Age adjustment issues in healthy people 2010
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Age Adjustment Issues in Healthy People 2010. John Aberle-Grasse, MPH National Center for Health Statistics. Calculation of age-adjusted rate. Age-adjusted rate = S i (m i *w si ) m i = d i / p i * 100,000 w si = standard population weight in age group i

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Age Adjustment Issues in Healthy People 2010

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Age Adjustment Issues in Healthy People 2010

John Aberle-Grasse, MPH

National Center for Health Statistics


Calculation of age-adjusted rate

  • Age-adjusted rate =

  • Si (mi*wsi)

  • mi = di / pi * 100,000

  • wsi = standard population weight in age group i

  • di = deaths in age group i

  • pi = population in age group i


Calculation of age-adjusted rate

  • Spreadsheet vs. “manual” calculation

  • NCHS continues to use “manual” method

  • Healthy People 2010 rate calculations are rounded/truncated to one decimal place

  • Weights are rounded/truncated to six places


Standard population- a population based on some age distribution

  • NCHS in the past

  • mortality data used 1940 standard

  • survey data used mostly 1970 & 1980 standard

  • NCHS now uses year 2000 US resident population as standard for all age adjustment


Standard population- a population based on some age distribution

  • NCHS in the past

  • mortality data used 1940 standard

  • survey data used mostly 1970 & 1980 standard

  • NCHS now uses year 2000 US resident population as standard for all age adjustment

  • 2000-adjusted rates better reflect national demographics and current crude rates


Crude and age adjusted death rates based on year 1940 and 2000 standard populations: United States, 1979-2000

2000 standard

crude rate

1940 standard


Standard population- a population based on some age distribution

  • IMPORTANT REMINDER: Comparisons can only be made between rates calculated using the same standard population


Age-adjustment inHealthy People 2010

  • Mortality data

  • Health outcomes, risk factors, and health services data


Diabetes prevalence by race/ethnicity (Obj. 5-3), 1999

Overall

Hispanic/

Latino

Asian/

Pacific Islander

Not-Hispanic

African American

Not-Hispanic

White

American Indian/

Alaska Native

Source: National Health Interview Survey (NHIS), CDC, NCHS.


Diabetes age specific rates, 1999

Source: National Health Interview Survey (NHIS), CDC, NCHS.


2000 Census age distribution


Diabetes prevalence (Obj. 5-3), 1999

Source: National Health Interview Survey (NHIS), CDC, NCHS.


Diabetes prevalence (Obj. 5-3), 1999

Source: National Health Interview Survey (NHIS), CDC, NCHS.


Age-adjustment inHealthy People 2010

  • Mortality data

  • Health outcomes, risk factors, and health services data

  • Main purposes:

    • Observe trends in populations over time

    • Monitor disparity between populations both at a point in time and over time


Standard population- age distributions

  • Several different age groupings are used to age-adjust data from different sources


Data systems Age distributions used


Standard population- age distributions

  • Several different age groupings are used to age-adjust data from different sources

  • Some data sources use fewer age groupings to stabilize the rates of less common events and smaller subpopulations (e.g. age groups for chronic disease)


Hispanics aged 2+ years with diabetes who have seen a dentist in the past year (Obj. 5-15)

Age-adjusted

Crude

Source: National Health Interview Survey (NHIS), CDC, NCHS.


Hispanics aged 2+ years with diabetes who have seen a dentist in the past year (Obj. 5-15)

Source: National Health Interview Survey (NHIS), CDC, NCHS.


Hispanics aged 2+ years with diabetes who have seen a dentist in the past year (Obj. 5-15)

< 45 separate

< 45 combined

Crude

Source: National Health Interview Survey (NHIS), CDC, NCHS.


Some exceptions

  • Data that are not age-adjusted

  • Maternal/Infant mortality

    (live births as denominator)

  • National Household Survey on Drug Abuse

  • Occupational injury and death

  • Fatality Analysis Reporting System

  • Census of Fatal Occupational Injuries


Some exceptions

  • When to be careful in age-adjusting

  • Age specific rates for a measure vary differently between two population groups


Age specific cancer death rates among females, 1970 to 1995

1995

1970

Source: National Vital Statistics System, CDC, NCHS.


Female cancer death rates, by age adjustment standard

Crude rate

2000 standard

population

1940 standard

population

Source: National Vital Statistics System, CDC, NCHS.


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