This dataset describes drug poisoning deaths at the U.S. and state level by selected demographic characteristics, and includes age-adjusted death rates for drug poisoning. 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 2011–2017 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. 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. Drug poisoning death rates may be underestimated in those instances. REFERENCES 1. National Center for Health Statistics. National Vital Statistics System: Mortality data. Available from: http://www.cdc.gov/nchs/deaths.htm. CDC. CDC Wonder: Underlying cause of death 1999–2016. Available from: http://wonder.cdc.gov/wonder/help/ucd.html.

IntroductionMany national and subnational governments need to routinely measure the completeness of death registration for monitoring and statistical purposes. Existing methods, such as death distribution and capture-recapture methods, have a number of limitations such as inaccuracy and complexity that prevent widespread application. This paper presents a novel empirical method to estimate completeness of death registration at the national and subnational level.MethodsRandom-effects models to predict the logit of death registration completeness were developed from 2,451 country-years in 110 countries from 1970–2015 using the Global Burden of Disease 2015 database. Predictors include the registered crude death rate, under-five mortality rate, population age structure and under-five death registration completeness. Models were developed separately for males, females and both sexes.FindingsAll variables are highly significant and reliably predict completeness of registration across a wide range of registered crude death rates (R-squared 0.85). Mean error is highest at medium levels of observed completeness. The models show quite close agreement between predicted and observed completeness for populations outside the dataset. There is high concordance with the Hybrid death distribution method in Brazilian states. Uncertainty in the under-five mortality rate, assessed using the dataset and in Colombian departmentos, has minimal impact on national level predicted completeness, but a larger effect at the subnational level.ConclusionsThe method demonstrates sufficient flexibility to predict a wide range of completeness levels at a given registered crude death rate. The method can be applied utilising data readily available at the subnational level, and can be used to assess completeness of deaths reported from health facilities, censuses and surveys. Its utility is diminished where the adult mortality rate is unusually high for a given under-five mortality rate. The method overcomes the considerable limitations of existing methods and has considerable potential for widespread application by national and subnational governments.

MMWR Surveillance Summary 66 (No. SS-1):1-8 found that nonmetropolitan areas have significant numbers of potentially excess deaths from the five leading causes of death. These figures accompany this report by presenting information on potentially excess deaths in nonmetropolitan and metropolitan areas at the state level. They also add additional years of data and options for selecting different age ranges and benchmarks. Potentially excess deaths are defined in MMWR Surveillance Summary 66(No. SS-1):1-8 as deaths that exceed the numbers that would be expected if the death rates of states with the lowest rates (benchmarks) occurred across all states. They are calculated by subtracting expected deaths for specific benchmarks from observed deaths. Not all potentially excess deaths can be prevented; some areas might have characteristics that predispose them to higher rates of death. However, many potentially excess deaths might represent deaths that could be prevented through improved public health programs that support healthier behaviors and neighborhoods or better access to health care services. Mortality data for U.S. residents come from the National Vital Statistics System. Estimates based on fewer than 10 observed deaths are not shown and shaded yellow on the map. Underlying cause of death is based on the International Classification of Diseases, 10th Revision (ICD-10) Heart disease (I00-I09, I11, I13, and I20–I51) Cancer (C00–C97) Unintentional injury (V01–X59 and Y85–Y86) Chronic lower respiratory disease (J40–J47) Stroke (I60–I69) Locality (nonmetropolitan vs. metropolitan) is based on the Office of Management and Budget’s 2013 county-based classification scheme. Benchmarks are based on the three states with the lowest age and cause-specific mortality rates. Potentially excess deaths for each state are calculated by subtracting deaths at the benchmark rates (expected deaths) from observed deaths. Users can explore three benchmarks: “2010 Fixed” is a fixed benchmark based on the best performing States in 2010. “2005 Fixed” is a fixed benchmark based on the best performing States in 2005. “Floating” is based on the best performing States in each year so change from year to year. SOURCES CDC/NCHS, National Vital Statistics System, mortality data (see http://www.cdc.gov/nchs/deaths.htm); and CDC WONDER (see http://wonder.cdc.gov). REFERENCES Moy E, Garcia MC, Bastian B, Rossen LM, Ingram DD, Faul M, Massetti GM, Thomas CC, Hong Y, Yoon PW, Iademarco MF. Leading Causes of Death in Nonmetropolitan and Metropolitan Areas – United States, 1999-2014. MMWR Surveillance Summary 2017; 66(No. SS-1):1-8. Garcia MC, Faul M, Massetti G, Thomas CC, Hong Y, Bauer UE, Iademarco MF. Reducing Potentially Excess Deaths from the Five Leading Causes of Death in the Rural United States. MMWR Surveillance Summary 2017; 66(No. SS-2):1–7.

