Duke University Medical Center Library Online

Sources of Statistics	Major Compilers	Getting Started
Using Indexes, Databases, WWW Print vs Internet Sources	Publications National International State/Local	Class Handout National International State/Local

Sources of Statistics

National registration systems gather data from birth, death, marriage, and divorce certificates
Ongoing surveys of ambulatory (outpatient) and institutionalized (inpatient) populations
Surveys of health facilities (hospitals, nursing facilities, etc.)
Organizations and institutions (both public and private)

While there is no single agency charged with collecting health data, many of them compile statistics relevant to their mission. Many agencies and institutions are required to collect and report certain statistics to the government. Therefore, this mandate enables some statistics to be easily accessible while others remain hard to find or are non-existent. Some statistics are buried within larger documents produced by private institutions and organizations, such as the Robert Wood Johnson Foundation or the Henry J. Kaiser Foundation. When searching for health statistics, keep in mind the types of data that should be registered with "some" agency (births, deaths, communicable diseases that put the public at risk, etc.) versus those that are not "mandated" (ie., number of persons with chronic disease in Durham County). Occasional surveys may be performed on a sample of the population in general and published only once by private and/or government agencies.

Major Compilers of Statistics

National

Dept. of Health and Human Services (HHS)
National Center for Health Statistics (NCHS)
Centers for Disease Control and Prevention (CDC)
Health Care Financing Administration (HCFA)
Bureau of the Census

International

World Health Organization (WHO)
Pan American Health Organization (PANHO)
United Nations (UN)

State-County

Various state departments such as human resources, state centers for health statistics, universities, hospitals, institutions, and other public and private organizations are all contributors to the abundance of health care data sets.

Getting Started

What is the subject/topic?
What are the specifics of the request?
Consider the sources to be checked
Consult those sources
Reformulate the request if information not found

Using Indexes, Databases, and the WWW

Indexes
Index to Health Information (IHI)
This index, published by Congressional Information Service (CIS) since 1988, covers all health-related statistical publications from federal and state agencies, associations, business organizations, international agencies, and commercial publishers. It contains all publication types and is indexed by subject, by countries or world regions, and by state. Letter codes indicate the type of issuing agency (e.g., "A" for association, "F" for the Federal government, etc.) This index does not contain clinical laboratory studies or highly technical medical literature. (Library has: 1988-2001) Index/Abstract Area
Statistics Sources: A Subject Guide To Data On Industrial, Business, Social, Educational, Financial, and Other Topics For The United States
International guide to current sources of statistical information on a variety of subjects, including health services, hospitals, medical care, drugs and medicines, and specific disease topics. Materials may be print, nonprint, published, or unpublished. It includes both U.S. and international publications. Perkins Library

MEDLINE and Other Databases
Many articles in MEDLINE (which also contains data from the former HealthSTAR and AIDSLINE databases), CINAHL, and CancerLit contain statistical data. While MEDLINE should not be your first choice when searching for health statistics, it does contain many articles that include such data. Helpful MeSH (subject headings) include: health surveys, mortality, morbidity, prevalence, incidence, vital statistics, and population. Valuable subheadings include: epidemiology (ep), statistics & numerical data (sn), mortality (mo), manpower (ma), utilization (ut), supply & distribution (sd), and trends (td). A few search tips to follow when searching MEDLINE and other NLM databases include:

Combine subject headings with subheadings: use epidemiology with disease headings; use statistics & numerical data with non-disease headings. EXAMPLE(S): Heart diseases/ep [epidemiology]; Office visits/sn [statistics & numerical data].
Combine subject headings for devices or procedures with the subheading(s) utilization or supply & distribution. EXAMPLE: Lithotripsy/ut [utilization].
When searching for the number of personnel in a specific field, combine the subject heading with the subheading manpower. EXAMPLE: Obstetrical nursing/ma [manpower].
When searching for statistics on heart diseases, perform a textword search on Framingham.

