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| How are the California County Profile Reports organized? |
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Each California County Profile Report is subdivided into two main sections. The first section presents primarily county level data
while the second section includes ZIP code level tabulations of the risk factors and outcomes presented in the first section.
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The first section includes the following themes:
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| Demography |
| Socioeconomic background |
| Prenatal |
| Mortality outcomes |
| Birth weight outcomes |
| Other outcomes |
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Each theme summarizes a selection of pertinent variables. For instance, the demography theme includes tabulations of the race/ethnicity and
maternal age distribution at the county level, and the geographic distribution of births in a county. Each theme is presented using three
components:
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The Introduction briefly introduces the concepts discussed and relevant sources.
The Definitions section summarizes the definitions used to compile the data included.
The Tables and Figures section includes a county level tabulations for the most recent data year, a ZIP code level map, and a county level trend chart showing data for 1991 through 2004 or 2005.
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Except for the Demography theme, each theme's variable(s) is/are presented in:
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The second section includes ZIP code level tabulations of all the variables discussed in the first section. Three tables
are presented:
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 | Healthy People 2010 Objectives |
| Race/ethnicity distribution |
| All other variables |
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Navigation to any of the sections or themes can be accomplished in a number of ways and is explained in the next section of this document.
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| How to navigate the IPODR-CCPR website? |
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The primary navigation tool used on the CCPR website is the menu bar that can be found at the top of each page.
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The navigation bar allows quick access to the different sections of a county's CCPR. The navigation bar on the left lets you choose a different county, this help screen. It also
includes a summary of all definitions used for compiling the CCPRs.
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The contents page shows a table of contents with hot links to each of the items tabulated, its definitions, and all tables and figures.
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| Acronyms used on the California County Profile Reports Website |
| APNCU | Adequacy of Prenatal Care Utilization |
| CCPR | California County Profile Reports |
| CDPH | California Department of Public Health |
| DRG | Diagnosis Related Group |
| GDT | Geographic Data Technology |
| GIF | CompuServe Graphics Interchange Format |
| IPODR | Improved Perinatal Outcome Data Reports |
| IPODM | Improved Perinatal Outcome Data Management |
| LBW | Low Birth Weight |
| NCHS | National Center for Health Statistics |
| OSHPD | Office of Statewide Health Planning and Development |
| PDD | Patient Discharge Data |
| PDF | Portable Document Format |
| VLBW | Very Low Birth Weight |
| VS | Vital Statistics |
| WWW | World Wide Web |
| XHTML | Extensible Hypertext Markup Language |
| ZCTA | Zip Code Tabulation Area |
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| What is shown in the tables included in the CCPRs? |
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ZIP code and county level tables are included in the California County Profile Reports. County level tables are presented by race/ethnicity
and overall. Furthermore, for comparison purposes numbers for California are also presented.
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For ZIP code level tables, any areas with fewer than 20 births are excluded from the display. In the case of a geographic area with
20 births or more, but fewer than 5 events, information is suppressed (***). As the rates based on events that occurred with a frequency of
under 20 are likely statistically unstable, rates pertaining to events with a frequency of 5 to 19 are displayed in gray. Furthermore, ZIP
codes of "00000" indicate a missing or invalid value in the data, or represent ZIPS that had very few births and which are not found in any
of the other data sources.
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| What is shown in the maps included in the CCPRs? |
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Maps are a helpful tool for visually identifying in-need areas. The maps included in the CCPRs are based on ZIP codes representing the
physical location of a residence. For the purpose of mapping ZIP code level information, any events occurring in point ZIPs (i.e., ZIPs with
zero geographic area) were included in the enclosing ZIP's numbers. A list of point ZIPs and their enclosing ZIPs is available in the ZIP
Code inventory section for a county.
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As ZIP codes vary in size tremendously, and as for the large number of them, one year of data will not provide a large enough number of
events and a large enough denominator, we have chosen to base the CCPR maps on three years of data.
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For our maps, we have chosen an alternative map format to present geographic information. Traditionally, simple choropleth maps were used.
Maps included in this report are significance level maps: Level is expressed by color and signficance relative to overall
California levels is expressed by pattern. For instance, a geographic region showing the darkest red color and a solid pattern shows the
highest level and the rate or percentage observed is highly statistically significantly different from the level observed for California; a
geographic region showing the darkest red color and a crosshatched or line pattern shows the highest level, but the rate or percentage
observed is not highly statistically significantly different form the level observed for California, etc. Such a map will detract attention
from geographic areas whose unusually high or low levels are relatively less important due to a too small population at risk or too few
expected events.
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Signifance level maps are a variant on maps known as z-score maps. At the local level, the at risk population as well as the number of
events might be too small to allow a statistically "good" estimation of a percentage or rate. A map showing just the level of a percentage
or rate observed will be misleading as areas with a small population and extreme rates will be inappropriately highlighted.
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A significance level map uses colors and patterns to make a more meaningful statement:
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The color of an area indicates level. The pattern indicates significance for a two-tailed signficance test at significance level 0.01.
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Colors in Significance Level Maps
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The maps all use a gradient of colors from yellow, orange, red to dark red. Yellow corresponds to the category summarizing the lowest
percentages/rates observed while dark red corresponds to the highest percentages/rates observed.
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The cut points chosen for the determination of different shadings of areas are dependent upon whether the displayed item has an
associated Healthy People 2010 Objective or not.
