Age adjustment
Age adjustment is a summarizing procedure to make comparisons of populations with different age distributions. It is used to compare risks for two or more populations at one point in time or for one population at two or more points in time. Age-adjusted rates are computed by the direct method by applying age-specific rates in a population of interest to a standardized age distribution, to eliminate differences in observed rates that result from age differences in population composition. The standard for age-adjusting death rates and estimates from surveys for most indicators in the HIW is the projected year 2000 U.S. resident population. Age-adjusted rates should be viewed as relative indexes rather than actual measures of risk. Age-adjusted estimates from any data source presented may differ from age-adjusted estimates based on the same data presented in other reports, if different age groups are used in the adjustment procedure.
Ambulatory surgical center
A place other than a hospital that does outpatient surgery. At an ambulatory (in and out) surgery center, you may stay for only a few hours or for one night.
Basic actions difficulty
Basic actions difficulty captures limitations or difficulties in movement, emotional, sensory, or cognitive functioning associated with a health problem. Persons with more than one of these difficulties are counted only once in the estimates. The full range of functional areas cannot be assessed on the basis of National Health Interview Survey (NHIS) questions; however, the available questions can identify difficulty in the following core areas of functioning: movement (walking, standing, sitting, bending or kneeling, reaching overhead, grasping objects with fingers, and lifting); selected elements of emotional functioning, in particular, feelings that interfere with accomplishing daily activities (based on responses to a series of questions that measure psychological distress); sensory functioning, based on difficulties seeing or hearing; and selected elements in cognitive functioning, specifically difficulties with remembering or experiencing confusion.
Birthweight
Birthweight is the first weight of the newborn obtained after birth. Low birthweight is defined as weighing less than 2,500 grams (5 lb 8 oz). Very low birthweight is defined as weighing less than 1,500 grams (3 lb 4 oz). Before 1979, low birthweight was defined as weighing 2,500 grams or less, and very low birthweight as 1,500 grams or less.
Blood pressure, high
Uncontrolled blood pressure is defined as having an average systolic blood pressure reading of at least 140 mmHg or diastolic reading of at least 90 mmHg. These blood pressure standards are consistent with the following: Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Those with elevated blood pressure also may be taking prescribed medicine for high blood pressure. People are considered to have hypertension if they have measured elevated blood pressure or if they report that they are taking a prescription medicine for high blood pressure, even if their blood pressure readings are within the normal range.
Body mass index (BMI)
BMI is a measure that adjusts bodyweight for height. It is calculated as weight in kilograms divided by height in meters squared. Healthy weight for adults (20 years of age and over) is defined as a BMI of 18.5 to less than 25; overweight, as greater than or equal to a BMI of 25; and obesity, as greater than or equal to a BMI of 30. BMI cut points for adults are defined in the following: U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2010. 7th Edition, Washington, DC: U.S. Government Printing Office, December 2010. Available from: Dietary Guidelines for Americans, 2010; National Heart, Lung, and Blood Institute. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: The evidence report. NIH pub no 98-4083. Bethesda, MD: National Institutes of Health; 1998. Available from: http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.htm; and U.S. Department of Health and Human Services. Tracking healthy people 2010, Part B, Operational definitions, ch 19, Nutrition and overweight, Objectives 19-1 to 19-3. Washington, DC: U.S. Government Printing Office; 2000. Available from: Objectives 19-1 to 19-3. Obesity for children and adolescents is defined as a BMI at or above the sex- and age-specific 95th percentile BMI cut points from: {link: 10214} . Starting with Health United States, 2010, the terminology describing height for weight among children changed from previous editions. The term obesity now refers to children who were formerly labeled as overweight. This is a change in terminology only and not measurement. For more information see: Ogden CL, Flegal KM. Changes in terminology for childhood overweight and obesity. National health statistics report; no. 25. Hyattsville, MD: NCHS; 2010. Available from: National health statistics report; no. 25 (PDF).
