Data Dictionary: ACS 2009 (1-Year Estimates)
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Data Source: U.S. Census Bureau
Table: B27018. Public Health Coverage By Ratio Of Income To Poverty Level In The Past 12 Months By Age [71]
Universe: Civilian noninstitutionalized population for whom poverty status is determined
Table Details
B27018. Public Health Coverage By Ratio Of Income To Poverty Level In The Past 12 Months By Age
Universe: Civilian noninstitutionalized population for whom poverty status is determined
Variable Label
B27018001
B27018002
B27018003
B27018004
B27018005
B27018006
B27018007
B27018008
B27018009
B27018010
B27018011
B27018012
B27018013
B27018014
B27018015
B27018016
B27018017
B27018018
B27018019
B27018020
B27018021
B27018022
B27018023
B27018024
B27018025
B27018026
B27018027
B27018028
B27018029
B27018030
B27018031
B27018032
B27018033
B27018034
B27018035
B27018036
B27018037
B27018038
B27018039
B27018040
B27018041
B27018042
B27018043
B27018044
B27018045
B27018046
B27018047
B27018048
B27018049
B27018050
B27018051
B27018052
B27018053
B27018054
B27018055
B27018056
B27018057
B27018058
B27018059
B27018060
B27018061
B27018062
B27018063
B27018064
B27018065
B27018066
B27018067
B27018068
B27018069
B27018070
B27018071
Relevant Documentation:
Excerpt from: Social Explorer; U.S. Census Bureau; American Community Survey 2009 Summary File: Technical Documentation.
 
Health Insurance Coverage
In 2009, data on health insurance coverage were derived from answers to Question 16, which was asked of all respondents. Respondents were instructed to report their current coverage and to mark "yes" or "no" for each of the eight types listed (labeled as parts 16a to 16h).

  1. Insurance through a current or former employer or union (of this person or another family member)
  2. Insurance purchased directly from an insurance company (by this person or another family member)
  3. Medicare, for people 65 and older, or people with certain disabilities
  4. Medicaid, Medical Assistance, or any kind of government-assistance plan for those with low incomes or a disability
  5. TRICARE or other military health care
  6. VA (including those who have ever used or enrolled for VA health care)
  7. Indian Health Service
  8. Any other type of health insurance or health coverage plan


Respondents who answered "yes" to question 16h were asked to provide their other type of coverage type in a write-in field.

Health insurance coverage in the ACS and other Census Bureau surveys define coverage to include plans and programs that provide comprehensive health coverage. Plans that provide insurance for specific conditions or situations such as cancer and long-term care policies are not considered coverage. Likewise, other types of insurance like dental, vision, life, and disability insurance are not considered health insurance coverage.

In defining types of coverage, write-in responses were reclassified into one of the first seven types of coverage or determined not to be a coverage type. Write-in responses that referenced the coverage of a family member were edited to assign coverage based on responses from other family members. As a result, only the first seven types of health coverage are included in the microdata file.

An eligibility edit was applied to give Medicaid, Medicare, and TRICARE coverage to individuals based on program eligibility rules. TRICARE or other military health care was given to active-duty military personnel and their spouses and children. Medicaid or other means-tested public coverage was given to foster children, certain individuals receiving Supplementary Security Income or Public Assistance, and the spouses and children of certain Medicaid beneficiaries. Medicare coverage was given to people 65 and older who received Social Security or Medicaid benefits.

People were considered insured if they reported at least one "yes" to Questions 16a to 16f. People who had no reported health coverage, or those whose only health coverage was Indian Health Service, were considered uninsured. For reporting purposes, the Census Bureau broadly classifies health insurance coverage as private health insurance or public coverage. Private health insurance is a plan provided through an employer or union, a plan purchased by an individual from a private company, or TRICARE or other military health care. Respondents reporting a "yes" to the types listed in parts a, b, or e were considered to have private health insurance. Public health coverage includes the federal programs Medicare, Medicaid, and VA Health Care (provided through the Department of Veterans Affairs); the Childrens Health Insurance Program (CHIP); and individual state health plans. Respondents reporting a "yes" to the types listed in c, d, or f were considered to have public coverage. The types of health insurance are not mutually exclusive; people may be covered by more than one at the same time.

The U.S. Department of Health and Human Services, as well as other federal agencies, use data on health insurance coverage to more accurately distribute resources and better understand state and local health insurance needs.

