The bipartisan CARES Act; and the Paycheck Protection Program and Health Care Enhancement Act (PPPHCEA); and the Coronavirus Response and Relief Supplemental Appropriations (CRRSA) Act provided $178 billion in relief funds to hospitals and other healthcare providers on the front lines of the coronavirus response. The Department of Health and Human Services through the Health Resources and Services Administration is allocating $2 billion in incentive payments to nursing home facilities that reduce both COVID-19 infection rates relative to their county and mortality rates against a national benchmark.
This data contains provisional counts for drug overdose deaths based on a current flow of mortality data in the National Vital Statistics System. Counts for the most recent final annual data are provided for comparison. National provisional counts include deaths occurring within the 50 states and the District of Columbia as of the date specified and may not include all deaths that occurred during a given time period. Provisional counts are often incomplete and causes of death may be pending investigation (see Technical notes) resulting in an underestimate relative to final counts. To address this, methods were developed to adjust provisional counts for reporting delays by generating a set of predicted provisional counts (see Technical notes). Starting in June 2018, this monthly data release will include both reported and predicted provisional counts.
The provisional data include: (a) the reported and predicted provisional counts of deaths due to drug overdose occurring nationally and in each jurisdiction; (b) the percentage changes in provisional drug overdose deaths for the current 12 month-ending period compared with the 12-month period ending in the same month of the previous year, by jurisdiction; and (c) the reported and predicted provisional counts of drug overdose deaths involving specific drugs or drug classes occurring nationally and in selected jurisdictions. The reported and predicted provisional counts represent the numbers of deaths due to drug overdose occurring in the 12-month periods ending in the month indicated. These counts include all seasons of the year and are insensitive to variations by seasonality. Deaths are reported by the jurisdiction in which the death occurred.
Several data quality metrics, including the percent completeness in overall death reporting, percentage of deaths with cause of death pending further investigation, and the percentage of drug overdose deaths with specific drugs or drug classes reported are included to aid in interpretation of provisional data as these measures are related to the accuracy of provisional counts (see Technical notes). Reporting of the specific drugs and drug classes involved in drug overdose deaths varies by jurisdiction, and comparisons of death rates involving specific drugs across selected jurisdictions should not be made (see Technical notes). Provisional data will be updated on a monthly basis as additional records are received.
Nature and sources of data
Provisional drug overdose death counts are based on death records received and processed by the National Center for Health Statistics (NCHS) as of a specified cutoff date. The cutoff date is generally the first Sunday of each month. National provisional estimates include deaths occurring within the 50 states and the District of Columbia. NCHS receives the death records from state vital registration offices through the Vital Statistics Cooperative Program (VSCP).
The timeliness of provisional mortality surveillance data in the National Vital Statistics System (NVSS) database varies by cause of death. The lag time (i.e., the time between when the death occurred and when the data are available for analysis) is longer for drug overdose deaths compared with other causes of death (1). Thus, provisional estimates of drug overdose deaths are reported 6 months after the date of death.
Provisional death counts presented in this data visualization are for “12-month ending periods,” defined as the number of deaths occurring in the 12-month period ending in the month indicated. For example, the 12-month ending period in June 2017 would include deaths occurring from July 1, 2016, through June 30, 2017. The 12-month ending period counts include all seasons of the year and are insensitive to reporting variations by seasonality. Counts for the 12-month period ending in the same month of the previous year are shown for comparison. These provisional counts of drug overdose deaths and re
TABLE III. Deaths in 122 U.S. cities – 2016. 122 Cities Mortality Reporting System — Each week, the vital statistics offices of 122 cities across the United States report the total number of death certificates processed and the number of those for which pneumonia or influenza was listed as the underlying or contributing cause of death by age group (Under 28 days, 28 days –1 year, 1-14 years, 15-24 years, 25-44 years, 45-64 years, 65-74 years, 75-84 years, and ≥ 85 years).
U: Unavailable. —: No reported cases.
* Mortality data in this table are voluntarily reported from 122 cities in the United States, most of which have populations of 100,000 or more. A death is reported by the place of its occurrence and by the week that the death certificate was filed. Fetal deaths are not included.
