Healthy
Vermonters & Healthy People
Methods
Vermont
Data Sources
Analysis Geography
Suggested Citation
The data contained in these maps, tables, and graphs represent the most complete and recent information available to the Vermont Department of Health about health status indicators of the Vermont population. However, as with any data, there are some limitations to keep in mind when interpreting the results.
Variety: Healthy Vermonters 2020 uses over 40 sources of data and each has its strengths and limitations. Some data are from national surveys or mandated surveillance while others are from internal tracking systems or program reporting. Data used for Healthy Vermonters 2020 may not apply in other states.
Data Quality: Several precautions were taken to ensure the reliability and validity of the data for each objective. Survey questionnaires were carefully designed and thoroughly tested by the Centers for Disease Control and Prevention. Survey results are statistically adjusted or “weighted” so that the sample accurately represents Vermonters. Non-survey data rely on completeness and methodology checks as well. Finally, all analyses were performed in duplicate. These precautions can reduce some sources of error, but not all.
Comparisons: It is natural to want to compare Vermont to the U.S. as a whole as well as to other states. Unless data sources and methodology are equivalent, we do not recommend this. Within Vermont we have used consistent data sources and methodology but we urge caution in making comparisons between counties, Health Department district offices areas (Districts), and hospital service areas (HSAs). Often there are many underlying differences in a region that are important context for understanding the story told by the data. Additionally, small differences may not be statistically different and may simply be a function of normal sampling error. Given this, we have chosen to display the statistical comparison, based on 95% confidence intervals, between the statewide statistic and the local region. Comparisons across regions are not displayed.
What, not Why: The health status indicators included in Healthy Vermonters 2020 reveal what behaviors Vermonters are doing. However, the indicators alone cannot answer why they are doing those behaviors.
Healthy Vermonters 2020 is considered the Vermont State Health Assessment and an important component of Vermont’s public health work. Healthy Vermonters is based on the U.S. Department of Health and Human Services Healthy People Initiative that “provides science-based, 10-year national objectives for improving the health of all Americans. For 3 decades, Healthy People has established benchmarks and monitored progress over time.”
The Healthy Vermonters Objectives align with these Healthy People 2020 Objectives
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Healthy Vermonters Objectives |
Healthy People 2020 Objectives |
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Nonfatal motor vehicle crash-related injury rate per 100,000 |
IVP-14 |
Reduce nonfatal motor vehicle crash-related injuries |
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Fall-related death rate per 100,000 adults age 65 and older† |
IVP-23.2 |
Reduce unintentional suffocation deaths among adults aged 65 years and older |
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ED visits for self-harm rate per 100,000† |
IVP-41 |
Reduce nonfatal intentional self-harm injuries |
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†Age-adjusted according to methodology used in Healthy People 2020 |
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More information on the methodology used in Healthy People 2020 is available from the Health Indicators Warehouse. For example, whether or not an indicator was age-adjusted to the U.S. standard population is noted in the Data tab of the Warehouse web pages. As a general rule, Vermont statistics align with this methodology.
Prevalence and percentages were calculated by using descriptive statistical procedures using software such as SPSS, SAS, and/or SUDAAN. These statistics describe the proportion of individuals with a given trait in the population during a specified period of time.
Mortality rates were calculated based on the ICD-10 code for the underlying cause of death listed on death records received by Vital Records. Only Vermont residents were included in these calculations. Rates were calculated by comparing the number of deaths in a given time period to the overall population of Vermont in the same time period.
Discharge rates were calculated using the Vermont Uniform Hospital Discharge data set. We looked at all hospital and ED discharge among Vermont residents who utilized services at regional hospitals (including hospitals in bordering states). We compared the number of discharges in a given time period to the Vermont population in the same time period to calculate discharge rates.
In U.S. data, age adjustment is used for comparison of regions with varying age breakdowns. In order to remain consistent with the methods of comparison at a national level, some statistics in Vermont were age adjusted. In cases where age adjustment was noted as being part of the statistical analysis, the estimates were adjusted based on the proportional age breakdowns of the U.S. population in 2000. For more detailed information on age adjustment visit http://www.cdc.gov/nchs/data/statnt/statnt20.pdf.
Confidence Intervals were used for statistical comparisons between the state and the various sub-geographies statistics. A confidence interval represents the range in which a parameter estimate would fall which is calculated based on the observed data. For this analysis, we used a 95% confidence interval, meaning that we are 95% confident that the true value of the parameter being examined falls within the specified confidence interval. Statistical significance is assessed by comparing the confidence intervals of different groups. If the confidence intervals from two groups, such as that for the state and a specific county, do not overlap we consider the estimates to be significantly different from one another.
