types of Data Assets on Open Data NY

Data assets that can be re-envisioned to

promote the prevention of obesity and

diabetes…

• Farmers Markets

• State Park Facility Points

• Accessible Outdoor Recreation Destinations

• Regulated Childcare Facilities

• Transportation: CDTA and MTA Sites

• Retail Food Establishments

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Dataset*: Community Health: Obesity and

Diabetes Related Indicators

• Data include: county level data for New York State

residents:

• Childhood and adult obesity prevalence

• Individual behaviors related to obesity:

breastfeeding, time watching TV, exercise, eating

fruit/vegetables.

• Diabetes prevalence among adults.

• Health burden: diabetes hospitalizations and

complications and deaths; cardiovascular disease

hospitalizations and deaths. *Dataset is currently on the test site and will be available on Open Data before the Code-a-thon

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Indicator List

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How can the data be used?

• Obesity and related diseases are among the State’s health

priorities, included in the State Health Improvement Plan:

Prevention Agenda 2013-2017

(www.health.ny.gov/prevention/prevention_agenda/2013-

2017/ ). These data are used for setting state objectives and

monitoring progress.

• Local health departments and hospitals use these data in

community health needs assessments, planning, monitoring and

evaluating public health interventions.

• Data can be used in conjunction with other data sources for

research, grant applications, community engagement,

educational materials, identifying and communicating local

priorities for interventions.

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www.health.ny.gov/statistics/chac/indicators/

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Student Weight Status Category

Reporting System

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Background

• Established by amendments to NYS Education Law

903 & 904 in 2007

– Added body mass index (BMI) and weight status category to

the school health certificate required at school entry (PreK

or K) and in grades 2, 4, 7 & 10

• Mandatory reporting of aggregated data to the NYS

Department of Health began during the 2008-09

school year

• New York City public schools, BOCES, special act

schools (4201 designated schools), charter, and

private schools are excluded

56

Student Weight on Health Data NY

• Dataset includes separate estimates of the % of

students overweight, obese and overweight or obese

for all reportable grades within the district, county

and/or region and by grade groups

• Variables representing the # of students on which

the percentages are based are also included

• An area identifier code is provided to enable linkage

of the district and county-level data with other data

sources

• Metadata documenting all the variables included

within the dataset is provided

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Area identifier Estimates (counts, percentages)

Filter by grade level or area type

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Statewide…

Region….

County….

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How is Student Weight Data Used?

• Statewide surveillance of childhood obesity in New

York State

• Monitor progress towards achieving NYS Prevention

Agenda objectives

• Encourage collaboration/use among local partners to

tailor obesity prevention programs

• Linkage analyses with economic data from NY State

Education Department

• Help identify high need communities in NYS

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Local-level charts/graphs

Prevention agenda tracking

Community needs index

Reports & analyses

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Student Weight: Geographic Representation

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Link to Code-a-thon Theme

• This data can be used to describe the problem of

childhood obesity at the district, county, regional

and state level

• The data can be used to locate obesity prevention

programs in districts or areas with the highest rates

of obesity

• This data can also be linked with a variety of other

data sets available at the federal, state & local level

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Limitations/Barriers to Innovation

• Have not used this data in combination with other

data available from DOH and other state/federal

agencies, such as:

– Food retail stores & restaurant locations

– Places to be physically active (parks, trails, etc.)

– Adult obesity/diabetes rates at the county level

– Rates of obesity among low-income preschoolers

– Census data

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Diabetes Type 2 Prevention Tips

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Prevention Tips on Health Data

• A set of over 60 quick and easy tips to

encourage lifestyle changes that may help

prevent type 2 diabetes.

• Some tips may also be useful for people who

already have type 2 diabetes

• Tips were compiled from four National

Diabetes Education Program (NDEP)

publications.

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Prevention Tips on Health Data

• The tips are grouped into five broad categories

based on each aspect of lifestyle change they

address:

-Reduce portion sizes

-Be physically active

-Make healthy food choices

-Stress reduction/mental health

-Prevention programs

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How is the Data Used?

