Analysis of ‘National Vital Statistics System (NVSS) - National Cardiovascular Disease Surveillance Data’ provided by Analyst-2 (analyst-2.ai), based on source dataset retrieved from https://catalog.data.gov/dataset/1da1a18e-6eea-4de9-88de-ac2789fc3c76 on 12 February 2022.

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

2000 forward. NVSS is a secure, web-based data management system that collects and disseminates the Nation's official vital statistics. Indicators from this data source have been computed by personnel in CDC's Division for Heart Disease and Stroke Prevention (DHDSP). This is one of the datasets provided by the National Cardiovascular Disease Surveillance System. The system is designed to integrate multiple indicators from many data sources to provide a comprehensive picture of the public health burden of CVDs and associated risk factors in the United States. The data are organized by location (national and state) and indicator; NVSS mortality data include CVDs (e.g., heart failure). The data can be viewed by temporal trends and stratified by age group, sex, and race/ethnicity.

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

2000 forward. NVSS is a secure, web-based data management system that collects and disseminates the Nation's official vital statistics. Indicators from this data source have been computed by personnel in CDC's Division for Heart Disease and Stroke Prevention (DHDSP). This is one of the datasets provided by the National Cardiovascular Disease Surveillance System. The system is designed to integrate multiple indicators from many data sources to provide a comprehensive picture of the public health burden of CVDs and associated risk factors in the United States. The data are organized by location (national and state) and indicator; NVSS mortality data include CVDs (e.g., heart failure). The data can be viewed by temporal trends and stratified by age group, sex, and race/ethnicity.

This dataset tracks the updates made on the dataset "National Vital Statistics System (NVSS) - National Cardiovascular Disease Surveillance Data" as a repository for previous versions of the data and metadata.

Analysis of ‘National Vital Statistics System (NVSS) - National Cardiovascular Disease Surveillance Data’ provided by Analyst-2 (analyst-2.ai), based on source dataset retrieved from https://catalog.data.gov/dataset/4b53a1b0-b9fe-4666-8791-3b1eb4e2673b on 12 February 2022.

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

2000 forward. NVSS is a secure, web-based data management system that collects and disseminates the Nation's official vital statistics. Indicators from this data source have been computed by personnel in CDC's Division for Heart Disease and Stroke Prevention (DHDSP). This is one of the datasets provided by the National Cardiovascular Disease Surveillance System. The system is designed to integrate multiple indicators from many data sources to provide a comprehensive picture of the public health burden of CVDs and associated risk factors in the United States. The data are organized by location (national and state) and indicator; NVSS mortality data include CVDs (e.g., heart failure). The data can be viewed by temporal trends and stratified by age group, sex, and race/ethnicity.

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

This dataset contains the following files for California influenza surveillance data: 1) Outpatient Influenza-like Illness Surveillance Data by Region and Influenza Season from volunteer sentinel providers; 2) Clinical Sentinel Laboratory Influenza and Other Respiratory Virus Surveillance Data by Region and Influenza Season from volunteer sentinel laboratories; and 3) Public Health Laboratory Influenza Respiratory Virus Surveillance Data by Region and Influenza Season from California public health laboratories. The Immunization Branch at the California Department of Public Health (CDPH) collects, compiles and analyzes information on influenza activity year-round in California and produces a weekly influenza surveillance report during October through May. The California influenza surveillance system is a collaborative effort between CDPH and its many partners at local health departments, public health and clinical laboratories, vital statistics offices, healthcare providers, clinics, emergency departments, and the Centers for Disease Control and Prevention (CDC). California data are also included in the CDC weekly influenza surveillance report, FluView, and help contribute to the national picture of Influenza activity in the United States. The information collected allows CDPH and CDC to: 1) find out when and where influenza activity is occurring; 2) track influenza-related illness; 3) determine what influenza viruses are circulating; 4) detect changes in influenza viruses; and 5) measure the impact influenza is having on hospitalizations and deaths.

The purpose of the investigation is to obtain information on the occurrence of infectious diseases to assess the development of the epidemiological situation in the Czech Republic, to monitor the health status of the population and to manage the provision of health care.

The EPIDAT program was developed in 1991 to ensure mandatory reporting, registration and analysis of the occurrence of infections, which follows on from ISPO (Information System of Transmissible Diseases). From 1993 to 2017, EPIDAT was used nationwide at all hygiene stations as the basis of local, regional and national infectious disease surveillance.

Statistical unit of inquiry: The statistical unit is the selected infectious disease. Confirmed disease, suspected disease, carriage, death are reported. Individual cases are statistically monitored according to ICD-10. Certain serious infectious diseases monitored by other separate information systems and registries are not the subject of reporting. These are tuberculosis disease (dg. A15–A19), infections transmitted mainly through sexual contact (dg. A50–A64) and human immunodeficiency virus disease HIV (dg. B20–B24). Acute respiratory infections (ARI) and influenza-like illness (ILI) also have a separate information system. In the EPIDAT information system, some diseases listed in other chapters IV, X and XX are also monitored. ICD-10, which is related to infectious diseases.

