APPENDIX A
Table A-1: Descriptive statistics for the derivation and validation data set
Derivation dataN=19018
Validation data N=19035 Age
Under 65
19.4% 20.0%
65-74
47.7 46.9
75-84
24.5 24.9
Over 85
8.4 8.2
Female
54.4 53.8
Race
Black
10.4 10.3
White
78.9 78.4
Hispanic
6.9 7.2
Other
3.8 4.2
In an HMO
26.7 27.4
Has Part B
93.5 92.9
Dual status
Full dual
13.3 13.2
Partial dual
5.8 5.7
not dual eligible
80.8 81.1
Part D status
Receives low income subsidy
23.1 23.0
Has Part D, no low income subsidy
39.1 39.2
Has no part D
37.8 37.8
Nursing home resident
1.6 1.7
Originally disabled
25.2 25.0
Proportion of zip code in poverty
13.8 (6) 13.9 (6)
Residence in a high poverty zip code
19.8 20.4
2010 Median zip income (in thousands)
55.3 (15) 55.4 (15)
Urbanicity
Urban area
77.6 78.0
Suburban
13.0 12.7
Large town
4.6 4.8
Small town/isolated rural
4.8 4.5
States
Alabama
3.3 3.5
Arizona
2.2 2.2
California
8.8 8.3
Connecticut
1.6 1.7
Florida
7.2 6.8
Georgia
3.2 3.2
Illinois
2.8 2.6
Kentucky
1.9 1.7
Massachusetts
1.7 1.9
Maryland
1.7 1.8
Michigan
5.4 4.9
Minnesota
2.1 2.1
Missouri
2.2 2.4
North Carolina
3.9 3.9
New Jersey
3.9 4.0
New Mexico
2.2 2.5
Nevada
2.6 2.7
New York
6.8 6.9
Ohio
5.0 5.0
Pennsylvania
5.0 4.8
Tennessee
2.6 2.6
Texas
7.0 7.1
Washington
3.7 3.8
Wisconsin
2.4 2.7
All other South
6.6 7.0
All other West
1.6 1.6
All other North and Midwest
2.6 2.4
Table A-2: Full results (including interaction terms) of income poverty with odds ratios and 95%
confidence intervals from bivariate analysis of derivation data
Factors Total
sample (N=19,018)
Sample in poverty (N=7,120)
Unadjusted odds ratio (95% CI)
Adjusted Odds ratio (95% CI) Age
Under 65 20.0 32.7 3.06 (2.85, 3.30) 1.24 (1.46, 1.05)
65-74 46.9 32.1 0.40 (0.37, 0.43) 0.00 (0.00, 0.00)
75-84 24.9 25.4 1.04 (0.97, 1.12) 1.31 (1.51, 1.13)
Over 85 8.2 9.8 1.36 (1.23, 1.52) 2.20 (2.85, 1.70)
Female 53.8 61.0 1.54 (1.45, 1.64) 0.74 (1.09, 0.51)
Race and interactions
White 78.4 65.1 REFERENCE
White * male * under 65 1.24 (1.46, 1.05)
White * Female * under 65 0.59 (0.69, 0.50)
White * male * Age 65-74 REFERENCE
White * female * Age 65-74 0.74 (1.09, 0.51)
White * male * Age 75-84 1.31 (1.51, 1.13)
White * female * age 75-84 0.98 (1.19, 0.81)
White * male * Over 85 2.20 (2.85, 1.70)
White * female * over 85 0.59 (0.81, 0.43)
Black 10.3 16.6 3.03 (2.75, 3.33)
Black * male * under 65 0.98 (1.18, 0.81)
Black * Female * under 65 0.83 (1.07, 0.64)
Black * male * Age 65-74 1.11 (1.81, 0.67)
Black * female * Age 65-74 0.63 (1.16, 0.34)
Black * male * Age 75-84 1.03 (1.29, 0.82)
