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An Ecosystem of Health Disparities and Minority Health Resources

Dictionary of Terms

A

AAPC: Average Annual Percent Changes are based on the APCs calculated by the Joinpoint Regression Program. To learn more about computing AAPCs see link.

APC: Annual Percent Change used to measure trend or the change in rate over time

Age-Adjusted Rate: An age-adjusted rate is a weighted average of the age-specific rates where the weights are the proportions of persons in the corresponding age groups of a standard million population. Age adjustment minimizes the effect of a difference in age distributions when comparing rates. For HDPulse, all rates are age-adjusted to the 2000 US standard million population to facilitate comparison of rates across geographic areas and demographic groups.

B

Body Mass Index (BMI): A measure of body fat based upon height and weight. The index applies to both men and women.

Broadband Access: Broadband Access is the percentage of households with a broadband internet connection through subscription. Broadband Access measures access at any speed; yet, not all broadband is fast enough to meet the needs of all households. Adequate minimum speeds to effectively access all content types (e.g. streaming videos or virtual classrooms) may vary according to a given household. In addition, this measure does not account for the reasons why a household does not have broadband access. Barriers to broadband access could be due to insufficient infrastructure, cost, or lack of personal interest (e.g. older adults are less likely to purchase home internet), and this metric is unable to untangle these specific barriers.

C

Census Tract: A subset of a county, closer to a neighborhood, used for statistical purposes. More detailed information is available from the US Census Bureau.

Colonoscopy: An examination of the inside of the colon using a thin, lighted tube (called a colonoscope) inserted into the rectum. If abnormal areas are seen, tissue can be removed and examined under a microscope to determine whether disease is present.

Colorectal: Having to do with the colon or the rectum.

County-Level Modeled Estimates Combined results from BRFSS and the National Health Interview Survey (NHIS), a smaller, in-person survey, using a statistical model that takes advantage of the strengths of each survey. For more information on County-Level Modeled Estimates and the differences between them and Direct Estimates, please visit Screening and Risk Factor Data Types.

Crowding: Households with > 1 person/room: A housing unit is often considered crowded if it has more than one person to a room. (The number of persons per room is calculated for a household by dividing the number of occupants by the number of rooms.)

For more detailed information on this topic, please see the SEER County Attributes web page or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.

D

Death Rate: Deaths per year per 100,000 persons

E

Education: Source: Demographic data provided by the Census Bureau and the American Community Survey.

Education: Bachelor's Degree: Persons with a Bachelor's Degree or Higher are those who have received a bachelor's degree from a college or university, or a master's, professional, or doctorate degree. Data includes only persons 25 years old and over. The percentages are obtained by dividing the counts of graduates by the total number of persons 25 years old and over.

For more detailed information on this topic, please see the SEER County Attributes web page or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.

Education: High School Graduates: High School Graduates include people whose highest degree was a high school diploma or its equivalent, people who attended college or professional school, and persons who received a college, university, or professional degree. Persons who reported completing the 12th grade but not receiving a diploma are not high school graduates. Data includes only persons 25 years old and over. The percentages are obtained by dividing the counts of graduates by the total number of persons 25 years old and over.

For more detailed information on this topic, please see the SEER County Attributes web page or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.

Education: Less than High School: These statistics include people who did not graduate high school or get a GED. Persons who reported completing the 12th grade but not receiving a diploma are not high school graduates. Data includes only persons 25 years old and over. The percentages are obtained by dividing the counts of people in this category by the total number of persons 25 years old and over.

For more detailed information on this topic, please see the SEER County Attributes web page or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.

Education: Less than 9th Grade: These statistics include people whose highest level of educational attainment was any of the following: nursery school, kindergarten, and elementary school (1st to 8th grades). Data includes only persons 25 years old and over.

For more detailed information on this topic, please see the SEER County Attributes web page or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.

F

Family: A group of two or more people who reside together and who are related by birth, marriage, or adoption.

For more detailed information on this topic, please see the SEER County Attributes web page or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.