WWW

Google (WWW search engine)
MetaCrawler (WWW search service)
Yahoo (WWW index)
National Center for Health Statistics
Centers for Disease Control and Prevention
Dept. of Health and Human Services
Bureau of the Census
FedSTATS
World Health Organization
Pan American Health Organization

Print vs. Internet Sources

When should one use the Internet versus a print source to find health statistics? Although there is no definite answer to this question, Internet search engines such as AltaVista and MetaCrawler have yielded favorable results for difficult to find statistics, especially those that deal with health behaviors and some chronic diseases. Use agency home pages to access frequently asked questions (FAQs); these pages contain a significant amount of statistical data. For example, the Department of Agriculture collects statistics that deal with nutrition and diet. Many printed statistical data sources are now appearing in full text on the Internet: Health, United States; Statistical Abstract of the United States, etc. The Internet can be used to find the answers to these questions:

What percentage of the US population is overweight?
How much money was spent on medical research in 1995?
Which HMOs are top performers in North Carolina?
Approximately how many board certified pediatricians are in Orange County, NC?

To assist you in your search for statistical information, you may also choose from a condensed list of print and Internet resources.

Publications

Unless otherwise indicated, print items are located in the Reference Area of the Medical Center Library

National Level
Trends in US Health Care
These tables and charts review statistics on the nation’s health, health manpower, health care financing, medical practice, and hospitals. Also includes international comparisons. Ref. 29 W16 T72
Health, United States
The Secretary of HHS’s report on the nation’s health. Presents national trends in health statistics. Major findings are summarized in the Highlights section; each issue contains a chartbook with detailed tables focusing on a major health topic. Data derived from the CDC and NCHS on population, fertility, mortality, measures of health, facilities, exercise, nutrition, etc. Ref. 29 WA900.AA1 H34
Statistical Record of Health & Medicine (SRHAM)
A comprehensive compilation of national, state, and municipal health and medical statistics highlighting health in the U.S. This work covers health status and lifestyles of Americans, hospitals and nursing homes, occupational safety and health, insurance, health care costs and expenditures to consumers, businesses and government, Medicare and Medicaid, companies, products and market trends, and medical professions and occupations. Data compiled from government, academic, association, trade, technical, and media sources. Ref. 29 WA900.AA1 St29
Healthy People - Brief History
In 1979, Healthy People: The Surgeon General's Report on Health Promotion and Disease Prevention (WA108 H342 1979) provided national goals for reducing premature deaths and preserving independence for older adult.
In 1980, another report, Promoting Health/Preventing Disease: Objectives for the Nation, outlined 226 targeted health objectives for the nation to achieve over the next 10 years.
Healthy People 2000: National Health Promotion and Disease Prevention Objectives (WA108 H342 1991) identified health improvement goals and objectives to be reached by the year 2000.
The Healthy People 2010 initiative (in two volumes) continues in this tradition as an instrument to improve health for the first decade of the 21st century. It sets national objectives for the decade: increase the span of healthy life and eliminate health disparities for all Americans (Med. Ctr. Reserve Room WA108 H342 2000).
A Review, Healthy People 2000 Review, provides annual data, if available, in all priority areas identified in Healthy People 2000: National Health Promotion and Disease Prevention (published in 1991) and follows the progress throughout the decade (Ref.29 WA900.AA1 H34a). The Final Review (Adobe Reader required) was published October, 2001 and is the last report in the Healthy People 2000 series. (Ref.29 WA900.AA1 H34a)