This data visualization presents county-level provisional counts for drug overdose deaths based on a current flow of mortality data in the National Vital Statistics System. County-level 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 resulting in an underestimate relative to final counts (see Technical Notes).

The provisional data presented on the dashboard below include reported 12 month-ending provisional counts of death due to drug overdose by the decedent’s county of residence and the month in which death occurred.

Percentages of deaths with a cause of death pending further investigation and a note on historical completeness (e.g. if the percent completeness was under 90% after 6 months) are included to aid in interpretation of provisional data as these measures are related to the accuracy of provisional counts (see Technical Notes). Counts between 1-9 are suppressed in accordance with NCHS confidentiality standards. Provisional data presented on this page will be updated on a quarterly basis as additional records are received.

Technical Notes

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 the 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 and jurisdiction in which the death occurred. 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 due to the time often needed to investigate these deaths (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 2020 would include deaths occurring from July 1, 2019 through June 30, 2020. The 12 month-ending period counts include all seasons of the year and are insensitive to reporting variations by seasonality. These provisional counts of drug overdose deaths and related data quality metrics are provided for public health surveillance and monitoring of emerging trends. Provisional drug overdose death data are often incomplete, and the degree of completeness varies by jurisdiction and 12 month-ending period. Consequently, the numbers of drug overdose deaths are underestimated based on provisional data relative to final data and are subject to random variation.

Cause of Death Classification and Definition of Drug Deaths

Mortality statistics are compiled in accordance with the World Health Organizations (WHO) regulations specifying that WHO member nations classify and code causes of death with the current revision of the International Statistical Classification of Diseases and Related Health Problems (ICD). ICD provides the basic guidance used in virtually all countries to code and classify causes of death. It provides not only disease, injury, and poisoning categories but also the rules used to select the single underlying cause of death for tabulation from the several diagnoses that may be reported on a single death certificate, as well as definitions, tabulation lists, the format of the death certificate, and regul

Note: DPH is updating and streamlining the COVID-19 cases, deaths, and testing data. As of 6/27/2022, the data will be published in four tables instead of twelve.

The COVID-19 Cases, Deaths, and Tests by Day dataset contains cases and test data by date of sample submission. The death data are by date of death. This dataset is updated daily and contains information back to the beginning of the pandemic. The data can be found at https://data.ct.gov/Health-and-Human-Services/COVID-19-Cases-Deaths-and-Tests-by-Day/g9vi-2ahj.

The COVID-19 State Metrics dataset contains over 93 columns of data. This dataset is updated daily and currently contains information starting June 21, 2022 to the present. The data can be found at https://data.ct.gov/Health-and-Human-Services/COVID-19-State-Level-Data/qmgw-5kp6 .

The COVID-19 County Metrics dataset contains 25 columns of data. This dataset is updated daily and currently contains information starting June 16, 2022 to the present. The data can be found at https://data.ct.gov/Health-and-Human-Services/COVID-19-County-Level-Data/ujiq-dy22 .

The COVID-19 Town Metrics dataset contains 16 columns of data. This dataset is updated daily and currently contains information starting June 16, 2022 to the present. The data can be found at https://data.ct.gov/Health-and-Human-Services/COVID-19-Town-Level-Data/icxw-cada . To protect confidentiality, if a town has fewer than 5 cases or positive NAAT tests over the past 7 days, those data will be suppressed.

Count of COVID-19-associated deaths by date of death. Deaths reported to either the OCME or DPH are included in the COVID-19 data. COVID-19-associated deaths include persons who tested positive for COVID-19 around the time of death and persons who were not tested for COVID-19 whose death certificate lists COVID-19 disease as a cause of death or a significant condition contributing to death.

Data on Connecticut deaths were obtained from the Connecticut Deaths Registry maintained by the DPH Office of Vital Records. Cause of death was determined by a death certifier (e.g., physician, APRN, medical examiner) using their best clinical judgment. Additionally, all COVID-19 deaths, including suspected or related, are required to be reported to OCME. On April 4, 2020, CT DPH and OCME released a joint memo to providers and facilities within Connecticut providing guidelines for certifying deaths due to COVID-19 that were consistent with the CDC’s guidelines and a reminder of the required reporting to OCME.25,26 As of July 1, 2021, OCME had reviewed every case reported and performed additional investigation on about one-third of reported deaths to better ascertain if COVID-19 did or did not cause or contribute to the death. Some of these investigations resulted in the OCME performing postmortem swabs for PCR testing on individuals whose deaths were suspected to be due to COVID-19, but antemortem diagnosis was unable to be made.31 The OCME issued or re-issued about 10% of COVID-19 death certificates and, when appropriate, removed COVID-19 from the death certificate. For standardization and tabulation of mortality statistics, written cause of death statements made by the certifiers on death certificates are sent to the National Center for Health Statistics (NCHS) at the CDC which assigns cause of death codes according to the International Causes of Disease 10th Revision (ICD-10) classification system.25,26 COVID-19 deaths in this report are defined as those for which the death certificate has an ICD-10 code of U07.1 as either a primary (underlying) or a contributing cause of death. More information on COVID-19 mortality can be found at the following link: https://portal.ct.gov/DPH/Health-Information-Systems--Reporting/Mortality/Mortality-Statistics

