CLUSTER HEALTH PROFILE Boomers & Babies -\ . , .. ~ . .' . .~ _. . '.. -... '>>~ -::-<:'..~:::;:);:\ ; i:n) Georgia Department of Human Resources Division of Public Health Version 1.0 May 24, 1997 Table of Contents Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 General Cluster Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Race/Ancestry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Family Type .................................................... 4 Age of Population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Employment Level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Household Income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Distribution of Boomers & Babies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Distribution by Health District . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Comparing Boomers & Babies to the Nation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 National Consumer Behaviors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Physical Activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Alcohol Consumption . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Tobacco Consumption ...................................... 9 Health Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Comparing Boomers & Babies to Georgia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Consumer Expenditures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Food Expenditures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Alcohol Expenditures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Tobacco Expenditures ..................................... 12 Housing Expenditures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Utilities and Public Services Expenditures . . . . . . . . . . . . . . . . . . . . . . 13 Medical Expenditures (out-of-pocket) . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Education Expenditures .................................... 14 Public Transportation Expenditures . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Hospital Usage Estimates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Causes of Hospitalization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Appendix A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Boomers & Babies Population by County and Health District . . . . . . . . . . . . . 17 Appendix B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 How to Use the Cluster Health Profiles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Cautions in Using the Cluster Health Profiles . . . . . . . . . . . . . . . . . . . . . . . . . 26 Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Cluster Health Profiles Georgia 1995 Introduction The following report, featuring Boomers & Babies, introduces a series of planning documents called the Cluster Health Profiles. Developed by Claritas, Inc., a marketing company, lifestyle clusters are populations characterized by commonalities in age, ethnicity, race, education and income, consumer preferences and neighborhood location. The completed series will address over 90 percent of the Georgia population. Each Cluster Health Profile will show a "health snap-shot" of the various lifestyle clusters found in Georgia. The profiles will include demographic descriptions; population tables by district and county; and a map showing the distribution of the cluster within the state. The following consumer patterns will also be included: dietary habits physical activity health insurance coverage tobacco and alcohol consumption housing and utility costs public transportation expenditures medical and drug expenditures hospital usage by diagnosis These marketing indicators may be used by health planners to identify in-need populations as well as those that may be at higher risk for health problems. The profiles may also assist planners in allocating resources and designing public health programs. Directions for the proper usage of this data and the methodologies involved in creating them are included in Appendix B. Special Requests . Public Health personnel may request additional information about the lifestyle clusters located in their health districts and counties. Cluster population data are available at the census tract and neighborhood block groups levels. Also available upon request are county maps that show the census tract or neighborhood block locations of lifestyle clusters. Please direct all inquiries and requests to: Center for Health Information Health Assessment Services Section Two Peachtree Street, NW, 3rd Floor Annex Atlanta, GA 30303 Primary Contact: Wilma Barshaw Phone: 404/657-6328 E-mail: web@ph.dhr.state.ga.us Boomers & Babies Boomers & Babies ranks second of all clusters for married couples with children, and first in total households with children, many of