An Open Access City-Level Data Platform

The Big Cities Health Inventory (BCHI) is the Big Cities Health Coalition’s (BCHC) open access data platform. It is a standardized data collection hub that provides a “snapshot” of health in 30 of the largest, most urban cities in the United States and allows for comparability of health indicators across most BCHC member jurisdictions. The platform contains over 18,000 data points across more than 50 health, socio-economic, and demographic indicators across 11 categories in the United States.  

Data, ideally those that are local and timely, are essential to the practice of public health, helping to ensure that programs are responsive to a community’s health needs. In the US, public health agencies are responsible for regularly collecting and analyzing data on health problems and opportunities, and for making such data publicly available. Data are collected at the state, county, and city levels, as well as through a number of federally run surveys such as the Behavioral Risk Factor Surveillance Survey (BRFSS).

However, much of the health-related data in the public domain is only disaggregated at a state or county level. This is not detailed enough – there is a clear need for city-level data to understand and inform a city’s health. Today, more than 80% of Americans live in metropolitan areas. Local health departments are key innovators and have a high potential for return on investment when it comes to health. Plus, the ability to compare jurisdictions can be invaluable to identify best practices and share learnings across departments. The BCHI helps fill this gap in data for cities by providing a baseline of health in urban communities, as well as evidence of innovative, best and promising policies and practices at work in BCHC member jurisdictions.

History of the BCHI

The BCHI was created to help address this continuing need for more comprehensive data and comparative perspective on the most pressing health issues facing the nation’s urban areas. The BCHI is the longest running initiative to make comparable city-level data publicly accessible. It was started in 1994 as a collaboration of local health departments, led by the Chicago Department of Public Health, to collect and release a report that presented an overview of health in a number of US cities. By 2003, four editions had been published with improvements in methodology and increased data. In 2014, BCHC assumed ownership over the BCHI, and at that point, the data moved to an online platform. This allowed users to better explore the data and for those data to be updated on a more regular, and rolling, basis. Currently, data are included only for BCHC member jurisdictions (30 cities), slightly smaller than the previous print editions. Regardless of BCHC’s role, the BCHI has always been, and continues to be, a collaborative project among the cities themselves.

What data are available on the BCHI?

The indicators encompass nine broad categories of public health importance: Behavioral Health and Substance Abuse; Cancer; Chronic Disease; Environmental Health; Food Safety; HIV/AIDs; Infectious Disease; Injury and Violence; and Maternal and Child Health. Two additional categories include demographics and life expectancy/overall death rate. These indicators were chosen based on their relationship to the leading causes of morbidity and mortality in the United States and their role in creating healthier, safer communities. The latter was largely gauged by whether an indicator was identified as a priority in the U.S. Department of Health and Human Service’s Healthy People 2020 goals, CDC’s Winnable Battles, or due to interest among Coalition members.

As changes in disease burden and priorities have occurred over the years, so have indicators included in the BCHI, leading to the addition of nutrition, obesity, and physical activity-related metrics. Moving forward, other relevant indicators will also be included. Throughout the years, the report’s contribution has been confirmed by local health department professionals, citations in newsletters, scholarly publications, and the press. Indicators are selected because of their impact on mortality and morbidity of residents in big cities and are among those commonly used in public health.

Where do these data come from?

Much of these data come directly from cities, while some were also secured from the U.S. Census or other similar publicly available data set for which city data are available. Where sample sizes allow, indicators are broken down into subpopulations for race and ethnicity categories. The city-specific data in the BCHI can help direct city health policies and priorities and allows for relative comparability across major urban centers in the US. The data can be organized by city, by indicator, and sorted by year, race, and sex. It features downloadable and shareable charts and data points. Additionally, the entire dataset is available for download as a csv file. This data can be analyzed to inform public health programs, used for dissertation or thesis research, or for grant applications, among other things.

This data inventory is managed by the Big Cities Health Coalition (BCHC), which is a project of the National Association of County and City Health Officials (NACCHO). The data inventory is primarily supported by a grant from the Centers for Disease Control and Prevention (Cooperative Agreement 5U38OT000172-03). The BCHC as an organization is supported by the de Beaumont Foundation and the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the CDC or the Coalition’s other funders.

Because our BCHI data is open access, we would love to know how you are using it. Please share with us any reports, publications, visualizations, etc. that you create from the data, as well as any stories about what the data has enabled you to do. Please send stories to mmcginty@naccho.org. You can also tweet your visualizations at @bigcitieshealth.

Thank you to our member departments who provide us with this data and to our advisory group members who ensure the BCHI is kept up to date and is relevant for cities and other users.

 

Current and Past Advisory Group Members

  • Joshua Bobrowsky, Director Policy and Legislative Affairs, LA County Department of Public Health
  • Catherine Cairns, Chief of Staff, Boston Public Health Commission
  • Ann Salyer Caldwell, Deputy Director for Public Health, Tarrant County Public Health
  • Kimberly Cantrell, Acting Associate Director, CDC Office for State, Tribal, Local and Territorial Support (OSTLTS)
  • Richard Carlson, MPH, MA, CPH, Senior Public Health Researcher and Epidemiologist, Minneapolis DPH
  • Theresa Chapple, PhD, MPH, Senior Research and Evaluation Officer, de Beaumont Foundation
  • Dan Dooley, Acting Director Research and Evaluation Office, Boston PH Commission
  • Joe Gibson, Director Epidemiology, Marion County Health Department
  • Kate Goodin, MPH, Office of Epidemiology, Maricopa County DPH
  • Beth Jacob, Project Director, CityHealth
  • Anita Kurian, DrPH, MBBS, MPH, Assistant Director, Communicable Disease Division, San Antonio Metropolitan Health District
  • Jesse Lava, MPP, Director of Policy, Chicago DPH
  • Giridhar Mallya, Senior Policy Officer, Robert Wood Johnson Foundation
  • Sarah Martin-Anderson, Manager of Community Engagement, Policy, and Accountability, Kansas City HD
  • Catherine Patterson, Senior Program Officer, de Beaumont Foundation
  • Megha Shah, MD, MPH, MS, Chief Health Assessment Unit, Los Angeles County DPH
  • Snehal Shah, MD, MPH, Director, Research and Evaluation Office, Boston PH Commission
  • Bill Snook, MS, Marketing Services Manager, Kansas City HD
  • Tim Van Wave, DrPH, Associate Director for Science, Office for State, Tribal, Local, and Territorial Support (OSTLTS), CDC