Question/Concept History
The ACS began asking questions about health insurance coverage in 2008. Because 2008 was the first year of collection, the Census Bureau limited the number and type of data products to simple age breakdowns of overall, private, and public coverage status. The evaluation of the 2008 data suggested that the data were of good quality, so the Census Bureau expanded the data products to include estimates of the specific types of coverage along with estimates about social, economic, and demographic details for people with and without health insurance.

For the 2008 data released September 2009, there was no eligibility edit applied. The eligibility edit that was developed for the 2009 was applied to the 2008 data during spring 2010. New estimates of health insurance coverage with this data are available at http://www.census.gov/hhes/www/hlthins/hlthins.html.

Limitation of the Data
The universe for most health insurance coverage estimates is the civilian noninstitutionalized population, which excludes active-duty military personnel and the population living in correctional facilities and nursing homes. Some noninstitutionalized GQ populations have health insurance coverage distributions that are different from the household population (e.g., the prevalence of private health insurance among residents of college dormitories is higher than the household population). The proportion of the universe that is in the noninstitutionalized GQ populations could therefore have a noticeable impact on estimates of the health insurance coverage. Institutionalized GQ populations may also have health insurance coverage distributions that are different from the civilian noninstitutionalized population, the distributions in the published tables may differ slightly from how they would look if the total population were represented.

Comparability
Health insurance coverage was added to the 2008 ACS and so no equivalent measure is available from previous ACS surveys or Census 2000. Because of the addition of the eligibility edit to 2009 ACS health insurance, data users should be careful as to which 2008 ACS estimates they use to make comparisons. National, state, county and place-level 2008 1-year data incorporating the eligibility edit are available at http://www.census.gov/hhes/www/hlthins/data/acs/2008/re-run.html; they are comparable to the 2009 estimates in American Fact Finder. For more information on the logical coverage (eligibility) edits, please see http://www.census.gov/hhes/www/hlthins/publications/coverage_edits_final.pdf.

Because coverage in the ACS references an individual's current status, caution should be taken when making comparisons to other surveys which may define coverage as "at any time in the last year" or "throughout the past year." A discussion of how the ACS health insurance estimates relate to other survey health insurance estimates can be found in "A Preliminary Evaluation of Health Insurance Coverage" in the 2008 American Community Survey (http://www.census.gov/hhes/www/hlthins/acs08paper/2008ACS_healthins.pdf).

Excerpt from: Social Explorer; U.S. Census Bureau; American Community Survey 2009 Summary File: Technical Documentation.
 
Ratio
This is a measure of the relative size of one number to a second number expressed as the quotient of the first number divided by the second. For example, the sex ratio is calculated by dividing the total number of males by the total number of females, and then multiplying by 100.




Excerpt from: Social Explorer; U.S. Census Bureau; American Community Survey 2009 Summary File: Technical Documentation.
 
Income in the Past 12 Months
The data on income were derived from answers to Questions 47 and 48, which were asked of the population 15 years old and over. "Total income" is the sum of the 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.

Receipts from the following sources are not included as income: capital gains, money received from the sale of property (unless the recipient was engaged in the business of selling such property); the value of income "in kind" from food stamps, public housing subsidies, medical care, employer contributions for individuals, etc.; withdrawal of bank deposits; money borrowed; tax refunds; exchange of money between relatives living in the same household; gifts and lump-sum inheritances, insurance payments, and other types of lump-sum receipts.

Income is a vital measure of general economic circumstances. Income data are used to determine poverty status, to measure economic well-being, and to assess the need for assistance. These data are included in federal allocation formulas for many government programs. For instance:

Social Services: Under the Older Americans Act, funds for food, health care, and legal services are distributed to local agencies based on data about elderly people with low incomes. Data about income at the state and county levels are used to allocate funds for food, health care, and classes in meal planning to low-income women with children.

Employment: Income data are used to identify local areas eligible for grants to stimulate economic recovery, run job-training programs, and define areas such as empowerment or enterprise zones.

Housing: Under the Low-Income Home Energy Assistance Program, income data are used to allocate funds to areas for home energy aid. Under the Community Development Block Grant Program, funding for housing assistance and other community development is based on income and other census data.

Education: Data about poor children are used to allocate funds to counties and school districts. These funds provide resources and services to improve the education of economically disadvantaged children.

In household surveys, respondents tend to underreport income. Asking the list of specific sources of income helps respondents remember all income amounts that have been received, and asking total income increases the overall response rate and thus, the accuracy of the answers to the income questions. The eight specific sources of income also provide needed detail about items such as earnings, retirement income, and public assistance.

Excerpt from: Social Explorer; U.S. Census Bureau; American Community Survey 2009 Summary File: Technical Documentation.
 
