This document summarizes a report on state-level estimates of households with only wireless telephone service from January 2007 to June 2010. The report uses statistical modeling techniques to estimate the percentage of adults and children living in wireless-only households in each state and selected counties. Estimates ranged from 12.8% to 35.2% for adults and 12.6% to 46.2% for children across states. The prevalence of wireless-only households increased substantially over this period and now exceeds households with only landline phones. Reliable state-level estimates are needed to properly weight telephone survey samples and account for non-coverage of wireless-only households.
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Wireless Substitution: State-level Estimates From the National Health Interview Survey, January 2007–June 2010
1. Number 39 n April 20, 2011
Wireless Substitution: State-level Estimates From
the National Health Interview Survey,
January 2007–June 2010
by Stephen J. Blumberg, Ph.D., and Julian V. Luke, Division of Health Interview Statistics,
National Center for Health Statistics; Nadarajasundaram Ganesh, Ph.D., and Michael E. Davern, Ph.D.,
NORC at the University of Chicago; and Michel H. Boudreaux, M.S., and Karen Soderberg, M.S.,
State Health Access Data Assistance Center, University of Minnesota
Abstract Introduction
Objectives—This report presents state-level estimates of the percentage of The prevalence and use of wireless
adults and children living in households that did not have a landline telephone telephones (also known as cellular
but did have at least one wireless telephone. National estimates for the 12-month telephones, cell phones, or mobile
time period from July 2009 through June 2010 indicate that 23.9% of adults and phones) has changed substantially over
27.5% of children were living in these wireless-only households. Estimates are the past decade. Today, an ever-
also presented for selected U.S. counties and groups of counties, for other increasing number of adults have chosen
household telephone service use categories (e.g., those that had only landlines to use wireless telephones rather than
and those that had landlines yet received all or almost all calls on wireless landline telephones to make and receive
telephones), and for 12-month time periods since January–December 2007. calls. As of the first half of 2010, more
Methods—Small-area statistical modeling techniques were used to estimate than one in four American households
the prevalence of adults and children living in households with various household (26.6%) had only wireless telephones—
telephone service types for 93 disjoint geographic areas that make up the entire an eightfold increase over just 6
United States. This modeling was based on January 2007–June 2010 data from years (1). The prevalence of such
the National Health Interview Survey, 2006–2009 data from the American ‘‘wireless-only’’ households now
Community Survey, and auxiliary information on the number of listed telephone markedly exceeds the prevalence of
lines per capita in 2007–2010. households with only landline
Results—The prevalence of wireless-only adults and children varied telephones (12.9%), and this difference
substantially across states. State-level estimates for July 2009–June 2010 ranged is expected to grow.
from 12.8% (Rhode Island and New Jersey) to 35.2% (Arkansas) of adults and The increasing prevalence of
from 12.6% (Connecticut and New Jersey) to 46.2% (Arkansas) of children. For wireless-only households has
adults, the magnitude of the increase from 2007 to 2010 was lowest in New implications for telephone surveys.
Jersey (7.2 percentage points) and highest in Arkansas (14.5 percentage points). Many health surveys, political polls, and
Keywords: cell phones • telephone surveys • noncoverage • small domain other research studies are conducted
estimation using random-digit-dial (RDD)
telephone surveys. Until recently, these
surveys did not include wireless
telephone numbers in their samples.
Now, despite operational challenges,
most major survey research organiza
tions include wireless telephone
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
National Center for Health Statistics
2. Page 2 National Health Statistics Reports n Number 39 n April 20, 2011
numbers when conducting RDD are needed. Direct state-level estimates Methods
telephone surveys. If they did not, the of this prevalence have not been
exclusion of households with only available from NHIS data because the Small-area statistical modeling
wireless telephones (along with the sample size of NHIS is insufficient for techniques were used to combine NHIS
2.0% of households that have no direct, reliable annual estimates for most data collected from within specific
telephone service) could bias states. However, in March 2009 NCHS geographies (states and some counties)
results (2–4). released the results of statistically with auxiliary data that are repre
Best practices for conducting modeled estimates of the prevalence of sentative of those geographies to
surveys by calling wireless telephones wireless-only adults at the state level, produce model-based estimates.