Vermont Uniform Hospital Discharge Data Set--VUHDDS
Vermont has been collecting and reporting hospital discharge data since the early 1980’s. All fourteen of Vermont's general acute care hospitals currently contribute records for Vermont residents and non-residents to the Vermont Uniform Hospital Discharge Data Set (VUHDDS). Under the statutory authority to collect these data (18 V.S.A. §§§ 9410, 9456 and 9457), the Vermont Green Mountain Care Board (GMCB) administers the program and the Vermont Department of Health (VDH) manages the data set under an agreement with GMCB. Under interstate agreements with agencies outside of Vermont, GMCB also receives hospital discharge data for Vermont residents using hospitals in bordering states, including New Hampshire, Massachusetts, and New York. The final dataset comprises the Vermont Uniform Hospital Discharge Data Set (VUHDDS) that is used by VDH in the analyses for the Vermont Hospital Utilization Reports.
The Veterans Administration Hospital in White River Junction voluntarily contributed hospital discharge records through June 30, 2006 but has not contributed data to VUHDDS since that date. The Vermont psychiatric hospitals, including the Brattleboro Retreat and the Vermont State Hospital, do not submit data to VUHDDS.
A Hospital Discharge is defined by a hospital visit that results in at least one overnight stay. An Emergency Department Visit is defined as a visit to the emergency department that does not result in an overnight hospital stay. ED visits that do result in an overnight stay are captured in the Hospital Discharge data.
For more information about the Uniform Hospital Discharge Data, please contact:
Barbara Carroll
(802) 865-7704
Vital Statistics -- Vital Statistics
The Vermont vital statistics system monitors the following vital events: births, deaths, marriages and civil unions, divorces and dissolutions, fetal deaths, and abortions. Each type of vital record follows a different path before being used to produce the statistics published here.
Births: When a birth occurs, the physician, midwife, or other birth attendant is required to complete a birth certificate and file it with the town clerk in the town of birth within 10 days. For hospital births, it is usually the medical records staff that enters the birth information into the Electronic Birth Registration System (EBRS) and prints the birth certificate. The birth certificate is recorded and filed in the town where the birth took place, and a certified copy is sent to the Department of Health.
Deaths: Although a physician is responsible for completing the death certificate, the job may be, and often is, delegated to the funeral director. Most of the information needed to complete the death certificate is obtained from the family of the deceased; however, the physician must complete and certify the cause of death information. Once a death record is completed in the Electronic Death Registration System (EDRS), it is registered and the death certificate is available to the town clerks for filing.
For more information about fall-related deaths in Vital Statistics, please contact:
Cindy Hooley
802-651-1636
cynthia.hooley@vermont.gov
The Vermont Department of Health routinely uses three substate geographies: counties, Department of Health district office area, and hospital services areas. For most population health measures, there are too few respondents by town to allow appropriate statistical analysis. For this reason, data collected from residents of individual towns are aggregated to county, district, and hospital service areas.
Citing a specific data point:
Model: Vermont Department of Health. INDICATOR WORDING (GEOGRAPHY, DATA SOURCE, YEAR(S) OF DATA) in Healthy Vermonters 2020: “TOPIC” Maps & Trends Vermont Health Indicators. Accessed DATE (E.G. TODAY). WEBLINK
Example: Vermont Department of Health. Fall-related death rate per 100,000 adults age 65 and older (Bennington County, Vital Statistics, 2009) in Healthy Vermonters 2020: “Injury & Violence Prevention” Maps & Trends Vermont Health Indicators. Accessed 7/1/15. https://apps.health.vermont.gov/gis/ias/querytool/?topic=HealthyVermonters2020&theme1=InjuryAndViolencePrevention
Citing the webpage more generally:
Model: Vermont Department of Health. Healthy Vermonters 2020: “TOPIC” Maps & Trends Vermont Health Indicators, by GEOGRAPHY. Accessed DATE (E.G.TODAY). WEBLINK
Example: Vermont Department of Health. Healthy Vermonters 2020: “Injury & Violence Prevention” Maps & Trends Vermont Health Indicators, by County. Accessed 7/1/15. https://apps.health.vermont.gov/gis/ias/querytool/?topic=HealthyVermonters2020&theme1=InjuryAndViolencePrevention
Parenthetical citation within text:
Model: (Vermont Department of Health, DATA SOURCE, YEAR(S) OF DATA).
Example: (Vermont Department of Health, Vital Statistics, 2009).