Census Bureau Data on the Social Determinants of Health

Jennifer Cheeseman Day, Ph.D.Assistant Division Chief

Social, Economic, and Housing Statistics DivisionU.S. Census Bureau

Knowledge 4 Equity Conference November 13, 2012

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Census Bureau Data on Social Determinants of Health

• Age• Ancestry• Commuting patterns

(distance/time) • Disability• Educational attainment• Employer type (industry, class of

work)• Employment status• Fertility• Food stamps receipt• Household and family

composition

• Housing value• Income and earnings amounts• Labor force status• Language spoken and English

ability• Marital status• Mobility• Nativity status/citizenship• Number of children• Other income sources• Perceived Health status• Poverty• Race and ethnicity

• School enrollment• Sex• Transportation to work• Type of work (occupation)• Veterans Disability• Veterans status• Wealth• Well-being: basic needs,

consumer durables, ability to get help, food security, fear of crime

Physical Determinants of HealthHousing

Age of housingPlumbingHeatingHousing cost (monthly)Housing conditions

Health care servicesAccessabilityHealth Care Workers

Number of medical personnelAvailability of medical offices/hospitalsTypes of medical

Utilization of health services

Health care costs and financingHealth insurance (Insured/not)Types of health insuranceSpells of health insuranceEmployer health insurance take-upReasons not coveredOut-of-pocket spending (MOOP)Family Care

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Which source best fits your needs?

• Decennial Census, Population Estimates• American Community Survey• Current Population Survey• Survey of Income and Program Participation• Small Area Poverty and Health Insurance

Estimates (SAIPE, SAHIE)• Economic Business data

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Content and Geography People Businesses

Decennial Census & Estimates

American Community

Survey

Current Population

Survey

Survey of Income and

Program Participation

Small Area Poverty and

Health Insurance Estimates

Economic business

data

(ACS) (CPS-ASEC) (SIPP) (Modeled) Demographics Age X X X X X Sex X X X X X Race/ethnicity X X X X X Geography Nation/Region X X X X X X State X X X X X X Substate X X X X Worksite X X

Sample Census3 million

addresses100,000

addresses 94,000 people modeled Business register

                       

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Census 2010 Demographics Across Geographies

• Number of people • Where they live• Age• Sex• Race• Hispanic origin

• Relationship in household• Rent or own home

http://2010.census.gov/2010census/

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Population Estimates

Level of Geography Level of Detail

Nation Total population  Population by age, sex, race, and Hispanic originStates Total population  Population by age, sex, race, and Hispanic originCounties Total population  Population by age, sex, race, and Hispanic origin

Cities and Towns (Incorporated Places and Minor Civil Divisions) Total population

Metropolitan and Micropolitan Statistical Areas Total populationPuerto Rico Commonwealth Total population  Population by age and sexPuerto Rico Municipios Total population  Population by age and sexHousing Units Total    

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Population Estimates and Projections

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American Community Survey: Content

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Data Products Release Schedule

Data Product Population Size Data released in: of Area 2006 2007 2008 2009 2010 2011 2012 2013

1-Year Estimates 65,000+ 2005 2006 2007 2008 2009 2010 2011 2012for Data Collected in:

3-Year Estimates 20,000+ 2005-2007 2006-2008 2007-2009 2008-2010 2009-2011 2010-2012for Data Collected in:

5-Year Estimates All Areas* 2005-2009 2006-2010 2007-2011 2008-2012for Data Collected in:

* Five-year estimates are available for areas as small as census tracts and block groups.

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Current Population SurveyAnnual Social and Economic Supplement

• Official Poverty Rate• Detailed income sources and

amounts• Health insurance and type• Medical Out-of-Pocket expenses• Health Status• Labor force detail• Household/family relationships

(parent pointers)• Two year averages for states• Historical

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Survey of Income and Program Participation

• Cross-sectional and longitudinal

• Transitions, churning• Core and Topical Module

questions• Focus on low-income• 3, 4, and 5 year panels, since

1984• Follows people when they

move• National level primarily, state• Current panel started 2008• Re-designed SIPP 2014

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SIPP Core Content

• Demographics• Labor Force• General Income• Assets• Health Insurance• Education• Program participation

Health Status, Health Insurance, And Medical Services Utilization: 2010

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2008 SIPP Topical Modules • Adult Well-being• Annual Income and Retirement Accounts• Assets and Liabilities• Child Care• Child Support Agreements• Child Well-Being• Economic Stimulus Questions • Education and Training History• Employer-Provided Health Benefits• Employment History• Fertility History• Functional Limitations and Disability• Household Relationships• Informal Care-giving• Int Accts, Stocks, Mortg, Val of Bus,

Rental

• Marital History• Medical Expenses/Utilization of Health

Care Migration History• Poverty (Work-related Expenses/Child

Support Paid)• Real Estate, Dependent Care, and

Vehicles• Recipiency History• Retirement and Pension Plan Coverage • Support for Non-household Members• Tax Rebates • Taxes• Welfare Reform• Work Disability History• Work Schedule

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Small Area Income and Poverty Estimates (SAIPE)

States & counties School districts

all people in poverty total population

children under age 18 in poverty

children ages 5 to 17

related children ages 5 to 17 in families in poverty

related children ages 5 to 17 in families in poverty

children under age 5 in poverty (for states only)

median household income

Modeled Poverty Estimates

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Small AreaHealth Insurance Estimates

For States and Counties:

• Age groups: 0-64, 18-64, 40-64, 50-64• Sex• Race:

– White alone (non-Hispanic), – Black alone (non- Hispanic),– Hispanic (any race)

