Monitoring the Healthcare Safety Net

Book 1. Data for Metropolitan Areas

Table A-1: Safety Net Measures in this Data Book, their Definitions, and Data Sources (Continued)

Health Care Delivery System

Measure Definition Data Source(s) Methodological Notes
HMO Competition Index
HMO competition index An index that indicates the extent to which the market share of managed care is concentrated in a small number of health plans, with a higher value indicating greater concentration. ("Herfindahl Index") 1999 InterStudy Data available at the MSA level only.
HMO Penetration %
HMO penetration rate Percent of area population enrolled in Health Maintenance Organizations. 1999 InterStudy Data available at the MSA level only.
Medicare Managed Care Penetration (%)
Medicare managed care penetration Number of Medicare managed care enrollees divided by the total number of Medicare beneficiaries. 2001 Area Resource File (1999 Data)  
Physician Supply per 100, 000
Number of pediatricians per 100,000 children Number of pediatricians divided by the number of individuals ages 0–17, multiplied by 100,000 (non-Federal, patient care physicians). Numerator from 2001 Area Resource File (1999 Data); Denominator from 2001 Claritas (1999 interpolated estimate) Figures are based on location of physician (not patient origin which may be from other counties).
Number of adult primary care providers per 100,000 adults Number of general internists, family practitioners, and general practitioners, divided by the number of individuals age 18 and older, multiplied by 100,000 (non-Federal, patient care physicians). Numerator from 2001 Area Resource File (1999 Data); Denominator from 2001 Claritas (1999 interpolated estimate) Figures are based on location of physician (not patient origin which may be from other counties).
Number of obstetricians/gynecologists per 100,000 women Number of obstetricians/gynecologists divided by the total number of women age 15 and older, multiplied by 100,000 (non- Federal, patient care physicians). Numerator from 2001 Area Resource File (1999 Data); Denominator from 2001 Claritas (1999 interpolated estimate) Figures are based on location of physician (not patient origin which may be from other counties).
Number of medical specialty doctors per 100,000 population Number of medical specialty doctors divided by the total population, multiplied by 100,000 (non-Federal, patient care physicians). Medical specialties include allergy and immunology, cardiovascular disease, dermatology, gastroenterology, internal medicine subspecialties, pediatric subspecialties, pediatric cardiology, and pulmonary disease. Numerator from 2001 Area Resource File (1999 Data); Denominator from 2001 Claritas (1999 interpolated estimate) Figures are based on location of physician (not patient origin which may be from other counties).
Number of surgical specialty doctors per 100,000 population Number of surgical specialty doctors, divided by the total population, multiplied by 100,000 (non- Federal, patient care physicians). Surgical specialties include colon/ rectal surgery, general surgery, neurological surgery, ophthalmology, orthopedic surgery, otolaryngology, plastic surgery, thoracic surgery, and urology. Numerator from 2001 Area Resource File (1999 Data); Denominator from 2001 Claritas (1999 interpolated estimate) Figures are based on location of physician (not patient origin which may be from other counties).
Supply/Utilization per 1,000
Number of inpatient hospital beds per 1,000 population Number of inpatient hospital beds divided by the total population, multiplied by 1,000 (non-Federal general medical/ surgical facilities). Numerator from 1999 American Hospital Association Annual Survey; Denominator from 2001 Claritas (1999 interpolated estimate)  
Number of inpatient hospital admissions per 1,000 population Number of admissions to inpatient hospitals divided by the total population, multiplied by 1,000 (non- Federal general medical/surgical facilities). Numerator from 1999 American Hospital Association Annual Survey; Denominator from 2001 Claritas (1999 interpolated estimate) Figures are based on location of physician (not patient origin which may be from other counties).
Number of emergency department visits per 1,000 population Number of visits to emergency departments divided by the total population, multiplied by 1,000 (non-Federal general medical/surgical facilities). Numerator from 1999 American Hospital Association Annual Survey; Denominator from 2001 Claritas (1999 interpolated estimate) Figures are based on location of physician (not patient origin which may be from other counties).