Poverty Status in the Past 12 Months
Poverty statistics in ACS products adhere to the standards specified by the Office of Management and Budget in Statistical Policy Directive 14. The Census Bureau uses a set of dollar value thresholds that vary by family size and composition to determine who is in poverty. Further, poverty thresholds for people living alone or with nonrelatives (unrelated individuals) vary by age (under 65 years or 65 years and older). The poverty thresholds for two-person families also vary by the age of the householder. If a familytotal income is less than the dollar value of the appropriate threshold, then that family and every individual in it are considered to be in poverty. Similarly, if an unrelated individuals total income is less than the appropriate threshold, then that individual is considered to be in poverty.

How the Census Bureau Determines Poverty Status
In determining the poverty status of families and unrelated individuals, the Census Bureau uses thresholds (income cutoffs) arranged in a two-dimensional matrix. The matrix consists of family size (from one person to nine or more people) cross-classified by presence and number of family members under 18 years old (from no children present to eight or more children present). Unrelated individuals and two-person families are further differentiated by age of reference person (RP) (under 65 years old and 65 years old and over).

To determine a person's poverty status, one compares the person's total family income in the last 12 months with the poverty threshold appropriate for that person's family size and composition (see example below). If the total income of that person's family is less than the threshold appropriate for that family, then the person is considered "below the poverty level," 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 total number of people "below the poverty level" is the sum of people in families and the number of unrelated individuals with incomes in the last 12 months below the poverty threshold.

Since ACS is a continuous survey, people respond throughout the year. Because the income questions specify a period covering the last 12 months, the appropriate poverty thresholds are determined by multiplying the base-year poverty thresholds (1982) by the average of the monthly inflation factors for the 12 months preceding the data collection. See the table in "Appendix A" titled "Poverty Thresholds in 1982, by Size of Family and Number of Related Children Under 18 Years (Dollars)," for appropriate base thresholds. See the table "The 2009 Poverty Factors" in "Appendix A" for the appropriate adjustment based on interview month.

For example, consider a family of three with one child under 18 years of age, interviewed in July 2009 and reporting a total family income of $14,000 for the last 12 months (July 2008 to June 2009). The base year (1982) threshold for such a family is $7,765, while the average of the 12 inflation factors is 2.22421. Multiplying $7,765 by 2.22421 determines the appropriate poverty threshold for this family type, which is $17,271. Comparing the familyincome of $14,000 with the poverty threshold shows that the family and all people in the family are considered to have been in poverty. The only difference for determining poverty status for unrelated individuals is that the person's individual total income is compared with the threshold rather than the family's income.

Specified Poverty Levels
For various reasons, the official poverty definition does not satisfy all the needs of data users. Therefore, some of the data reflect the number of people below different percentages of the poverty thresholds. These specified poverty levels are obtained by multiplying the official thresholds by the appropriate factor. Using the previous example cited (a family of three with one related child under 18 years responding in July 2009), the dollar value of 125 percent of the poverty threshold was $ 21,589 ($ 17,271x 1.25). Income Deficit - Income deficit represents the difference between the total income in the last 12 months of families and unrelated individuals "below the poverty level" and their respective poverty thresholds. In computing the income deficit, families reporting a net income loss are assigned zero dollars and for such cases the deficit is equal to the poverty threshold. This measure provides an estimate of the amount, which would be required to raise the incomes of all poor families and unrelated individuals to their respective poverty thresholds. The income deficit is thus a measure of the degree of the impoverishment of a family or unrelated individual. However, please use caution when comparing the average deficits of families with different characteristics. Apparent differences in average income deficits may, to some extent, be a function of differences in family size.

Excerpt from: Social Explorer; U.S. Census Bureau; American Community Survey 2009 Summary File: Technical Documentation.
 
Age
The data on age were derived from answers to Question 4. The age classification is based on the age of the person in complete years at the time of interview. Both age and date of birth are used in combination to calculate the most accurate age at the time of the interview. Respondents are asked to give an age in whole, completed years as of interview date as well as the month, day and year of birth. People are not to round an age up if the person is close to having a birthday and to estimate an age if the exact age is not known. An additional instruction on babies also asks respondents to print "0" for babies less than one year old. Inconsistently reported and missing values are assigned or imputed based on the values of other variables for that person, from other people in the household, or from people in other households ("hot deck" imputation).