Note the counts in this dataset may vary from the death counts in the other COVID-19-related datasets published on data.ct.gov, where deaths are counted on the date reported rather than the date of death

This dataset includes birth rates for females by age group in the United States since 1940. The number of states in the reporting area differ historically. In 1915 (when the birth registration area was established), 10 states and the District of Columbia reported births; by 1933, 48 states and the District of Columbia were reporting births, with the last two states, Alaska and Hawaii, added to the registration area in 1959 and 1960, when these regions gained statehood. Reporting area information is detailed in references 1 and 2 below. Trend lines for 1909–1958 are based on live births adjusted for under-registration; beginning with 1959, trend lines are based on registered live births. SOURCES NCHS, National Vital Statistics System, birth data (see https://www.cdc.gov/nchs/births.htm); public-use data files (see https://www.cdc.gov/nchs/data_access/VitalStatsOnline.htm); and CDC WONDER (see http://wonder.cdc.gov/). REFERENCES National Office of Vital Statistics. Vital Statistics of the United States, 1950, Volume I. 1954. Available from: https://www.cdc.gov/nchs/data/vsus/vsus_1950_1.pdf. Hetzel AM. U.S. vital statistics system: major activities and developments, 1950-95. National Center for Health Statistics. 1997. Available from: https://www.cdc.gov/nchs/data/misc/usvss.pdf. National Center for Health Statistics. Vital Statistics of the United States, 1967, Volume I–Natality. 1969. Available from: https://www.cdc.gov/nchs/data/vsus/nat67_1.pdf. Martin JA, Hamilton BE, Osterman MJK, et al. Births: Final data for 2015. National vital statistics reports; vol 66 no 1. Hyattsville, MD: National Center for Health Statistics. 2017. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr66/nvsr66_01.pdf. Martin JA, Hamilton BE, Osterman MJK, Driscoll AK, Drake P. Births: Final data for 2016. National Vital Statistics Reports; vol 67 no 1. Hyattsville, MD: National Center for Health Statistics. 2018. Available from: https://www.cdc.gov/nvsr/nvsr67/nvsr67_01.pdf. Martin JA, Hamilton BE, Osterman MJK, Driscoll AK, Births: Final data for 2018. National vital statistics reports; vol 68 no 13. Hyattsville, MD: National Center for Health Statistics. 2019. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_13.pdf.

Analysis of ‘United States COVID-19 Cases and Deaths by State over Time’ provided by Analyst-2 (analyst-2.ai), based on source dataset retrieved from https://catalog.data.gov/dataset/94385ab5-449a-41ff-8253-15a9f6283539 on 12 February 2022.

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

CDC reports aggregate counts of COVID-19 cases and death numbers daily online. Data on the COVID-19 website and CDC’s COVID Data Tracker are based on these most recent numbers reported by states, territories, and other jurisdictions. This data set of “United States COVID-19 Cases and Deaths by State over Time” combines this information. However, data are dependent on jurisdictions’ timely and accurate reporting.

Separately, CDC also regularly reports provisional death certificate data from the National Vital Statistics System (NVSS) on data.cdc.gov. Details are described on the NCHS website. Reporting the number of deaths by using death certificates ultimately provides more complete information but is a longer process; therefore, these numbers will be less than the death counts on the COVID-19 website.

Accuracy of Data
CDC tracks COVID-19 illnesses, hospitalizations, and deaths to track trends, detect outbreaks, and monitor whether public health measures are working. However, counting exact numbers of COVID-19 cases is not possible. COVID-19 can cause mild illness, symptoms might not appear immediately, there are delays in reporting and testing, not everyone who is infected gets tested or seeks medical care, and there are differences in how completely states and territories report their cases.

COVID-19 is one of about 120 diseases or conditions health departments voluntarily report to CDC. State, local, and territorial public health departments verify and report cases to CDC. When there are differences between numbers of cases reported by CDC versus by health departments, data reported by health departments should be considered the most up to date. Health departments may update case data over time when they receive more complete and accurate information. The number of new cases reported each day fluctuates. There is generally less reporting on the weekends and holidays.

