throughout the department. Besides the Epidemiology Division itself, Stark noted that his comments were based on the ACS uses by the Disease Control and Emergency Response divisions of DOHMH, as well as the office of the Commissioner of Health.

Similar to Call’s remarks, Stark said that the most common demand for ACS data is to construct basic demographic profiles. Much more than basic age-and-sex characteristics, Stark said thatOHMH bureaus had needed (and requested) data on very precise groups drawing from many ACS variables, including:

  • Household composition for public employees (distinct from private-sector employees);
  • Recent immigrants, including language spoken; and
  • Enrollment in private school (for comparison with public school data).

One perennial demand—discussed in more detail in the context of implementing the Voting Rights Act in Section 7–A—is to understand the primary languages spoken by New York City residents, broken down by neighborhood. Stark displayed a map derived from 2000 census long-form-sample data showing the range of non-English languages spoken in the city, plotted so that individual dots represent about 150 households that use a particular language. This analysis demonstrates, for example, the wide range of language diversity in the borough of Brooklyn, and the dominance of Spanish as the primary non-English language spoken in Manhattan and the Bronx. At the request of the commissioner’s office, and the communications officer in particular, the Epidemiology bureau has replicated this analysis using the most recent 5-year small-area estimates, with the intent of continuing to update the map over time. Stark said that this will help DOHMH produce and provide health-related material for city residents that is both neighborhood- and language-specific.

Given New York City’s large population, counts and analysis by neighborhoods or other small areas within the city are of particular interest to DOHMH. However, their analyses also require work with the ACS at higher levels of geographic region as well: counties (the boroughs of the city), the surrounding counties around New York City, and the nation as a whole. Again, given New York City’s size, Stark noted that DOHMH is frequently called upon to put analyses within the city in context, through contrast with the rest of the nation; the ACS has proved particularly useful in this regard.

Though ACS-based estimates are interesting in their own right, one primary use of the ACS by DOHMH is to generate denominators, to compute rates based on the department’s own health surveys. Chief among these are the New York City Community Health Survey (CHS), a telephone-only cross-sectional survey of approximately 10,000 adults within the city that is administered by the DOHMH Bureau of Epidemiology Services each year. In its administration and content, the CHS is patterned after the Behavioral Risk Factor Surveillance System (BRFSS) conducted by the U.S. Centers for Disease Control and Pre-



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