whom are pre-schoolers. This population has used education to become executives and technicians working in varied fields. Boomers & Babies members are more likely to join a health club or gym, have a first mortgage loan, listen to variety radio, watch Funniest Home Videos, read the newspaper home & garden and entertainment sections and Working Mother magazme. General Cluster Characteristics: 1995 Households (% U.S.) Population (% U.S.) 1,209,000 (1.3%) 3,670,500 (1.4%) Households (% GA) 33,831 (1.3%) Population (% GA) 98,903 (1.4%) Demographic Caption Young White-Collar Suburban Families Ethnic Diversity Dominant White, High Asian Family Type Married Couples with Children Predominant Age Ranges 25-34, 35-44 Education Some College Employment Level White Collar/Professional Median Household Income ~- ' ~ - ' - ., -~-- Upper Middle/$46,000 per year "' --~- The tables on the following pages indicate how this cluster population compares to the U.S. population regarding the above characteristics. The tables show the percent of the U.S. population for each variable and the percent for the cluster. If the U.S. and cluster percents are the same, the index will read 100. For example, an index of 200 for "less than 8th grade" will mean that the cluster is twice as likely to have less than an 8th grade education than the U.S. as a whole. Georgia Division of Public Health 3 Boomers & Babies Cluster Profile Race/Ancestry Race/Ancestry White Black All Other Races Hispanic Ancestry Asia'::'~ Af!cestry --- - -~ ~ - .. U.S.% Cluster% 83.2 87.7 12.4 7.2 4.4 5.1 9.9 10.3 5.4 - ~ _, --. ~ 6.0 . -~ Family Type Index 105 58 116 . 105 111 Family Type Married Couples Married Couples with Children Single Parents Singles u.s.% 28.1 26.6 9.1 36.2 -~ - - ~-- Cluster% 26.2 41.9 8.5 23.4 - - - - - -~- ~--- ~-- . Age of Population 18-24 25-34 35-44 45-54 55-64 65+ Median Age -- ~ - ~- ~- -- - Age of Population -~- - U.S.% -- Cluster% 10.1 8.1 16.2 20.1 15.8 19.1 11.1 9.9 8.1 5.1 12.7 5.2 - - - - . - -~---- --=~ -~~ ~ --~-~~,~~-~-- 46.5 - ' ~- -~----=- 40.6 Index 93 158 93 65 Index 79 124 121 89 63 41 87 4 Georgia Division of Public Health Boomers & Babies Cluster Profile Education Education 4+ Years College 1-3 Years College High School Grad Less than 8th Grade U.S.% 20.5 25.1 29.9 10.2 . ~ ~ Cluster% 22.1 35.9 28.7 4.0 Employment Level Index 108 143 96 39 Employment Level Professional/ Manager Other White-Collar Blue-Collar Service Farming/Mining/ Ranching -- ~ ~-- ---~-c U.S.% 26.6 31.8 26.1 13.1 2.4 ~cluster% 28.0 36.8 23.2 11.0 0.9 . ~ ~ Household Income ------ - -- - = ~- Household Income Less than $15,000 $15,000 - $24,999 $25,000 - $34,999 $35,000 - $49,999 $50,000-$74,999 $75,000 - $99,999 $100,000+ Median HH Income - --~ U.S.% 20.8 15.7 14.7 17.9 17.7 7.1 6.2 $36,700 Cluster% 7.3 9.9 14.2 25.3 28.5 9.8 5.0 $46,000 Index 106 116 89 84 38 Index 35 63 97 142 161 137 80 125 Georgia Division of Public Health 5 Boomers & Babies Cluster Profile Distribution of Boomers & Babies Georgia Counties, 1995 Boomers & Babies communities are found in five (3 .1%) of Georgia's 159 counties. With a population of 98,903 ( 1.4% of the state population), this group ranks twenty-seventh among the lifestyle clusters in Georgia. Located in five ofthe state's 19 health districts, most Boomers & Babies communities are found in the Atlanta metropolitan area. The largest concentration of the cluster is found in DeKalb (District 3-5) where they are more than six percent of the district population; however, Cobb (District 3-1) and Savannah (District 9-1) also have sizable Boomers & Babies populations. A complete listing of counties that contain Boomers & Babies populations is found in Appendix A of this document. Percent of County Population D None D .01 to20 D 21 to 50 - OverSO CJ Health Districts WN*E s 6 Georgia Division of Public Health Boomers & Babies Cluster Profile Boomers & Babies Distribution by Health District Health District DeKalb (3-5) Cobb (3-1) Savannah (9-1) Dalton (1-2) Lawrenceville (3-4) Percent of District Population 6.4 4.7 5.9 5.2 0.7 Cluster Population District Population 1 37,388 28,524 15,199 13,984 3,808 583,119 601,498 258,142 268,474 562,172 1 District population estimates are from Claritas' 1995 projections based on the 1990 U.S. Census. Georgia Division of Public Health 7 Boomers & Babies Cluster Profile Comparing Boomers & Babies to the Nation National Consumer Behaviors The Claritas Marketing System provides information about the consumer preferences of the lifestyle clusters in the United States.2 These preferences can be associated with health-related behaviors such as smoking, alcohol usage or exercise. Indexes for certain categories of consumption may indicate which clusters are at lower, average or elevated risk for specific health problems and needs. The