Tools to Visualize Local Health Data

Have you ever wondered which issues have the biggest impact on public health in your community, or how your county’s public health ranks in comparison to other counties in your state?  Here are two helpful tools for visualizing and comparing county-level health data, found through the list of County and Local Health Data tools at PHPartners.org (I originally learned about these tools through the free NNLM class Health and Wellness @ the Library: The Essentials of Providing Consumer Health Services).

CHSI 2015

CHSI 2015 (created by the Centers for Disease Control and Prevention) describes itself as “an interactive web application that produces health profiles for all 3,143 counties in the United States.”  Select a state and county to view an “at-a-glance” summary (under the “Summary Comparison Report” section) on “how the selected county compares with peer counties” (better, moderate or worse) “on the full set of Primary Indicators” (arranged under categories Mortality, Morbidity, Healthcare Access and Quality, Health Behaviors, Social Factors, and Physical Environment).

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The Summary Comparison Report for Montgomery County, MD at CHSI 2015.

CHSI 2015 also allows you to view county demographics data and county-level data for specific Primary Indicators.  For instance, the age adjusted Alzheimer’s disease death rate for Montgomery County, MD is 13.3 per 100,000 residents, while the US median rate is 27.3.

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Data on Alzheimer’s disease death rate for Montgomery County, MD at CHSI 2015.

County Health Rankings and Roadmaps

County Health Rankings and Roadmaps (created by Robert Wood Johnson Foundation (RWJF) and University of Wisconsin) measure “the health of nearly all counties in the nation and rank them within states” using “county-level measures from a variety of national and state data sources.”  Check their Our Approach page for more information on their data sources and ranking methods.

Try searching by state from the County Health Rankings homepage, and then choose a county to view the Rankings data for the county (compared against overall state-level data and its ranking compared to other counties in the state)  under categories including Health Outcomes (Length of Life and Quality of Life) and Health Factors (Health Behaviors, Clinical Care, Social and Economic Factors, and Physical Environment).  Choose the “Show areas of strength” checkbox at the top of the screen to highlight public health factors where the county has a strong ranking, or choose “Show areas to explore” to highlight categories where the county has a weaker ranking.

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Viewing County Health Rankings data for Montgomery County, MD.

Choose the “Compare Counties” option to create charts comparing the public health data of two or more counties (including counties in different states).  For instance, the screenshot below shows a chart comparing County Health Rankings data for Calvert, MD, Fairfax, VA, and Montgomery, MD.

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Comparing County Health Rankings data for three different counties.

I also want to highlight a website specifically for my local county (Montgomery County, Maryland) called Healthy Montgomery, which allows users to create customized health dashboards for their local zip code.

From the Healthy Montgomery homepage, choose the Community Health Dashboards option under the Find Data drop-down menu.  You can then choose to view county health dashboards based on a variety of health indicator measurements (like Healthy People 2020 or Maryland SHIP 2017).  You can also build a custom dashboard and filter to view only specific indicators, view data for a specific location (zip codes within Montgomery County), filter by comparisons (like Healthy People 2020 or Maryland SHIP), filter by subgroups (like age, gender, or race), or filter by data source.

The dashboards include helpful icons beside measurement data to indicate if the measurement is higher or lower than county/US average, or if the measurement has an upwards or downwards trend when compared to prior values.

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Customized dashboard from Healthy Montgomery for Silver Spring, MD (zip code 20910).

While the county-level health data tools like CHSI 2015 and County Health Rankings are useful for getting a general idea about public health in larger communities, I hope all counties will eventually have websites like Healthy Montgomery available to view health status (and local health disparities) at a more granular, neighborhood-based level.

From Submarine Blueprints to Intricate Fruit: Digital Collections of Historic Images, Science and Medicine

Library collections often extend far beyond just books and journals, and today’s digital collections offer free access to all types of multimedia.  Online collections from the Library of Congress include photos/prints, manuscripts, video, audio, maps, and even archived websites. One of my favorite types of digital collections are historic images in the science and medicine field.  It can be fascinating to see catalog images for intricate machines from a century ago, infographics from the 1950s about medical careers, or beautifully detailed watercolors of plants.  Here are a few of my favorite places to look for historic science and medicine image collections:

Library of Congress Digital Collections (Science and Technology) – View 19 collections, such as Architecture, Design & Engineering Drawings. This collection “covers about 40,000 drawings (described in more than 3,900 catalog records), spanning 1600 to 1989” and includes a wide range of architectural and engineering designs, such as a submarine design from 1806.

