Time-dependent County Attributes

The time-dependent county attributes include a socioeconomic status (SES) index and seven county-level SES attributes that were used to construct the index. The attributes and the index are estimated at various time points using data obtained from the 1990 and 2000 U.S. Decennial Census long form survey, and a series of American Community Survey (ACS) 5-year estimates from 2006 to 2023. At each time point, a SES index is constructed from these attributes using a factor analysis (Yu et al. 2014). The attributes and the index are then linked to cancer cases/deaths at the county level by matching the survey data year and diagnosis/death year. Thus, for any of the seven attributes and index, cancer cases/deaths in the same county may have different values for different years. The mapping of the SES attributes/index and diagnosis or death year are shown in Table 1.

Table 1.

Variable Descriptions

The selection of attributes for constructing the SES index is based on Yost et al. (2001). Below are the tables and formulas used to calculate the base variables used in constructing the SES score. The tables are from the 2017-2021 American Community Survey (ACS) 5 –year estimates. Similar tables were used from the 1990 and 2000 Census and the 2006-2010, 2007-2011, 2008-2012, 2009-2013, 2010-2014, 2011-2015, 2012-2016, 2013-2017, 2014-2018, 2015-2019, 2016-2020, 2017-2021, 2018-2022, and 2019-2023 ACS.

Median Household Income

Median household income is taken from table B19013: Median Household Income in the Past 12 Months (in 2023 inflation adjusted dollars). The inflation adjustment is different for each of the data sources (i.e., 2018-22 ACS median income is in 2022 inflation adjusted dollars). In addition to the median income from the original data source, median income is available for all time points adjusted to 2023 dollars. This is available as dollars and income groupings.

Median House Value

Median house value is taken from table B25077: Median Value (Dollars).

Median Gross Rent

Median gross rent is taken from table B25064: Median Gross Rent (Dollars)

Percent Below 150% Poverty

The percent below 150% of poverty line is calculated using table C17002: Ratio of Income to Poverty Level in the Past 12 Months. The formula for this is:

• Below 150% poverty: ((C17002e02 + C17002e03 + C17002e04 + C17002e05) / C1702e01) * 100

Education Index

The education index is calculated using table B15002: Sex by Educational Attainment for the Population 25 Years and Over. The percent with less than high school graduate, high school only and more than high school are calculated, as follows:

• Less than HS grad: ((B15002e03 + ... + B15002e10 + B15002e20 + ... + B15002e27) / B15002e01) * 100
• HS Only: ((B15002e11+B15002e28)/B15002e01) * 100
• More than HS grad: ((B15002e12 + ... + B15002e18 + B15002e29 + ... + B15002e35) / B15002e01) * 100

Using the percentages calculated above, the education index is calculated as follows:

• Education Index: (Less than HS grad * 9) + (HS only *12) + (More than HS grad * 16)

Working Class

The percent working class is calculated using table C24010: Sex by Occupation for the Civilian Employed Population 16 Years and Over.  The formula for this is:

• Working Class: ((C24010e20 + C24010e24 + C24010e25 + C24010e26 + C24010e27 + C24010e30 + C24010e34 + C24010e56 + C24010e60 + C24010e61 + C24010e62 + C24010e63 + C24010e66 + C24010e70)) / C24010e01) * 100

Percent Unemployed

The percent of persons ages 16 and over who are unemployed is calculated using table B23025: Employment Status for the Population 16 Years and Over. The percent unemployed is calculated for civilians in the labor force. Persons in the armed forces or not in the labor force are not included in the calculation. The formula used is:

• Unemployed: (B23025e05 / B23025e03) * 100

Rural-Urban Continuum Codes

Rural-Urban Continuum Codes were developed by the United States Department of Agriculture (USDA).

Rural-Urban Continuum Codes form a classification scheme that distinguishes metropolitan (metro) counties by the population size of their metro area, and nonmetropolitan (nonmetro) counties by degree of urbanization and adjacency to a metro area or areas.

The mapping of the original Rural-Urban Continuum Codes to the collapse categories available in the time dependent county attributes are shown in Tables 2, 3, and 4.

Table 2. RUCC 1993 (1990-1997)

Table 3. RUCC 2003 (1998-2007), RUCC 2013 (2008-2017 All Counties, 2018-2023 Connecticut Counties)

Table 3. RUCC 2023 (2018-2023 All Counties Except Connecticut Counties)

In addition to the mapped categories in the tables above, the following categories are used to classify areas that are not covered by the RUCC.

• 88: Unknown-Alaska/Hawaii State/not official USDA Rural-Urban Continuum code
• 99: Unknown/not official USDA Rural-Urban Continuum code

The Rural-Urban Continuum Codes for 2023 are not available for counties in Connecticut. The data are only available for planning regions. To be consistent with geographies in the incidence and death data the value for 2013 are used for 2008-2023 for Connecticut. For more information about using Rural-Urban Continuum Codes, go to Rural-Urban Continuum Codes in SEER*Stat.

References

Yost K, Perkins C, Cohen R, Morris C, Wright W (2001) Socioeconomic status and breast cancer incidence in California for different race/ethnic groups. Cancer Causes Control 12(8):703–711. doi:10.1023/a:1011240019516.

Yu M, Tatalovich Z, Gibson JT, Cronin KA. Using a composite index of socioeconomic status to investigate health disparities while protecting the confidentiality of cancer registry data. Cancer Causes & Control. 2014;25(1):81-92.