The 2013 Rural-Urban Continuum Codes form a classification scheme that distinguishes metropolitan counties by the population size of their metro area, and nonmetropolitan counties by degree of urbanization and adjacency to a metro area. The official Office of Management and Budget (OMB) metro and nonmetro categories have been subdivided into three metro and six nonmetro categories. Each county in the U.S. is assigned one of the 9 codes. This scheme allows researchers to break county data into finer residential groups, beyond metro and nonmetro, particularly for the analysis of trends in nonmetro areas that are related to population density and metro influence. The Rural-Urban Continuum Codes were originally developed in 1974. They have been updated each decennial since (1983, 1993, 2003, 2013), and slightly revised in 1988. Note that the 2013 Rural-Urban Continuum Codes are not directly comparable with the codes prior to 2000 because of the new methodology used in developing the 2000 metropolitan areas. See the Documentation for details and a map of the codes. An update of the Rural-Urban Continuum Codes is planned for mid-2023.

{"definition": "9-level classification of counties by metro-nonmetro status, location, and urban size", "availableYears": "2000", "name": "Rural-urban continuum code, 2003", "units": "Classification", "shortName": "RuralUrbanContinuumCode2003", "geographicLevel": "County", "dataSources": "U.S. Department of Agriculture, Economic Research Service, using data from the U.S. Census Bureau"}

© RuralUrbanContinuumCode2003 This layer is sourced from gis.ers.usda.gov.

The USRDS is the largest and most comprehensive national ESRD surveillance system in the US (Collins et al., 2015). The USRDS contains data on all ESRD cases in the US through the Medical Evidence Report CMS-2728 which is mandated for all new patients diagnosed with ESRD (Foley and Collins, 2013). Detailed information about the USRDS can be found on their website (http://www.usrds.org). The EQI was constructed for 2000-2005 for all US counties and is composed of five domains (air, water, built, land, and sociodemographic), each composed of variables to represent the environmental quality of that domain. Domain-specific EQIs were developed using principal components analysis (PCA) to reduce these variables within each domain while the overall EQI was constructed from a second PCA from these individual domains (L. C. Messer et al., 2014). To account for differences in environment across rural and urban counties, the overall and domain-specific EQIs were stratified by rural urban continuum codes (RUCCs) (U.S. Department of Agriculture, 2015). This dataset is not publicly accessible because: EPA cannot release personally identifiable information regarding living individuals, according to the Privacy Act and the Freedom of Information Act (FOIA). This dataset contains information about human research subjects. Because there is potential to identify individual participants and disclose personal information, either alone or in combination with other datasets, individual level data are not appropriate to post for public access. Restricted access may be granted to authorized persons by contacting the party listed. It can be accessed through the following means: Human health data are not available publicly. EQI data are available at: https://edg.epa.gov/data/Public/ORD/NHEERL/EQI. Format: Data stored as csv files. This dataset is associated with the following publication: Kosnik, M., D. Reif, D. Lobdell, T. Astell-Burt, X. Feng, J. Hader, and J. Hoppin. Associations between access to healthcare, environmental quality, and end-stage renal disease survival time: Proportional-hazards models of over 1,000,000 people over 14 years. PLoS ONE. Public Library of Science, San Francisco, CA, USA, 14(3): e0214094, (2019).

IntroductionBased on questions about impairments and activity limitations, the American Community Survey shows that roughly 13% of the U.S. population is experiencing disability. As most people live in households with other persons, this study explores disability at the household level. Considering the literature on household decision-making, solidarity, and capabilities in disability, this analysis of the household context of disability takes into account residential settings, household composition, and urban–rural differences.MethodThe 2015–2019 ACS Public Use Microdata Sample (PUMS), which shows persons with disability (PwD) and persons without disability (PwoD), also indicates household membership, used here to separately identify PwoD as those living in households with persons with disability (PwoD_HHwD) and those in households without any household member with disability (PwoD_HHwoD). Relationship variables reveal the composition of households with and without disabilities. An adaption of Beale's rural–urban continuum code for counties is used to approximate rural–urban differences with ACS PUMS data.ResultsSolo living is two times as common among persons with disability than among persons without disability, and higher in rural than urban areas. In addition to 43 million PwD, there are another 42 million PwoD_HHwD. Two times as many persons are impacted by disability, either of their own or that of a household member, than shown by an analysis of individual-level disability. For family households, differences in the composition of households with and without disabilities are considerable with much greater complexities in the makeup of families with disability. The presence of multiple generations stands out. Adult sons or daughters without disability play an important role. Modest urban–rural differences exist in the composition of family households with disability, with a greater presence of multigenerational households in large cities.DiscussionThis research reveals the much wider scope of household-level disability than indicated by disability of individuals alone. The greater complexity and multigenerational makeup of households with disability imply intergenerational solidarity, reciprocity, and resource sharing. Household members without disability may add to the capabilities of persons with disabilities. For the sizeable share of PwD living solo, there is concern about their needs being met.