Fecal Occult Blood Test: A screening test for cancers of the colon or rectum that checks for blood in stool. (Fecal refers to stool; occult means hidden.)

Food Environment Index: Food Environment Index is a scaled index The Food Environment Index ranges from a scale of 0 (worst) to 10 (best) and equally weights two indicators of the food environment:
1) Limited access to healthy foods estimates the percentage of the population that is low income and does not live close to a grocery store. Low income is defined as having an annual family income of less than or equal to 200 percent of the federal poverty threshold for the family size. Living close to a grocery store is defined differently in rural and nonrural areas; in rural areas, it means living less than 10 miles from a grocery store whereas in nonrural areas, it means less than 1 mile.
2) Food insecurity estimates the percentage of the population that did not have access to a reliable source of food during the past year. A two-stage fixed effects model was created using information from the Community Population Survey, Bureau of Labor Statistics, and American Community Survey to estimate food insecurity.
In 2023, the average value (median) for counties was 7.6 and most counties fell between about 6.8 and 8.2. More information on the two metrics the food environment consists of can be found in their measure descriptions.

H

Healthy People 2010: The prevention agenda for the Nation. It is a statement of national health objectives designed to identify the most significant preventable threats to health and to establish national goals to reduce these threats.

Hispanic/Latino: Hispanic/Latino data include all people who identify themselves as being of Hispanic/Latino origin. Hispanic/Latino ethnicity is considered independently of race, so Hispanic/Latino persons may be of any race.

For state exclusions that are used when producing Hispanic/Latino mortality rates, see Policy for Calculating Hispanic Mortality.

Household: A household includes all the people who occupy a housing unit as their usual place of residence.

For more detailed information on this topic, please see the SEER County Attributes web page or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.

I

Income: 'Total income' is the sum of the amounts reported separately for wages, salary, commissions, bonuses, or tips; self-employment income from own nonfarm or farm businesses, including proprietorships and partnerships; interest, dividends, net rental income, royalty income, or income from estates and trusts; Social Security or Railroad Retirement income; Supplemental Security Income (SSI); any public assistance or welfare payments from the state or local welfare office; retirement, survivor, or disability pensions; and any other sources of income received regularly such as Veterans' (VA) payments, unemployment compensation, child support, or alimony.

For more detailed information on this topic, please see the SEER County Attributes web page or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.

Income: Median Family Income: Family income is the sum of money received in the calendar year by all family members residing together, not including non-relatives. Data are limited to the household population and exclude the population living in institutions, college dormitories, and other group quarters. The median income divides the income distribution into two equal groups, one having incomes above the median, and other having incomes below the median.

For more detailed information on this topic, please see the SEER County Attributes web page or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.

Income: Median Household Income: Household income is the sum of money income received in the calendar year by all household members 15 years old and over, including household members not related to the householder, people living alone, and other nonfamily household members. Included in the total are amounts reported separately for wage or salary income; net self-employment income; interest, dividends, or net rental or royalty income or income from estates and trusts; Social Security or Railroad Retirement income; Supplemental Security Income (SSI); public assistance or welfare payments; retirement, survivor, or disability pensions; and all other income. The median income divides the income distribution into two equal groups, one having incomes above the median, and other having incomes below the median.

For more detailed information on this topic, please see the SEER County Attributes web page or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.

Income: Vast Majority Income: Vast majority income data is calculated using the Per Capita Income and the Gini Index of Income Inequality provided by the Census Bureau and the American Community Survey. Vast Majority Income (VMI) =(1.1 X [per capita income]) X (1- [gini]). More information about this topic can be found at "The Vast Majority Income (VMI): A New Measure of Global Inequality" by Anwar Shaikh and Amr Ragab.

Insurance: Source: US Census Bureau Small Area Health Insurance Estimates
https://www.census.gov/programs-surveys/sahie.html

Interval Color: Color on the map that the state or county is represented by as well as other values in that range.

Interval Range: Range of values that the state or county has been grouped with.

J

Joinpoint: Statistical software for the analysis of trends using a joinpoint regression model, that is, models describe the trends by a sequence of connected straight line segments.

