by age group for states, counties and school districts (http://www.census.gov/hhes/www/saipe/, REFS to CNSTAT reports). These are calculated using a multivariate hierarchical Bayes model. A relatively new Small Area Health Insurance Estimates (SAHIE) program releases similar estimates for states and counties (http://www.census.gov/hhes/www/sahie/). Estimates from these programs are likely to become increasingly accurate as data from the American Community Survey (ACS) become available, providing additional small-area detail. The Substance Abuse and Mental Health Services Administration (SAMHSA) releases small-area estimates for states and sub-state areas of variables related to substance use, treatment and mental health, based on data from the National Survey on Drug Use and Health (NSDUH) (SAMHSA, 2008). Numerous research studies have been performed to develop small-area estimates of health-related indicators, of which we cite only a few examples (Nandram and Choi, 2005; Schenker and Raghunathan, 2007; Xie et al., 2007). However, it is not evident that any of these have been adopted by any agency to be produced as an ongoing series. Thus although small-area estimation has the potential to fill important gaps in availability of domain estimates, the actual availability of such estimates is limited. The SUSA project should monitor the future availability of such estimates and encourage their development on an ongoing basis by agencies.

REFERENCES

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Nandram, B., and J. W. Choi. 2005. Hierarchical bayesian nonignorable nonresponse regression models for small areas: An application to the NHANES data. Survey Methodology 31(1):73–84.

SAMHSA (Substance Abuse and Mental Health Services Administration). 2008. Substate estimates from the 20042006 national surveys on drug use and health. Rockville, MD: SAMHSA.

Schenker, N., and T. E. Raghunathan. 2007. Combining information from multiple surveys to enhance estimation of measures of health. Statistics in Medicine 26(8):1802–1811.

Xie, D., T. E. Raghunathan, and J. M. Lepkowski. 2007. Estimation of the proportion of overweight individuals in small areas—a robust extension of the fay-herriot model. Statistics in Medicine 26(13):2699–2715.

Zaslavsky, A. M. 2001. Statistical issues in reporting quality data: Small samples and casemix variation. International Journal for Quality in Health Care 13(6):481–488.



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