Census Bureau Data on the Social Determinants of

Census Bureau Data on the Social Determinants of

Census Bureau Data on the Social Determinants of Health Jennifer Cheeseman Day, Ph.D. Assistant Division Chief Social, Economic, and Housing Statistics Division U.S. Census Bureau Knowledge 4 Equity Conference November 13, 2012 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 Physical Determinants of Health Housing Age of housing Plumbing Heating Housing cost (monthly) Housing conditions 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 Health care costs and financing Health insurance (Insured/not) Types of health insurance Spells of health insurance Employer health insurance take-up Reasons not covered Out-of-pocket spending (MOOP) Family Care 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 Health care services Accessability Health Care Workers Number of medical personnel Availability of medical offices/hospitals Types of medical Utilization of health services 2 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 3 Content and Geography People

Businesses Small Area Survey of Poverty and Income and Health Program Insurance Participation Estimates (SIPP) (Modeled) Decennial Census & Estimates American Community Survey (ACS) Current Population Survey (CPS-ASEC) Demographics Age Sex Race/ethnicity X

X X X X X X X X X X X X X X Geography Nation/Region State Substate X X X X X X X

X X X X X X Worksite Sample X Census 3 million addresses Economic business data X X X X 100,000 addresses 94,000 people modeled

Business register 4 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/ 5 Population Estimates Level of Geography Level of Detail Nation

Total population Population by age, sex, race, and Hispanic origin Total population Population by age, sex, race, and Hispanic origin Total population Population by age, sex, race, and Hispanic origin States Counties Cities and Towns (Incorporated Places and Minor Civil Divisions) Metropolitan and Micropolitan Statistical Areas Puerto Rico Commonwealth Puerto Rico Municipios Housing Units Total population Total population Total population Population by age and sex Total population Population by age and sex Total 6 Population Estimates and Projections 7 American Community Survey: Content

8 Data Products Release Schedule Data Product Population Size of Area 2006 1-Year Estimates for Data Collected in: 65,000+ 3-Year Estimates for Data Collected in: 20,000+ 5-Year Estimates for Data Collected in: All Areas* 2005 2007 2008 Data released in: 2009 2010

2006 2007 2008 2009 2011 2012 2013 2010 2011 2012 2005-2007 2006-2008 2007-2009 2008-2010 2009-2011 2010-2012 2005-2009 2006-2010 2007-2011 2008-2012 * Five-year estimates are available for areas as small as census tracts and block groups. 9 9 Current Population Survey Annual 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 10 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 11 SIPP Core Content

Demographics Labor Force General Income Assets Health Insurance Education Program participation Health Status, Health Insurance, And Medical Services Utilization: 2010 12 2008 SIPP Topical Modules Adult Well-being Annual Income and Retirement Accounts Int Accts, Stocks, Mortg, Val of Bus, Rental

Marital History Assets and Liabilities Child Care Medical Expenses/Utilization of Health Care Migration History Child Support Agreements Poverty (Work-related Expenses/Child Support Paid) Child Well-Being

Economic Stimulus Questions Real Estate, Dependent Care, and Vehicles Education and Training History Recipiency History Employer-Provided Health Benefits Employment History Retirement and Pension Plan Coverage Fertility History

Support for Non-household Members Functional Limitations and Disability Tax Rebates Household Relationships Taxes 13 Small Area Income and Poverty Estimates (SAIPE) Modeled Poverty Estimates 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 related children ages 5 to 17 in families in poverty families in poverty children under age 5 in poverty (for states only) median household income 14 Small Area Health Insurance Estimates Modeled Health Insurance Estimates of Insured/Not insured 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 15 Subnational Economic Data Sources About Businesses and Governments Program name Metro Zip Latest areas Counties Cities 1 codes data Content Economic Census Survey of Business Owners Statistics of U.S. Businesses Statistics of U.S. Businesses County Business Patterns ZIP Code Business Patterns Nonemployer Statistics Local Employment Dynamics X

X X X X X X Building Permits X 2007 Sales, employment, payroll for establishments 2007 Sales, employment, payroll for firms by sex and ethnicity of owner X 2009 Employment and payroll for firms by employment size X

X 2009 Births, deaths, expansions, contractions for establishments X X 2010 Employment and payroll for establishments; employment size 2010 Establishments by employment size by detailed industry Receipts for establishments with no paid employees X X X 2010 X X

2011 X X X 2012 Quarterly employment, job creation, earnings by age, sex & sector Number of housing units authorized by building permits by size X X X 2010 Federal, state, and local governments and activities http://www.census.gov/econ/progoverview.html#services Governments NAICS Industry Code: 62 Health Care and Social Assistance 16

County Business Patterns 17 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 18 How to access these data? WWW.CENSUS.GOV 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 19 For more information www.census.gov Jennifer Cheeseman Day Assistant Division Chief for Employment Characteristics Social, Economic, and Housing Statistics Division [email protected] 301-763-3399 20 Additional slides 21 Supply of health care workers Occupational illness

Industry Industry and Occupation Occupation ACS SIPP CPS Write-ins, coded SOC / NAICS 22 Disability Questions ACS CPS SIPP 23 Veterans: Service Connected Disability Service Connected Disability Among Veterans: 2011 100.0 80.0 60.0 40.0 20.0 0.0

Disability Rating Among Veterans with a Service Connected Disability ACS CPS Rating not reported 70 percent or higher 50 or 60 percent 30 or 40 percent 10 or 20 percent 0 percent 0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 24 American Community Survey: Health Insurance Health Insurance by type, small geography 25 Medical Out Of Pocket Expenses During 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-thecounter 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 copayments 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 2010 SIPP 26 Work Interruption for Family Care Sex of Caregivers (Percent distribution of employed workers who had work interruption for family care) W 25 percent of employed women have taken an extended break from work of 6 months or longer to care for family members. Men

93.1% 6.9% Type of Family Care (Percent distribution of employed women who had work interruption for family care) Care for c... 94.7% Care for elder rela... 3.8% SIPP Care for disabled rela... 1.5% Note: Among workers aged 25 to 62. Source: Survey of Income Program Participation, 2004 Panel, Wave 27 1. Nurse midwives Podiatrists Recreational therapists Occupational therapy assistants and aides Radiation therapists Health diagnosing and treating practitioners, all other Audiologists Nurse anesthetists Veterinary assistants and laboratory animal caretakers Pharmacy aides

Optometrists Opticians, dispensing Chiropractors Physical therapist assistants and aides Medical transcriptionists Massage therapists Veterinarians Occupational therapists Dental hygienists Dietitians and nutritionists Phlebotomists Nurse practitioners Speech-language pathologists Other healthcare practitioners and technical occupations Respiratory therapists Medical records and health information technicians Healthcare support workers, all other, including medical equipment preparers Miscellaneous health technologists and technicians Physician assistants Miscellaneous therapists, including exercise physiologists Dentists Physical therapists Emergency medical technicians and paramedics Dental assistants Pharmacists Diagnostic related technologists and technicians Clinical laboratory technologists and technicians Medical assistants Health practitioner support technologists and technicians Licensed practical and licensed vocational nurses Physicians and surgeons Nursing, psychiatric, and home health aides Registered nurses

0 Health care occupations 500,000 1,000,000 1,500,000 2,000,000 Source: American Community Survey, 2011. 28 Geography of ACS New 29

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