1. 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 5NEU1EH 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.

2. 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

3. 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

4. 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)

5. ZIP Code Changes in Leon County
32308 and were decreased dramatically in size in 2001
32317 was added, along with 32305
A 5-year study from 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

6. 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

7. 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

8. 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

9. Questions?
Chris DuClos Program Manager / GIS Specialist Environmental Public Health Tracking (850)