Wesley James | University of Memphis (original) (raw)

Papers by Wesley James

Research paper thumbnail of Healthy and unhealthy places in America: Are these really spatial clusters

Proceedings of the 22nd Annual ESRI International User Conference, 2002

When healthy and unhealthy counties (defined as above or below U.S. average death rates or life e... more When healthy and unhealthy counties (defined as above or below U.S. average death rates or life expectancy of the population) are mapped, clear instances of spatial clustering are visible. This exploratory data visualization cannot answer the follow-on questions; are they indeed spatial clusters and are they statistically significant? Investigators at the Social Science Research Center use several Arc-extension spatial statistical techniques to answer those questions and we assess the relative difficulty of using these techniques versus the results that they generate.

Research paper thumbnail of Suicide Ideation and Bullying Among US Adolescents: Examining the Intersections of Sexual Orientation, Gender, and Race/Ethnicity

American Journal of Public Health, 2015

We examined how race/ethnicity, gender, and sexual orientation shape adolescents&... more We examined how race/ethnicity, gender, and sexual orientation shape adolescents' likelihood of being bullied and vulnerability to suicide ideation. We analyzed pooled data from the 2009 and 2011 Youth Risk Behavior Surveys (n = 75 344) to assess race/ethnicity, gender, and sexual orientation variation in being bullied and suicide ideation. White and Hispanic gay and bisexual males, White lesbian and bisexual females, and Hispanic bisexual females were more likely to be bullied than were White heterosexual adolescents. Black lesbian, gay, and bisexual youths' vulnerability to being bullied was not significantly different from that of White heterosexual youths. Black and Hispanic heterosexual youths were less likely to be bullied than were White heterosexual youths. Despite differences in the likelihood of being bullied, sexual minority youths were more likely to report suicide ideation, regardless of their race/ethnicity, their gender, or whether they have been bullied. Future research should examine how adolescents' intersecting identities shape their experience of victimization and suicidality. School personnel should develop antibullying and antihomophobia policies in response to the disproportionate risk of being bullied and reporting suicidality among sexual minority youths. (Am J Public Health. Published online ahead of print March 19, 2015: e1-e6. doi:10.2105/AJPH.2014.302391).

Research paper thumbnail of Correlating pharmaceutical data with a national health survey as a proxy for estimating rural population health

Population health metrics, 2010

Chronic disease accounts for nearly three-quarters of US deaths, yet prevalence rates are not con... more Chronic disease accounts for nearly three-quarters of US deaths, yet prevalence rates are not consistently reported at the state level and are not available at the sub-state level. This makes it difficult to assess trends in prevalence and impossible to measure sub-state differences. Such county-level differences could inform and direct the delivery of health services to those with the greatest need. We used a database of prescription drugs filled in the US as a proxy for nationwide, county-level prevalence of three top causes of death: heart disease, stroke, and diabetes. We tested whether prescription data are statistically valid proxy measures for prevalence, using the correlation between prescriptions filled at the state level and comparable Behavioral Risk Factor Surveillance System (BRFSS) data. We further tested for statistically significant national geographic patterns. Fourteen correlations were tested for years in which the BRFSS questions were asked (1999-2003), and all w...

Research paper thumbnail of Inequality, Health Infrastructure, and Spatial Context: Understanding Pathways to Variations in the Causal Determinants of Race-Specific Mortality Rates

Sociological Spectrum, 2012

Previous research examines the ecological relationship between income inequality and mortality, a... more Previous research examines the ecological relationship between income inequality and mortality, and results are inconclusive. This analysis builds upon these findings by implementing a spatially weighted path analysis to better understand the mediating relationships of economic and social inequality, health infrastructure, and mortality. In the analysis, overall and race-specific mortality rates are combined with local health infrastructure data, income inequality and racial segregation data, and a series of ecological controls to undertake this examination. Ultimately, findings show that income inequality is a stronger determinant of mortality than is segregation, for whites and blacks, regardless of the existing health infrastructure. We also find racial disparities in the direct effect of local health infrastructure on mortality. In contrast to previous literature suggesting no association between income inequality and mortality after accounting for race and model sophistication, we argue that the significance of the relationship persists using race-specific, spatially weighted path models.