cluster indexes relate each cluster's consumer pattern to the country as a whole. As compared to a national average of 100, the indexes indicate whether a cluster is more or less likely to use a product or service or engage in an activity. The cluster index profiles below show that Boomers & Babies communities are more likely to participate in most of the listed categories of exercise. In fact, they are 27 percent more likely to exercise two or more times per week than the U.S. population. Boomers & Babies communities also report higher than average consumption of most of the common varieties of alcohol. However, their cigarette smoking is only three percent above the national average, and their consumption of other tobacco products is relatively low. Regarding insurance access, Boomers & Babies members report 41 percent more use ofHMOs and 20 percent more insurance purchase through agents than the U.S. adult population. This pattern, coupled with very low reporting of Medicare eligibility and Medicaid use, suggests that the cluster has a high level of employer-provided insurance and small populations of poor and elderly. _____ :_- . . " -~ Physical Activity In Last Year Cluster Index In Last Year Cluster Index Hiking 103 Golf 127 Jogging 132 Softball 136 Walking 118 Tennis 117 Swimming 110 Hunting 84 Weight-lifting 124 Exercised 2+ times Aerobics 137 per week - - --~--~~~~ 127 2 Claritas bases its cluster consumer profiles on a self-reported survey of consumer behaviors conducted by Mediamark Research, Inc. (MRI). The current information reports survey results for the years 1994-1995 for the 18+ adult population. 8 Georgia Division of Public Health Boomers & Babies Cluster Profile In Last Week Domestic Beer Domestic Wine Imported Wine In Last 6 Months Malt Liquor Alcohol Consumption Cluster Index In Last Month 92 Bourbon 85 Scotch 114 Whiskey Cluster Index Vodka 82 Gin Rum Cluster Index 117 114 125 110 83 125 ~ ~ In Last 6 Months -- ~- Tobacco Consurn ption -. Cluster Index In Last Year Pipe Tobacco 76 Cigarettes Cigars 61 Non-filter cigarettes Chewing Tobacco 50 Smoked 40+ cigarettes per day Purchased cigarettes by the carton ~ ~ ~ ... ~ In Last Year -"rr-->" ----~- o-- ---- Health Insurance ~ Cluster Index In Last Year Medical Insurance through Membership Group3 Medical Insurance through HMO Medical Insurance through an Agent ------ - - ~- -~ = ~~ 89 Medicare 141 Medicaid 120 -- Cluster Index 103 71 63 80 Cluster Index 41 76 3 Refers to health insurance acquired from a fraternal, professional or other membership organization. Georgia Division of Public Health 9 Boomers & Babies Cluster Profile Comparing Boomers & Babies to Georgia Consumer Expenditures The Claritas Marketing System includes Conswner CLOUT, a retail database that estimates product expenditure in specific geographic areas. 4 The Center for Health Information has used Consumer CLOUT to create expenditure indexes for lifestyle clusters that are found in Georgia. Indexes relating' to food, tobacco and alcohol may be used as indicators of a cluster's behavioral risk for certain diseases~ Indexes for consumer categories such as medical services, housing and utilities can be used to show how the clusters spend their incomes in regard to basic needs. The cluster expenditure indexes relate a cluster's pattern of spending to the state as a whole. As compared to a Georgia average of 100, the indexes show whether a cluster is more or less likely to spend a portion of their consumer dollar on a product. For instance, a bacon expenditure index of 92 shows that Boomers & Babies members spend eight percent less of their total grocery expenditure on bacon than does the Georgia population. The expenditure profile below shows that Boomers & Babies members are average to below average for most of their grocery expenditures. They spend a smaller portion of their grocery dollar on many high fat foods (bacon, whole milk and eggs) and spend a slightly larger portion on poultry, fish, fresh fruits and vegetables. Their expenditures on cookies, cakes, potato chips and snacks are above the Georgia average. In contrast to their national profile, the cluster spends below the Georgia average on alcohol, with the exception of wine at and away from home. This difference may be due to over-reporting at the national level, differences between the national Boomers & Babies group and the Georgia Boomers & Babies group, or differences between the average national consumption profile and the average Georgia expenditure profile. Their tobacco spending is well below the Georgia average. The cluster spends a larger portion of consumer income on homeowner expenses, and a smaller portion on renter expenses, indicating that many Boomers & Babies members own their homes. Their low to average utility and public service costs reflects their suburban housing pattern. Likewise, Boomers & Babies are below average spenders on mass transit and taxis. Regarding out-of-pocket medical costs, Boomers & Babies is below average for all the listed services, except dental services. This may reflect a willingness and ability to pay for preventive dental services. This pattern reflects the lack of elderly in the cluster and possibly the high level of HMO usage reported nationally by the group. 