Power in the Data
In 2018, Dr. Nathan Nickel led an innovative data study of Manitobans with alcohol use disorders.
It revealed that Manitobans who drink to excess are much heavier users of the health-care system and have much more contact with social services and the justice system than those who don’t.
The study attained several global firsts, including being the first to look back in time and track individuals with alcohol addictions from five years before their diagnosis to as long as 20 years after it.
Nickel and his colleagues at the Manitoba Centre for Health Policy (MCHP), a research unit within UM’s Max Rady College of Medicine, were able to shed new light on people with these disorders because of the extraordinary breadth, depth and linkability of the data stored in the Manitoba Population Research Data Repository at MCHP.
In 2022, Nickel stepped into a new role as the director of MCHP. He sees vast potential for the centre’s team of more than 60 researchers, data analysts and other staff to keep pushing the boundaries of this kind of research.
“We’re doing groundbreaking work,” says Nickel, associate professor of community health sciences. “This is a really special place.”
MCHP was founded in 1991. The repository, curated and maintained by the centre on behalf of the province, is the richest data mine in Canada – in fact, one of the richest in the world – for population-based research.
Data is collected from the health-care, education, social service and justice systems every time a Manitoban comes into contact with these systems. Although the data is de-identified (anonymous), numeric codes allow each individual to be tracked across sectors and over time.
“MCHP is a leader on many fronts of data science,” Nickel says. “We have data dating back to the 1970s. We have the capacity to track the health of three, and in some cases four, generations of Manitoba families. We’re starting to use artificial intelligence to analyze data.
“We also have world-class expertise in data quality and data curation. We’re recruiting for a Canada Research Chair to take our data curation to the next level.”
Born and raised in southern California, Nickel earned his PhD in maternal and child health policy at the Gillings School of Global Public Health at the University of North Carolina. His goal was to generate research evidence that would inform public policy and lead to improved health outcomes, not sit on a shelf.
At a conference, he met the late Patricia Martens [B.Sc./72, Cert. Ed./73, M.Sc./94, PhD/99], who was the director of MCHP from 2005 to 2014. She told him that the Manitoba government regularly commissioned MCHP to do studies that went into the hands of policy-makers. In 2012, Nickel arrived at UM for postdoctoral work.
“The quality of the data, alongside that unique relationship with government, made it an irresistible opportunity,” he says.
By linking data sets, Nickel notes, researchers can generate findings that tell striking stories.
In 2019, an MCHP study that linked health status to postal codes showed that people living in Winnipeg’s Point Douglas South neighbourhood had an average life expectancy 18 years shorter than people in the nearby Inkster West neighbourhood.
“These drastic differences point to the fact that we must do better as a society to close these gaps,” says Nickel. “That’s the power of the data.”
MCHP has traditionally been funded by Manitoba Health to complete five major studies – conducted at arm’s length from government – per year. Recently, the centre and two partners have been piloting a new process: a quarterly intake of studies for government that may vary in size and scope.
The partner organizations are the George & Fay Yee Centre for Healthcare Innovation, jointly operated by UM and Shared Health, and the Manitoba arm of Supporting Older Adult Healthcare Reform Through Research, a research program focused on nursing homes.
“We’re now providing a single portal where the health-care system can access all three organizations,” Nickel says. “The intent is to foster more collaboration and be more responsive to emerging needs for research.”
Nickel’s vision for MCHP includes lending more expertise to researchers beyond Manitoba and Canada. The centre can support UM’s Institute for Global Public Health, for example, in analyzing health data in countries such as Kenya. MCHP researcher Malcolm Doupe [BPE/89, M.Sc./94, PhD/05] is collaborating with scientists in Norway on a project examining elder care.
A significant area of untapped potential, Nickel says, is for the repository data to be used by more non-health researchers, such as social scientists. Marni Brownell [PhD/91], associate director of research at MCHP, received a grant to explore how the data can be leveraged by community organizations and non-health government departments.
Other priorities at the centre are to identify and address systemic biases in data research and to contribute to the area of data sovereignty, recognizing, for example, that Indigenous communities have the right to governance over data about them.
Having worked for more than a decade at MCHP, Nickel has been gratified to see the unit’s findings spur change, including the introduction of new treatments, programs and services.
The fact that MCHP documents the lived experience of Manitobans is crucial to informing provincial policy, Nickel says.
“When we’re sitting around the table over at the Legislature, talking about trends like wait times at emergency departments, we’re not pulling information from Ontario or British Columbia. We’re saying, ‘This is here in Manitoba.’ It carries a lot more weight for decision-making.”