Cause of death
For the purpose of mortality statistics, every death is attributed to one underlying condition, based on information reported on the death certificate and using the international rules for selecting the underlying cause of death from the conditions stated on the certificate. The underlying cause is defined by the World Health Organization (WHO) as “the disease or injury that initiated the train of events leading directly to death, or the circumstances of the accident or violence that produced the fatal injury. “ Generally, more medical information is reported on death certificates than is directly reflected in the underlying cause of death. Conditions that are not selected as underlying cause of death constitute the nonunderlying causes of death, also known as multiple cause of death. Cause of death is coded according to the appropriate revision of the International Classification of Diseases (ICD). Effective with deaths occurring in 1999, the United States began using the 10th revision of the ICD (ICD-10); during the period 1979-1998, causes of death were coded and classified according to the 9th revision (ICD-9).
Complex activity limitation
Complex activity limitation is a construct used to measure disability as defined by the inability to function successfully in certain social roles. Complex activities consist of the tasks and organized activity that make up numerous social roles like working, maintaining a household, living independently, or participating in community activities. Complex activity performance requires the execution of a combination of core areas of functioning. Complex activity limitation describes limitations or restrictions in an individual’s ability to participate fully in social role activities. Complex activities include the following: maintaining independence, including self care and the ability to carry out activities associated with maintaining a household, such as shopping, cooking, and taking care of bills (measures are based on questions commonly known as activities of daily living (ADLs) and instrumental activities of daily living (IADLs)). Limitations in these activities usually reflect severe restrictions and are associated with limitations in other complex activities; difficulties experienced with social and leisure activities—represented in this measure by using questions about attending movies or sporting events, visiting with friends, or pursuing hobbies or relaxation activities; and perceived limitation in the ability to work (a core aspect of social participation for the majority of the U.S. population)—represented by the respondent’s self-defined limitation in the kind or amount of work they can do or their inability to work at a job or business.
Condition
A health condition is a departure from a state of physical or mental well-being.
Confidence interval (CI)
Estimates based on samples are subject to random error. Generally, the larger the sample the more reliable the estimate is likely to be. Confidence intervals reflect the precision of an estimate. If the confidence interval is very wide, the estimate is relatively unreliable because it is based on a relatively small sample. If the confidence interval is narrow, the estimate can be viewed as relatively precise. A 95% confidence level means that 95% of the intervals would include the number.
Unless otherwise noted on the overview page, all confidence intervals presented are 95% confidence intervals.
Critical access hospital
A small facility that gives limited outpatient and inpatient hospital services to people in rural areas.
Determinants
Factors hypothesized to affect health outcomes. Determinants can refer to such factors as demographic and population (host) factors; environmental factors, such as disease vectors or transmission agents (e.g., food or water); social, economic, educational, healthcare, cultural, or other systems; and preventive interventions.
Disability
Disability is operationally defined in a number of different ways for program purposes and for analytic and research purposes, depending on the data collected by the data systems.The Centers for Disease Control and Prevention proposed that a standardized set of questions on disability status be developed. There are two questions that were proposed: 1) Are you limited in any way in any activities because of physical, mental or emotional problems? and/or 2) Do you now have any health problem that requires you to use special equipment, such as a cane, a wheelchair, a special bed or a special telephone? Some data sources have adopted these constructs, with minor wording differences, providing the opportunity to have a standard definition of people with disabilities that can be used across data systems and geographic levels.
DNA
DNA indicates that data have not been analyzed for a particular subpopulation group, although the data are available to do so.
DNC
DNC indicates that data were not collected for a particular subpopulation group. For instance, many data sources do not collect information on sexual orientation.
DSU
DSU indicates that data do not meet the criteria for statistical reliability, data quality, or confidentiality and therefore data are suppressed.
Durable medical equipment
Medical equipment that is ordered by a doctor (or, if Medicare allows, a nurse practitioner, physician assistant or clinical nurse specialist) for use in the home. A hospital or nursing home that mostly provides skilled care can't qualify as a 'home' in this situation. These items must be reusable, such as walkers, wheelchairs, or hospital beds. DME is paid for under both Medicare Part B and Part A for home health services.
Educational attainment
Education is frequently used as the measure of socioeconomic status in presentations of health data for several reasons. Education is generally more completely reported than income. Unlike oppcuation, all adults may be characterized by their education level. Finally, unlike income or occupation, education remains fixed for most people after the age of 25 and usually is not influenced by health. Educational attainment is generally measured as the highest level of school the respondent has completed or the highest credential received. In general, data on educational attainment are presented for ages beginning with 25 years, consistent with guidance given by the U.S. Bureau of the Census.