CDC reports death data on three other sections of the website: U.S. Cases & Deaths, COVID Data Tracker, and NCHS Provisional Death Counts. The U.S. Cases and Deaths webpages and COVID Data Tracker get their information from the same source (total case counts); however, NCHS Death Counts are based on death certificates that use information reported by physicians, medical examiners, or coroners in the cause-of-death section of each certificate. Data from each of these pages are considered provisional (not complete and pending verification) and are therefore subject to change. Counts from previous weeks are continually revised as more records are received and processed. Because not all jurisdictions report counts daily, counts may increase at different intervals.

Confirmed & Probable Counts
As of April 14, 2020, CDC case counts and death counts include both confirmed and probable cases and deaths. This change was made to reflect an interim COVID-19 position statement issued by the Council for State and Territorial Epidemiologists on April 5, 2020. The position statement included a case definition and made COVID-19 a nationally notifiable disease. Nationally notifiable disease cases are voluntarily reported to CDC by jurisdictions. Confirmed and probable case definition criteria are described here: https://wwwn.cdc.gov/nndss/conditions/coronavirus-disease-2019-covid-19/case-definition/2020/. Not all jurisdictions report probable cases and deaths to CDC. When not available to CDC, it is noted as N/A. Please note that jurisdiction

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

This dataset contains the number of births, deaths, marriages, and stillbirths registered by the Registrar General from 1994. Data released for 2023 and 2024 (January to June) is preliminary and may not match counts from other sources. The data represents counts in the reference calendar quarters, which are collated approximately 90 days after the end of the quarter. Previously released counts for 2023 and 2024 (January to June) are updated to reflect vital event registrations completed after the release of the initial report. Each subsequent quarterly report is the cumulative total of the preceding quarterly reports. ServiceOntario’s ability to provide timely information depends on receiving vital event registration information from a variety of sources. The preliminary data presented may not represent all the events that occurred in the reporting period. This is particularly true for events that occurred near the end of the reporting period as they may not have been received by ServiceOntario by the time the data is collated. Final counts for the reporting year will be released with the publication of the Office of the Registrar General Annual Report. The Vital Statistics Act requires that after the end of each calendar year, the Registrar General publish a report that includes the number of births, marriages, deaths, still-births, adoptions and changes of name registered during the calendar year preceding the one that has ended.

JO: Completeness of Total Death Reporting data was reported at 82.074 % in 2008. This records a decrease from the previous number of 89.938 % for 2006. JO: Completeness of Total Death Reporting data is updated yearly, averaging 86.006 % from Dec 2006 (Median) to 2008, with 2 observations. The data reached an all-time high of 89.938 % in 2006 and a record low of 82.074 % in 2008. JO: Completeness of Total Death Reporting data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s Jordan – Table JO.World Bank.WDI: Health Statistics. Completeness of total death reporting is the number of total deaths reported by national statistics authorities to the United Nations Statistics Division's Demography Yearbook divided by the number of total deaths estimated by the United Nations Population Division.; ; The United Nations Statistics Division's Population and Vital Statistics Report and the United Nations Population Division's World Population Prospects.; Weighted average;

This dataset includes percent distribution of births for females by age group in the United States since 1933.

The number of states in the reporting area differ historically. In 1915 (when the birth registration area was established), 10 states and the District of Columbia reported births; by 1933, 48 states and the District of Columbia were reporting births, with the last two states, Alaska and Hawaii, added to the registration area in 1959 and 1960, when these regions gained statehood. Reporting area information is detailed in references 1 and 2 below. Trend lines for 1909–1958 are based on live births adjusted for under-registration; beginning with 1959, trend lines are based on registered live births.

SOURCES

NCHS, National Vital Statistics System, birth data (see https://www.cdc.gov/nchs/births.htm); public-use data files (see https://www.cdc.gov/nchs/data_access/VitalStatsOnline.htm); and CDC WONDER (see http://wonder.cdc.gov/).

REFERENCES

1. National Office of Vital Statistics. Vital Statistics of the United States, 1950, Volume I. 1954. Available from: https://www.cdc.gov/nchs/data/vsus/vsus_1950_1.pdf.

2. Hetzel AM. U.S. vital statistics system: major activities and developments, 1950-95. National Center for Health Statistics. 1997. Available from: https://www.cdc.gov/nchs/data/misc/usvss.pdf.

3. National Center for Health Statistics. Vital Statistics of the United States, 1967, Volume I–Natality. 1969. Available from: https://www.cdc.gov/nchs/data/vsus/nat67_1.pdf.

4. Martin JA, Hamilton BE, Osterman MJK, et al. Births: Final data for 2015. National vital statistics reports; vol 66 no 1. Hyattsville, MD: National Center for Health Statistics. 2017. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr66/nvsr66_01.pdf.

5. Martin JA, Hamilton BE, Osterman MJK, Driscoll AK, Drake P. Births: Final data for 2016. National Vital Statistics Reports; vol 67 no 1. Hyattsville, MD: National Center for Health Statistics. 2018. Available from: https://www.cdc.gov/nvsr/nvsr67/nvsr67_01.pdf.

