The 500 Cities Project: What’s on the Horizon

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What is 500 Cities?

You may know that the secret to a healthier city is sharing data, but you have also probably discovered that finding and collecting data can be very challenging, particularly at the community level. The Centers for Disease Control and Prevention, in partnership with the Robert Wood Johnson Foundation and the CDC Foundation, recently released a wealth of data from the Behavioral Risk Factor Surveillance System. Using a multilevel regression and poststratification (MRP) approach that links geocoded health surveys and high spatial resolution population demographic and socioeconomic data, the 500 Cities project models small area estimates of chronic disease risk factors, health outcomes, and clinical preventive service use at the census-tract level for the 500 most populous cities in the US – covering one-third of the nation’s population.

The data available in the 500 Cities Project can be used to:

  • Identify health issues in a city or neighborhood
  • Establish key health objectives
  • Guide the development and implementation of effective and targeted prevention activities
  • Start community conversations about health priorities
  • Understand how where we live matters to our health
  • Help communities assess what they are doing well and where they can improve

As part of the Chronic Disease and Open Data initiative, 500 Cities helps the CDC make their data more available to the public. The project offers map books for available cities containing census tract-level data for all 28 BRFSS measures for one city. Starting March 2, 2017 an interactive web application provides instant use of this first-of-its kind data to access small-area estimates for the risk behaviors that cause much illness, suffering, and early death, as well as reveal the conditions and diseases that are the most common, costly, and preventable. The data are available to download as well as visualize using tools provided on the website.

Key observations from the kickoff meeting

Data Across Sectors for Health (DASH) National Program Office (NPO) staff and some public health grantees attended the project kickoff in December, with DASH Baltimore project BFRIEND’s Josh Sharfstein providing an excellent get-started presentation on data-driven collaborations for community health. While planners and health officials are happy to have access to this level of BRFSS data, some challenges remain, particularly in communicating with stakeholders with different levels of data literacy. For example, currently 500 Cities is a two-year project, using BRFSS data from 2014 and 2015, and the 2010 census, which does not account for population changes. Robust interaction with the data portal may help make the case to extend the project and allow for updates.

Communities that have defined their own areas or approaches which differ from the 500 Cities dataset may need to explain perceived discrepancies. The current modeling procedure does not support using the estimates to track changes at the local level over time. Model-based local estimates should not be used to evaluate the impact of local public health programs, policies, or interventions. The CDC suggests using the model-based estimates as a baseline for communities to conduct their own surveys evaluating the impact of their interventions.

500 Cities data complements existing data sources by providing information on unhealthy behaviors, health outcomes and prevention practices in small geographic areas. For example, public health officials can use the following data sets to paint a more complete picture of the health of their regions:

  • The annual County Health Rankings measures county-level health factors (obesity, smoking, food access, income, housing, etc.) for all counties in the U.S. The site also includes a Roadmaps to Health Action Center section that provide guidance and tools to help communities take action. Communities that want more information to help select and implement evidence-informed policies, programs, and system changes that will improve the variety of factors we know affect health can visit the County Health Rankings What Works for Health website.
  • In Milwaukee, Wisconsin, community-based organizations (such as the National Neighborhood Indicators Partnership) are using the newly available data to better understand community conditions and plan more effective urban development strategies. This is the very first time they have access to health indicator data at the neighborhood level.
  • America’s Health Rankings, a project of the American Public Health Association, the United Health Foundation and Partnership for Prevention, is a source for trends in nationwide public health and state-by-state rankings using 34 measures of behaviors, community and environment, policies, and clinical care data.
  • VCU Life Expectancy Maps illustrate how opportunities to lead a long and healthy life vary dramatically using ZIP code or census tract data. In some cases, life expectancy can differ by as much as 20 years in neighborhoods only about five miles apart.

Other initiatives at the meeting with exciting implications for community-based collaborations included:

Questions about the 500 Cities Project can be directed to 500Cities@cdc.gov.