PAEON

How can we compare health across places when their populations, resources, and access to care differ?

Research program in development

The research question

What makes a fair county comparison?

A larger county can have more deaths even when its residents do not face a higher death rate. Counties can also differ in age distribution, access to care, and how consistently an outcome is recorded. A comparison needs to account for the differences that matter to the question.

The Population-Adjusted Epidemiology Outcomes Network (PAEON) is Acropolis’s program for developing a common way to make those comparisons. It brings population, survey, surveillance, mortality, and access measures into the same county-and-year frame.

What is a county-year?

One county observed for one year. Comparing the same county across years asks about change over time. Comparing multiple counties in the same year asks about differences between places. Neither tells us what happened to a particular resident.

Comparison design

From a county and a year to an estimate

Define the comparison. Specify the outcome, population, geography, and years. A count answers “how many?”; a rate also needs the population at risk.
Align the sources. Match county boundaries, reference periods, and definitions before combining survey, mortality, healthcare-access, or other measures.
Choose the analysis. Planned methods include trend comparisons, small-area estimation, and models that account for multiple factors. The method depends on the question and available data.
Explain what remains uncertain. Limited observations or changing definitions can weaken a comparison. County-level associations describe places; they do not establish a cause or an individual’s risk.

Program roadmap

Six planned applications

These are proposed directions, not six completed studies. Each needs a defined question, suitable data and methods, and a release plan before it can produce a public result.

I · PAX: Border population health. Demographic, disease, and crime patterns along the U.S.–Mexico border corridor defined by the La Paz Agreement.
II · AORTA: Cardiovascular burden. How cardiovascular risk and mortality vary with behavioral, metabolic, demographic, and structural conditions.
III · PANCREA: Diabetes and metabolic risk. Patterns in diabetes, obesity, inactivity, and access to preventive care.
IV · PNEUMA: Respiratory health. Asthma and chronic obstructive pulmonary disease in relation to tobacco exposure and environmental conditions.
V · MNEME: Cognitive health and caregiving. Dementia-related burden, caregiver strain, and the geographic distribution of services. For the separate participant-facing project, see the ADRD caregiver study.
VI · ONKOS: Cancer prevention and access. Geographic differences in screening, access, and population risk.

Public outputs

Program releases

The program is designed to produce documented datasets, maps, risk summaries, methods notes, and decision briefs. The roadmap above is not a list of available downloads.

Browse the research library for publicly released work, or read how Acropolis documents evidence.