Estimating county-level tobacco use and exposure in South Carolina: a spatial model-based small area estimation approach.

Abstract:

PURPOSE:Local health statistics are increasingly requested for policy-making and programmatic purposes; however, population-based surveys are often inadequate to support direct estimation for small areas. Model-based estimation techniques can be used to create local estimates for public health outcomes. Using the 2014-2015 South Carolina (SC) Adult Tobacco Survey, we examined tobacco-related outcomes at the county level using a spatial multilevel, poststratification approach. METHODS:To create county-level tobacco estimates, we used a two-level model with a spatially intrinsic conditional autoregressive random intercept. Stratum-specific (race, age, and sex) estimates for each county were then created and averaged based on population data obtained from the U.S. Census. RESULTS:The estimated prevalence of current smoking in SC counties among adults ranged from 7.4% to 35.1%, and the percentage reporting ever trying an e-cigarette ranged from 4.2% to 30.2%. Model validation showed considerable agreement between direct and indirect estimates (Pearson and Spearman correlations all >0.75) that varied by the sample size of the outcome, as hypothesized. CONCLUSIONS:Data from the SC Adult Tobacco Survey were used to develop county-level estimates of multiple tobacco-related outcomes using a spatial multilevel, poststratification approach. The results showed heterogeneity in smoking behaviors across the state along with marked spatial correlation.

journal_name

Ann Epidemiol

journal_title

Annals of epidemiology

authors

Eberth JM,McLain AC,Hong Y,Sercy E,Diedhiou A,Kilpatrick DJ

doi

10.1016/j.annepidem.2018.03.015

subject

Has Abstract

pub_date

2018-07-01 00:00:00

pages

481-488.e4

issue

7

eissn

1047-2797

issn

1873-2585

pii

S1047-2797(17)30971-7

journal_volume

28

pub_type

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