are not yet known, but substantial using data from the 2007 NHIS and the Specifically, we used a combination of
research has been conducted to address direct survey estimates from the
2008 Current Population Survey’s
the known operational challenges (5). 2007–2010 NHIS, direct survey
Annual Social and Economic
Statistical challenges also exist when estimates from the 2006–2009 ACS, and
Supplement (6). Those estimates were
combining samples of wireless-only auxiliary information on the number of
the first state-level estimates of the size
households with samples of landline listed telephone lines per capita in
households from RDD surveys. To of this population available from the 2007–2010. The small-area model was
ensure that each sample is appropriately federal government. used to derive estimates of the
represented in the final data set and In this report, we update those proportion of people who lived in
appropriately weighted in the final original 2007 estimates. We present households that were wireless-only,
analyses, reliable estimates of the results of modeled estimates of the wireless-mostly, dual-use, landline
prevalence of wireless-only households prevalence of wireless-only adults and mostly, and landline-only for the
are needed (5). Moreover, if the persons wireless-only children at the state level, following seven 6-month periods:
interviewed on their wireless telephones using data from the 2007–2010 NHIS January–June 2007, July–December
are not screened to exclude persons who and the 2006–2009 American 2007, January–June 2008, July–
also have landlines, reliable estimates of Community Survey (ACS), along with December 2008, January–June 2009,
the prevalence of landline and wireless auxiliary information on the number of July–December 2009, and January–
telephone service use may be required listed telephone lines per capita. By June 2010.
to address the probability that an incorporating data from multiple Estimates were derived for adults
individual could be in both samples (5). sources, the modeled estimates presented and children for 93 nonoverlapping
The National Health Interview here take advantage of the unique areas that make up the entire United
Survey (NHIS) is the most widely cited strengths of each data set. States. Twenty-six of these areas were
source for data on the ownership and This report also expands on the states, and one was the District of
use of wireless telephones. Every 6 original 2007 estimates in three Columbia; others areas consisted of
months, the Centers for Disease Control important ways. First, it includes selected counties, groups of counties, or
and Prevention’s (CDC) National Center estimates for 42 additional substate the balance of the state population
for Health Statistics (NCHS) releases a excluding the selected counties. No
geographic areas in the United States.
report with the most up-to-date areas crossed state lines, and every
Second, it includes estimates not only
estimates available from the federal location in the United States was part of
for July 2009–June 2010, but also for
government concerning the size and one (and only one) of the 93 areas.
12-month time periods from January
characteristics of the wireless-only Areas considered for inclusion in this
population (1). That report, published as 2007 through June 2010. Third, it report included urban areas that receive
part of the NHIS Early Release includes estimates not only for persons federal Section 317 immunization grants
Program, presents national and regional living in wireless-only households, but and other substate areas that are strata
estimates. also for additional household telephone for CDC’s National Immunization
Many RDD telephone surveys are service use categories. Estimates are Survey (7). Areas were selected for this
designed to collect data and produce presented for adults and children living report on the basis of available survey
results at the state or local level, in wireless-mostly households (defined sample sizes and the stability of the
including several surveys conducted by as households that have landlines yet modeled estimates.
CDC (e.g., the Behavioral Risk Factor receive all or almost all calls on For each telephone category, the
Surveillance System, the National wireless telephones), dual-use 6-month estimates for all 93 small areas
Immunization Survey, and the State and households (which receive significant were modeled jointly. That is, all
Local Area Integrated Telephone amounts of calls on both landlines and 6-month periods were modeled together
Survey). For such surveys to effectively wireless telephones), landline-mostly in a single model rather than separately
combine samples of wireless-only households (which have wireless as seven models (one for each 6-month
households with samples of landline telephones yet receive all or almost all period). Separate small-area models
households, state-level estimates of the calls on landlines), and landline-only were fitted for each telephone service
prevalence of wireless-only households households. use category (e.g., wireless-only,
3. National Health Statistics Reports n Number 39 n April 20, 2011 Page 3
dual-use) and by age group (adults or these three distinct sets of estimates 12-month state-level estimates were
children). The model-based estimates for were combined, the weights associated obtained by appropriately weighting the
each telephone service use category, with each set reflected the relative 12-month small-area estimates by
small area, and 6-month period were precision of each estimate. population size.
derived using a standard small-area Although model-based estimates Further detail regarding this
modeling and estimation approach were produced for every small area and estimation methodology is available in
known as ‘‘empirical best linear 6-month period, consecutive 6-month the Technical Notes section.
unbiased prediction’’ (8–10). The period estimates were combined to
model-based estimates were a weighted produce 12-month estimates. The Estimates for Adults
combination of three distinct sets of small-area estimates for 12-month and Children Living
estimates: (a) the direct estimate from periods were obtained by averaging two in Wireless-only
NHIS for the small area during the consecutive 6-month estimates. This
6-month period of interest, (b) a helped to reduce the variability of the
Households
synthetic estimate derived from a estimates. Then, the 12-month small- Results from the small-area
regression model involving ACS and area estimates for each phone category modeling strategy showed great
other auxiliary data for the small area were adjusted so that they agreed with variation in the prevalence of adults
during the 6-month period of interest, the national direct estimates from NHIS living in wireless-only households
and (c) ‘‘adjusted direct estimates’’ from for the corresponding phone category across states (Figures 1 and 2).