4 Consumer CLOUT's 1992 estimates of retail expenditures are developed from: Consumer Expenditure Survey (U.S. Bureau of Labor Statistics); Census of Retail Trade (U.S. Department of Commerce); Annual Consumer Expenditures Study published by Supermarket Business Magazine. Other sources include data from > 200 trade, business and commercial organizations. 10 Georgia Division of Public Health Boomers & Babies Cluster Profile Meat, Poultry and Fish (includes luncheon meats, lamb and organ meats and the following products) Beef Pork Pork Sausage Pork Chop Bacon Poultry Fish and Seafood Fresh Fruits Fresh Vegetables Food Expenditures GA Expenditure Cluster Expenditure Per $1,0005 Per $1,000 $229.57 $228.32 $92.41 $48.71 $7.96 $12.65 $7.59 $44.71 $17.31 $36.87 $98.12 $92.16 $45.97 $7.57 $12.08 $6.97 $45.45 $18.38 $37.13 $99.85 Dairy Products $90.67 Whole Milk $17.17 Butter $2.74 Cheese $18.36 Ice Cream $15.64 Eggs $11.88 Bakery Products (includes biscuits, rolls, muffins, crackers, doughnuts, pies and the following products) $76.60 Cookies $10.44 Cakes and Cupcakes $8.30 White Bread . , $18.17 5 Number of dollars spent per $1,000 oftotal grocery expenditure. Georgia Division of Public Health $89.21 $16.13 $2.70 $18.91 $15.92 $11.11 $76.11 $10.82 $8.47 $16.93 Cluster Index 99 100 94 95 95 92 102 106 101 102 98 94 98 103 102 93 99 104 102 93 11 Boomers & Babies Cluster Profile GA Expenditure Cluster Expenditure Per $1,0006 Per $1,000 Cereals and Cereal Products (includes flour, breakfast cereal, rice and pasta) $37.93 $37.02 Sugar and Other Sweets (includes candy, jam & jelly) $39.76 $39.40 Potato Chips & Snacks - - ~~-, ,,.T $21.13 $21.79 Alcohol Expenditures - GA Expenditure Cluster Expenditure Per $1,0007 Per $1,000 Beer at Home $4.79 $4.46 Whiskey at Home $0.33 $0.32 Wine at Home $1.06 $1.16 Beer Away from Home $2.21 $2.03 Wine Away from Home $0.54 $0.56 Total Alcohol (includes all other types of alcohol in addition to beer, whiskey and wine) . ~ . - $11.11 ... - ~- Tobacco Expenditures $10.73 GA Expenditure Cluster Expenditure Per $1,0007 Per $1,000 Cigarettes $10.68 $8.91 Cigars, Pipes and Other Tobacco Products $0.69 $0.52 Total Smoking Products and Supplies (includes smoking accessories) $11.47 $9.51 6 Number of dollars spent per $1,000 of total grocery expenditure. 7 Number of dollars spent per $1,000 of total consumer expenditure. 12 Georgia Division of Public Health Cluster Index 98 99 103 I I I Cluster I Index 93 97 110 92 104 97 Cluster Index 83 75 83 Boomers & Babies Cluster Profile Owned Dwelling Expenses (includes interest, taxes, maintenance and repair) Home Owner's Insurance Rented Dwelling Expenses (rent, maintenance and insurance) -~ . ~ Housing Expenditures GA Expenditure Cluster Expenditure Per $1,0008 Per $1,000 $126.18 $156.03 $5.76 $47.34 $6.07 $26.29 Utilities and Public Services Expenditures GA Expenditure Cluster Expenditure Per $1,0008 Per $1,000 Electricity $27.35 $25.91 Natural Gas $6.05 $6.06 Bottled/Tank Gas $1.02 $0.53 Misc. Fuel (coal, wood or kerosene) $0.72 $0.40 Telephone $19.30 $17.54 Water/Sewerage $7.63 $6.42 Total Fuels, Utilities and Public Services $67.22 $62.98 Cluster Index 124 105 56 Cluster Index 95 100 51 55 91 84 94 8 Number of dollars spent per $1,000 of total consumer expenditure. Georgia Division of Public Health 13 Boomers & Babies Cluster Profile Medical Expenditures (out-of-pocket) GA Expenditure Per $1,0009 Cluster Expenditure Per $1,000 Medical Services (includes eye exams, treatment, surgery, lab tests, x-rays and other medical services including the four listed below) $27.99 $27.76 Physician Services $9.90 $9.82 Dental Services $5.82 $6.28 Hospital Room/Meals $0.94 $0.76 Nursing Home Care $0.23 $0.06 Cluster Index 99 99 108 81 28 Non-prescription Drugs $3.72 $3.28 88 Prescription Drugs -- ~. "~~ ,...__ - .. $9.34 $7.50 - -- ~ -- ~~- -~----- ~ ... -~ ~duc_ation Expenditures .. . GA Expenditure Cluster Expenditure Per $1,0009 Per $1,000 :: ---~- 80 .. ... Cluster Index College Tuition . - $6.95 $7.03 101 i .. -- =----- Public Transportation Expenditures l GA Expenditure Per $1,0009 Intracity Mass Transit (where applicable) $1.21 Cluster Expenditure Per $1,000 $1.08 Cluster Index 89. Intercity Bus Fares $0.39 $0.34 87 Taxi (local trips, not out-of-town) ... $0.28 .. . $0.20 70 9 Number of dollars spent per $1,000 of total consumer expenditure. 