2017, 2016. Data were provided by the Centers for Disease Control and Prevention (CDC), Division of Population Health, Epidemiology and Surveillance Branch. The project was funded by the Robert Wood Johnson Foundation (RWJF) in conjunction with the CDC Foundation. 500 cities project census tract-level data in GIS-friendly format can be joined with census tract spatial data (https://chronicdata.cdc.gov/500-Cities/500-Cities-Census-Tract-Boundaries/x7zy-2xmx) in a geographic information system (GIS) to produce maps of 27 measures at the census tract level. There are 7 measures (all teeth lost, dental visits, mammograms, Pap tests, colorectal cancer screening, core preventive services among older adults, and sleep less than 7 hours) in this 2019 release from the 2016 BRFSS that were the same as the 2018 release.
2013-2014. The National Adult Tobacco Survey (NATS) was created to assess the prevalence of tobacco use, as well as the factors promoting and impeding tobacco use among adults. NATS also establishes a comprehensive framework for evaluating both the national and state-specific tobacco control programs. NATS was designed as a stratified, national, landline, and cell phone survey of non-institutionalized adults aged 18 years and older residing in the 50 states or D.C. It was developed to yield data representative and comparable at both national and state levels. The sample design also aims to provide national estimates for subgroups defined by gender, age, and race/ethnicity.
County data on race and Hispanic origin is available for counties with more than 100 COVID-19 deaths. Urban-rural classification is based on the 2013 National Center for Health Statistics Urban-Rural Classification Scheme for Counties (https://www.cdc.gov/nchs/data_access/urban_rural.htm). Deaths are cumulative from the week ending January 4, 2020 to the most recent reporting week.
This dataset describes drug poisoning deaths at the county level by selected demographic characteristics and includes age-adjusted death rates for drug poisoning from 1999 to 2015.
Deaths are classified using the International Classification of Diseases, Tenth Revision (ICD–10). Drug-poisoning deaths are defined as having ICD–10 underlying cause-of-death codes X40–X44 (unintentional), X60–X64 (suicide), X85 (homicide), or Y10–Y14 (undetermined intent).
Estimates are based on the National Vital Statistics System multiple cause-of-death mortality files (1). Age-adjusted death rates (deaths per 100,000 U.S. standard population for 2000) are calculated using the direct method. Populations used for computing death rates for 2011–2015 are postcensal estimates based on the 2010 U.S. census. Rates for census years are based on populations enumerated in the corresponding censuses. Rates for noncensus years before 2010 are revised using updated intercensal population estimates and may differ from rates previously published.
Estimate does not meet standards of reliability or precision. Death rates are flagged as “Unreliable” in the chart when the rate is calculated with a numerator of 20 or less.
Death rates for some states and years may be low due to a high number of unresolved pending cases or misclassification of ICD–10 codes for unintentional poisoning as R99, “Other ill-defined and unspecified causes of mortality” (2). For example, this issue is known to affect New Jersey in 2009 and West Virginia in 2005 and 2009 but also may affect other years and other states. Estimates should be interpreted with caution.
Smoothed county age-adjusted death rates (deaths per 100,000 population) were obtained according to methods described elsewhere (3–5). Briefly, two-stage hierarchical models were used to generate empirical Bayes estimates of county age-adjusted death rates due to drug poisoning for each year during 1999–2015. These annual county-level estimates “borrow strength” across counties to generate stable estimates of death rates where data are sparse due to small population size (3,5). Estimates are unavailable for Broomfield County, Colo., and Denali County, Alaska, before 2003 (6,7). Additionally, Bedford City, Virginia was added to Bedford County in 2015 and no longer appears in the mortality file in 2015. County boundaries are consistent with the vintage 2005-2007 bridged-race population file geographies (6).
1965, 1966, 1970, 1974-2015, 2017. Centers for Disease Control and Prevention (CDC). Office on Smoking and Health (OSH). Survey Questions (Tobacco Use). The QIT is a compilation of more than 7,000 historical tobacco-related survey questions from various state, national and international surveys.
2005-2009. SAMMEC - Smoking-Attributable Mortality, Morbidity, and Economic Costs. Smoking-attributable expenditures (SAEs) are excess health care expenditures attributable to cigarette smoking by type of service among adults ages 19 years of age and older.