Emergency department
A portion of the hospital where emergency diagnosis and treatment of illness or injury is provided.
End-stage renal disease (ESRD)
ESRD is a complete or near complete failure of the kidneys to function to excrete wastes, concentrate urine, and regulate electrolytes. ESRD occurs when the kidneys are no longer able to function at the level necessary for day-to-day life. It usually occurs as chronic renal failure worsens to the point where kidney function is less than 10% of normal. At that point, kidney function is so low that without dialysis or kidney transplantation, complications are multiple and severe, and death will occur from accumulation of fluids and waste products in the body. Without treatment, the loss of kidney function in ESRD is usually irreversible and permanent, and death follows.
Evidence-based method
A strategy for explicitly linking public health or clinical practice recommendations to scientific evidence of the effectiveness and/or other characteristics of such practices.
External cause of injury
The external cause of injury is used for classifying the circumstances in which injuries occur. The International Classification of Diseases, 9th revision (ICD-9), External Cause of Injury Matrix is a two-dimensional array describing both the mechanism or external cause of the injury (e.g., fall, motor vehicle traffic) and the manner or intent of the injury (e.g., unintentional, self-inflicted, or assault). Although this matrix was originally developed for mortality, it has been adapted for use with the ICD-9-Clinical Modification. For more information, see: NCHS Injury Tools and Injury in the United States: 2007 Chartbook.
FIPS (Federal Information Processing Standards) Code
Federal information processing standards codes (FIPS codes) are a standardized set of numeric or alphabetic codes issued by the National Institute of Standards and Technology (NIST) to ensure uniform identification of geographic entities through all federal government agencies. The entities covered include: states and statistically equivalent entities, counties and statistically equivalent entities, named populated and related location entities (such as, places and county subdivisions), and American Indian and Alaska Native areas.
Geographic region
The U.S. Census Bureau groups the 50 states and the District of Columbia, for statistical purposes, into four geographic regions—Northeast, Midwest, South, and West
Guide to Clinical Preventive Services (Clinical Guide)
The clinical counterpart to the Guide to Community Preventive Services, prepared and published by the U.S. Preventive Services Task Force (USPSTF). The Clinical Guide, widely used by primary care providers, health policy makers, and others, provides current and scientifically defensible information from published clinical research on the effectiveness of different preventive services and the quality of evidence upon which conclusions are based.
Guide to Community Preventive Services (Community Guide)
The body of evidence and recommendations approved by the Task Force on Community Preventive Services, including the Community Guide; the website, www.thecommunityguide.org; and articles published in scientific journals. See the website for a full explanation of the scope of the Community Guide: What is the Community Guide?
.
Health indicator
Health indicators are measurable characteristics that describe the health of a population (such as life expectancy, mortality, disease incidence or prevalence, or other health states); determinants of health (such as health behaviors, health risk factors, physical environments, and socioeconomic environments); and health care access, cost, quality, and use. Depending on the measure, a health indicator may be defined for a specific population, place, political jurisdiction, or geographic area.
Health insurance status
Health insurance is broadly defined to include both public and private payors who cover medical expenditures incurred by a defined population in a variety of settings. Respondents were considered to be covered by private health insurance if they indicated private health insurance. Private health insurance includes managed care such as health maintenance organizations (HMOs). Persons were considered to be covered by public insurance if they reported Medicaid, a state-sponsored health program, the Children’s Health Insurance Program (CHIP), Medicare, military health plan coverage, or other government-sponsored program coverage. The uninsured were persons who did not have coverage under private health insurance, a public health plan, or any other plan of unknown type. Persons with only Indian Health Service coverage were considered uninsured.
Health outcome
A measure of health or loss of health that assesses one or more of the following factors: 1) Mortality (rates of death, years of potential life lost, quality adjusted life years gained, disability adjusted life years lost); 2) Morbidity (disease or injury rates, infertility rates, disability, chronic pain, functional status, psychiatric disorders, etc.); 3) Positive measures of health (e.g., measures of well-being, physical, social or occupational function); or 4) Pregnancy and birth rates. Hospital referral regions were named for the hospital service area containing the referral hospital or hospitals most often used by residents of the region. The regions sometimes cross state boundaries.
