Title
Small-area estimation and prioritizing communities for tobacco control efforts in Massachusetts
UMMS Affiliation
Department of Medicine, Division of Preventive and Behavioral Medicine; Department of Family Medicine and Community Health
Publication Date
2009-01-20
Document Type
Article
Subjects
*Community Health Services; Confidence Intervals; *Health Promotion; Humans; Massachusetts; Odds Ratio; Population Surveillance; Prevalence; *Public Health; Public Health Practice; Risk Factors; Smoking; *Social Marketing; Socioeconomic Factors; Time Factors; *Tobacco; Tobacco Use Disorder
Disciplines
Life Sciences | Medicine and Health Sciences
Abstract
OBJECTIVES: We developed a method to evaluate geographic and temporal variations in community-level risk factors and prevalence estimates, and used that method to identify communities in Massachusetts that should be considered high priority communities for smoking interventions.
METHODS: We integrated individual-level data from the Behavioral Risk Factor Surveillance System from 1999 to 2005 with community-level data in Massachusetts. We used small-area estimation models to assess the associations of adults' smoking status with both individual- and community-level characteristics and to estimate community-specific smoking prevalence in 398 communities. We classified communities into 8 groups according to their prevalence estimates, the precision of the estimates, and temporal trends.
RESULTS: Community-level prevalence of current cigarette smoking among adults ranged from 5% to 36% in 2005 and declined in all but 16 (4%) communities between 1999 and 2005. However, less than 15% of the communities met the national prevalence goal of 12% or less. High smoking prevalence remained in communities with lower income, higher percentage of blue-collar workers, and higher density of tobacco outlets.
CONCLUSIONS: Prioritizing communities for intervention can be accomplished through the use of small-area estimation models. In Massachusetts, socioeconomically disadvantaged communities have high smoking prevalence rates and should be of high priority to those working to control tobacco use.
DOI of Published Version
10.2105/AJPH.2007.130112
Source
Am J Public Health. 2009 Mar;99(3):470-9. Epub 2009 Jan 15. Link to article on publisher's site
Journal/Book/Conference Title
American journal of public health
Related Resources
PubMed ID
19150913
Repository Citation
Li W, Land T, Zhang Z, Keithly L, Kelsey JL. (2009). Small-area estimation and prioritizing communities for tobacco control efforts in Massachusetts. Open Access Publications by UMass Chan Authors. https://doi.org/10.2105/AJPH.2007.130112. Retrieved from https://escholarship.umassmed.edu/oapubs/2087