6. Martin JA, Hamilton BE, Osterman MJK, Driscoll AK, Births: Final data for 2018. National vital statistics reports; vol 68 no 13. Hyattsville, MD: National Center for Health Statistics. 2019. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_13.pdf.

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.

Technical notes

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 related data quality metrics are provided for public health surveillance and monitoring of emerging trends. Provisional drug overdose death data are often incomplete, and the degree of completeness varies by jurisdiction and 12-month ending period. Consequently, the numbers of drug overdose deaths are underestimated based on provisional data relative to final data and are subject to random variation. Methods to adjust provisional counts have been developed to provide predicted provisional counts of drug overdose deaths, accounting for delayed reporting (see Percentage of records pending investigation and Adjustments for delayed reporting).

Provisional data are based on available records that meet certain data quality criteria at the time of analysis and may not include all deaths that occurred during a given time period. Therefore, they should not be considered comparable with final data and are subject to change.

Cause-of-death classification and definition of drug deaths
Mortality statistics are compiled in accordance with World Health Organization (WHO) regulations specifying that WHO member nations classify and code causes of death with the current revision of the International Statistical Classification of Diseases and Related Health Problems (ICD). ICD provides the basic guidance used in virtually all countries to code and classify causes of death. It provides not only disease, injury, and poisoning categories but also the rules used to select the single underlying cause of death for tabulation from the several diagnoses that may be reported on a single death certificate, as well as definitions, tabulation lists, the format of the death certificate, and regulations on use of the classification. Causes of death for data presented in this report were coded according to ICD guidelines described in annual issues of Part 2a of the NCHS Instruction Manual (2).

Drug overdose deaths are identified using underlying cause-of-death codes from the Tenth Revision of ICD (ICD–10): X40–X44 (unintentional), X60–X64 (suicide), X85 (homicide), and Y10–Y14 (undetermined). Drug overdose deaths involving selected drug categories are identified by specific multiple cause-of-death codes. Drug categories presented include: heroin (T40.1); natural opioid analgesics, including morphine and codeine, and semisynthetic opioids, including drugs such as oxycodone, hydrocodone, hydromorphone, and oxymorphone (T40.2); methadone, a synthetic opioid (T40.3); synthetic opioid analgesics other than methadone, including drugs such as fentanyl and tramadol (T40.4); cocaine (T40.5); and psychostimulants with abuse potential, which includes methamphetamine (T43.6). Opioid overdose deaths are identified by the presence of any of the following MCOD codes: opium (T40.0); heroin (T40.1); natural opioid analgesics (T40.2); methadone (T40.3); synthetic opioid analgesics other than methadone (T40.4); or other and unspecified narcotics (T40.6). This latter category includes drug overdose deaths where ‘opioid’ is reported without more specific information to assign a more specific ICD–10 code (T40.0–T40.4) (3,4). Among deaths with an underlying cause of drug overdose, the percentage with at least one drug or drug class specified is defined as that with at least one ICD–10 multiple cause-of-death code in the range T36–T50.8.

Drug overdose deaths may involve multiple drugs; therefore, a single death might be included in more than one category when describing the number of drug overdose deaths involving specific drugs. For example, a death that involved both heroin and fentanyl would be included in both the number of drug overdose deaths involving heroin and the number of drug overdose deaths involving synthetic opioids other than methadone.

Selection of specific states and other jurisdictions to report
Provisional counts are presented by the jurisdiction in which the death occurred (i.e., the reporting jurisdiction). Data quality and timeliness for drug overdose deaths vary by reporting jurisdiction. Provisional counts are presented for reporting jurisdictions based on measures of data quality: the percentage of records where the manner of death is listed as “pending investigation,” the overall completeness of the data, and the percentage of drug overdose death records with specific drugs or drug classes recorded. These criteria are defined below.

Percentage of records pending investigation

Drug overdose deaths often require lengthy investigations, and death certificates may be initially filed with a manner of death “pending investigation” and/or with a preliminary or unknown cause of death. When the percentage of records reported as “pending investigation” is high for a given jurisdiction, the number of drug overdose deaths is likely to be underestimated. For jurisdictions reporting fewer than 1% of records as “pending investigation”, the provisional number of drug overdose deaths occurring in the fourth quarter of 2015 was approximately 5% lower than the final count of drug overdose deaths occurring in that same time period. For jurisdictions reporting greater than 1% of records as “pending investigation” the provisional counts of drug overdose deaths may underestimate the final count of drug overdose deaths by as much as 30%. Thus, jurisdictions are included in Table 2 if 1% or fewer of their records in NVSS are reported as “pending investigation,” following a 6-month lag for the 12-month ending periods included in the dashboard. Values for records pending investigation are updated with each monthly release and reflect the most current data available.