• Different from our traditional health datasets

because it includes resource information

• The information itself is displayed in tabular form

rather than our typical data which include

numerical counts or rates.

– This data can be used by individuals at high

risk for developing diabetes to identify easy

steps that may help prevent or delay the

onset of type 2 diabetes.

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Link to Code-a-thon Theme

• This dataset provides

information about

lifestyle changes that

can help prevent type

2 diabetes and even

help those with

diabetes manage their

disease to avoid

complications.

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Limitations/Barriers to Innovation

• This information hasn’t been linked to places

or resources in the community that could

help people adopt some of these behaviors:

– These tips could be linked to existing data sources

on Health Data NY or Open Data NY

– Turning resource information into action

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ExamplesTip: Use calorie labeling information at fast food restaurants and on restaurant menus.

Link to data on locations of retail food establishments in NYS

Tip: Get off the bus one stop early and walk the rest of the way home or to work if it is safe.

Link to data on locations of CDTA bus stops

Tip: Walking is one of the best ways to increase your activity level. Start slowly by walking 5 minutes more each day.

Link to data on locations of parks and trails in NYS

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Special Supplemental Nutrition

Program for Women, Infants, and

Children (WIC)

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About WIC

Mission - To safeguard the health of low-

income women, infants, and children up to

age 5 who are at nutrition risk by providing

nutritious supplemental foods, breastfeeding

support, nutrition education, and referrals to

health care and social services.

Vouchers for supplemental foods are used at

authorized food stores.

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Who is Eligible?

Must meet each of 4 criteria:

1. Be a:

– Pregnant woman;

– Infant or child up to 5 years;

– Mother of a baby up to 6 months of age; OR

– Breastfeeding mother of baby up to 12 months

2. Resident of New York State

3. Meet income eligibility guidelines

4. Be at nutritional risk as determined by a health

professional

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500,000Approximate

#

participants

served

monthly

94Contracting

Agencies

210Permanent

Sites

259Temporary

Sites

5VMAs

Reach of WIC

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Open WIC Data

Data sets include:

WIC program eligibility criteria

Income eligibility guidelines

WIC site locations

Benefits of Open WIC data

Assist consumers with assessing potential

eligibility

Connecting consumers with local WIC services and

vendors

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Open WIC Data

Data sets include:

WIC program eligibility criteria

Income eligibility guidelines

WIC site locations

Benefits of Open WIC data

Assist consumers with assessing potential

eligibility

Connecting consumers with local WIC services and

vendors

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WIC Program Eligibility

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WIC Income Guidelines

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WIC Program Site Information

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WIC Program Site Map

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WIC Sites Filtered

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New York State Office of Parks, Recreation and Historic Preservation

Office of Parks, Recreation and Historic Preservation

Mission Statement

The mission of the Office of Parks, Recreation and Historic Preservation is to provide safe and enjoyable recreational and interpretive opportunities for all New York State residents and visitors and to be responsible stewards of our valuable natural, historic,

and cultural resources.

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Office of Parks, Recreation and Historic Preservation

Allegany: 4 parks Central: 20 parks,7 historic sites

Finger Lakes: 25 parks, 2 historic sites

Genesee: 8 parks

Long Island: 26 parks, 3 historic sites

New York City: 7 parks Niagara: 17 parks2 historic sites

Palisades: 21 parks6 historic sites

Saratoga-Capital District: 12 parks, 8 historic sites

Taconic: 13 parks,6 historic sites

Thousand Islands: 26 parks,1 historic sites

11 State Park Regions, 179 State Parks, 35 Historic Sites, 60 million visitors

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New York State’s Expansive System of Parks, Historic Sites,

