Attachment2_CHIS_Making_an_Impact

Attachment 2
CHIS Making an Impact

California Health Interview Survey
CHIS Making an Impact
California Health Interview Survey is an invaluable resource for
building healthier communities

C

alifornia Health Interview Survey (CHIS) data and results are invaluable tools for health
policy makers at the local, state and national levels. Health advocates, media, health care
providers, foundations and researchers also depend on this rich source of population-based
data for critical health information.
Beginning in 2001, CHIS has been conducted every two years by the UCLA Center for Health
Policy Research in collaboration with the California Department of Public Health, the Department
of Health Care Services and the Public Health Institute. Data from the 2001, 2003, and 2005 surveys
have already been put to work enhancing the health and access to care for children and adults
throughout California and the nation.

Supporting New Efforts to
Cover the Uninsured
California state government officials, as well
as local agencies and advocacy groups, rely on
CHIS data to support their efforts to expand
health coverage to the uninsured – especially
uninsured children.
First 5 County Commissions

Making
California’s
Voices Heard
on Health

More than a dozen county First 5 commissions – created by California voters to direct
tobacco tax revenues to promote early childhood
development – have used CHIS data to develop
new public-private expansion programs for children ineligible for private insurance, Medi-Cal,
or Healthy Families. In most cases, CHIS has
been the only data source available.
First 5 agencies from Fresno, Kern, Los
Angeles, Riverside, San Joaquin, Marin,
San Luis Obispo and Tulare counties have
relied on CHIS data to advocate for and plan
these expansion projects, as has a coalition
of commissions from Sacramento, Colusa, El
Dorado, Yolo and Yuba counties.
State and Local Expansion Efforts

California Health
Interview Survey
UCLA Center for Health
Policy Research
10960 Wilshire Blvd.
Suite 1550
Los Angeles,
California 90024
Tel (310) 794-0925
Toll Free (866) 275-2447
Fax (310) 794-2686

www.chis.ucla.edu

• The Los Angeles County Children’s Health
Initiative – a broad coalition of public and
private entities ensuring access to coverage
to all children through age 18 – built its
groundbreaking expansion using CHIS
estimates of the number of uninsured
children who are eligible for Medi-Cal and
Healthy Families, as well as those who are
not eligible for these programs.

• The Santa Cruz County Health Services
Agency used CHIS data to develop a health
insurance plan for all children up to age 18.
• The Santa Cruz County Health Department
also relied on CHIS data in its successful
application for a federal Community Access
Program grant that provided three years
of funding for expanded clinic services,
outreach to enroll eligible uninsured
residents in public health insurance
programs, and creation of a Health
Improvement Partnership Council.

Obtaining Funding to Improve
Access to Care
CHIS data are used by local agencies and
community clinics to support their efforts to
obtain funding to serve low-income families
and individuals.
• The Community Clinic Association of
Los Angeles County uses CHIS data in its
advocacy and planning activities and in
its proposals to government agencies and
foundations in support of its 41 member
community clinics and health centers.
• The San Francisco Community Clinic
Consortium and San Francisco Department
of Public Health used CHIS data to develop
its two-year federal Community Access
Program, a project to improve access to
and quality of care for San Francisco’s
indigent and uninsured. The CHIS data
helped identify the special problems and
needs of the target population, and direct
Continued

interventions.

CHIS and the Fight Against Hunger

• The Contra Costa County Office
of Education’s Children’s Report
Card used CHIS 2001 data to
compare health insurance coverage
of children in Contra Costa County
to children statewide.

A series of publications by the UCLA Center for Health Policy
Research, which used CHIS data to analyze the extent of food insecurity
in California, prompted the Legislature in 2003 to pass Assembly Bill 231,
making it easier for low-income families to access food stamps.
Moreover, the California Food Policy Advocates (CPFA), which funded
the series, used subsequent publications to generate substantial media
interest in the subject of hunger, and used local CHIS data to identify
increased rates of food insecurity among low-income Californians in 23 of
the states smallest counties. Advocates were then able to work with rural
food banks and community-based organizations to identify effective ways
to reach people who need food assistance.

Building Healthier
Communities
Local governments and organizations continue to discover new ways
to integrate CHIS data into their individual health-related projects in their
communities.
• First 5 San Diego used CHIS
health insurance and oral health
data in developing new, local
requests for proposals. First 5
San Diego used CHIS data in its
planning to allocate $6 million for
efforts to enroll uninsured eligible
children in existing programs.
• Health policy researchers at the
University of California, Berkeley,
used CHIS data in the first study to
compare measures of mental health
and general well-being among
California’s county populations.
The results are published in
Measuring Mental Health in
California’s Counties: What Can
We Learn?

Using Data to
Better Serve Ethnic
Communities

Indian-Alaskan Native populations to better understand how
cancer affects this population.
•

The Asian Pacific American
Legal Center used CHIS estimates to compile health data on
California and several counties
to produce demographic profiles
of the Asian and Pacific Islander
populations.

