Underenumeration in 1991 census. Census inaccurate for many ethnic groups.
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Adolescent↗
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Letter to the editor: the 1970 U.S. census. Reply from the Census Bureau.
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Communication↗
Estimating census undercount from school enrollment data: an application to the Soviet censuses of 1959 and 1970.
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Adolescent↗
Collecting information on disability in the 2000 Census: an example of interagency cooperation.
The United States Constitution requires that an enumeration (or census) of the population be conducted every 10 years to apportion seats in the House of Representatives. Census information is also used to allocate funds and to plan and manage programs. Census 2000 occurs on April 1, 2000, when one-sixth of all American households will be mailed the "long form," containing disability, demographic, economic, and housing questions. Although no short set of commonly accepted questions on disability existed, one was developed for Census 2000 by a collaborative, federal interagency work group on disability, convened by the Office of Management and Budget. The work group consisted of staff from the Social Security Administration (SSA), the Department of Health and Human Services, the U.S. Census Bureau, and other agencies. They reviewed questions initially proposed by the Census Bureau, developed an alternative proposal, tested both versions in the Census Bureau's cognitive questionnaire lab, and on the basis of testing, derived a consensus version for Census 2000. In many ways, the six questions now contained on Census 2000 are an improvement over previous efforts. Disability is ascertained for children as well as for adults, and information will be collected separately for several domains of disability (for example, sensory, mental, physical). The need for a brief set of disability measures goes beyond Census 2000. If such data were collected regularly on national surveys, critical policy and program concerns across agencies could be addressed because better information could be gathered on changes in disability prevalence and on the characteristics of persons with disabilities. Other similar efforts include the former Disability Evaluation Study, now known as the National Study of Health and Activity--a national sample survey on working-age disability to be conducted by SSA--and the President's Task Force on the Employment of Adults with Disabilities (Executive Order 13078).
Activities of Daily Living↗
The Demeny-Shorter and three-census methods for correcting age data.
This paper presents, tests, applies, and compares methods that utilize age data collected at consecutive censuses to examine and adjust for age and coverage errors. The Demeny-Shorter method, for example, was devised for this purpose, and its flexibility in regard to census coverage errors is examined. The Demeny-Shorter method is found difficult to apply directly, so a method based on the same idea as the Demeny-Shorter method but utilizing age data from three, instead of two, successive censuses is presented and discussed as a possible alternative. This three-census method is applied to data from Turkey's censuses and, in some cases, found to be better than the Demeny-Shorter method, because the former allows for and estimates the likely changes in census coverage and different patterns of age errors in successive censuses. Unfortunately, the three-census method cannot be applied to data from most developing countries on account of a lack of the requisite series of censuses.
Demography↗
Time-weighted nursing demand is a better predictor than midnight census of nursing supply in an intensive care unit.
PURPOSE: Labor costs are the largest fraction of operating costs in an intensive care unit (ICU). Estimation of appropriate nursing supply is frequently based on the midnight census of patients, which is a "snapshot" view of the ICU. We postulated that the midnight census would not correlate as well as time-weighted nursing demand (a calculation of need for nursing staff) with the actual number of nurses who were required to staff the ICU (nursing supply). The purpose of this study was to compare the correlation between midnight census and actual nursing supply with the correlation between time-weighted nursing demand and nursing supply. MATERIALS AND METHODS: We measured nursing activity, midnight census, and actual nursing supply for each of 77 consecutive days in a 14-bed medical-surgical ICU within a 450-bed tertiary care teaching hospital. We calculated time-weighted nursing demand based on 1:1 nursing for ICU patients, 1:2 nursing for step-down patients, 0.5 additional nurse hours for each cardiac arrest, and 0.5 additional nurse hours for each new admission to the ICU. RESULTS: There was a correlation between midnight census and nursing supply (r2 = .42, P<.0001) and between nursing demand and nursing supply (r2 = .83, P<.0001). The correlation coefficient for the relationship between nursing demand and nursing supply was significantly greater than that for the relationship between midnight census and nursing supply (P<.01). CONCLUSIONS: Time-weighted nursing demand is a better predictor than midnight census of nursing supply in an ICU.
