Purpose
Listing of additional data sources used by the Chronic Disease Indicators (CDI) Application.
Data sources
Purpose:
To provide annual estimates of income, education, employment, health insurance coverage, and housing costs and conditions for residents of the United States.
Target Population:
The U.S. population, including the population living in group quarters, such as nursing homes, military barracks, and college/university student housing.
How Often Collected:
Full implementation began in 2005. Conducted annually.
Data Source Limitations:
ACS data may be subject to systematic errors that result from noncoverage (such as residence in a noneligible household), nonresponse (such as refusal to participate in the survey or answer specific questions), or measurement errors (such as social desirability or recall bias). This is true of all self-reported sample surveys. The US Census Bureau changed the 2020 ACS release schedule because of the COVID-19 pandemic. Instead of providing the standard 1-year data products, it released 1-year experimental estimates. As a result of this change, the Census Bureau does not recommend comparing 2020 ACS 1-year experimental estimates with standard ACS estimates or with decennial census data. The Census Bureau also does not recommend comparing 2020 1-year Public Use Microdata Sample data with standard pretabulated products or PUMS-based estimates from previous years.
Treatment of Missing Data:
Responses that are missing or marked as “don’t know” or “not sure” are not included in the numerator or denominator unless otherwise stated.
Data Suppression:
Because ACS provides data at various geographic levels, data suppression is based on population thresholds, geographic restrictions, and data quality population thresholds (such as coefficient of variation).
Age-Standardization:
None reported for Chronic Disease Indicator estimates.
Sponsor:
Census Bureau, U.S. Department of Commerce
Purpose:
To provide findings based on alcoholic beverage sales data.
Target Population:
US population aged 14 years or older
How Often Collected:
Annual
Mode of Collection:
Data compiled from state alcohol sales in the form of volume or tax revenue or beverage industry reports on alcohol sales. Population estimates from the US Census Bureau used to calculate per capita rates.
Data Source Limitations:
None
Treatment of Missing Data:
Not applicable.
Age-Standardization:
Not applicable.
Sponsor:
National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism
Purpose:
To provide a national repository of state and local tobacco-related ordinances and regulations in the United States.
Target Population:
US population
How Often Collected:
Annual
Mode of Collection:
Compilation of state and local tobacco-related laws on clean air, sales and distribution, youth access, advertising, excise taxes and conditional use permits.
Notes:
Data from ANRF sometimes differ from data from other smoke-free policy databases, such as the State Tobacco Activities Tracking and Evaluation (STATE) System, because of variations in the definition of a comprehensive smoke-free policy.
Treatment of Missing Data:
Not applicable.
Age-Standardization:
Not applicable.
Sponsor:
American NonSmokers’ Rights Foundation
Website:
Purpose:
To collect state-level information on health risk behaviors, preventive health practices, and health care access primarily related to chronic disease and injury.
Target Population:
US civilian, noninstitutionalized population aged 18 years or older residing in households
How Often Collected:
Annual
Mode of Collection:
Sample survey: telephone interview (cell and landline).
Data Limitations:
BRFSS data may be subject to systematic errors that result from noncoverage (such as residence on college campuses or in the military), nonresponse (such as refusal to participate in the survey or answer specific questions), or measurement (such as social desirability or recall bias). This is true for all self-reported sample surveys. To address other potential systematic errors, BRFSS began including people who use only cell phones in the survey sample in 2011. The BRFSS survey is conducted by all 50 US states, the District of Columbia, Puerto Rico, the US Virgin Islands, Guam, American Samoa, and Palau. It consists of: (1) A standardized core questionnaire with core questions that are asked every year (fixed core) and other questions that are asked every other year (rotating core). (2) Optional modules that states can choose to use according to need. (3) State-added questions. Occasionally, a state may not collect enough data to meet the minimum requirements for inclusion in the BRFSS public-use dataset for a specific year.
Treatment of Missing Data:
Responses that are missing or marked as “don’t know” or “not sure” are not included in the numerator or denominator unless otherwise stated.
Data Suppression:
Current recommendations for suppression of BRFSS estimates are estimates with a relative standard error >30% or total respondents <50.
Age-Standardization:
Unless otherwise stated, age-adjusted prevalence is standardized by the direct method to the year 2000 projected US population using the following age groups: 18–24, 25–34, 35–44, 45–64, and ≥65 years.
