
ZIP Code-Level Estimates from a Local Health Survey: Added Value and Limitations
Author(s) -
Qifang Bi,
Fangtao He,
Kevin J. Konty,
L. Hannah Gould,
Stephen Immerwahr,
Amber Leva Seligson
Publication year - 2020
Publication title -
journal of urban health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.211
H-Index - 92
eISSN - 1468-2869
pISSN - 1099-3460
DOI - 10.1007/s11524-020-00423-z
Subject(s) - zip code , statistics , geography , econometrics , ultra high frequency , mathematics , computer science , cartography , telecommunications
We assessed the added value and limitations of generating directly estimated ZIP Code-level estimates by aggregating 5 years of data from an annual cross-sectional survey, the New York City Community Health Survey (n = 44,886) from 2009 to 2013, that were designed to provide reliable estimates only of larger geographies. Survey weights generated directly-observed ZIP Code (n = 128) level estimates. We assessed the heterogeneity of ZIP Code-level estimates within coarser United Hospital Fund (UHF) neighborhood areas (n = 34) by using the Rao-Scott Chi-Square test and one-way ANOVA. Orthogonal linear contrasts assessed whether there were linear trends at the UHF level from 2009 to 2013. 22 of 37 health indicators were reliable in over 50% of ZIP Codes. 14 of the 22 variables showed heterogeneity in ≥4 UHFs. Variables for drinking, nutrition, and HIV testing showed heterogeneity in the most UHFs (9-24 UHFs). In half of the 32 UHFs, >20% variables had within-UHF heterogeneity. Flu vaccination and sugary beverage consumption showed significant time trends in the largest number of UHFs (12 or more UHFs). Overall, heterogeneity of ZIP Code-level estimates suggests that there is value in aggregating 5 years of data to make direct small area estimates.