Black * female * age 75-84 0.97 (1.31, 0.73)
Black * male * Over 85 1.12 (1.73, 0.73)
Black * female * over 85 0.83 (1.40, 0.49)
Hispanic 7.2 12.2 3.41 (3.05, 3.82)
Hispanic * male * under 65 0.47 (0.57, 0.38)
Hispanic * Female * under 65 1.86 (2.48, 1.39)
Hispanic * male * Age 65-74 0.64 (1.08, 0.37)
Hispanic * female * Age 65-74 2.18 (4.35, 1.09)
Hispanic * male * Age 75-84 0.80 (1.04, 0.61)
Hispanic * female * age 75-84 1.65 (2.33, 1.17)
Hispanic * male * Over 85 0.60 (0.94, 0.38)
Hispanic * female * over 85 1.68 (2.99, 0.94)
Other 4.2 6.2 2.54 (2.20, 2.94)
Other * male * under 65 1.81 (2.33, 1.41)
Other * Female * under 65 0.58 (0.86, 0.39)
Other * male * Age 65-74 2.49 (4.89, 1.26)
Other * female * Age 65-74 0.45 (1.05, 0.19)
Other * male * Age 75-84 1.17 (1.65, 0.83)
Other * female * age 75-84 0.59 (0.91, 0.38)
Other * male * Over 85 2.24 (4.00, 1.26)
Other * female * over 85 0.38 (0.76, 0.19)
In an HMO 27.4 28.6 3.06 (2.85, 3.30) 1.01 (1.15, 0.90)
In an HMO * under 65 interaction 0.83 (0.93, 0.74)
Has Part B 92.9 97.2 2.70 (2.51, 2.90) 1.71 (2.08, 1.40)
Dual status
Full dual 13.2 34.7 21.05 (18.60, 23.82) 10.68 (29.63, 3.85)
Partial dual 5.7 14.7 13.98 (11.76, 16.62) 8.90 (24.57, 3.22)
not dual eligible 81.1 50.7 REFERENCE REFERENCE
Part D status
Receives low income subsidy 23.0 58.0 29.48 (26.59, 32.69) 9.56 (11.43, 7.99) Has Part D, no low income subsidy 39.2 24.9 1.52 (1.39, 1.65) 1.34 (1.48, 1.21)
Has no part D 37.8 17.1 REFERENCE REFERENCE
Has Part D LIS and Medicaid interaction
0.31 (0.86, 0.11)
Nursing home resident 1.7 3.6 5.51 (4.29, 7.08) 0.68 (0.95, 0.49)
Originally disabled 25.0 40.3 3.21 (3.00, 3.44) 1.43 (1.67, 1.23)
Proportion of zip code in poverty 13.9 (6.00) 16.6 (11.00) 1.06 (1.06, 1.07) 1.00 (1.01, 0.99) Residence in a high poverty zip code 69.4 0.1 2.70 (2.51, 2.90) 1.23 (1.46, 1.04)
High poverty by under 65 interaction 1.06 (1.20, 0.94)
2010 Median zip income (in thousands) 55 (15.00) 49.4 (22.00) 0.98 (0.98, 0.98) 0.99 (0.99, 0.98) Urbanicity
Urban area
Suburban 78.0 75.0 1.19 (1.09, 1.31) 1.14 (1.30, 1.00)
Large town 12.7 13.8 1.54 (1.35, 1.77) 0.94 (1.13, 0.79)
Small town/isolated rural 4.8 6.0 1.32 (1.15, 1.53) 0.99 (1.18, 0.82)
Urbanicity by age interaction
Suburban * under 65 1.05 (1.19, 0.92)
Large town * under 65 1.03 (1.23, 0.86)
Small town/isolated rural * under 65 0.82 (0.98, 0.68)
States
Alabama 3.5 4.4 1.69 (1.32, 2.18) 1.57 (2.03, 1.21)
Arizona 2.2 1.3 0.58 (0.42, 0.79) 0.52 (0.75, 0.37)
California 8.3 8.9 1.29 (1.03, 1.62) 0.72 (0.91, 0.57)
Connecticut 1.7 1.2 0.73 (0.53, 1.01) 0.78 (1.37, 0.44)
