title: A latent class model to identify city/town chronic disease patterns.
abstract: OBJECTIVE
  Most departments of health grapple with how to most effectively allocate resources to address chronic diseases. We adapted a model created by Massachusetts to create customized city/town profiles in order to identify the patterns of chronic disease among 39 cities/towns in Rhode Island.
  
  
  METHODS
  We used four data sources to identify 20 indicators of four domains: demographics and socioeconomic status; health behaviors and chronic diseases prevalence; no regular provider and non-emergent emergency department visits; and chronic disease-related hospitalizations. A latent class model was used to group cities/towns into distinct latent class memberships based on similar patterns of indicators. Data were analyzed in 2014.
  
  
  RESULTS
  The latent class model differentiated three distinct classes of city/town, reflecting three levels of economic and health indicators.
  
  
  CONCLUSIONS
  Our model was a simplified version of one constructed by Massachusetts that larger states can also use to understand chronic disease patterns among cities/towns. Chronic disease programs and policies can use the findings to direct resources toward targets not always identified by more traditional analyses.
authors.affiliation: Center for Health Data and Analysis, Rhode Island Department of Health, Providence, RI, USA; Brown University School of Public Health, Department of Epidemiology, Providence, RI, USA. Electronic address: yongwen.jiang@health.ri.gov.
authors.forename: Yongwen
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Division of Chronic Disease & Health Promotion, Rhode Island Department of Health, Providence, RI, USA.
authors.forename: Dora M
authors.initials: DM
authors.lastname: Dumont
authors.affiliation: Center for Health Data and Analysis, Rhode Island Department of Health, Providence, RI, USA.
authors.forename: Tara
authors.initials: T
authors.lastname: Cooper
authors.affiliation: Division of Chronic Disease & Health Promotion, Rhode Island Department of Health, Providence, RI, USA.
authors.forename: Kristi A
authors.initials: KA
authors.lastname: Paiva
authors.affiliation: Center for Health Data and Analysis, Rhode Island Department of Health, Providence, RI, USA.
authors.forename: Samara
authors.initials: S
authors.lastname: Viner-Brown
mesh_terms: D040343:Behavioral Risk Factor Surveillance System; D002908:Chronic Disease / Q000453:epidemiology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015233:Models, Statistical; D012237:Rhode Island / Q000453:epidemiology; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data*
keywords: American Community Survey; Behavioral Risk Factor Surveillance Survey; Chronic diseases; Emergency department visits; Health behaviors; Latent class model; Pattern; Social determinants