Research paper thumbnail of Does regional variation affect ecological mortality research? An examination of mortality, income inequality and health infrastructure in the Mississippi Delta

Population Research and Policy Review, 2006

Mortality research has often focused on individual-level, socioeconomic, and demographic factors ... more Mortality research has often focused on individual-level, socioeconomic, and demographic factors indicating health outcomes. Consistent with a recent trend in the public health field, this research examines mortality at the aggregate, contextual level. Based on Wilkinson's relative income hypothesis, specifically being manifest through an underinvestment in social goods including health infrastructure, the focus of this study is a regional examination in the effects of income inequality on mortality at the county level. Health infrastructure is included as a mediating variable in the relationship between income inequality and mortality, relating back to Wilkinson's work. Unlike previous research, regional differences in this relationship are examined to identify variation at the county level in health outcomes. The Mississippi Delta is an adequate test bed to examine the relationship between these variables based on its socioeconomic, demographic, and high inequality characteristics. It is hypothesized that Delta-designated counties within the threestate Delta region distinguish a significant positive relationship between income inequality and mortality, that this relationship is stronger than in non-Delta classified counties, and that health infrastructure significantly mediates the relationship between income inequality and mortality.

Research paper thumbnail of RuralUrban Analyses of Health-Related Quality of Life Among People With Multiple Sclerosis

The Journal of Rural Health, 2008

Context: Health-related quality of life (HRQOL) is a multi-dimensional construct including aspect... more Context: Health-related quality of life (HRQOL) is a multi-dimensional construct including aspects of life quality or function that are affected by physical health and symptoms, psychosocial factors, and psychiatric conditions. HRQOL gives a broader measure of the burden of disease than physical impairment or disability levels. Purpose: To identify factors associated with HRQOL among people with multiple sclerosis (MS) utilizing the SF-8 Health Survey. Methods: Data presented in this study were collected in a survey of 1,518 people with MS living in all 50 states. The survey sample was randomly selected from the database of the National Multiple Sclerosis Society, using ZIP codes to recruit the survey sample. A multiple linear regression model was employed to analyze the survey data, with the Physical Component Summary and the Mental Component Summary of the SF-8 the dependent variables. Independent variables were demographic characteristics, MS-disease characteristics, and health services utilized. Findings: People with MS in rural areas tended to report lower physically related HRQOL. Worsening MS symptoms were associated with reduced physical and mental dimensions of HRQOL. In addition, people with MS who received a diagnosis of depression tended to have reduced physical and mental dimensions of HRQOL. Receiving MS care at an MS clinic was associated with better physically related HRQOL, while having a neurologist as principal care physician was associated with better mental-related HRQOL. Conclusion: The challenge is to increase the access that people living with MS in rural areas have to MS-focused specialty care.

Research paper thumbnail of Research note: imputing large group averages for missing data, using rural-urban continuum codes for density driven industry sectors

Journal of Population Research, 2009

Understanding the effects and consequences of missing data imputation is vital to the ability to ... more Understanding the effects and consequences of missing data imputation is vital to the ability to obtain meaningful and reliable statistics and coefficients in the examination of any quantitatively-based phenomena. Over time a series of sophisticated methods have been developed to handle the issue of missing data imputation however, these sophisticated methods may not always be appropriate or attainable. In these specific cases more traditional approaches to missing data imputation must be employed and driven by the research project, theoretical framework, and the data. In this research note we offer a brief account of one such instance, implementing a large-group mean imputation approach to handling missing data. The analysis is drawn from a much larger project and shows the effect of proper group selection in terms of mean imputation using a cross-validation approach based on the imputed data's relation to known values. Ultimately, the results show that the use of Rural-Urban Continuum codes are superior to currently used group-means in the U.S., thus introducing a new, and more efficient, approach to the handling of missing data using group-mean imputation.

Research paper thumbnail of Public support for Hispanic deportation in the United States: the effects of ethnic prejudice and perceptions of economic competition in a period of economic distress

Journal of Population Research, 2013

ABSTRACT

Research paper thumbnail of Using Maps to Monitor At-Risk Geographic Areas of Heart Disease: Tracking Access to Prescription Medication and Mortality Rates

Journal of Maps, 2010

This manuscript describes a method of identifying at-risk regions for heart disease morbidity and... more This manuscript describes a method of identifying at-risk regions for heart disease morbidity and mortality in the United States using the creative combination of spatial visualization, spatial statistics, and two unique datasets. There are very few health surveillance systems in the United States that monitor the prevalence of major diseases and the geographic location in which they are most highly concentrated. The Behavioral Risk Factor Surveillance System (BRFSS), the world's largest ongoing system of tracking health conditions and risk behaviors in the U.S. (Center for Disease Control and Prevention, 2010a), is arguably the gold standard of the existing disease surveillance systems currently in the United States, but it is not available at the sub-state level. Although there is a need for improved monitoring of morbidity, scientists must be even more creative in their assessments of medically underserved or deprived areas in regards to a crucial component of treating chronic illness: access to prescription medication. This article describes a methodology by which scientists can assess medically underserved regions with the use of maps in combination with disease-specific data on access to medication and mortality.

