title: Reliability of the American Community Survey for unintentional drowning and submersion injury surveillance: a comprehensive assessment of 10 socioeconomic indicators derived from the 2006-2013 annual and multi-year data cycles.
abstract: BACKGROUND
  Our objective was to evaluate the reliability and predictability of ten socioeconomic indicators obtained from the 2006-2013 annual and multi-year ACS data cycles for unintentional drowning and submersion injury surveillance.
  
  
  METHODS
  Each indicator was evaluated using its margin of error and coefficient of variation. For the multi-year data cycles we calculated the frequency that estimates for the same geographic areas from consecutive surveys were statistically significantly different. Relative risk estimates of drowning-related deaths were constructed using the National Center for Health Statistics compressed mortality file. All analyses were derived using census counties.
  
  
  RESULTS
  Five of the ten socioeconomic indicators derived from the annual and multi-year data cycles produced high reliability CV estimates for at least 85 % of all US counties. On average, differences in socioeconomic characteristics for the same geographic areas for consecutive 3- and 5-year data cycles were unlikely to be caused by sampling error in only 17 % (5-89 %) and 21 % (5-93 %) of all counties. No indicator produced statistically significant relative risk estimates across all data cycles and survey years.
  
  
  CONCLUSIONS
  The reliability of the annual and multi-year county-level ACS data cycles varies by census indicator. More than 75 % of the differences in estimates between consecutive multi-year surveys are likely to have occurred as a result of sampling error, suggesting that researchers should be judicious when interpreting overlapping survey data as reflective of real changes in socioeconomic conditions. Although no indicator predicted disparities in drowning-related injury mortality across all data cycles and years, further studies are needed to determine if these associations remain consistent at different geographic scales and for injury morbidity.
authors.affiliation: College of Nursing, University of South Carolina, 1601 Green St., Columbia, SC 29208 USA ; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Green St., Columbia, SC 29208 USA ; Department of Surgery, University of South Carolina, 2 Medical Dr., Columbia, SC 29203 USA.
authors.forename: Nathaniel
authors.identifier: 0000-0001-5081-0034
authors.initials: N
authors.lastname: Bell
authors.affiliation: Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Green St., Columbia, SC 29208 USA.
authors.forename: Bo
authors.initials: B
authors.lastname: Cai
keywords: American Community Survey; Drowning; Injuries; Risk; Social class