DOI: 10.3886/e244362v1
title: Trends in COVID-19 Cases and Deaths in the United States, by County-level Population Factors - ARCHIVED

description: Reporting of Aggregate Case and Death Count data was discontinued on 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.

The surveillance case definition for COVID-19, a nationally notifiable disease, was first described in a position statement from the Council for State and Territorial Epidemiologists, which was later revised. However, there is some variation in how jurisdictions implemented these case definitions. More information on how CDC collects COVID-19 case surveillance data can be found at FAQ: COVID-19 Data and Surveillance.

Aggregate Data Collection Process
Since the beginning of the COVID-19 pandemic, data were reported from state and local health departments through a robust process with the following steps:

Aggregate county-level counts were obtained indirectly, via automated overnight web collection, or directly, via a data submission process.
If more than one official county data source existed, CDC used a comprehensive data selection process comparing each official county data source to retrieve the highest case and death counts, unless otherwise specified by the state.
A CDC data team reviewed counts for congruency prior to integration and set up alerts to monitor for discrepancies in the data.
CDC routinely compiled these data and post the finalized information on COVID Data Tracker.
County level data were aggregated to obtain state- and territory- specific totals.
Counting of cases and deaths is based on date of report and not on the date of symptom onset. CDC calculates rates in these data by using population estimates provided by the US Census Bureau Population Estimates Program (2019 Vintage).
COVID-19 aggregate case and death data are organized in a time series that includes cumulative number of cases and deaths as reported by a jurisdiction on a given date. New case and death counts are calculated as the week-to-week change in cumulative counts of cases and deaths reported (i.e., newly reported cases and deaths = cumulative number of cases/deaths reported this week minus the cumulative total reported the prior week.


This process was collaborative, with CDC and jurisdictions working together to ensure the accuracy of COVID-19 case and death numbers. County counts provided the most up-to-date numbers on cases and deaths by report date. Throughout data collection, CDC retrospectively updated counts to correct known data quality issues.

Description
This archived public use dataset focuses on the cumulative and weekly case and death rates per 100,000 persons within various sociodemographic factors across all states and their counties. All resulting data are expressed as rates calculated as the number of cases or deaths per 100,000 persons in counties meeting various classification criteria using the US Census Bureau Population Estimates Program (2019 Vintage).

Each county within jurisdictions is classified into multiple categories for each factor. All rates in this dataset are based on classification of counties by the characteristics of their population, not individual-level factors. This applies to each of the available factors observed in this dataset. Specific factors and their corresponding categories are detailed below.

Population-level factors
Each unique population factor is detailed below. Please note that the “Classification” column describes each of the 12 factors in the dataset, including a data dictionary describing what each numeric digit means within each classification. The “Category” column uses numeric digits (2-6, depending on the factor) defined in the “Classification” column.

Metro vs. Non-Metro – “Metro_Rural”
Metro vs. Non-Metro classification type is an aggregation of the 6 National Center for Health Statistics (NCHS) Urban-Rural classifications, where “Metro” counties include Large Central Metro, Large Fringe Metro, Medium Metro, and Small Metro areas and “Non-Metro” counties include Micropolitan and Non-Core (Rural) areas.
1 – Metro, including “Large Central Metro, Large Fringe Metro, Medium Metro, and Small Metro” areas
2 – Non-Metro, including “Micropolitan, and Non-Core” areas

Urban/rural - “NCHS_Class”
Urban/rural classification type is based on the 2013 National Center for Health Statistics Urban-Rural Classification Scheme for Counties. Levels consist of:

1 Large Central Metro
2 Large Fringe Metro
3 Medium Metro
4 Small Metro
5 Micropolitan
6 Non-Core (Rural)

American Community Survey (ACS) data were used to classify counties based on their age, race/ethnicity, household size, poverty level, and health insurance status distributions. Cut points were generated by using tertiles and categorized as High, Moderate, and Low percentages. The classification “Percent non-Hispanic, Native Hawaiian/Pacific Islander” is only available for “Hawaii” due to low numbers in this category for other available locations. This limitation also applies to other race/ethnicity categories within certain jurisdictions, where 0 counties fall into the certain category. The cut points for each ACS category are further detailed below:

Age 65 - “Age65”

1 Low (0-24.4%)
2 Moderate (&gt;24.4%-28.6%)
3 High (&gt;28.6%)

Non-Hispanic, Asian - “NHAA”

1 Low (&lt;=5.7%)
2 Moderate (&gt;5.7%-17.4%)
3 High (&gt;17.4%)

Non-Hispanic, American Indian/Alaskan Native - “NHIA”

1 Low (&lt;=0.7%)
2 Moderate (&gt;0.7%-30.1%)
3 High (&gt;30.1%)

Non-Hispanic, Black - “NHBA”

1 Low (&lt;=2.5%)
2 Moderate (&gt;2.5%-37%)
3 High (&gt;37%)

Hispanic - “HISP”

1 Low (&lt;=18.3%)
2 Moderate (&gt;18.3%-45.5%)
3 High (&gt;45.5%)

Population in Poverty - “Pov”

1 Low (0-12.3%)
2 Moderate (&gt;12.3%-17.3%)
3 High (&gt;17.3%)

Population Uninsured- “Unins”

1 Low (0-7.1%)
2 Moderate (&gt;7.1%-11.4%)
3 High (&gt;11.4%)

Average Household Size - “HH”

1 Low (1-2.4)
2 Moderate (&gt;2.4-2.6)
3 High (&gt;2.6)

Community Vulnerability Index Value - “CCVI”
COVID-19 Community Vulnerability Index (CCVI) scores are from Surgo Ventures, which range from 0 to 1, were generated based on tertiles and categorized as:

1 Low Vulnerability (0.0-0.4)
2 Moderate Vulnerability (0.4-0.6)
3 High Vulnerability (0.6-1.0)

Social Vulnerability Index Value – “SVI"
Social Vulnerability Index (SVI) scores (vintage 2020), which also range from 0 to 1, are from CDC/ASTDR’s Geospatial Research, Analysis & Service Program. Cut points for CCVI and SVI scores were generated based on tertiles and categorized as:

1 Low Vulnerability (0-0.333)
2 Moderate Vulnerability (0.334-0.666)
3 High Vulnerability (0.667-1)
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