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FAQ: What is the best way to see service area of a health center, not by ZCTA?

Because UDS patient data are available by ZIP Code, service area data in the UDS Mapper are based on patient origin and organized into ZCTAs (US Census Bureau's approximation of ZIP Codes). For geographic comparison, county boundaries are also visible on the map by default, and Census Tract boundaries can also be turned on in the Basemaps and Optional Layers tool, however ZCTAs do not nest within these geographies.

FAQ: What is the ideal number of people at 200% of poverty for a Health Center Program grant to be established?

The exact number of people depends on the size of the population and the location’s designation as an MUA/P. Details from Section 330 of the Public Health Service Act can be found here:

FAQ: What is the preferred internet browser for using the UDS Mapper?

The UDS Mapper website will work on any browser.

FAQ: What year of the Federal Poverty Level is used to calculate the five-year American Community Survey (ACS) poverty measure?

The Census Bureau uses poverty levels for whatever year the ACS survey was taken are used. The Census Bureau uses income thresholds to determine who is in poverty. If a family's total income is less than the family's threshold, then that family and every individual in it is considered in poverty. The official poverty thresholds do not vary geographically, but they are updated annually for inflation using the Consumer Price Index (CPI). The monthly inflation factor is based on 12 monthly Consumer Indexes and the base-year CPI (1982-1894=100). Then the data are aggregated to determine the five-year estimate.

FAQ: When I export the map, can copies be made in various colors, sizes and formats?

No. When you export the map, it will be a full color version PDF with a pre-designed layout.

FAQ: When I scrolled over one ZCTA it said that '4' health centers were serving it; but I see on the map that 3 health center locations are within the ZCTA boundary; where is the fourth health center?

The number of health centers serving patients that live in a particular ZCTA refers to the number of HCP grantees and look-alikes that people who live in a ZCTA travel to for services, not how many locations are physically located in a ZCTA. Keep in mind that within this tool there is no easy way to verify which health centers are serving that ZCTA beyond the five with the largest share of health center patients in that ZCTA or which sites the patients are going to.

FAQ: When using Population Indicators, why are all the ZCTAs colored when I select an indicator?

When you select an indicator, you will see that every valid ZCTA on the map (that has population and data) becomes filled in because the default for the threshold is set to zero. Because each ZCTA has a rate or percent of at least 0 for the that indicator the ZCTAs will be filled in. Once you move the slider you will see ZCTAs become un-filled as the threshold increases.

FAQ: Which fields are exported from the UDS?

UDS data are used throughout the Mapper. The number of Health Center Program (HCP) grantees and/or look-alikes serving a ZCTA, the total number of HCP grantee and/or look-alike patients, several percent change in patient measures, patients by insurance type and health center dominance are taken directly from the cleaned and verified UDS data presented to us by John Snow, Inc. on behalf of HRSA. There are also several calculated main map layers which use both 2016 UDS data and 2012-2016 American Community Survey (ACS) data at the ZCTA level: Individuals not served by health centers by insurance type and the health center penetration of the low income and total populations (at the ZCTA level). The Information Card Deck feature associated with Health Center Administrative Locations in the Explore Service Area Tool offers Patient Characteristics, Patient Demographics, Costs, Services, and Staffing details.

FAQ: Why are the data in the UDS Mapper only displayed by ZCTA?

First, Health Center Program (HCP) grantees and look-alikes report their patients to the BPHC (in the Uniform Data System) by their ZIP Code of origin. Second, no demographics are available describing ZIP Codes as they are constructed by the US Postal Service, so the U.S. Census Bureau, for the first time in 2000, developed a methodology for providing statistically relevant data that approximates the existing ZIP Codes by creating ZIP Code Tabulation Areas (ZCTAs) which generally are meant to cover one or more ZIP Codes. By aggregating the health center patients by ZIP Code to the ZCTA level, it is possible to compare the number of health center patients to the population.

FAQ: Why are there some ZCTAs with more than 100% penetration of the population?

There are three scenarios where a penetration rate (particularly for the low-income) can exceed 100%: 1. Health centers in the area serve a significant population over 200% of poverty (and the UDS doesn't distinguish). 2. Multiple health centers are serving the same individuals (particularly an issue where one health center provides a non-medical service, such as dental, for a broad area). 3. Health centers may serve large numbers of transient groups which may not be counted by Census (students, migrants, homeless, etc.) The first of these is the probably the biggest issue in most cases. It is important to note that 91.9% of health centers patients of known income are below 200% of poverty nationally and we can't readily extrapolate from the grantee's overall poverty mix as many grantees report a significant number of users of unknown income (approximately 27.9% of users nationally). Conversely, it would not necessarily be true that every member of the low-income population would be expected to have a visit in the past year, so this may mean the denominator is higher than ideal as well. The issue is well understood and doesn't fundamentally change the basic utility of the calculation in assessing the role of health centers in serving the community. The data should be considered the starting point for considering this issue, not the final answer. Note: It is true that rural centers are more likely to be serving those over 200% of poverty (because the issue is overall access not financial access). Also, there is a penetration rate amongst the total population calculated which may be more reflective of the role of health centers in a rural or frontier area.

