Small-Area Estimation of U.S. Health Disparities

• Activity Number: 562
• Type: Topic Contributed
• Date/Time: Wednesday, August 4, 2010 : 2:00 PM to 3:50 PM
• Sponsor: Biometrics Section
• Author(s): Tanja Srebotniak*+ and Christopher J.L. Murray and Ali Mokdad and Rafael Lozano
• Companies: Ecologic Institute and Institute for Health Metrics and Evaluation and Institute for Health Metrics and Evaluation and Institute for Health Metrics and Evaluation
• Keywords: small area estimation ; generalized linear mixed model ; predictive validity ; diabetes ; insurance

Abstract

Health disparities in the United States have been the subject of extensive critical scrutiny and analysis. Inequalities in insurance coverage, health-care access and utilization, and quality of care have also been investigated. For example, data from the Behavioral Risk Factor Surveillance System (BRFSS), a large state-based surveillance system, shows a wide disparity in health risk factors at state and county levels. In this project, we develop an integrated and robust small area modeling approach that combines the strategies of using data for multiple years, geospatial relatedness, and unit- and area-level covariates. Predictive validity metrics show that our framework is superior to using direct, single-year survey estimates. We present results for selected health outcomes and risk factors.