Florida 6.8 6.9 1.17 (0.93, 1.48) 0.79 (0.99, 0.63)
Georgia 3.2 4.3 1.93 (1.49, 2.49) 1.37 (1.77, 1.05)
Illinois 2.6 3.0 1.44 (1.10, 1.88) 2.11 (2.91, 1.52)
Kentucky 1.7 1.8 1.28 (0.94, 1.73) 1.31 (2.00, 0.86)
Massachusetts 1.9 1.9 1.15 (0.86, 1.55) 0.97 (1.54, 0.60)
Maryland 1.8 1.3 0.76 (0.55, 1.04) 1.57 (2.29, 1.08)
Michigan 4.9 4.5 1.01 (0.79, 1.28) 1.04 (1.33, 0.81)
Minnesota 2.1 1.4 0.66 (0.48, 0.89) 0.58 (1.02, 0.33)
Missouri 2.4 2.7 1.38 (1.05, 1.82) 1.21 (1.64, 0.89)
North Carolina 3.9 5.1 1.77 (1.38, 2.27) 0.80 (1.06, 0.60)
New Jersey 4.0 3.7 1.02 (0.79, 1.31) 1.44 (1.92, 1.07)
New Mexico 2.5 2.1 0.90 (0.68, 1.20) 1.27 (1.77, 0.91)
Nevada 2.7 2.6 1.12 (0.85, 1.46) 1.24 (1.67, 0.92)
New York 6.9 7.4 1.28 (1.02, 1.61) 0.75 (0.95, 0.59)
Ohio 5.0 4.2 0.88 (0.69, 1.13) 0.83 (1.07, 0.65)
Pennsylvania 4.8 5.6 1.46 (1.15, 1.86) 1.39 (1.74, 1.10)
Tennessee 2.6 3.5 1.83 (1.40, 2.39) 1.33 (1.85, 0.96)
Texas 7.1 7.0 1.14 (0.90, 1.43) 0.98 (1.19, 0.80)
Washington 3.8 2.7 0.69 (0.53, 0.90) 0.62 (0.86, 0.45)
Wisconsin 2.7 1.8 0.64 (0.48, 0.85) 0.83 (1.25, 0.55)
All other South 7.0 7.7 1.32 (1.05, 1.66) 1.09 (1.31, 0.92)
All other West 1.6 1.0 0.63 (0.45, 0.88) 0.76 (1.22, 0.48)
All other North and Midwest 2.4 2.2 REFERENCE REFERENCE
State/region by Medicaid 0.00 (0.00, 0.00)
Alabama * Medicaid 2.31 (5.26, 1.01)
Arizona * Medicaid 0.37 (0.73, 0.18)
California * Medicaid 1.81 (2.73, 1.19)
Connecticut * Medicaid 0.53 (1.12, 0.25)
Florida * Medicaid 1.29 (2.07, 0.80)
Georgia * Medicaid 0.69 (1.20, 0.39)
Illinois * Medicaid 0.63 (1.20, 0.33)
Kentucky * Medicaid 1.88 (6.13, 0.57)
Massachusetts * Medicaid 1.31 (2.96, 0.58)
Maryland * Medicaid 0.63 (1.80, 0.22)
Michigan * Medicaid 1.07 (1.99, 0.57)
Minnesota * Medicaid 1.75 (4.82, 0.64)
Missouri * Medicaid 0.77 (1.52, 0.39)
North Carolina * Medicaid 2.85 (6.13, 1.33)
New Jersey * Medicaid 0.63 (1.18, 0.34)
New Mexico * Medicaid 1.35 (3.76, 0.48)
Nevada * Medicaid 1.75 (4.08, 0.75)
New York * Medicaid 1.11 (1.65, 0.75)
Ohio * Medicaid 0.79 (1.30, 0.48)
Pennsylvania * Medicaid 0.60 (0.97, 0.37)
Tennessee * Medicaid 0.74 (1.37, 0.39)
Texas * Medicaid 0.86 (1.33, 0.56)
Washington * Medicaid 2.49 (4.97, 1.24)
Wisconsin * Medicaid 0.54 (1.14, 0.25)
All other South * Medicaid 0.69 (1.04, 0.46)
All other West * Medicaid 0.57 (1.37, 0.24)
All other North and Midwest * Medicaid
REFERENCE State/region by under 65
Alabama * under 65 1.61 (2.07, 1.25)
Arizona * under 65 1.08 (1.48, 0.79)
California * under 65 0.77 (0.96, 0.63)
Connecticut * under 65 0.87 (1.37, 0.55)