Infant mortality was defined as death before completion of first year of life [1]. We obtained linked birth and infant death data from the U.S. Centers for Disease Control and Prevention for the years 2000–2005, corresponding to the time frame covered by the EQI. The EQI was constructed for 2000-2005 for all US counties and is composed of five domains (air, water, built, land, and sociodemographic), each composed of variables to represent the environmental quality of that domain. Domain-specific EQIs were developed using principal components analysis (PCA) to reduce these variables within each domain while the overall EQI was constructed from a second PCA from these individual domains (L. C. Messer et al., 2014). To account for differences in environment across rural and urban counties, the overall and domain-specific EQIs were stratified by rural urban continuum codes (RUCCs) (U.S. Department of Agriculture, 2015). This dataset is not publicly accessible because: EPA cannot release personally identifiable information regarding living individuals, according to the Privacy Act and the Freedom of Information Act (FOIA). This dataset contains information about human research subjects. Because there is potential to identify individual participants and disclose personal information, either alone or in combination with other datasets, individual level data are not appropriate to post for public access. Restricted access may be granted to authorized persons by contacting the party listed. It can be accessed through the following means: Human health data are not available publicly. EQI data are available at: https://edg.epa.gov/data/Public/ORD/NHEERL/EQI. Format: Data are stored as csv files. This dataset is associated with the following publication: Patel, A., J. Jagai, L. Messer, C. Gray, K. Rappazzo, S. DeflorioBarker, and D. Lobdell. Associations between environmental quality and infant mortality in the United States, 2000-2005. Archives of Public Health. BioMed Central Ltd, London, UK, 76(60): 1, (2018).

This link contains downloadable data for the Atlas of Rural and Small-Town America which provides statistics by broad categories of socioeconomic factors: People: Demographic data from the American Community Survey (ACS), including age, race and ethnicity, migration and immigration, education, household size, and family composition. Jobs: Economic data from the Bureau of Labor Statistics and other sources, including information on employment trends, unemployment, and industrial composition of employment from the ACS. County classifications: Categorical variables including the rural-urban continuum codes, economic dependence codes, persistent poverty, persistent child poverty, population loss, onshore oil/natural gas counties, and other ERS county typology codes. Income: Data on median household income, per capita income, and poverty (including child poverty). Veterans: Data on veterans, including service period, education, unemployment, income, and other demographic characteristics.

Population-based county-level estimates for diagnosed (DDP), undiagnosed (UDP), and total diabetes prevalence (TDP) were acquired from the Institute for Health Metrics and Evaluation (IHME) for the years 2004-2012 (Evaluation 2017). Prevalence estimates were calculated using a two-stage approach. The first stage used National Health and Nutrition Examination Survey (NHANES) data to predict high fasting plasma glucose (FPG) levels (≥126 mg/dL) and/or hemoglobin A1C (HbA1C) levels (≥6.5% [48 mmol/mol]) based on self-reported demographic and behavioral characteristics (Dwyer-Lindgren, Mackenbach et al. 2016). This model was then applied to Behavioral Risk Factor Surveillance System (BRFSS) data to impute high FPG and/or A1C status for each BRFSS respondent (Dwyer-Lindgren, Mackenbach et al. 2016). The second stage used the imputed BRFSS data to fit a series of small area models, which were used to predict the county-level prevalence of each of the diabetes-related outcomes (Dwyer-Lindgren, Mackenbach et al. 2016). Diagnosed diabetes was defined as the proportion of adults (age 20+ years) who reported a previous diabetes diagnosis, represented as an age-standardized prevalence percentage. Undiagnosed diabetes was defined as proportion of adults (age 20+ years) who have a high FPG or HbA1C but did not report a previous diagnosis of diabetes. Total diabetes was defined as the proportion of adults (age 20+ years) who reported a previous diabetes diagnosis and/or had a high FPG/HbA1C. The age-standardized diabetes prevalence (%) was used as the outcome. The EQI was constructed for 2000-2005 for all US counties and is composed of five domains (air, water, built, land, and sociodemographic), each composed of variables to represent the environmental quality of that _domain. Domain-specific EQIs were developed using principal components analysis (PCA) to reduce these variables within each _domain while the overall EQI was constructed from a second PCA from these individual domains (L. C. Messer et al., 2014). To account for differences in environment across rural and urban counties, the overall and _domain-specific EQIs were stratified by rural urban continuum codes (RUCCs) (U.S. Department of Agriculture, 2015). This dataset is not publicly accessible because: EPA cannot release personally identifiable information regarding living individuals, according to the Privacy Act and the Freedom of Information Act (FOIA). This dataset contains information about human research subjects. Because there is potential to identify individual participants and disclose personal information, either alone or in combination with other datasets, individual level data are not appropriate to post for public access. Restricted access may be granted to authorized persons by contacting the party listed. It can be accessed through the following means: Human health data are not available publicly. EQI data are available at: https://edg.epa.gov/data/Public/ORD/NHEERL/EQI. Format: Data are stored as csv files. This dataset is associated with the following publication: Jagai, J., A. Krajewski, S. Shaikh, D. Lobdell, and R. Sargis. Association between environmental quality and diabetes in the U.S.A.. Journal of Diabetes Investigation. John Wiley & Sons, Inc., Hoboken, NJ, USA, 11(2): 315-324, (2020).

