Healthy People 2010 is a national health goal and objective setting activity led by the Office of Disease Prevention and Health Promotion and a compendium of health outcomes desired by the year 2010. Achievable target levels for many health outcomes are provided. Many communities will be adopting or adapting these for local use. Healthy People 2010 target rates/percents and 2005 U.S. rates/percents are presented as a point of comparison for counties in assessing their current health status.
NOTE: Death rates age-adjusted to the year 2000 standard were calculated by Health Resources and Services Administration. Mortality data are from the National Center for Health Statistics,
National Vital Statistics System, 1996–2005 for the ICD-9/ICD-10 codes listed after each variable. Population estimates are from the U.S. Bureau of the Census and represent the best available estimate for each year between 1996 and 2005. The bridged race population estimates are available on the NCHS website for 1990 forward, at:
http://www.cdc.gov/nchs/nvss/bridged_race.htm. The latest "Vintage bridged-race postcensal population estimates" of the resident population of the United States were used as denominator for age-adjusted death rate calculation in CHSI 2009 from website
http://www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2008. Depending on the population estimates used, other sources may have different rates. Depending upon county population size, the period age-adjusted rate for the most recent 3, 5, or 10 years is reported (see Table 1 in Peer County Section). The abbreviation “nda” (no data available) is used to represent indicators for Broomfield, CO because only 2003-2005 data were available.
An (
) indicates that the county’s value is favorable (equal or better) when compared with the median of the peer county rate or percent.
A (
) indicates that the county’s value is unfavorable (worse than) by comparison (i.e., higher than the median). Though there is demographic homogeneity among peers, health outcomes are not uniform. Thus, ranking above or below the median is useful as a measure of population health and its potential for improvement. More discussion of this comparison is provided in the Relative Health Importance section below.
Age Adjustment — This is a tool used to account for the different age distributions of the population. Age adjustment enables populations (e.g., counties) with dissimilar age distributions (e.g., high percentage of elderly residents) to be compared. Age adjustment to the same standard population allows meaningful comparisons of vital rates over time and between geographic areas and population groups.
Age-adjusted rates are based on the newer, year 2000 standard. Use of the year 2000 standard has generally resulted in age-adjusted death rates that are substantially larger than those based on the previously used 1940 standard. Rates age-adjusted to year 2000 cannot be compared with rates age-adjusted to a different standard year. For more information regarding age adjustment and the year 2000 standard, refer to: Anderson, R and Rosenberg, H Age Standardization of Death Rates: Implementation of the Year 2000 Standard.
National Vital Statistics Reports 1998; 47(3). This publication can be obtained at:
http://www.cdc.gov/nchs/data/nvsr/nvsr47/nvs47_03.pdf.
County Percent or Rate — Each county-specific health indicator is provided as a rate or percent. Birth measures are percents, infant mortality measures are deaths per 1,000 births, and death measures are age-adjusted death rates per 100,000 population. Small numbers are defined for birth and infant mortality indicators as fewer than 500 births in the denominator and 5 events (births or infant deaths) or for death measures as fewer than 10 deaths.
Confidence Interval for County Percent or Rate — A 95% confidence interval is presented for each county indicator, which alerts the reader to the natural random variation found in vital statistics from one year or one period to another. A 95% confidence interval is calculated using the method most appropriate to the measure (see below).
Peer County Range — The low and the high values found in each stratum of peers is provided. The low number is the tenth percentile of rates or percents in the stratum; the high number represents the ninetieth percentile. Eighty percent of all county values within the strata lie within this range.
2005 U.S. Percent/Rates— Presented as a point of comparison for counties in assessing their current health status. The U.S. death rates are age-adjusted to the year 2000 standard; per 100,000 population. The 2005 U.S. death rates and most birth measures were accessed at the Healthy People 2010 database
http://wonder.cdc.gov/data2010/focus.htm maintained by NCHS. Therefore the percent for “Births to Women younger than 18"; "Births to Women age 40-54"; and "Births to Unmarried Women” have no corresponding objective or target from Healthy People 2010, were calculated from NCHS 2005 Natality data.
Healthy People 2010 Target — Is a national health goal and objective setting activity led by the Office of Disease Prevention and Health Promotion and a compendium of health outcomes desired by the Year 2010. Achievable target levels for many health outcomes are provided. The 2010 targets used in the county reports are those published in the Healthy People 2010 Midcourse Review
(http://www.healthypeople.gov/data/midcourse/default.htm). The 2010 targets are subject to revision when baseline data are revised. The most recent Healthy People 2010 data and targets can be found at
http://wonder.cdc.gov/data2010/focus.htm.
Birth Measures
NOTE: Data are from the National Center for Health Statistics, National Vital Statistics System; 1996–2005. Depending upon county population size, the period county percent for the most recent 3, 5, or 10 years is reported (see Table 1 in Peer County Section). A 95-percent confidence interval is calculated based on the normal distribution (Joyce A. Martin, et al. 2005. National Vital Statistics Reports Vol, 54(2)) at
http://www.cdc.gov/nchs/data/nvsr/nvsr54/nvsr54_02.pdf.
Low Birth Weight — Percentage of all births less than 2,500 grams.
Very Low Birth Weight — Percentage of all births less than 1,500 grams.
Premature Births — Percentage of births with a reported gestation period of less than 37 completed weeks.
Births to Women under 18 — Percentage of all births to mothers less than 18 years of age.
