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Using Federal Survey Data to
       Inform State Health Policy
       Joanna Turner

       U.S. Census Bureau Health Statistics Forum
       October 17, 2012
       Washington, DC




Funded by the Robert Wood Johnson Foundation and Federal and State Agencies
About SHADAC

• We help states collect and analyze data to
  inform state health policy decisions relating to
  health insurance coverage and access to care
• Our goal: To help states bridge the gap
  between health data and the policy-making
  process
• Based at the University of Minnesota
• Funded primarily by the Robert Wood Johnson
  Foundation (RWJF)

                                                     2
Outline
• Data products
• SHADAC data enhancements relevant to health
  policy
• Policy questions SHADAC helps states answer
• Disseminate estimates in easy to use format
• Survey research
• Education and capacity building for states
• Suggestions for Census Bureau



                                                3
Outline
• Data products
• SHADAC data enhancements relevant to health
  policy
• Policy questions SHADAC helps states answer
• Disseminate estimates in easy to use format
• Survey research
• Education and capacity building for states
• Suggestions for Census Bureau



                                                4
Key federal survey data sources
• General household survey
   – ACS: American Community Survey
• Employment/Income survey
   – CPS: Current Population Survey (ASEC)
• Longitudinal survey
   – SIPP: Survey of Income and Program Participation
• Health surveys
   – NHIS: National Health Interview Survey
   – MEPS: Medical Expenditure Panel Survey
   – BRFSS: Behavioral Risk Factor Surveillance System




                                                         5
Data products used
• Census Bureau published reports and
  summary tabulations
  – Timely estimates
  – Sub-state geographies (counties)
  – Small sub-population analysis
• Public Use Micro-data files
  – Custom tabulations, for example age 19-25
    and <=138% poverty
  – Easier to work with standard errors

                                                6
State Data Centers
• Missouri Census Data Center
  – MABLE/Geocorr for geography crosswalks
  – mcdc.missouri.edu/websas/geocorr2k.html


• Minnesota Population Center
  – Integrated Public Use Microdata Series
    (IPUMS)
  – www.ipums.org



                                              7
Outline
• Data products
• SHADAC data enhancements relevant to health
  policy
• Policy questions SHADAC helps states answer
• Disseminate estimates in easy to use format
• Survey research
• Education and capacity building for states
• Suggestions for Census Bureau



                                                8
SHADAC’s data enhancements
• Create policy relevant measures for the
  CPS and ACS
  – Health Insurance Unit (HIU)
  – Federal Poverty Guidelines (FPG)


• Create a consistent CPS time series with
  historical weighting and coverage
  enhancements
  – SHADAC-Enhanced CPS

                                             9
Outline
• Data products
• SHADAC data enhancements relevant to health
  policy
• Policy questions SHADAC helps states answer
• Disseminate estimates in easy to use format
• Survey research
• Education and capacity building for states
• Suggestions for Census Bureau



                                                10
Where should we allocate funds for
 community clinics?
         % Uninsured in West Virginia, Age 0-64, ≤200% of poverty




Source: 2010 American Community Survey
                                                                    11
Percent of private sector employers offering
   employer-sponsored coverage 2008/2009




Source: Agency for Healthcare Research and Quality, Center for Cost and Financing
Studies. Medical Expenditure Panel Survey – Insurance Component.

                                                                                    12
Outline
• Data products
• SHADAC data enhancements relevant to health
  policy
• Policy questions SHADAC helps states answer
• Disseminate estimates in easy to use format
• Survey research
• Education and capacity building for states
• Suggestions for Census Bureau



                                                13
SHADAC’s Data Center




www.shadac.org/datacenter
                            14
Robert Wood Johnson Foundation
(RWFJ) Data Hub
Percent of individuals in families with a high health care cost burden
(Total, 2010-2011)




                                                              http://www.rwjf.org/en/resear
                                                              ch-publications/research-
                                                              features/rwjf-datahub.html




                                                                                          15
Outline
• Data products
• SHADAC data enhancements relevant to health
  policy
• Policy questions SHADAC helps states answer
• Disseminate estimates in easy to use format
• Survey research
• Education and capacity building for states
• Suggestions for Census Bureau



                                                16
Survey research: use of ACS data
• State surveys use as control totals in
  weighting
  – To make state surveys representative of the
    population weight to ACS estimates




                                                  17
Outline
• Data products
• SHADAC data enhancements relevant to health
  policy
• Policy questions SHADAC helps states answer
• Disseminate estimates in easy to use format
• Survey research
• Education and capacity building for states
• Suggestions for Census Bureau