FAQ: Why aren't there any check-boxes next to the list of Main Maps?

Unlike the 'Optional' layers, where multiple items can be turned on at once, only one 'Main Map' can be viewed at a time.

FAQ: Why can’t I see my ZIP Code on the map?

The UDS Mapper displays ZCTAs, not ZIP Codes. ZCTAs are the US Census Bureau’s approximation of ZIP Codes, and while in most instances the ZCTA code equals the ZIP Code for an area, not all ZIP Codes have their own ZCTA. The UDS Mapper contains updated national ZCTAs reflecting U.S. Postal Service ZIP Code changes through October, 2010, and there may not be any further updates of ZCTA boundaries until the 2020 Census. Therefore, since US Postal Service ZIP Codes can change at any time as needed for efficient delivery of the mail, ZIP Codes exist that have not been converted to ZCTAs. To address this issue, in their annual preparation of Uniform Data System data from Health Center Program (HCP) grantees and look-alikes, John Snow, Inc. assures that every valid ZIP Code maps to the ZCTA that best fits its location. Therefore, reported health center patients are never left out of counts/analyses due to new or changed ZIP Codes. Note: within the reference geography (e.g., reflected in the search and zoom functions) underlying this tool, ZIP Codes are included. Therefore, you can enter a ZIP Code that is not a ZCTA and zoom to that area, but may not see the ZIP Code number or area represented on the map. This is because there is no ZCTA for that ZIP Code. Although you will be seeing the correct area, it will not be labeled as such.

FAQ: Why does the legend have different colors for the Health Center Administrative Locations and Health Center Service Access Points?

The images in the legend for Health Center Administrative Locations and Health Center Service Access Points are meant to convey the size of the points you see on the map. Points for Health Center Administrative Locations are larger than Health Center Service Access Points. The colors of the points in the legend are meant to indicate that you will see different colors when you look at the map, however, not every health center location will show up as pink or green. Within the map itself, a color is randomly assigned to each health center and its service access points so that, ideally, neighbors will show up in a different color and can easily be distinguished. A health center and its service access points will always be a matching color. This way it will be easy to tell which Service Access Point belongs with which HCP grantee or look-alike in areas where there are multiple health centers in close proximity.

FAQ: Will there be additional data such as service specific data for mental health and dental services?

Currently Health Center Program (HCP) grantee and look-alike UDS data are reported in aggregate (all patients for all services) by ZIP Code. Say three patients come to a health center and all of them live in ZIP Code 00000. When patient A comes in for medical care, she will be counted once by the health center for ZIP Code 00000. When patient B comes in for dental care, he will also be counted once by the health center for ZIP Code 00000. Patient C comes in for medical and dental care, but she will also be counted only once by the health center for ZIP Code 00000. Unless and until health centers report their patient data in the UDS by service type by ZIP Code, we will not be able to display service areas for these specific services. While service specific data cannot currently be mapped due to reporting methods, service specific data can be viewed in the Explore Service Area tool Health Center Administrative Locations Information Card Deck.

FAQ: Will you be adding any additional layers to the UDS Mapper? Do you take suggestions for other data to add to the UDS Mapper?

We will not add layers each time they are requested, but will happily take your suggestions for how to improve the system. If there are data out there that you would like to see added to the map, please send us your suggestions. We compile the suggestions for consideration to include in future updates.

FAQ: Will you ever use census tract data in this tool?

Data inclusion in the UDS Mapper is dependent on the reporting of the Health Center Program. Presently, Health Center Program grantees and look-alikes are required to submit patient data by ZIP Code, which is why the slightly adjusted ZCTA geography is used in the UDS Mapper. If health centers were to report their data by census tract, we would be happy to make the shift to that geography along with them.

FAQ: You say that data are by calendar year but there are layers in here that say "2012-2016." Are these combined data?

There are several layers in the UDS Mapper that make use of multiple years of data. Some of these layers show the change in the number of patients from one UDS reporting cycle to another. The 2015-2016 layers show the change in the number of patients in each ZCTA from 2015 to 2016. The 2014-2016 layers show the change in the number of patients in each ZCTA from 2014 to 2016.

Estimates such as American Community Survey (ACS) 2012-2016 five-year estimate are based on data collected over a given time period as opposed to data collected at a single point in time. ACS collects survey information continuously for a specific time period and then aggregates those results over a specific time period (in this case five years). The data are then spread evenly across the entire period represented so that no month or year is over represented.

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