Sponsor:
Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion
Website:
Purpose:
To provide claims data for key attributes related to medical care, such as admission and discharge dates, diagnoses and procedure codes, source of care, date of death, and demographic data (such as age, race and ethnicity, place of residence).
Target Population:
All people enrolled in the Medicare program (enrollment data) and Medicare fee-for-service beneficiaries who filed claims (claims data), not including beneficiaries enrolled in managed care plans.
How Often Collected:
Annual
Mode of Collection:
Abstraction of administrative and claims data.
Data Limitations:
Because Medicare managed care programs may not file claims, files based only on claims data will exclude care for people enrolled in Medicare managed care programs. In addition, to maintain a manageable file size, some files are based on a sample of enrollees, rather than on all Medicare enrollees. Procedure codes and the interpretation of Medicare coverage rules have changed over the life of the Medicare program. Practice patterns, care settings, and payment mechanisms can also affect claims records. In addition, medical conditions must be diagnosed to be listed as a diagnosis, and some diseases may be underdiagnosed.
Treatment of Missing Data:
Cases that are missing are not included in the numerator or denominator unless otherwise stated.
Data Suppression:
The CMS suppression policy sets minimum thresholds for the display of CMS data. No cell (such as admissions, discharges, patients, services) containing a value of 1 to 10 can be reported directly. However, a value of 0 does not violate the minimum cell size policy.
Age-Standardization:
None reported for Chronic Disease Indicator estimates.
Sponsor:
Centers for Medicare & Medicaid Services
Website:
Purpose:
To provide information about the prevalence and severity of food insecurity in US households.
Target Population:
US civilian, noninstitutionalized population
How Often Collected:
Annual
Mode of Collection:
Multistage sample survey: household-based, one person responding for all household members.
Data Limitations:
The CPS-FSS is an annual supplement to the Current Population Survey (CPS). It asks one adult in each household a series of questions about experiences and behaviors of household members that could indicate food insecurity. Answers are used to assign a food security status for the household based on the number of food-insecure conditions reported. Households with very low food security for children are identified by responses to a subset of questions about the conditions and experiences of children. Survey respondents also report the amount of money their households spend on food and whether they use public or private food and nutrition assistance programs. All households with incomes below 185% of the federal poverty threshold are asked questions about the use of federal and community-based food and nutrition assistance programs. To minimize the burden on respondents, households with incomes above that level are not asked these questions unless they indicate some level of difficulty in meeting their food needs when respondents answer preliminary screening questions.
Treatment of Missing Data:
Responses that are missing or marked as “no response” are not included in the numerator or denominator.
Data Suppression:
Caution is recommended when interpreting results that are based on a relatively small number of cases because summary measures may not reveal useful information when computed on a subpopulation smaller than 75,000. However, when CPS was redesigned after the 1980 census, the survey sample was allocated across the states to produce accurate state and national estimates, while keeping total sample size to a minimum.
Age-Standardization:
Not applicable to Chronic Disease Indicator estimates.
Sponsor:
US Census Bureau and US Department of Agriculture, Economic Research Service
Purpose:
To monitor vaccination coverage among children aged 19 to 35 months and teenagers aged 13 to 17 years, flu vaccinations for children aged 6 months to 17 years, and COVID-19 vaccinations for children and teenagers in eligible age groups.
Target Population:
Children and adolescents aged 6 months to 17 years living in the United States
How Often Collected:
Annual
Mode of Collection:
Census: abstraction of data from medical records
Data Limitations:
NIS data may be subject to systematic errors that result from noncoverage (e.g., residence on college campuses or in the military), nonresponse (e.g., refusal to participate in the survey or to answer specific questions), or measurement (e.g., social desirability or recall bias). This is true of all self-reported sample surveys.
Treatment of Missing Data:
Responses that are missing or marked as “don’t know” or “not sure” are not included in the numerator or denominator unless otherwise stated.
Data Suppression:
Age-Standardization:
Not applicable to Chronic Disease Indicator estimates
Sponsor:
Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases
Purpose:
To provide annual national and state-level information on the health and well-being of children aged 0 to 17 years in the United States.
Target Population:
Children aged 0 to 17 years in all 50 states and the District of Columbia.
How Often Collected:
Annual (starting in 2016)
Mode of Collection:
Data are collected through self-administered web and paper questionnaires. Respondents are parents or guardians living in the home who have knowledge of the sampled child.