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).

This dataset contains counts of deaths for California counties based on information entered on death certificates. Final counts are derived from static data and include out-of-state deaths to California residents, whereas provisional counts are derived from incomplete and dynamic data. Provisional counts are based on the records available when the data was retrieved and may not represent all deaths that occurred during the time period. Deaths involving injuries from external or environmental forces, such as accidents, homicide and suicide, often require additional investigation that tends to delay certification of the cause and manner of death. This can result in significant under-reporting of these deaths in provisional data.

The final data tables include both deaths that occurred in each California county regardless of the place of residence (by occurrence) and deaths to residents of each California county (by residence), whereas the provisional data table only includes deaths that occurred in each county regardless of the place of residence (by occurrence). The data are reported as totals, as well as stratified by age, gender, race-ethnicity, and death place type. Deaths due to all causes (ALL) and selected underlying cause of death categories are provided. See temporal coverage for more information on which combinations are available for which years.

The cause of death categories are based solely on the underlying cause of death as coded by the International Classification of Diseases. The underlying cause of death is defined by the World Health Organization (WHO) as "the disease or injury which initiated the train of events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury." It is a single value assigned to each death based on the details as entered on the death certificate. When more than one cause is listed, the order in which they are listed can affect which cause is coded as the underlying cause. This means that similar events could be coded with different underlying causes of death depending on variations in how they were entered. Consequently, while underlying cause of death provides a convenient comparison between cause of death categories, it may not capture the full impact of each cause of death as it does not always take into account all conditions contributing to the death.

Analysis of ‘NCHS - Potentially Excess Deaths from the Five Leading Causes of Death’ provided by Analyst-2 (analyst-2.ai), based on source dataset retrieved from https://catalog.data.gov/dataset/3d1da62a-9f1c-47e8-b5a1-b473f57d7fdc on 28 January 2022.

--- Dataset description provided by original source is as follows ---

MMWR Surveillance Summary 66 (No. SS-1):1-8 found that nonmetropolitan areas have significant numbers of potentially excess deaths from the five leading causes of death. These figures accompany this report by presenting information on potentially excess deaths in nonmetropolitan and metropolitan areas at the state level. They also add additional years of data and options for selecting different age ranges and benchmarks.

Potentially excess deaths are defined in MMWR Surveillance Summary 66(No. SS-1):1-8 as deaths that exceed the numbers that would be expected if the death rates of states with the lowest rates (benchmarks) occurred across all states. They are calculated by subtracting expected deaths for specific benchmarks from observed deaths.

Not all potentially excess deaths can be prevented; some areas might have characteristics that predispose them to higher rates of death. However, many potentially excess deaths might represent deaths that could be prevented through improved public health programs that support healthier behaviors and neighborhoods or better access to health care services.

Mortality data for U.S. residents come from the National Vital Statistics System. Estimates based on fewer than 10 observed deaths are not shown and shaded yellow on the map.

Underlying cause of death is based on the International Classification of Diseases, 10th Revision (ICD-10)

Heart disease (I00-I09, I11, I13, and I20–I51) Cancer (C00–C97) Unintentional injury (V01–X59 and Y85–Y86) Chronic lower respiratory disease (J40–J47) Stroke (I60–I69) Locality (nonmetropolitan vs. metropolitan) is based on the Office of Management and Budget’s 2013 county-based classification scheme.

Benchmarks are based on the three states with the lowest age and cause-specific mortality rates.

Potentially excess deaths for each state are calculated by subtracting deaths at the benchmark rates (expected deaths) from observed deaths.

Users can explore three benchmarks:

“2010 Fixed” is a fixed benchmark based on the best performing States in 2010. “2005 Fixed” is a fixed benchmark based on the best performing States in 2005. “Floating” is based on the best performing States in each year so change from year to year.

SOURCES

CDC/NCHS, National Vital Statistics System, mortality data (see http://www.cdc.gov/nchs/deaths.htm); and CDC WONDER (see http://wonder.cdc.gov).

REFERENCES

1. Moy E, Garcia MC, Bastian B, Rossen LM, Ingram DD, Faul M, Massetti GM, Thomas CC, Hong Y, Yoon PW, Iademarco MF. Leading Causes of Death in Nonmetropolitan and Metropolitan Areas – United States, 1999-2014. MMWR Surveillance Summary 2017; 66(No. SS-1):1-8.