Health Professional Shortage Area (HPSA)
Health Professional Shortage Area — These are counties that have been designated as single-county, primary medical care, health professional shortage areas, as determined by the Secretary of Health and Human Services. They have a shortage of health professionals, meeting the criteria for designating HPSAs that were published as final regulations (42 CFR part 5) in 1980.
Hispanic origin
Hispanic or Latino origin includes persons of Mexican, Puerto Rican, Cuban, Central and South American, and other or unknown Latin American or Spanish origins. Persons of Hispanic origin may be of any race.
Home health care
Limited part-time or intermittent skilled nursing care and home health aide services, physical therapy, occupational therapy, speech-language therapy, medical social services, durable medical equipment (such as wheelchairs, hospital beds, oxygen, and walkers), medical supplies, and other services.
Hospice care
A special way of caring for people who are terminally ill, and for their family. This care includes physical care and counseling. Hospice care is covered under Medicare Part A (Hospital Insurance).
Hospital Referral Region (HRR)
Hospital referral regions were defined by the Dartmouth Atlas Group by documenting where patients were referred for major cardiovascular surgical procedures and for neurosurgery. Each hospital service area was examined to determine where most of its residents went for these services. The result was the aggregation of the 3,436 hospital service areas into 306 hospital referral regions. Each hospital referral region had at least one city where both major cardiovascular surgical procedures and neurosurgery were performed. Maps were used to make sure that the small number of “orphan” hospital service areas – those surrounded by hospital service areas allocated to a different hospital referral region – were reassigned, in almost all cases, to ensure geographic contiguity. Hospital referral regions were pooled with neighbors if their populations were less than 120,000 or if less than 65% of their residents’ hospitalizations occurred within the region. Hospital referral regions were named for the hospital service area containing the referral hospital or hospitals most often used by residents of the region. The regions sometimes cross state boundaries.
Incidence
Incidence is the number of cases of disease having their onset during a prescribed period of time. It is often expressed as a rate (e.g., the incidence of measles per 1,000 children 5-15 years of age during a specified year). Measuring incidence may be complicated because the population at risk for the disease may change during the period of interest, for example, due to births, deaths, or migration. In addition, determining whether a case is new—that is, that its onset occurred during the prescribed period of time—may be difficult. Because of these difficulties in measuring incidence, many health statistics are instead measured in terms of prevalence.
Income
Income is a common measure of socioeconomic status. Current income provides a direct measure of the quality of food, housing, leisure-time amenities, and health care an individual is able to acquire, as well as reflecting the relative position in society. However, income may fluctuate over time so that income received in a given year may not accurately reflect one's lifetime income stream or total wealth. For most indicators, income reflects total family income for a given reference period, usually the previous 12 months or last calendar year. For most data sources, income is defined as money income before taxes and does not include the value of non-case benefits such as food stamps, Medicare, Medicaid, public housing, and employer-provided fringe benefits.
Infant death
An infant death is the death of a live-born child before his or her first birthday. Age at death may be further classified as neonatal or postneonatal. Neonatal deaths are those that occur before the 28th day of life; postneonatal deaths are those that occur between 28 and 365 days of age.
Injury
The International Classification of External Causes of Injuries (ICECI) Coordination and Maintenance Group defines injury as a (suspected) bodily lesion resulting from acute overexposure to energy (this can be mechanical, thermal, electrical, chemical, or radiant) interacting with the body in amounts or rates that exceed the threshold of physiological tolerance. The time between exposure to the energy and the appearance of an injury is short. In some cases, an injury results from an insufficiency of any of the vital elements (i.e., air, water, or warmth), as in strangulation, drowning, or freezing. Acute poisonings and toxic effects, including overdoses of substances and wrong substances given or taken in error are included, as are adverse effects and complications of therapeutic, surgical, and medical care. Psychological harm is excluded. Injuries can be intentional or unintentional (i.e., accidental). In NCHS data systems, external causes of nonfatal injuries are coded to the International Classification of Diseases, 9th revision, Clinical Modification, Supplementary Classification of External Causes of Injury and Poisoning, and the codes are often referred to as E codes. See the NCHS injury website: NCHS injury website.
