Glossary

B

Birth

Birth is defined as delivery of an infant that shows specified signs of life as defined by the CDC. For more information, please see: http://www.cdc.gov/nchs/products/other/miscpub/statereq.htm.

C

Chronic condition

Surveys defined chronic conditions in similar ways for the purposes of displaying data on the Health System Measurement Project, however, the definitions vary slightly due to survey methodology and data constraints.  Examples are below.

 

The Medical Expenditure Panel Survey (MEPS) defined chronic conditions derived from the Clinical Classification Codes (CSS).

                                                                                       

The National Health Interview Survey (NHIS), defined a count of chronic conditions as follows. For adults, multiple types of cancers were only counted once for the count of chronic conditions.   Multiple types of heart conditions (for adults: coronary heart disease, myocardial infarction, other heart disease or condition; for children: congenital heart disease, other heart condition) were also only counted once.  Adults with emphysema and/or chronic bronchitis were considered to have chronic obstructive pulmonary disease (COPD); therefore prevalence of both conditions was only counted once. For children, multiple types of developmental conditions (Down syndrome, mental retardation, other developmental disorder) were only counted once.

 

The National Health and Nutrition Examination Survey (NHANES) defined chronic conditions as ever being told by a health professional that an individual had cancer, hypertension, coronary heart disease, myocardial infarction, heart disease, stroke, asthma, diabetes, arthritis, liver condition, chronic bronchitis or if they had measured hepatitis antibodies.

 

The National Ambulatory Medical Care Survey (NAMCS) defined chronic conditions as if a sampled visit had any of the following conditions on their chart: arthritis, asthma, cancer, cerebrovascular disease , chronic renal failure, congestive heart failure, COPD, depression, diabetes, hyperlipidemia, hypertension, ischemic heart disease, obesity, or osteoporosis.

Confidence interval

The confidence interval measures the statistical probability that the range obtained from the sample contains the true population value. For example, a 95% confidence interval is expected to contain the true population value in 95% of samples.

D

Disability

Historically, disability has been defined and measured in a variety of ways by federal agencies, depending upon the purpose and use of the information. The Social Security Administration has used a severe disability standard, defining disability as a severe impairment which lasts for a continuous period of more than one year and makes an individual unable to maintain employment. A number of agency surveys have defined disability in terms of Activities of Daily Living (ADLs) or Instrumental Activities of Daily Living (IADLs). In recent years, the disability standard has become more closely aligned with the American Community Survey (ACS) definition, which defines disability using standard questions. In the ACS, individuals are identified as having a disability if any of the following conditions exist: is deaf or has serious difficulty hearing; is blind or has serious difficulty seeing even when wearing glasses; has difficulty dressing or bathing; has serious difficulty concentrating, remembering, or making decisions; has serious difficulty walking or climbing stairs; or has difficulty doing errands alone such as visiting a doctor's office or shopping.

E

Ethnicity

All federal data collections are required to use the Office of Management and Budget (OMB) minimum data standards for race and ethnicity. The OMB’s government-wide standards were originally issued in 1997 after a comprehensive public engagement process and extensive field testing.   These standards had to be implemented by 2003. A detailed explanation of these standards is available at: www.whitehouse.gov/omb/fedreg_1997standards/.

Most surveys now include the new classifications though some are still in the process of converting to the new questions. Prior to 2003, racial and ethnic classifications were: American Indian or Alaskan Native; Asian or Pacific Islander; Black; Hispanic; and White. As of 2003, surveyors were encouraged to use a two-question format with ethnicity asked separately and before the question on race, and must provide respondents with the option of identifying with more than one race . The first question asks for self-identified ethnicity, with the classifications: Hispanic or Latino; and Not Hispanic or Latino. The second question asks for self-identified race, with the classifications: American Indian or Alaska Native; Asian; Black or African American; Native Hawaiian or Pacific Islander, or White. In rare instances, surveyors may also use a combined, single-question format, with the classifications: American Indian or Alaska Native; Asian; Black or African American; Native Hawaiian or Pacific Islander; White; and Hispanic or Latino. Please note that samples sizes for some categories, particularly American Indian or Alaskan Natives, may be small and estimates may not be available for all categories for all years in all measures.