The MarketScan health claims database is a compilation of nearly 110 million patient records with information from more than 100 private insurance carriers and large self-insuring companies. Public forms of insurance (i.e., Medicare and Medicaid) are not included, nor are small (< 100 employees) or medium (1000 employees). We excluded the relatively few (n=6735) individuals over 65 years of age because Medicare is the primary insurance of U.S. adults over 65. The EQI was constructed for 2000-2005 for all US counties and is composed of five domains (air, water, built, land, and sociodemographic), each composed of variables to represent the environmental quality of that domain. Domain-specific EQIs were developed using principal components analysis (PCA) to reduce these variables within each domain while the overall EQI was constructed from a second PCA from these individual domains (L. C. Messer et al., 2014). To account for differences in environment across rural and urban counties, the overall and domain-specific EQIs were stratified by rural urban continuum codes (RUCCs) (U.S. Department of Agriculture, 2015). This dataset is not publicly accessible because: EPA cannot release personally identifiable information regarding living individuals, according to the Privacy Act and the Freedom of Information Act (FOIA). This dataset contains information about human research subjects. Because there is potential to identify individual participants and disclose personal information, either alone or in combination with other datasets, individual level data are not appropriate to post for public access. Restricted access may be granted to authorized persons by contacting the party listed. It can be accessed through the following means: Human health data are not available publicly. EQI data are available at: https://edg.epa.gov/data/Public/ORD/NHEERL/EQI. Format: Data are stored as csv files. This dataset is associated with the following publication: Gray, C., D. Lobdell, K. Rappazzo, Y. Jian, J. Jagai, L. Messer, A. Patel, S. Deflorio-Barker, C. Lyttle, J. Solway, and A. Rzhetsky. Associations between environmental quality and adult asthma prevalence in medical claims data. ENVIRONMENTAL RESEARCH. Elsevier B.V., Amsterdam, NETHERLANDS, 166: 529-536, (2018).

There has been considerable international study on the etiology of rising mental disorders, such as attention-deficit hyperactivity disorder (ADHD), in human populations. As glyphosate is the most commonly used herbicide in the world, we sought to test the hypothesis that glyphosate use in agriculture may be a contributing environmental factor to the rise of ADHD in human populations. State estimates for glyphosate use and nitrogen fertilizer use were obtained from the U.S. Geological Survey (USGS). We queried the Healthcare Cost and Utilization Project net (HCUPNET) for state-level hospitalization discharge data in all patients for all-listed ADHD from 2007 to 2010. We used rural-urban continuum codes from the USDA-Economic Research Service when exploring the effect of urbanization on the relationship between herbicide use and ADHD. Least squares dummy variable (LSDV) method and within method using two-way fixed effects was used to elucidate the relationship between glyphosate use and all-listed ADHD hospital discharges. We show that a one kilogram increase in glyphosate use, in particular, in one year significantly positively predicts state-level all-listed ADHD discharges, expressed as a percent of total mental disorders, the following year (coefficient = 5.54E-08, p

