Using the American Community Survey Public Use Microdata Sample with GIS to Target Health Services for Children

The US Census Bureau's American Community Survey (ACS) Public Use Microdata Sample (PUMS) is an underused source of data when planning public health services and interventions. These population data provide the most current demographic and socio-economic information. In 2008, the PUMS also began to include information about health insurance status. In densely populated areas, these data can be used at sub-county and neighborhood levels, when aggregated using Public Use Microdata Areas (PUMA). The Memorial-Herman Healthcare System's Community Benefit Corporation recently began to develop a long-term plan to provide health services to uninsured children in the Houston, Texas, metropolitan area. The plan requires reasonable estimates of, not only uninsured children, but also how many children have Medicaid or CHIP, how many are uninsured but eligible, and how many are uninsured but not eligible, due to either citizenship status or household income. It is also important to have these data at neighborhood levels in order to best utilize available resources. The ACS PUMS (2008 and 2006-08 combined files) are being used to provide this information at the small area levels required. Moreover, as part of the planning process, these data are being used with capacity data from more than 50 safety net providers of children's health services to determine the most underserved areas. To do this, providers are geocoded within a GIS application environment; and, estimated needs and current capacities are spatially analyzed. Areas showing the greatest differences between needs and capacities will become priority targets for new services.