Health Care State Rankings
States are ranked high to low on various measures, such as incidence of disease, births, deaths, etc. Ref. 29 WA900.AA1 H344
Statistical Abstract of the United States
Use this work especially when looking for statistics other than health statistics. Contains tables addressing the nation’s social organization, economy and politics, as well as health. It serves as a guide to other publications in that the citation for each table is given. Ref. 29 HA202 Un3s
Vital and Health Statistics
Individual reports published from surveys and studies conducted by the NCHS. Consists of irregularly issued subseries focusing on various health reports such as Mortality trends for Alzheimer's disease and Serum lipids of adults 20-74 years: United States. This "Rainbow" series contains the National Health Interview Survey, National Health Examination Survey (NHANES), Hospital Discharge Survey, and the National Ambulatory Medical Survey. Collectively these titles comprise what is known as the National Health Survey. Its weakness is that it contains no index. However, Walsh & Bothmer’s Vital and Health Statistics Series: an Annotated Checklist and Index to the Publications of the “Rainbow Series” lists, annotates and indexes all the reports issued up until 1991. (Ref. 29 WA900.AA1 V83 1991). Vital and Health Statistics is located in the Index/Abstract Area.
At the national level, the NCHS reports on the nation’s health status, while the CDC monitors and protects the nation's public health. With this in mind, the National Health Examination Survey (NHANES) in Series 11 of Vital and Health Statistics provides the most comprehensive data on chronic diseases, while the National Health Interview Survey in Series 10 offers the most data on injuries and disabilities.
Monthly Vital Statistics Report
Monthly and cummulative data on births, deaths, marriages, divorces, and infant death. Each issue covers one month and includes trends for multiple years based on samples from the population. Two to three current issues are available in full text from the NCHS Website. The data will later appear in Vital Statistics of the United States. Index/Abstract Area
Vital Statistics of the United States
Although outdated for more than five years, this publication represents the final accumulation of United States vital statistics published in three volumes: Natality, Mortality, and Marriage and Divorce statistics. Volume II is published in two parts (A & B) with detailed mortality data that includes tabulations for each state and county, specific urban places, etc. More current data can be found in the Monthly Vital Statistics Report. Index/Abstract Area
Advance Data From Vital and Health Statistics
Brief early release information gathered from surveys and reports of the NCHS, which will eventually appear as the full report in various issues of Vital and Health Statistics. Index/Abstract Area
Morbidity and Mortality Weekly Report (MMWR)
Contains data on notifiable diseases indexed by state or region. It has two main sections: MMWR Recommendations and Reports (reports pertaining to infectious diseases, testing, immunizations, etc.) and MMWR Surveillance Summaries (reports on a broad range of risk factors and health conditions). Index/Abstract Area
Statistical Bulletin
Reviews data on vital statistics, demographics, medical costs, diseases, accidents, etc. Journal stacks.
Health Care Financing Review
Covers economic data on expenditures, providers (HMOs & DRGs) and beneficiaries. Published by the Health Care Financing Administration, the organization responsible for monitoring the two major health care financing programs, Medicare and Medicaid. Journal stacks
Atlas of United States Mortality
The first publication in map format to show all leading causes of death, by race and sex for small geographic areas of the United States. Ref. 29 WA900.AA1 At65
The Dartmouth Atlas of Health Care
Also in map format, this atlas covers national, regional, and local statistical information on physician distribution, hospital capacity, common diagnostic and surgical procedures, and reimbursements. Ref. 29 W84.AA1 D25d

