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Reflecting the Community: Demographic
    Variations in Landline and Cell-Only
Households for a Statewide Telephone Survey
        Sarah Walsh, MPH, CHES, Foundation for a Healthy Kentucky
     Jennifer Chubinski, MS, The Health Foundation of Greater Cincinnati
    Michelle Vargas, Institute for Policy Research, University of Cincinnati
 Eric Rademacher, PhD, Institute for Policy Research, University of Cincinnati
Presenter Disclosures
The following personal financial
relationships with commercial interests
relevant to this presentation existed
during the past 12 months:

  NO RELATIONSHIPS TO DISCLOSE.
Kentucky Health Issues Poll (KHIP)
• Questions vary by year, but include:
  – Health status
  – Socioeconomic variables
  – Public opinion on health related topics
• KHIP gives policymakers and advocates
  valuable data for keeping health on the public
  agenda.
KHIP
KHIP Methodology
• Conducted annually, since 2008
• Random Digit Dial Telephone survey (RDD)
  – Cell phone sampling started 2009
• Data collection done by the Institute for Policy
  Research (IPR) at the University of Cincinnati
• Analysis done by Foundation staff
KHIP sample over time
          1,632 landline interviews
2008    January 16-February 11, 2008


              1,464 landline; 205 cell-only interviews
   2009            October 8-November 6, 2009


                        1,469 landline; 208 cell-only interviews
          2010             December 3-22 and 27-28, 2010


                                        ≈ 1,200 landline; ≈ 300 cell any
                     2011                          interviews
                                             September 27-present
Cell-only Households, 2009-2010




Blumberg SJ, Luke JV, Ganesh N, et al. Wireless substitution: State-level estimates from the National Health Interview
Survey, January 2007-June 2010. National health statistics reports; no 39. Hyattsville, MD: National Center for Health
Statistics. 2011. Available at http://www.cdc.gov/nchs/nhis.html
Why Cell?
• KY high cell-only state
• Vulnerable populations and more likely cell
  phone-only users important to our mission
  – Low-income
  – Minority
  – Young adults
• More reliable sample of population
UNWEIGHTED Results
2009 Unweighted Results
           Landline               Combined   Weighted
             Only     Cell Only    Sample     Target
percent
           34.0%      48.8%       35.8%       48%
 Males
percent
            5.3%       8.9%        5.8%        7%
 Black
percent
           26.5%      71.7%       32.1%       56%
 18-45
2010 Unweighted Results
           Landline               Combined   Weighted
             Only     Cell Only    Sample     Target
percent
           35.0%      45.7%       36.3%       48%
 Males
percent
            5.6%       8.2%        5.9%        7%
 Black
percent
           22.7%      61.5%       27.5%       56%
 18-45
Results (unweighted)
• Cell phone sample increased size (as compared
  to a landline only sample) of:
  – Minority (races not white, and Hispanic) ≈ 1%
  – **Young adults ≈3-4%
  – Men ≈2%
  – Low-income adults (under 100 and 200% FPG) ≈1%
  – Uninsured ≈2%

  ** strongest effect
WEIGHTED Results
2009 Results
                           Weighted       Weighted
                         Landline Only Combined Sample

 Currently Uninsured       28.0%          27.5%

Uninsured in Past Year     31.5%          31.7%

   Below 100% FPL          27.1%          26.4%

   Below 200% FPL          47.4%          47.3%
2010 Results
                           Weighted       Weighted
                         Landline Only Combined Sample

