Health Outcome Reviews: Background & Methods

James Bowers, MPH

NYS Department of Health Bureau of Environmental & Occupational Epidemiology

Objective of the Review

Answer the question Are the health outcomes observed among residents of the study area different than residents of areas not near Newtown Creek?

How Is That Question Answered?

Compare the number of people diagnosed with a health condition while living in the study area with the number we expect.

Steps of a Health Statistics Review

1. Select time frame & outcomes to study 2. Select the study area 3. Determine number of Observed health outcomes 4. Determine number of Expected health outcomes 5. Compare the Observed and Expected

Health Outcomes & Timeframes

Birth Outcomes

1990 - most recent 1990 - most recent 1990 - most recent

Data from birth certificates

Birth Defects

Data from NYS Congenital Malformations registry

Cancer

Data from NYS Cancer Registry

Not actual cases

Not actual cases

Limitations
No way of knowing if persons who develop disease were exposed Limited availability of information on individual risk factors Cannot account for geographic mobility Cannot link health outcomes with specific causes

Study Area Possibilities

Census blocks within mile of Newtown Creek
Also includes several blocks from SVI investigation Current study design 2010 population approximately 16,000

Census blocks within mile of Newtown Creek

2010 population approximately 66,000

Too Big? Too Small?

How can including residents of unexposed areas impact the results?

Study 20 years of data about a cancer with an incidence rate of 20/100,000 people Study a population where exposures are associated with a 50% increase in that cancer

Population 16,000 66,000

Observed 96 296

Expected 64 264

SIR (95% CI) 1.50 (1.22-1.83) 1.12 (1.00-1.26)

Questions? Comments?