Insurance status
Health insurance is broadly defined to include both public and private payors who cover medical expenditures incurred by a defined population in a variety of settings. Respondents were considered to be covered by private health insurance if they indicated private health insurance. Private health insurance includes managed care such as health maintenance organizations (HMOs). Persons were considered to be covered by Medicaid if they reported Medicaid, a state-sponsored health program, or the Children’s Health Insurance Program (CHIP). Medicaid, Medicare, military health plan or other government-sponsored program coverage is considered public coverage. The uninsured were persons who did not have coverage under private health insurance, Medicare, Medicaid, public assistance, a state-sponsored health plan, other government-sponsored programs, or a military health plan. Persons with only Indian Health Service coverage were considered uninsured.
International Classification of Diseases (ICD)
The purpose of the ICD is to promote international comparability in the collection, classification, processing, and presentation of health statistics. The ICD is used to code and classify cause-of-death data. The ICD is developed collaboratively by the World Health Organization and 10 international centers, one of which is housed at the National Center for Health Statistics. Since 1900, the ICD has been modified about once every 10 years, except for the 20-year interval between the 9th and 10th revisions (ICD–9 and ICD–10) . The purpose of the revisions is to stay abreast of advances in medical science. New revisions usually introduce major disruptions in time series of mortality statistics. For more information about the ICD, visit the WHO Web site at: WHO: International Classification of Diseases (ICD). For more information about ICD-10, see the NCHS ICD–10 website: at: NCHS ICD-10.
International Classification of Diseases, Ninth Revision, Clinical Modification (ICD–9–CM)
ICD–9–CM is based on, and is compatible with, the World Health Organization’s ICD–9. The United States currently uses ICD–9–CM to code morbidity diagnoses and inpatient procedures. ICD–9–CM consists of three volumes. Volumes 1 and 2 contain the diagnosis tabular list and index; Volume 3 contains the procedure classification (tabular list and index combined). ICD–9–CM is divided into 17 chapters and two supplemental classifications. The chapters are arranged primarily by body system. In addition, there are chapters for Infectious and parasitic diseases; Neoplasms; Endocrine, nutritional, and metabolic diseases; Mental disorders; Complications of pregnancy, childbirth, and puerperium; Certain conditions originating in the perinatal period; Congenital anomalies; and Symptoms, signs, and ill-defined conditions. The two supplemental classifications are for factors influencing health status and contact with health services (V codes), and for external causes of injury and poisoning (E codes). For additional information about ICD–9–CM, see: NCHS Classifications of Diseases and Functioning & Disability.
Intervention
In the Community Guide, an intervention is any kind of planned activity or group of activities ( (including, but not limited to laws, mandates, regulations, standards, resolutions, and guidelines) designed to prevent disease or injury or promote health in a group of people, about which a single summary conclusion can be drawn.
Long-term care
A variety of services that help people with health or personal needs and activities of daily living over a period of time. Long-term care can be provided at home, in the community, or in various types of facilities, including nursing homes and assisted living facilities. Most long-term care is custodial care. Medicare doesn?t pay for this type of care if this is the only kind of care you need.
Marital status
Marital status is classified through self-reporting into the categories married and unmarried. The term married encompasses all married people, including those separated from their spouses. Unmarried includes those who are single (never married), divorced, or widowed.
Medicare
The federal health insurance program for: people 65 years of age or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure with dialysis or a transplant, sometimes called ESRD).
Metropolitan statistical area (MSA)
The Office of Management and Budget (OMB) defines MSAs according to published standards that are applied to U.S. Census Bureau data. The standards are revised periodically, generally prior to the decennial census. The most recent standards were released in June 2010 (available from: June 2010 Standards (PDF)) but have not yet been applied to data presented in Health, United States. In the 2000 standards, an MSA is a county or group of contiguous counties that contains at least one urbanized area of 50,000 or more population. In addition to the county or counties that contain all or part of the urbanized area, an MSA may contain other counties if there are strong economic ties with the central county or counties, as measured by commuting. Counties that are not within an MSA are considered to be nonmetropolitan. For additional information, see: Metropolitan and Micropolitan Statistical Areas; and Bulletin 05-02, Update of Statistical Area Definitions and Guidance on Their Uses.
