Decomposing geographic disparities in health and health behaviors to inform community interventions
RESULT: Using state average prevalence rate of 26% as a benchmark, the ratio of community-specific prevalence rate to state average rate ranged from 0.4 to 1.34. In logarithmic scale, demographic factors (sex, age, race/ethnicity), socioeconomic (education, income, employment) and contextual (e.g., per capita income, density of housing units) factors contribute 56% (range: 34%-70%), 15% (range: 8%-24%) and 25% (range: 15% to 36%), respectively, to the variation in community-level prevalence estimates. For a given community, domain specific disparity indices were frequently in opposite directions. CONCLUSION: The effects of a particular domain for town-level disparities can easily be overlooked when only overall disparities are calculated. Use of domain-specific disparity indices will help epidemiologists understand the relative importance of demographic, socioeconomic and environmental factors to the observed community-level health disparities. Such information can be used to formulate and prioritize community-based interventions.
Learning Areas:Program planning
Public health or related research
Analyze community-level disparities in health and health behaviors in relation to community demographic composition, socioeconomic status and environmental factors. Evaluate domain-specific disparities and their relative contributions to the overall disparities. Discuss how to use the domain-specific disparity indices to help community-based programs (e.g., CTG) identify effective intervention strategies.
Keyword(s): Community Health Planning, Health Disparities
Qualified on the content I am responsible for because: I am Associate Professor of Medicine (Biostatistics) actively working on large public health databases. I have over 10 years of analyzing public health data after I obtained my PhD on Biostatistics and Epidemiology.
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.