Florida * under 65 0.72 (0.88, 0.58)
Georgia * under 65 0.75 (0.96, 0.59)
Illinois * under 65 1.48 (1.99, 1.09)
Kentucky * under 65 1.36 (2.04, 0.91)
Massachusetts * under 65 0.93 (1.41, 0.62)
Maryland * under 65 0.98 (1.41, 0.69)
Michigan * under 65 1.12 (1.42, 0.89)
Minnesota * under 65 0.72 (1.22, 0.43)
Missouri * under 65 1.26 (1.67, 0.95)
North Carolina * under 65 0.56 (0.73, 0.42)
New Jersey * under 65 0.89 (1.17, 0.68)
New Mexico * under 65 2.43 (3.36, 1.76)
Nevada * under 65 1.61 (2.14, 1.21)
New York * under 65 0.94 (1.16, 0.77)
Ohio * under 65 0.87 (1.09, 0.69)
Pennsylvania * under 65 1.02 (1.25, 0.82)
All other South * under 65 0.87 (1.03, 0.74)
Tennessee * under 65 1.01 (1.37, 0.75)
Texas * under 65 0.88 (1.05, 0.73)
All other West * under 65 1.01 (1.55, 0.66)
Washington * under 65 0.94 (1.26, 0.70)
Wisconsin * under 65 0.95 (1.38, 0.66)
All other North and Midwest * under 65
REFERENCE
APPENDIX B
Table B-1: Predictors of income and asset poverty with odds ratios and 95% confidence intervals from bivariate analysis of derivation data
Factors Total
sample (N=19,018)
Sample in poverty (N=7,120)
Unadjusted odds ratio (95% CI)
Adjusted Odds ratio (95% CI) Age
Under 65 17.1 37.4 4.63 (4.13, 5.19)
65-74 45.6 29.4 0.42 (0.37, 0.46)
75-84 27.2 21.9 0.70 (0.62, 0.78)
Over 85 10.1 11.2 1.17 (1.00, 1.37)
Female 54.5 60.8 1.39 (1.26, 1.54)
Race and interactions by race
White 78.6 53.8 REFERENCE
White * male * under 65 1.34 (1.02, 1.76)
White * Female * under 65 0.64 (0.48, 0.86)
White * male * Age 65-74 REFERENCE
White * female * Age 65-74 1.54 (0.88, 2.67)
White * male * Age 75-84 0.89 (0.71, 1.12)
White * female * age 75-84 1.51 (1.13, 2.00)
White * male * Over 85 1.58 (1.12, 2.22)
White * female * over 85 0.96 (0.61, 1.50)
Black 10.4 22.8 5.25 (4.57, 6.04)
Black * male * under 65 0.84 (0.63, 1.12)
Black * Female * under 65 1.23 (0.81, 1.87)
Black * male * Age 65-74 0.90 (0.46, 1.75)
Black * female * Age 65-74 2.07 (0.89, 4.83)
Black * male * Age 75-84 0.68 (0.47, 0.98)
Black * female * age 75-84 1.60 (1.01, 2.55)
Black * male * Over 85 1.21 (0.69, 2.11)
Black * female * over 85 1.48 (0.74, 2.95)
Hispanic 7.5 16.7 5.47 (4.66, 6.43)
Hispanic * male * under 65 0.81 (0.59, 1.10)
Hispanic * Female * under 65 0.69 (0.44, 1.08)
Hispanic * male * Age 65-74 1.39 (0.64, 3.02)
Hispanic * female * Age 65-74 0.59 (0.21, 1.62)
Hispanic * male * Age 75-84 1.17 (0.80, 1.72)
Hispanic * female * age 75-84 0.58 (0.35, 0.95)
Hispanic * male * Over 85 0.67 (0.35, 1.30)
Hispanic * female * over 85 1.68 (0.71, 4.00)