British Columbia↗
Using data from the 1991 census.
The 1991 census for England and Wales provides a substantial amount of data on demography, ethnicity, housing tenure, employment status, and other social factors for geographical areas ranging in size from enumeration districts upwards. Many in the health service and in the academic community are making use of the data in the 1991 census. However, users of census data need to be aware of the problems and limitations of these data, which include the format of the data, data modification and suppression, sampling error, and underenumeration. An important innovation of the 1991 census was that the census form included a question on the postcode of respondents; this allowed the Office of Population Censuses and Surveys to produce a postcode-enumeration district look up table which overcomes many of the problems previously encountered in trying to assign postcodes to enumeration districts. The new look up table also includes the grid reference of postcodes, and this will improve the geographical referencing of census data.
Data Collection↗
Interpreting the new illness question in the UK census for health research on small areas.
STUDY OBJECTIVE: The study aimed to identify the various factors that seem to influence the average response to the new census question on limiting, long standing illness at the small area level, to assess the extent to which the new questions adds to information already available in the census and elsewhere, and to discuss how useful the data are likely to be for those planning health and social services. DESIGN: This was a cross sectional analysis of the relationship between rates of limiting, long standing illness (standardised for age and sex) and a large number of indicators of health and socioeconomic status at the small area level. SETTING: The study used data relating to 4985 small areas covering the whole of England. The average population was about 10 000. PARTICIPANTS: The 1991 census of population was addressed to the entire population of England. MAIN RESULTS: There are wide variations in the levels of self reported long standing illness between small areas, 70% of which are explained by demographic factors. Variation in age/sex standardised responses to the new census question at the small area level can largely be explained by census data on self reported disability among those of working age, standardised mortality ratio, and by indicators of socioeconomic circumstances relating to social class, ethnicity, and the elderly living alone. These does not seem to be a significant reporting bias due to underemployment. CONCLUSION: Unlike the disability question in the census, the standardised, self reported long standing limiting illness ratio covers the entire population and it is not skewed towards men. Although the variable is a synthesis of the health and social determinants of perceived morbidity, it does not provide much information that was not already available. In addition, it is available every 10 years only and thus may be rather inaccurate as an indicator of relative need towards the end of the decade. Moreover, in future censuses, individuals' answers might be influenced by the knowledge that their responses will affect the volume of resources allocated to the area in which they live.
Adolescent↗
Overcoming the absence of socioeconomic data in medical records: validation and application of a census-based methodology.
BACKGROUND: Most US medical records lack socioeconomic data, hindering studies of social gradients in health and ascertainment of whether study samples are representative of the general population. This study assessed the validity of a census-based approach in addressing these problems. METHODS: Socioeconomic data from 1980 census tracts and block groups were matched to the 1985 membership records of a large prepaid health plan (n = 1.9 million), with the link provided by each individual's residential address. Among a subset of 14,420 Black and White members, comparisons were made of the association of individual, census tract, and census block-group socioeconomic measures with hypertension, height, smoking, and reproductive history. RESULTS: Census-level and individual-level socioeconomic measures were similarly associated with the selected health outcomes. Census data permitted assessing response bias due to missing individual-level socioeconomic data and also contextual effects involving the interaction of individual- and neighborhood-level socioeconomic traits. On the basis of block-group characteristics, health plan members generally were representative of the total population; persons in impoverished neighborhoods, however, were underrepresented. CONCLUSIONS: This census-based methodology offers a valid and useful approach to overcoming the absence of socioeconomic data in most US medical records.
Adult↗
The use of census data for determining race and education as SES indicators: a validation study.