2. Garcia MC, Faul M, Massetti G, Thomas CC, Hong Y, Bauer UE, Iademarco MF. Reducing Potentially Excess Deaths from the Five Leading Causes of Death in the Rural United States. MMWR Surveillance Summary 2017; 66(No. SS-2):1–7.

--- Original source retains full ownership of the source dataset ---

Data for CDC’s COVID Data Tracker site on Rates of COVID-19 Cases and Deaths by Vaccination Status. Click 'More' for important dataset description and footnotes

Dataset and data visualization details: These data were posted on October 21, 2022, archived on November 18, 2022, and revised on February 22, 2023. These data reflect cases among persons with a positive specimen collection date through September 24, 2022, and deaths among persons with a positive specimen collection date through September 3, 2022.

Vaccination status: A person vaccinated with a primary series had SARS-CoV-2 RNA or antigen detected on a respiratory specimen collected ≥14 days after verifiably completing the primary series of an FDA-authorized or approved COVID-19 vaccine. An unvaccinated person had SARS-CoV-2 RNA or antigen detected on a respiratory specimen and has not been verified to have received COVID-19 vaccine. Excluded were partially vaccinated people who received at least one FDA-authorized vaccine dose but did not complete a primary series ≥14 days before collection of a specimen where SARS-CoV-2 RNA or antigen was detected. Additional or booster dose: A person vaccinated with a primary series and an additional or booster dose had SARS-CoV-2 RNA or antigen detected on a respiratory specimen collected ≥14 days after receipt of an additional or booster dose of any COVID-19 vaccine on or after August 13, 2021. For people ages 18 years and older, data are graphed starting the week including September 24, 2021, when a COVID-19 booster dose was first recommended by CDC for adults 65+ years old and people in certain populations and high risk occupational and institutional settings. For people ages 12-17 years, data are graphed starting the week of December 26, 2021, 2 weeks after the first recommendation for a booster dose for adolescents ages 16-17 years. For people ages 5-11 years, data are included starting the week of June 5, 2022, 2 weeks after the first recommendation for a booster dose for children aged 5-11 years. For people ages 50 years and older, data on second booster doses are graphed starting the week including March 29, 2022, when the recommendation was made for second boosters. Vertical lines represent dates when changes occurred in U.S. policy for COVID-19 vaccination (details provided above). Reporting is by primary series vaccine type rather than additional or booster dose vaccine type. The booster dose vaccine type may be different than the primary series vaccine type. ** Because data on the immune status of cases and associated deaths are unavailable, an additional dose in an immunocompromised person cannot be distinguished from a booster dose. This is a relevant consideration because vaccines can be less effective in this group. Deaths: A COVID-19–associated death occurred in a person with a documented COVID-19 diagnosis who died; health department staff reviewed to make a determination using vital records, public health investigation, or other data sources. Rates of COVID-19 deaths by vaccination status are reported based on when the patient was tested for COVID-19, not the date they died. Deaths usually occur up to 30 days after COVID-19 diagnosis. Participating jurisdictions: Currently, these 31 health departments that regularly link their case surveillance to immunization information system data are included in these incidence rate estimates: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, District of Columbia, Florida, Georgia, Idaho, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, Nebraska, New Jersey, New Mexico, New York, New York City (New York), North Carolina, Philadelphia (Pennsylvania), Rhode Island, South Dakota, Tennessee, Texas, Utah, Washington, and West Virginia; 30 jurisdictions also report deaths among vaccinated and unvaccinated people. These jurisdictions represent 72% of the total U.S. population and all ten of the Health and Human Services Regions. Data on cases among people who received additional or booster doses were reported from 31 jurisdictions; 30 jurisdictions also reported data on deaths among people who received one or more additional or booster dose; 28 jurisdictions reported cases among people who received two or more additional or booster doses; and 26 jurisdictions reported deaths among people who received two or more additional or booster doses. This list will be updated as more jurisdictions participate. Incidence rate estimates: Weekly age-specific incidence rates by vaccination status were calculated as the number of cases or deaths divided by the number of people vaccinated with a primary series, overall or with/without a booster dose (cumulative) or unvaccinated (obtained by subtracting the cumulative number of people vaccinated with a primary series and partially vaccinated people from the 2019 U.S. intercensal population estimates) and multiplied by 100,000. Overall incidence rates were age-standardized using the 2000 U.S. Census standard population. To estimate population counts for ages 6 months through 1 year, half of the single-year population counts for ages 0 through 1 year were used. All rates are plotted by positive specimen collection date to reflect when incident infections occurred. For the primary series analysis, age-standardized rates include ages 12 years and older from April 4, 2021 through December 4, 2021, ages 5 years and older from December 5, 2021 through July 30, 2022 and ages 6 months and older from July 31, 2022 onwards. For the booster dose analysis, age-standardized rates include ages 18 years and older from September 19, 2021 through December 25, 2021, ages 12 years and older from December 26, 2021, and ages 5 years and older from June 5, 2022 onwards. Small numbers could contribute to less precision when calculating death rates among some groups. Continuity correction: A continuity correction has been applied to the denominators by capping the percent population coverage at 95%. To do this, we assumed that at least 5% of each age group would always be unvaccinated in each jurisdiction. Adding this correction ensures that there is always a reasonable denominator for the unvaccinated population that would prevent incidence and death rates from growing unrealistically large due to potential overestimates of vaccination coverage. Incidence rate ratios (IRRs): IRRs for the past one month were calculated by dividing the average weekly incidence rates among unvaccinated people by that among people vaccinated with a primary series either overall or with a booster dose. Publications: Scobie HM, Johnson AG, Suthar AB, et al. Monitoring Incidence of COVID-19 Cases, Hospitalizations, and Deaths, by Vaccination Status — 13 U.S. Jurisdictions, April 4–July 17, 2021. MMWR Morb Mortal Wkly Rep 2021;70:1284–1290. Johnson AG, Amin AB, Ali AR, et al. COVID-19 Incidence and Death Rates Among Unvaccinated and Fully Vaccinated Adults with and Without Booster Doses During Periods of Delta and Omicron Variant Emergence — 25 U.S. Jurisdictions, April 4–December 25, 2021. MMWR Morb Mortal Wkly Rep 2022;71:132–138. Johnson AG, Linde L, Ali AR, et al. COVID-19 Incidence and Mortality Among Unvaccinated and Vaccinated Persons Aged ≥12 Years by Receipt of Bivalent Booster Doses and Time Since Vaccination — 24 U.S. Jurisdictions, October 3, 2021–December 24, 2022. MMWR Morb Mortal Wkly Rep 2023;72:145–152. Johnson AG, Linde L, Payne AB, et al. Notes from the Field: Comparison of COVID-19 Mortality Rates Among Adults Aged ≥65 Years Who Were Unvaccinated and Those Who Received a Bivalent Booster Dose Within the Preceding 6 Months — 20 U.S. Jurisdictions, September 18, 2022–April 1, 2023. MMWR Morb Mortal Wkly Rep 2023;72:667–669.