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[Submarine (“Submarine Vessel, Submarine Bombs and Mode of Attack”) for the United States government. Cock cavity and wheel details for “plunging boat”]
National Library of Medicine Digital Collections – I recommend exploring the almost 70,000 images within the Images from the History of Medicine collection.  Browse health-related advertisements, educational material, images of patients and healthcare professionals, medical illustrations, etc. from before 1600 to the present.  For example, check out this infographic from 1957 about the growing field of health service occupations.

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Health service occupations: a growing field of employment for both men and women

Smithsonian Libraries Digital Collections – One of my favorite collections, which I first became familiar with when hunting for online trade literature collections for patent searches, is the Instruments for Science, 1800-1914 collection.  This collection lets you browse through catalogs for scientific instruments and machinery from over a century ago.  Here’s an instrument called a “Moist Chamber” from an 1899 catalog, which was used to “keep a muscle and nerve preparation damp during the experiment” (yikes).

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Moist Chamber (pg 29)

United States Department of Agriculture Special Collections – Some science images are absolute works of art, like the watercolors of fruits and nuts from the USDA Pomological Watercolor Collection.  This painting of strawberries from 1914 is one beautiful example.

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Fragaria: Pine Apple

This is only just scratching the surface of online image collections…if you have a lot of time to kill, visit the British Library Flickr page, which offers over a million public domain images scanned from old books.

Legacy of Beall’s List: Ongoing Efforts to Identify Predatory Journals

The sudden disappearance of Beall’s List of potential, possible, or probable predatory scholarly open-access publishers was one of the more dramatic sagas I’ve come across in the scientific publishing/librarian fields.  Here’s a bare-bones timeline of the story (cobbled together from No More ‘Beall’s List’ by Carl Straumsheim, Beall’s article What I learned from predatory publishers, and the Wikipedia page on predatory open-access publishing):

  • between 2008 and 2010: Jeffery Beall, librarian and researcher at University of Colorado Denver, first posted his list of predatory publishers on the Posterous blog platform.
  • January 2012: Beall launched a blog called Scholarly Open Access that listed predatory publishers/journals and also offered criticism of scholarly open-access publishing.
  • August 2012: Beall posted his criteria for evaluating publishers.
  • February 2013: Beall added a process for a publisher to appeal their inclusion in the list.
  • 2013: OMICS publishing group threatened to sue Beall for $1 billion for including them on the list (this threat obviously wasn’t successful, since the list lived on for another 4 years).
  • January 17, 2017: The list was taken offline.  Beall describes his reasons for taking down the list in his article What I learned from predatory publishers:

In January 2017, facing intense pressure from my employer, the University of Colorado Denver, and fearing for my job, I shut down the blog and removed all its content from the blog platform.

So that’s the story in a nutshell.  Beall’s List was highly controversial (angering both open-access publishers included on the list and some open-access advocates), but it was also incredibly useful, with many researchers and librarians using the list as an authoritative resource to identify predatory journals to avoid publishing in and using for research.

Thankfully, there are still ongoing efforts to identify predatory journals and guide researchers towards high-quality, reputable journals for publishing and research.  Many of these efforts utilize or build on Beall’s work.  Here are a few ways Beall’s legacy lives on:

  • Archived versions of Beall’s List: Some LibGuides and blogs link to or post archived versions of the list. A site called Beall’s List of Predatory Journals and Publishers (hosted on Weebly) also appears to be built from archived versions of Beall’s List.
  • Active updates of Beall’s List: The website Stop Predatory Journals seeks to continue updating Beall’s list through a collaborative community effort.  It’s unclear if this page is still regularly updated, though, since the last post on the homepage is from February 10, 2017.
  • Cabell’s Predatory Journal Blacklist (subscription tool): A Nature.com article titled Pay-to-view blacklist of predatory journals set to launch describes the new subscription-based predatory journal blacklist from scholarly-services firm Cabell’s International. Rick Anderson at The Scholarly Kitchen offers a detailed review of Cabell’s list.
  • Guidelines for Avoiding Predatory Journals: The website Thinkchecksubmit.org provides guidelines and resources for researchers to help them identify reputable journals where they can safely publish their work.

Are there other ways researchers and librarians are working to identify and avoid predatory publishers?  Let me know in the comments or on Twitter!