                                                18
Education and capacity building for
states
• Documentation and help navigating Census
  Bureau products
• Annual ACS and CPS data release webinar with
  Census Bureau experts
  – http://www.shadac.org/publications/shadac-webinar-
    2011-acs-cps-state-health-insurance-estimates
• Provide resources for states to conduct own
  analysis
  – Variables available through IPUMS for HIU and FPG
    for CPS and ACS and SHADAC-Enhanced CPS
  – STATA and SAS code for HIU and FPG

                                                         19
Outline
• Data products
• SHADAC data enhancements relevant to health
  policy
• Policy questions SHADAC helps states answer
• Disseminate estimates in easy to use format
• Survey research
• Education and capacity building for states
• Suggestions for Census Bureau



                                                20
Suggestions for Census Bureau
• American FactFinder (AFF)
    – Percent and margin of error
    – Totals for categories (a lot of cells to add up)
    – Training so it’s more accessible
•   ACS PUMS verification, percent example
•   Provide CPS public use data in SAS
•   CPS continuous poverty variable
•   Documentation

                                                         21
Resources
• “Defining Family for Studies of Health
  Insurance Coverage”
  – http://www.shadac.org/publications/defining-
    family-studies-health-insurance-coverage
• Briefs about SHADAC-Enhanced CPS
  – http://www.shadac.org/publications/comparing
    -state-uninsurance-estimates-shadac-
    enhanced-cps-and-cps



                                                   22
Resources (2)
• “State-Level Trends in Employer-
  Sponsored Health Insurance”
  – http://www.shadac.org/publications/trends-in-
    us-employer-sponsored-health-insurance
• “Monitoring the Impacts of Health Reform
  at the State Level: Using Federal Survey
  Data”
  – http://www.shadac.org/publications/monitoring
    -impacts-health-reform-state-level-using-
    federal-survey-data
                                                    23
Resources (3)
• “Number of Children with Health Coverage
  Increases During Economic Downturn”
  – http://www.shadac.org/publications/keeping-
    kids-covered-number-children-health-
    coverage-increases-during-economic-
    downturn
• “Understanding 1-, 3-, and 5-year ACS”
  – http://www.shadac.org/publications/understan
    ding-1-3-and-5-year-acs-estimates-summary-
    tabulations-and-public-use-files

                                                   24
Joanna Turner
          Senior Research Fellow
State Health Access Data Assistance Center
 University of Minnesota, Minneapolis, MN
               612-624-4802
            turn0053@umn.edu




      Sign up to receive our newsletter and updates at
                     www.shadac.org
                           @shadac

