instituting policy changes aimed at improving adult immunization rates. She needs to understand local differences in patterns for people with higher immunization rates compared with those who have lower rates. Using cluster analysis to form groups is a viable method for using her data to understand important differences in these rates. Looking at the key variables selected by the computer would help her understand the differences between clusters that might be used to leverage her resources with the lower-scoring clusters.
Fortunately, the director has very large samples with which she can test large numbers of combinations of variables in computer runs that would have been impossible only a few years ago. In minutes, she can test the most likely 30 or 40 variables. Once she sees the major contributing characteristics for cluster membership, she can look at the socioeconomic and cultural structures of the area, and then work with local expert interventionists in support of public health care policy.
A few words of caution are in order for using groups and clusters. Groups and clusters simplify analyses by reinforcing the notion of differences between people or events. The potential for stereotyping, intentional or not, is high. Appeals to a higher authority, such as the funding source, are not sufficient justification for unreflectively highlighting differences that are not relevant to the question or are wrong by sometimes subtle inference. No method beyond honest reflection exists that will ensure the ethical use and labeling of groups or clusters.
To walk the path of statistical knowledge is to remain aware of unintentional damage that unreflective analyses might cause. These are the latent functions (the unintended consequences, in policy and program evaluation terms) of policy or reporting, be it public or private, large or small. Either formally or not, statistics are often used as evidence to support one perspective at the expense of another. Think about what those perspectives might be and whether you would want to be associated with them.
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