Picturing inequities for health impact assessment: linked electronic records, mortality and regional disparities in Portugal. Issue 1 (2nd January 2018)

• Record Type: Journal Article
• Authors: Bacelar-Nicolau, Leonor; Rodrigues, Teresa; Fernandes, Elisabete; Lobo, Mariana F.; Nisa, Cláudia Fernandes; Azzone, Vanessa; Teixeira-Pinto, Armando; Costa-Pereira, Altamiro; Normand, Sharon-Lise Teresa; Pereira Miguel, José
• Is Part Of: Impact assessment and project appraisal. Volume 36:Issue 1(2018)
• Page Start: 90
• Page End: 104
• Publication Date: 2018-01-02
• Subjects: Equity -- quantification -- decision-making -- Big Data -- data science -- acute myocardial infarction; 333.714
• DOI: 10.1080/14615517.2017.1364016
• Languages: English
• ISSNs: 1461-5517

Abstract

Abstract: Health impact assessment (HIA) focuses on minimizing inequities when studying the effects of a policy on the population's health. Nevertheless, it is seldom simultaneously quantified, multivariate, and visually graphically comprehensible for non-statisticians. This paper aims to address that gap, assessing a policy promoting the quality of Electronic Health Records, linking hospital and primary health care data (Blood Pressure, Cholesterol, Triglycerides, Waist Circumference, Body Mass Index) to mortality outcomes and regional inequities. Acute Myocardial Infarction patients admitted in the hospital are then followed regularly in Portuguese NHS Primary Care. Regional disparities regarding recorded information are observed and different association patterns with mortality identified, ranked, and visualized through adjusted ORs for sex, age, and indicators of severity of hospital admission, complemented with multivariate correspondence analysis. A pathway to handling equity within quantitative HIA shows that complexity in data and methods may generate simplicity and clarity through visual graphical aids. Tackling Big Data with Data Science in HIA may even be at the center of future health reforms, assessing impacts of health promotion and chronic disease policies.