Online Program

Small-area estimation on current asthma prevalence among adults in Massachusetts using BRFSS survey data

Monday, November 4, 2013 : 9:10 a.m. - 9:30 a.m.

Jing Guo, PhD, Bureau of Community Health and Prevention, Massachusetts Department of Public Health, Boston, MA
Thomas Land, PhD, Bureau of Community Health and Prevention, Massachusetts Department of Public Health, Boston, MA
Jean M. Zotter, JD, The Medical Foundation, Boston Urban Asthma Coalition, Dorchester, MA
Xingyou Zhang, PhD, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA
Erica Marshall, MPH, Bureau of Community Health and Prevention, Massachusetts Department of Public Health, Boston, MA
Wenjun Li, PhD, Health Statistics and Geography Lab, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA
Background: Asthma is a significant public health problem in the United States, affecting over 25 million people. The adult asthma prevalence in Massachusetts (MA), among the highest in the U.S, increased from 8.5% in 2000 to 10.7% in 2011. However, municipality-level asthma prevalence estimates for adults are not usually available. Using model based approaches, estimates of adult asthma using MA BRFSS data were computed for 351 MA municipalities. These estimates can be used to guide the allocation of scarce public health resources.

Methods: We developed a multilevel, mixed-effect logistic regression model to estimate and compare municipality level of asthma prevalence among adults using pooled 2008, 2009 and 2010 MA BRFSS survey data, other related administrative data, and 2010 American Community Survey population estimates. The analytic sample included more than 52,000 respondents with an average age of 54 years, 63% women, 17% racial/ethnic minorities, 63% college educated, and 66% household income less than $75,000. Municipality-level estimates were derived based on the model and according to socio-demographic composition and municipality characteristics.

Results: The three-year average annual state asthma prevalence estimate is 10.8%. The municipality-level prevalence estimates ranged from 8.4% to 17.2%. Urban and poor neighborhood municipalities had higher prevalence rates.

Discussion: The results will by used by MDPH and its partners to identify high prevalence municipality and prioritize municipality-based interventions in order to improve the quality of life for residents with asthma and to reduce disparities in asthma outcomes between distinct population groups.

Learning Areas:

Biostatistics, economics
Chronic disease management and prevention
Public health administration or related administration
Public health or related research

Learning Objectives:
Describe how survey and administrative data can be combined to strengthen local area estimates.

Keyword(s): Asthma, Community Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have has served as a biostatistician on several prevention projects related to mental health and asthma. I am interested in developing new methods to solve problems arising from health-related projects using survey or health claims data.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.