State Data

References and Methodology for State Data

The sources for health, funding, and state economic facts come from a variety of publicly available sources.

Key Health Facts

Population Facts

U.S. Total Population estimates come from the U.S. Census Bureau, National and State Population Estimates, Annual Estimates of the Population for the United States, Regions, States, and Puerto Rico: April 1, 2001 to July 1, 2009, released December 2009 (accessed January 5, 2010).

Total Number of U.S. Uninsured, All Ages estimates come from the U.S. Census Bureau, Current Population Survey, Table HI06. Health Insurance Coverage Status by State for All People: 2008. (accessed December 11, 2009).

Total Number of Uninsured, 18 and under estimates come from the U.S. Census Bureau. Current Population Survey, Table HI05: Health Insurance Coverage Status and Type of Coverage by State and Age for All People: 2008 (accessed December 11, 2009).

Adult Health Facts

AIDS Cumulative Cases Aged 13 and Older 2007 Yr End data come from the U.S. Centers for Disease Control and Prevention, National Center for HIV, STD, and TB Prevention, Table 16, HIV/AIDS Surveillance Report: Cases of HIV Infection and AIDS in the United States, 2006, 2007 Cumulative (accessed December 11, 2009).

Alzheimer's Estimated Cases among 65+ (2010) data come from the Alzheimer's Association report Alzheimer's Disease Facts and Figures 2008 (accessed December 11, 2009).

Asthma 2006-2008 3 Yr Average data come from the BRFSS Prevalence Data 2006-2008, percent responding "ever been told" they have asthma. National Center for Chronic Disease Prevention & Health Promotion, Centers for Disease Control and Prevention. Available at http://apps.nccd.cdc.gov/brfss/index.asp

Breast Feeding Report Card 2006 data come from "Breastfeeding Report Card, United States: Outcome Indicators." CDC National Immunization Survey, Provisional Data, 2006 births.  (accessed November 2, 2009).

Cancer Estimated New Cases 2009 data come from the American Cancer Society's Cancer Facts and Figures 2009 (accessed December 3, 2009).

Chlamydia Rates per 100,000 Population (2008) data come from the Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, U.S. Centers for Disease Control and Prevention Sexually Transmitted Disease Surveillance, 2008, (accessed November 16, 2009).

Fruit and Vegetable Behavioral Indicator data come from the BRFSS Prevalence Data 2007, percent who consume the recommended 2+ and 3+ servings of fruit and vegetables daily.  "State Indicator Report on Fruits and Vegetables, 2009.  HHS."  (accessed November 9, 2009).

Human West Nile Virus Cases 2009 data come from the U.S. Centers for Disease Control and Prevention, Division of Vector-Borne Infectious Diseases (accessed December 4, 2009).

Pneumococcal Vaccination Rates 65 and Over 2006-2008 3 Yr Average data come from the BRFSS Prevalence Data 2006-2008.  National Center for Chronic Disease Prevention & Health Promotion, Centers for Disease Control and Prevention.  Available at http://apps.nccd.cdc.gov/brfss/index.asp

Syphilis Rates per 100,000 Population (2008) data come from the Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, U.S. Centers for Disease Control and Prevention Sexually Transmitted Disease Surveillance, 2008, November 2009 (accessed November 16, 2009).

Tobacco Use - Current Smokers 2006-2008 3 Yr Average data come from the BRFSS Prevalence Data 2006-2008, percent responding they are current smokers. National Center for Chronic Disease Prevention & Health Promotion, Centers for Disease Control and Prevention. Available at http://apps.nccd.cdc.gov/brfss/index.asp.

Tuberculosis (TB) Number of Cases 2008 data come from "Reported Tuberculosis in the United States, 2008," U.S. Centers for Disease Control and Prevention, September 2009 (accessed October 29, 2009).

Child and Adolescent Health Facts

AIDS Cumulative Cases Children Under 13 2007 data come from the U.S. Centers for Disease Control and Prevention, National Center for HIV, STD, and TB Prevention, Table 16, HIV/AIDS Surveillance Report: Cases of HIV Infection and AIDS in the United States, 2006, 2007 Cumulative (accessed October 29, 2009).

Asthma 2007 High School Students data come from the Youth Risk Behavior Surveillance System, Comprehensive Results 2007, percent responding "ever been told" they have asthma. National Center for Chronic Disease Prevention & Health Promotion, Centers for Disease Control and Prevention. Available at: http://www.cdc.gov/HealthyYouth/yrbs/index.htm. (accessed December 11, 2008).

