ES 1. Assess and monitor population health

Core Function: Assessment

Why This Is Important

  • Helps health departments understand how opioids and other drugs are being used in the community, as well as the associated health outcomes
  • Helps health department measure the impact of opioid and other drug use and overdose on those subpopulations most vulnerable to behavioral health disparities and health inequities.

What’s Involved

  • Collect readily available state and local archival data. These data are often presented in epidemiological profiles—detailed reports that summarize the problems affecting a community or population. Hospitals, law enforcement agencies, first responders (e.g., fire departments, private ambulance companies), government agencies (e.g., city clerk death records), community organizations, and state agencies can also be important sources of archival data.
  • Review local health and behavioral health surveys, such as Youth Risk Behavior Surveillance System (YRBSS) surveys conducted by local schools and community assessments conducted routinely by many service organizations; these can be rich sources of information.
  • Partner with existing substance use prevention coalitions in the area, who routinely collect this information to inform their planning.

Key Considerations

  • Designing and implementing equitable and inclusive data collection and analysis processes will help to ensure that the data you collect tells a complete story. To inform this process, bring to the prevention table stakeholders who have been historically excluded and ensure that their voices are heard.
  • Center lived and living experience in the data collection and analysis process. Lived and living experience can include a variety identities and experiences, including one’s own past or current substance use, mental health challenges, and other relevant life experiences, or someone’s role as a close friend or family member related to such. Value the merits of qualitative data, including anecdotal data and personal stories.
  • When reviewing data, identify those subpopulations that are vulnerable to behavioral health disparities and health inequities and make sure you have collected data on opioid-related problems for these populations. If information on these populations is missing from existing data sources, take time to gain approval from community members to collect new data to fill the gaps.

Racial Equity Data Roadmap

In 2020, the Massachusetts Department of Public Health (DPH) released the Racial Equity Data Roadmap. The purpose of this tool is to improve the use of data across DPH-funded programs to inform racial equity work in order to achieve equitable health outcomes across the Commonwealth. It challenges prevention practitioners to “examine the role that data can have in perpetuating and failing to address health inequities . . .  [and] disrupt the status quo; face racial inequities head on; and inform data-to-action approaches that can be used to test new ideas that may finally lead to all people having the opportunity to reach their full potential for health and wellbeing.

Get Started!

  • Identify potential partners (e.g., hospitals, police, emergency medical services, medical examiners and coroners’ offices) who routinely collect data related to opioid use.
  • Find out who is in charge of maintaining these data (i.e., the data-keepers) and reach out. Put in place data-sharing agreements with local partners to facilitate access to local data sources. Be prepared to make a compelling case for why the data keeper should share their data. Acknowledge potential barriers to data-sharing and brainstorm possible solutions. Continue to engage these partners in helping you analyze and understand the data once it is compiled.
  • Use data mapping tools like the free MDPH Bureau of Substance Addiction Services (BSAS) Data Dashboard to track key substance use-related outcomes, including overdose, at the municipal level.
  • Review PMP data periodically to track emerging trends. Share with prescribers, pharmacies, and prevention practitioners any relevant data about new controlled substances (e.g., if rates of use are increasing).
  • Consider what data is missing from your review. Just because data isn’t available doesn’t mean the problem doesn’t exist! Consider partnering with an evaluator or someone with data savvy who can help you identify gaps.
  • Consider ways to sustain relationships with the agencies and organizations that provided data and continue to involve them in your opioid prevention services. Invite them to attend your events (and sponsor and attend theirs!), promote/publicize their work, and seek out funding opportunities that you can apply to as partners.

Assessment in Action: Using PMP Data to Inform Prevention Efforts

To inform its strategic plan for preventing prescription drug misuse (also known as SPF-Rx), the Massachusetts Department of Public Health’s Bureau of Substance Addiction Services (BSAS) is working closely with the Massachusetts PMP to analyze data on the number of individuals in the Commonwealth receiving prescription drugs and reported to the PMP from 2016 to 2021. The data will be disaggregated by zip code (or county, if zip code is not possible) and by gender, payment type, and age group. BSAS will also examine patterns in the number of prescription drugs disaggregated by days of supply, amount/patient, and solid quantity reported.

The proposed data analyses will help BSAS identify prescribing patterns of medications with high misuse potential—most notably opioids, central nervous system depressants (like benzodiazepines), and stimulants. It will also help to identify patterns of potential prescription drug misuse (e.g., inappropriate prescribing and multiple provider episodes) by geographic location, as well as factors associated with prescribing patterns and potential misuse such as gender, age, and insurance coverage (as a proxy for socioeconomic status).

These data, triangulated with other sources of information (e.g., literature review, interviews and focus groups with key informants, analysis of other sources of state and local data) will help to identify populations defined by geography or other factors that may benefit from more intensive or tailored interventions to be defined in the state’s SPF-Rx.