Preserving the Internet: Library of Congress and the Internet Archive

Preserving internet content seems to be a Sisyphean task, especially content from social media.  A recent article from Forbes.com on Why We Need To Archive The Web In Order To Preserve Twitter by Kalev Leetaru made a great point about the challenges of preserving online content:

Perhaps the most important lesson is the reminder that in a networked information world, preserving a single object in isolation may not actually preserve it if it consists of links to other resources which are lost.

The content of the web changes every second, and a website can be taken down at any time.  If a Tweet links to a website that’s no longer available, how useful is an archived version of that Tweet?  And that’s just the tip of the iceberg…the Library of Congress (LOC) has been trying to figure how out to create a usable archive of Tweets since 2010.

Obstacles in Archiving Twitter

An article last year from The Atlantic, Can Twitter Fit Inside the Library of Congress? by Andrew McGill, provides an overview of the agreement the Library of Congress made with Twitter in April 2010:

Twitter promised to hand over all the tweets posted since the company’s launch in 2006, as well as a regular feed of new submissions. In return, the library agreed to embargo the data for six months and ensure that private and deleted tweets were not exposed.

The Library of Congress has the raw data, but it struggles with the ever-growing size and complexity of the Tweets archive.  With 500 million Tweets added a day (in 2012) and the added metadata of embedded images, videos, and conversation threads, the archive of Tweets has become nearly unsearchable with current technology available to the LOC.  The Atlantic article quotes an LOC blog post from 2013 that describes how “executing a single search of just the fixed 2006-2010 archive on the Library’s systems could take 24 hours.” Researchers desperately want free access to the Twitter archives, but the sheer volume, variety, and velocity of this big data makes it extremely difficult to create an easily searchable portal.  Even if the LOC does create a searchable portal for the Twitter archives, how useful will those preserved Tweets really be without the context of working links?

Preserving the Internet: The Internet Archive

Twitter is just a single social media platform…how can we possibly preserve all versions of all websites ever available on the web?  Many well written articles have already pondered this question:

One thread uniting these articles are mentions of the Internet Archive, which describes itself as “a non-profit library of millions of free books, movies, software, music, websites, and more.”  You can search everything from copyright records to TV clips of President Trump on the Internet Archive, but the crowning achievement of the site is the Wayback Machine, which allows users to explore more than 299 billion web pages saved over the past two decades.

For example, if I want to explore all archived versions of the MedlinePlus homepage, I can just search by the URL and view 3,551 versions of the page, saved between April 7, 2000 and July 21, 2017.  Some links on the archived pages will take you to similar archived versions of the linked webpages (although the captures of the linked pages may have a different time stamp). Many of the images and drop-down menus are also preserved, so you get a relatively accurate feel for what the webpage looked like during that time. The Wayback Machine is a fascinating tool for cultural and historical research, and it’s even used for more creative purposes like patent searching and improving search engine optimization (SEO).

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Capture of the MedlinePlus homepage from April 7, 2000 on the Wayback Machine.

Exhibiting the Internet: The Library of Congress

Although the Library of Congress has yet to release a usable Twitter archive, the LOC still offers plenty of smaller online content archives which provide valuable insights into web culture.  The LOC recently announced the release of the Webcomics Web Archive and the Web Cultures Web Archive. The Webcomics archive focuses on “award-winning comics as well as webcomics that are significant for their longevity, reputation or subject matter”, while the Web Cultures archive includes “a representative sampling of websites documenting the creation and sharing of emergent cultural traditions on the web such as GIFs, memes and emoji.”

Each archived website includes a metadata page with a representative screenshot and bibliographic data about the website (including a summary and description of the site).  The archived website page also links to a timeline of all captured versions of the site.  For example, the Cute Overload! 😉 archived website page links to 122 captures of the Cute Overload homepage between October 3, 2006 to June 1, 2016.

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Archived Website page for Cute Overload on the Library of Congress website.

While the Internet Archive aims for quantity and preserving as many webpage captures as possible, the Library of Congress online collections aim for a representative sample of high-quality sites.  The Library of Congress collections also include helpful metadata for each archived website, so they are easily discoverable.  The LOC collection can be used as an internet history museum, while the Internet Archive Wayback Machine is the closest thing we currently have to an actual archive of the internet.  Hopefully we’ll eventually also have access to a full Twitter archive from LOC, but that may be years down the road.

Librarians on Twitter: Hashtags, Twitter Chats, and Beyond

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I’ll admit it: I’m a few years behind the game with starting a personal-professional Twitter account.  I’ve used Twitter plenty for work over the years, but Tweeting to promote a brand or a website is different than Tweeting just to promote yourself and your own ideas. There is already a thriving Twitosphere of librarians out there, and it can be daunting to try to jump in and join the conversation.  Who should I follow?  What hashtags should I use?  Where can I find other medical librarians on Twitter?

