September 22, 2009. Today marks the release of the state and county health insurance estimates from the American Community Survey (ACS), showing 45.1 million uninsured people in the United States in 2008 (15.1% of the U.S. population). These estimates are the first release of coverage estimates from the ACS, which is expected to be the prominent source for state health policy analysts going forward.
The ACS is conducted by the U.S. Census Bureau to provide communities with up-to-date information on key demographics and policy-relevant data. It is the replacement for the former “long form” questionnaire used in the decennial census. With annual data releases each fall, the ACS we will have much more up-to-date data on local communities, which will be a great tool for policy makers.
The other major source of state-level estimates is the Current Population Survey (CPS), also conducted by the Census Bureau. The CPS has the advantage of providing over 20 years of trend estimates, but with small state sample sizes that result in greater variance. The ACS, on the other hand, has large sample size in each state and is expected to provide robust estimates for states and sub-state areas. The 2008 topline health insurance coverage estimates for the ACS and CPS track very closely despite some methodological differences.
If you want a quick visualization of uninsurance by state and congressional district, check out this NPR link.
A formal evaluation of the ACS, which includes topline and state-level estimates and comparisons to the Current Population Survey and National Health Interview Survey, is at this Census Bureau link.
If you want to dig into more details, a variety of summary tables are available at American FactFinder. This is not a very user-friendly system and produces only counts (not percents). Later this fall SHADAC will release a user-friendly online table generator that will include ACS estimates for variables relevant to health policy.
Data users will be able to access public use microdata next week (anticipated release date of September 29); the American FactFinder site will have a link to the data download. The single year 2008 datafile will allow state-level and sub-state analysis for geographic areas with population of 65,000 or more. Going forward, 3-year combined datafiles will allow analysis for smaller areas.
We have already fielded questions from many analysts about the ACS, and a common question is how to present the ACS estimates to policy makers when they have used the CPS for past reporting. SHADAC will evaluate both data sources and work with analysts to offer recommendations.