M

Metropolitan status

Metropolitan and micropolitan statistical areas (metro and micro areas) are geographic entities defined by the U.S. Office of Management and Budget (OMB) for use by Federal statistical agencies in collecting, tabulating, and publishing Federal statistics. An "MSA" is made up of both metro and micro areas. A metro area contains a core urban area of 50,000 or more population, and a micro area contains an urban core of at least 10,000 (but less than 50,000) population. Each metro or micro area consists of one or more counties and includes the counties containing the core urban area, as well as any adjacent counties that have a high degree of social and economic integration (as measured by commuting to work) with the urban core. Counties without these characteristics are considered outside Core Based Statistical Areas (MSAs).

 

Where data are available, the following six categories are used:
  • Metropolitan: large central -- Counties in metropolitan statistical areas of >=1 million population
    • and that contain the entire population of the largest principal city of the metropolitan statistical area,
    • or whose entire population resides in the largest principal city of the metropolitan statistical area,
    • or that contain at least 250,000 of the population of any principal city in the metropolitan statistical area
  • Metropolitan: large fringe -- Counties in metropolitan statistical areas of >=1 million population that do not qualify as large central
  • Metropolitan: medium metro -- Counties in metropolitan statistical areas of 250,000-999,999 population
  • Metropolitan: small metro -- Counties in metropolitan statistical areas of 50,000-249,999 population
  • Nonmetropolitan: Micropolitan counties
  • Nonmetropolitan: Noncore counties: Counties that are neither metropolitan or micropolitan counties
If data for the six categories above are not available, the following categorizations are used:
  • In MSA (In metropolitan and micropolitan statistical areas)
  • Outside MSA (Outside of metropolitan and micropolitan statistical areas)
For more information, please see: http://www.census.gov/population/www/metroareas/metroarea.html.

P

Poverty Line

The poverty line is the federal government’s official measure of income inadequacy. There are two versions of the measure. The Census Bureau’s poverty thresholds are used to calculate the number of Americans in poverty each year. The HHS poverty guidelines are used in determining eligibility for certain federal and nonfederal programs. The measure of poverty used to determine income levels as a percent of poverty in the Health System Tracking Project varies by measure. The measure of poverty used is noted next to each dataset displaying income as a percent of poverty. For 2010, the weighted average poverty threshold was $11,139 for a single individual and $22,314 for a family of four. The 2010 HHS poverty guideline was $10,830 for a single individual and $22,050 for a family of four. For more information, please see http://www.census.gov/hhes/www/poverty/about/overview/measure.html and http://aspe.hhs.gov/poverty/12poverty.shtml.

R

Race

All federal data collections are required to use the Office of Management and Budget (OMB) minimum data standards for race and ethnicity. The OMB’s government-wide standards were originally issued in 1997 after a comprehensive public engagement process and extensive field testing.   These standards had to be implemented by 2003. A detailed explanation of these standards is available at: www.whitehouse.gov/omb/fedreg_1997standards/.

Most surveys now include the new classifications though some are still in the process of converting to the new questions. Prior to 2003, racial and ethnic classifications were: American Indian or Alaskan Native; Asian or Pacific Islander; Black; Hispanic; and White. As of 2003, surveyors were encouraged to use a two-question format with ethnicity asked separately and before the question on race, and must provide respondents with the option of identifying with more than one race . The first question asks for self-identified ethnicity, with the classifications: Hispanic or Latino; and Not Hispanic or Latino. The second question asks for self-identified race, with the classifications: American Indian or Alaska Native; Asian; Black or African American; Native Hawaiian or Pacific Islander, or White. In rare instances, surveyors may also use a combined, single-question format, with the classifications: American Indian or Alaska Native; Asian; Black or African American; Native Hawaiian or Pacific Islander; White; and Hispanic or Latino. Please note that samples sizes for some categories, particularly American Indian or Alaskan Natives, may be small and estimates may not be available for all categories for all years in all measures.

Region

The regions in these reports are defined by the U.S. Census Bureau, which delineates four census regions.
  • The Northeast region includes: Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont.
  • The Midwest region includes: Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin.
  • The South region includes: Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, and West Virginia.
  • The West region includes: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming.
A map is available at the following link: http://www.census.gov/geo/www/us_regdiv.pdf.

Relative standard error

The relative standard error describes how likely it is that the value obtained in the sample is the true population value, relative to the sample value. For a sample value of $8,000 and a standard error of $2,000, this means the relative standard error is 25%.

S

Sex

Sex describes self-reported physical sex identification. It does not include gender identification and is limited to identification as either male or female. For more information, please see: http://quickfacts.census.gov/qfd/meta/long_SEX255209.htm.

Standard error

The standard error describes how likely it is that the value obtained in the sample is the true population value. It provides an estimate such that the value obtained in the sample would be within two standard errors of the true population value in 95% of samples.