Benefits, Burdens, and Prospects of the American Community Survey Summary of a Workshop (2013) / Chapter Skim
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2 Planning Health Care and Transportation Using the ACS
2 Planning Health Care and Transportation Using the ACS
Pages 11-34
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From page 11... ...
As a single session in a short-duration workshop, the presentations in this session only scratch the surface of the applications of the American Community Survey (ACS) data in these topic areas; in particular, the workshop treatment necessarily understates the great attention that has been given to the utility of ACS products in the transportation arena, in which the survey's information on journeys between work and home is vital to infrastructure planning.1 But the presentations in the session combine some specific applications of the data with some more general "framework" discussions outlining the analytic process in which the data may be brought to bear to solve important problems.
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From page 12... ...
SHADAC projects typically involve assessing health care coverage -- both access to health care services and health insurance coverage. Call suggested that states need good data on health care coverage because policy decisions concerning health care have become major (if not dominant)
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From page 13... ...
3 The Census Bureau is the data collection agent for the National Health Interview Survey (as well as the ACS) , though the survey is sponsored and organized by the National Center for Health Statistics.
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From page 14... ...
The ACS version of the question -- "Is this person CURRENTLY covered by any of the following types of health insurance or health coverage plans? " -- emphasizes current coverage; it permits yes/no answers to seven types of insurance coverage, plus a write-in category.5 However, there is a new interpretation challenge presented by ACS estimates -- explaining, for instance, what an estimate of current health insurance coverage means in an average computed over 1, 3, or 5 years of data.
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From page 15... ...
PLANNING HEALTH CARE AND TRANSPORTATION USING THE ACS 15 American Community Survey Current Population Survey Figure 2-1 Estimated percent of uninsured persons, age 0–64 and at or below 200 percent of the poverty level, in West Virginia, derived from the American Community Survey and the Current Population Survey SOURCE: Workshop presentation by Kathleen Thiede Call, based on data from 2010 American Community Survey and 2011 Current Population Survey (which covers calendar year 2010)
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From page 16... ...
The data center site -- accessible at http://www.shadac.org/datacenter -- acts as a table and chart generator using both ACS and CPS data, enhanced to describe health insurance units (as 6 See http://aspe.hhs.gov/poverty/12poverty.shtml for further description of the distinction between the thresholds and the guidelines, and their 2012 versions. 7 As of September 2012, the American FactFinder interface was modified to directly add a 138 percent-of-poverty-threshold tabulation.
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From page 17... ...
Like the Census Bureau's American FactFinder interface, SHADAC believes it important to present both estimates and standard errors overtly, so that users can assess differences across population and demographic groups of interest. Call closed by noting her concerns about the possibility of reductions in effective ACS sample size and generalizability that she said would occur if the survey were made voluntary; she said that such an outcome could greatly impair the representativeness of the data and the states' ability to benchmark and to look directly at some subpopulations of interest within state boundaries.
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From page 18... ...
, a telephone-only cross-sectional survey of approximately 10,000 adults within the city that is administered by the DOHMH Bureau of Epidemiology Services each year. In its administration and content, the CHS is patterned after the Behavioral Risk Factor Surveillance System (BRFSS)
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From page 19... ...
about 40 districts that are finer than whole boroughs but larger than individual ZIP Codes. DOHMH anticipates updating these analyses using ACS data, with interest in comparison with similarly defined areas/districts throughout the nation; technically, one question with which they are grappling is the appropriate variety of ACS estimates to use (3- or 5-year estimates)
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From page 20... ...
2–C FRAMEWORK FOR ACS- AND DATA-BASED HEALTH CARE PLANNING Speaking from decades of experience as an independent consultant, instructor, and author -- as he put it, mostly in the area of health care and always with a heavy infusion of census data -- Rick Thomas (Center for Population Studies, University of Mississippi and Health and Performance Resources, Memphis, Tennessee) framed his presentation as an outline of general approaches to using the ACS in the health care area.
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From page 21... ...
, and pulling the ACS information that is most relevant to the specific subpopulation. Finally, as noted earlier by Call and Stark, there are a few questions on the ACS that speak directly to health issues -- for instance, disability and health insurance coverage, as well as insights that can be drawn related to fertility.