• Income:– less than or equal to: 138, 200, 250,

400 percent of poverty threshold

• For Children (0-18):– less than or equal to: 138, 200, 250,

400 percent of poverty threshold

Modeled Health Insurance Estimates of Insured/Not insured

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Subnational Economic Data Sources About Businesses and Governments

http://www.census.gov/econ/progoverview.html#services

Program nameMetro areas Counties Cities 1

Zip codes

Latest data Content

Economic Census X X X X 2007 Sales, employment, payroll for establishments

Survey of Business Owners X X X 2007

Sales, employment, payroll for firms by sex and ethnicity of owner

Statistics of U.S. Businesses X X 2009 Employment and payroll for firms by employment size

Statistics of U.S. Businesses X X 2009

Births, deaths, expansions, contractions for establishments

County Business Patterns X X 2010

Employment and payroll for establishments; employment size

ZIP Code Business Patterns X 2010 Establishments by employment size by detailed industry

Nonemployer Statistics X X 2010 Receipts for establishments with no paid employees

Local Employment Dynamics X X 2011

Quarterly employment, job creation, earnings by age, sex & sector

Building Permits X X X 2012 Number of housing units authorized by building permits by size

Governments X X X 2010 Federal, state, and local governments and activities

NAICS Industry Code: 62 Health Care and Social Assistance

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County Business Patterns

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Custom Tabs with Health-Related Occupations and Industries

• EEO File– Detailed geography (Nation, States, CBSAs, counties/county sets,

places)– Civilian population 16 and older– Residence and worksite tables– Occupation, race/ethnicity, sex, education, earnings, industry,

citizenship– Sourced from 2006-2010 ACS 5-year data– Release: November 29, 2012 on American FactFinder

• Disability File– Selected tables from EEO file by disability (no industries)– Sourced from 2008-2010 ACS 3-year data– Planned release: Spring 2013 on American FactFinder

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How to access these data?

• Reports and Papers Subject Census web page Survey Census Web page: ACS, SIPP, CPS Working papers and conference papers http://

www.census.gov/prod/www/workpaps.html

• Tables and Table packages Subject Area Census web page American FactFinder (AFF)

• Unit Record Data -- PUMS files for ACS, SIPP, CPS DataFerret CPS Table Generator

WWW.CENSUS.GOV

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For more informationwww.census.gov

Jennifer Cheeseman DayAssistant Division Chief for Employment CharacteristicsSocial, Economic, and Housing Statistics Division

Jennifer.Cheeseman.Day@Census.gov301-763-3399

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Additional slides

Industry and Occupation

ACS

SIPP

CPS

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Industry

Occupation

Write-ins, codedSOC / NAICS

Supply of health care workers

Occupational illness

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Disability QuestionsACSCPSSIPP

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Veterans: Service Connected Disability

Has no service-connected disability rating

Has a service-connected disability rating:

0.010.020.030.040.050.060.070.080.090.0

100.0

Service Connected Disability Among Veterans: 2011

0 percent

10 or 20 percent

30 or 40 percent

50 or 60 percent

70 percent or higher

Rating not reported

0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0

Disability Rating Among Veterans with a Service Connected Disability

ACS

CPS

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American Community Survey: Health Insurance

Health Insurance by type, small geography

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Medical Out Of Pocket ExpensesDuring 2011, about how much did (name/you) pay for health insurance premiums for (yourself/himself/herself) or others in the household, after any reimbursements? Please include premiums paid for HMOs, Fee for Service Plans, Commercial Medicare Supplements, or other special purpose plans,such as vision or dental plans. Include prescription drug insurance such as medicare Part D premiums,and Medicare Advantage premiums. DO NOT include Medicare Part B premiums.Enter dollar amount ________________

During 2011, about how much was paid for (name/you) for over-the-counter health related products such as aspirin, cold remedies, bandages, first aid supplies, and other items? Include any amount paid on (your/his/her) behalf by anyone in this household, that was not reimbursed.Enter dollar amount________________

Aside from over-the-counter items, during 2011, about how much was paid for (name's/your) own medical care, including payments and co-payments for hospital visits, medical providers, dental services, prescription medicine, vision aids, and medical supplies? Include any amount paid on (your/his/her) behalf by anyone in this household, that was not reimbursed.Enter dollar amount ________________

CPS, new in 2010SIPP

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Work Interruption for Family Care

25 percent of employed women have taken an extended break from work of 6 months or longer to care for family members.

Care for disabled relative

Care for elder relative

Care for child

1.5%

3.8%

94.7%

Type of Family Care(Percent distribution of employed women who had work interruption for family care)

Men

Women

6.9%

93.1%

Sex of Caregivers(Percent distribution of employed workers who had work interruption for family care)

Note: Among workers aged 25 to 62.Source: Survey of Income Program Participation, 2004 Panel, Wave 1.

SIPP

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Registered nurses

Physicians and surgeons

Health practitioner support technologists and technicians

Clinical laboratory technologists and technicians

Pharmacists

Emergency medical technicians and paramedics

Dentists

Physician assistants

Healthcare support workers, all other, including medical equipment preparers

Respiratory therapists

Speech-language pathologists

Phlebotomists

Dental hygienists

Veterinarians

Medical transcriptionists

Chiropractors

Optometrists

Veterinary assistants and laboratory animal caretakers

Audiologists

Radiation therapists

Recreational therapists

Nurse midwives

0 500,000 1,000,000 1,500,000 2,000,000

Health care occupations

Source: American Community Survey, 2011.

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Geography of ACS

New