14 Georgia Division of Public Health Boomers & Babies Cluster Profile Hospital Usage Estimates The Claritas Marketing System provides estimates of hospital usage by disease diagnosis for specified geographic areas. 10 These indexes provide a means of estimating morbidity risk in a population when actual hospital discharge data are not available. Hospital usage indexes by lifestyle cluster show which clusters are more or less likely to be hospitalized for specific causes as compared to Georgia as a whole. For instance, compared to a state average of 100, Boomers & Babies members are 34 percent less likely to be hospitalized for prostate cancer. Generally, the cluster index profile below indicates that Boomers & Babies neighborhoods are at lower risk of hospitalization for most of the infectious and chronic diseases. However, the cluster may show a higher incidence of being hospitalized for two childhood diseases: otitis media and acute tonsillitis. The hospitalization estimate for female pelvic inflammatory disease is 10 percent above the Georgia average. In addition, this population is at increased risk of hospitalization due to chronic liver disease and cirrhosis. Interestingly, estimated hospital cases of pulmonary tuberculosis in the group are five percent higher than the Georgia population as a whole. "--- --- --- ' ~ ~ -~ ~~~ Causes of Hospitalization - GA Rate11 Cluster Rate Cluster Index Pulmonary Tuberculosis 8.7 9.1 105 Total Cancer 1,432.9 1,154.7 81 Trachea/Lung Cancer 150.5 120.3 80 Breast Cancer (female) 81.1 68.8 85 Cervical Cancer 14.0 13.1 94 Prostate Cancer 80.7 53.6 66 Diabetes 1,255.6 1,027.3 82 Otitis Media 92.8 99.1 107 Circulatory Disease 8,629.1 6,866.3 80 Hypertensive Disease 1,746.8 1,392.3 80 Acute Myocardial Infarction -- ~ T --- ---- 284.7 cc- 224.5 79 cc 1 Claritas has produced disease-specific estimates of hospital usage ( 1995) by applying age-race-sex profiles of local geographic areas to national age-race-sex specific incidence rates of hospitalization. Estimated incidence rates are provided by Health Care Investment Analysts, Inc. 11 Rates are per I00,000 population. Georgia Division of Public Health 15 Boomers & Babies Cluster Profile Causes of Hospitalization GA Rate12 Cluster Rate Cerebrovascular Disease Acute Tonsillitis Acute Bronchitis Pneumonia and Influenza Chronic Obstructive Pulmonary Disease (COPD) Asthma Chronic Liver Disease and Cirrhosis Female Pelvic Inflammatory Disease Injury and Poisonings . < ~ -- -~ 624.7 12.6 194.2 588.1 1,132.8 373.3 135.6 169.3 2,625.7 435.8 15.2 172.9 496.4 925.1 371.1 139.5 187.1 2,451.9 Cluster Index 70 121 89 l 84 82 99 103 110 93 -~- - 12 Rates are per 100,000 population. 16 Georgia Division of Public Health Boomers & Babies Cluster Profile -Appendix A Appendix A Boomers & Babies Counties by Health District County Name Bartow Catoosa Chattooga Dade Floyd Gordon Haralson Paulding Polk Walker Cherokee Fannin Gilmer Murray Pickens Whitfield Banks Dawson Forsyth Franklin Cluster Percent of County Population Cluster Population Rome (District 1-1) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Dalton (District 1-2) 12.5 13,984 0 0 0 0 0 0 0 0 0 0 Gainesville (District 2) 0 0 0 0 0 0 0 0 Georgia Division of Public Health County Populations 62,626 47,242 22,847 14,065 83,626 38,230 23,229 58,452 34,706 60,162 112,059 17,226 15,465 29,487 16,656 77,581 11 '182 11,694 59,256 17,585 17 County Name Habersham Hall Hart Lumpkin Rabun Stephens Towns Union White Cobb Douglas Fulton Clayton Gwinnett Newton Rockdale DeKalb Butts Carroll Boomers & Babies Cluster Profile -Appendix A Cluster Percent of County Population Cluster Population 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Cobb (District 3-1) 5.5 28,524 0 0 Fulton (District 3-2) 0 0 Clayton (District 3-3) 0 0 Lawrenceville (District 3-4) 0.8 3,808 0 0 0 0 DeKalb (District 3-5) 6.4 37,388 LaGrange (District 4) 0 0 0 0 18 Georgia Division of Public Health County Populationa 29,899 106,604 20,553 16,652 12,341 24,968 7,466 13,902 14,865 520,048 _I 81 ,450l l 698,931 197,282 449,219 49,547 63,406 583,119 15,646 77,437 County Name Coweta Fayette Heard Henry Lamar Meriwether Pike Spalding Troup Upson Bleckley Dodge Johnson Laurens Montgomery Pulaski Telfair Treutlen Wheeler Wilcox Baldwin Bibb Crawford Boomers & Babies Cluster Profile - Appendix A Cluster Percent of County Population Cluster Population 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Dublin (District 5-1) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Macon (District 5-2) 0 0 0 0 0 0 Georgia Division of Public Health County Populationa 70,420 78,280 9,413 82,587 13,747 23,096 11,053 57,444 57,953 26,876 10,805 17,889 8,404 42,721 7,708 8,281 11,676 5,951 4,800 7,096 41,631 155,603 9,974 19 County Name : Hancock Houston Jasper Jones Monroe Peach Putnam Twiggs Washington Wilkinson 'Burke Columbia Emanuel Glascock Jefferson Jenkins Lincoln McDuffie Richmond Screven Taliaferro Warren Wilkes - Boomers & Babies Cluster Profile - Appendix A Cluster Percent of County Population Cluster Population 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Augusta (District 6) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ------- County Populationa 9,109 100,071 9,081 21,804 18,751 23,049 15,874 9,918 19,941 10,550 : 21,826. 