Chapter 7.1 · The body keeps the address · Report

Health behaviors and the supply of care

In the most deprived tenth of census tracts, the modeled 2022 share of adults with a past-year dental visit was 24.4 points below the least deprived tenth, and the routine-checkup share 3.6 points above.

Author: Vishal Singh
Affiliation: NYU Stern
Published: 9 October 2026

Every estimate of the chapter with its interval and every figure as a table, generated from the chapter's data files. Table n of this report is figure n of the chapter. The same report as Markdown: report.md.

Identification

Title

Health behaviors and the supply of care

Label

The body keeps the address

Chapter

7.1 (Part VII, Health and care; An American life)

Question

How steeply do health behaviors and chronic conditions rise with neighborhood deprivation, and does the supply of doctors and dentists follow need?

Dek

Grain

neighborhoods

Status

published

Published

9 October 2026

Updated

not revised

Data sources

CDC PLACES. CDC PLACES 2024 release, census tracts: modeled prevalence among adults for 40 measures (BRFSS 2022; 2021 for four measures), crude prevalence; years: 2024 release (tracts); 2025 release (ZCTAs, 2023 data year); weights: adult population of each tract (PLACES)
Area Deprivation Index. Neighborhood Atlas Area Deprivation Index 2023, national percentile, tract and county (county mean of tract ranks); years: 2023 release (version 4.0.1; built on ACS 2019-2023); weights: adult population of each tract; ACS 2019-2023 population for county means
County Health Rankings. County Health Rankings 2024: provider counts (physicians 2021, dentists 2022, mental health providers 2023), preventable hospital stays 2021, food environment index 2019 and 2021, percent rural; years: 2024 release; weights: pooled ratios of counts; county population for county means and correlations
American Community Survey. ACS 2019-2023 tracts: median household income and the shares of residents who are ages 65 and over, Black alone and Hispanic; years: 2019-2023 (5-year); weights: none (controls and the income axis)

Canonical URL

https://vishalsingh.org/zipcode/health-behaviors-and-the-supply-of-care

Markdown

https://vishalsingh.org/zipcode/health-behaviors-and-the-supply-of-care/report.md

BibTeX

@misc{singh2026healthbehaviorsandthesupplyofcare,
  author = {Singh, Vishal},
  title = {Health behaviors and the supply of care},
  year = {2026},
  url = {https://vishalsingh.org/zipcode/health-behaviors-and-the-supply-of-care},
  note = {In ZIP Code Destiny. Published 9 October 2026.}
}

Principal estimates

The facts the dek and the opening prose cite, in order of appearance. Every fact is in the table of all estimates below.

Estimand	Population	Period	Value	Interval	n	Weights	Source	Fact id
difference between the weighted mean prevalence of the least deprived and the most deprived tenth of tracts by ADI national percentile, bootstrap interval over counties (draws shared by the two means)	adults: dental visit in the past year	BRFSS 2022 (PLACES 2024 release); ADI 2023	24.4	95% CI 22.5 to 26.5	8,213 tracts	adult population of the tract (PLACES)	CDC PLACES	flat_dental_delta
difference between the weighted mean prevalence of the least deprived and the most deprived tenth of tracts by ADI national percentile, bootstrap interval over counties (draws shared by the two means)	adults: routine checkup in the past year	BRFSS 2022 (PLACES 2024 release); ADI 2023	3.6	95% CI 2.4 to 4.6	8,213 tracts	adult population of the tract (PLACES)	CDC PLACES	flat_checkup_delta
weighted mean of the tract prevalence in a tenth of tracts (equal numbers of tracts), bootstrap interval over counties	adults in the most deprived tenth of tracts by ADI national percentile: dental visit in the past year	BRFSS 2022 (PLACES 2024 release); ADI 2023	45.8%	95% CI 45.0% to 46.6%	8,213 tracts	adult population of the tract (PLACES)	CDC PLACES	flat_dental_d10
weighted mean of the tract prevalence in a tenth of tracts (equal numbers of tracts), bootstrap interval over counties	adults in the least deprived tenth of tracts by ADI national percentile: dental visit in the past year	BRFSS 2022 (PLACES 2024 release); ADI 2023	70.3%	95% CI 68.5% to 72.1%	8,274 tracts	adult population of the tract (PLACES)	CDC PLACES	flat_dental_d1
weighted mean of the tract prevalence in a tenth of tracts (equal numbers of tracts), bootstrap interval over counties	adults in the most deprived tenth of tracts by ADI national percentile: routine checkup in the past year	BRFSS 2022 (PLACES 2024 release); ADI 2023	77.8%	95% CI 77.3% to 78.2%	8,213 tracts	adult population of the tract (PLACES)	CDC PLACES	checkup_hi
weighted mean of the tract prevalence in a tenth of tracts (equal numbers of tracts), bootstrap interval over counties	adults in the least deprived tenth of tracts by ADI national percentile: routine checkup in the past year	BRFSS 2022 (PLACES 2024 release); ADI 2023	74.2%	95% CI 73.2% to 75.3%	8,274 tracts	adult population of the tract (PLACES)	CDC PLACES	checkup_lo

Findings

The share of adults who visited a dentist in the past year was 45.8% in the most deprived tenth of census tracts and 70.3% in the least deprived tenth. The share who had a routine checkup in the past year went the other way, 77.8% in the most deprived tenth against 74.2% in the least deprived. Both are modeled estimates from the 2024 release of CDC PLACES, which uses survey responses from 2022, and the tenths rank tracts on the Area Deprivation Index (ADI).[1, 2] The chapter places those two measures among the other measures of health that rise with deprivation, the behaviors that sort by income, and the supply of physicians, dentists and mental health providers in deprived counties.