NHIS for the small area during all and year. The 12-month estimates were Estimates for July 2009–June 2010
6-month periods other than the 6-month further adjusted so that they agreed with ranged from a high of 35.2% in
period of interest. By using estimates the 2008 or 2009 ACS estimate for the Arkansas to a low of 12.8% in Rhode
from all seven 6-month periods, the population with a telephone (either Island and New Jersey (Table 1). Other
model-based estimate allows for landline or wireless) for each small area. states in which the prevalence of
‘‘borrowing strength’’ across time. When For states with multiple small areas, wireless-only adults was relatively high
Less than 20%
20% to less than 25%
25% to less than 30%
Greater than or equal to 30%
DATA SOURCES: CDC/NCHS, National Health Interview Survey, January 2007–2010; U.S. Census Bureau, American Community Survey, 2006–2009; and infoUSA.com consumer database,
2007–2010. Estimates were calculated by NORC at the University of Chicago.
Figure 1. State-level comparisons of the percentage of adults living in wireless-only households, using modeled estimates: United States,
July 2009–June 2010
4. Page 4 National Health Statistics Reports n Number 39 n April 20, 2011
40
35
30
25
Percent
20
15
10
5
0
WA
WY
WV
NM
MO
MN
MD
AR
OR
OK
GA
OH
CO
SC
SD
ND
WI
NC
MS
NH
NE
TN
TX
NV
ME
CA
NY
MA
DE
MT
UT
CT
KY
KS
AZ
VA
AK
PA
VT
AL
LA
FL
NJ
ID
IN
MI
HI
RI
IA
IL
State
DATA SOURCES: CDC/NCHS, National Health Interview Survey, January 2007–2010; U.S. Census Bureau, American Community Survey, 2006–2009; and infoUSA.com consumer database,
2007–2010. Estimates were calculated by NORC at the University of Chicago.
Figure 2. Modeled state-level estimates of the percentage of adults living in wireless-only households: United States, July 2009–June 2010
(exceeding 31%) were Mississippi low prevalence of wireless-only children (14.1) and North Dakota (13.0). Other
(35.1%), Texas (32.5%), North Dakota included New Hampshire (15.0%), states with a smaller-than-average
(32.3%), Idaho (31.7%), and Kentucky Massachusetts (15.1%), Rhode Island increase included New York (7.3),
(31.5%). Several other states in the (15.8%), and New York (16.6%). Pennsylvania (7.5), Rhode Island (7.5),
Northeast region joined Rhode Island Table 1 also provides the modeled and Utah (7.6). Table 2 can be used to
and New Jersey with prevalence rates estimates of the prevalence of wireless- produce similar estimates of change
below 17%, including Connecticut only adults for each 12-month time over time for children living in wireless-
(13.6%), New Hampshire (16.0%), period from January 2007 through June only households.
Pennsylvania (16.5%), Delaware 2010. Nationally, the prevalence of
(16.5%), and Massachusetts (16.8%). wireless-only adults increased from Estimates for Adults
Prevalence rates were also relatively low 13.6% to 23.9%, an absolute increase of Living in Households
in South Dakota (15.6%). 10.3 percentage points. As expected, the With Wireless
Similarly, results showed great values increased in every state from
variation in the prevalence of wireless- 2007 to 2010, and the increase in
Telephones
only children across states, ranging from prevalence was statistically significant in Table 3 presents modeled estimates
a high of 46.2% in Arkansas to a low of every state. The absolute increase from for July 2009–June 2010 for the
12.6% in Connecticut and New Jersey 2007 to 2010 ranged from a high of prevalence of adults living in
(Table 2). Other states with a high 14.5 percentage points in Arkansas to a households with various telephone
prevalence of wireless-only children low of 7.2 percentage points in New service types, including but not limited
included Mississippi (41.9%), North Jersey. Other states with a larger-than- to wireless-only status. Estimates are
Dakota (39.7%), New Mexico (38.9%), average increase in the prevalence of presented for adults living in wireless-
and Idaho (37.3%). Other states with a wireless-only adults included Mississippi mostly households, landline-mostly
5. National Health Statistics Reports n Number 39 n April 20, 2011 Page 5
households, dual-use households, and wireless-only persons (11). The results Pennsylvania), Davidson County
landline-only households. These results in this report clearly show that, for (Nashville, Tennessee), Dallas County
can be used to obtain the prevalence of many states, national and regional (Dallas, Texas), and King County
adults living in households with any estimates are not sufficiently accurate (Seattle, Washington), where the
wireless telephones (regardless of for these purposes. prevalence of wireless-only adults
whether the wireless telephones are the Results from the small-area significantly exceeded the corresponding
only telephones). Estimates ranged from statistical models show great state-level state-level prevalence.
