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Substance Abuse in States and Metropolitan Areas: Model Based Estimates from the 1991-1993 National Household Surveys on Drug Abuse

Footnotes

   

Footnote #1:

1Detailed descriptions of the methodology and the evaluation results can be found in Folsom, R., et al. (1996) Substance Abuse in States and Metropolitan Areas: Model Based Estimates from the 1991-1993 National Household Surveys on Drug Abuse, Methodology Report. Preliminary results from the study were reviewed by an advisory panel assembled by SAMHSA in May 1995. Panelists include Robert Fay (Bureau of the Census), Arthur Hughes (National Institute on Drug Abuse), Donald Malec (National Center for Health Statistics), William McAuliffe (National Technical Center for Substance Abuse Needs Assessment), Daniel McCaffrey (Rand Corporation), Wes Schaible (Bureau of Labor Statistics), and James Schmeidler (New York State Office of Alcoholism and Substance Abuse Services). Many of the recommendations of this panel were subsequently incorporated in the study including an extensive series of evaluations of the methodology.

   

 Footnote #2:

2Detailed definitions of these dependence measures can be found in Appendix A.

   

Footnote #3:

3Data on arrests are also available from the FBI Uniform Crime Reports. The UCR data are not directly comparable because they indicate number of arrests while the NHSDA estimates represent number of people who have been arrested at least once. Adjustments of NHSDA substance abuse statistics based on ratios of administrative record arrest counts divided by NHSDA survey estimated arrest reports have been proposed by D. Wright and J. Gfroerer (1994). "The use of external data sources and ratio estimation to improve estimates to hard-core drug use from the NHSDA," in Harrison, L. and Hughes, A., eds. The Validity of Self-Reported Drug Use: Improving the Accuracy of Survey Estimates. NIDA Research Monograph 167, NIH Pub. No. 96-4147, Washington, DC, Supt. Of Docs., U.S. Government Printing Office. However, these adjustments were not done for this report. Thus, some of the estimates in this report will be inconsistent with estimates shown elsewhere that include the ratio adjustment.

   

Footnote #4: 

4An exhibit that presents the confidence intervals is also included in Appendix C.

   

Footnote #5:

5Recognizing this problem, SAMHSA has produced adjusted estimates of treatment need, using a ratio-adjustment procedure. See for example, Office of National Drug Control Policy (1996) National Drug Control Strategy.

   

Footnote #6: 

6See Schaible, W.L. (1996) Indirect Estimators in US Federal Programs: Lecture Notes in Statistics 108, New York: Springer-Verlag, Inc. For a discussion of statistics that are produced by the federal government using indirect or small area estimation techniques. A similar discussion can be found in U.S. Office of Management and Budget (1993), "Indirect Estimators in Federal Programs, "Statistical Policy Working Paper 21, National Technical Information Service, (NTIS Document Sales, PB93-209294) Springfield, Virginia.

   

Footnote #7: 

7For a fuller discussion of alternative methods of producing estimates for small are and the various terms that have been used to describe the methods see Schaible (1996) op cit and Ghosh, M. and Rao, J.N.K. (1994) "Small Area Estimation: An Appraisal," Statistical Science, Vol.9, 55-93.

   

Footnote #8: 

8See for example the discussion by Malec, D. (1966) "Model Based State Estimates form the National Health Interview Survey," in Schaible (1996) op.cit.

   

Footnote #9:

9The subscript s indicates that the factor is a function of direct sample data.

   

Footnote #10:

10This square bracketed term is the logistic regression analog of the linear survey regression estimators commonly treated in sampling texts (see for example, Sarndal, C., Swensson, B., and Wertman, J. (1991) Model Assisted Survey Sampling. New York: Springer-Verlag) and is the "direct" component of the composite estimator.

   

Footnote #11:

11If this is not done, post-hoc adjustments are needed to force State estimates to agree with national estimates.

   

 Footnote #12:

12Breslow, NE and Clayton, DG (1993). "Approximate Inference in Generalized Linear Mixed Models," Journal of the American Statistical Association, Vol. 88, No. 421, 9-25.