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For percentages or rates for which a Healthy People 2010 Objective exists, the first cut point is based on the Healthy People 2010
Objective. The second cut point is chosen as 125%, the third cutpoint is chosen as 150% of the objective. As an example, for the neonatal
mortality rate, the Healthy People 2010 Objective is 2.9 deaths per 1,000 live births. The corresponding cut points for the map are: 2.9,
3.125 (2.9 * 1.25), and 4.35 (2.9 * 1.5). Locations with a neonatal mortality rate less than 2.9 are colored in yellow; locations with a
neonatal mortality rate of 4.35 or higher are colored in dark red.
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For percentages or rates for which a Healthy People 2010 Objective does not exist, the cut points are based on the distribution of
the percentage/rate across CA ZIP codes weighted by the number of births. The first cut point is the first quartile. In other words, if we
were to plot a map of all the ZIP codes in California, the areas highlighted in yellow would be the locations of roughly 25% of the births
that occurred in California.
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Patterns in Significance Level Maps
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The maps presented all use either a solid pattern or some sort of broken pattern. Whether or not a solid or broken pattern is used depends
on the result of a test of significance. The significance test performed depends on the data item being mapped.
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For all percentages and rates for which a Healthy People 2010 Objective has been set, the significance test compares the observed
percentage or rate to the Healthy People 2010 Objective. If an area's value is statistically signifcantly different from the one set forth
by the Healthy People 2010 Objective, a solid pattern is used, otherwise a broken pattern.
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For all percentages and rates for which a Healthy People 2010 Objective has not been set, the significance test compares the observed
percentage or rate to the mean percentage or rate observed in California. If an area's value is statistically signifcantly different from
the California mean, a solid pattern is used, otherwise a broken pattern.
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For all tests of significance, we used a significance level of 0.01.
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Note that it is quite possible that a pattern or color does not appear in a map.
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As with tables, all maps can be viewed on-line. A high resolution version of each map can be downloaded in pdf format using a hotlink under
each map. To see and print maps in pdf format, it is necessary to obtain
Adobe Acrobat Reader.
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The maps can also be saved by clicking on a map with the right mouse button, and then selecting Save target as... from the menu that pops
up. This procedure will save the maps in GIF format.
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| What is shown in the trend diagrams included in the CCPRs? |
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Trend diagrams are used to display time trends for each data item for which such data are available. All diagrams display California and
county level trends. All trend diagrams include 95% confidence limits for the county mean predicted value. Where applicable, the 2010
objective is indicated by a labeled reference line.
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As with tables and maps, all trend diagrams can be viewed on-line. A high resolution version of each trend diagram can be downloaded in pdf
format using a hotlink under each graph. To see and print trend diagrams in pdf format, it is necessary to obtain Adobe Acrobat Reader.
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The trend diagrams can also be saved by clicking on a trend diagrams with the right mouse button, and then selecting Save picture as... from
the menu that pops up. This procedure will save the trend diagrams in GIF format.
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| Data Sources and Additional Data Items Available Upon Request (IPODR Help) |
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Additional tabulations from the Vital Statistics Birth, Death, and Patient Discharge Data
that are included in IPODR besides those available through the CCPR can be requested. Click here to look at
more information on the data sources used to obtain the IPODR tabulations and at further detail on additional tabulations not yet available
on-line.
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| Which mortality measures are available for which year? |
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The mortality rates included in the CCPRs are based on the most recent data available as of February 2008. The 2004 mortality data are based on the
2004 birth cohort file. The birth cohort file is released annually by the California Department of
Public Health (CDPH). The birth cohort file includes all births that occurred in California or births that occurred to California
residents outside of California along with linked information on infant death within the first year of life (either inside or outside
California within the Unites States). The birth cohort file is usually released with a lag of three years, in other words, the 2004 birth
cohort file was released in 2007. |
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In order to supply more recent mortality information, the CCPRs provide information on neonatal mortality based on a preliminary
link of the most recent year for which both, vital statistics birth master file and vital statistics death master file, are available.
Currently, the most recent year for which both of these data files are available is 2005. Note that this preliminary link does not include
births to California residents that occurred out-of-state. Nor does the preliminary linked file include deaths of babies that were born in
California, but passed away outside of California within the first year.
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For the calculation of neonatal and perinatal mortality, we need a 28-day follow-up period after the birth. Therefore, for neonatal and
perinatal mortality only those births that occurred prior to December 3 of the most current birth/death master file year available
(currently 2005) are used. Postneonatal and infant mortality cannot be reported for 2005 based on the preliminary linked file; therefore, information
on the previous year's (2004) mortality levels is listed.
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| Steps undertaken to generate IPODR, the CCPRs, and the CCPR website |
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The following steps need to happen to generate the CCPRs:
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| Obtain the VS/PDD linked file. |
| Obtain a valid inventory of ZIP codes for the corresponding year. |
| Validate the county-ZIP code combination in the VS/PDD linked file. |
| For invalid county-ZIP code combinations in the vital statistics data, assign '00000' as ZIP code. For invalid counties of residence, assign '000' as county of residence code. |
| Generate all IPODR variables based on the VS/PDD file and only retain those variables along with county and ZIP codes as IPODR base files. |
| Generate CCPR for each county. |
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All these steps are performed in SAS.
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