 Currently Uninsured       21.3%          22.5%

Uninsured in Past Year     29.8%          31.6%

   Below 100% FPL          23.6%          24.7%

   Below 200% FPL          48.1%          49.1%
Results (weighted)
• Most differences lost in weighting procedure
  – Weights based on 2008 American Community
    Survey (ACS)
  – Sample weighted on age, race, sex, education,
    regional distribution, number of adults and phone
    lines in the household.
• HOWEVER, the cell phone sample reduced the
  magnitude of the weights
Lessons Learned- KHIP 2011
• Cell sampling changed from cell only to cell
  mostly
• Larger percentage of cell phones
• Larger cost with cell sampling, but cost is
  going down
  – Previously 5x a landline response
  – Currently 3x a landline response
Draw your own conclusions
• Raw data available in free statistical portal
  – Online Analysis and Statistical Information System
    (OASIS) www.oasisdataarchive.org
Draw your own conclusions
• Data available for mapping in free mapping
  portal- HealthLandscape
  www.healthlandscape.org
Questions?
Sarah Walsh                        Jennifer Chubinski
Senior Program Officer, Local      Director of Community
Data for Local Action Initiative   Research



(502) 326-2583                     (513) 458-6608
swalsh@healthy-ky.org              jchubinski@healthfoundation.org

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Kentucky Health Issues Poll,

  • 1. Reflecting the Community: Demographic Variations in Landline and Cell-Only Households for a Statewide Telephone Survey Sarah Walsh, MPH, CHES, Foundation for a Healthy Kentucky Jennifer Chubinski, MS, The Health Foundation of Greater Cincinnati Michelle Vargas, Institute for Policy Research, University of Cincinnati Eric Rademacher, PhD, Institute for Policy Research, University of Cincinnati
  • 2. Presenter Disclosures The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: NO RELATIONSHIPS TO DISCLOSE.
  • 3. Kentucky Health Issues Poll (KHIP) • Questions vary by year, but include: – Health status – Socioeconomic variables – Public opinion on health related topics • KHIP gives policymakers and advocates valuable data for keeping health on the public agenda.
  • 5. KHIP Methodology • Conducted annually, since 2008 • Random Digit Dial Telephone survey (RDD) – Cell phone sampling started 2009 • Data collection done by the Institute for Policy Research (IPR) at the University of Cincinnati • Analysis done by Foundation staff
  • 6. KHIP sample over time 1,632 landline interviews 2008 January 16-February 11, 2008 1,464 landline; 205 cell-only interviews 2009 October 8-November 6, 2009 1,469 landline; 208 cell-only interviews 2010 December 3-22 and 27-28, 2010 ≈ 1,200 landline; ≈ 300 cell any 2011 interviews September 27-present
  • 7. Cell-only Households, 2009-2010 Blumberg SJ, Luke JV, Ganesh N, et al. Wireless substitution: State-level estimates from the National Health Interview Survey, January 2007-June 2010. National health statistics reports; no 39. Hyattsville, MD: National Center for Health Statistics. 2011. Available at http://www.cdc.gov/nchs/nhis.html
  • 8. Why Cell? • KY high cell-only state • Vulnerable populations and more likely cell phone-only users important to our mission – Low-income – Minority – Young adults • More reliable sample of population
  • 10. 2009 Unweighted Results Landline Combined Weighted Only Cell Only Sample Target percent 34.0% 48.8% 35.8% 48% Males percent 5.3% 8.9% 5.8% 7% Black percent 26.5% 71.7% 32.1% 56% 18-45
  • 11. 2010 Unweighted Results Landline Combined Weighted Only Cell Only Sample Target percent 35.0% 45.7% 36.3% 48% Males percent 5.6% 8.2% 5.9% 7% Black percent 22.7% 61.5% 27.5% 56% 18-45
  • 12. Results (unweighted) • Cell phone sample increased size (as compared to a landline only sample) of: – Minority (races not white, and Hispanic) ≈ 1% – **Young adults ≈3-4% – Men ≈2% – Low-income adults (under 100 and 200% FPG) ≈1% – Uninsured ≈2% ** strongest effect
  • 14. 2009 Results Weighted Weighted Landline Only Combined Sample Currently Uninsured 28.0% 27.5% Uninsured in Past Year 31.5% 31.7% Below 100% FPL 27.1% 26.4% Below 200% FPL 47.4% 47.3%
  • 15. 2010 Results Weighted Weighted Landline Only Combined Sample Currently Uninsured 21.3% 22.5% Uninsured in Past Year 29.8% 31.6% Below 100% FPL 23.6% 24.7% Below 200% FPL 48.1% 49.1%
  • 16. Results (weighted) • Most differences lost in weighting procedure – Weights based on 2008 American Community Survey (ACS) – Sample weighted on age, race, sex, education, regional distribution, number of adults and phone lines in the household. • HOWEVER, the cell phone sample reduced the magnitude of the weights
  • 17. Lessons Learned- KHIP 2011 • Cell sampling changed from cell only to cell mostly • Larger percentage of cell phones • Larger cost with cell sampling, but cost is going down – Previously 5x a landline response – Currently 3x a landline response
  • 18. Draw your own conclusions • Raw data available in free statistical portal – Online Analysis and Statistical Information System (OASIS) www.oasisdataarchive.org
  • 19. Draw your own conclusions • Data available for mapping in free mapping portal- HealthLandscape www.healthlandscape.org
  • 20. Questions? Sarah Walsh Jennifer Chubinski Senior Program Officer, Local Director of Community Data for Local Action Initiative Research (502) 326-2583 (513) 458-6608 swalsh@healthy-ky.org jchubinski@healthfoundation.org