Percent completeness

NCHS receives monthly counts of the estimated number of deaths from each jurisdictional vital registration offices (referred to as “control counts”). This number represents the best estimate of how many

JP: Completeness of Total Death Reporting data was reported at 100.000 % in 2009. This stayed constant from the previous number of 100.000 % for 2008. JP: Completeness of Total Death Reporting data is updated yearly, averaging 100.000 % from Dec 2006 (Median) to 2009, with 3 observations. The data reached an all-time high of 100.000 % in 2009 and a record low of 100.000 % in 2009. JP: Completeness of Total Death Reporting data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s Japan – Table JP.World Bank: Health Statistics. Completeness of total death reporting is the number of total deaths reported by national statistics authorities to the United Nations Statistics Division's Demography Yearbook divided by the number of total deaths estimated by the United Nations Population Division.; ; The United Nations Statistics Division's Population and Vital Statistics Report and the United Nations Population Division's World Population Prospects.; Weighted Average;

United States US: Completeness of Infant Death Reporting data was reported at 97.585 % in 2008. This records a decrease from the previous number of 100.000 % for 2007. United States US: Completeness of Infant Death Reporting data is updated yearly, averaging 98.108 % from Dec 2006 (Median) to 2008, with 3 observations. The data reached an all-time high of 100.000 % in 2007 and a record low of 97.585 % in 2008. United States US: Completeness of Infant Death Reporting data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s United States – Table US.World Bank.WDI: Health Statistics. Completeness of infant death reporting is the number of infant deaths reported by national statistics authorities to the United Nations Statistics Division's Demography Yearbook divided by the number of infant deaths estimated by the United Nations Population Division.; ; The United Nations Statistics Division's Population and Vital Statistics Report and the United Nations Population Division's World Population Prospects.; ;

This dataset provides model-based provisional estimates of the weekly numbers of drug overdose, suicide, and transportation-related deaths using “nowcasting” methods to account for the normal lag between the occurrence and reporting of these deaths. Estimates less than 10 are suppressed. These early model-based provisional estimates were generated using a multi-stage hierarchical Bayesian modeling process to generate smoothed estimates of the weekly numbers of death, accounting for reporting lags. These estimates are based on several assumptions about how the reporting lags have changed in recent months across different jurisdictions, and the resulting estimates differ from other sources of provisional mortality data. For now, these estimates should be considered highly uncertain until further evaluations can be done to determine the validity of these assumptions about timeliness. The true patterns in reporting lags will not be known until data are finalized, typically 11–12 months after the end of the calendar year. Importantly, these estimates are not a replacement for monthly provisional drug overdose death counts, or quarterly provisional mortality estimates. For more detail about the nowcasting methods and models, see:

Rossen LM, Hedegaard H, Warner M, Ahmad FB, Sutton PD. Early provisional estimates of drug overdose, suicide, and transportation-related deaths: Nowcasting methods to account for reporting lags. Vital Statistics Rapid Release; no 11. Hyattsville, MD: National Center for Health Statistics. February 2021. DOI: https://doi.org/10.15620/ cdc:101132

This dataset includes live births, birth rates, and fertility rates by race of mother in the United States since 1960.

Data availability varies by race and ethnicity groups. All birth data by race before 1980 are based on race of the child. Since 1980, birth data by race are based on race of the mother. For race, data are available for Black and White births since 1960, and for American Indians/Alaska Native and Asian/Pacific Islander births since 1980. Data on Hispanic origin are available since 1989. Teen birth rates for specific racial and ethnic categories are also available since 1989. From 2003 through 2015, the birth data by race were based on the “bridged” race categories (5). Starting in 2016, the race categories for reporting birth data changed; the new race and Hispanic origin categories are: Non-Hispanic, Single Race White; Non-Hispanic, Single Race Black; Non-Hispanic, Single Race American Indian/Alaska Native; Non-Hispanic, Single Race Asian; and, Non-Hispanic, Single Race Native Hawaiian/Pacific Islander (5,6). Birth data by the prior, “bridged” race (and Hispanic origin) categories are included through 2018 for comparison.

SOURCES

NCHS, National Vital Statistics System, birth data (see https://www.cdc.gov/nchs/births.htm); public-use data files (see https://www.cdc.gov/nchs/data_access/VitalStatsOnline.htm); and CDC WONDER (see http://wonder.cdc.gov/).

REFERENCES

1. National Office of Vital Statistics. Vital Statistics of the United States, 1950, Volume I. 1954. Available from: https://www.cdc.gov/nchs/data/vsus/vsus_1950_1.pdf.

2. Hetzel AM. U.S. vital statistics system: major activities and developments, 1950-95. National Center for Health Statistics. 1997. Available from: https://www.cdc.gov/nchs/data/misc/usvss.pdf.