Health and access measures rise with deprivation, and the checkup rises least

The share of adults who smoke was 9.1% (95% CI 8.5% to 9.6%) in the least deprived tenth of tracts and 22.8% (95% CI 22.5% to 23.1%) in the most deprived, 2.5 (95% CI 2.4 to 2.7) times as high. The share with diagnosed diabetes rose from 9.5% to 17.5%.

PLACES estimates 83,522 tracts, and 82,781 of them have an ADI rank, so the 741 without one are left out. Tenths hold from 8,118 to 8,511 tracts, because tracts with tied ranks fall in the same tenth.

Table 1 follows 12 measures of health, behavior and access across the whole index. They are this book's selection from the 40 that PLACES publishes for tracts: conditions and behaviors that the first edition followed, insurance, food insecurity and the checkup. For 11 of the 12 measures, the largest step between neighboring twentieths of tracts is the last one, at the deprived end of the index.

For the 11 measures other than the annual checkup, the ratio of prevalence in the most deprived tenth to the least deprived runs from 1.25 (95% CI 1.21 to 1.30) (depression) to 3.6 (95% CI 3.1 to 4.1) (all teeth lost among adults ages 65 and over).

Table 1. 11 measures are at least 4.8 points more common in the most deprived tenth of tracts than in the least deprived, and the annual checkup is 3.6 points more common

Among the twelve, the annual checkup rises least in ratio terms. Its rate was 74.2% (95% CI 73.2% to 75.3%) in the least deprived tenth and 77.8% (95% CI 77.3% to 78.2%) in the most deprived, a ratio of 1.05 (95% CI 1.03 to 1.06). The next smallest ratio of the twelve is 1.25 for depression. Of all 40 PLACES measures, 34 are higher in the most deprived tenth, and the checkup has the smallest ratio of them, with 1.08 for blood pressure medicine next.

In points the ranking differs. The checkup rises 3.6 (95% CI 2.4 to 4.6) points, and 4 measures outside the twelve (asthma, stroke, high cholesterol and social isolation) rise by less. Depression rises by 4.8 (95% CI 4.1 to 5.6) points, close to the checkup in points but from a lower base. The second view of the figure, in multiples of the least deprived tenth, separates the two.

Part of every PLACES gradient in this chapter is built in. PLACES does not count anyone. It fits a model to responses from the Behavioral Risk Factor Surveillance System (BRFSS) and applies the model to each tract's population. The model uses county poverty, the age, sex, race and ethnicity of the tract's residents and their education, with state and county random effects. The inputs come from the census and the American Community Survey.[1] The Area Deprivation Index is built from American Community Survey data as well,[2] so part of the association between the model's estimates and the index is mechanical. The shared inputs do not guarantee a contrast between two measures, such as the checkup and the dental visit. The model can still produce one through the demographic mix of tracts, because the survey responses it is fitted to differ by age, race and education. Within a county, the model gives tracts different values only through the demographic composition of their residents. Slopes within counties, and in part slopes within states and the coefficient zoo, therefore show how the model maps composition and county inputs into prevalence, and not what the residents of those tracts do. The sections below ask how much of each pattern survives when the state, the county and part of the mix are held fixed.

The PLACES 2024 release uses BRFSS responses from 2022, and from 2021 for blood pressure, blood pressure medicine, high cholesterol and cholesterol screening. Values are crude prevalence among adults, so the age structure of a tract moves them. The tract file carries no intervals, and the bands in this chapter come from resampling counties.

Behaviors and conditions fall with income in every state except binge drinking, which rises

One reading of the gradient is that deprived places are sicker because their residents behave worse. The analysis uses 6 PLACES measures that bear on that reading, and they do not sort the same way. For each state, the prevalence of each across the state's tracts is regressed on the log of tract median household income, with the shares of residents who are older, Black and Hispanic held fixed, and each coefficient is scaled to a doubling of income. A set of such coefficients, 306 here, one per state and measure, is a coefficient zoo (Table 2), and Chapter 10.1, Gradients, slopes and variance takes up the method.

Smoking, obesity, diabetes, frequent mental distress and physical inactivity all have a negative slope in all 51 states. A doubling of tract income goes with a median of −4.7 points of smoking, −4.3 points of obesity and −6.7 points of physical inactivity.

For each of these five measures the interval lies below zero in at least 47 of the 51 states. Binge drinking has the opposite sign. Its slope is positive in 50 states, with a median of +1.2 points per doubling and an interval above zero in 41. Maryland is the one state with a negative estimate, and its interval includes zero.

Table 2. Binge drinking is higher in higher-income tracts in 50 of 51 states, while the other measures are lower in higher-income tracts in all 51 states

These are differences between tracts, and they do not say who drinks. Tracts with higher incomes have a higher modeled share of adults who binge drink, and tract values cannot show whether the drinkers are the high-income residents of those tracts. Survey estimates for individuals, with design-based intervals, are the subject of Chapter 7.2, Health behaviors, person by person. The PLACES model and the census income measure share inputs, so the coefficients show what those inputs and the survey responses give together. Whatever the model contributes, the six measures do not share one direction with income, and an index of deprivation does not rank places on all of them alike.