Other race 3.6 6.7 3.88 (3.10, 4.86)
Other * male * under 65 1.26 (0.84, 1.90)
Other * Female * under 65 1.32 (0.65, 2.69)
Other * male * Age 65-74 1.31 (0.55, 3.12)
Other * female * Age 65-74 1.29 (0.37, 4.43)
Other * male * Age 75-84 0.95 (0.58, 1.58)
Other * female * age 75-84 1.56 (0.82, 2.96)
Other * male * Over 85 1.24 (0.61, 2.50)
Other * female * over 85 0.44 (0.17, 1.17)
In an HMO 29.4 28.9 4.63 (4.13, 5.19) 0.84 (0.69, 1.02)
Has Part B 95.7 97.9 2.91 (2.60, 3.24) 1.33 (0.86, 2.05)
Dual status
Full dual 11.8 44.2 29.03 (24.58, 34.27) 27.84 (9.02, 85.89)
Partial dual 6.4 21.5 12.70 (10.51, 15.36) 17.06 (5.62, 51.79)
not dual eligible 81.9 34.3 REFERENCE REFERENCE
Part D status
Receives low income subsidy 22.2 75.4 39.29 (33.25, 46.43) 11.30 (8.65, 14.75) Has Part D, no low income subsidy 43.3 13.8 1.01 (0.84, 1.21) 1.18 (0.96, 1.45)
Has no part D 34.5 10.9 REFERENCE REFERENCE
Has part D and Medicaid (interaction) 0.19 (0.19, 0.19)
Nursing home resident 0.6 1.2 2.90 (1.69, 4.99) 0.27 (0.14, 0.53)
Originally disabled 23.8 47.2 4.30 (3.87, 4.78) 1.49 (1.14, 1.94)
Proportion of zip code in poverty 13.9 (6.00) 17.5 (11.00) 1.07 (1.06, 1.07) 0.99 (0.97, 1.01) Residence in a high poverty zip code 70.9 0.1 2.91 (2.60, 3.24) 1.34 (1.01, 1.79)
High poverty * under 65 interaction 0.96 (0.80, 1.16)
2010 Median zip income (in thousands) 55 (15.00) 48.0 (22.00) 0.98 (0.97, 0.98) 0.99 (0.98, 1.00) Urbanicity and urbanicity interactions
Urban area 78.0 79.2 REFERENCE REFERENCE
Suburban 13.0 11.3 0.82 (0.70, 0.95)
Suburban * under 65 0.98 (0.98, 0.98)
Suburban * 65+ 0.85 (0.85, 0.85)
Large town 4.9 5.7 1.19 (0.96, 1.47)
Large town * under 65 1.43 (1.43, 1.43)
Large town * 65+ 1.46 (1.46, 1.46)
Small town/isolated rural 4.2 3.9 0.90 (0.70, 1.16)
Small town * under 65 0.66 (0.66, 0.66)
Small town * 65+ 0.75 (0.75, 0.75)
Regions
New England 3.4 3.5 3.27 (2.06, 5.20) 1.14 (0.60, 2.17)
Mid-Atlantic 14.6 14.9 REFERENCE REFERENCE
Midwest 16.5 13.9 1.49 (0.87, 2.54) 1.09 (0.84, 1.40)
West North Central 6.6 3.7 2.58 (1.69, 3.94) 0.43 (0.25, 0.74)
South Atlantic 19.9 22.4 1.62 (0.91, 2.91) 1.07 (0.85, 1.34)
East South Central 7.6 9.5 2.09 (1.36, 3.23) 1.24 (0.90, 1.72)
West South Central 10.3 11.4 2.84 (1.78, 4.53) 1.37 (1.04, 1.81)
Mountain 8.5 8.5 2.53 (1.57, 4.07) 1.37 (1.01, 1.87)
Pacific 12.5 12.3 1.63 (0.94, 2.84) 0.79 (0.56, 1.10)
Region by Medicaid status interactions
New England * Medicaid 0.76 (0.33, 1.76)
Midwest * Medicaid 0.82 (0.55, 1.24)
West North Central * Medicaid 1.82 (0.88, 3.74)
South Atlantic * Medicaid 0.70 (0.50, 0.98)
