Show Looking at Data By State As mentioned Utah has been notoriously low in childhood immunization rates but recently has moved well out of last place nationwide see Table The CDC estimates that as of June 1999 Utahimmunization rate was 80 UTD 3 at 24 months Childhood Immunization 2000 This value representssignificant and meaningful increase over the past decade Figureillustrates the UTD 3 at 24 months for the state of Utah through the 1990s These data are instructive but are not helpful in identifying how and where scarce resources should be applied in the state Looking at Data by Health District Recent data broken down by Utah health district are presented in Table These data show that considerable variability exists between these large geographic areas and again this perspective may not be helpful in gainingclear picture of how to apply resources within the state Small Area Assessment Using these largescale areas state health district for calculation of immunization rates or other health outcomes may actually mask pockets of underimmunization and give incorrect impressions about the extent ofproblem or the success or failure ofprogram or effort In order to address this difficulty the technique of small area assessment SAA can be applied to formulatemore realistic picture based on much smaller geographic areas that encompassmore homogeneous population Community Health Status 2000 SAA attempts to measure outcomes atvery local level which is critical for realistic assessment and in conjunction application of scarce resources SAA is not without unavoidable drawbacks Usually small number of people are subject toparticular health outcome insmall area Therefore rates including immunization rates tend to be unstable and subject to extensive Privacy issues can beproblem error especially with sensitive outcomes such as AIDS or suicide There is also the overriding problem of where people are counted in the small area of their residence or of their medical care Since 2ip codes are the smallest geographic unit for available generally is information which childhood immunization rates were investigated asfunction of zip code within Salt Lake County Goals The goal was to collect and analyze childhood immunization data for Salt Lake County using the tool of SAA The hypothesis was that pockets of under-immunized children are present which are masked by analyzing data asfunction of larger geographic areas In addition an assessment of particular communities with respect to per capita income population availability of health care etc was made to look for common features or distinct patterns in relation to immunization rates Methods Immunization rate data broken down by zip code of medical care were obtained fromvariety of public health officials Jacobs 2000 Stevenson 2000 Sukhan 2000 Data are not generally available in this form In addition the data presented are solely from providersthe public sector g Salt Lake Valley Health Department SLVHD Women Infants and Children Nutrition Program WIC and Association for Utah Health AUCH Comparable Community information from the private sector g Blue Cross Blue Shield Intermountain Health Care IHC and United Health Care was impossible to obtain Graphs of immunization rates for public providers by zip codes were then constructed An immunization rate of 85 UTD or less was chosen as poor e 5 below the national goal and zip codes under that cut-off were considered separately from the larger data set Information was then obtained about various attributes of the low immunization communities including the availability of health care the number of elementary schools and day care centers S West Yellow Pages 1999 as well as defails such as median age per capita income population and numerous health outcomes that have been cataloged by the State Community Health Status 2000 These features were then compared across the low rate zip codes as well as tozip code defined as good immunization rate area e 90 UTD Results and Discussion As of March 2000 there weretotal of 48 792 children under the age ofyears in Salt Lake County 33 16 101 of those are seen in the public sector and 66 32 203 in the private sector Stevenson 2000 This breakdown illustrates the reason why data from private providers are so crucial Figureillustrates the Digital image 2005 Marriott Library University of Utah Al rights reserved |