The annual checkup does not follow the gradient that the dental visit does

The checkup measures contact with a physician, and the dental visit measures routine dental care, which is mostly preventive. Table 3 plots both against the index. The dental visit rate falls from 70.3% (95% CI 68.5% to 72.1%) in the least deprived tenth of tracts to 45.8% (95% CI 45.0% to 46.6%) in the most deprived, 24.4 (95% CI 22.5 to 26.5) points lower. The checkup rate rises from 74.2% to 77.8%, 3.6 (95% CI 2.4 to 4.6) points higher. Across the most deprived tenth of the index the dental line falls fastest and the checkup line rises fastest.

Table 3. From the least to the most deprived tenth of tracts, the dental visit rate falls from 70.3% to 45.8% while the annual checkup rate rises from 74.2% to 77.8%

The same split appears across a wider ledger of care (Table 4). Among women ages 50 to 74, mammography is 7.0 (95% CI 6.3 to 7.8) points lower in the most deprived tenth. Cholesterol screening is 6.9 (95% CI 6.2 to 7.5) points lower, and colorectal cancer screening among adults ages 45 to 75 is 6.2 (95% CI 4.4 to 8.2) points lower.

Among adults ages 18 to 64, the share without health insurance is 17.4% (95% CI 16.1% to 18.9%) in the most deprived tenth against 6.3% (95% CI 5.7% to 6.8%) in the least deprived, 11.1 (95% CI 9.7 to 12.7) points higher.

The share of adults without reliable transportation is 9.7 (95% CI 9.0 to 10.5) points higher. Among adults with high blood pressure, the share taking medicine for it is 5.9 (95% CI 4.8 to 6.7) points higher, and the checkup, as above, is 3.6 points higher. Tract means weight each tract by all its adults, including for the measures that cover only some ages, because the file carries no population for them. The figure groups the measures as checkup and treatment, dental visit and screening, and barriers. The grouping is this book's, since PLACES files the checkup, blood pressure medicine, the dental visit and insurance together under prevention. Within it, the dental visit and the screening tests fall with deprivation, and the checkup and blood pressure medicine rise.

Table 4. In the most deprived tenth of tracts, the dental visit and screening tests are less common by 6.2 to 24.4 points and barriers to care are more common by 9.7 and 11.1 points

Within states and counties the checkup slope stays near zero

The national checkup difference could reflect where deprived tracts are, because the checkup rate differs across states. Table 5 compares four ways of drawing the slope across 82,779 tracts that have an ADI rank, both measures and the three census shares. Across all tracts, the checkup rate rises +0.41 (95% CI 0.29 to 0.54) points for each ten-point step in the ADI percentile. Within states, with a separate baseline for each state (state fixed effects), the slope is −0.01 (95% CI −0.08 to 0.05), and within counties it is −0.27 (95% CI −0.35 to −0.19), a decline. Holding the tract's shares of older, Black and Hispanic residents fixed within states gives −0.05 (95% CI −0.10 to 0.01).

The dental slope is −2.37 (95% CI −2.66 to −2.08) across all tracts, −2.97 (95% CI −3.14 to −2.80) within states, −3.86 (95% CI −3.99 to −3.73) within counties and −2.38 (95% CI −2.51 to −2.24) within states with the controls. Within a state or a county the checkup slope is at most 0.27 in size, and the smallest dental slope is 8.8 times as large.

Table 5. The checkup slope is within 0.5 points of zero in all four specifications, and the dental slope is between −2.37 and −3.86 points

Fitting the slope separately in each state gives the same contrast (Table 6). The dental slope is negative in 51 of 51 states and has an interval below zero in 50, with a median of −3.2 points per ten-point step. It is within 0.5 points of zero in 0 states.

The checkup slope is within 0.5 points of zero in 42 states, with a median of +0.03. It is not zero everywhere. The interval lies below zero in 18 states, above zero in 10 and across zero in 23.

The largest checkup estimate is +1.7 (95% CI 1.3 to 2.1) in the District of Columbia, which is a single county, so its interval is not clustered. Every state has at least 158 tracts, above the floor of 60 tracts for entering the comparison, so none is dropped.

Table 6. The dental visit rate falls with deprivation in all 51 states, and the checkup slope is within 0.5 points of zero in 42

None of this removes the model's inputs, and a slope within counties still shows how the model maps composition into prevalence. What the comparison does show is that two measures that share every input, the checkup and the dental visit, have slopes that differ in size by a factor of 8.8 or more in every specification that holds the state or county fixed.

The supply of providers is thinner in deprived counties

In 1971 the physician Julian Tudor Hart observed that the availability of good medical care tends to vary inversely with the need for it in the population served.[3] Read descriptively, the inverse care law predicts that counties with more deprivation, where measures of illness are higher, have fewer providers for their residents. County Health Rankings (CHR) counts providers by county: primary care physicians in 2021, dentists in 2022 and mental health providers in 2023.[4] Primary care physicians are practicing non-federal physicians in general practice, family medicine, internal medicine and pediatrics. Dentists are those with a National Provider Identifier. Mental health providers include psychiatrists, psychologists, social workers, counselors and therapists, and nurse practitioners who specialize in mental health. Across the 3,143 counties there is one primary care physician for every 1,334 residents, one dentist for every 1,361 and one mental health provider for every 319.

Ranking 3,128 counties on a county ADI, the population-weighted mean of tract ranks, and pooling each tenth, residents per primary care physician rise from 1,159 (95% CI 1,093 to 1,205) in the least deprived tenth of counties to 2,730 (95% CI 2,452 to 3,018) in the most deprived, a ratio of 2.4 (95% CI 2.1 to 2.6). For dentists the figures are 1,131 and 3,055, a ratio of 2.7 (95% CI 2.3 to 3.1).

