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Data sources for identifying low-income, uninsured populations: application to public health—National Breast and Cervical Cancer Early Detection Program

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Cancer Causes & Control Aims and scope Submit manuscript

An Erratum to this article was published on 05 May 2015

Abstract

Objective

To provide information on the sources of data for estimating low-income, uninsured populations. To recommend uses of these data sources. To demonstrate the application of these data sources in the public health field, using the National Breast and Cervical Cancer Early Detection Program as an example.

Methods

We describe U.S. Census Bureau data sources for identifying low-income, uninsured populations using two population surveys: the Annual Social and Economic Supplement to the Current Population Survey (CPS ASEC) and the American Community Survey (ACS), and using one model-based estimation program, the Small Area Health Insurance Estimates (SAHIE). We provide recommendations for use of these data sources, and we use CPS ASEC and SAHIE to estimate the percent of U.S. women eligible for the National Breast and Cervical Cancer Early Detection Program (NBCCEDP).

Results

CPS ASEC, ACS, and SAHIE are produced by the U.S. Census Bureau, and they are reliable sources for estimates of the low-income, uninsured populations in the USA. Key characteristics of these three data sources were presented to highlight the strengths of each to meet the needs of various programs at national and local levels. Recommendations are made on the use of the data sources. Based on these three data sources, estimates of NBCCEDP eligibility showed substantial variation over time at the national and state levels, and across states and counties.

Conclusions

Publicly funded programs that are directed toward low-income, uninsured individuals require information on their eligible populations to make decisions about program policy and resource allocation, and to monitor and evaluate the effectiveness of the programs. The U.S. Census Bureau produces three data sources (CPS ASEC, ACS, and SAHIE) for these estimates. The percent of U.S. women eligible for NBCCEDP varies over time and across states and counties. The data sources for these estimates are changing in order to measure key dimensions of the Affordable Care Act (ACA) and can provide helpful information for assessing the legislation’s impact.

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References

  1. U.S. Census Bureau (2014) About health insurance. [cited 2014 June 8]. http://www.census.gov/hhes/www/hlthins/about/index.html

  2. State Health Access Data Assistance Center (2012) Comparing federal government surveys that count the uninsured. http://www.shadac.org/publications/comparing-federal-government-surveys-count-uninsured

  3. Bauder M, Luery D, Szelepka S (2014) Small area estimation of health insurance coverage in 2010–2012. http://www.census.gov/did/www/sahie/methods/files/sahie_tech_2012.pdf

  4. Databases for estimating health insurance coverage for children: a workshop summary (2010) Modeling strategies for improving estimates. http://www.nap.edu/catalog/13024/databases-for-estimating-health-insurance-coverage-for-children-a-workshop

  5. U.S. Census Bureau. Small Area Health Insurance Estimates. [cited 2014 Apr 25]. http://www.census.gov/did/www/sahie/

  6. U.S. Census Bureau. DataFerrett. [cited 2014 June 18]. http://thedataweb.rm.census.gov/Products_Services/DataFerrett.html

  7. U.S. Census Bureau. American Community Survey. [cited 2014 June 18]. http://www.census.gov/acs/www/

  8. U.S. Census Bureau. CPS Table Creator. [cited 2014 June 18]. http://www.census.gov/cps/data/cpstablecreator.html

  9. U.S. Census Bureau. Microdata access. [cited 2014 Aug 21]. http://www.census.gov/hhes/www/poverty/data/microdata.html

  10. Centers for Disease Control and Prevention (CDC) National Breast and Cervical Cancer Early Detection Program [cited 2014 April 19]. http://www.cdc.gov/cancer/nbccedp/about.htm

  11. Lee NC, Wong FL, Jamison PM et al (2014) Implementation of the National Breast and Cervical Cancer Early Detection Program: the beginning. Cancer 120(Suppl 16):2540–2548

    Article  PubMed  Google Scholar 

  12. U.S. Census Bureau. Poverty thresholds. [cited 2014 July 28]. http://www.census.gov/hhes/www/poverty/data/threshld/index.html

  13. U.S. Preventive Services Task Force (2012) Screening for cervical cancer: clinical summary of U.S. Preventive Services Task Force recommendation. AHRQ Publication No. 11-05156-EF-3. http://www.uspreventiveservicestaskforce.org/uspstf11/cervcancer/cervcancersum.htm

  14. Tangka FKL, Howard D, Royalty J, Dalzell LP, O’Hara B, Miller J et al (2015) Cervical cancer screening of underserved women in the United States: Results from the National Breast and Cervical Cancer Early Detection Program, 1997–2012. Cancer Causes Control. (forthcoming, this supplement)

  15. Howard D, Tangka FKL, Royalty J, Dalzell LP, Miller J, O’Hara B, Joseph K, Kenney K, Guy G, Hall IJ (2015) Breast cancer screening of underserved women in the United States: results from the National Breast and Cervical Cancer Early Detection Program, 1998–2012. Cancer Causes & Control (forthcoming, this supplement)