Recreational Facilities and Infrastructure Tops the Nation

Office of Parks, Recreation and Historic Preservation

214 State Parks and Historic Sites

350,000 Acres 60 Million Visitors Annually 5000 Buildings 29 Golf courses 36 Swimming pools 67 Beaches 27 Marinas 40 Boat Launch Sites 18 Nature Centers 3 major concert venues 817 Cabins 8,355 Campsites 2000 Miles of Trails Hundreds of Miles of Roads

1st in Operating Facilities; 2nd in Visitation; 5th in Acreage

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New York State Parks: Connecting with our Communities, Providing Safe and Enjoyable Outdoor Recreation

Office of Parks, Recreation and Historic Preservation

Open Data:

Connecting People to

Our Parks

Datasets posted to

data.ny.gov to date

include:

•State Park Facilities

Point Map

•Campgrounds by

County

•State Park Golf

Courses

•State Historic Sites

•State Nature Centers

•State Park Boat

Launch SitesRoberto Clemente State Park

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New York State Parks: Connecting with our Communities, Providing Safe and Enjoyable Outdoor Recreation

Office of Parks, Recreation and Historic Preservation

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New York State Parks: Connecting with our Communities, Providing Safe and Enjoyable Outdoor Recreation

Office of Parks, Recreation and Historic Preservation

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Office of Parks, Recreation and Historic Preservation

Promoting Outdoor Recreation at State Parks for Healthy Communities Where it Makes the Greatest Impact

How: Identify where parks are located in proximity to:• Poverty areas• High incidence of childhood obesity• High incidence of physician-diagnosed adult diabetes

What: Use that information to inform park planning, develop a message campaign, and work with state and community partners to identify ways to increase park attendance in those areas.

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Office of Parks, Recreation and Historic Preservation

Data Identification

Use publicly available data to identify areas of high obesity among school-aged children near our parks

• Poverty Data: US Census Bureau• http://factfinder2.census.gov/faces/nav/jsf/pages/index.xhtml

• Childhood Obesity Data: NYS Department of Health• https://www.health.ny.gov/statistics/chac/indicators/obs.htm

• Adult Diabetes: NYS Department of Health• https://www.health.ny.gov/statistics/chac/indicators/dia.htm

• Park Location Data: NYS OPRHP GIS Bureau• https://data.ny.gov/Recreation/State-Park-Facility-Points/9uuk-x7vh

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Office of Parks, Recreation and Historic Preservation

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Office of Parks, Recreation and Historic Preservation

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Office of Parks, Recreation and Historic Preservation

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Office of Parks, Recreation and Historic Preservation

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Office of Parks, Recreation and Historic Preservation

Process

• Data was obtained from the various sources

outlined

• Data sets were joined to geographic data such as

census tracts and county boundaries

• Result was a map used by staff to inform decision

makers about the proximity to parks to areas of

interest

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Office of Parks, Recreation and Historic Preservation

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Using APIs with

HealthDataNY

and

OpenNY

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What is an API

• An application programming interface (API) specifies how some software components should

interact with each other.

• In addition to accessing databases or computer hardware, such as hard disk drives or video

cards, an API can be used to ease the work of programming graphical user

interface components

* Wikipedia

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Socrata’s Open Data APIs

* From Socrata.com/open-data-portal

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Socrata’s Open Data APIs

* From Socrata.com/open-data-portal

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Socrata’s Developer Resources

* From dev.socrata.com

105

Socrata Open Data API

* From dev.socrata.com

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Socrata Open Data API

* From dev.socrata.com

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Featured NYS APIs

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HealthDataNY Featured APIs

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HealthDataNY Featured APIs

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HealthDataNY Featured APIs

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HealthDataNY Featured APIs

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Example Code

First, get dataset identifier

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Then use identifier in request URL

Example Code

Use .csv to return CSV file

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Example Code

Thank You!Maureen Spence

mms07@health.ny.gov

Tel: (518) 408-5142

Ian Brissette

ifb01@health.ny.gov

Tel: (518) 473-7817

George Javitz

HealthDataNY Team

nyshealthdatacodo@health.state.ny.us