Joyce C. Pressley, PhD, MPH, Center for the Health of Urban Minorities and the Departments of Health Policy and Management and Epidemiology, Columbia University, 722 W. 168th Street, Room 17-12, New York, NY 10032, 212-342-0421, jp376@columbia.edu

Background: Investigations of injury-related health disparities requires consideration of individual and neighborhood/environmental factors. Frequently used in injury surveillance, statewide hospital discharge and vital statistics data provide individual level variables, but little information on neighborhood/environment. Although a wealth of information is collected through Census efforts, this data is not being used to its full potential to further injury-related disparities research.

Methods. This study explored the feasibility, technical accessibility, and epidemiologic advantages of obtaining environmental and neighborhood variables by Zip Code Tabulated Area (ZCTA) from U.S. Census data files and using these to create multilevel data sets with administratively collected injury data. Relevant variables from 25 of 76 New York State 2000 Census files were extracted and merged with zip code level hospital discharge data to provide a multi-level dataset containing individual and community level variables suitable for mapping and multivariable logistic regression analyses.

Results. Multi-level data facilitated development of multi-layered maps to visually display patterns of injury layered on relevant neighborhood characteristics. The relation between several major injury mechanisms, neighborhood characteristics and environmental “exposure” variables were investigated. State hospital discharge data provided individual level data with race/ethnicity, insurance, injury mechanisms and diagnoses with census contributing not otherwise available neighborhood characteristics including housing features, heating sources, transportation, family structure, urban/rural/central city residence, linguistic isolation, education, income, public assistance, and an expanded range of socioeconomic variables.

Conclusion. This study demonstrates the feasibility, technical accessibility, and epidemiological advantages of combining neighborhood level census and individual level discharge data to conduct multi-level injury disparities research.

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