Research paper thumbnail of Risk of congenital anomalies around a municipal solid waste incinerator: a GIS-based case-control study

International Journal of Health Geographics, 2009

Background: This study uses geographic information systems (GIS) as a tool to evaluate and visual... more Background: This study uses geographic information systems (GIS) as a tool to evaluate and visualize the general accessibility of areas within the province of Alberta (Canada) to cardiac catheterization facilities. Current American and European guidelines suggest performing catheterization within 90 minutes of the first medical contact. For this reason, this study evaluates the populated places that are within a 90 minute transfer time to a city with a catheterization facility. The three modes of transport considered in this study are ground ambulance, rotary wing air ambulance and fixed wing air ambulance.

Research paper thumbnail of Persistent Clusters of Mortality in the United States

American Journal of Public Health, 2007

Cossman et al. | Peer Reviewed | Research and Practice | 2149  RESEARCH AND PRACTICE  Note. Rat... more Cossman et al. | Peer Reviewed | Research and Practice | 2149  RESEARCH AND PRACTICE  Note. Rates for Alaska and Hawaii were calculated, but they were not included in these analyses. Counties within 1 SD of the national average for 4 or more periods are shown in white. Counties with "high" mortality (black pattern) had mortality rates more than 1 SD greater than the US mean rate for at least 4 of the 7 (i.e., more than half) time periods. Counties with "low" mortality (black dotted pattern) had mortality rates more than 1 SD less than the US mean rate for at least 4 of the 7 time periods.

Research paper thumbnail of Preliminary Evidence for an Emerging Nonmetropolitan Mortality Penalty in the United States

American Journal of Public Health, 2008

We discovered an emerging nonmetropolitan mortality penalty by contrasting 37 years of age-adjust... more We discovered an emerging nonmetropolitan mortality penalty by contrasting 37 years of age-adjusted mortality rates for metropolitan versus nonmetropolitan US counties. During the 1980s, annual metropolitannonmetropolitan differences averaged 6.2 excess deaths per 100 000 nonmetropolitan population, or approximately 3600 excess deaths; however, by 2000 to 2004, the difference had increased more than 10 times to average 71.7 excess deaths, or approximately 35 000 excess deaths. We recommend that research be undertaken to evaluate and utilize our preliminary findings of an emerging US nonmetropolitan mortality penalty. (Am J Public Health.

Research paper thumbnail of Underlying Causes of the Emerging Nonmetropolitan Mortality Penalty

American Journal of Public Health, 2010

should be mandated to ensure safety and autonomy regarding women's decisions. These data in no wa... more should be mandated to ensure safety and autonomy regarding women's decisions. These data in no way indicate that women's access to abortion services should be impeded, rather that reductions in abusive men's coercive control over women's reproductive choices may well reduce many women's need for such services. Policies aimed at requiring women to notify partners or to obtain partner consent before undergoing an abortion should be reconsidered because of the likelihood of both endangering women and placing them at risk for coercion regarding this critical decision. Efforts to prevent the violent and coercive behavior of men and boys should be incorporated within any comprehensive program to reduce unintended pregnancy and the subsequent need for abortion services. j

Research paper thumbnail of Evaluating heart disease presciptions-filled as a proxy for heart disease prevalence rates

Journal of health and human services administration, 2008

Heart disease is the leading cause of death in the U.S. Yet, prevalence rates are not reported at... more Heart disease is the leading cause of death in the U.S. Yet, prevalence rates are not reported at the county level. Not knowing how many have the disease, and where they are, may be a knowledge barrier to effective health care interventions. We use heart disease drug prescriptions-filled as a proxy measure for prevalence of heart disease. We test the correlation to the Behavioral Risk Factor Surveillance System (BRFSS) and find positive, statistically significant correlations. Next we illustrate the geographic patterns revealed using the county-level prevalence estimate maps. This information can be used to provide a better understanding of sub-state variations in disease patterns and subsequently target the delivery of health resources to small areas in need.