Immunization Gap: Children Aged 19 to 35 Months without All Immunizations 2008 data come from Estimated Vaccination Coverage with Individual Vaccines and Selected Vaccination Series Among Children 19-35 Months of Age by State and Local Area U.S., National Immunization Survey, 2008 (accessed October 29, 2009). TFAH used the data for the 4:3:1:3:3:1 series which is the CDC-recommended series for children aged 19--35 months. The 4:3:1:3:3:1 series is used to evaluate progress toward one of the Healthy People 2010 objectives, which aims to achieve greater than 80% coverage with the series among children ages 19--35 months.

Infant Mortality per 1,000 Live Births 2006 data come from the National Center for Health Statistics, National Vital Statistics Report, Deaths: Final Data for 2006 (accessed October 30, 2009).

Low Birthweight Babies 2007 data come from the National Center for Health Statistics, National Vital Statistics Report, Births: Preliminary Data for 2007, State-specific Detailed Tables for 2007 (accessed January 15, 2010).

Pre-Term Births as Percent of Live Births 2007 data the National Center for Health Statistics, National Vital Statistics Report, Births: Preliminary Data for 2007 (accessed January 15, 2010).

Tobacco: Current Smokers High School Students 2007 data come from the Youth Risk Behavior Surveillance System, Comprehensive Results 2007, percent of "students who smoked cigarettes on one or more of the past 30 days." National Center for Chronic Disease Prevention & Health Promotion, Centers for Disease Control and Prevention. Available at http://www.cdc.gov/HealthyYouth/yrbs/index.htm. (accessed December 11, 2008). 

Other Public Health Indicators

Health Professions Shortage Areas: Primary Care, Mental Health, Dental Care FY 2009 data come from HRSA's Geospatial Data Warehouse, State Profile Report (accessed October 29, 2009).

Projected Supply vs. Demand for RNs (2010) data comes from the National Center for Health Workforce Analysis in the Bureau of Health Professions, Health Resources and Services Administration paper "What Is Behind HRSA's Projected Supply, Demand and Shortage of Registered Nurses?" Washington, D.C.: September 2004.

F as in Fat Key Facts

Obesity 2007-2009 3 Yr Average data were calculated by contractors using self-reported height and weight measure from the BRFSS Prevalence Data 2007-2009. National Center for Chronic Disease Prevention & Health Promotion, Centers for Disease Control and Prevention. Available at http://apps.nccd.cdc.gov/brfss/index.asp. Obesity was defined as having a BMI greater than or equal to 30.

Hypertension 2005-2009 3 Yr Average data come from the BRFSS Prevalence Data 2005-2009, percent responding "ever been told" they have high blood pressure. Hypertension data is collected only on odd-numbered years. To stabilize the data, researchers used combined data from 2005, 2007 and 2009. National Center for Chronic Disease Prevention & Health Promotion, Centers for Disease Control and Prevention. Available at http://apps.nccd.cdc.gov/brfss/index.asp.

Diabetes 2007-2009 3 Yr Average data come from the BRFSS Prevalence Data 2007-2009, percent responding "ever been told" they have diabetes. National Center for Chronic Disease Prevention & Health Promotion, Centers for Disease Control and Prevention. Available at http://apps.nccd.cdc.gov/brfss/index.asp.

Adult Physical Inactivity Rate 2007-2009 3 Yr Average data come from the BRFSS Prevalence Data 2007-2009, percent responding "did not engage in any physical activity". National Center for Chronic Disease Prevention & Health Promotion, Centers for Disease Control and Prevention. Available at http://apps.nccd.cdc.gov/brfss.index.asp

Obese High School Students 2009 data come from the Youth Risk Behavior Surveillance System, Comprehensive Results 2009. National Center for Chronic Disease Prevention & Health Promotion, Centers for Disease Control and Prevention. Available at http://www.cdc.gov/HealthyYouth/yrbs/index.htm.

Obese 10 to 17 Year Olds 2007 data come from the National Survey of Children's Health, 2007. Child and Adolescent Health Measurement Initiative. 2007 National Survey of Children's Health, Data Resource Center for Child and Adolescent Health website.  Available at http://www.nschdata.org/Content/Default.aspx (accessed July 6, 2009).

Cost of Obesity (2003) data are from "State-Level Estimates of Annual Medical Expenditures Attributable to Obesity," Obesity Research 12:1, January 2004. TFAH calculated the per capita figures based on state expenditures and population.

Public Health Preparedness Facts

Ready or Not 2009 Emergency Preparedness Indicators are from TFAH's Ready or Not 2009, Protecting the Public's Health from Disease, Disasters, and Bioterrorism, December 2009.

Pandemic Preparedness Key Facts are from TFAH's Pandemic Flu and Potential for U.S. Economic Recession, March 2007.