Age is asked for all person's in a household or group quarters. On the mailout/mailback paper questionnaire for households, both age and date of birth are asked for person's listed as person numbers 1-5 on the form. Only age (in years) is initially asked for person's listed as 6-12 on the mailout/mailback paper questionnaire. If a respondent indicates that there are more than 5 people living in the household, then the household is eligible for Failed Edit Follow-up (FEFU). During FEFU operations, telephone center staffers call respondents to obtain missing data. This includes asking date of birth for any person in the household missing date of birth information. In Computer Assisted Telephone Interviews (CATI) and Computer Assisted Personal Interview (CAPI) instruments both age and date of birth is asked for all person's. In 2006, the ACS began collecting data in group quarters (GQs). This included asking both age and date of birth for person's living in a group quarters. For additional data collection methodology, please see www.census.gov/acs.

Data on age are used to determine the applicability of other questions for a particular individual and to classify other characteristics in tabulations. Age data are needed to interpret most social and economic characteristics used to plan and analyze programs and policies. Age is central for any number of federal programs that target funds or services to children, working-age adults, women of childbearing age, or the older population. The U.S. Department of Education uses census age data in its formula for allotment to states. The U.S. Department of Veterans Affairs uses age to develop its mandated state projections on the need for hospitals, nursing homes, cemeteries, domiciliary services, and other benefits for veterans. For more information on the use of age data in Federal programs, please see www.census.gov/acs.

Median Age
The median age is the age that divides the population into two equal-size groups. Half of the population is older than the median age and half is younger. Median age is based on a standard distribution of the population by single years of age and is shown to the nearest tenth of a year. (See the sections on "Standard Distributions" and "Medians" under "Derived Measures".)

Age Dependency Ratio
The age dependency ratio is derived by dividing the combined under 18 years and 65 years and over populations by the 18-to-64 population and multiplying by 100.

Old-Age Dependency Ratio
The old-age dependency ratio is derived by dividing the population 65 years and over by the 18-to-64 population and multiplying by 100.

Child Dependency Ratio
The child dependency ratio is derived by dividing the population under 18 years by the 18-to-64 population, and multiplying by 100.

Question/Concept History
The 1996-2002 American Community Survey question asked for month, day, and year of birth before age. Since 2003, the American Community Survey question asked for age, followed by month, day, and year of birth. In 2008, an additional instruction was provided with the age and date of birth question on the American Community Survey questionnaire to report babies as age 0 when the child was less than 1 year old. The addition of this instruction occurred after 2005 National Census Test results indicated increased accuracy of age reporting for babies less than one year old.

Limitation of the Data
Beginning in 2006, the population living in group quarters (GQ) was included in the American Community Survey population universe. Some types of group quarters have populations with age distributions that are very different from that of the household population. The inclusion of the GQ population could therefore have a noticeable impact on the age distribution for a given geographic area. This is particularly true for areas with a substantial GQ population. For example, in areas with large colleges and universities, the percent of individuals 18-24 would increase due to the inclusion of GQs in the American Community Survey universe.

Comparability
Caution should be taken when comparing population in age groups across time. The entire population continually ages into older age groups over time, and babies fill in the youngest age group. Therefore, the population of a certain age is made up of a completely different group of people in one time period than in another (e.g. one age group in 2000 versus same age group in 2009). Since populations occasionally experience booms/increases and busts/decreases in births, deaths, or migration (for example, the postwar Baby Boom from 1946-1964), one should not necessarily expect that the population in an age group in one year should be similar in size or proportion to the population in the same age group in a different period in time. For example, Baby Boomers were age 36 to 54 in Census 2000 while they were age 45 to 63 in 2009 ACS. The age structure and distribution would therefore shift in those age groups to reflect the change in people occupying those age-specific groups over time.

Data users should also be aware of methodology differences that may exist between different data sources if they are comparing American Community Survey age data to data sources, such as Population Estimates or Decennial Census data. For example, the American Community Survey data are that of a respondent-based survey and subject to various quality measures, such as sampling and nonsampling error, response rates and item allocation error. This differs in design and methodology from other data sources, such as Population Estimates, which is not a survey and involves computational methodology to derive intercensal estimates of the population. While ACS estimates are controlled to Population Estimates for age at the nation, state and county levels of geography as part of the ACS weighting procedure, variation may exist in the age structure of a population at lower levels of geography when comparing different time periods or comparing across time due to the absence of controls below the county geography level. For more information on American Community Survey data accuracy and weighting procedures, please see www.census.gov/acs.

It should also be noted that although the American Community Survey (ACS) produces population, demographic and housing unit estimates, it is the Census Bureau's Population Estimates Program that produces and disseminates theofficial estimates of the population for the nation, states, counties, cities and towns and estimates of housing units for states and counties. (Please refer to: factfinder.census.gov/home/en/official_estimates_2008.html)