Linked population databases: Methods for monitoring population level health inequalities
During his tenure in Montreal,
Professor Mark Daniel developed the
MEGAPHONE geographic information system (Montreal Epidemiological and
Geographic Analysis of Population Health Outcomes and Neighbourhood Effects)
for facilitating population and public health research and surveillance
across the Montreal Metropolitan region.
This software combines a diverse array of spatial databases and spatial analysis tools for characterising physical and social environmental exposures, and analysing these in relation to health outcome at the population level (via aggregated administrative health data) and the individual level (using multi-level modelling and individual outcomes).
While MEGAPHONE is in fact a comprehensive data system, its value is as a comprehensive relational infrastructure for the storing, management, and use of health-related geographic data. At the University of South Australia, Mark is continuing this line of research in submitting an NHMRC grant to evaluate whether psychosocial factors mediate a relationship between residential area characteristics and development of the metabolic syndrome in a community cohort of 4,000 persons measured over an 8-year interval.
Professor John Lynch and colleagues have been engaged in projects to develop a suite of suitable indicators that can help summarize levels of health inequalities and their trends over time taking account of both changes in health and changes in the composition of population sub-groups. This represents truly translational research in that while such measures have been developed, especially in disciplines such as economics and demography, they have not been widely applied within or outside academic environments. Professor Lynch has made significant contributions to improving methods for monitoring population level health inequalities.
Professor Lynch has published 2 monographs and 1 paper with colleagues from the National Cancer Institute, (two others in development) and three other publications using innovative methods applied from adjacent disciplines. Professor Lynch continues to work with public health partners to devise appropriate schemes to better monitor health inequalities, develop self-paced CD-ROMS and graphical display techniques via the internet for local public health use.
Over 5,000 of these CD-ROMs have been ordered from 22 countries. Professor Lynch’s latest project is working the 2009 Global Burden of Disease Study to quantify the GBD associated with social disadvantage. He has used routinely collected population data from national surveys such as the Behavioral Risk Factor Surveillance Survey, National Health Interview Survey, SEER (cancer), the NCHS Mortality files, and linked census/mortality files in Canada.
Professor Adrian Esterman has been involved in numerous studies using linked
data. In particular he was part of the National Evaluation team for the
Australian Coordinated Care Trials, as well as part of the Local Evaluation
Team for the SA HealthPlus trial. Along with A/Prof James Harrison from
Flinders and Andrew McAlindon from the SA Department of Health, Professor Esterman organised a major workshop on data linkage in South Australia,
which has resulted in the establishment of an SA Data Linkage Facility.