Public Health Funding Facts

Federal Budget Information

CDC Funds for State and Local Health Departments, Universities, & Other Public and Private Agencies FY 2009 data were all provided by the U.S. Centers for Disease Control and Prevention's Financial Management Office. The total (all categories) was also provided by the CDC; it includes program areas not highlighted here. CDC Per Capita Total FY 2009 calculated by TFAH by dividing CDC provided total by July 1, 2009 U.S. Census Bureau population estimates. CDC Per Capita Ranking based on TFAH calculated per capita totals.

HRSA Health Professions, HIV/AIDS, Maternal & Child Health, and Primary Health Care FY 2009 funding data come from HRSA's Geospatial Data Warehouse, State Profile Report (accessed September 2009.) The total HRSA dollar amount also came from this source. HRSA key program area totals, however, were calculated by TFAH using Microsoft Excel. HRSA Per Capita Total FY 2009 calculated by TFAH by dividing HRSA Total dollars by July 1, 2009 U.S. Census Bureau population estimates. HRSA Per Capita Ranking based on TFAH calculated per capita totals.

ASPR Hospital Preparedness Program FY 2009 funding from U.S. Department of Health and Human Services: Office fo the ASsistant Secretary for Preparedness and Response Office of Preparedness and Emergency Operations Division of National Healthcare Preparedness Programs.  "FY 09 Hospital Preparedness Program Funding Opportunity Announcement."  <!-- /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-parent:""; margin:0in; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman"; mso-fareast-font-family:"Times New Roman";} @page Section1 {size:8.5in 11.0in; margin:1.0in 1.25in 1.0in 1.25in; mso-header-margin:.5in; mso-footer-margin:.5in; mso-paper-source:0;} div.Section1 {page:Section1;} -->  

State Public Health Budgets

TFAH conducted an analysis of state spending on public health for the last budget cycle, fiscal year 2008-2009. For those states that only report their budgets in biennium cycles, the 2009-2011 period (or the 2008-2010 and 2009-2010 for Virginia and Wyoming respectively) was used, and the percent change was calculated from the last biennium, 2007-2009 (or 2006-2008 and 2007-2008 for Virginia and Wyoming respectively).

This analysis was conducted from August to October of 2009 using publicly available budget documents through state government web sites. Based on what was made publicly available, budget documents used included either executive budget document that listed actual expenditures, estimated expenditures, or final appropriations; appropriations bills enacted by the state's legislature; or documents from legislative analysis offices.

"Public health" is defined to broadly include all health spending with the exception of Medicaid, CHIP, or comparable health coverage programs for low-income residents. Federal funds, mental health funds, addiction or substance abuse-related funds, WIC funds, services related to developmental disabilities or severely disabled persons, and state-sponsored pharmaceutical programs also were not included in order to make the state-by-state comparison more accurate since many states receive federal money for these particular programs. In a few cases, state budget documents did not allow these programs, or other similar human services, to be disaggregated; these exceptions are noted. For most states, all state funding, regardless of general revenue or other state funds (e.g. dedicated revenue, fee revenue, etc.), was used. In some cases, only general revenue funds were used in order to separate out federal funds; these exceptions are also noted.  Because each state allocates and reports its budget in a unique way, comparisons across states are difficult. This methodology may include programs that, in come cases, the state may consider a public health function, but the methodology used was selected to maximize the ability to be consistent across states. As a result, there may be programs or items states may wish to be considered "public health" that may not be included in order to maintain the comparative value of the data.

Related State Economic Facts

Gross Domestic Product 2005 data are from TFAH's Pandemic Flu and Potential for U.S. Economic Recession, March 2007 (accessed September 23, 2007).

Median Family Income 2006 data are from U.S. Census Bureau, American Community Survey, Table B19119 "Median Family Income in the Past 12 Months" (accessed September 23, 2007).

Percent Living in Poverty, 2003-2005 three year average data are from U.S. Census Bureau, Table 8 "Percentage of People in Poverty by State Using 2- and 3-Year Averages: 2003 to 2005" (accessed September 23, 2007).

Top 5 Industries data are from TFAH's Pandemic Flu and Potential for U.S. Economic Recession, March 2007 (accessed September 23, 2007).

Note: The Behavioral Risk Factor Surveillance System (BRFSS) is a survey conducted by states annually and the data are reported to CDC. It is the largest phone survey in the world. All BRFSS statistics on TFAH's state pages use three years of combined data to "stabilize" yearly figures, since some state have different sample sizes. TFAH contracted with Daniel Eisenberg, PhD, Assistant Professor, and Edward Okeke, MBBS, Health Service Organization and Policy Doctoral Student, with the Department of Health Management and Policy at the University of Michigan School of Public Health to carry out this data analysis. U.S. Totals for BRFSS data are medians of the state surveys. There are often different surveys or studies conducted by CDC or other agencies at the U.S. Department of Health and Human Services which may have different national totals since they use different methodologies. Additional information about BRFSS can be found on the CDC's National Center for Chronic Disease Prevention & Health Promotion website.