East South Central * Medicaid 1.17 (0.70, 1.95)
West South Central * Medicaid 1.35 (0.80, 2.28)
Mountain * Medicaid 0.89 (0.53, 1.52)
Pacific * Medicaid 1.00 (0.63, 1.58)
Region by under 65
New England * under 65 0.93 (0.58, 1.49)
Midwest * under 65 0.92 (0.75, 1.14)
West North Central * under65 0.70 (0.46, 1.06)
South Atlantic * under 65 0.91 (0.76, 1.10)
East South Central * under 65 1.13 (0.86, 1.49)
West South Central * under 65 1.24 (0.97, 1.57)
Mountain * under 65 1.38 (1.06, 1.79)
Pacific * under 65 0.90 (0.69, 1.18)
Figure B-1: Proportion in true asset and income poverty by predicted asset and income poverty score.
Proportions at top of bars indicate proportion of the group with predicted scores in the given range that are true poor, in the derivation and validation sets.
Low (<0.2) N= 14403
Medium (0.2-0.8) N= 10058
High (0>0.80) N=19071 0.00
0.10 0.20 0.30 0.40 0.50 0.60 0.70 0.80 0.90 1.00
0.06
0.58
0.87
0.05
0.54 Derivation data 0.80
Validation data
Predicted poverty score Proportion in poverty
Figure B-2: Measures of sensitivity, specificity, and positive predictive value based on threshold at which one scores an individual as “poor” on a binary variable using asset and income poverty
0.00 0.10 0.20 0.30 0.40 0.50 0.60 0.70 0.80 0.90 1.00
0 20 40 60 80 100
Poverty score Percentage
Table B-2: Comparison of asset and income poverty score with alternative proxy measures for poverty
Developed here Alternatives
Income and asset poverty
score (derivation)
Income and asset poverty
score (validation)
Zip code poverty (continuous)
Dual eligible status (dichotomous)
Median zip income (continuous)
Sensitivity
72 70
16% 49% 2%Specificity
95 94
94 96 99Positive predictive value
79 74
58 87 68C-statistic
0.901
0.902 0.627 0.747 0.622Note: sensitivity, specificity, and positive predictive values are calculated using a threshold of 0.5 for
our asset and income poverty score
Table B-3: Performance of asset and income poverty score by key measures of interest
Sensitivity Specificity Positive predictive
value Age
Under 65
85.1 78.2 76.4
Age 65 and over
62.7 96.4 76.7
Self-reported health
Fair/Poor 77.6 86.3 75.5
Good+ 66.1 96.4 77.5
Managed care
Yes
69.1 94.0 74.3
No
71.6 94.5 77.4
Assets
<$6K
71.4 84.8 89.3
>$6K
44.4 95.9 6.0
Disability
Disabled
82.9 82.2 76.9
Not disabled
60.3 96.9 76.1
Race
White
63.7 96.4 75.2
Black
78.5 82.0 76.4
Hispanic
80.6 82.3 79.8
Other
84.3 86.0 78.4
Note: sensitivity, specificity, and percent correctly scored are assessed using a threshold of 0.5 for the
asset and income poverty score.