•

United American Indian
Involvement used CHIS data in
a successful competitive grant
application to the Indian Health
Service for a Diabetes Primary
Prevention Demonstration
project in Los Angeles County.
The project implements diet
and exercise community-based
diabetes intervention programs
for American Indians.

•

Because of its size, sample design,
and ability to reach households in
several languages, CHIS is of great
value to those seeking to identify the
health needs of ethnic communities in
California and beyond.
•

The National Cancer Institute
(NCI) uses CHIS data to better
understand how cancer impacts
Chinese, Filipino, Korean, Vietnamese and other Asian ethnic
populations, which are growing
throughout the United States.
NCI is also taking advantage of
CHIS’ large sample of American

•

The Office of Multicultural
Health at the California Department of Public Health used CHIS
data for legislative analyses of
Assembly Bill 1963 (to encourage the use of promotores de
salud and community health
workers to provide better health
outcomes for rural and underserved communities) and Assembly Bill 9 to address disparities
in the delivery of health services
to multicultural populations in
specific areas of Los Angeles
County), among other legislation.
The National Latino Research
Center at Cal State San Marcos

used data from CHIS in its publication, Health Disparities in San
Diego County: Immigration and
Citizenship.
•

CHIS data was used in the Asian
and Pacific Islander American
Case Study: The Diabetic
Vietnamese Population of San
Diego County.

In the Battle Against
Asthma, Diabetes, and
Other Chronic Diseases
CHIS is widely used both to track
chronic diseases and to stimulate and
guide prevention action and policies.
• The Community Action to Fight
Asthma (CAFA) relies on CHIS
data and estimates to support the
work of a dozen grantees of The
California Endowment in addressing the multiple environmental
triggers of asthma symptoms
among school-aged children.
• The Orange County Health Needs
Assessment uses CHIS estimates
of Californians diagnosed
with diabetes, heart disease,
hypertension, or arthritis, among
other CHIS measures.
• Monterey County produced an annual County Health Profile using
CHIS data and successfully used
CHIS and the Center for Disease
Control’s Behavioral Risk Factor Surveillance System survey
to receive $8 million from a CDC
Continued

STEPS grant to coordinate programs addressing asthma, diabetes
and obesity.
• The California Department of
Public Health produces County
Health Facts, a series of reports
using CHIS data to describe the
prevalence of key health indicators
in California’s counties. The Department has published county data
reports relying on CHIS data on
the prevalence of diabetes, obesity
and health weight, arthritis, binge
drinking, and heart disease.
• Statewide, CHIS data are being
recommended for use in California’s environmental health tracking
system, being developed by the
California Department of Public
Health with funding from CDC’s
National Center for Environmental
Health.
• The California Health Benefits
Review Program uses CHIS data
in its analyses of legislative bills,
including bills that would mandate
childhood asthma management
programs.
• Researchers from the Integrative Medicine and Public Health
Program at the University of California, San Francisco, used CHIS
data for a report on The State of
the Great Central Valley – Public
Health and Access to Care. Data
were used for information on asthma prevalence, uninsured children,
older adult immunization rates,
and the prevalence of binge drinking among adults in California.
• The Central California Children’s
Institute used CHIS data to develop reports on the prevalence
of childhood asthma, childhood
obesity, and physical inactivity in
the Central California Region and
a report entitled, Children Count
2002-2003 Report Card on the
Well-Being of Children in Fresno
County. Another report, Children
in Jeopardy: A Sourcebook for
Community Action, used CHIS

data for its child health insurance,
access, asthma, and dental health
indicators.
• Community advocates in Solano
County successfully argued against
developing another truck stop
along I-80 in the county, based on
published CHIS 2001 estimates
showing that the county had the
state’s highest rate of asthma
symptom prevalence overall
and one of the highest rates for
children.

• The Santa Barbara County
KIDS Network and First 5 Santa
Barbara used CHIS data in their
collaborative Santa Barbara
County Children’s Scorecard 2003
to compare the overweight and
obesity of adults in Santa Barbara
County and California overall.
• The 2003 Kern County Assessment
used CHIS data on diabetes
prevalence to compare Kern
County with other counties in the
San Joaquin Valley.

• CHIS data helped the Fresno Metro Ministry secure funding from
the USDA for its Food Security
Project.

Supporting Vital
Research on Health
Needs and Disparities

• Health in the Heartland: The
Crisis Continues, a report on
health status and access to care
in the San Joaquin Valley was
produced by the Central Valley
Health Policy Institute, California
State University, Fresno. The
report relied on CHIS data to
estimate adults diagnosed with
diabetes, insurance status, and
– using CHIS and other sources –
health status in San Joaquin Valley
Counties.

