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. 2009 Mar;99(3):470-9.
doi: 10.2105/AJPH.2007.130112. Epub 2009 Jan 15.

Small-area estimation and prioritizing communities for tobacco control efforts in Massachusetts

Wenjun Li  1 , Thomas Land, Zi Zhang, Lois Keithly, Jennifer L Kelsey
Affiliations

Small-area estimation and prioritizing communities for tobacco control efforts in Massachusetts

Wenjun Li et al. Am J Public Health. 2009 Mar.

Abstract

Objectives: We developed a method to evaluate geographic and temporal variations in community-level risk factors and prevalence estimates, and used that method to identify communities in Massachusetts that should be considered high priority communities for smoking interventions.

Methods: We integrated individual-level data from the Behavioral Risk Factor Surveillance System from 1999 to 2005 with community-level data in Massachusetts. We used small-area estimation models to assess the associations of adults' smoking status with both individual- and community-level characteristics and to estimate community-specific smoking prevalence in 398 communities. We classified communities into 8 groups according to their prevalence estimates, the precision of the estimates, and temporal trends.

Results: Community-level prevalence of current cigarette smoking among adults ranged from 5% to 36% in 2005 and declined in all but 16 (4%) communities between 1999 and 2005. However, less than 15% of the communities met the national prevalence goal of 12% or less. High smoking prevalence remained in communities with lower income, higher percentage of blue-collar workers, and higher density of tobacco outlets.

Conclusions: Prioritizing communities for intervention can be accomplished through the use of small-area estimation models. In Massachusetts, socioeconomically disadvantaged communities have high smoking prevalence rates and should be of high priority to those working to control tobacco use.

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Figures

FIGURE 1
FIGURE 1
Town- and city-level prevalence of cigarette smoking: Massachusetts, 2005.
FIGURE 2
FIGURE 2
Smoking intervention priority classes of communities: Massachusetts, 2005.
See this image and copyright information in PMC

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