Using the American Community Survey for Public Health Assessment Ann Glusker Public Health- Seattle & King County NACDD Academy SDOH Session, 3/26/09

Pluses and Minuses of the ACS... Yearly release-- fast data processing By 2011, available for small areas Detailed analyses possible... BUT: Sample size/Error issues Rolling averages for smaller areas Coverage issues

Using Census Data for Public Health: Perform GIS functions Conduct Spatial Analysis Calculate risk of disease Create Community profile Design Intervention & Prevention Programs Locate High-risk Populations (from: “Where the People Are: Using Census Data for Health Preparedness”, Jane L. Garb)

Using Census Data for Public Health: continued Perform GIS functions (using TIGER files): Geocoding Data Aggregation Polygon overlay Calculating Risk: Disease Rates Risk of disease Health data – numerators Census data – denominators (CAUTION WITH ACS!) Geographic distribution of disease risk Create a Community Profile: Identify factors in disease Tracts, blocks, neighborhoods, are units of analysis Disease rates compared for geographic units Relationship of census characteristics to disease distribution Accounts for spatial proximity (from: “Where the People Are: Using Census Data for Health Preparedness”, Jane L. Garb)

ACS Data variables for persons: Gender Age Relationship to householder Marital status *Race and Hispanic/Latino Ethnicity *Place of birth, Native- vs. Foreign-Born Citizenship and Year of entry *School enrollment and Educational attainment Ancestry *Language spoken at home and Language Ability Residence one year ago Children born in the past 12 months Grandparents as caregivers * Represents most-used variables at PHSKC *Disability Veteran status Labor force Place of work Journey to work Work status last week Class of worker Industry Occupation *Income *Sources of Income *Poverty Level And, from 2008 on, health insurance, veteran service- related disability, and marital history!

ACS Data variables for households: *Units in structure *Year structure built Year household moved in Number of rooms *Occupants/room Bedrooms Plumbing Kitchen Telephone Vehicles Heating fuel Cost of utilities *Tenure Vacancies *Rent/Gross Rent as a % of Household Income Value Real estate taxes *Mortgage/ Monthly Owner Costs

Cautions... Not intended for population estimation! See census bureau site for estimates, and/or apply proportions to reliable estimates Be sure to report proportions with margin of error; numerous resources exist to help with those calculations Here’s a good one: alCalculationsMenu.xls

Scenario (this section is part of a presentation created by the U.S. Census Bureau) 8

A health care administrator in Missouri asks: Where can I get detailed information about income-to- poverty ratios for children in Missouri by their living arrangements and the nativity of their parents? 9

Detailed Tables Best source for advanced data users or those who want access to the most detailed ACS tables Detailed Tables are also available for download through the ACS FTP site (www2.census.gov/) Missing cells due to sample size restrictions 10

Sample Detailed Table Source: 11

Geographic Components Option Source: 12

List of Geographic Components Urban Rural In metropolitan or micropolitan statistical area Not in metropolitan or micropolitan statistical area In metropolitan statistical area In metropolitan statistical area – in principal city In metropolitan statistical area – not in principal city Not in metropolitan statistical area In micropolitan statistical area In micropolitan statistical area – in principal city In micropolitan statistical area – not in principal city Components only available for the national-level data profiles: American Indian reservation and trust land – Federal Tribe Oklahoma Tribal Statistical Area Tribal Designated Statistical Area Alaska Native Village Statistical Area State Designated American Indian Statistical Area 13

Geographic Components Option 14 Source:

Geographic Components Option Source: 15

Saving/Loading Queries Source:

Downloading Data 17 Source:

Time to get creative If you can use PUMAS (counties/cities with 100,000+ pop.), think about using the ACS 1% PUMS data Flexibility! But small sample sizes. Resource: University of Minnesota's IPUMS lets you create downloads interactively:

Compare ACS with other data sources 2000 long form data (see resources in handout) Local school district data Local/state population estimates Other national survey data such as Current Population Survey, BRFSS Vital Statistics data (for fertility)

Combine ACS with other data sources (easier after 2011) Springfield, MA example in handout Late stage breast cancer exploration ACS for demographic and social indicators (SES, race/ethnicity, housing, transportation, age distribution) Police department for local geography, plus planning department, health department and Baystate Medical Center

Check out resources... Examples of others' projects User handbook from census bureau Guide to using ACS for disability stats from Cornell University MacDonald's “warm and fuzzy” article And why not examine the questionnaires and develop your own analytical questions??? (you could use PUMS if a table is not available directly on census site)

MANY THANKS TO: Linda Clark, U.S. Census Bureau Diana Canzoneri, City of Seattle Eva Wong, Public Health-Seattle & King County Ann Glusker Public Health- Seattle & King County