Researchers in the California Department of Public Health, other State
agencies, the National Cancer Institute, the Centers for Disease Control
and Prevention, the federal Agency
for Healthcare Research and Quality
(AHRQ), and universities and other
research organizations have been using CHIS data for studies on many
important health issues.
More than 160 studies using
CHIS 2001 and CHIS 2003 data
have been identified. Taken together
they demonstrate the survey’s wide
applicability. Here are just a few of
the topic areas for which researchers
have used CHIS data:

• Using CHIS data, the Fresno
County public health officer identified obesity, diabetes and asthma
as the most important public health
issues in that county and obtained
additional resources to address
these issues.
• The Fresno Metro Ministry Hunger
& Nutrition Project used CHIS
data in its advocacy to Fresno
community leaders, state agencies,
and the American Heart Association Minority Summit on Health
Disparities.
• The Santa Barbara County Public Health Depart­ment, which
sponsored a CHIS 2001 county
oversample, relied on CHIS data
on obesity and many other health
indicators in its report on The
Health and Well-Being of the People of Santa Barbara County.

Continued

CHIS and AHRQ
CHIS was selected by the
federal Agency for Healthcare
Research and Quality (AHRQ) as
the only subnational population
survey to be included in its first
National Healthcare Disparities
Report. AHRQ selected CHIS
because it provides adequate
samples of Asian and Latino
ethnic groups that are unavailable
in national surveys, and
cutting-edge measures related
to ethnicity, immigration and
culture.

Health Needs of Racial/Ethnic
Groups
• Racial/ethnic disparities in access
to preventive dental services in
California
• Health disparities among Asian
and Pacific Islander children and
adolescents in California
• Racial/ethnic disparities in cancer
screening in California
• Relationship between socioeconomic position and health among
Asian American ethnic groups
• Language, cultural and systemic
barriers to mental health care
among racial and ethnic groups
• Ethnic enclaves and cardiovascular
risk factors in Asian Americans
• Smoking prevalence among Asian
Americans in California
• Obesity, diet, and physical activity
in Asian Americans
Children’s Health and Health Care
Needs
• Health of young children in
California
• Access to specialty care for

California’s children with special
health care needs
• Healthcare access for children of
the working poor
• Sexually transmitted disease related behavior among California
adolescents
Health Insurance Coverage and
Access to Care
• Long-term and intermittent lack
of health insurance coverage in
California
• Health insurance status of immigrant farm workers and their families
• Impact of private and public health
insurance on medication use for
adults with chronic diseases
Diabetes, Asthma, Cancer and
Other Chronic Health Needs and
Their Prevention
• Uncontrolled asthma and exposure
to air pollution
• Cancer screening in California
• Prostate cancer screening in
California
• Estimates of fruit and vegetable
consumption in California

CHIS is a key resource
for data about ethnic
subgroups

• Social capital and cardiovascular
disease in California

Because CHIS offers large
samples for ethnic subgroups,
researchers rely on CHIS data
to study disparities in health and
health behaviors. For example,
a recent journal article by Namratha Kandula, M.D., Northwestern University, and Diane
Lauderdale, Ph.D., University of
Chicago, used CHIS to describe
how recent Asian immigrants
have low physical activity levels,
which increases their risk for
heart disease. The researchers are
now using CHIS to study cancer
risk factors among Asian Americans.

• Disparities in health insurance
coverage among lesbian, gay, and
bisexual Californians

Sexual Orientation

• Effect of sexual orientation on
women’s access to healthcare,
preventive care, and health risk
behaviors
To learn more about these and other
studies using CHIS data, please visit
the CHIS Research Clearinghouse at
www.chis.ucla.edu/rc.

Unparalleled Access
Results and data files from CHIS
are available in a variety of ways
to anyone with an interest in public
health issues:

Getting Out the Data
• More than 8,000 registered
users have placed more than
135,000 queries on AskCHIS
since 2002.
• Researchers have downloaded
more than 850 CHIS 2003 Public
Use Files since February, 2003.
• The CHIS Research Clearinghouse (www.chis.ucla.edu/rc) is
tracking more than 160 projects
using CHIS data. Visitors have
accessed this online resource
more than 14,000 times to learn
more about these projects.
• Reports, policy briefs and fact
sheets in print and online free at
www.healthpolicy.ucla.edu.
• AskCHIS , an easy-to-use free
online data query system available
at www.chis.ucla.edu, enables
users to obtain survey results on
health topics, population groups
and geographic areas.
• Public-use data files and accompanying documentation can be
downloaded free from www.chis.
ucla.edu and are also available on
CD-ROM.
• Technical assistance through regional workshops and consultation
is available to agencies, community organizations and researchers
using CHIS data.
• UCLA Center for Health Policy
Research’s Data Access Center
(DAC) enables researchers to
work with confidential files in a
secure environment. The DAC also
offers programming and statistical
consulting services.

Learn More
For information about the
California Health Interview Survey,
please visit www.chis.ucla.edu.
Specific questions can be emailed to
[email protected].
10/08/07