M

Malignant: Cancerous. Malignant tumors can invade and destroy nearby tissue and spread to other parts of the body.

Mammography: The use of x-rays to create a picture of the breast.

Mobility: The American Community Survey (ACS) and the Puerto Rico Community Survey (PRCS) ask respondents age 1 year and over whether they lived in the same residence 1 year ago. For people who lived in a different residence, the location of their previous residence is collected. ACS uses a series of monthly samples to produce estimates. Estimates for geographies of population 65,000 or greater are published annually using these monthly samples. Three years of monthly samples are needed to publish estimates for geographies of 20,000 or greater and five years for smaller geographies. The 5-year dataset is used for the county-to-county migration flows since many counties have a population less than 20,000. The first 5-year ACS dataset covers the years 2005 through 2009.

For more detailed information on this topic, please see the SEER County Attributes web page or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.

Mobility: Haven't moved (in last yr): Persons who responded that they lived in the same residence 1 year ago.

Mobility: Moved from Outside US: Persons who responded that they did not live in the same residence one year ago and the previous residence was not in the US.

Mobility: Moved, Different County this State: Persons who responded that they did not live in the same residence and their previous residence was in the same state but a different county within that state.

Mobility: Moved, Different State: Persons who responded that they did not live in the same residence and their previous residence was in a different state.

Mobility: Moved, Same County: Persons who responded that they did not live in the same residence and their previous residence was in the same county.

Mortality: Death

Mortality Rate: The number of deaths per year per 100,000 persons

N

National Cancer Institute: NCI. The National Cancer Institute, part of the National Institutes of Health of the United States Department of Health and Human Services, is the Federal Government's principal agency for cancer research.

National Institute on Minority Health and Health Disparities: NIMHD. NIMHD's work touches the lives of millions of Americans burdened by disparities in health status and health care delivery, including racial and ethnic minority groups, rural populations, populations with low socioeconomic status, and other population groups.

Non-English Language: Language isolation: A linguistically isolated household is one in which no member 14 years old and over (1) speaks only English or (2) speaks a non-English language and speaks English 'very well.' In other words, all members 14 years old and over have at least some difficulty with English. Data is shown as a percentage of households.

For more detailed information on this topic, please see the SEER County Attributes web page or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.

P

Pap smear: The collection of cells from the cervix for examination under a microscope. It is used to detect changes that may be cancer or may lead to cancer, and can show noncancerous conditions, such as infection or inflammation. Also called a Pap test.

Preventable Hospital Stays: Preventable Hospital Stays is a rate. Preventable Hospital Stays measures the number of hospital stays for ambulatory-care sensitive conditions per 100,000 Medicare enrollees. Rates measure the number of events (e.g., deaths, births) in a given time period (generally one or more years) divided by the average number of people at risk during that period. Rates help us compare health data across counties with different population sizes. Preventable Hospital Stays is age-adjusted. Age is a non-modifiable risk factor, and as age increases, poor health outcomes are more likely. We report an age-adjusted rate in order to fairly compare counties with differing age structures.

Population: Statistics based on age, race/ethnicity, and others.

Population: Age Under 18: These data are derived from estimates of the resident population of all U.S counties and county equivalents by single years of age (age 0, 1, 2,....85 and over) for July 1 of the reference year, for years since 2000, or for April 1 for 2000.

For more detailed information on this topic, please see the SEER County Attributes web page or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.

Population: Age 18 to 39: These data are derived from estimates of the resident population of all U.S counties and county equivalents by single years of age (age 0, 1, 2,....85 and over) for July 1 of the reference year, for years since 2000, or for April 1 for 2000.

For more detailed information on this topic, please see the SEER County Attributes web page or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.

Population: Age 40 and Over: These data are derived from estimates of the resident population of all U.S counties and county equivalents by single years of age (age 0, 1, 2,....85 and over) for July 1 of the reference year, for years since 2000, or for April 1 for 2000.

For more detailed information on this topic, please see the SEER County Attributes web page or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.