The actions of Public Health France

Public Health France’s mission is to improve and protect the health of populations. During the health crisis linked to the COVID-19 epidemic, Public Health France is responsible for monitoring and understanding the dynamics of the epidemic, anticipating the various scenarios and implementing actions to prevent and limit the transmission of this virus on the national territory.

Description of the dataset

This dataset describes the level of standardised excess mortality during the COVID-19 outbreak, at the departmental and regional level.

The level of excess mortality is described for two age categories: — for all ages; — for persons over 65 years of age.

Method of calculating levels

The data are derived from the administrative part of the death certificate, collected by the civil registry offices of the municipalities having a dematerialised transmission with INSEE. The observed number of deaths is compared to an expected number, estimated from a statistical model established by the EuroMomo consortium and used by 24 countries or regions in Europe.

The estimation of excess deaths is based on the calculation of a standardised indicator (Z-score), which makes it possible to compare excesses between different geographical levels or age groups.

The Z-score is calculated by the formula: (observed number — expected number)/standard deviation of expected number.

The five categories of excess are defined as follows: — No excess: standardised Death Indicator (Z-score) < 2 — Moderate excess of death: standardised Death Indicator (Z-score) between 2 and 4.99 — High excess of death: standardised Death Indicator (Z-score) between 5 and 6.99: — Very high excess of death: standardised Death Indicator (Z-score) between 7 and 11.99: Exceptional excess of standardised death indicator of death (Z-score) greater than 12

Limits of the calculation method

The estimated excesses are established on a set of 3000 municipalities for which Santé publique France has a long history of data. These 3000 municipalities account for 77 % of national mortality, varying from 63 % to 96 % depending on the regions and from 42 % to 98 % depending on the departments.

Taking into account the legal deadlines for declaring a death to civil status and the time taken by the civil registry office to enter the information, a period between the occurrence of the death and the arrival of the information at Santé publique France is observed. This period can be extended punctually (public holidays, extended weekends, bridges, school holidays, very strong epidemic period, confinement). Mortality data are considered consolidated within 30 days.

