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. 2020 Aug;97(4):561-567.
doi: 10.1007/s11524-020-00423-z.

ZIP Code-Level Estimates from a Local Health Survey: Added Value and Limitations

Qifang Bi  1   2 , Fangtao He  3 , Kevin Konty  3 , L Hannah Gould  3 , Stephen Immerwahr  3 , Amber Levanon Seligson  3
Affiliations

ZIP Code-Level Estimates from a Local Health Survey: Added Value and Limitations

Qifang Bi et al. J Urban Health. 2020 Aug.

Abstract

We assessed the added value and limitations of generating directly estimated ZIP Code-level estimates by aggregating 5 years of data from an annual cross-sectional survey, the New York City Community Health Survey (n = 44,886) from 2009 to 2013, that were designed to provide reliable estimates only of larger geographies. Survey weights generated directly-observed ZIP Code (n = 128) level estimates. We assessed the heterogeneity of ZIP Code-level estimates within coarser United Hospital Fund (UHF) neighborhood areas (n = 34) by using the Rao-Scott Chi-Square test and one-way ANOVA. Orthogonal linear contrasts assessed whether there were linear trends at the UHF level from 2009 to 2013. 22 of 37 health indicators were reliable in over 50% of ZIP Codes. 14 of the 22 variables showed heterogeneity in ≥4 UHFs. Variables for drinking, nutrition, and HIV testing showed heterogeneity in the most UHFs (9-24 UHFs). In half of the 32 UHFs, >20% variables had within-UHF heterogeneity. Flu vaccination and sugary beverage consumption showed significant time trends in the largest number of UHFs (12 or more UHFs). Overall, heterogeneity of ZIP Code-level estimates suggests that there is value in aggregating 5 years of data to make direct small area estimates.

Keywords: Population health; Survey; ZIP Code.

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Figures

Fig. 1
Fig. 1
A UHF neighborhood level map showing the percentage of variables whose ZIP Code-level estimates within the same UHF were statistically different from each other. Heterogeneity of variables in two UHFs - Kingsbridge and Sunset Park – could not be assessed because the ZIP Codes in the two UHF neighborhoods had fewer than 30,000 residents according to the 2010 Census, and thus were combined with each other to make a single grouped estimate. Source: NYC Community Health Survey, 2009–2013. 2009–2013 data were weighted to the NYC adult residential population as per the American Community Survey, 2009–2013
Fig. 2
Fig. 2
A UHF neighborhood level map showing the proportion of variables showing significant linear trends over time. Source: NYC Community Health Survey, 2009, 2010, 2011, 2013, and 2013
See this image and copyright information in PMC

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