Research paper thumbnail of Healthy and unhealthy places in America: Are these really spatial clusters

Proceedings of the 22nd Annual ESRI International User Conference, 2002

When healthy and unhealthy counties (defined as above or below U.S. average death rates or life e... more When healthy and unhealthy counties (defined as above or below U.S. average death rates or life expectancy of the population) are mapped, clear instances of spatial clustering are visible. This exploratory data visualization cannot answer the follow-on questions; are they indeed spatial clusters and are they statistically significant? Investigators at the Social Science Research Center use several Arc-extension spatial statistical techniques to answer those questions and we assess the relative difficulty of using these techniques versus the results that they generate.

Research paper thumbnail of Suicide Ideation and Bullying Among US Adolescents: Examining the Intersections of Sexual Orientation, Gender, and Race/Ethnicity

American Journal of Public Health, 2015

We examined how race/ethnicity, gender, and sexual orientation shape adolescents&... more We examined how race/ethnicity, gender, and sexual orientation shape adolescents' likelihood of being bullied and vulnerability to suicide ideation. We analyzed pooled data from the 2009 and 2011 Youth Risk Behavior Surveys (n = 75 344) to assess race/ethnicity, gender, and sexual orientation variation in being bullied and suicide ideation. White and Hispanic gay and bisexual males, White lesbian and bisexual females, and Hispanic bisexual females were more likely to be bullied than were White heterosexual adolescents. Black lesbian, gay, and bisexual youths' vulnerability to being bullied was not significantly different from that of White heterosexual youths. Black and Hispanic heterosexual youths were less likely to be bullied than were White heterosexual youths. Despite differences in the likelihood of being bullied, sexual minority youths were more likely to report suicide ideation, regardless of their race/ethnicity, their gender, or whether they have been bullied. Future research should examine how adolescents' intersecting identities shape their experience of victimization and suicidality. School personnel should develop antibullying and antihomophobia policies in response to the disproportionate risk of being bullied and reporting suicidality among sexual minority youths. (Am J Public Health. Published online ahead of print March 19, 2015: e1-e6. doi:10.2105/AJPH.2014.302391).

Research paper thumbnail of Correlating pharmaceutical data with a national health survey as a proxy for estimating rural population health

Population health metrics, 2010

Chronic disease accounts for nearly three-quarters of US deaths, yet prevalence rates are not con... more Chronic disease accounts for nearly three-quarters of US deaths, yet prevalence rates are not consistently reported at the state level and are not available at the sub-state level. This makes it difficult to assess trends in prevalence and impossible to measure sub-state differences. Such county-level differences could inform and direct the delivery of health services to those with the greatest need. We used a database of prescription drugs filled in the US as a proxy for nationwide, county-level prevalence of three top causes of death: heart disease, stroke, and diabetes. We tested whether prescription data are statistically valid proxy measures for prevalence, using the correlation between prescriptions filled at the state level and comparable Behavioral Risk Factor Surveillance System (BRFSS) data. We further tested for statistically significant national geographic patterns. Fourteen correlations were tested for years in which the BRFSS questions were asked (1999-2003), and all w...

Research paper thumbnail of Inequality, Health Infrastructure, and Spatial Context: Understanding Pathways to Variations in the Causal Determinants of Race-Specific Mortality Rates

Sociological Spectrum, 2012

Previous research examines the ecological relationship between income inequality and mortality, a... more Previous research examines the ecological relationship between income inequality and mortality, and results are inconclusive. This analysis builds upon these findings by implementing a spatially weighted path analysis to better understand the mediating relationships of economic and social inequality, health infrastructure, and mortality. In the analysis, overall and race-specific mortality rates are combined with local health infrastructure data, income inequality and racial segregation data, and a series of ecological controls to undertake this examination. Ultimately, findings show that income inequality is a stronger determinant of mortality than is segregation, for whites and blacks, regardless of the existing health infrastructure. We also find racial disparities in the direct effect of local health infrastructure on mortality. In contrast to previous literature suggesting no association between income inequality and mortality after accounting for race and model sophistication, we argue that the significance of the relationship persists using race-specific, spatially weighted path models.