3. National Center for Health Statistics. Vital Statistics of the United States, 1967, Volume I–Natality. 1969. Available from: https://www.cdc.gov/nchs/data/vsus/nat67_1.pdf.

4. Martin JA, Hamilton BE, Osterman MJK, et al. Births: Final data for 2015. National vital statistics reports; vol 66 no 1. Hyattsville, MD: National Center for Health Statistics. 2017. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr66/nvsr66_01.pdf.

5. Martin JA, Hamilton BE, Osterman MJK, Driscoll AK, Drake P. Births: Final data for 2016. National Vital Statistics Reports; vol 67 no 1. Hyattsville, MD: National Center for Health Statistics. 2018. Available from: https://www.cdc.gov/nvsr/nvsr67/nvsr67_01.pdf.

6. Martin JA, Hamilton BE, Osterman MJK, Driscoll AK, Births: Final data for 2018. National vital statistics reports; vol 68 no 13. Hyattsville, MD: National Center for Health Statistics. 2019. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_13.pdf.

Costa Rica CR: Completeness of Total Death Reporting data was reported at 97.581 % in 2010. This records an increase from the previous number of 97.382 % for 2009. Costa Rica CR: Completeness of Total Death Reporting data is updated yearly, averaging 97.382 % from Dec 2006 (Median) to 2010, with 3 observations. The data reached an all-time high of 97.581 % in 2010 and a record low of 94.836 % in 2006. Costa Rica CR: Completeness of Total Death Reporting data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s Costa Rica – Table CR.World Bank.WDI: Social: Health Statistics. Completeness of total death reporting is the number of total deaths reported by national statistics authorities to the United Nations Statistics Division's Demography Yearbook divided by the number of total deaths estimated by the United Nations Population Division.; ; The United Nations Statistics Division's Population and Vital Statistics Report and the United Nations Population Division's World Population Prospects.; Weighted average;

Reporting of Aggregate Case and Death Count data was discontinued 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.

This archived public use dataset has 11 data elements reflecting United States COVID-19 community levels for all available counties.

The COVID-19 community levels were developed using a combination of three metrics — new COVID-19 admissions per 100,000 population in the past 7 days, the percent of staffed inpatient beds occupied by COVID-19 patients, and total new COVID-19 cases per 100,000 population in the past 7 days. The COVID-19 community level was determined by the higher of the new admissions and inpatient beds metrics, based on the current level of new cases per 100,000 population in the past 7 days. New COVID-19 admissions and the percent of staffed inpatient beds occupied represent the current potential for strain on the health system. Data on new cases acts as an early warning indicator of potential increases in health system strain in the event of a COVID-19 surge.

Using these data, the COVID-19 community level was classified as low, medium, or high.

COVID-19 Community Levels were used to help communities and individuals make decisions based on their local context and their unique needs. Community vaccination coverage and other local information, like early alerts from surveillance, such as through wastewater or the number of emergency department visits for COVID-19, when available, can also inform decision making for health officials and individuals.

For the most accurate and up-to-date data for any county or state, visit the relevant health department website. COVID Data Tracker may display data that differ from state and local websites. This can be due to differences in how data were collected, how metrics were calculated, or the timing of web updates.

Archived Data Notes:

This dataset was renamed from "United States COVID-19 Community Levels by County as Originally Posted" to "United States COVID-19 Community Levels by County" on March 31, 2022.

March 31, 2022: Column name for county population was changed to “county_population”. No change was made to the data points previous released.

March 31, 2022: New column, “health_service_area_population”, was added to the dataset to denote the total population in the designated Health Service Area based on 2019 Census estimate.

March 31, 2022: FIPS codes for territories American Samoa, Guam, Commonwealth of the Northern Mariana Islands, and United States Virgin Islands were re-formatted to 5-digit numeric for records released on 3/3/2022 to be consistent with other records in the dataset.

March 31, 2022: Changes were made to the text fields in variables “county”, “state”, and “health_service_area” so the formats are consistent across releases.

March 31, 2022: The “%” sign was removed from the text field in column “covid_inpatient_bed_utilization”. No change was made to the data. As indicated in the column description, values in this column represent the percentage of staffed inpatient beds occupied by COVID-19 patients (7-day average).

March 31, 2022: Data values for columns, “county_population”, “health_service_area_number”, and “health_service_area” were backfilled for records released on 2/24/2022. These columns were added since the week of 3/3/2022, thus the values were previously missing for records released the week prior.

April 7, 2022: Updates made to data released on 3/24/2022 for Guam, Commonwealth of the Northern Mariana Islands, and United States Virgin Islands to correct a data mapping error.

April 21, 2022: COVID-19 Community Level (CCL) data released for counties in Nebraska for the week of April 21, 2022 have 3 counties identified in the high category and 37 in the medium category. CDC has been working with state officials to verify the data submitted, as other data systems are not providing alerts for substantial increases in disease transmission or severity in the state.