82,338. . 21,027 2,352 17,711 8,615 8,011 21,403 196,560 14,208 1,814 6,110 10,550 20 Georgia Division of Public Health County Name Chattahoochee Clay Crisp Dooly Harris Macon Marion Muscogee Quitman Randolph Schley Stewart Sumter Talbot Taylor Webster Ben Hill Berrien Brooks Cook Echols Irwin Lanier Boomers & Babies Cluster Profile - Appendix A Cluster Percent of County Population Cluster Population Columbus (District 7) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Valdosta (District 8-1) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Georgia Division of Public Health County Populations 15,363 3,480 20,735 10,334 20,287 13,147 6,285 188,431 2,410 8,146 3,765 5,440 31,532 6,781 7,986 2,255 17,302 15,446 15,636 14,134 2,156 8,550 6,265 21 County Name Lowndes Tift Turner Baker Calhoun Colquitt Decatur Dougherty Early Grady Lee Miller Mitchell Seminole Terrell Thomas Worth Chatham Effingham Appling Atkinson Bacon 22 Boomers & Babies Cluster Profile -Appendix A Cluster Percent of County Population Cluster Population 0 0 0 0 0 0 Albany (District 8-2) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Savannah (District 9-1) 6.7 15,199 0 0 Waycross (District 9-2) 0 0 0 0 0 0 -~-- Georgia Division of Public Health County Populationa 83,417 35,517 8,937 3,714 4,930 37,701 26,337 98,272 12,116, 21,344: 19,520; 6,216 20,751 9,298 10,978 40,622 21,513 226,670 31,472 16,237 6,615 10,567 County Name Brantley Bulloch Candler Charlton Clinch Coffee Evans Jeff Davis Pierce Tattnall Toombs Ware Wayne Bryan Camden Glynn Liberty Long Mcintosh Barrow Clarke Elbert Greene Boomers & Babies Cluster Profile - Appendix A Cluster Percent of County Population Cluster Population 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Brunswick (District 9-3) 0 0 0 0 0 0 0 0 0 0 0 0 Athens (District 10) 0 0 0 0 0 0 0 0 Georgia Division of Public Health County Populationa 12,615 48,720 8,603 9,385 6,464 32,517 9,396 12,324 14,671 18,238 24,993 35,638 24,606 20,826 43,466 65,444 60,187 7,578 9,219 35,231 90,785 19,130 12,792 23 Boomers & Babies Cluster Profile -Appendix A County Name Cluster Percent of County Population Cluster Population Jackson 0 0 Madison 0 0 Morgan 0 0 Oconee 0 0 Oglethorpe 0 0 Walton .. ' - - ' .. 0 0 - ~- - - a. Population: Claritas' 1995 projections based on the 1990 U.S. Census. County Populationa 33,639 23,186 13,954 20,656 10,803 45,891 24 Georgia Division of Public Health Boomers & Babies Cluster Profile - Appendix B Appendix B How to Use the Cluster Health Profiles The Cluster Health Profiles are based on the Claritas PRIZM system, the nation's most widely recognized neighborhood lifestyle segmentation system. This system creates a demographic and consumer portrait of the people living in America's neighborhoods. Marketers use systems like PRIZM to identify and locate their best marketing opportunities. Public health planners may also benefit from marketing methods in identifying and targeting populations for disease prevention and health promotion activities. Identify: Who are the targets, and what are they like? Marketers want to identify the characteristics of lifestyle clusters which perform at, above or below average usage of a product or service. They also want to know what these clusters are like. Are they older? Likely to be married? Or employed in white-collar jobs? By understanding who their existing customers are, marketers can predict who their customers will be in the future. Similarly, health planners may want to identify populations which perform at, above or below certain indicators of health risk, health status or health care need. For instance, planners may ask: Which clusters show above averages rates of cigarette smoking? Which clusters have higher or lower rates of hospitalization for diabetes? Which clusters have a high out-of-pocket expenditure for medical services? It is also important to know what members of these clusters are like. What are their educational levels? Are they more predominantly white, black or Hispanic? Are many of them single parents? By asking the above questions, health planners may begin to identify existing and potential customers for public health services, health promotion messages and other communitybased health activities. Locate: Where are the targets? Maps and local retail reports help