a high of 91.8% in Iowa to a low of variation in the prevalence of wireless- Prevalence estimates are included
47.9% in South Dakota. Other states only adults, even within regions. The not only for July 2009–June 2010, but
exceeding 90% included Utah (90.9%), range of prevalence exceeded also for 12-month time periods from
Colorado (90.7%), Kansas (90.7%), 10 percentage points in the Northeast January 2007 through June 2010. The
Minnesota (90.3%), and Delaware region, 13 percentage points in the West statistical model based on 3½ years of
(90.3%). Other states below 70% region, 16 percentage points in the data—and therefore larger sample sizes
included Montana (60.6%), Wyoming Midwest region, and 18 percentage in each geographic area—is more stable
(63.3%), and Nevada (66.2%). points in the South region. In fact, in than a model based on only a single
Table 3 can also be used to look at the Midwest region, the state with the year of data. Estimates from the more
the prevalence of adults living in lowest prevalence (South Dakota, stable model are presumed to be more
households that receive all or almost all 15.6%) borders the state with the reliable. Thus, we presume that the
calls on wireless telephones, regardless highest prevalence (North Dakota, estimates for 2007 presented in this
of whether the households have landline 32.3%). Wider ranges within regions report are more reliable than the
telephones. Both wireless-only and were observed for estimates of the estimates for 2007 presented in our
wireless-mostly adults are in this group. prevalence of wireless-only children. previous report (6). Modeled estimates
Estimates of the prevalence of adults Survey researchers and for January 2007–June 2009 for
living in households where wireless telecommunications companies household telephone service use
telephones are the primary means of interested in local areas may question categories other than wireless-only have
receiving calls ranged from 52.8% in whether state-level prevalence estimates not been included in this report but are
Texas to 24.9% in South Dakota. Other are sufficiently specific. This report available upon request.
states exceeding 47% included Arkansas includes estimates for 42 counties or The estimates developed for this
(50.9%), Mississippi (49.8%), Arizona groups of counties, selected from a list report are based on data from 2007
(48.1%), and Nebraska (47.3%). Other of immunization-policy-relevant areas through 2010. The number of American
states below 30% included Connecticut on the basis of available survey sample homes with only wireless telephones
(28.2%), New Hampshire (29.4%), and sizes and the stability of the modeled continues to grow (1), and it is very
Rhode Island (29.6%). estimates. Most of these substate areas likely that the current prevalence rates
Table 4 presents modeled estimates are major metropolitan cities, and of wireless-only adults and children are
for July 2009–June 2010 for the national estimates suggest that adults greater than the estimates presented
prevalence of children living in living in metropolitan areas are more here. Researchers may find that the rates
households with various telephone likely to live in wireless-only of growth presented in Tables 1 and 2
service types. The table can be used to households than are adults living in for states and substate areas are useful
calculate estimates for children similar nonmetropolitan areas. The mean of the for predicting current or future
to those for adults described above. 42 substate-area estimates of the prevalence rates.
prevalence of wireless-only adults Finally, the state and substate
(26.7%) was greater than the mean of estimates presented here may differ
Discussion the ‘‘rest of state’’ estimates for those 24 from estimates produced by other
Because of the limited availability states (23.5%). However, for the sources. For example, Arbitron, Inc.,
of reliable and updated state-level majority of the substate areas, the released Fall 2009 estimates of the
prevalence estimates for the wireless- prevalence of wireless-only adults did prevalence of wireless-only households
only population, survey researchers not differ significantly from the area’s in local radio markets (12). Their
interested in combining state-level corresponding state-level prevalence estimates are based largely on survey
samples of wireless-only households estimate. Exceptions included Orange responses received from mailed
with samples of landline households County (Orlando, Florida), Cook County screening questionnaires, which may be
have relied on national or regional (Chicago, Illinois), Madison/St. Clair subject to various nonresponse biases.
estimates of the relative sizes of these counties (Metro East St. Louis, Illinois), The estimates presented here are less
two populations (5). Similarly, Marion County (Indianapolis, Indiana), likely to be biased by survey
telecommunications companies seeking Suffolk County (Boston, Massachusetts), nonresponse (due to the high NHIS
greater understanding of conditions in Wayne County (Detroit, Michigan), response rates), but are more likely to
state and local markets have relied on Essex County (Newark, New Jersey), be biased by the focus here on
regional estimates of the prevalence of Allegheny County (Pittsburgh, demographic characteristics in the
6. Page 6 National Health Statistics Reports n Number 39 n April 20, 2011
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reveal higher wireless-only prevalence A user’s guide for the 2008 public-
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