NA
NA indicates that an estimate is not appropriate or applicable for a particular subpopulation. For instance, it is considered that suicide is not an applicable cause of death for persons less than 5 years of age.
Notifiable disease
A notifiable disease is one that, when diagnosed, health providers are required, usually by law, to report to state or local public health officials. Notifiable diseases are those of public interest by reason of their contagiousness, severity, or frequency. For more information, see: http://www.cdc.gov/ncphi/disss/nndss/phs/infdis.htm.
Obese
See Body Mass Index (BMI).
Outpatient department
According to the National Hospital Ambulatory Medical Care Survey (NHAMCS), an outpatient department (OPD) is a hospital facility where nonurgent ambulatory medical care is provided. The following types of OPDs are excluded from the NHAMCS: ambulatory surgical centers, chemotherapy, employee health services, renal dialysis, methadone maintenance, and radiology.
Overweight
See Body Mass Index (BMI).
Part A (Medicare)
Hospital insurance that pays for inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
Part B (Medicare)
Medicare medical insurance that helps pay for doctors' services, outpatient hospital care, durable medical equipment, and some medical services that aren't covered by Part A.
Physical activity, leisure-time
Leisure-time physical activity is defined based on the 2008 Federal Physical Activity Guidelines for Americans Physical Activity Guidelines. Adults who met the 2008 guidelines reported at least 150 minutes per week of moderate-intensity or 75 minutes per week of vigorous-intensity aerobic physical activity (or an equivalent combination of moderate- and vigorous-intensity aerobic activity) and muscle strengthening activities at least twice a week.
Policy
A set of organizational rules (including but not limited to laws) intended to promote health or prevent disease.
Population
The U.S. Census Bureau collects and publishes data on populations in the United States according to several different definitions. Various statistical systems then use the appropriate population for calculating rates. Resident population includes persons whose usual place of residence (i.e., the place where one usually lives and sleeps) is in one of the 50 states or the District of Columbia. It includes members of the Armed Forces stationed in the United States and their families. It excludes members of the Armed Forces stationed outside the United States and civilian U.S. citizens whose usual place of residence is outside the United States. The resident population is the denominator for calculating birth and death rates and incidence of disease. Civilian population is the resident population excluding members of the Armed Forces, although families of members of the Armed Forces are included. Civilian noninstitutionalized population is the civilian population excluding persons residing in institutions (such as nursing homes, prisons, jails, mental hospitals, and juvenile correctional facilities).
Poverty status
Family income expressed as a percent of the poverty threshold. Each member of a family is classified according to the total income of the family. Unrelated individuals are classified according to their own income. Reported and imputed income levels are grouped into categories relative to the poverty threshold. The poverty threshold for each year is based on definitions originally developed by the Social Security Administration. These include a set of money income thresholds that vary by family size and composition. Families or individuals with income below their appropriate thresholds are classified as below the poverty threshold. These thresholds are updated annually by the U.S. Census Bureau to reflect changes in the Consumer Price Index for all urban consumers (CPI-U). For more information, see U.S. Census Bureau poverty.
Preventive service
An intervention (activity) that prevents disease or injury or promotes health. In Community Guide documents, “preventive services” and “interventions” are used interchangeably.
Prospective payment system
A method of reimbursement in which Medicare payment is made based on a predetermined, fixed amount. The payment amount for a particular service is derived based on the classification system of that service (for example, DRGs for inpatient hospital services).
Race
In 1977, the Office of Management and Budget (OMB) issued Race and Ethnic Standards for Federal Statistics and Administrative Reporting (Statistical Policy Directive 15) to promote comparability of data among federal data systems. The 1977 Standards called for the federal government’s data systems to classify individuals into the following four racial groups: American Indian or Alaska Native, Asian or Pacific Islander, black, and white. Depending on the data source, the classification by race was based on self-classification or on observation by an interviewer or other person filling out the questionnaire. In 1997, revisions were announced for classification of individuals by race within the federal government’s data systems (Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity. Fed Regist 1997 October 30;62:58781-90). The 1997 Standards specify five racial groups: American Indian or Alaska Native, Asian, black or African American, Native Hawaiian or Other Pacific Islander, and white. These five categories are the minimum set for data on race in federal statistics. The 1997 Standards also offer an opportunity for respondents to select more than one of the five groups, leading to many possible multiple-race categories. As with the single-race groups, data for the multiple-race groups are to be reported when estimates meet agency requirements for reliability and confidentiality. The 1997 Standards allow for observer or proxy identification of race but clearly state a preference for self-classification. The federal government considers race and Hispanic origin to be two separate and distinct concepts. Thus, Hispanics may be of any race. Federal data systems were required to comply with the 1997 Standards by 2003.