Data Limitations:
The survey consists of two questionnaires. The first is an initial screener to assess the presence of children in the home and help choose a child of focus (with oversampling of children with special health care needs and those aged 0 to 5 years). The second is a substantive topical questionnaire.
Treatment of Missing Data:
Responses that are missing or marked as “don’t know” or “not sure” are not included in the numerator or denominator unless otherwise stated.
Data Suppression:
Data suppression criteria are set by the Maternal Child Health Bureau. Data are suppressed if an estimate’s unweighted denominator is less than 30. Data are flagged as “interpreted with caution” if: (1) The absolute confidence interval (CI) width is greater than 20%. (2) The relative CI width is greater than 120% (1.2 times the estimate). (3) The CI is inestimable because of no sample variance (estimate is exactly 0% or 100%). Data will also be suppressed for Chronic Disease Indicators.
Age-Standardization:
Not applicable.
Sponsor:
Health Resources and Services Administration and US Census Bureau
Purpose:
To present characteristics of people dying in the United States, to determine life expectancy, and to compare mortality trends in the United States with trends in other countries.
Target Population:
US population: death data for the entire United States for events occurring within the United States
How Often Collected:
Annual
Mode of Collection:
Census: records of all deaths registered in the United States
Data Limitations:
Data used to estimate death rates and determine life expectancy include death certificate data from the NVSS and population estimates from the US Census Bureau or suitable alternative. The International Classification of Diseases (ICD), which is revised periodically, codes and classifies causes of death. Because these revisions may prevent continuity in trend data by cause of death, comparison of death rates across different versions of the ICD should be made with caution and should include reference to the comparability ratios. The 10th Revision of the ICD (ICD-10) has been used since 1999. Revisions to the Standard Certificate of Death may also create a lack of continuity in the classification or availability of selected data items. Details on methods used to calculate life expectancy are published by CDC’s National Center for Health Statistics.
Treatment of Missing Data:
Not applicable to Chronic Disease Indicator estimates.
Data Suppression:
Death rates are flagged as unreliable or suppressed based on the following criteria: (1) Death counts <20 are considered unreliable. (2) Death counts of 1 to 9 are considered suppressed. Data will also be suppressed for Chronic Disease Indicators.
Age-Standardization:
Unless otherwise stated, age-adjusted death rates are standardized by the direct method to the 2000 US standard population using the following age groups: < 1, 1–4, 5–14, 15–24, 25–34, 35–44, 45–54, 55–64, 65–74, 75–84, and ≥85 years.
Sponsor:
Centers for Disease Control and Prevention, National Center for Health Statistics
Website:
Purpose:
To collect data to identify groups of women and infants at high risk for health problems, to monitor changes in health status, and to measure progress toward goals to improve the health of mothers and infants.
Target Population:
Women with a recent live birth
How Often Collected:
Annual
Mode of Collection:
Sample survey: mail and web questionnaire with telephone follow-up for nonrespondents. Before 2023, PRAMS was conducted as a mail questionnaire with telephone follow-up for nonrespondents.
Data Limitations:
The PRAMS sample of women who have had a recent live birth is drawn from state, local, or territorial birth certificate files. Each participating jurisdiction draws a stratified systematic sample of 100 to 250 new mothers every month from a frame of eligible birth certificates. Many jurisdictions oversample low birth weight infants or stratify by mother’s race or ethnicity. As of 2020, all states except California, Idaho, and Ohio participate in PRAMS. Live births reported in PRAMS represent 81% of all births in the United States.
Treatment of Missing Data:
Responses that are missing or marked as “don’t know” or “not sure” are not included in the numerator or denominator unless otherwise stated.
Data Suppression:
PRAMS currently has a minimum overall response rate threshold policy for the release of data. PRAMS’ analyses suppress marginal totals (row or column totals) that are <30.
Age-Standardization:
Not applicable to Chronic Disease Indicator estimates.
Sponsor:
Joint surveillance project of the Centers for Disease Control and Prevention, Division of Reproductive Health, and state, local, and territorial health departments, with data supplied by CDC’s National Center for Disease Prevention and Health Promotion
Website:
Purpose:
To provide estimates on newly diagnosed cancer cases and cancer deaths for the whole U.S. population. This national coverage enables the public, including researchers, clinicians, policy makers, and public health professionals, to (a) monitor populations most affected by cancer, (b) evaluate the success of programs designed to prevent cancer and diagnose cancer at early stages, and (c) identify additional needs for cancer prevention and control efforts at national, state, and local levels.
