Bigger data, better health
M.P.H. program grads mine data in an effort to inform healthy policy for the entire country
From her desk at the Vanderbilt University Medical Center in Nashville, Sunita Thapa is crunching numbers. Again.
A graduate of the Population Health Analytics track within UND’s Master of Public Health Program, Thapa is today in the middle of two projects designed to analyze Medicare claims data. The first project is looking at the factors that have slowed the growth of federal Medicare spending in recent years; the second is exploring how enrollment in Medicare Shared Savings Program-based Accountable Care Organizations (ACOs) changes the appropriateness of screening for breast, colorectal, and prostate cancers among the Medicare beneficiaries.
On the opposite side of the country, Michael Mudgett, an epidemiologist with the California Rural Indian Health Board who graduated with an M.P.H. degree in Health Policy and Management in 2015, is collecting data on behavioral health risk factors among American Indians in his state.
“My role is to work on sampling design, data collection, analysis, and reporting to Indian Health Service [IHS] programs, which are very interested in our findings,” Mudgett told North Dakota Medicine over the phone from his office in Sacramento. “We serve the California IHS region by providing surveillance, statistics, and epidemiological support to tribes, clinics, and IHS programs throughout the state.”
While often conducted in a low-profile sort of way, the work that both graduates of the UND Master of Public Health Program do every day impacts the well-being of local communities, marginalized populations, and even the future direction of U.S. health policy.
Bending the cost curve
“It’s been great here so far,” said Thapa from Vanderbilt, adding that she felt well-prepared for her work. “I had a good experience at UND working on research with data, with my advisors. The coursework gave me a basis for public health policy, and the research projects aided substantially to sharpen the knowledge I gained from the courses to conduct epidemiological research.”
Originally from Nepal, Thapa came to the U.S. in 2009 to attend college at Minnesota State University – Moorhead. After earning an undergraduate degree in health service administration, she stayed in the Fargo-Moorhead area, taking a job with the Family Healthcare Center in Fargo.
“While I was working there I was looking for a graduate degree program that was more technical,” Thapa recalled. “That’s when I found the UND M.P.H. Program, which was a good combination of research, statistics, data analysis, and public health. That’s what made me choose UND.”
And Thapa’s former instructors are glad she did.
“Sunita perfectly represents the skills and knowledge we strive to cultivate in our M.P.H. students,” said Arielle Selya, assistant professor in the SMHS Department of Population Health and Thapa’s advisor. “During her time here, she became proficient in applied data analysis of health-related data, and learned how to use those data to inform public health questions. I’m thrilled that Sunita’s hard work and perseverance are paying off at Vanderbilt.”
Or, as the program manager for UND’s Master of Public Health Program, Ashley Evenson, put it, “Sunita is absolutely a ‘poster graduate.’ She utilized our program to the fullest and left UND with publications on her résumé.”
Among those publications were a paper on nicotine dependence (co-authored by Selya and assistant professor S. Cristina Oancea) and helping program faculty like Raymond and Karen Goldsteen update portions of their influential health policy textbook Jonas’ Introduction to the U.S. Health Care System.
Correcting the database
For his part, Mudgett earned an undergraduate degree in psychology from UND before entering the School’s M.P.H. Program.
“A big part of what we do here is advocacy,” explained Mudgett, who was raised on the Spirit Lake Reservation in North Dakota and completed an M.P.H. practicum with the Urban Indian Health Institute in Seattle, Wash., before ending up in California. “Regular state and national data tends not to represent American Indians well. When you’re not represented, you don’t generalize to the survey results, which then don’t apply to you. So when funding is available for populations at risk for certain behaviors—drug use for example—if survey data doesn’t apply to your population, you can’t get grant funding.”
So Mudgett is working to correct such data. As a result, Mudgett said, much of his job requires that he be a health data conduit between state government and California’s more than 100 American Indian tribes.
“In a nutshell, it seems that American Indians are ‘born Indian, but die white,’ as my friend put it,” Mudgett laughed. “What that means is that we’re often not captured in mortality data accurately. For example, our preliminary results [from a recent mortality study] show an almost 30 percent rate of misclassification in sexually-transmitted infection data for Indians. So, what we’re doing now is correcting that sort of thing in the state database, hoping to get better estimates for injury deaths as well. Because our communities are telling us this is an issue, but we’re not seeing it in the data. And since we can’t tell our communities they’re wrong, we’re exploring this and correcting the IHS data to get new estimates for these conditions affecting our communities.”
Collecting data, providing accurate information to policymakers, and improving the health and wellbeing not only of the American population but the entire health system: such is the work graduates of the M.P.H. Program at UND are accomplishing not only in North Dakota but across the nation every day.
Or, as Thapa summarized, “My job is to get results from the data.”
