Using the Data

Yes.  It is technically possible to create estimates for census blocks, and any larger geographies into which census blocks nest.

We cannot include policy and/or program intervention effects, which would occur locally, in the modeling process.  Therefore, the estimates for local areas are the statistically expected prevalence of the risk factor, health outcome, or preventive service use based on the associations that we observe through the overall model.  It is possible that a community may have a program intervention that has a substantial impact, such that the resulting prevalence of a health risk factor (for example) is lower or preventive service is higher than what is statistically predicted by our model.  In that case, if a community relies solely on the small area estimates, the impact of that local intervention would be underestimated.  

The data can be used to:

• Identify the health issues facing a city or neighborhoods within cities
• Identify emerging health problems
• Establish key health objectives
• Develop and implement effective and targeted prevention activities

The 500 Cities project does not provide a weighted composite score for the included cities, therefore the data should not be used to rank the overall health of a city. Cities can be compared on individual measures, however.

We cannot include local intervention effects in the modeling process. Therefore, the estimates for local areas are the statistically expected prevalence based on the associations we observe through the overall model. In the absence of strong local public health intervention impact, model-based estimates are quite close to reliable direct survey estimates and could reflect the local geographic variations in health indicators.

Thus, without reliable local information about public health programs, model-based local estimates should not be used to evaluate the impact of local public health programs, policies, or interventions. We would suggest using the model-based estimates for the baseline and for communities conducting their own surveys to evaluate the impact of their interventions.