Priority health risk behaviors (i.e. preventable behaviors that contribute to the leading causes of morbidity and mortality) are often established during childhood and adolescence and extend into adulthood. Ongoing surveillance of youth risk behaviors is critical for the design, implementation, and evaluation of public health interventions to improve adolescent health. The YRBS is a national surveillance system that was established in 1991 by the Centers for Disease Control and Prevention (CDC) to monitor the prevalence of health risk behaviors among youth. YRBS data are routinely collected on high school students, but only a few states collect data in middle schools.
The Nevada YRBS is biennial, anonymous and voluntary survey of middle (grades 6th-8th grade) and high (9th-12th grade) students in regular public, charter, and alternative schools. Students self-report their behaviors in six major areas of health that directly lead to morbidity and mortality, these include:
- Behaviors that contribute to unintentional injuries and violence;
- Sexual behaviors that contribute to human immunodeficiency virus (HIV) infection, other sexually transmitted diseases, and unintended pregnancy (high school only);
- Tobacco use;
- Alcohol and other drug use;
- Unhealthy dietary behaviors; and
- Physical inactivity.
The CDC randomly choses around 35 high school each survey year to represent Nevada. To ensure greater representation from schools in all districts, the Nevada Division of Public and Behavioral Health contracts with the University of Nevada, Reno School of Public Health to conduct the YRBS in the remaining high schools and all middle schools throughout the state. The Nevada YRBS provides statewide data to assess priority health-risk behaviors among secondary school students; measure progress toward achieving national health objectives for Healthy People 2030 and other program and policy indicators; and evaluate the impact of school and community interventions at the national, state, and local level.
The National Syndromic Surveillance Program (NSSP) is a collaborative effort involving local and state health departments, the Centers for Disease Control and Prevention (CDC), and various partners. When individuals seek care at medical facilities, such as emergency departments, those facilities submit de-identified visit data, including chief complaints, diagnosis codes, and patient demographics, to state or local health departments. This information is then transmitted to the NSSP’s BioSense Platform, where public health professionals and members of the NSSP Community of Practice can analyze the data to monitor emerging public health issues and support emergency response efforts. The platform’s main user interface, known as ESSENCE, enables users to view and interpret the data.
By applying established NSSP syndrome definitions, such as the CDC’s “Suspected Child Abuse and Neglect” definition, syndromic surveillance data can be used to track broad trends related to Adverse Childhood Experiences (ACEs) at local, state, and national levels. This data allows for both direct monitoring of ACE-related indicators through emergency department visits involving children (e.g., child abuse, neglect, homelessness) and indirect monitoring through adult conditions (e.g., substance use, intimate partner violence) that may reflect household or community-level adversity. Additionally, syndromic surveillance can be leveraged to observe trends in potential consequences of ACEs, including mental health disorders, suicide-related incidents, drug overdoses, and alcohol misuse among children and adolescents. In Nevada, data are submitted from nearly all emergency department facilities.
The Behavioral Risk Factor Surveillance System (BRFSS) is the nation’s premier system of health-related telephone surveys that collect state data about U.S. residents regarding their health-related risk behaviors, chronic health conditions, and use of preventive services. Nevada BRFSS is collaborative project among UNR Nevada Center for Surveys, Evaluation and Statistics (CSES) at School of Public Health, Nevada State Division of Public and Behavior Health (DPBH), and US Center for Disease Control and Services (CDC). The Nevada BRFSS is an annual anonymous voluntary telephone survey of adults (aged 18 years or older).
PRAMS (Pregnancy Risk Assessment Monitoring System) is a nationwide system to find out why some babies are born healthy and others are not. Nevada PRAMS is collaborative project among UNR Nevada Center for Surveys, Evaluation and Statistics (CSES) at School of Public Health, Nevada State Division of Public and Behavior Health (DPBH), and US Center for Disease Control and Services (CDC). The overall goal of PRAMS is to reduce infant morbidity and mortality and to promote maternal health by influencing maternal and child health programs, policies, and maternal behaviors during pregnancy and early infancy. To do this, the PRAMS questionnaire asks new mothers about their behaviors and experiences before, during, and after their pregnancy. Each year in Nevada there are hundreds of babies born with serious health problems. Answers to the PRAMS survey will help us to learn more about ways to improve the health of mothers and babies in Nevada.
Area Deprivation Index (ADI)
Area Deprivation Index (ADI) ranks neighborhoods by socioeconomic disadvantage in a region of interest and includes factors for the theoretical domains of income, education, employment, and housing quality. Lower scores of disadvantage means the neighborhood has less disadvantage and higher scores means the neighborhood has more disadvantage. ADI scores are available at the census-tract and zip code level. ADI offers a mapping function that allows users to zoom in to a specific area or lookup the ADI score of a specific address, the mapping function can be accessed here.
Child Opportunity Index (COI)
Child Opportunity Index (COI) captures neighborhood resources and conditions that matter for children’s healthy development in a single metric. The index spans 3 domains: education, health and environment, and social and economic. A higher level of COI means the neighborhood has more resources and conditions for children’s healthy development. COI data is available at the census-tract level. COI offers a mapping function that allows users to zoom in to a specific area or lookup the COI level of a specific address, the mapping function can be accessed here.
Social Vulnerability Index (SVI)
Social Vulnerability Index (SVI) helps local officials identify communities that may need support before, during, or after disasters, so it may not be the best SDOH indicator for addressing child and adolescent health issues. A number of factors, including poverty, lack of access to transportation, and crowded housing may weaken a community’s ability to prevent human suffering and financial loss in a disaster. A higher level of SVI means the neighborhood may need more support before, during, or after disasters. SVI data are available at the county and census-tract levels. SVI offers a mapping function that allows users to zoom in to a specific area or lookup the SVI level of a specific address, the mapping function can be accessed here.
Environmental Justice Index (COI)
Environmental Justice Index (EJI) ranks the cumulative impacts of environmental injustice on health for every census tract. EJI rank is based on three overarching modules: environmental burden, social vulnerability, and health vulnerability. A higher EJI score means the neighborhood may feel a higher impact of environmental injustice on their health. EJI data is available at the census-tract level. EJI offers a mapping function that allows users to zoom in to a specific area or lookup the EJI score of a specific address, the mapping function can be accessed here.
County Health Rankings
County Health Rankings pulls in multiple data sources to allow for easy comparisons between states and counties. County Health Rankings might be one the most user-friendly ways to view a variety of health data for a county. County Health Rankings complies data on health outcomes and health factors, including health behaviors, clinical care, social & economic factors, and physical environment. County Health Rankings pulls data at the state and county level. County Health Rankings data can be viewed here.
American Community Survey (ACS)
The American Community Survey (ACS) is an annual surveillance system across the U.S. The ACS asks about business and economy, education, employment, families and living arrangements, government, health, housing, income and poverty, populations and people, and race and ethnicity. ACS data is available at the national, state, county, zip code, metropolitan statistical area, census tract, and block levels. ACS presents the data as both 1-year and 5-year estimates; however, data for less populous areas and lower prevalence indicators may only be available as a 5-year estimate. Accessing ACS data is not always user-friendly, especially compared to other SDOH indexes and data sources. ACS data can be accessed here.