PURPOSE: Little research has examined the validity of using census data to determine an individual's socio-economic status (SES), as measured by race and educational level. This study assessed the accuracy of using aggregate level data from United States Census Block Groups in determining race and education SES indicators in a cohort of women from North Carolina. METHODS: The study analyzed patient data from the Carolina Mammography Registry and 1990 United States Census in 21 North Carolina counties. Women (n = 39,546) were geocoded to their census block group and their block group characteristics (surrogate measures) were validated with their self-reported values on race and education. An analysis was performed to explore whether using these surrogate measures would affect measured associations with the self-reported values. RESULTS: Whites were accurately identified (84.8%) more consistently than Blacks (14.1%) regardless of their urban/rural status. Women without a high school diploma or equivalent were accurately identified (56.2%) more often than those with higher education levels (45.9%). Analyses using the surrogate measures were significantly different than the true values according to chi-square statistics. CONCLUSIONS: Use of census data to derive SES indicators tends to be more accurate for the majority than the minority population. Researchers must be sensitive to the ecologic fallacy when using aggregate level data such as the census to determine individual level characteristics.
Black or African American↗
Use of census-based aggregate variables to proxy for socioeconomic group: evidence from national samples.
Increasingly, investigators append census-based socioeconomic characteristics of residential areas to individual records to address the problem of inadequate socioeconomic information on health data sets. Little empirical attention has been given to the validity of this approach. The authors estimate health outcome equations using samples from nationally representative data sets linked to census data. They investigate whether statistical power is sensitive to the timing of census data collection or to the level of aggregation of the census data; whether different census items are conceptually distinct; and whether the use of multiple aggregate measures in health outcome equations improves prediction compared with a single aggregate measure. The authors find little difference in estimates when using 1970 compared with 1980 US Bureau of the Census data or zip code compared with tract level variables. However, aggregate variables are highly multicollinear. Associations of health outcomes with aggregate measures are substantially weaker than with microlevel measures. The authors conclude that aggregate measures can not be interpreted as if they were microlevel variables nor should a specific aggregate measure be interpreted to represent the effects of what it is labeled.
Censuses↗
Anonymous linkage of New Zealand mortality and Census data.
BACKGROUND: The New Zealand Census-Mortality Study (NZCMS) aims to investigate socio-economic mortality gradients in New Zealand, by anonymously linking Census and mortality records. OBJECTIVES: To describe the record linkage method, and to estimate the magnitude of bias in that linkage by demographic and socio-economic factors. METHODS: Anonymous 1991 Census records, and mortality records for decedents aged 0-74 years on Census night and dying in the three-year period 1991-94, were probabilistically linked using Automatch. Bias in the record linkage was determined by comparing the demographic and socio-economic profile of linked mortality records to unlinked mortality records. RESULTS: 31,635 of 41,310 (76.6%) mortality records were linked to one of 3,373,896 Census records. The percentage of mortality records linked to a Census record was lowest for 20-24 year old decedents (49.0%) and highest for 65-69 year old decedents (81.0%). By ethnic group, 63.4%, 57.7%, and 78.6% of Maori, Pacific, and decedents of other ethnic groups, respectively, were linked. Controlling for demographic factors, decedents from the most deprived decile of small areas were 8% less likely to be linked than decedents from the least deprived decile, and male decedents from the lowest occupational class were 6% less likely to be linked than decedents from the highest occupational class. CONCLUSION: The proportion and accuracy of mortality records linked was satisfactorily high. Future estimates of the relative risk of mortality by socio-economic status will be modestly under-estimated by 5-10%.
Adolescent↗
Census tract analysis of lead exposure in Rhode Island children.
There has been increasing interest in a targeted approach to the screening and prevention of lead exposure in children. Targeted screening requires an understanding of variation in lead exposure in individual children or by region. In order to better understand variation by region, we studied Rhode Island lead poisoning screening data, examining average lead exposure to children living in 136 Providence County census tracts (CTs). The study population included 17,956 children aged 59 months and under, who were screened between May 1, 1992, and April 30, 1993. We evaluated the relationship between the percentage of children with blood lead > or = 10 micrograms/dL (pe10) and sociodemographic and housing characteristics, derived from United States 1990 Census data, of these CTs. CT descriptors included population density, percentage of households receiving public assistance income, median per capita income, percentage of households female headed, percentage of houses owner occupied, percentage of houses built before 1950, percentage of houses vacant, percentage of population Black, percentage of recent immigrants, and intraurban mobility. On average, 109 children were screened in each census tract; mean screening rate was 44%. There was wide variation in average lead exposure among census tracts, with pe10 ranging from 3 to 60% of screened children (mean 27%). Individual census variables explained between 24 and 67% of the variance in pe10 among CTs. A multiple regression model including percentage screened, percentage of households receiving public assistance, percentage of houses built before 1950, In (percentage of houses vacant), and percentage of recent immigrants explained 83% of variance in pe10. The percentage of houses built before 1950, a variable which models the presence of lead paint in old houses, displayed the largest adjusted effect on pe10 over the range observed for that variable in RI CTs. The percentage of houses vacant was also a highly significant and robust predictor; we suggest that vacancy is an ecological marker for the deterioration of leadbased paint, with higher vacancy neighborhoods containing houses in poorer condition. In Rhode Island, census tracts with high vacancy rates also have high rates of recent immigration, making immigrant groups vulnerable to lead exposure. Small-areas analysis may be useful in directing resources to high risk areas, explaining the sociocultural forces which produce such exposure and analyzing the effects of housing policy over time in states with high screening penetration.