For mental health providers they are 250 and 550, a ratio of 2.2 (95% CI 1.5 to 3.5). The most deprived tenth, though, has fewer residents per mental health provider than the ninth, and its interval is wide (Table 7).

Weighted by county residents, the county ADI correlates −0.41 (95% CI −0.46 to −0.35) with physicians per hundred thousand residents, −0.52 (95% CI −0.61 to −0.41) with dentists and −0.42 (95% CI −0.53 to −0.26) with mental health providers. Counting each county once, the correlations are −0.37 (95% CI −0.43 to −0.32), −0.35 (95% CI −0.45 to −0.27) and −0.33 (95% CI −0.44 to −0.23), smaller in size but still negative.

Table 7. Residents per primary care physician rise from 1,159 to 2,730 and per dentist from 1,131 to 3,055 between the least and most deprived tenths of counties

Residents per provider here is a county group's residents divided by its providers, so a county with no provider adds residents and no providers. CHR leaves the ratio blank for a county with no provider when its population is above 2,000 for physicians, 4,000 for dentists and 1,000 for mental health providers, and reports a rate of zero for smaller counties. The first edition of this book dropped the blank ones and averaged the county ratios. That average is larger in every tenth for all three provider types, because small counties with one or two providers have very large ratios.

Counties with no provider stay in these figures. Among all 3,143 counties there are 232 with no recorded primary care physician, 239 with no dentist and 216 with no mental health provider; the 15 counties without a deprivation rank are outside the tenths.

Table 8 maps residents per mental health provider. In 275 counties the ratio is above 3,200, and 91.6% of those counties are majority rural. Most lie in the South and the Midwest (96.0%). The 216 gray counties have no recorded provider, so the ratio is undefined for them and their supply is the thinnest of all.

Table 8. Residents per mental health provider exceed 3,200 in 275 counties, and 91.6% of those counties have a mostly rural population

Two other county measures move with the same index. Preventable hospital stays, admissions for conditions that outpatient care can often manage, were 2,370 (95% CI 2,188 to 2,599) per hundred thousand Medicare enrollees in the least deprived tenth of counties and 4,012 (95% CI 3,608 to 4,435) in the most deprived, and the county ADI correlates +0.46 (95% CI 0.31 to 0.56) with the rate, +0.38 (95% CI 0.30 to 0.46) counting each county once.

The CHR food environment index, a county score that combines access to healthy food with food insecurity and on which a higher value is better, falls from 8.6 (95% CI 8.5 to 8.8) to 6.1 (95% CI 5.7 to 6.6) across the same tenths, and correlates −0.66 (95% CI −0.74 to −0.59) with the county ADI, −0.51 (95% CI −0.58 to −0.45) counting each county once.

Evidence on coverage and capacity

Causal evidenceRandomized lottery; difference-in-differences

Coverage expansions and community health centers

The gradients above describe places. Four studies ask whether adding coverage or capacity changes the use of care and health for the people who gain it.

In 2008 Oregon drew names by lottery for the chance to apply for Medicaid, so the people selected could be compared with the people who were not. In the first year, Medicaid coverage raised the use of health care, including primary and preventive care, lowered out-of-pocket medical spending and medical debt, and improved self-reported health.[5] At the later follow-up, coverage raised the use of preventive services, raised the detection and management of diabetes and lowered the rate of positive screens for depression, but produced no significant change in measured blood pressure, cholesterol or glycated hemoglobin.[6]

Miller, Johnson and Wherry linked survey records to death records and compared near-elderly adults in states that expanded Medicaid under the Affordable Care Act with those in states that did not, before and after the expansions. This difference-in-differences design, checked with an event study of the years before the expansions, found lower annual mortality in the expansion states.[7] Bailey and Goodman-Bacon applied a difference-in-differences event study to the 1965 to 1974 rollout of community health centers, comparing counties that opened a center earlier with counties that opened one later, and found lower mortality among older adults in the counties that opened a center earlier.[8]

The Oregon and Medicaid studies change insurance coverage, which is not the same as changing the number of dentists or mental health providers in a county, and the health center study changes clinic capacity. The estimates apply to the people and years each study covers, and none of the four measures what adding providers to the counties in the figures would do.

Residents per primary care physician rise under all four rankings

Over the 3,125 counties that have all four rankings, the ADI baseline runs from 1,164 (95% CI 1,100 to 1,210) residents per primary care physician in the least deprived tenth of counties to 2,749 (95% CI 2,473 to 3,038) in the most deprived, with a rank correlation of +1.00 between tenth and ratio (Table 9). The standardized index, which applies the ADI's coefficients after standardizing each measure, gives 1,094 (95% CI 1,037 to 1,170) and 2,687 (95% CI 2,514 to 2,973), with a correlation of +0.99. Ranked by median household income the tenths run from 1,104 (95% CI 1,041 to 1,175) to 2,615 (95% CI 2,386 to 2,921), and ranked by the bachelor's degree share from 1,010 (95% CI 965 to 1,060) to 3,520 (95% CI 3,228 to 3,805). Under each ranking the two ends differ and the ratio rises steadily toward the deprived end, so none of the three alternatives changes the gradient under the book's rule (Chapter 9.1, How far one ranking goes).