Notas do Editor

  1. APHA-mandated slide
  2. Health status = BMI, current smoker, etc.Socioeconomic = age, race, sex, education, income, etc.Public opinion = support for smoke free laws, support for the ACA, identification of legislative priorities.
  3. Something to the effect of this is the history of KHIP – I’m hoping we will have 2011 out of the field by then and can report on the number of completes.Point out that 2009 and 2010 are the only years we are discussing in this paper.
  4. When we were first contemplating adding a cell sample for KHIP, studies estimated the number of cell-only households about 21%. I remember thinking that “more than 1 in 5” was such a huge proportion. More current data suggests that we’re now talking about “nearly one in three.” This map shows state-level estimates of cell-only households for our study period.The authors estimate that 31.5% of Kentucky adults, ages 18 and older, lived in “wireless-only” households between July 2009 and June 2010. This puts us in the top ten for the nation. (An additional 13.8% of adults lived in “wireless-mostly” households). Over the summer, early results from the National Health Interview Survey were released for the second half of 2010. While state-level figures are not available, Blumberg and Luke estimate that in the South, 31.1% of adults live in wireless-only households, suggesting that the rate of cell-only households continues to climb.
  5. The sample is weighted to the 2008 American Community Survey population estimates based on gender, race, age, educational attainment and region of the state.Both 2009 and 2010 were weighted to the 2008 ACS. A similar pattern emerges for both years – the cell-only sample tends to be younger, is more likely to be non-white, is more likely to be male.While the overall impact on the pooled sample is modest, inclusion of the cell-only respondents moves the total sample slightly closer to the weighting target, thereby limiting the impact of the weights and their associated biases.
  6. The sample is weighted to the 2008 American Community Survey population estimates based on gender, race, age, educational attainment and region of the state.Both 2009 and 2010 were weighted to the 2008 ACS. A similar pattern emerges for both years – the cell-only sample tends to be younger, is more likely to be non-white, is more likely to be male.While the overall impact on the pooled sample is modest, inclusion of the cell-only respondents moves the total sample slightly closer to the weighting target, thereby limiting the impact of the weights and their associated biases.
  7. DO WE NEED TO PRESENT THE DEMOGRAPHICS OF KY – MOSTLY WHITE NOT BIG HISPANIC POPULATION?
  8. Ultimately, the findings did not change significantly for other variables based on the inclusion of the cell sample in the weighted total.
  9. Ultimately, the findings did not change significantly for other variables based on the inclusion of the cell sample in the weighted total.
  10. DO WE NEED TO PRESENT THE DEMOGRAPHICS OF KY – MOSTLY WHITE NOT BIG HISPANIC POPULATION?
  11. JENNIFER CHECK THIS