   

 Footnote #13:

13Self-administered questionnaires ensure that the answers given by respondents to the highly sensitive questions on drug use are anonymous. This has been shown to increase the accuracy of reports of drug use, particularly for illicit substances. See, for example, Turner, CF, Lessler, JT, and Gfroerer, JC (1992). "Survey Measurement of Drug Use: Methodological Studies," DHHS Publication No. (ADM) 92-1929. See Aquilino, WS (1994) "Interview Mode Effects in Surveys of Drug and Alcohol Use: A Field Experiment," Public Opinion Quarterly. Vol. 58, 210-240.

   

Footnote #14:

14From Summary Tape File 3, 1990 Census of Population and Housing.

   

Footnote #15:

15Further information on these long form Census data can be found in the technical documentation for Summary Tape File #3 of the 1990 Census of Population and Housing as well as in the booklet "1990 Census of Population and Housing Tabulation and Publication Program" prepared by the U.S. Bureau of Census.

   

Footnote #16:

16Claritas, Inc., 201 N. Union St. Suite 200, Alexandria, VA., 22314-2645, (703) 683-8300.

   

Footnote #17:

17Full descriptions of all of the evaluations can be found in Folsom, et al. (1996) op.cit.

   

 Footnote #18:

18A discussion of methods for assessing the fit of logistic regression models can be found in Hosmer, D and Lemeshow, S. (1989) Applied Logistic Regression, New York: John Wiley & Sons.

   

Footnote #19:

19the evaluation subgroups are formed using the distribution of the predicted substance abuse prevalence rates. Using the model, the predicted values were calculated for each person in the sample. This represents the model predicted probability of the person using the particular substance in question. Then these predicted values were used to order the sample from highest to lowest and evaluation subsamples were formed by starting at the top and dividing the sample into 40 subsamples each of which contained 2.5 percent of the population. Thus, the entire sample is partitioned into evaluation subsamples which are predicted to have similar levels for the prevalence of substance abuse.

   

Footnote #20:

20This prediction subsamples span the entire set of evaluation subgroups.

   

Footnote #21:

21This cross-validation approach is done to eliminate an undesired correlation between the predicted estimates and the direct estimates in the evaluation subgroups. A fuller explanation of why this was done is given in Folsom, et.al (1996) op.cit.

   

Footnote #22:

22A modification of the Hosmer-Lemeshow goodness-of-fit statistic (Hosmer and Lemeshow, 1989) was used to take into account the complex sample design. A full description is given in Folsom, et al. (1996).

  

Footnote #23:

23Due to the cost of computations, these tests were restricted to a single age group (26-34) and the six estimates shown in the table.

   

Footnote #24:

24For example, in a study that predicted college performance using a number of characteristics one might find that for the particular sample used to construct the model, people with red-hair did better in college. However, this might be an artifact in that by chance a number of very smart people with red-hair were in the first sample. Thus, if the model was evaluated in another sample, including hair color in the model would result in predictions of higher performance for red-haired people and lower performance for those who did not have red hair with the results that the estimated performance would have more variability than actually exists.

   

Footnote #25:

25In areas were there was a large NHSDA sample, the full SAE model will do better because the estimation method was constructed so that it would take maximum advantage of the highly precise direct estimate in the areas with large samples. This is a desirable property of composite small area estimators and is called "shrinkage."

   

 Footnote #26:

26Rank correlations are calculated by ranking the states according to prevalence and calculating the correlation of the ranks.

   

Footnote #27:

27The range ratios in Exhibits 4.3 – 4.6 are different from as those in Exhibit 4.2 because, for a particular state, the estimates are averages across all levels of prevalence, whereas, in Exhibit 4.2 we used artificial subpopulations which were constructed to have widely divergent prevalence rates.

   

Footnote #28:

28Aquilino (1994) op.cit.

   

Footnote #29:

29For example, the ratio of range across states in the prevalence of cigarette use to the national mean for the BRFSS is about 0.45 whereas for the NDATUS estimates of drug treatment this range is 3.15. Thus, for treatment information there is wide variability across states in a very low prevalence characteristic which makes it more difficult to model this variability using the set of predictors that were chosen for this study.

   

Footnote #30:

30And additional information on these evaluations in Folsom (1996).

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