The aim of this study was to provide a systematic empirical assessment of three basic organizational premises of Community-Oriented Policing (COP). This study constructed a comprehensive data set by synthesizing data available in separate national data sets on police agencies and communities. The base data source used was the 1999 Law Enforcement Management and Administrative Statistics (LEMAS) survey [LAW ENFORCEMENT MANAGEMENT AND ADMINISTRATIVE STATISTICS (LEMAS), 1999 (ICPSR 3079)], which contained data on police organizational characteristics and on adoption of community-oriented policing procedures. The 1999 survey was supplemented with additional organizational variables from the 1997 LEMAS survey [LAW ENFORCEMENT MANAGEMENT AND ADMINISTRATIVE STATISTICS (LEMAS), 1997 (ICPSR 2700)] and from the 1996 Directory of Law Enforcement Agencies [DIRECTORY OF LAW ENFORCEMENT AGENCIES, 1996: UNITED STATES]. Data on community characteristics were extracted from the 1994 County and City Data Book, from the 1996 to 1999 Uniform Crime Reports [UNIFORM CRIME REPORTING PROGRAM DATA. [UNITED STATES]: OFFENSES KNOWN AND CLEARANCES BY ARREST (1996-1997: ICPSR 9028, 1998: ICPSR 2904, 1999: ICPSR 3158)], from the 1990 and 2000 Census Gazetteer files, and from Rural-Urban Community classifications. The merging of the separate data sources was accomplished by using the Law Enforcement Agency Identifiers Crosswalk file [LAW ENFORCEMENT AGENCY IDENTIFIERS CROSSWALK [UNITED STATES], 1996 (ICPSR 2876)]. In all, 23 data files from eight separate sources collected by four different governmental agencies were used to create the merged data set. The entire merging process resulted in a combined final sample of 3,005 local general jurisdiction policing agencies. Variables for this study provide information regarding police organizational structure include type of government, type of agency, and number and various types of employees. Several indices from the LEMAS surveys are also provided. Community-oriented policing variables are the percent of full-time sworn employees assigned to COP positions, if the agency had a COP plan, and several indices from the 1999 LEMAS survey. Community context variables include various Census population categories, rural-urban continuum (Beale) codes, urban influence codes, and total serious crime rate for different year ranges. Geographic variables include FIPS State, county, and place codes, and region.

Population-based county-level estimates for prevalence of DC were obtained from the Institute for Health Metrics and Evaluation (IHME) for the years 2004-2012 (16). DC prevalence rate was defined as the propor-tion of people within a county who had previously been diagnosed with diabetes (high fasting plasma glu-cose 126 mg/dL, hemoglobin A1c (HbA1c) of 6.5%, or diabetes diagnosis) but do not currently have high fasting plasma glucose or HbA1c for the period 2004-2012. DC prevalence estimates were calculated using a two-stage approach. The first stage used National Health and Nutrition Examination Survey (NHANES) data to predict high fasting plasma glucose (FPG) levels (≥126 mg/dL) and/or HbA1C levels (≥6.5% [48 mmol/mol]) based on self-reported demographic and behavioral characteristics (16). This model was then applied to Behavioral Risk Factor Surveillance System (BRFSS) data to impute high FPG and/or HbA1C status for each BRFSS respondent (16). The second stage used the imputed BRFSS data to fit a series of small area models, which were used to predict county-level prevalence of diabetes-related outcomes, including DC (16). The EQI was constructed for 2006-2010 for all US counties and is composed of five domains (air, water, built, land, and sociodemographic), each composed of variables to represent the environmental quality of that _domain. Domain-specific EQIs were developed using principal components analysis (PCA) to reduce these variables within each _domain while the overall EQI was constructed from a second PCA from these individual domains (L. C. Messer et al., 2014). To account for differences in environment across rural and urban counties, the overall and _domain-specific EQIs were stratified by rural urban continuum codes (RUCCs) (U.S. Department of Agriculture, 2015). Results are reported as prevalence rate differences (PRD) with 95% confidence intervals (CIs) comparing the highest quintile/worst environmental quality to the lowest quintile/best environmental quality expo-sure metrics. PRDs are representative of the entire period of interest, 2004-2012. Due to availability of DC data and covariate data, not all counties were captured, however, the majority, 3134 of 3142 were utilized in the analysis. This dataset is not publicly accessible because: EPA cannot release personally identifiable information regarding living individuals, according to the Privacy Act and the Freedom of Information Act (FOIA). This dataset contains information about human research subjects. Because there is potential to identify individual participants and disclose personal information, either alone or in combination with other datasets, individual level data are not appropriate to post for public access. Restricted access may be granted to authorized persons by contacting the party listed. It can be accessed through the following means: Human health data are not available publicly. EQI data are available at: https://edg.epa.gov/data/Public/ORD/NHEERL/EQI. Format: Data are stored as csv files. This dataset is associated with the following publication: Jagai, J., A. Krajewski, K. Price, D. Lobdell, and R. Sargis. Diabetes control is associated with environmental quality in the USA. Endocrine Connections. BioScientifica Ltd., Bristol, UK, 10(9): 1018-1026, (2021).