Births to Women age 40-54 — Percentage of all births to mothers 40-54 years of age.
Births to Unmarried Women — Percentage of all births to mothers who report not being married.
No Care in First Trimester — Percentage of births to mothers who reported receiving no prenatal care during the first trimester (3 months) of pregnancy, and includes those with no prenatal care. Comparable 2003, 2004, or 2005 data are not available for counties of 13 (2, 7, and 4 states respectively) states: Florida, Idaho, Kansas, Kentucky, Nebraska, New Hampshire, New York (excluding New York City), Pennsylvania, South Carolina, Tennessee, Texas, Vermont, and Washington, which have implemented the revision to the U.S. Standard Birth Certificate. For these affected counties, data are reported as “cdna” (comparable data not available.) More explanation of this change in data collection may be found in the report: Births: Final data for 2005. Vol 56(6), 12/5/07 (
http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_06.pdf). The county percent, confidence interval, peer range for county percent, peer county indicator, 2005 U.S. percentage, relative health importance indicator for No Care in First trimester is calculated for the 37 states, DC and New York City which have not revised their birth certificate in 2005.
Infant Mortality
NOTE: The linked birth/infant death data files are from the National Center for Health Statistics, National Vital Statistics System, 1996–2005. Infant deaths are weighted so numbers may be not an exact integer, and the summation of 3, 5, or 10 years of infant death count is rounded to the next whole integer before infant mortality rate is calculated. The methodology used is described here:
http://www.cdc.gov/nchs/data/nvsr/nvsr55/nvsr55_14.pdf. All rates are deaths to infants less than one year of age per 1,000 births. Depending upon county population size, the period infant mortality rate for the most recent 3, 5, or 10 years is reported (see Table 1 in Peer County Section). A 95-percent confidence interval is calculated using the method from NCHS (Mathews TJ and MacDorman MF. 2007. National Vital Statistics Reports Vol. 55(14) available at:
http://www.cdc.gov/nchs/data/nvsr/nvsr55/nvsr55_14.pdf.
Infant Mortality — Death of an individual less than one year old from any cause
Neonatal Mortality — Infant deaths occurring before day 28
Postneonatal Mortality — Infant deaths occurring day 28 to less than one year
White Non-Hispanic Infant Mortality — Death of an infant born to a white non-Hispanic mother less than one year old from any cause
Black Non-Hispanic Infant Mortality — Death of an infant born to a black non-Hispanic mother less than one year old from any cause
Hispanic Infant Mortality — Death of an infant born to an Hispanic mother less than one year old from any cause
Death Measures
NOTE: In this section, the ICD codes include causes of death corresponding to the definitions used in the Nation’s health objectives outlined
in Healthy People 2010: National Health Promotion and Disease Prevention Objectives (Conference Edition). From 1996–1998, underlying cause of death was coded using ICD-9. From 1999 forward, underlying cause of death was coded using ICD-10. Due to the changes in the classification of deaths, the ICD-9 categories used for 1996–1998 may not be strictly comparable to the ICD-10 categories used for 1999 and later years (see
http://www.cdc.gov/nchs/data/nvsr/nvsr49/nvsr49_02.pdf). All death rates (excluding infant mortality) are per 100,000 population, and age-adjusted to the year 2000 standard. A 95% confidence interval is calculated according to method provided by NCHS at
http://www.cdc.gov/nchs/data/nvsr/nvsr47/nvs47_03.pdf (Anderson R and Rosenberg H. 1998.
National Vital Statistics Reports Vol. 47(3)).
Breast Cancer (Female) — Death due to malignant neoplasm of the female breast, ICD-9 code: 174. ICD-10 code: C50.
Colon Cancer — Death due to malignant neoplasm of the colon, rectum and anus, ICD-9 codes: 153 and 154. ICD-10 codes: C18-C21.
Coronary Heart Disease — Death due to hypertensive heart disease and ischemic heart diseases (acute myocardial infarction, other acute ischemic heart diseases, and other forms of chronic ischemic heart disease), ICD-9 codes: 402, 410-414, and 429.2. ICD-10 codes: I11, I20-I25.
Homicide — Death due to assault, ICD-9 codes: E960-E969. ICD-10 codes: *U01-*U02, X85-X99, Y00-Y09, Y87.1.
Lung Cancer — Death due to malignant neoplasm of the trachea, bronchus and lung, ICD-9 code: 162. ICD-10 codes: C33-C34.
Motor Vehicle Injuries — Death due to motor vehicle accidents classified under accidents (unintentional injuries), ICD-9 codes: E810-E825. ICD-10 codes: V02-V04, V09.0, V09.2, V12-V14, V19.0-V19.6, V20-V79, V80.3-V80.5, V81.0, V81.1, V82.0, V82.1, V83-V86, V87.0-V87.8, V88.0-V88.8, V89.0, V89.2.
Stroke — Death due to cerebrovascular diseases, ICD-9 codes: 430-438. ICD-10 codes: I60-I69
Suicide — Death due to intentional self harm, ICD-9 codes: E950-E959. ICD-10 codes: *U03, X60-X84, Y87.0.
Unintentional Injury (excluding motor vehicle accidents) — Death due to all accidents (unintentional injuries) not related to motor vehicle accidents, ICD-9 codes: E800-E807 and E826-E949. ICD-10 codes: V01-V99, W00-W99, X00-X59, Y85, Y86 minus Motor Vehicle Injury (ICD-10 codes as noted above).
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