Background: Mortality rate rapidly decreases with age after birth, and, simultaneously, the spectrum of death causes show remarkable changes with age. This study analyzed age-associated decreases in mortality rate from diseases of all main chapters of the 10th revision of the International Classification of Diseases.Methods: The number of deaths was extracted from the mortality database of the World Health Organization. As zero cases could be ascertained for a specific age category, the Halley method was used to calculate the mortality rates in all possible calendar years and in all countries combined.Results: All causes mortality from the 1st day of life to the age of 10 years can be represented by an inverse proportion model with a single parameter. High coefficients of determination were observed for total mortality in all populations (arithmetic mean = 0.9942 and standard deviation = 0.0039).Slower or no mortality decrease with age was detected in the 1st year of life, while the inverse proportion method was valid for the age range [1, 10) years in most of all main chapters with three exceptions. The decrease was faster for the chapter “Certain conditions originating in the perinatal period” (XVI).The inverse proportion was valid already from the 1st day for the chapter “Congenital malformations, deformations and chromosomal abnormalities” (XVII).The shape of the mortality decrease was very different for the chapter “Neoplasms” (II) and the rates of mortality from neoplasms were age-independent in the age range [1, 10) years in all populations.Conclusion: The theory of congenital individual risks of death is presented and can explain the results. If it is valid, latent congenital impairments may be present among all cases of death that are not related to congenital impairments. All results are based on published data, and the data are presented as a supplement.

This record contains raw data related to article "High mortality in COVID-19 patients with mild respiratory disease"

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected 189 000 people in Italy, with more than 25 000 deaths. Several predictive factors of mortality have been identified; however, none has been validated in patients presenting with mild disease.

Methods: Patients with a diagnosis of interstitial pneumonia caused by SARS-CoV-2, presenting with mild symptoms, and requiring hospitalization in a non-intensive care unit with known discharge status were prospectively collected and retrospectively analysed. Demographical, clinical and biochemical parameters were recorded, as need for non-invasive mechanical ventilation and admission in intensive care unit. Univariate and multivariate logistic regression analyses were used to identify independent predictors of death.

Results: Between 28 February and 10 April 2020, 229 consecutive patients were included in the study cohort; the majority were males with a mean age of 60 years. 54% of patients had at least one comorbidity, with hypertension being the most commonly represented, followed by diabetes mellitus. 196 patients were discharged after a mean of 9 days, while 14.4% died during hospitalization because of respiratory failure. Age higher than 75 years, low platelet count (<150 × 103 /mm3 ) and higher ferritin levels (>750 ng/mL) were independent predictors of death. Comorbidities were not independently associated with in-hospital mortality.

Conclusions: In-hospital mortality of patients with COVID-19 presenting with mild symptoms is high and is associated with older age, platelet count and ferritin levels. Identifying early predictors of outcome can be useful in the clinical practice to better stratify and manage patients with COVID-19.

Analysis of ‘NCHS - Drug Poisoning Mortality by County: United States’ provided by Analyst-2 (analyst-2.ai), based on source dataset retrieved from https://catalog.data.gov/dataset/3452f1d5-5a52-4f78-8ff8-02a7f7bff7fc on 12 February 2022.

--- Dataset description provided by original source is as follows ---

This dataset contains model-based county estimates for drug-poisoning mortality.

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 2011–2016 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.

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. Drug poisoning death rates may be underestimated in those instances.

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. 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 for 1999-2015 have been updated, and may differ slightly from previously published estimates. Differences are expected to be minimal, and may result from different county boundaries used in this release (see below) and from the inclusion of an additional year of data. Previously published estimates can be found here for comparison.(6) Estimates are unavailable for Broomfield County, Colorado, and Denali County, Alaska, before 2003 (7,8). Additionally, Clifton Forge County, Virginia only appears on the mortality files prior to 2003, while Bedford City, Virginia was added to Bedford County in 2015 and no longer appears in the mortality file in 2015. These counties were therefore merged with adjacent counties where necessary to create a consistent set of geographic units across the time period. County boundaries are largely consistent with the vintage 2005-2007 bridged-race population file geographies, with the modifications noted previously (7,8).

REFERENCES 1. National Center for Health Statistics. National Vital Statistics System: Mortality data. Available from: http://www.cdc.gov/nchs/deaths.htm.

