The Public Health Benefit of Using Census Tracts from Full Patient Address Chris DuClos, MS, GISP Program Manager Environmental Public Health Tracking This project was supported by Cooperative Agreement Number 5NEU1EH001349 from the Centers for Disease Control and Prevention. The contents of this presentation are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.

Current Situation Under Florida Administrative Code Chapter 59E-7 AHCA only collects the billing ZIP Code and county of the patient from reporting hospital and ED providers Billing ZIP Code is the only sub-county geography available Tampa General Hospital

The Problem with ZIP Codes USPS can change ZIP Code boundaries as often as twice a year USPS must disclose numeric changes, but does not publish the boundary changes for ZIP Codes Billing ZIP Codes include some PO Boxes, which is why physical address is actually preferred Wikipedia.org

Public Health Indicators based on ZIP Codes Environmental Public Health Tracking uses hospitalizations and emergency department visits to create indicator data Asthma COPD Carbon Monoxide Poisoning Heart Attacks Heat Related Illness Injuries (e.g. Dog Bites)

ZIP Code Changes in Leon County 32308 and 32311 were decreased dramatically in size in 2001 32317 was added, along with 32305 A 5-year study from 1999-2004 would be hard to do With the full address, the census tract can be assigned through geocoding Tracts allow for better long-term studies of health outcomes and related determinants of health Enables high-quality sub-county studies, suitable for community health assessments and health improvement plans

ZIP Codes vs. Census Tracts Available in AHCA data currently Only assignable with full street address Change frequently, possibly more than once a year, as needed by USPS Change every 10 years with decennial census (e.g. 2020) Boundary changes are not published by USPS Changes published by US Census Bureau and tracked with nested files Boundary files only available from private vendors for a fee Boundary files freely available from US Census Bureau Generally have at least 30,000 people Generally have about 4,000 people Harder to link to other data Better linkage to other local data sets like income, education, race, etc. Wikipedia.org

Preferred Solution – Need Address to Get Tract Revise FAC Chapter 59E-7 and add the required address fields for hospitals/emergency departments to send to AHCA Retain fields needed for existing surveillance efforts, especially SSN and Masked SSN fields

Benefits of Collecting Full Address With the full address, the census tract can be assigned through geocoding Tracts allow for better long-term studies of health outcomes and related determinants of health Enables high-quality sub-county studies, suitable for community health assessments and health improvement plans

Questions? Chris DuClos Program Manager / GIS Specialist Environmental Public Health Tracking (850) 245-4264 chris.duclos@FLHealth.gov