Here are a few lessons learned while starting my new Twitter account, @jamornini:

So I guess I need to get Tweeting.  Maybe in the future (if I’m brave enough) I’ll follow the librarian community onto Instagram or Snapchat.  Social media is a brave new world, and librarians are constantly adapting to sharing information through the latest digital channels.

Health Programming at Public Libraries: What Works?

When you think of programming at public libraries, probably story time for children, book clubs, and maybe a workshop for job hunting comes to mind.  Did you know libraries also often offer programs to improve public health?  OCLC’s WebJunction offers a great infographic that sums up why public libraries “are in a unique position to bring together the people, programs, and partners necessary to make health information and services accessible to everyone.”  Basically, all people have equal access to the library,  and many people use library resources (books, internet, reference staff) to identify reliable health information.  Public libraries often use local community partners from the health and wellness field to:

  • Offer fitness classes to patrons.
  • Bring in healthcare providers to offer limited health screening services.
  • Use screenings to offer referrals to local health and social service agencies.
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Section of “Library Heroes Make Health Happen” infographic.

Public librarians aren’t providing medical advice or services themselves (and many public libraries have disclaimers attesting to this), but they are helping patrons locate reliable resources for finding local health services and insurance options.

Examples of Health Programming at Libraries

What types of health programming are most successful at public libraries? I first took a quick look at the health programs available through Montgomery County Public Libraries (MCPL, my local library system), and popular classes seem to include Bone Builders (a bone building and fall prevention program for older adults), meditation classes (in Spanish and English), Tai Chi classes, and yoga classes.  Overall, fitness classes seem to be the most prevalent health programming in my local library system, especially low impact fitness activities accessible to older adults.

Another place I checked for examples of programming was Urban Library Council’s 2016 Innovation awards for Health, Safety and Sustainability.  The 2016 Top Innovator award went to Biblio Bistro program in San Francisco, “a mobile, librarian-staffed cooking cart, [offering] demonstrations and classes to makes the connection between self-prepared meals and wellness.”  2016 Honorable Mentions include programs like:

These programs use creative partnerships with local organizations to plan health classes and events which meet the specific needs of the local library patrons.  Now when visiting your public library, you can check out a few books AND attend a yoga class, or learn how to cook!

Resources for Health Programming at Public Libraries

Here are a few useful resources for planning consumer health programming at local libraries, free classes for librarians to learn about providing health programs, and online tools to learn about local community health issues:

What Role Should Libraries Play in Preventing Opioid Abuse?

The abuse of opioids (both prescription and illegal) is a major public health crisis in the US.  The Centers for Disease Control describe how 91 Americans die every day from an opioid overdose, and the number of opioid overdose deaths have quadrupled since 1999.  More overdoses are occurring at public libraries, which leads to the question: what roles should librarians have in helping to prevent and treat opioid abuse?

Public Libraries Preventing and Treating Overdoses

A coworker recently shared a fantastic article with me from American Libraries (a publication of the American Library Association) by Anne Ford, called “Saving Lives in the Stacks.”  The article describes how many public libraries are taking active steps to prevent overdoses onsite, such as:

  • Monitoring public bathroom use (to prevent overdoses in restroom stalls).
  • Training staff to administer Narcan (generic name naloxone), a medication that can reverse the life-threatening effects of opioid overdose while waiting for emergency services to arrive.

Public librarians often take on a wide variety of roles, ranging from teacher to program planner, but do librarians also need medical training to act as first responders?  This question raises legal and ethical issues beyond what I’m able to answer myself, but there is one role that I’m confident librarians can fill during this public health crisis: as information providers.

Information on Opioid Addiction and Treatment

Medical, academic, and public librarians are working to create a range of online information tools for both the general public and for healthcare professionals on preventing and treating opioid addiction:

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Opioid Abuse and Addiction Health Topics page on MedlinePlus.
  • Public Libraries: Some public libraries also provide LibGuides or online lists about opioid prevention and treatment resources (especially information on local resources), such as the Westport Library in Westport, CT or the Memorial Hall Library in Andover, MA.

Public librarians, especially those who have to handle actual overdoses and even provide emergency medical treatment, are true heroes in this battle, and all libraries (including academic and medical) can work to provide reliable information to the public and healthcare professionals on prevention and treatment resources for opioid addiction.