Rate
A rate is a measure of some event, disease, or condition in relation to a unit of population, along with some specification of time. Birth rate is calculated by dividing the number of live births in a population in a year by the resident population. Fertility rate is the total number of live births, regardless of the age of the mother, per 1,000 women of reproductive age (15-44 years). Death rate is calculated by dividing the number of deaths in a population in a year by the midyear resident population. Infant mortality rate, based on period files, is calculated by dividing the number of infant deaths during a calendar year by the number of live births reported in the same year. It is expressed as the number of infant deaths per 1,000 live births. Neonatal mortality rate is the number of deaths of children under 28 days of age per 1,000 live births. Postneonatal mortality rate is the number of deaths of children that occur between 28 days and 365 days after birth, per 1,000 live births. Visit rate is a basic measure of service utilization for event-based data. Examples of events include physician office visits with drugs provided or hospital discharges. In the visit rate calculation, the numerator is the number of estimated events, and the denominator is the corresponding U.S. population estimate for those who possibly could have had events during a given period of time. Other rates are computed by dividing the number of events (births, deaths by c ause, conditions, visits, etc.) by the population that could have experienced these events.
Relative standard error (RSE)
RSE is a measure of an estimate’s reliability. The RSE of an estimate is obtained by dividing the standard error of the estimate (SE(r)) by the estimate itself (r). This quantity is expressed as a percentage of the estimate and is calculated as follows: RSE = 100 x (SE(r) / (r)). Estimates with large RSEs (usually greater than 30% but sometimes more than 20%) are considered unreliable, that is, if you took a different sample and computed the statistic again, it would be less likely to have a value similar to the estimate you took before.
Skilled nursing facility
A facility (which meets specific regulatory certification requirements) which primarily provides inpatient skilled nursing care and related services to patients who require medical, nursing, or rehabilitative services but does not provide the level of care or treatment available in a hospital.
Standard error (SE)
The standard error (SE) is a measure or estimate of the sampling errors affecting a statistic; a measure of the amount the statistic may be expected to differ by chance from the true value of the statistic. It is a measure of how spread out data values are around the estimate or statistic, defined as the square root of the variance. The larger the SE, the less sure you can be that if you took a different sample and computed the statistic again, that it would be close to the statistic you computed from the first sample.
SUR
SUR indicates that an estimate has been surpressed at the request of the data provider for a reason that is not due to confidentiality or statistical precision.
Task Force on Community Preventive Services
A 15-member non-federal panel initiated in 1996 by the Director, Centers for Disease Control and Prevention (CDC), under the auspices of the U.S. Public Health Service. The mission of this task force is to carry out systematic reviews of prevention intervention that can be carried out in communities, and to develop recommendations based on the findings of these reviews. The Task Force findings are presented in the Guide to Community Preventive Services (the Community Guide).
Task Force on Community Preventive Services
A 15-member non-federal panel initiated in 1996 by the Director, Centers for Disease Control and Prevention (CDC), under the auspices of the U.S. Public Health Service. The mission of this task force is to carry out systematic reviews of prevention intervention that can be carried out in communities, and to develop recommendations based on the findings of these reviews. The Task Force findings are presented in the Guide to Community Preventive Services (the Community Guide).
U.S. Preventive Services Task Force (USPSTF)
A non-federal panel, commissioned by the U.S. Public Health Service in 1984 and 1990, charged with developing recommendations for clinicians on the appropriate use of preventive interventions, based on systematic reviews of evidence of clinical effectiveness. USPSTF findings are presented in the Guide to Clinical Preventive Services (the Clinical Guide).