Initial Assessment of Small Area Estimation of the Number of Eligible Women for the CDC's NBCCEDP

摘要

The Centers for Disease Control and Prevention (CDC) have a congressional mandate to provide screening services for breast and cervical cancer to low-income, uninsured, and underserved women through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Currently, the NBCCEDP produces national and state participation rates for this program. Participation rates serve many functions such as evaluation of long-term performance by states and as an aid to grantees in prioritizing their resources toward at risk groups. Currently, calculating these participation rates relies on direct estimates from the Annual Social and Economic Supplement of the Current Population Survey, computed and tabulated by the U.S. Census Bureau. The state estimates contain 2-year and 3-year averages of the number of uninsured low-income women by age group (18-64, 40-64, and 50-64). The national estimates include the same information by race and ethnicity. The purpose of this project is to investigate the feasibility of estimating the numbers of eligible women by race and ethnicity, age, and poverty level (0-200 and 0-250 percent of the federal poverty threshold) for states and counties. Because of small sample sizes, direct estimates alone cannot be used for these sub-groups. These estimates are required for calculating the screening rates for most of the NBCCEDP grantees. This report is a product of the second phase of our cooperative work. Phase one dealt primarily with data acquisition and model development for the uninsured. Phase two assesses the feasibility of producing estimates of the number of low-income uninsured women by age. Additionally, we investigated race and ethnicity categories. This work builds on the Census Bureaus Small Area Health Insurance Estimates (SAHIE) program, which provided county and state health insurance coverage estimates for 2000 by age. We conducted an extensive review of the literature on health insurance to determine necessary information for the model. When possible, we collected the relevant data. Otherwise, we are in the process of obtaining the needed data. Model development began for county and state small area estimates (SAE) of women eligible for the NBCCEDP, by income to poverty ratios (IPRs), age, race, and ethnicity. For the feasibility study, the IPRs and age categories are the same as already mentioned.