Child, Preschool↗
Evaluation of methods for calculating census health indicators for GP practices.
The patients registered with a general practice are usually spread over many census areas and overlap with the distribution of neighbouring practices, so a validated method of aggregating census data to describe the characteristics of practice patients is required. Four methods were used to provide estimates of the percentage of patients aged 75 years and over from census data for 81 practices in Suffolk, England, and these were compared with values derived from the FHSA patient register. Census values for practice areas produced better estimates than those based on the location of the surgery, but the best methods were based on patient-weighted averages of ward and enumeration district data. The finer geographical detail of enumeration districts did not produce substantially more accurate estimates than the ward-level data: both gave estimates with limits of agreement within 2% of the patient register values. Errors in the census, errors in patient registers and selective geographical distributions of practice patients prevent close matching of census and register measures, but two of the methods tested produced estimates that allow broad comparisons between practices.
Aged↗
Predicting population dental disease experience at a small area level using Census and health service data.
BACKGROUND: Information on the dental disease patterns of child populations is required at a small area level. At present, this can be provided only by expensive whole population surveys. The aim of this study was to evaluate the ability of Census data combined with health service information to provide estimates of population dental disease experience at the small area level. METHOD: Clinical dental data were collected from a large cross-sectional survey of 5-year-old children. A preliminary series of bivariate linear regression analyses were undertaken at ward level with the mean number of decayed, missing or filled teeth per child (dmft) as the dependent variable, and the Census and health service and lifestyle variables suspected of having a strong relationship with dmft as independent variables. This was followed by fitting a multiple linear regression model using a stepwise procedure to include independent variables that explain most of the variability in the dependent variable dmft. RESULTS: All deprivation indicators derived from the Census showed a highly significant (p<0.001) bivariate linear relationship with ward dmft. The Jarman deprivation score gave the highest R2 value (0.45), but the Townsend index (R2=0.43) and the single Census variable 'percentage of households with no car' (R2 = 0.42) gave very similar results. The health and lifestyle indicators also showed highly significant (p<0.001) linear relationships with dmft. The R2 values were generally much lower than the deprivation-related Census variables, with the exception of the percentage of residents who smoked (R2 = 0.42). None of the health or lifestyle variables was included in the final dental disadvantage model. This model explained 51 per cent of the variability of ward dmft. CONCLUSIONS: The results demonstrate the strong relationship between dental decay and deprivation, and all of the commonly used measures of deprivation exhibited a similar performance. For this population of young children health and health services shelf data did not improve on the ability of deprivation-related Census variables to predict population dental caries experience at a small area level.
Child, Preschool↗
Allocating census data to general practice populations: implications for study of prescribing variation at practice level.