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Community Context—Population

Measure Definition Data Source(s) Methodological Notes
Total Population
Total population Total number of people in the area. U.S. Census 2000  
Square Miles
Square miles The size of the area in square miles. 2001 Claritas (1999 interpolated estimate)  
Population Density
Population density Total population, divided by the number of square miles. Numerator from U. S. Census 2000; Denominator from 2001 Claritas (1999 interpolated estimate)  
% Population
Percent of population ages 0–17 Population ages 0–17 divided by the total population. U.S. Census 2000  
Percent of population ages 18– 64 Population ages 18–64 divided by the total population. U.S. Census 2000  
Percent of population age 65 and older Population age 65 and older divided by the total population. U.S. Census 2000  
% Population Change 1990–2000
Percent population change 1990–2000, total 2000 total population minus 1990 total population, divided by 1990 population. U.S. Census 2000  
Percent population change 1990–2000, ages 0–17 2000 total population ages 0–17 minus 1990 total population ages 0–17, divided by 1990 population aged 0–17. U.S. Census 2000  
Percent population change 1990–2000, ages 18–64 2000 total population ages 18–64 minus 1990 total population ages 18–64, divided by 1990 population ages 18–64. U.S. Census 2000  
Percent population change 1990–2000, age 65 and older 2000 total population age 65 and older minus 1990 total population age 65 and older, divided by 1990 population age 65 and older. U.S. Census 2000  

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Community Context—Race/Ethnicity

Measure Definition Data Source(s) Methodological Notes
% Population
Percent of the population identifying their race as white Number of individuals reporting white race divided by the total population reporting race. U.S. Census 2000 See U.S. Census 2000 documentation for detailed description of definitions for race.
Percent of the population identifying their race as black Number of individuals reporting black race divided by the total population reporting race. U.S. Census 2000 See U.S. Census 2000 documentation for detailed description of definitions for race.
Percent of the population identifying their race as Asian American Number of individuals reporting Asian- American race divided by the total population reporting race. U.S. Census 2000 See U.S. Census 2000 documentation for detailed description of definitions for race.
Percent of the population identifying their race as Native American Number of individuals reporting Native- American race divided by the total population reporting race. U.S. Census 2000 See U.S. Census 2000 documentation for detailed description of definitions for race.
Percent of the population identifying their race as Native Hawaiian or Pacific Islander Number of individuals reporting Native- Hawaiian and other Pacific Islander race, divided by the total population reporting race. U.S. Census 2000 See U.S. Census 2000 documentation for detailed description of definitions for race.
Percent of the population identifying their race as "other" Number of individuals reporting some other race (not white, black, Asian American, Native American, or Pacific Islander), divided by the total population reporting race. U.S. Census 2000 See U.S. Census 2000 documentation for detailed description of definitions for race.
Percent of the population identifying two or more races Number of individuals indicating two or more races divided by the total population reporting race. U.S. Census 2000 See U.S. Census 2000 documentation for detailed description of definitions for race.
% Population Hispanic (Any Race)
Percent of the population identifying their ethnicity as Hispanic or Latino, any race Number of individuals reporting Hispanic ethnicity divided by the total population reporting ethnicity. U.S. Census 2000 See U.S. Census 2000 documentation for detailed description of definitions for Hispanic categories.
Percent of the population identifying their ethnicity as Mexican, any race Number of individuals reporting Mexican ethnicity divided by the total population reporting ethnicity. U.S. Census 2000 See U.S. Census 2000 documentation for detailed description of definitions for Hispanic categories.
Percent of the population identifying their ethnicity as Puerto Rican, any race Number of individuals reporting Puerto Rican ethnicity divided by the total population reporting ethnicity. U.S. Census 2000 See U.S. Census 2000 documentation for detailed description of definitions for Hispanic categories.
Percent of the population identifying their ethnicity as Cuban, any race Number of individuals reporting Cuban ethnicity divided by the total population reporting ethnicity. U.S. Census 2000 See U.S. Census 2000 documentation for detailed description of definitions for Hispanic categories.
Percent of the population identifying their ethnicity as other Hispanic or Latino, any race Number of individuals reporting "Other Hispanic or Latino" ethnicity (not Mexican, Puerto Rican, or Cuban) divided by the total population reporting ethnicity. U.S. Census 2000 See U.S. Census 2000 documentation for detailed description of definitions for Hispanic categories.