Target Population:
U.S. population
How Often Collected:
Annual
Mode of Collection:
Incidence data are from the registries participating in the Centers for Disease Control and Prevention’s (CDC’s) National Program of Cancer Registries (NPCR) and the National Cancer Institute’s (NCI’s) Surveillance, Epidemiology, and End Results (SEER) Program. Data from state central cancer registries that are supported by both NPCR and SEER are presented as reported to CDC in 2022. Medical records are the primary source of data on cancer incidence. Staff at health care facilities abstract data from patients’ medical records, enter it into the facility’s cancer registry (if it has one), and then send the data to the central registry. Other data sources include physicians’ offices, radiation facilities, freestanding surgical centers, and pathology laboratories. Cancer mortality statistics are based on information from all death certificates filed in the 50 states, the District of Columbia, and Puerto Rico, and processed by the National Vital Statistics System. The population estimates for the denominators of incidence and death rates are race-specific, ethnicity-specific, and sex-specific county population estimates aggregated to the state or metropolitan-area level. For more information on data sources see U.S. Cancer Statistics Data Visualizations tool Technical Notes.
Notes:
Most recent information is available at U. S. Cancer Statistics Data Visualizations tool Technical Notes and archived information for data from previous data submissions is available in Archived Reports and Technical Notes section.
Treatment of Missing Data:
Data are evaluated according to NCPR standards. For more information see U.S. Cancer Statistics Data Visualizations tool Technical Notes.
Data Suppression:
Rates and counts are suppressed if fewer than 16 cases (or deaths) were reported in a specific category, such as cancer type, race or ethnicity, age, or state. For more information on data suppressions see U.S. Cancer Statistics Data Visualizations tool Technical Notes.
Age-Standardization:
Rates are the number of cases (or deaths) per 100,000 people. They are age-adjusted to the 2000 US standard population (19 age groups, Census P25-1130).
Sponsor:
Incidence data are from CDC’s National Program of Cancer Registries (NPCR) and the National Cancer Institute’s (NCI) Surveillance, Epidemiology, and End Results (SEER) Program. Mortality data are from CDC’s National Center for Health Statistics. Population estimated are based data from U.S. Census Bureau, United States Department of Commerce. Suggested Citation: U.S. Cancer Statistics Working Group. U.S. Cancer Statistics Data Visualizations Tool, based on 2022 submission data (1999-2020): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute; https://www.cdc.gov/cancer/dataviz, released in November 2023.
Purpose:
To collect, analyze, and distribute information about end-stage renal disease (ESRD) in the United States.
Target Population:
Medicare and non-Medicare patients with ESRD and Medicare patients with chronic kidney disease.
How Often Collected:
Annual
Mode of Collection:
Abstraction of administrative and claims data and other data: data for the USRDS database are compiled from existing data sources in the Centers for Medicare & Medicaid Services (CMS), CDC, and elsewhere.
Data Limitations:
Data for the USRDS database are compiled from existing data sources, including the CMS Renal Management Information System (REMIS), CMS claims data, facility survey data, CDC survey data (National Health And Nutrition Examination Survey), Standard Information Management System (SIMS), Medicare Evidence form (CMS-2728), ESRD Death Notification form (CMS-2746), and United Network for Organ Sharing transplant and wait-list data. CMS data files are supplemented by CMS with enrollment, payer history, and other administrative data, to provide utilization and demographic information on ESRD patients.
Treatment of Missing Data:
Estimates of incidence are primarily informed by validated submissions of the ESRD Medical Evidence Report (form CMS 2728), which by rule must be submitted whenever a patient is newly treated for ESRD. A description of how missing data is treated is not provided.
Data Suppression:
If a count is less than or equal to 10, then data cannot be displayed, per CMS reporting rules.
Age-Standardization:
Adjusted rates are standardized to the age, sex, and race and ethnicity distribution of the 2015 US population.
Sponsor:
National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases
Purpose:
To provide information on participant income and nutrition risk characteristics and estimates of breastfeeding initiation rates for WIC infants.
Target Population:
WIC participants
How Often Collected:
Implementation began in 2018. Conducted annually.
Data Sponsor:
United States Department of Agriculture, Food and Nutrition Service
Sponsor:
Census Bureau, U.S. Department of Commerce
Area
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