2016–2021. CMS compiles claims data for Medicare and Medicaid patients across a variety of categories and years. This includes Inpatient and Outpatient claims, Master Beneficiary Summary Files, and many other files. Indicators from this data source have been computed by personnel in CDC's Division for Heart Disease and Stroke Prevention (DHDSP). This was one of the datasets provided by the National Cardiovascular Disease Surveillance System and presented on DHDSP’s Data, Trends, and Maps online tool. This tool was retired in April of 2024 and this dataset will not be updated. Contact dhdsprequests@cdc.gov if you need assistance with data previously included in this dataset. The data are organized by location (national and state) and indicator. The data can be plotted as trends and stratified by sex and race/ethnicity.

2000–2020. 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 was one of the datasets provided by the National Cardiovascular Disease Surveillance System and presented on DHDSP’s Data, Trends, and Maps online tool. This tool was retired in April of 2024 and this dataset will not be updated. Contact dhdsprequests@cdc.gov if you need assistance with data previously included in this dataset. 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.

2011–2020. BRFSS is a continuous, state-based surveillance system that collects information about modifiable risk factors for chronic diseases and other leading causes of death. Indicators from this data source have been computed by personnel in CDC's Division for Heart Disease and Stroke Prevention (DHDSP). This was one of the datasets provided by the National Cardiovascular Disease Surveillance System and presented on DHDSP’s Data, Trends, and Maps online tool. This tool was retired in April of 2024 and this dataset will not be updated. Contact dhdsprequests@cdc.gov if you need assistance with data previously included in this dataset. The data are organized by location (national, regional, state, and selected sites) and indicator, and they include CVDs (e.g., heart failure) and risk factors (e.g., hypertension). The data can be plotted as trends and stratified by age group, sex, and race/ethnicity.

2019–2020. The National Health Interview Survey (NHIS) has monitored the health of the nation since 1957. NHIS data on a broad range of health topics are collected through personal household interviews. Indicators for this dataset has been computed by personnel in CDC's Division for Heart Disease and Stroke Prevention (DHDSP). This was one of the datasets provided by the National Cardiovascular Disease Surveillance System and presented on DHDSP’s Data, Trends, and Maps online tool. This tool was retired in April of 2024 and this dataset will not be updated. Contact dhdsprequests@cdc.gov if you need assistance with data previously included in this dataset. The data are organized by location (region) and indicator, and they include CVDs (e.g., heart failure) and risk factors (e.g., hypertension). The data can be plotted as trends and stratified by age group, sex, and race/ethnicity.

2012 to 2014, 3-year average. Rates are age-standardized. County rates are spatially smoothed. The data can be viewed by gender and race/ethnicity. Data source: National Vital Statistics System. Additional data, maps, and methodology can be viewed on the Interactive Atlas of Heart Disease and Stroke http://www.cdc.gov/dhdsp/maps/atlas

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

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

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

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

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

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

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

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

Users can explore three benchmarks:

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

SOURCES

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

REFERENCES

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

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

This dataset documents rates and trends in local coronary heart disease (CHD) and stroke death rates. Specifically, this report presents county (or county equivalent) estimates of stroke and CHD death rates in 1999-2018 and trends during three intervals (1999-2005, 2005-2011, 2011-2018) by age group (ages 35–64 and 65 and older). The rates and trends were estimated using a Bayesian spatiotempotal model and a smoothed over space, time, and age group. Rates are age-standardized. Data source: National Vital Statistics System.

2014 to 2016, 3-year average. Rates are age-standardized. County rates are spatially smoothed. The data can be viewed by gender and race/ethnicity. Data source: National Vital Statistics System. Additional data, maps, and methodology can be viewed on the Interactive Atlas of Heart Disease and Stroke http://www.cdc.gov/dhdsp/maps/atlas

2017 to 2019, 3-year average. Rates are age-standardized. County rates are spatially smoothed. The data can be viewed by gender and race/ethnicity. Data source: National Vital Statistics System. Additional data, maps, and methodology can be viewed on the Interactive Atlas of Heart Disease and Stroke http://www.cdc.gov/dhdsp/maps/atlas

2016 to 2018, 3-year average. Rates are age-standardized. County rates are spatially smoothed. The data can be viewed by gender and race/ethnicity. Data source: National Vital Statistics System. Additional data, maps, and methodology can be viewed on the Interactive Atlas of Heart Disease and Stroke http://www.cdc.gov/dhdsp/maps/atlas