1. CDC. CDC Wonder: Underlying cause of death 1999–2016. Available from: http://wonder.cdc.gov/wonder/help/ucd.html.

2. Rossen LM, Khan D, Warner M. Trends and geographic patterns in drug-poisoning death rates in the U.S., 1999–2009. Am J Prev Med 45(6):e19–25. 2013.

3. Rossen LM, Khan D, Warner M. Hot spots in mortality from drug poisoning in the United States, 2007–2009. Health Place 26:14–20. 2014.

4. Rossen LM, Khan D, Hamilton B, Warner M. Spatiotemporal variation in selected health outcomes from the National Vital Statistics System. Presented at: 2015 National Conference on Health Statistics, August 25, 2015, Bethesda, MD. Available from: http://www.cdc.gov/nchs/ppt/nchs2015/Rossen_Tuesday_WhiteOak_BB3.pdf.

5. Rossen LM, Bastian B, Warner M, and Khan D. NCHS – Drug Poisoning Mortality by County: United States, 1999-2015. Available from: https://data.cdc.gov/NCHS/NCHS-Drug-Poisoning-Mortality-by-County-United-Sta/pbkm-d27e.

6. National Center for Health Statistics. County geog

--- Original source retains full ownership of the source dataset ---

Analysis of ‘NCHS - Drug Poisoning Mortality by State: United States’ provided by Analyst-2 (analyst-2.ai), based on source dataset retrieved from https://catalog.data.gov/dataset/e469e38a-aa81-4bf9-9218-7fbed56cb5a5 on 27 January 2022.

--- Dataset description provided by original source is as follows ---

This dataset describes drug poisoning deaths at the U.S. and state 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).

--- Original source retains full ownership of the source dataset ---

Effective September 27, 2023, this dataset will no longer be updated. Similar data are accessible from wonder.cdc.gov.

Estimates of excess deaths can provide information about the burden of mortality potentially related to COVID-19, beyond the number of deaths that are directly attributed to COVID-19. Excess deaths are typically defined as the difference between observed numbers of deaths and expected numbers. This visualization provides weekly data on excess deaths by jurisdiction of occurrence. Counts of deaths in more recent weeks are compared with historical trends to determine whether the number of deaths is significantly higher than expected.

Estimates of excess deaths can be calculated in a variety of ways, and will vary depending on the methodology and assumptions about how many deaths are expected to occur. Estimates of excess deaths presented in this webpage were calculated using Farrington surveillance algorithms (1). For each jurisdiction, a model is used to generate a set of expected counts, and the upper bound of the 95% Confidence Intervals (95% CI) of these expected counts is used as a threshold to estimate excess deaths. Observed counts are compared to these upper bound estimates to determine whether a significant increase in deaths has occurred. Provisional counts are weighted to account for potential underreporting in the most recent weeks. However, data for the most recent week(s) are still likely to be incomplete. Only about 60% of deaths are reported within 10 days of the date of death, and there is considerable variation by jurisdiction. More detail about the methods, weighting, data, and limitations can be found in the Technical Notes.

Deaths were determined to be COVID-associated if they met the Department of Public Health's surveillance definition at the time of death.The cumulative COVID-19 mortality rate can be used to measure the most severe impacts of COVID-19 in a community. There have been documented inequities in COVID-19 mortality rates by demographic and geographic factors. Black and Brown residents, seniors, and those living in areas with higher rates of poverty have all been disproportionally impacted.For more information about the Community Health Profiles Data Initiative, please see the initiative homepage.

BackgroundSegmentation of heterogeneous patient populations into parsimonious and relatively homogenous groups with similar healthcare needs can facilitate healthcare resource planning and development of effective integrated healthcare interventions for each segment. We aimed to apply a data-driven, healthcare utilization-based clustering analysis to segment a regional health system patient population and validate its discriminative ability on 4-year longitudinal healthcare utilization and mortality data.MethodsWe extracted data from the Singapore Health Services Electronic Health Intelligence System, an electronic medical record database that included healthcare utilization (inpatient admissions, specialist outpatient clinic visits, emergency department visits, and primary care clinic visits), mortality, diseases, and demographics for all adult Singapore residents who resided in and had a healthcare encounter with our regional health system in 2012. Hierarchical clustering analysis (Ward’s linkage) and K-means cluster analysis using age and healthcare utilization data in 2012 were applied to segment the selected population. These segments were compared using their demographics (other than age) and morbidities in 2012, and longitudinal healthcare utilization and mortality from 2013–2016.ResultsAmong 146,999 subjects, five distinct patient segments “Young, healthy”; “Middle age, healthy”; “Stable, chronic disease”; “Complicated chronic disease” and “Frequent admitters” were identified. Healthcare utilization patterns in 2012, morbidity patterns and demographics differed significantly across all segments. The “Frequent admitters” segment had the smallest number of patients (1.79% of the population) but consumed 69% of inpatient admissions, 77% of specialist outpatient visits, 54% of emergency department visits, and 23% of primary care clinic visits in 2012. 11.5% and 31.2% of this segment has end stage renal failure and malignancy respectively. The validity of cluster-analysis derived segments is supported by discriminative ability for longitudinal healthcare utilization and mortality from 2013–2016. Incident rate ratios for healthcare utilization and Cox hazards ratio for mortality increased as patient segments increased in complexity. Patients in the “Frequent admitters” segment accounted for a disproportionate healthcare utilization and 8.16 times higher mortality rate.ConclusionOur data-driven clustering analysis on a general patient population in Singapore identified five patient segments with distinct longitudinal healthcare utilization patterns and mortality risk to provide an evidence-based segmentation of a regional health system’s healthcare needs.

