Conduent Healthy Communities Institute

CDC PLACES Project

Background

  • The PLACES Project is an expansion of the original 500 Cities Project that began in 2015. The original project was launched by the Centers for Disease Control and Prevention (CDC) in partnership with the Robert Wood Johnson Foundation (RWJF) and CDC Foundation.
  • This project represents a first-of-its-kind data analysis to release information for all US counties, places, census tracts, and ZCTA-level data and uses small area estimation methods to obtain 27 chronic disease measures for the entire United States.
  • The data from this project complements existing surveillance data necessary as a method to more fully understand the health issues affecting the residents of local areas of all sizes and regardless of urban or rural status.

Locations

  • County: There are 3,142 counties within 50 states and District of Columbia (DC), including 9 county and city consolidated cities.
  • Place: 28,484 of 29,321 Places or Census Designated Places (CDP) with a population of 50 or more from Census Tiger 2019 Places and CDPs based on the Census 2010 population count.
  • Census tract: 72,337 of 73,057 census tracts in the 50 states and Washington, DC that have a Census 2010 population of 50 or more people. Compared with the original 500 Cities Project in which estimates were made only for the part of tracts within cities, this project will provide the estimates for the entire census tract regardless of city boundaries.
  • ZCTA: 32,409 of 32,989 ZCTAs in the 50 states and Washington, DC with Census 2010 population of 50 or more people.

Methodology

  • Detailed methodology for the project
  • The method of generating small area estimates (SAE) of the measures is a multi-level statistical modeling framework.
    • Specifically, an innovative peer-reviewed multilevel regression and poststratification (MRP) approach that links geocoded health surveys and high spatial resolution population demographic and socioeconomic data.
    • This accounts for the associations between individual health outcomes, individual characteristics, and spatial contexts and factors at multiple levels (e.g., state, county); predicts individual disease risk and health behaviors in a multi-level modeling framework, and estimates the geographic distributions of population disease burden and health behaviors.
  • Internal and external validation studies confirm the strong consistency between MRP model-based SAEs and direct BRFSS survey estimates at both state and county levels.

Sources of Data

  • The primary data sources for this project are the CDC Behavioral Risk Factor Surveillance System, the Census 2010 population, and the American Community Survey estimates.

Indicators

  • Indicators HCI will maintain for the PLACES project are listed below: 
    • Adults 65+ who Received Recommended Preventive Services: Females
    • Adults 65+ who Received Recommended Preventive Services: Males
    • Adults 65+ with Total Tooth Loss
    • Adults who are Obese     
    • Adults who are Sedentary
    • Adults who Binge Drink
    • Adults who Experienced a Stroke
    • Adults who Experienced Coronary Heart Disease
    • Adults who have had a Routine Checkup: Past Year
    • Adults who Have Taken Medications for High Blood Pressure
    • Adults who Smoke
    • Adults who Visited a Dentist
    • Adults with Arthritis
    • Adults with Cancer
    • Adults with COPD
    • Adults with Current Asthma
    • Adults with Diabetes
    • Adults with Kidney Disease
    • Adults without Health Insurance
    • Cervical Cancer Screening: 21-65
    • Cholesterol Test History: 5 Years
    • Colon Cancer Screening: Sigmoidoscopy Past 5 Years and FOBT Past 3 Years, Colonoscopy Past 10 Years, or FOBT Past Year
    • High Blood Pressure Prevalence
    • High Cholesterol Prevalence: Adults 18+
    • Insufficient Sleep
    • Mammogram: 50-74 Past 2 Years
    • Pap Test: Past 3 Years 21-65                   
    • Poor Mental Health Days: 14+ Days
    • Poor Physical Health Days: 14+ Days
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