Comment:

The Philadelphia HealthManagement Corporation provided data from the Southeastern Pennsylvania Household Health Survey, which is administered via random digit dialing every 2 years to a new cohort of approximately 5,000 Philadelphians. We used responses from the survey’s 1998, 2000, 2002, 2004, 2006, and 2008 waves, which had census tractlevel data and an average response rate of 30.7%. Survey balancing weights and small-area estimation techniques were used to obtain adjusted estimates by census tract (43). The average of the surrounding years’ estimates per tract was used to fill in years between survey waves. Poor health status was defined as answering fair or poor to the question, ‘‘Would you say your health, in general, is excellent, good, fair, or poor?’’