Reliability of the American Community Survey for unintentional drowning and submersion injury surveillance: a comprehensive assessment of 10 socioeconomic indicators derived from the 2006-2013 annual and multi-year data cycles.

Nathaniel Bell,Bo Cai

doi:10.1186/s40621-015-0065-0

Abstract

BackgroundOur objective was to evaluate the reliability and predictability of ten socioeconomic indicators obtained from the 2006–2013 annual and multi-year ACS data cycles for unintentional drowning and submersion injury surveillance.MethodsEach indicator was evaluated using its margin of error and coefficient of variation. For the multi-year data cycles we calculated the frequency that estimates for the same geographic areas from consecutive surveys were statistically significantly different. Relative risk estimates of drowning-related deaths were constructed using the National Center for Health Statistics compressed mortality file. All analyses were derived using census counties.ResultsFive of the ten socioeconomic indicators derived from the annual and multi-year data cycles produced high reliability CV estimates for at least 85 % of all US counties. On average, differences in socioeconomic characteristics for the same geographic areas for consecutive 3- and 5-year data cycles were unlikely to be caused by sampling error in only 17 % (5–89 %) and 21 % (5–93 %) of all counties. No indicator produced statistically significant relative risk estimates across all data cycles and survey years.ConclusionsThe reliability of the annual and multi-year county-level ACS data cycles varies by census indicator. More than 75 % of the differences in estimates between consecutive multi-year surveys are likely to have occurred as a result of sampling error, suggesting that researchers should be judicious when interpreting overlapping survey data as reflective of real changes in socioeconomic conditions. Although no indicator predicted disparities in drowning-related injury mortality across all data cycles and years, further studies are needed to determine if these associations remain consistent at different geographic scales and for injury morbidity.

Highlights

Our objective was to evaluate the reliability and predictability of ten socioeconomic indicators obtained from the 2006–2013 annual and multi-year ACS data cycles for unintentional drowning and submersion injury surveillance
The indicators we evaluated were selected based on their previous application for monitoring drowning-related injuries in the United States (US) (Brenner et al 2001; Browne et al 2003; Gilchrist & Parker 2014; Peek-Asa et al 2004; Saluja et al 2006; Thompson & Rivara 2000; Wright et al 2013) and abroad (Burrows et al 2013; Giashuddin et al 2009; Kim et al 2007) All geographic and socioeconomic files were downloaded from the American Fact Finder database
Between 2006 and 2013 there were 28,367 deaths attributed to unintentional drowning and submersions recorded by the National Center for Health Statistics (NCHS)

Summary

Introduction

Our objective was to evaluate the reliability and predictability of ten socioeconomic indicators obtained from the 2006–2013 annual and multi-year ACS data cycles for unintentional drowning and submersion injury surveillance. Causes of Injury Death: Centers for Disease Control and Prevention & Control 2013) Over this same period it remained a top ten cause of all injury-related deaths among all persons under the age of 55. Factors such as lower socioeconomic status, age, gender, ethnicity, alcohol, and living in a rural environment all increase risk of hospitalization or death from drowning (Brenner et al 2001; Browne et al 2003; Burrows et al 2013; Giashuddin et al 2009; Gilchrist & Parker 2014; Kim et al 2007; Peek-Asa et al 2004; Saluja et al 2006; Thompson & Rivara 2000; Wright et al 2013). Recent systematic reviews show that these factors remain indicative of variation in risk both in the US and abroad (Leavy et al 2015a; Leavy et al 2015b; Wallis et al 2015)

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