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Pres census oct18_turner

  • 1. Using Federal Survey Data to Inform State Health Policy Joanna Turner U.S. Census Bureau Health Statistics Forum October 17, 2012 Washington, DC Funded by the Robert Wood Johnson Foundation and Federal and State Agencies
  • 2. About SHADAC • We help states collect and analyze data to inform state health policy decisions relating to health insurance coverage and access to care • Our goal: To help states bridge the gap between health data and the policy-making process • Based at the University of Minnesota • Funded primarily by the Robert Wood Johnson Foundation (RWJF) 2
  • 3. Outline • Data products • SHADAC data enhancements relevant to health policy • Policy questions SHADAC helps states answer • Disseminate estimates in easy to use format • Survey research • Education and capacity building for states • Suggestions for Census Bureau 3
  • 4. Outline • Data products • SHADAC data enhancements relevant to health policy • Policy questions SHADAC helps states answer • Disseminate estimates in easy to use format • Survey research • Education and capacity building for states • Suggestions for Census Bureau 4
  • 5. Key federal survey data sources • General household survey – ACS: American Community Survey • Employment/Income survey – CPS: Current Population Survey (ASEC) • Longitudinal survey – SIPP: Survey of Income and Program Participation • Health surveys – NHIS: National Health Interview Survey – MEPS: Medical Expenditure Panel Survey – BRFSS: Behavioral Risk Factor Surveillance System 5
  • 6. Data products used • Census Bureau published reports and summary tabulations – Timely estimates – Sub-state geographies (counties) – Small sub-population analysis • Public Use Micro-data files – Custom tabulations, for example age 19-25 and <=138% poverty – Easier to work with standard errors 6
  • 7. State Data Centers • Missouri Census Data Center – MABLE/Geocorr for geography crosswalks – mcdc.missouri.edu/websas/geocorr2k.html • Minnesota Population Center – Integrated Public Use Microdata Series (IPUMS) – www.ipums.org 7
  • 8. Outline • Data products • SHADAC data enhancements relevant to health policy • Policy questions SHADAC helps states answer • Disseminate estimates in easy to use format • Survey research • Education and capacity building for states • Suggestions for Census Bureau 8
  • 9. SHADAC’s data enhancements • Create policy relevant measures for the CPS and ACS – Health Insurance Unit (HIU) – Federal Poverty Guidelines (FPG) • Create a consistent CPS time series with historical weighting and coverage enhancements – SHADAC-Enhanced CPS 9
  • 10. Outline • Data products • SHADAC data enhancements relevant to health policy • Policy questions SHADAC helps states answer • Disseminate estimates in easy to use format • Survey research • Education and capacity building for states • Suggestions for Census Bureau 10
  • 11. Where should we allocate funds for community clinics? % Uninsured in West Virginia, Age 0-64, ≤200% of poverty Source: 2010 American Community Survey 11
  • 12. Percent of private sector employers offering employer-sponsored coverage 2008/2009 Source: Agency for Healthcare Research and Quality, Center for Cost and Financing Studies. Medical Expenditure Panel Survey – Insurance Component. 12
  • 13. Outline • Data products • SHADAC data enhancements relevant to health policy • Policy questions SHADAC helps states answer • Disseminate estimates in easy to use format • Survey research • Education and capacity building for states • Suggestions for Census Bureau 13
  • 15. Robert Wood Johnson Foundation (RWFJ) Data Hub Percent of individuals in families with a high health care cost burden (Total, 2010-2011) http://www.rwjf.org/en/resear ch-publications/research- features/rwjf-datahub.html 15
  • 16. Outline • Data products • SHADAC data enhancements relevant to health policy • Policy questions SHADAC helps states answer • Disseminate estimates in easy to use format • Survey research • Education and capacity building for states • Suggestions for Census Bureau 16
  • 17. Survey research: use of ACS data • State surveys use as control totals in weighting – To make state surveys representative of the population weight to ACS estimates 17
  • 18. Outline • Data products • SHADAC data enhancements relevant to health policy • Policy questions SHADAC helps states answer • Disseminate estimates in easy to use format • Survey research • Education and capacity building for states • Suggestions for Census Bureau 18
  • 19. Education and capacity building for states • Documentation and help navigating Census Bureau products • Annual ACS and CPS data release webinar with Census Bureau experts – http://www.shadac.org/publications/shadac-webinar- 2011-acs-cps-state-health-insurance-estimates • Provide resources for states to conduct own analysis – Variables available through IPUMS for HIU and FPG for CPS and ACS and SHADAC-Enhanced CPS – STATA and SAS code for HIU and FPG 19
  • 20. Outline • Data products • SHADAC data enhancements relevant to health policy • Policy questions SHADAC helps states answer • Disseminate estimates in easy to use format • Survey research • Education and capacity building for states • Suggestions for Census Bureau 20
  • 21. Suggestions for Census Bureau • American FactFinder (AFF) – Percent and margin of error – Totals for categories (a lot of cells to add up) – Training so it’s more accessible • ACS PUMS verification, percent example • Provide CPS public use data in SAS • CPS continuous poverty variable • Documentation 21
  • 22. Resources • “Defining Family for Studies of Health Insurance Coverage” – http://www.shadac.org/publications/defining- family-studies-health-insurance-coverage • Briefs about SHADAC-Enhanced CPS – http://www.shadac.org/publications/comparing -state-uninsurance-estimates-shadac- enhanced-cps-and-cps 22
  • 23. Resources (2) • “State-Level Trends in Employer- Sponsored Health Insurance” – http://www.shadac.org/publications/trends-in- us-employer-sponsored-health-insurance • “Monitoring the Impacts of Health Reform at the State Level: Using Federal Survey Data” – http://www.shadac.org/publications/monitoring -impacts-health-reform-state-level-using- federal-survey-data 23
  • 24. Resources (3) • “Number of Children with Health Coverage Increases During Economic Downturn” – http://www.shadac.org/publications/keeping- kids-covered-number-children-health- coverage-increases-during-economic- downturn • “Understanding 1-, 3-, and 5-year ACS” – http://www.shadac.org/publications/understan ding-1-3-and-5-year-acs-estimates-summary- tabulations-and-public-use-files 24
  • 25. Joanna Turner Senior Research Fellow State Health Access Data Assistance Center University of Minnesota, Minneapolis, MN 612-624-4802 turn0053@umn.edu Sign up to receive our newsletter and updates at www.shadac.org @shadac