1. New York State Health Data
Code-a-Thon
Obesity and Type 2 Diabetes
Prevention
December 13, 2013

2. Webinar Housekeeping
1

3. The Obesity and Type 2 Diabetes Epidemics
in NYS
NYS Department of Health
• Maureen Spence
• Susan Millstein
2

4. 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
3

5. Where Are You?
4

6. Obesity
5

7. Obesity in NYS Adults
• 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%).
6
6

8. Obesity in NYS Adults
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%).
7
7

9. Obesity in Adolescents and
Children
• 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.
8
8

10. Obesity Prevalence Trends among WIC Children 2-4
Years by Race/Ethnicity
New York State, 1990-2010
25
1990-2003 (↑2.7 )
2003-2010 (↓3.6)
Percent (%)
20
1989-2003 (↑3.9)
15
2003-2010 (↓2.8)
10
2003-2010 (↓0.6)
1989-2003 (↑3.4)
5
0
1990
1992
1994
Source: 2010 Pediatric Nutrition Surveillance Report, table 18c
1996
1998
Black
2000
Hispanic
2002
2004
2006
2008
2010
White
9

11. 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
10

12. Diabetes
11

13. 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)
12

14. 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
13

15. Portion Distortion Through the Years
14

16. Sedentary Lifestyles
15

17. 16

18. AUDIENCE
POLL
17

19. 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
18

20. 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.
19

21. 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.
20

22. >1.5 million with diagnosed
Diabetes
Approximately 750,000 have
diabetes but don’t know it
4.5 million
with Prediabetes
21

23. 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.
22

24. 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
23

25. 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
24

26. 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.
25

27. 26
26

28. How is the NYS Department of Health
Addressing the Twin Epidemics?
27

29. Environmental Approaches
Environmental approaches promote health
and support and reinforce healthful behaviors
in schools and childcare, worksites, and
communities.
28

30. 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.
29

31. Community-Clinical Linkages
Ensuring that communities support and healthcare
providers refer patients to programs that improve the
prevention and management of chronic conditions.
30

32. Prevention Agenda 2013-2017: New
York State's Health Improvement Plan
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.
31

33. Setting the Context for Innovation:
Review of Key Data Assets

34. 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
33

35. Innovation
34

36. Defining Innovation
Innovate (verb):
To introduce
something new or
different;
To renew what exist
already;
35

37. 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;
36

38. Variation… over time,
place
and person
37

39. 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?
38

40. Your Mission… Should You Choose
to Accept It
Utilize 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
39

41. 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
40

42. 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
41

43. 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
42

44. 43

45. 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
44

46. Indicator List
45

47. 46

48. 47

49. 48

50. 49

51. 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/20132017/ ). 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.
50

52. www.health.ny.gov/statistics/chac/indicators/
51

53. 52

54. 53

55. Student Weight Status Category
Reporting System

56. 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
55

57. 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
56

58. Area identifier
Estimates (counts, percentages)
Filter by grade level or area type
57

59. Statewide…
Region….
County….
58

60. 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
59

61. Reports & analyses
Community needs index
Prevention agenda
tracking
Local-level charts/graphs
60

62. Student Weight: Geographic Representation
61

63. 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
62

64. 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
63

65. 64

66. Diabetes Type 2 Prevention Tips

67. 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.
66

68. 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
67

69. 68

70. 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.
69

71. 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.
70

72. 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
71

73. Examples
Tip: 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.
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
Link to data on
locations of CDTA
bus stops
72

74. 73

75. Special Supplemental Nutrition
Program for Women, Infants, and
Children (WIC)

76. About WIC
 Mission - To safeguard the health of lowincome 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.
75

77. 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
76

78. Reach of WIC
500,000
Approximate
#
participants
served
monthly
94
Contracting
Agencies
210
Permanent
Sites
259
Temporary
Sites
5
VMAs
77

79. 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

78

80. 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
79

81. WIC Program Eligibility
80

82. WIC Income Guidelines
81

83. WIC Program Site Information
82

84. WIC Program Site Map
83

85. WIC Sites Filtered
84

86. 85

87. Office of Parks, Recreation
and Historic Preservation
New York State 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.
86

88. Office of Parks, Recreation
and Historic Preservation
11 State Park Regions, 179 State Parks, 35 Historic Sites, 60 million visitors
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 parks
2 historic sites
Palisades: 21 parks
6 historic sites
Taconic: 13 parks,
6 historic sites
Thousand Islands: 26 parks,
1 historic sites
Saratoga-Capital District:
12 parks, 8 historic sites
87

89. Office of Parks, Recreation
and Historic Preservation
New York State’s Expansive System of Parks, Historic Sites,
Recreational Facilities and Infrastructure Tops the Nation
1st in Operating Facilities; 2nd in Visitation; 5th in Acreage
 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
88

90. Office of Parks, Recreation
and Historic Preservation
New York State Parks: Connecting with our Communities, Providing Safe
and Enjoyable Outdoor Recreation
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 Sites
Roberto Clemente State Park
89

91. Office of Parks, Recreation
and Historic Preservation
New York State Parks: Connecting with our Communities, Providing Safe
and Enjoyable Outdoor Recreation
90

92. Office of Parks, Recreation
and Historic Preservation
New York State Parks: Connecting with our Communities, Providing Safe
and Enjoyable Outdoor Recreation
91

93. 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.
92

94. 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
93

95. Office of Parks, Recreation
and Historic Preservation
94

96. Office of Parks, Recreation
and Historic Preservation
95

97. Office of Parks, Recreation
and Historic Preservation
96

98. Office of Parks, Recreation
and Historic Preservation
97

99. 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
98

100. Office of Parks, Recreation
and Historic Preservation
99

101. Using APIs with
HealthDataNY
and
OpenNY
100

102. 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
101

103. Socrata’s Open Data APIs
* From Socrata.com/open-data-portal
102

104. Socrata’s Open Data APIs
* From Socrata.com/open-data-portal
103

105. Socrata’s Developer Resources
* From dev.socrata.com
104

106. Socrata Open Data API
* From dev.socrata.com
105

107. Socrata Open Data API
* From dev.socrata.com
106

108. Featured NYS APIs
107

109. HealthDataNY Featured APIs
108

110. HealthDataNY Featured APIs
109

111. HealthDataNY Featured APIs
110

112. HealthDataNY Featured APIs
111

113. Example Code
First, get dataset identifier
112

114. Example Code
Then use identifier in request URL
Use .csv to return CSV file
113

115. Example Code
114

116. 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