Research paper thumbnail of Does regional variation affect ecological mortality research? An examination of mortality, income inequality and health infrastructure in the Mississippi Delta

Population Research and Policy Review, 2006

Mortality research has often focused on individual-level, socioeconomic, and demographic factors ... more Mortality research has often focused on individual-level, socioeconomic, and demographic factors indicating health outcomes. Consistent with a recent trend in the public health field, this research examines mortality at the aggregate, contextual level. Based on Wilkinson's relative income hypothesis, specifically being manifest through an underinvestment in social goods including health infrastructure, the focus of this study is a regional examination in the effects of income inequality on mortality at the county level. Health infrastructure is included as a mediating variable in the relationship between income inequality and mortality, relating back to Wilkinson's work. Unlike previous research, regional differences in this relationship are examined to identify variation at the county level in health outcomes. The Mississippi Delta is an adequate test bed to examine the relationship between these variables based on its socioeconomic, demographic, and high inequality characteristics. It is hypothesized that Delta-designated counties within the threestate Delta region distinguish a significant positive relationship between income inequality and mortality, that this relationship is stronger than in non-Delta classified counties, and that health infrastructure significantly mediates the relationship between income inequality and mortality.

Research paper thumbnail of RuralUrban Analyses of Health-Related Quality of Life Among People With Multiple Sclerosis

The Journal of Rural Health, 2008

Context: Health-related quality of life (HRQOL) is a multi-dimensional construct including aspect... more Context: Health-related quality of life (HRQOL) is a multi-dimensional construct including aspects of life quality or function that are affected by physical health and symptoms, psychosocial factors, and psychiatric conditions. HRQOL gives a broader measure of the burden of disease than physical impairment or disability levels. Purpose: To identify factors associated with HRQOL among people with multiple sclerosis (MS) utilizing the SF-8 Health Survey. Methods: Data presented in this study were collected in a survey of 1,518 people with MS living in all 50 states. The survey sample was randomly selected from the database of the National Multiple Sclerosis Society, using ZIP codes to recruit the survey sample. A multiple linear regression model was employed to analyze the survey data, with the Physical Component Summary and the Mental Component Summary of the SF-8 the dependent variables. Independent variables were demographic characteristics, MS-disease characteristics, and health services utilized. Findings: People with MS in rural areas tended to report lower physically related HRQOL. Worsening MS symptoms were associated with reduced physical and mental dimensions of HRQOL. In addition, people with MS who received a diagnosis of depression tended to have reduced physical and mental dimensions of HRQOL. Receiving MS care at an MS clinic was associated with better physically related HRQOL, while having a neurologist as principal care physician was associated with better mental-related HRQOL. Conclusion: The challenge is to increase the access that people living with MS in rural areas have to MS-focused specialty care.

Research paper thumbnail of Research note: imputing large group averages for missing data, using rural-urban continuum codes for density driven industry sectors

Journal of Population Research, 2009

Understanding the effects and consequences of missing data imputation is vital to the ability to ... more Understanding the effects and consequences of missing data imputation is vital to the ability to obtain meaningful and reliable statistics and coefficients in the examination of any quantitatively-based phenomena. Over time a series of sophisticated methods have been developed to handle the issue of missing data imputation however, these sophisticated methods may not always be appropriate or attainable. In these specific cases more traditional approaches to missing data imputation must be employed and driven by the research project, theoretical framework, and the data. In this research note we offer a brief account of one such instance, implementing a large-group mean imputation approach to handling missing data. The analysis is drawn from a much larger project and shows the effect of proper group selection in terms of mean imputation using a cross-validation approach based on the imputed data's relation to known values. Ultimately, the results show that the use of Rural-Urban Continuum codes are superior to currently used group-means in the U.S., thus introducing a new, and more efficient, approach to the handling of missing data using group-mean imputation.

Research paper thumbnail of Public support for Hispanic deportation in the United States: the effects of ethnic prejudice and perceptions of economic competition in a period of economic distress

Journal of Population Research, 2013

ABSTRACT

Research paper thumbnail of Using Maps to Monitor At-Risk Geographic Areas of Heart Disease: Tracking Access to Prescription Medication and Mortality Rates

Journal of Maps, 2010

This manuscript describes a method of identifying at-risk regions for heart disease morbidity and... more This manuscript describes a method of identifying at-risk regions for heart disease morbidity and mortality in the United States using the creative combination of spatial visualization, spatial statistics, and two unique datasets. There are very few health surveillance systems in the United States that monitor the prevalence of major diseases and the geographic location in which they are most highly concentrated. The Behavioral Risk Factor Surveillance System (BRFSS), the world's largest ongoing system of tracking health conditions and risk behaviors in the U.S. (Center for Disease Control and Prevention, 2010a), is arguably the gold standard of the existing disease surveillance systems currently in the United States, but it is not available at the sub-state level. Although there is a need for improved monitoring of morbidity, scientists must be even more creative in their assessments of medically underserved or deprived areas in regards to a crucial component of treating chronic illness: access to prescription medication. This article describes a methodology by which scientists can assess medically underserved regions with the use of maps in combination with disease-specific data on access to medication and mortality.