Table 9. Residents per primary care physician is steadily worse toward the more deprived end under the ADI and under each of the three other rankings

What these data cannot show

PLACES values are modeled estimates, and the tract file has no intervals, so the bands in this chapter describe the sampling of counties and not the model's own uncertainty. The model and the Area Deprivation Index draw on overlapping census inputs, which builds part of each gradient into the numbers, and the data cannot say how much. The values are crude prevalence among adults and are not adjusted for age. CDC advises against using them to rank the overall health of an area or to track change at the local level, which this chapter does not do.[9] The slopes and coefficients compare tracts and say nothing about the behavior of a person. Within a county the model gives tracts different values only through their demographic composition, so the comparison of the checkup and the dental visit within counties cannot separate behavior from composition at all.

The checkup measure is the share of adults who report a routine checkup in the past year, and the dental measure is the share who report a dental visit. Neither says what happened at the visit, whether the care was timely or whether it was affordable. Dental coverage is a separate matter from medical coverage, and the chapter has no measure of it.

Provider counts locate providers where they practice and divide by residents. They do not measure capacity, wait times or whether a provider accepts a patient's insurance, and county averages hide deserts inside counties and care that crosses county lines. The three provider counts come from different years, 2021 to 2023, and the PLACES estimates describe 2022 on an index built from 2019 to 2023 census data, so the sources do not describe one moment. Connecticut appears in PLACES under planning-region codes, which serve as its counties for the bootstrap, and in CHR under its eight legacy counties. 15 small counties have no deprivation rank and are left out of the tenths in the provider figures, and Puerto Rico is covered by neither PLACES nor the maps.

The association between supply and deprivation could run in either direction or through a third factor such as rurality, and the figures do not separate them. The studies in the box concern coverage and clinic capacity, and none of them estimates how a change in the supply of providers would alter the county gradients.

Tables

Table 1. 11 measures are at least 4.8 points more common in the most deprived tenth of tracts than in the least deprived, and the annual checkup is 3.6 points more common

Adults with each condition or behavior, percentage points above the least deprived tenth of tracts, by twentieth of tracts ranked on the Area Deprivation Index national percentile, 2022