OBJECTIVES: To assign census data to general practice populations and to test accuracy of different procedures for estimating the proportion of patients aged over 64. DESIGN: Patients' postcodes from patient register of one family health services authority and the directory linking postcodes to census enumeration districts were used to locate patients in their census area of residence. With different levels of census geography and four different allocation procedures, proportion of patients aged over 64 in each area was used to predict proportion of patients aged over 64 in each general practice. Predicted figures were compared with real figures from each practice register to assess accuracy of allocation methods. SETTING: Data from 1991 census and from 73 practices administered by one family health services authority. MAIN OUTCOME MEASURES: Actual and predicted proportions of patients aged over 64 in general practice populations. RESULTS: Correlations between actual and predicted proportions of patients aged over 64 were significant for all four allocation procedures--values of 0.66, 0.7, 0.84, and 0.84 were achieved (P < 0.0005). Predicted ranges of proportions of patients aged over 64, however, were well short of those that actually existed, and significant differences existed between predicted percentages and actual figures for all four methods. CONCLUSION: Although predicted values correlated with actual values, the failure of the allocation procedures to correctly predict values, especially at the extremes, casts doubt on the validity of similar techniques for allocating census variables to general practice populations.
Age Factors↗
Occupational cancer in Denmark. Cancer incidence in the 1970 census population.
Data sources and creation of data files. The cohort of persons who were 20-64 years of age at the time of the 1970 census has been followed for cancer incidence for a ten-year period. The study was made by linkage of individual records from the 1970 census, the Central Population Register, death certificates, and cancer registrations. Data were included on individual characteristics recorded in the census on prevalent cancer cases at the time of the census and on deaths, emigrations, and incident cancer cases during the ten-year follow-up period. The study includes a total of 2.8 million persons, of whom 2.0 million were economically active at the time of the 1970 census. A total of 115,000 incident cancer cases were registered during the follow-up period, and 77,000 of these occurred in persons who were economically active in 1970. The classifications used in the census included 218 codes for occupation and 245 codes for industry. The Cancer Registry data included 639 codes for diagnosis. Cancer incidence by social groups in Denmark. The cancer incidence was tabulated across 32 socioeconomic groups for 43 cancer sites among the men and 45 cancer sites among the women. The study showed an almost twofold difference in the overall cancer incidence between the socioeconomic groups of the men. Self-employed farmers were at low risk (RR 0.68), and unskilled workers in shipping/fishing were at high risk (RR 1.28) when the cancer incidence among all economically active men was used for the comparison. The social pattern in cancer incidence correlated well with the pattern for cancer mortality among men. As a rough estimate, the cumulative incidence for all cancer among persons under 75 years of age could be reduced by 32% if all Danish men had the cancer incidence of farmers. There was a fivefold or larger difference between the socioeconomic groups in the incidence for nine cancer sites. These nine cancer sites together represented 7% of the cumulative incidence for all cancer. Estimated in a similar way, the cumulative incidence could be reduced by 44% if all Danish men had the site-specific cancer incidence of the respective low-risk groups. The overall cancer incidence among the women varied from a relative risk of 0.71 for unskilled workers in agriculture to a relative risk of 1.18 for self-employed women in other industries I (dentists, lawyers, etc) when the cancer incidence among all economically active women was used for the comparison.(ABSTRACT TRUNCATED AT 400 WORDS)
Adult↗
[History of 1906 census of handicapped patients].
The census of cripples ("Reichskrüppelzählung") in the German Reich plays a central role in the development of orthopaedic surgery. Local censuses conducted by protestant ministers had already pointed out the great number of disabled children without appropriate care. It was the achievement of Konrad Biesalski, who was an orthopaedic surgeon, and of Eduard Dietrich, a Prussian government official, that a nation-wide census for disabled people was conducted. The concerns of the Reich-health-administration, which had complained about the way the survey was to be made, were neglected. These concerns were not all unjustified. Both the planning of the census itself and the technical interpretation of the obtained numbers were full of errors. The number of cripples in need of a place in an asylum were very exaggerated. Biesalski is to be held responsible for this systematic error. For him the census was only a way to influence the public opinion and had no scientific value. The public was worried by the great numbers of cripples in need of medical care and the foundation of asylums for cripples was added to the social political agenda. Along with these asylums came the promotion of orthopaedic surgery. The law, which laid the foundation for these institutions, the "law for the welfare of the cripples in Prussia" of 1920, would have never been passed, if it had not been for Biesalski's manipulated numbers. One can say that the artificially inflated numbers of the "Reichskrüppelzählung" were a lie for a good cause.
Adult↗