International Level

World Health Statistics Quarterly
A WHO publication covering data on health and vital statistics on a global scale. Its focus is on the interpretation of data on major health topics of current interest, such as the aging population or breast-feeding. Also included is a detailed analysis of the particular topic. Ceased publicaiton with the 1998 volume. Index/Abstract Area
World Health Statistics Annual
The WHO Statistical Information System is the guide to health and health-related epidemiological and statistical information available from the World Health Organization. Most WHO technical programmes make statistical information available, and they will be linked from here. You also have the possibility to search by keywords within the WHOSIS or throughout the entire WHO site.Index/Abstract Area
Weekly Epidemiological Record (Adobe Reader required)
Also published by WHO, this weekly offers surveillance data on communicable diseases throughout the world. Index/Abstract Area
Demographic Yearbook
A United Nations publication offering comprehensive demographic statistics on approximately 233 countries. Basic tables show summary population estimates, infant mortality, general mortality, marriage and divorce statistics. Each annual issue contains a special topic such as household and family characteristics or international migration statistics. Ref. 29 HA17 D39
Health in the Americas (Adobe Reader required)
This two-volume set of international statistics published by the Pan American Health Organization focuses on the epidemiologic situation from a regional perspective. Text is supplemented by tables and graphs. Volume II contains statistics on each country within a particular region and is searchable from the PAHO home page under Country Health Profiles. Ref. 29 WA900.DA1 P194
Health Statistics from the Americas
Mortality estimates and projections for a selected group of causes arranged by country, year, age and sex. Causes of death include cancer, communicable diseases, external causes, etc. In addition to current data, a historical perspective is presented. Data obtained from detailed statistical information acquired from databases maintained by PAHO and other sources. Ref. 29 WA900.DA1 H34
Emerging Infectious Diseases
Part of the CDC’s plan to combat emerging infectious diseases. This peer reviewed, full-text quarterly journal includes statistics covering human demographics and behavior, international travel, public health measures, specific diseases or syndromes, and epidemiologic reports with an international scope. Journal stacks
International Health Systems: a Chartbook Perspective
A graphic representation of comparative statistics on international health systems. Topics include demographics, health care spending, utilization and resources. Ref. 29 W84.1 R822i

State/Local Level
(NC) Two major state departments in North Carolina oversee the collection of health statistics: the Department of Environment and Natural Resources (DENR), Division of Environmental Health and the North Carolina Department of Health and Human Services (DHHS). DENR's focus is towards public health, while DHHS collects statistics on mental health, substance abuse and social services. The State Center for Health Statistics is responsible for collecting North Carolina statistics; click here to see what the Center produces. NC@Your Service and the State Data Center are also available.
An Inventory of North Carolina Health Data
This publication brings together health-related data currently being collected and published in North Carolina. Emphasis has been placed toward on-going data collection rather than one-time publications. Data sets are listed under subject categories such as health status, health service use, health resources, health care cost & expenditures, employment, occupational health, crime and public safety. Appendices list organizations that contribute or collect data, those having one or more sets, and an alphabetical list of data sets. Ref. 29 WA900.AN8 In8
North Carolina Chartbook on Population and Health
Graphs and charts that highlight certain aspects of the health status and population characteristics of North Carolinians. Topics include: population, pregnancy, fetal & infant mortality, morbidity, and health care resources. Ref. 29 WA900.AN8 N814
North Carolina Health Atlas
The North Carolina Health Atlas contains maps of North Carolina that depict county level health and health-related information. The primary purpose of the Atlas is to provide a way to interpret visually a broad range of data and information about the health of North Carolinians.
North Carolina Health Statistics Pocket Guide (Adobe Reader required)
Folded tables list and rank North Carolina, with other states and the nation, on basic indicators such as demographics, social & economic factors, morbidity & mortality statistics, and health care resources. Ref. 29

North Carolina Vital Statistics
A compilation of several subseries that focus on three sources of North Carolina statistics: Leading Causes of Death, Basic Automated Birth Yearbook, and Detailed Mortality Statistics Report. All are conveniently shelved under North Carolina in the Index/Abstract Area.
CHES Studies
Short reports on various North Carolina health-related topics. Search this series in the Duke Libraries' Online Catalog (Aleph).

Other NC Sites

Durham County Government
Information on population characteristics, employment, cost of living, and much more.
NC State & Local Government
A guide compiled by Alex Hess of the Institute of Government, UNC. Arranged by topic, this guide will lead you to information on NC cities and counties as well as various state directories. Topics include agriculture, crime and corrections, economics, education, elections, employment, government, health, land area, and much more.
North Carolina State Library
With links to resources such as NC Live, access to the State Catalog and FIND NC, the State Library also has many statistical documents.
The Sheps Center for Health Services Research
The Center produces and maintains data sets for the health professions data system, the NC rural health research program cartographic archives, and the RNDMU-Region IV Network for Data Management and Utilization.