Data Sources

Data Sources

• Deaths National Vital Statistics System. Bridged-Race Postcensal Population Estimates from National Center for Health Statistics.
• Hospitalizations and hospitalization discharge status. Centers for Medicare and Medicaid Services Medicare Provider Analysis and Review (MEDPAR) file, Part A.

ICD Codes

Mortality: International Classification of Diseases, 10th Revision (ICD-10) codes:

• Total Cardiovascular Disease: I00-I78; underlying cause of death.
• All Heart Disease: I00-I09, I11, I13, I20-I51; underlying cause of death.
• Coronary Heart Disease: I20-I25; underlying cause of death.
• Acute Myocardial Infarction: I21-I22; underlying cause of death.
• Cardiac Dysrhythmia: I47-I49; underlying cause of death.
• Heart Failure: I50; deaths with heart failure mentioned in any of the 20 listed causes of death on the death certificate.
• Hypertension: I10-I15; deaths with hypertension mentioned in any of the 20 listed causes of death on the death certificate.
• All Stroke: I60-I69; underlying cause of death.
• Ischemic Stroke: I63, I65-I66; underlying cause of death.
• Hemorrhagic Stroke: I60-I62; underlying cause of death.

Hospitalizations after 2015: International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes.

• Total Cardiovascular Disease: I00-I78; principle (i.e., first-listed) diagnosis.
• All Heart Disease: I00-I09, I11, I13, I20-I51; principle (i.e., first-listed) diagnosis.
• Coronary Heart Disease: I20-I25; principle (i.e., first-listed) diagnosis.
• Acute Myocardial Infarction: I21-I22; principle (i.e., first-listed) diagnosis.
• Cardiac Dysrhythmia: I47-I49; principle (i.e., first-listed) diagnosis.
• Atrial Fibrillation: I48.0-I48.2; principle (i.e., first-listed) diagnosis.
• Heart Failure: I09.81, I11.0, I13.0, I13.2, I50.1-I50.4, I50.8-I50.9; principle (i.e., first-listed) diagnosis.
• Hypertension: I10-I15; principle (i.e., first-listed) diagnosis.
• All Stroke: I60-I69; principle (i.e., first-listed) diagnosis.
• Ischemic Stroke: I63, I65-I66; principle (i.e., first-listed) diagnosis.
• Hemorrhagic Stroke: I60-I62; principle (i.e., first-listed) diagnosis.

Hospitalizations before 2015: International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes.

• Total Cardiovascular Disease: 390-434, 436-448; principle (i.e., first-listed) diagnosis.
• All Heart Disease: 390-398, 402, 404, 410-429; principle (i.e., first-listed) diagnosis.
• Coronary Heart Disease: 410-414, 429.2; principle (i.e., first-listed) diagnosis.
• Acute Myocardial Infarction: 410; principle (i.e., first-listed) diagnosis.
• Cardiac Dysrhythmia: 427; principle (i.e., first-listed) diagnosis.
• Atrial Fibrillation: 427.31; principle (i.e., first-listed) diagnosis.
• Heart Failure: 398.91, 402.01, 402.11, 402.91, 404.01, 404.03, 404.11, 404.13, 404.91, 404.93, 428; principle (i.e., first-listed) diagnosis.
• Hypertension: 401-405; principle (i.e., first-listed) diagnosis.
• All Stroke: 430-434, 436-438; principle (i.e., first-listed) diagnosis.
• Ischemic Stroke: 433-434; principle (i.e., first-listed) diagnosis.
• Hemorrhagic Stroke: 430-432; principle (i.e., first-listed) diagnosis.

County estimates of Diagnosed Diabetes, Obesity, and Leisure-time Physical Inactivity were calculated by the Division of Diabetes Translation. Learn more about the data and statistical methods. Additional data and statistical methods can be found here: https://gis.cdc.gov/grasp/diabetes/diabetesatlas-surveillance.html

County estimates of High Cholesterol Awareness and Current Smoking were calculated as part of PLACES, a collaboration between CDC, the Robert Wood Johnson Foundation, and the CDC Foundation. PLACES provides model-based population-level analysis and community estimates based on CDC’s Behavioral Risk Factor Surveillance System. Additional data and statistical methods can be found here: https://www.cdc.gov/places/methodology/index.html

Data sources are shown on the map and include a variety of national publicly available data (e.g., US Census Bureau). Data are available at the county and census tract level. The years represented by the data are shown in the title bar.

• Data sources are shown on the map and include a variety of national publicly available data (e.g., Health Resources and Services Administration Area Health Resources Files). Data are available at the county level. The years represented by the data are shown in the title bar.
• Medication Nonadherence, defined as a proportion of days a beneficiary was covered with medication of <80%, was assessed using prescription drug claims data among Medicare Advantage or Medicare fee-for-service beneficiaries aged ≥65 years with Medicare Part D coverage. More information is available at Vital Signs https://www.cdc.gov/vitalsigns/blood-pressure/index.html.
• Cardiac Rehabilitation Usage: Medicare fee-for-service beneficiaries aged ≥65 years were considered eligible for outpatient cardiac rehabilitation (CR) if they experience a qualifying event. Participation was defined as the percentage of CR eligible beneficiaries who participated in ≥1 CR sessions within 365 days of the qualifying event. Completion was defined as the percentage of those initiating participation who participated in ≥36 sessions. Mean number of sessions describes the number of sessions used by participants within 365 days of the qualifying event.
  • For more information on data sources and outcome calculations: https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.119.005902
  • For additional guidance on CR surveillance methodology: https://millionhearts.hhs.gov/files/Cardiac-Rehab-Use-Surveillance-Guidance-508.pdf [PDF – 255 KB]
  • For information on spatial smoothing and data suppression methods used for the Interactive Atlas of Heart Disease and Stroke, see the Statistical Methods section of these help pages.
• Hospitals are shown as the number of hospitals per county. Physicians and specialists and pharmacies are shown as either the population per physician or the number of pharmacies per population.

The data used are from the Centers for Medicare and Medicaid Services’ (CMS) Chronic Conditions Data Warehouse.

Learn more about the Health Care Costs data.

Data sources

• Federally Qualified Health Centers—Health Resources and Services Administration
• Hospitals—American Hospital Association
• Stroke Centers by Certification
  • DNV-GL
  • Healthcare Facilities Accreditation Program (HFAP)
  • The Joint Commission
• Congressional districts—US Census Bureau
• The American Indian/Alaska Native/Native Hawaiian (AIANNH) Areas Shapefile includes the following legal entities: federally recognized American Indian reservations and off-reservation trust land areas, state-recognized American Indian reservations, and Hawaiian home lands (HHLs). https://catalog.data.gov/dataset/tiger-line-shapefile-2017-nation-u-s-current-american-indian-alaska-native-native-hawaiian-area
• U.S.–Mexico Border Area – Counties included based on the 1983 La Paz Agreement (i.e., counties for each state fall within 100 kilometers of the Border).