May 26, 2022: COVID-19 Community Level (CCL) data released for McCracken County, KY for the week of May 5, 2022 have been updated to correct a data processing error. McCracken County, KY should have appeared in the low community level category during the week of May 5, 2022. This correction is reflected in this update.

May 26, 2022: COVID-19 Community Level (CCL) data released for several Florida counties for the week of May 19th, 2022, have been corrected for a data processing error. Of note, Broward, Miami-Dade, Palm Beach Counties should have appeared in the high CCL category, and Osceola County should have appeared in the medium CCL category. These corrections are reflected in this update.

May 26, 2022: COVID-19 Community Level (CCL) data released for Orange County, New York for the week of May 26, 2022 displayed an erroneous case rate of zero and a CCL category of low due to a data source error. This county should have appeared in the medium CCL category.

June 2, 2022: COVID-19 Community Level (CCL) data released for Tolland County, CT for the week of May 26, 2022 have been updated to correct a data processing error. Tolland County, CT should have appeared in the medium community level category during the week of May 26, 2022. This correction is reflected in this update.

June 9, 2022: COVID-19 Community Level (CCL) data released for Tolland County, CT for the week of May 26, 2022 have been updated to correct a misspelling. The medium community level category for Tolland County, CT on the week of May 26, 2022 was misspelled as “meduim” in the data set. This correction is reflected in this update.

June 9, 2022: COVID-19 Community Level (CCL) data released for Mississippi counties for the week of June 9, 2022 should be interpreted with caution due to a reporting cadence change over the Memorial Day holiday that resulted in artificially inflated case rates in the state.

July 7, 2022: COVID-19 Community Level (CCL) data released for Rock County, Minnesota for the week of July 7, 2022 displayed an artificially low case rate and CCL category due to a data source error. This county should have appeared in the high CCL category.

July 14, 2022: COVID-19 Community Level (CCL) data released for Massachusetts counties for the week of July 14, 2022 should be interpreted with caution due to a reporting cadence change that resulted in lower than expected case rates and CCL categories in the state.

July 28, 2022: COVID-19 Community Level (CCL) data released for all Montana counties for the week of July 21, 2022 had case rates of 0 due to a reporting issue. The case rates have been corrected in this update.

July 28, 2022: COVID-19 Community Level (CCL) data released for Alaska for all weeks prior to July 21, 2022 included non-resident cases. The case rates for the time series have been corrected in this update.

July 28, 2022: A laboratory in Nevada reported a backlog of historic COVID-19 cases. As a result, the 7-day case count and rate will be inflated in Clark County, NV for the week of July 28, 2022.

August 4, 2022: COVID-19 Community Level (CCL) data was updated on August 2, 2022 in error during performance testing. Data for the week of July 28, 2022 was changed during this update due to additional case and hospital data as a result of late reporting between July 28, 2022 and August 2, 2022. Since the purpose of this data set is to provide point-in-time views of COVID-19 Community Levels on Thursdays, any changes made to the data set during the August 2, 2022 update have been reverted in this update.

August 4, 2022: COVID-19 Community Level (CCL) data for the week of July 28, 2022 for 8 counties in Utah (Beaver County, Daggett County, Duchesne County, Garfield County, Iron County, Kane County, Uintah County, and Washington County) case data was missing due to data collection issues. CDC and its partners have resolved the issue and the correction is reflected in this update.

August 4, 2022: Due to a reporting cadence change, case rates for all Alabama counties will be lower than expected. As a result, the CCL levels published on August 4, 2022 should be interpreted with caution.

August 11, 2022: COVID-19 Community Level (CCL) data for the week of August 4, 2022 for South Carolina have been updated to correct a data collection error that resulted in incorrect case data. CDC and its partners have resolved the issue and the correction is reflected in this update.

August 18, 2022: COVID-19 Community Level (CCL) data for the week of August 11, 2022 for Connecticut have been updated to correct a data ingestion error that inflated the CT case rates. CDC, in collaboration with CT, has resolved the issue and the correction is reflected in this update.

August 25, 2022: A laboratory in Tennessee reported a backlog of historic COVID-19 cases. As a result, the 7-day case count and rate may be inflated in many counties and the CCLs published on August 25, 2022 should be interpreted with caution.

August 25, 2022: Due to a data source error, the 7-day case rate for St. Louis County, Missouri, is reported as zero in the COVID-19 Community Level data released on August 25, 2022. Therefore, the COVID-19 Community Level for this county should be interpreted with caution.

September 1, 2022: Due to a reporting issue, case rates for all Nebraska counties will include 6 days of data instead of 7 days in the COVID-19 Community Level (CCL) data released on September 1, 2022. Therefore, the CCLs for all Nebraska counties should be interpreted with caution.

September 8, 2022: Due to a data processing error, the case rate for Philadelphia County, Pennsylvania,