Our federal government collects health data. These data form the basis of information important to you. If you follow this column, you may recall reading about the importance of data in healthcare. Recent reductions in federal support and massive layoffs are reducing the amount and quality of information that propels advances in clinical medicine and public health. If you are not concerned, you should be. Your health and the health of those you love are at stake.
Since 1957, the U.S. Department of Health and Human Services, with the help of its associated branches, has been collecting data about the health of our country. This information betters our understanding of health-related trends (such as the rising incidence of diabetes) and clustered health problems (like lead poisoning in Flint, Mich.). In addition, finding out how much these issues cost consumers and providers, and the number of patients covered by health insurance, along with their ability to pay, lead to the development of targeted interventions to improve the overall health of our population. This information matters to our local community and you. (See the information summarized by the County Health Rankings and Roadmaps, which compares our county, Dukes, to other counties in Massachusetts and the U.S., at bit.ly/CHRR_DukesCounty.)
These distillations of America’s health are done through the Medical Expenditure Panel Survey (MEPS) and the National Health Interview Survey (NHIS). The MEPS is a collaboration between the U.S. Census Bureau, which collects the data, and the Agency for Healthcare Research and Quality (AHRQ). The AHRQ designs the survey, sets research goals, and analyzes and publishes the data, ensuring that the survey aligns with health policy research needs.
The MEPS is important because it provides a detailed breakdown of who is using the healthcare system and why. From it we find out how many people are insured or underinsured, and the associated costs. This understanding enables Congress to make informed decisions about Medicare, Medicaid, and the Affordable Care Act, and guides politicians toward introducing legislation that will support the health of their constituents. It allows hospitals and insurance companies to analyze trends in healthcare costs and coverage, and assists researchers in evaluating health-related disparities in order to spearhead reforms or to move in productive directions. It motivates pharmaceutical companies to develop medications based on the needs of the population, and is a springboard for preventive services such as cancer screenings and vaccinations. Without MEPS, our healthcare leaders would “travel blind,” and be forced to make policy decisions based on assumptions and guesses, rather than fact.
The National Health Interview Survey (NHIS) is conducted by the National Center for Health Statistics (NCHS) in collaboration with the Census Bureau, and provides comprehensive information on the health of the U.S. population. It collects data on a broad range of topics, including a person’s state of health, their health behaviors, and their ability to access and use healthcare services. Through the survey, data collectors are able to find out how many people are afflicted with disease, what types and doses of medications they take, their level of functionality, and their financial burden. A recent post from the Economist reflects the survey’s accuracy: “America’s current system manages a spectacular feat. From Inuits in remote corners of Alaska to Spanish speakers in the Bronx, it measures the country and its inhabitants remarkably well, given that the population is highly diverse and spread out over 4 million square miles.”
The Census Bureau sends out an impressive 1.5 million surveys each month in its quest for figures that will propel our healthcare into the future, improving its quality and accessibility. But recent layoffs made by the Department of Governmental Efficiency (DOGE) threaten the surveys’ future. Without MEPS, we would have no Medicare Part D to cover the cost of prescriptions for our elderly. There would be insufficient insurance coverage for those seeking mental health treatment. Essentially, compromising the survey makes us ignorant of things we can change to improve health. Without the NHIS survey, there would have been no Tobacco Control Act, no workforce accommodation policies, and a lack of prioritization for vaccine distribution and many other decisions that improved health. Without good data, our society will become less healthy.
According to Reuters, the federal workforce has decreased by more than 260,000 positions (through layoffs, buyouts, and early retirements), many of which are within our healthcare sector. The Agency for Healthcare Research and Quality is being dissolved. Eighty percent of its budget has been cur. These staffing changes have raised concerns among public health experts about the potential impact on our country’s ability to respond to health emergencies and conduct essential research. How will we answer emerging health-related questions without data-driven answers? The answer is simple: Poorly.
Our government should work for us. The MEPS and NHIS surveys do.
To learn more about the MEPS and NHIS surveys and the valuable work of the U.S. Census Bureau, visit the following sites: bit.ly/USCB_MEPS, bit.ly/CDC_NHIS, census.gov.