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Community Context— Indices of Racial and Economic Separation

Measure Definition Data Source(s) Methodological Notes
   Community Context— Indices of Racial and Economic Separation
Racial Dissimilarity Indices
Racial dissimilarity index–Black Percent of the black population in an area that would have to move for all area zip codes to have an equal proportion of the area's black population. 2001 Claritas (1999 interpolated estimate)  
Racial dissimilarity index–Hispanic Percent of the Hispanic-American population in an area that would have to move for all area zip codes to have an equal proportion of the area's Hispanic population. 2001 Claritas (1999 interpolated estimate)  
Racial dissimilarity index–All non-white Percent of the non-white population in an area that would have to move for all area zip codes to have an equal proportion of the area's non-white population. 2001 Claritas (1999 interpolated estimate)  
Economic Indices
Gini coefficient The proportion of income that would have to be redistributed to equalize the incomes of all residents of an area. 2001 Claritas (1999 interpolated estimate)  
Economic dissimilarity index Percent of the population with family incomes less than $15,000 per year in an area that would have to move for all area zip codes to have an equal proportion of the population with family incomes less than $15,000 per year. 2001 Claritas (1999 interpolated estimate)  

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Community Context—Immigrant Population

Measure Definition Data Source(s) Methodological Notes
% Population Foreign Born
Percent of the population that is foreign born Number of individuals born outside of the U. S. divided by the total population for whom nativity and place of birth is reported. U.S. Census 2000  
Foreign Born
Percent of the foreign-born population that has lived in the U.S. 10 years or less Number of individuals born outside of the U.S. who have lived in the U. S. for 10 years or less, divided by the total number of individuals born outside of the U.S. U.S. Census 2000  
Percent of the foreign-born population that has been naturalized as a U. S. citizen Number of individuals born outside of the U.S. who have been naturalized as U. S. citizens, divided by the total number of individuals born outside of the U.S. U.S. Census 2000  
Place of Foreign Birth
Place of foreign birth: Latin America Number of individuals born in Latin America divided by the total number of individuals born outside of the U.S. U.S. Census 2000  
Place of foreign birth: Asia Number of individuals born in Asia divided by the total number of individuals born outside of the U.S. U.S. Census 2000  
Place of foreign birth: Africa Number of individuals born in Africa divided by the total number of individuals born outside of the U.S. U.S. Census 2000  
Place of foreign birth: Europe Number of individuals born in Europe divided by the total number of individuals born outside of the U.S. U.S. Census 2000  
Place of foreign birth: North America Number of individuals born in North America (outside of the U.S.), divided by the total number of individuals born outside of the U.S. U.S. Census 2000  
Place of foreign birth: Oceania Number of individuals born outside of the U.S. but not on one of the above- named continents (Latin America, Asia, Africa, Europe, or North America), divided by the total number of individuals born outside of the U.S. U.S. Census 2000  
% Speak Non-English at Home
Percent of the population speaking a language other than English at home Number of individuals age 5 and older speaking a language other than English at home, divided by the total population age 5 and older who reported language spoken at home. U.S. Census 2000  
% Speak English Less Than Very Well
Percent of the population speaking English less than very well Number of individuals age 5 and older who report speaking English less than very well, divided by the total population age 5 and older who reported language spoken at home. U.S. Census 2000  
Contents of Data Books
Contents of Table A-1: Safety Net Measures in this Data Book, their Definitions, and Data Sources
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