Department of Biostatistics Seminar/Workshop Series

Small Area Life Expectancy: Computational Challenges, Controversies, and Potential Solutions

Robert E. Johnson, PhD

Associate Professor, Department of Biostatistics

Vanderbilt University School of Medicine

Leaders and scientists in public health and medicine have held a longstanding interest in geographic disparities in health outcomes. With growing recognition that health outcomes vary across smaller geographic areas and that they are so deeply shaped by the social and physical environment in which people live, interest has grown in measuring disparities with greater granularity. Health metrics often center on mortality measures. Age-adjusted mortality rate, years of potential life lost, and life expectancy (LE) are among the common ones. LE offers the advantage of being a facile statistic that resonates with the public and policymakers and that is strongly associated with other summary measures of overall health. LE is traditionally calculated at the national or state/provincial level, and concerns about precision and accuracy arise when attempts are made to estimate or interpret LE on a small geographic scale. Census tracts, for example, have considerably smaller death counts and population sizes, which inevitably influences the precision of the LE estimate and lead to substantial statistical uncertainty. The increased standard errors and confidence intervals that accompany these LE estimates are a major methodological challenge discussed in the demographic literature. Potential solutions include aggregating more years of data, merging census tracts, and collapsing age groups. At least three approaches to handling zero or small age-specific death counts are discussed. These include simple imputation, weighted averages based on minimum required sample size, and Bayesian hierarchical modeling. This presentation is driven by a recent proposal submitted by researchers in the Virginia Commonwealth University Center on Health and Society, at the request of the Robert Wood Johnson Foundation. I joined the team as an adjunct professor from 2012-2015 and currently as a consultant.

Topic revision: r1 - 11 Feb 2016, AshleeBartley
 

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