By Genelle R.S. Lamont, MPH, PHD
Genelle Lamont is the Oral Health Surveillance Coordinator at the Minnesota Department of Health, Oral Health Program, where she leads the Minnesota Oral Health Statistics System (MNOHSS).
Epidemiologists are scientists who track rates of disease, health conditions and injuries in the population through systematic data collection, analysis and reporting. In public health, we call this surveillance; and a data tracking system is a tool to display the data.
Data tracking systems help us understand and respond to health problems by answering questions like:
- How common is a disease or health condition in this population?
- Who is most affected (e.g. gender, age, race/ethnicity, rural/urban residence)?
- Are there factors that increase or decrease the rates of disease?
This data helps government, non-profit organizations, healthcare systems and policymakers assess and respond effectively to individual, family and community health needs.
Many data systems aren’t health literate
Data tracking systems and reports often lack health literacy, the ability [of systems and professionals to provide health information that is easy] to find, understand, evaluate, communicate and use.
Couple that with the mismatch between the health literacy and math skills of Americans, and the communication skills of health professionals. A 2003 national study found that nearly 9 in 10 adults in the United States have limited health literacy. And according to an international study of adults aged 16-65 years from over 20 industrialized countries,Americans also score below average in their ability to understand and work with numbers and to use technology to problem solve.
Health data are often complex, housed in multiple locations across several organizations and require a graduate level degree in statistics or epidemiology to understand, leaving many of us fishing blindly for understandable data and health information on the internet —it’s like trying to catch a northern pike in Lake Superior and ending up with a tangle of weeds.
Data visualization technology is a tool to access health data
Recognizing health literacy as a major barrier to accessing oral health data, in 2015 the Minnesota Department of Health Oral Health Program developed the Minnesota Oral Health Statistics System (MNOHSS) (pronounced “minnows”). Funded by Delta Dental of Minnesota Foundation, MNOHSS is a state oral health data tracking system that has been nationally recognized as a model for providing a publicly accessible one-stop source for accurate, easy-to-use, action-driven, online state and county oral health data.
MNOHSS advances oral health literacy and data visualization through a user-friendly platform, the MN Data Access Portal – administered by the MN Tracking Program under a Centers for Disease Control and Prevention (CDC) cooperative grant of the National Environmental Public Health Tracking Network.
The MN Data Access Portal meets a high standard of accessibility, features a friendly, user-driven design with both mobile and web applications, offering a data query tool with a downloadable option, dynamic charts, custom reports and interactive maps. A thorough content development and review process includes oral health and mapping professionals, epidemiologists, statisticians, health literacy and web development experts, coupled with audience testing to ensure that data is communicated accurately, clearly and with context.
MNOHSS applies a health literacy lens to its content using best practices, such as:
- Headers and information chunking
- Use of plain language
- Clear definitions for technical terms
- Simpler charts, tables and maps
- Color-blind friendly, printer-safe colors and alternative text
Engaging consumers with data and technology
American statistician and pioneer in the field of data visualization Dr. Edward R. Tufte said, “Clutter and confusion are failures of design, not attributes of information.” Data does not have to be confusing, nor should it require a graduate or professional degree to understand at a basic level.
Blending technology with best practices in web design, usability and health literacy, including numeracy, accessibility, plain language and audience-centered or culturally appropriate communications can increase the data literacy of patients and consumers.
Many science, health and math professionals struggle with communicating data in ways that everyone can understand because communications and health literacy are not typically part of the graduate and professional school training they receive. There are lots of training opportunities, tools and resources available to health professionals to improve their communication skills.
Some of my favorites include:
- Agency for Healthcare Research and Quality (AHRQ) Health Literacy Universal Precautions Toolkit
- Ancker J.S., Y. Senathirajah, R. Kukafka, and J.B. Starren. Design features of graphs in health risk communication: a systematic review. Journal of the American Medical Information Association. 2006; 13: 608-618.
- Centers for Disease Control and Prevention (CDC) Health Literacy
- Few, S. Now you see it: simple visualization techniques for quantitative analysis. Oakland, CA: Analytic Press; 2009.
- Lipkus IM and J.G. Hollands. The visual communication of risk. Journal of the National Cancer Institute Monographs. 1999; 25: 149-263.
- Minnesota Health Literacy Partnership Presentations and Training Materials
- National Academies of Science, Institute of Medicine (IOM) Roundtable on Health Literacy
- National Cancer Institute (NCI) Making Data Talk: A Workbook [pdf]
- Pleasant A., M. Rooney, C. O’Leary, L. Myers, and R. Rudd. Discussion Paper: Strategies to enhance numeracy skills. Washington D.C.: National Academy of Medicine; 2016. http://nam.edu/wp-content/uploads/2016/05/Strategies-to-Enhance-Numeracy-Skills.pdf.
- Tufte E.R. The Visual Display of Quantitative Information. Cheshire, CT: Graphics Press; 1983.
- S. Department of Health and Human Services, Office of Minority Health Cultural and Linguistic Competency
- S. Food and Drug Administration Communicating Risks and Benefits: An Evidence-Based User’s Guide [pdf]
- Evergreen, S. D.H. Presenting data effectively: communicating your findings for maximum impact. Thousand Oaks, CA: Sage Publications, Inc. 2014.
 Coleman C, Kurtz-Rossi S, McKinney J, Peasant A, Rootman I and Shohet L. The Calgary Charter on Health Literacy: Rationale and Core Principles for the Development of Health Literacy Curricula. 2011. The Centre for Literacy. http://www.centreforliteracy.qc.ca/health_literacy/calgary_charter
 Kutner M., E. Greenberg, Y. Jin and C. Paulson. The Health Literacy of America’s Adults: Results from the 2003 National Assessment of Adult Literacy. Washington, D.C.: U.S. Department of Education; 2006. https://nces.ed.gov/pubs2006/2006483.pdf
 Rampey BD, Finnegan R, Goodman M, Mohadjer L, Krenzke T, Hogan J and Provansnik S. Skills of U.S. Unemployed, Young and Older Adults in Sharper Focus: Results from the Program for the International Assessment of Adult Competencies (PIAAC) 2012/2014: First Look (NCES 2016-039rev). U.S. Department of Education. Washington D.C.: National Center for Health Statistics; 2016.