Measure	Mean ADI percentile	Prevalence (%)	Points above least deprived tenth	Lower limit of the 95% interval	Upper limit of the 95% interval	Multiple of least deprived tenth	Tracts
Diagnosed diabetes	3.5	9.1	−0.3	−0.5	−0.1	0.96	4,307
Diagnosed diabetes	8.7	9.9	0.4	0.2	0.6	1.04	3,967
Diagnosed diabetes	13.7	10.2	0.7	0.3	1.1	1.07	4,246
Diagnosed diabetes	18.5	10.5	1.1	0.5	1.6	1.11	3,872
Diagnosed diabetes	23.3	10.3	0.8	0.5	1.2	1.09	4,314
Diagnosed diabetes	28.2	10.6	1.1	0.7	1.7	1.12	4,197
Diagnosed diabetes	33.0	10.7	1.2	0.8	1.7	1.13	4,082
Diagnosed diabetes	37.7	11.0	1.5	1.1	2.0	1.16	4,179
Diagnosed diabetes	42.5	11.3	1.8	1.4	2.3	1.19	3,944
Diagnosed diabetes	47.3	11.6	2.1	1.7	2.6	1.22	4,245
Diagnosed diabetes	52.1	11.9	2.4	2.0	3.0	1.26	4,090
Diagnosed diabetes	56.8	12.3	2.8	2.3	3.3	1.29	4,228
Diagnosed diabetes	61.5	12.6	3.1	2.6	3.7	1.33	4,008
Diagnosed diabetes	66.2	13.0	3.5	3.0	4.1	1.37	4,297
Diagnosed diabetes	71.0	13.4	3.9	3.4	4.5	1.41	4,044
Diagnosed diabetes	75.8	13.8	4.4	3.9	4.9	1.46	4,194
Diagnosed diabetes	80.7	14.4	4.9	4.4	5.5	1.52	4,171
Diagnosed diabetes	85.9	15.2	5.7	5.2	6.3	1.60	4,183
Diagnosed diabetes	91.3	16.4	6.9	6.4	7.5	1.73	4,206
Diagnosed diabetes	97.1	18.9	9.5	8.9	10.1	2.00	4,007
Obesity	3.5	22.5	−1.4	−1.7	−1.1	0.94	4,307
Obesity	8.7	25.4	1.5	1.0	2.0	1.06	3,967
Obesity	13.7	27.4	3.5	2.9	4.2	1.15	4,246
Obesity	18.5	28.8	4.9	4.1	5.6	1.21	3,872
Obesity	23.3	29.8	6.0	5.1	6.7	1.25	4,314
Obesity	28.2	31.1	7.3	6.3	8.1	1.30	4,197
Obesity	33.0	31.7	7.9	7.0	8.7	1.33	4,082
Obesity	37.7	32.6	8.7	7.8	9.5	1.37	4,179
Obesity	42.5	33.5	9.6	8.7	10.4	1.40	3,944
Obesity	47.3	34.2	10.4	9.4	11.1	1.43	4,245
Obesity	52.1	35.0	11.1	10.2	11.9	1.47	4,090
Obesity	56.8	35.8	11.9	11.0	12.7	1.50	4,228
Obesity	61.5	36.4	12.5	11.6	13.3	1.53	4,008
Obesity	66.2	37.3	13.4	12.5	14.2	1.56	4,297
Obesity	71.0	38.0	14.2	13.3	15.0	1.59	4,044
Obesity	75.8	38.7	14.8	13.9	15.6	1.62	4,194
Obesity	80.7	39.6	15.8	14.9	16.6	1.66	4,171
Obesity	85.9	40.6	16.8	15.9	17.5	1.70	4,183
Obesity	91.3	42.3	18.4	17.5	19.2	1.77	4,206
Obesity	97.1	45.8	21.9	20.9	22.8	1.92	4,007
Current smoking	3.5	8.4	−0.6	−0.8	−0.4	0.93	4,307
Current smoking	8.7	9.7	0.7	0.5	0.9	1.07	3,967
Current smoking	13.7	10.5	1.4	0.8	1.8	1.16	4,246
Current smoking	18.5	11.0	2.0	1.4	2.5	1.22	3,872
Current smoking	23.3	11.3	2.2	1.6	2.7	1.25	4,314
Current smoking	28.2	11.9	2.9	2.3	3.5	1.32	4,197
Current smoking	33.0	12.3	3.3	2.7	3.8	1.36	4,082
Current smoking	37.7	13.0	3.9	3.3	4.5	1.43	4,179
Current smoking	42.5	13.5	4.5	3.9	5.0	1.49	3,944
Current smoking	47.3	14.2	5.2	4.6	5.7	1.57	4,245
Current smoking	52.1	14.8	5.7	5.2	6.3	1.63	4,090
Current smoking	56.8	15.4	6.3	5.8	6.9	1.70	4,228
Current smoking	61.5	16.0	6.9	6.4	7.5	1.76	4,008
Current smoking	66.2	16.8	7.7	7.2	8.3	1.85	4,297
Current smoking	71.0	17.4	8.3	7.8	8.9	1.92	4,044
Current smoking	75.8	18.1	9.1	8.5	9.6	2.00	4,194
Current smoking	80.7	19.0	9.9	9.3	10.4	2.09	4,171
Current smoking	85.9	20.0	10.9	10.3	11.5	2.20	4,183
Current smoking	91.3	21.4	12.3	11.7	12.9	2.36	4,206
Current smoking	97.1	24.6	15.5	14.8	16.2	2.71	4,007
Depression	3.5	19.3	−0.2	−0.5	0.0	0.99	4,307
Depression	8.7	19.8	0.3	0.0	0.6	1.01	3,967
Depression	13.7	20.4	0.8	0.4	1.3	1.04	4,246
Depression	18.5	20.7	1.1	0.7	1.6	1.06	3,872
Depression	23.3	21.3	1.8	1.2	2.4	1.09	4,314
Depression	28.2	21.4	1.9	1.2	2.5	1.09	4,197
Depression	33.0	21.7	2.2	1.5	2.9	1.11	4,082
Depression	37.7	22.0	2.4	1.8	3.1	1.12	4,179
Depression	42.5	22.2	2.6	1.9	3.3	1.13	3,944
Depression	47.3	22.5	3.0	2.3	3.7	1.15	4,245
Depression	52.1	22.8	3.2	2.5	4.0	1.17	4,090
Depression	56.8	23.1	3.5	2.8	4.2	1.18	4,228
Depression	61.5	23.2	3.6	2.9	4.4	1.19	4,008
Depression	66.2	23.5	4.0	3.3	4.7	1.20	4,297
Depression	71.0	23.7	4.2	3.5	4.9	1.22	4,044
Depression	75.8	24.0	4.4	3.7	5.2	1.23	4,194
Depression	80.7	24.2	4.7	4.0	5.4	1.24	4,171
Depression	85.9	24.4	4.9	4.2	5.6	1.25	4,183
Depression	91.3	24.4	4.9	4.2	5.6	1.25	4,206
Depression	97.1	24.3	4.8	4.1	5.6	1.25	4,007
Frequent mental distress	3.5	13.4	−0.4	−0.6	−0.2	0.97	4,307