marketers to find their best prospects, especially if clusters can be located at the ZIP code, census tract or neighborhood block levels. By identifying the areas where existing customers live, marketers can accurately predict the areas where they will find additional customers for their products. Maps are vital information for new site locations, advertising and other site-based marketing activities such as door-to-door campaigns. The county map of the state which is featured in each Cluster Health Profile shows the county locations of a particular lifestyle cluster. The map allows District and county planners to identify which clusters are located within their areas of responsibility. Public health personnel, however, may request cluster mapping and data below the county level. Knowledge of cluster Georgia Division of Public Health 25 Boemers & Babies Cluster Profile - Appendix B locations at the ZIP code, census tract or block levels will assist in allocation of public health and community resources as well as location of health facilities. Cautions in Using the Cluster Health Profiles 1. Marketing is not Epidemiology Marketers are not necessarily concerned with an exact measure of a cluster's product "performance;" rather, they are mainly interested in a "best guess" as to which populations will more likely buy their goods. A cluster index is considered a good measure when it increases the probability of matching a potential market with specific services and products. Health planners should interpret the cluster indexes in the Cluster Health Profiles as estimates. Cluster indexes are planning tools, not epidemiological measures. They are not based on any methodology that attempts to describe the determinants and distribution of disease in a human population. 2. Cluster indexes do not describe the behavior of individuals. A cluster index should not be interpreted as an absolute. Every person living in an area identified as belonging to a certain lifestyle cluster will not conform exactly to the cluster's index for a particular consumer behavior. The index is merely an indication that a behavior or event is more or less likely to occur in areas where a specific type of population is located. 3. Cluster indexes should not be used as causal inferences. A cluster may be 50% less likely than the U.S. adult population to exercise twice a week, but this consumer indicator should not be interpreted as "causing" a health problem in a population. Health planners, however, should take note of clusters which demonstrate certain types of consumer behaviors such as high fat diet, low levels of exercise, or excessive smoking. Since these behaviors are associated with risk for certain health problems, clusters showing above average indexes for these indicators would be more appropriate targets for public health interventions. 4. Cluster expenditure indexes do not always measure personal behaviors. Users should use caution in interpreting some of the expenditure indexes. For instance, a high index for alcohol consumption indicates that a cluster spends more of its consumer dollar on alcohol than the Georgia population. The measure, however, may mean that the cluster buys more expensive brands or types of alcohol, not that the cluster drinks more than other Georgians. Cigarette expenditure, however, may be interpreted behaviorally since cigarette costs do not usually vary considerably by brand. 26 Georgia Division of Public Health Boomers & Babies Cluster Profile -Appendix B Methodology The PRIZM Lifestyle Cluster Model The Lifestyle Concept The Cluster Health Profiles are built upon Claritas' segmentation of the U.S. population into distinct sub-populations called "lifestyle clusters." A lifestyle cluster is a specific sub-group whose purchasing patterns, demographic composition and residential locations are expected to differ from those of other sub-groups. A cluster, therefore, shares a certain "way of life" or "lifestyle" that includes such commonalities as age, ethnicity, family type, education, housing and income. A cluster also shares a similar consumer background regarding food purchases, alcohol and tobacco consumption, recreational preferences and other social and economic features. PRIZM Segmentation Methodology The PRIZM segmentation model includes two major components: consumer records and census demographics. Applying the demographic findings from a national sample of 500,000 individuals, Claritas has segmented the U.S. population according to six categories: housing, mobility, ethnicity, social rank, household composition and degree of urbanization. These population segments have then been interlocked with consumer preference surveys such as those inventoried by Simmons Market Research, Mediamark Research, Inc., Nielsen Television, Arbitron