This dataset describes drug poisoning deaths at the U.S. and state 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).

These indicators are designed to accompany the SHMI publication. As well as information on the main condition the patient is in hospital for (the primary diagnosis), the SHMI data contain up to 19 secondary diagnosis codes for other conditions the patient is suffering from. This information is used to calculate the expected number of deaths. 'Depth of coding' is defined as the number of secondary diagnosis codes for each record in the data. A higher mean depth of coding may indicate a higher proportion of patients with multiple conditions and/or comorbidities, but may also be due to differences in coding practices between trusts. Contextual indicators on the mean depth of coding for elective and non-elective admissions are produced to support the interpretation of the SHMI. Notes: 1. On 1st January 2025, North Middlesex University Hospital NHS Trust (trust code RAP) was acquired by Royal Free London NHS Foundation Trust (trust code RAL). This new organisation structure is reflected from this publication onwards. 2. There is a shortfall in the number of records for Northumbria Healthcare NHS Foundation Trust (trust code RTF), The Rotherham NHS Foundation Trust (trust code RFR), The Shrewsbury and Telford Hospital NHS Trust (trust code RXW), and Wirral University Teaching Hospital NHS Foundation Trust (trust code RBL). Values for these trusts are based on incomplete data and should therefore be interpreted with caution. 3. There is a high percentage of invalid diagnosis codes for Chesterfield Royal Hospital NHS Foundation Trust (trust code RFS), East Lancashire Hospitals NHS Trust (trust code RXR), Great Western Hospitals NHS Foundation Trust (trust code RN3), Harrogate and District NHS Foundation Trust (trust code RCD), Milton Keynes University Hospital NHS Foundation Trust (trust code RD8), Portsmouth Hospitals University NHS Trust (trust code RHU), Royal United Hospitals Bath NHS Foundation Trust (trust code RD1), University Hospitals Birmingham NHS Foundation Trust (trust code RRK), University Hospitals of North Midlands NHS Trust (trust code RJE), and University Hospitals Plymouth NHS Trust (trust code RK9). Values for these trusts should therefore be interpreted with caution. 4. A number of trusts are now submitting Same Day Emergency Care (SDEC) data to the Emergency Care Data Set (ECDS) rather than the Admitted Patient Care (APC) dataset. The SHMI is calculated using APC data. Removal of SDEC activity from the APC data may impact a trust’s SHMI value and may increase it. More information about this is available in the Background Quality Report. 5. Further information on data quality can be found in the SHMI background quality report, which can be downloaded from the 'Resources' section of this page.

Reporting of Aggregate Case and Death Count data was discontinued on May 11, 2023, with the expiration of the COVID-19 public health emergency declaration. Although these data will continue to be publicly available, this dataset will no longer be updated.

The surveillance case definition for COVID-19, a nationally notifiable disease, was first described in a position statement from the Council for State and Territorial Epidemiologists, which was later revised. However, there is some variation in how jurisdictions implemented these case definitions. More information on how CDC collects COVID-19 case surveillance data can be found at FAQ: COVID-19 Data and Surveillance.