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From page 22... ...
In some situations, Thomas said that he might incorporate other variables, to get a sense of transportation access, geographic mobility, or primary language spoken at home. • Screen population for eligibility: Federally qualified health centers have to demonstrate certain criteria within their target population in order to qualify for funding from the U.S.
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From page 23... ...
Other NCHS data such as the National Ambulatory Medical Care Survey, the new National Hospital Care Survey, and its predecessor National Hospital Discharge Survey are coded to the same breakdown of four census regions; these surveys would be used to estimate utilization levels, as discussed below.
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From page 24... ...
There are already many health insurance companies and -- under the PPACA's health care exchanges -- there will now be tens of millions of individuals potentially choosing a health care insurance carrier. Accordingly, the insurance providers are going to be increasingly interested in profiling their potential customers, and developing strategies to identify and engage them.
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From page 25... ...
. In addition to serving as the San Diego region's designated census data center, SANDAG focuses on issues of major regional impact such as air quality/environmental planning, housing development -- and transportation planning.
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From page 26... ...
These underlying demographic and economic forecasts of the basic composition of the population are further scrutinized in what Jarosz described as subregional or "neighborhood"-level forecasts -- drilling into finer geographic detail than the region as a whole, and attempting to predict how the population and characteristics will be distributed spatially over time. The next step is application of a synthetic population model -- the basic idea of which is to simulate actions by all actors in the transportation network and model how they will travel through the system.
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From page 27... ...
The synthetic population model typically draws from analysis of ACS PUMS data, while the activity based transportation model draws from special tabulations of data that the Census Bureau distributes as part of the Census Transportation Planning Package (CTPP) .13 CTPP tabulations are coded to the special level of geography typically used by transportation planners: Traffic Analysis Zones (TAZs)
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From page 28... ...
2–E MEETING LANGUAGE IMPLEMENTATION REQUIREMENTS IN PUBLIC TRANSIT IN HARRIS COUNTY, TEXAS In her presentation, Jarosz briefly mentioned the important use of ACS data in establishing compliance with federal, state, and local law and guidelines on environmental justice, social equity, and public access to services. This theme was carried forward by Vincent Sanders, lead transportation systems planner for the Metropolitan Transit Authority of Harris County, Texas (hereafter, METRO)
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From page 29... ...
-- an important funding source for transit agencies like METRO -- slightly adjusted its requirements for documenting Title VI compliance. Specifically, as summarized in Box 2-2, the new guidance to FTA fund recipients called for creation and maintenance of a language implementation plan for the relevant service population's limited English proficiency (LEP)
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From page 30... ...
and five smaller school districts serving part of the METRO service population. The school district data permitted Houston to create a map of its transit hubs and network structure, 14 As implied by the agency's full name, METRO's service population is principally in Harris County; however, Sanders noted that the agency's service population spreads over slightly into neighboring Fort Bend, Montgomery, and Waller Counties.
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From page 31... ...
updated previous guidelines issued in 1988. The new circular reinforced a triennial Title VI compliance reporting process for most FTA recipients (except for some metropolitan planning organizations, which are on a 4-year reporting process; p.
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From page 32... ...
Sanders answered that METRO was generally pleased with the coverage of the data it assembled from school districts; he has done some direct comparison of the school district data with ACS tabulations and noted that the agency's early work with the school district numbers had yielded surprises and directions for future work. However, METRO is sufficiently comfortable with and confident about the ACS as a consistent source of data for areas and groups within its whole service population that it does not plan to repeat the school district collection.
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From page 33... ...
followed this general thread of calibration between the ACS and the decennial census, asking the Census Bureau staff in the room about the shock in the 1- and 3-year estimates caused by the changing population base used to weight the user survey. To construct ACS estimates, the survey data must be weighted based on population controls that -- until a new decennial census takes place -- are based on the Census Bureau's population estimates program, essentially updating population counts every year between the censuses.
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From page 34... ...
. Hence, the Census Bureau periodically constructs ZIP Code tabulation areas to approximate the delivery areas of 5digit ZIP Codes.
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