Radio and Television and the National Family Opinion Research Study. This linking of demographic and consumer data has produced 62 distinct lifestyle clusters in the U.S. A complete listing of the U.S. lifestyle clusters can be found in the Public Health Marketing Data Directory, Georgia Department of Human Resources, Division of Public Health, 1996. How is a lifestyle cluster identity assigned to the population in a specific geographic area? To determine the cluster identity of a local population, the PRIZM system applies a complex statistical analysis fusing data from the six demographic categories. This analysis begins at the neighborhood block level. Given that a block is distinguished by a composite profile of the selected demographic elements, it will be assigned to the appropriate cluster. The cluster identity of a higher geography such as a census tract is built up from the block level. A tract usually includes several blocks within its boundaries. The census tract is assigned a cluster name according to the cluster identity of those blocks that contribute most to its population. Document Organization This document is divided into two parts. One section provides national cluster indexes that compare a lifestyle cluster's consumer pattern to that of the U.S. adult population. The other section Georgia Division of Public Health 27 Boomers & Babies Cluster Profile - Appendix B provides state cluster indexes that compare a lifestyle cluster's retail consumer pattern and hospital usage pattern to that of the Georgia population. Comparing Lifestyle Clusters to the Nation The indexes included in this section are based on a 1995 survey of self-reported behaviors and conSlliller preferences provided by Mediamark Research, Inc. Claritas, Inc. provides national cluster indexes in their "Target Cluster Index" Reports. Examples of these reports are given in the Public Health Marketing Data Directory, Georgia Department of Human Resources, Division of Public Health, 1996. The national cluster indexes are generalized to all geographic locations in which the lifestyle cluster is located. If a cluster's index for "swimming" is 50 as compared to a U.S. average of 100, then the cluster is 50% less likely to engage in that physical activity. This assumption is made for populations in any area of Georgia (or the U.S.) that has been identified as representing that lifestyle cluster. Comparing Lifestyle Clusters to Georgia Because Claritas does not interlock retail expenditures and hospital utilization data with the lifestyle clusters, the Center for Health Information has created its own cluster indexes. These indexes are based on two Claritas databases: Consumer CLOUT, a 1995 retail expenditures database and Claritas' 1995 hospital utilization database. These measures of consumption are indexed against Georgia only (not the U.S.) since Claritas licenses only Georgia-specific databases to the Georgia Division of Public Health. "Clustering" Retail Expenditures Cluster expenditure indexes are calculated by dividing the cluster's rate of product expenditure by the state's rate of product expenditure and multiplying the result by 100. All cluster expenditure rates and state expenditure rates (except for food products) are based on total annual household expenditures. The food product rates are based on total annual household expenditures for groceries. A complete description of the method used to calculate these indexes may be requested from the Center for Health Information. "Clustering" Hospital Usage by Diagnosis Claritas bases its 1995 estimates of hospitalization on two sources: Claritas' own 1995 population estimates by age, race and sex; and a database provided by Health Care Investment, Inc. (HCI). HCI produces estimates of U.S. age-race-sex hospitalization rates by diagnosis (ICD-9-CM). 28 Georgia Division of Public Health Boomers & Babies Cluster Profile - Appendix B Claritas processes the U.S. age-race-sex hospitalization rates into a matrix of 102 cells. The matrix includes seventeen 5-year age categories; three race categories (white, black and other); and male/female. Synthetic estimates of a state's hospital usage rates, for instance, are created by applying the U.S. rates in each cell to the corresponding state populations. Hospital case rates can also be estimated for counties, ZIP codes and census tracts by applying this method. The cluster hospital usage indexes are calculated by dividing a cluster's case rate for a particular diagnosis by the state's case rate for the same diagnosis, and multiplying the result by 100. The rates are calculated per 100,000 population. A complete description of the method used to compute these indexes may be requested from the Center for Health Information. Georgia Division of Public Health 29 DPH97 .36mHW