Frequent mental distress	8.7	14.3	0.5	0.3	0.7	1.03	3,967
Frequent mental distress	13.7	15.0	1.1	0.7	1.5	1.08	4,246
Frequent mental distress	18.5	15.3	1.5	1.0	2.0	1.11	3,872
Frequent mental distress	23.3	15.5	1.7	1.3	2.0	1.12	4,314
Frequent mental distress	28.2	15.7	1.9	1.4	2.3	1.13	4,197
Frequent mental distress	33.0	15.9	2.1	1.6	2.5	1.15	4,082
Frequent mental distress	37.7	16.2	2.4	1.9	2.9	1.17	4,179
Frequent mental distress	42.5	16.5	2.6	2.2	3.1	1.19	3,944
Frequent mental distress	47.3	16.7	2.9	2.5	3.4	1.21	4,245
Frequent mental distress	52.1	17.1	3.3	2.9	3.8	1.24	4,090
Frequent mental distress	56.8	17.4	3.5	3.1	4.0	1.25	4,228
Frequent mental distress	61.5	17.7	3.9	3.4	4.3	1.28	4,008
Frequent mental distress	66.2	18.0	4.2	3.8	4.7	1.30	4,297
Frequent mental distress	71.0	18.4	4.5	4.1	5.0	1.33	4,044
Frequent mental distress	75.8	18.7	4.9	4.5	5.4	1.35	4,194
Frequent mental distress	80.7	19.0	5.2	4.8	5.7	1.37	4,171
Frequent mental distress	85.9	19.5	5.7	5.3	6.2	1.41	4,183
Frequent mental distress	91.3	20.3	6.4	6.0	6.9	1.46	4,206
Frequent mental distress	97.1	21.9	8.1	7.6	8.6	1.58	4,007
No leisure-time physical activity	3.5	16.8	−1.0	−1.5	−0.5	0.94	4,307
No leisure-time physical activity	8.7	18.9	1.1	0.5	1.5	1.06	3,967
No leisure-time physical activity	13.7	19.8	2.0	0.6	3.3	1.11	4,246
No leisure-time physical activity	18.5	20.8	3.0	1.3	4.6	1.17	3,872
No leisure-time physical activity	23.3	20.5	2.7	1.2	3.9	1.15	4,314
No leisure-time physical activity	28.2	21.4	3.5	2.0	5.3	1.20	4,197
No leisure-time physical activity	33.0	21.5	3.7	2.3	5.0	1.21	4,082
No leisure-time physical activity	37.7	22.3	4.5	3.1	5.9	1.25	4,179
No leisure-time physical activity	42.5	23.0	5.2	3.8	6.6	1.29	3,944
No leisure-time physical activity	47.3	23.8	6.0	4.5	7.3	1.33	4,245
No leisure-time physical activity	52.1	24.7	6.9	5.5	8.3	1.39	4,090
No leisure-time physical activity	56.8	25.4	7.6	6.2	9.0	1.43	4,228
No leisure-time physical activity	61.5	26.3	8.5	7.1	9.9	1.48	4,008
No leisure-time physical activity	66.2	27.3	9.5	8.1	10.9	1.53	4,297
No leisure-time physical activity	71.0	28.2	10.4	9.0	11.8	1.59	4,044
No leisure-time physical activity	75.8	29.2	11.4	10.1	12.8	1.64	4,194
No leisure-time physical activity	80.7	30.4	12.6	11.2	14.0	1.71	4,171
No leisure-time physical activity	85.9	32.0	14.2	12.8	15.6	1.80	4,183
No leisure-time physical activity	91.3	34.3	16.5	15.1	17.9	1.93	4,206
No leisure-time physical activity	97.1	38.7	20.9	19.5	22.3	2.17	4,007
Short sleep duration	3.5	31.9	−0.8	−1.1	−0.5	0.97	4,307
Short sleep duration	8.7	33.6	0.9	0.5	1.3	1.03	3,967
Short sleep duration	13.7	34.2	1.5	0.5	2.2	1.04	4,246
Short sleep duration	18.5	34.6	1.8	0.7	2.8	1.06	3,872
Short sleep duration	23.3	34.4	1.6	0.5	2.7	1.05	4,314
Short sleep duration	28.2	34.7	2.0	0.8	3.2	1.06	4,197
Short sleep duration	33.0	34.8	2.1	0.9	3.2	1.06	4,082
Short sleep duration	37.7	35.3	2.6	1.4	3.8	1.08	4,179
Short sleep duration	42.5	35.5	2.8	1.6	4.0	1.09	3,944
Short sleep duration	47.3	35.9	3.2	2.0	4.3	1.10	4,245
Short sleep duration	52.1	36.4	3.7	2.5	4.9	1.11	4,090
Short sleep duration	56.8	36.7	4.0	2.8	5.2	1.12	4,228
Short sleep duration	61.5	37.2	4.5	3.2	5.6	1.14	4,008
Short sleep duration	66.2	37.5	4.8	3.6	6.0	1.15	4,297
Short sleep duration	71.0	38.0	5.3	4.1	6.5	1.16	4,044
Short sleep duration	75.8	38.4	5.7	4.5	6.9	1.18	4,194
Short sleep duration	80.7	38.9	6.2	5.0	7.4	1.19	4,171
Short sleep duration	85.9	39.7	7.0	5.8	8.2	1.21	4,183
Short sleep duration	91.3	41.1	8.4	7.2	9.6	1.26	4,206
Short sleep duration	97.1	44.4	11.7	10.5	13.1	1.36	4,007
Food insecurity	3.5	8.3	−1.0	−1.7	−0.3	0.89	3,228
Food insecurity	8.7	10.5	1.2	0.3	1.9	1.13	2,713
Food insecurity	13.7	12.3	2.9	1.1	4.9	1.31	2,931
Food insecurity	18.5	13.4	4.1	1.8	6.6	1.44	2,860
Food insecurity	23.3	12.4	3.0	1.8	4.7	1.32	3,253
Food insecurity	28.2	12.4	3.0	2.1	4.2	1.32	3,173
Food insecurity	33.0	12.8	3.5	2.5	4.9	1.38	3,183
Food insecurity	37.7	13.6	4.3	3.0	6.0	1.46	3,348
Food insecurity	42.5	14.1	4.8	3.6	6.4	1.51	3,125
Food insecurity	47.3	14.6	5.3	3.9	7.0	1.57	3,362