Population: Age 40 to 64: These data are derived from estimates of the resident population of all U.S counties and county equivalents by single years of age (age 0, 1, 2,....85 and over) for July 1 of the reference year, for years since 2000, or for April 1 for 2000.

For more detailed information on this topic, please see the SEER County Attributes web page or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.

Population: Age 50 and Over: These data are derived from estimates of the resident population of all U.S counties and county equivalents by single years of age (age 0, 1, 2,....85 and over) for July 1 of the reference year, for years since 2000, or for April 1 for 2000.

For more detailed information on this topic, please see the SEER County Attributes web page or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.

Population: Age 65 and Over: These data are derived from estimates of the resident population of all U.S counties and county equivalents by single years of age (age 0, 1, 2,....85 and over) for July 1 of the reference year, for years since 2000, or for April 1 for 2000.

For more detailed information on this topic, please see the SEER County Attributes web page or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.

Population: American Indian/Alaska Native: A person having origins in any of the original peoples of North and South America (including Central America) and who maintain tribal affiliation or community attachment.

For more detailed information on this topic, please see the SEER County Attributes web page or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.

Population: Asian / Pacific Islander: Asian is defined as a person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. It includes "Asian Indian," "Chinese," "Filipino," "Korean," "Japanese," "Vietnamese," and "Other Asian." Pacific Islander is defined as a person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. It includes people who indicate their race as "Native Hawaiian," "Guamanian or Chamorro," "Samoan," and "Other Pacific Islander."

For more detailed information on this topic, please see the SEER County Attributes web page or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.

Population: Black: A person having origins in any of the Black racial groups of Africa. It includes people who indicate their race as "Black, African Am., or Negro," or provide written entries such as African American, Afro American, Kenyan, Nigerian, or Haitian.

For more detailed information on this topic, please see the SEER County Attributes web page or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.

Population: Foreign Born: Foreign-born persons include all people who indicated they were either a U.S. citizen by naturalization or they were not a citizen of the United States. Persons born abroad of American parents or born in Puerto Rico or other U.S. Island Areas are not considered foreign born. The percentage shown is obtained by dividing the count of foreign-born persons by the total population.

For more detailed information on this topic, please see the SEER County Attributes web page or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.

Population: Hispanic/Latino: Hispanic/Latino data include all people who identify themselves as being of Hispanic/Latino origin. Hispanic/Latino ethnicity is considered independently of race, so Hispanic/Latino persons may be of any race. More information can be found at the SEER web site, the data.census.gov platform to access data and digital content from the U.S. Census Bureau, and the NAACCR web site (PDF)

Population: White: A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

Poverty: Statistics for people and families who are below poverty

Poverty: Families/Persons Below Poverty: Families and persons are classified as below poverty if their total family income or unrelated individual income was less than the poverty threshold specified for the applicable family size, age of householder, and number of related children under 18 present. The Census Bureau uses the federal government's official poverty definition.

If the total income of a person's family is less than the threshold appropriate for that family, then the person is considered poor, together with every member of his or her family. If a person is not living with anyone related by birth, marriage, or adoption, then the person's own income is compared with his or her poverty threshold.

The poverty thresholds are updated every year to reflect changes in the Consumer Price Index. The poverty thresholds are the same for all parts of the country they are not adjusted for regional, state or local variations in the cost of living.

Poverty status is not determined for institutionalized people, people in military group quarters, people in college dormitories, and unrelated individuals under 15 years old. These groups were excluded from the numerator and denominator when calculating the percent of persons below poverty.

For more detailed information on this topic, please see the SEER County Attributes web page,the poverty section of the Census Web site or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.

Poverty: Persons Below 150% of Poverty: Families and persons are classified as below poverty if their total family income or unrelated individual income was less than the poverty threshold specified for the applicable family size, age of householder, and number of related children under 18 present. The Census Bureau uses the federal government's official poverty definition.