Research paper thumbnail of Risk of congenital anomalies around a municipal solid waste incinerator: a GIS-based case-control study

International Journal of Health Geographics, 2009

Background: This study uses geographic information systems (GIS) as a tool to evaluate and visual... more Background: This study uses geographic information systems (GIS) as a tool to evaluate and visualize the general accessibility of areas within the province of Alberta (Canada) to cardiac catheterization facilities. Current American and European guidelines suggest performing catheterization within 90 minutes of the first medical contact. For this reason, this study evaluates the populated places that are within a 90 minute transfer time to a city with a catheterization facility. The three modes of transport considered in this study are ground ambulance, rotary wing air ambulance and fixed wing air ambulance.

Research paper thumbnail of Persistent Clusters of Mortality in the United States

American Journal of Public Health, 2007

Cossman et al. | Peer Reviewed | Research and Practice | 2149  RESEARCH AND PRACTICE  Note. Rat... more Cossman et al. | Peer Reviewed | Research and Practice | 2149  RESEARCH AND PRACTICE  Note. Rates for Alaska and Hawaii were calculated, but they were not included in these analyses. Counties within 1 SD of the national average for 4 or more periods are shown in white. Counties with "high" mortality (black pattern) had mortality rates more than 1 SD greater than the US mean rate for at least 4 of the 7 (i.e., more than half) time periods. Counties with "low" mortality (black dotted pattern) had mortality rates more than 1 SD less than the US mean rate for at least 4 of the 7 time periods.

Research paper thumbnail of Preliminary Evidence for an Emerging Nonmetropolitan Mortality Penalty in the United States

American Journal of Public Health, 2008

We discovered an emerging nonmetropolitan mortality penalty by contrasting 37 years of age-adjust... more We discovered an emerging nonmetropolitan mortality penalty by contrasting 37 years of age-adjusted mortality rates for metropolitan versus nonmetropolitan US counties. During the 1980s, annual metropolitannonmetropolitan differences averaged 6.2 excess deaths per 100 000 nonmetropolitan population, or approximately 3600 excess deaths; however, by 2000 to 2004, the difference had increased more than 10 times to average 71.7 excess deaths, or approximately 35 000 excess deaths. We recommend that research be undertaken to evaluate and utilize our preliminary findings of an emerging US nonmetropolitan mortality penalty. (Am J Public Health.

Research paper thumbnail of Underlying Causes of the Emerging Nonmetropolitan Mortality Penalty

American Journal of Public Health, 2010

should be mandated to ensure safety and autonomy regarding women's decisions. These data in no wa... more should be mandated to ensure safety and autonomy regarding women's decisions. These data in no way indicate that women's access to abortion services should be impeded, rather that reductions in abusive men's coercive control over women's reproductive choices may well reduce many women's need for such services. Policies aimed at requiring women to notify partners or to obtain partner consent before undergoing an abortion should be reconsidered because of the likelihood of both endangering women and placing them at risk for coercion regarding this critical decision. Efforts to prevent the violent and coercive behavior of men and boys should be incorporated within any comprehensive program to reduce unintended pregnancy and the subsequent need for abortion services. j

Research paper thumbnail of Evaluating heart disease presciptions-filled as a proxy for heart disease prevalence rates

Journal of health and human services administration, 2008

Heart disease is the leading cause of death in the U.S. Yet, prevalence rates are not reported at... more Heart disease is the leading cause of death in the U.S. Yet, prevalence rates are not reported at the county level. Not knowing how many have the disease, and where they are, may be a knowledge barrier to effective health care interventions. We use heart disease drug prescriptions-filled as a proxy measure for prevalence of heart disease. We test the correlation to the Behavioral Risk Factor Surveillance System (BRFSS) and find positive, statistically significant correlations. Next we illustrate the geographic patterns revealed using the county-level prevalence estimate maps. This information can be used to provide a better understanding of sub-state variations in disease patterns and subsequently target the delivery of health resources to small areas in need.