By Vincent Lim
Originally published in Hamovitch PI, Spring 2014
Many state, local, and national organizations have compiled publicly available data from sources such as the U.S. Census Bureau to produce health scorecards or rankings that seek to offer meaningful information about the health of different communities.
In developing these scorecards, questions arise about the precise relationship between commonly used community-level indicators such as the total number of health care facilities in a particular community and health outcomes for members of that community. Even less is known about the relationship between those indicators and health outcomes among specific segments of the population such as older adults in the community.
The USC Edward R. Roybal Institute on Aging at the USC School of Social Work is currently leading a pilot project to study the potential connections between factors such as air quality and the health of older adults in a specific neighborhood.
Donald Lloyd, a research associate professor at the USC Roybal Institute who is the principal investigator for the study, hopes his work will inform the development of improved scorecards that provide more accurate insights about the wellbeing of older adult populations in areas like Los Angeles County.
“We hope the study will make scorecards more powerful tools for public health planning and interventions, and we hope it will inform the design of future studies of health and place,” Lloyd said.
Supported by a subaward from the National Institute on Aging through the USC/UCLA Center on Biodemography and Population Health, the study aims to move beyond practical concerns and instinctual biases that can influence the selection of variables for scorecards.
“This is a step toward making a more rational, evidence-based choice of what indicators to use to compare places and health capacity,” Lloyd said. “Instead of choosing measures intuitively or because they’ve been used before, we’re evaluating the usefulness of these various measures for indicating community health by comparing them directly with the health of people living in those communities.”
Sometimes conclusions are drawn by assuming that there is a direct link between factors such as the types of food establishments in a community and particular health consequences like cardiovascular disease, when the explanation for this statistical association is frequently more complex.
The study will bring together community-level data from sources such as the U.S. Census Bureau and health data about individuals from sources like the California Health Interview Survey to determine how well certain indicators represent the health of aging adults.
The USC Roybal Institute is uniquely positioned to engage in this work because its mission is to advance research whose goal is to enhance optimal aging for persons in minority and low-income communities.
“It is critical to see the implications of our research for practice,” said William Vega, provost professor, executive director of the USC Roybal Institute, and a coinvestigator on the study. “We hope the results of our work can be shared with direct service providers and will inform how they evaluate population health and the needs of those who they serve.”
Study leaders also hope to contribute to research as well as practice.
“Some people in academic research settings aren’t interested in doing applied research,” Lloyd said. “At the same time, many people out in the field such as health systems planners and policy makers don’t necessarily have the depth of research experience to make appropriate judgments about what will be best indicators to use for their populations of interest.”
Study data will be drawn from Los Angeles County, a densely populated part of the country that is well suited for the implementation of place-based interventions such as the opening of a community health center.
“The project responds to the growing recognition — particularly in the context of a rapidly changing American health care landscape — that a valid and consistently measured system of population health indicators is necessary to maximize public health investments,” Lloyd said. “It is designed to be locally relevant and responsive to the local stakeholder priorities and to capitalize on their intimate knowledge of the real world of health care of the aged.”