If the total income of a person's family is less than the threshold appropriate for that family, then the person is considered poor, together with every member of his or her family. If a person is not living with anyone related by birth, marriage, or adoption, then the person's own income is compared with his or her poverty threshold. If their income is less than half their poverty threshold, they are below 50% of poverty; less than the threshold itself, they are in poverty (below 100% of poverty); less than 1.25 times the threshold, below 125% of poverty, and so on. The greater the ratio of income to poverty, the more people fall under the category, because higher ratios include more people with higher incomes.

The poverty thresholds are updated every year to reflect changes in the Consumer Price Index. The poverty thresholds are the same for all parts of the country they are not adjusted for regional, state or local variations in the cost of living.

Poverty status is not determined for institutionalized people, people in military group quarters, people in college dormitories, and unrelated individuals under 15 years old. These groups were excluded from the numerator and denominator when calculating the percent of persons below poverty.

For more detailed information on this topic, please see the SEER County Attributes web page,the poverty section of the Census Web site or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.

R

Rate: Cases or deaths per 100,000 persons

Residential Segregation – Black/White Racial/ethnic residential segregation refers to the degree to which two or more groups live separately from one another in a geographic area. The index of dissimilarity is a demographic measure of the evenness with which two groups (Black and White residents, in this case) are distributed across the component geographic areas (census tracts, in this case) that make up a larger area (counties, in this case). The residential segregation index ranges from 0 (complete integration) to 100 (complete segregation). The index score can be interpreted as the percentage of either Black or White residents that would have to move to different geographic areas in order to produce a distribution that matches that of the larger area. More information is available from County Health Rankings.

S

SEER*Stat: Software used with the SEER public-use file over the Internet or as a PC desktop system for production of a myriad of cancer statistics, such as mortality rates and survival rates, for various demographic and medical input variables.

Sigmoidoscopy: Inspection of the lower colon using a thin, lighted tube called a sigmoidoscope. Samples of tissue or cells may be collected for examination under a microscope. Also called proctosigmoidoscopy.

T

Trend: Change in rate over time expressed as an average annual percent change

U

United States: Depending on the data source, the US can be either the total US or a subsection of the US based upon the SEER Registries

Urban/Rural: Continuum Code: Rural-Urban Continuum Codes were developed by the United States Department of Agriculture (USDA).

Rural-Urban Continuum Codes form a classification scheme that distinguishes metropolitan (metro) counties by the population size of their metro area, and nonmetropolitan (nonmetro) counties by degree of urbanization and adjacency to a metro area or areas. For more information about using Rural-Urban Continuum Codes, go to Rural-Urban Continuum Codes in SEER*Stat.

Urban/Rural: Urban Percent: All territory, population and housing units in urbanized areas and in places of more than 2,500 persons outside of urbanized areas. 'Urban' classification cuts across other hierarchies and can be in metropolitan or non-metropolitan areas.

For more detailed information on this topic, please see the SEER County Attributes web page or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.

W

Workforce: Statistics in this group include data from different sources that are all related to employment.

Workforce: Occupational Injuries (Fatal): Data for fatal workplace injuries come from the Bureau of Labor Statistics.

Workforce: Occupational Injuries (Severe): Data for severe workplace injuries come from OSHA.

Workforce: Unemployed: All civilians 16 years old and over are classified as unemployed if they (1) were neither 'at work' nor 'with a job but not at work' during the reference week, and (2) were actively looking for work during the last 4 weeks, and (3) were available to accept a job. Also included as unemployed are civilians who did not work at all during the reference week, were waiting to be called back to a job from which they had been laid off, and were available for work except for temporary illness.

For more detailed information on this topic, please see the SEER County Attributes web page or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.

Workforce: Union Affiliation: Percent of people who are union members. Data from the Bureau of Labor Statistics from the Current Population Survey (CPS). Additional details can be found in this table from BLS.

Workforce: White Collar: Percent White Collar is calculated as a percentage of the employed civilian population 16 years and over, and includes those employed in management, professional and related occupations, fire fighting, prevention and law enforcement workers, including supervisors.

For more detailed information on this topic, please see the SEER County Attributes web page or the data.census.gov platform to access data and digital content from the U.S. Census Bureau.


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