  16. Centers for Disease Control and Prevention, National Health Interview Survey. Questionnaires, datasets, and related documentation 1997 to the present. 2014. [cited 2014 June 16]. http://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm#2005_NHIS

  17. Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System Survey Questionnaire. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention [2010]. [cited 2014 June 18]. http://www.cdc.gov/brfss/annual_data/pdf-ques/2010brfss.pdf

  18. U.S. Preventive Services Task Force. Screening for breast cancer. [cited 2014 Sept 21]. http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm

  19. U.S. Preventive Services Task Force. Screening for cervical cancer. [cited 2014 Sept 21]. http://www.uspreventiveservicestaskforce.org/uspstf/uspscerv.htm

  20. Tangka FKL, Dalaker J, Chattopadhyay SK, Gardner JG, Royalty J, Hall IJ, DeGroff A, Blackman DK, Coates RJ (2006) Meeting the mammography screening needs of underserved women: the performance of the National Breast and Cervical Cancer Early Detection Program in 2002–2003. Cancer Causes Control 17:1145–1154

    Article  PubMed Central  PubMed  Google Scholar 

  21. U.S. Census Bureau. Source and accuracy of estimates for income, poverty, and health insurance coverage in the United States: 2012. [cited 2014 June 19]. Released in 2013. http://www.census.gov/hhes/www/p60_245sa.pdf

  22. National Bureau of Economic Research. Information on recessions and recoveries, the NBER business cycle dating committee, and related topics. 2014. [cited 2014 June 17]. http://www.nber.org/cycles/main.html

  23. U.S. Census Bureau. Census regions and divisions of the United States [cited 2015 March 2]. https://www.census.gov/geo/maps-data/maps/pdfs/reference/us_regdiv.pdf

  24. U.S. Census Bureau, DeNavas-Walt C, Proctor BD, Smith JC (2013) Current Population Reports, P60-245, Income, poverty, and health insurance coverage in the United States: 2012. U.S. Government Printing Office, Washington, DC

  25. Medicaid.gov. State Medicaid and CHIP Policies for 2014. [cited 2014 Sept 21]. http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-State/By-State.html

  26. U.S. Department of Health & Human Services (2012) ASPE issue brief: overview of immigrants’ Eligibility for SNAP, TANF, Medicaid, and CHIP. http://aspe.hhs.gov/hsp/11/ImmigrantAccess/Eligibility/ib.shtml

  27. U.S. Census Bureau. How the Census Bureau measures poverty. [cited 2014 Sept 21]. http://www.census.gov/hhes/www/poverty/about/overview/measure.html

  28. U.S. Census Bureau. American Community Survey, Accuracy of the Data. [cited 2014 June 19]. http://www.census.gov/acs/www/data_documentation/documentation_main/

  29. Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services. Frequently asked questions related to the poverty guidelines and poverty. [cited 2015 Feb 28]. http://aspe.hhs.gov/poverty/faq.cfm#differences

  30. Thompson JH (2014) Statement by Census Bureau Director John H. Thompson on Improved Health Insurance Questions in the current population survey. http://www.census.gov/newsroom/releases/archives/directors_corner/cb14-67.html

  31. Medalia C, O’Hara B, Rodean J, Steinweg A, Brault M (2014) Changing the CPS Health Insurance Questions and the implications on the uninsured rate: redesign and production estimates. http://www.census.gov/hhes/www/hlthins/publications/sehsd_wp_2014-16.pdf

  32. Levy AR, Bruen BK, Ku L (2012) Health care reform and women’s insurance coverage for breast and cervical cancer screening. Prev Chronic Dis 9:E159

    Article  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

The U.S. Census Bureau received support for this research from the Centers for Disease Control and Prevention (IAA # 13FED1303129).

Author information

Authors and Affiliations

  1. Social, Economic and Housing Statistics Division, 6H123, U.S. Census Bureau, 4600 Silver Hill Road, Washington, DC, 20233-8500, USA

    Lucinda P. Dalzell, David S. Powers, Brett J. O’Hara & Walter Holmes

  2. Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, MS F-76, Atlanta, GA, 30341, USA

    Florence K. L. Tangka & Janet Royalty

  3. Noncommunicable Disease Unit, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, MS E-93, Atlanta, GA, 30329, USA

    Kristy Joseph

Authors
  1. Lucinda P. Dalzell
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  2. Florence K. L. Tangka
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  3. David S. Powers
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  4. Brett J. O’Hara
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  5. Walter Holmes
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  6. Kristy Joseph
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  7. Janet Royalty
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Corresponding author

Correspondence to Lucinda P. Dalzell.

Additional information

The findings and conclusions in this report are those of the authors and do not necessarily represent the official positions of the U.S. Census Bureau or of the Centers for Disease Control and Prevention.

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Dalzell, L.P., Tangka, F.K.L., Powers, D.S. et al. Data sources for identifying low-income, uninsured populations: application to public health—National Breast and Cervical Cancer Early Detection Program. Cancer Causes Control 26, 699–709 (2015). https://doi.org/10.1007/s10552-015-0571-y

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  • DOI: https://doi.org/10.1007/s10552-015-0571-y

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