Aggregate Data Collection Process Since the beginning of the COVID-19 pandemic, data were reported from state and local health departments through a robust process with the following steps:

• Aggregate county-level counts were obtained indirectly, via automated overnight web collection, or directly, via a data submission process.
• If more than one official county data source existed, CDC used a comprehensive data selection process comparing each official county data source to retrieve the highest case and death counts, unless otherwise specified by the state.
• A CDC data team reviewed counts for congruency prior to integration and set up alerts to monitor for discrepancies in the data.
• CDC routinely compiled these data and post the finalized information on COVID Data Tracker.
• County level data were aggregated to obtain state- and territory- specific totals.
• Counting of cases and deaths is based on date of report and not on the date of symptom onset. CDC calculates rates in these data by using population estimates provided by the US Census Bureau Population Estimates Program (2019 Vintage).
• COVID-19 aggregate case and death data are organized in a time series that includes cumulative number of cases and deaths as reported by a jurisdiction on a given date. New case and death counts are calculated as the week-to-week change in cumulative counts of cases and deaths reported (i.e., newly reported cases and deaths = cumulative number of cases/deaths reported this week minus the cumulative total reported the prior week.

This process was collaborative, with CDC and jurisdictions working together to ensure the accuracy of COVID-19 case and death numbers. County counts provided the most up-to-date numbers on cases and deaths by report date. Throughout data collection, CDC retrospectively updated counts to correct known data quality issues.

Description This archived public use dataset focuses on the cumulative and weekly case and death rates per 100,000 persons within various sociodemographic factors across all states and their counties. All resulting data are expressed as rates calculated as the number of cases or deaths per 100,000 persons in counties meeting various classification criteria using the US Census Bureau Population Estimates Program (2019 Vintage).

Each county within jurisdictions is classified into multiple categories for each factor. All rates in this dataset are based on classification of counties by the characteristics of their population, not individual-level factors. This applies to each of the available factors observed in this dataset. Specific factors and their corresponding categories are detailed below.

Population-level factors Each unique population factor is detailed below. Please note that the “Classification” column describes each of the 12 factors in the dataset, including a data dict

Context

Estimates of excess deaths can provide information about the burden of mortality potentially related to COVID-19, beyond the number of deaths that are directly attributed to COVID-19.

Content

Estimates of excess deaths can provide information about the burden of mortality potentially related to COVID-19, beyond the number of deaths that are directly attributed to COVID-19. Excess deaths are typically defined as the difference between observed numbers of deaths and expected numbers. This visualization provides weekly data on excess deaths by the jurisdiction of occurrence. Counts of deaths in more recent weeks are compared with historical trends to determine whether the number of deaths is significantly higher than expected.

Estimates of excess deaths can be calculated in a variety of ways and will vary depending on the methodology and assumptions about how many deaths are expected to occur. Estimates of excess deaths presented in this webpage were calculated using Farrington surveillance algorithms (1). For each jurisdiction, a model is used to generate a set of expected counts, and the upper bound of the 95% Confidence Intervals (95% CI) of these expected counts is used as a threshold to estimate excess deaths. Observed counts are compared to these upper bound estimates to determine whether a significant increase in deaths has occurred. Provisional counts are weighted to account for potential underreporting in the most recent weeks. However, data for the most recent week(s) are still likely to be incomplete. Only about 60% of deaths are reported within 10 days of the date of death, and there is considerable variation by jurisdiction. More detail about the methods, weighting, data, and limitations can be found in the Technical Notes.

• Source: data.cdc.gov
• Publisher: Centers for Disease Control and Prevention, cdc.gov
• Homepage URL: https://data.cdc.gov/d/xkkf-xrst
• License: https://www.usa.gov/government-works
• Contact Email: cdcinfo@cdc.gov
• Public Access Level: Public

Additional information

Dashboard: https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm

https://raw.githubusercontent.com/kabartay/kaggle-datasets-supports/master/images/WeeklyExcessDeaths.png%20=1349x572" alt="">

Acknowledgements

Thanks to:
- data.cdc.gov - healthdata.gov

References

• Noufaily A, Enki DG, Farrington P, Garthwaite P, Andrews N, Charlett A. An Improved Algorithm for Outbreak Detection in Multiple Surveillance Systems. Statistics in Medicine 2012;32(7):1206-1222.
• Salmon M, Schumacher D, Hohle M. Monitoring Count Time Series in R: Aberration Detection in Public Health Surveillance. Journal of Statistical Software 2016;70(10):1-35.
• Rue H, Martino S, Chopin N. Approximate Bayesian inference for latent Gaussian models using integrated nested Laplace approximations (with discussion). Journal of the Royal Statistical Society Series B 2009;71(2):319-392.
• Spencer MR, Ahmad F. Timeliness of death certificate data for mortality surveillance and provisional estimates. National Center for Health Statistics. 2016. http://www.cdc.gov/nchs/data/vsrr/report001.pdf.pdf icon

Number of infant deaths and infant mortality rates, by age group (neonatal and post-neonatal), 1991 to most recent year.