Food insecurity	52.1	15.4	6.1	4.7	7.8	1.65	3,211
Food insecurity	56.8	15.9	6.6	5.1	8.4	1.71	3,394
Food insecurity	61.5	16.9	7.5	6.0	9.3	1.80	3,104
Food insecurity	66.2	17.6	8.2	6.6	10.2	1.88	3,329
Food insecurity	71.0	18.3	9.0	7.5	10.7	1.96	3,194
Food insecurity	75.8	19.4	10.0	8.5	11.8	2.08	3,238
Food insecurity	80.7	20.2	10.8	9.3	12.6	2.16	3,183
Food insecurity	85.9	22.1	12.8	11.3	14.5	2.37	3,193
Food insecurity	91.3	25.7	16.4	14.8	18.3	2.75	3,247
Food insecurity	97.1	33.8	24.4	22.7	26.3	3.62	3,101
No health insurance, ages 18 to 64	3.5	5.6	−0.8	−1.1	−0.4	0.88	4,307
No health insurance, ages 18 to 64	8.7	7.1	0.8	0.4	1.2	1.13	3,967
No health insurance, ages 18 to 64	13.7	8.2	1.9	0.8	3.0	1.29	4,246
No health insurance, ages 18 to 64	18.5	9.3	3.0	1.7	4.6	1.48	3,872
No health insurance, ages 18 to 64	23.3	9.1	2.8	1.8	3.8	1.44	4,314
No health insurance, ages 18 to 64	28.2	9.7	3.4	2.5	4.3	1.54	4,197
No health insurance, ages 18 to 64	33.0	10.0	3.7	2.9	4.5	1.58	4,082
No health insurance, ages 18 to 64	37.7	10.6	4.3	3.4	5.3	1.68	4,179
No health insurance, ages 18 to 64	42.5	11.0	4.7	3.8	5.6	1.74	3,944
No health insurance, ages 18 to 64	47.3	11.2	4.9	4.0	5.8	1.77	4,245
No health insurance, ages 18 to 64	52.1	11.8	5.5	4.5	6.5	1.87	4,090
No health insurance, ages 18 to 64	56.8	12.1	5.8	4.7	6.9	1.92	4,228
No health insurance, ages 18 to 64	61.5	12.8	6.5	5.3	7.7	2.03	4,008
No health insurance, ages 18 to 64	66.2	12.8	6.5	5.3	7.8	2.02	4,297
No health insurance, ages 18 to 64	71.0	13.1	6.8	5.7	8.1	2.08	4,044
No health insurance, ages 18 to 64	75.8	13.6	7.3	6.1	8.7	2.16	4,194
No health insurance, ages 18 to 64	80.7	13.9	7.6	6.5	8.9	2.21	4,171
No health insurance, ages 18 to 64	85.9	14.8	8.4	7.3	9.8	2.34	4,183
No health insurance, ages 18 to 64	91.3	16.5	10.2	8.7	11.9	2.62	4,206
No health insurance, ages 18 to 64	97.1	18.5	12.2	10.8	14.0	2.94	4,007
All teeth lost, ages 65 and over	3.5	6.6	−0.6	−0.9	−0.3	0.92	4,307
All teeth lost, ages 65 and over	8.7	7.8	0.7	0.3	0.9	1.09	3,967
All teeth lost, ages 65 and over	13.7	8.5	1.4	0.2	2.3	1.19	4,246
All teeth lost, ages 65 and over	18.5	9.2	2.0	0.7	3.0	1.28	3,872
All teeth lost, ages 65 and over	23.3	9.3	2.1	0.9	3.1	1.29	4,314
All teeth lost, ages 65 and over	28.2	9.9	2.7	1.4	3.9	1.37	4,197
All teeth lost, ages 65 and over	33.0	10.1	2.9	1.8	3.7	1.40	4,082
All teeth lost, ages 65 and over	37.7	10.6	3.4	2.2	4.3	1.48	4,179
All teeth lost, ages 65 and over	42.5	11.3	4.1	2.9	5.0	1.57	3,944
All teeth lost, ages 65 and over	47.3	11.9	4.7	3.6	5.7	1.66	4,245
All teeth lost, ages 65 and over	52.1	12.7	5.5	4.4	6.5	1.77	4,090
All teeth lost, ages 65 and over	56.8	13.4	6.3	5.1	7.2	1.87	4,228
All teeth lost, ages 65 and over	61.5	14.3	7.1	5.9	8.0	1.98	4,008
All teeth lost, ages 65 and over	66.2	15.3	8.1	6.9	9.1	2.13	4,297
All teeth lost, ages 65 and over	71.0	16.2	9.0	7.8	9.9	2.25	4,044
All teeth lost, ages 65 and over	75.8	17.4	10.2	9.1	11.1	2.42	4,194
All teeth lost, ages 65 and over	80.7	18.5	11.3	10.1	12.2	2.57	4,171
All teeth lost, ages 65 and over	85.9	20.3	13.1	12.0	14.0	2.83	4,183
All teeth lost, ages 65 and over	91.3	23.0	15.8	14.6	16.7	3.20	4,206
All teeth lost, ages 65 and over	97.1	29.5	22.3	21.1	23.4	4.11	4,007
Fair or poor health	3.5	12.7	−0.8	−1.2	−0.3	0.94	4,307
Fair or poor health	8.7	14.3	0.8	0.3	1.2	1.06	3,967
Fair or poor health	13.7	15.2	1.7	0.6	2.9	1.13	4,246
Fair or poor health	18.5	16.1	2.7	1.2	4.3	1.20	3,872
Fair or poor health	23.3	15.7	2.2	1.2	3.2	1.16	4,314
Fair or poor health	28.2	16.2	2.8	1.7	4.1	1.21	4,197
Fair or poor health	33.0	16.2	2.8	1.9	3.8	1.21	4,082
Fair or poor health	37.7	16.9	3.4	2.5	4.5	1.25	4,179
Fair or poor health	42.5	17.4	3.9	3.0	5.0	1.29	3,944
Fair or poor health	47.3	18.0	4.5	3.6	5.6	1.33	4,245
Fair or poor health	52.1	18.7	5.2	4.3	6.3	1.39	4,090
Fair or poor health	56.8	19.3	5.8	4.9	7.0	1.43	4,228
Fair or poor health	61.5	20.2	6.7	5.7	7.8	1.50	4,008
Fair or poor health	66.2	20.9	7.5	6.5	8.6	1.55	4,297
Fair or poor health	71.0	21.7	8.2	7.3	9.3	1.61	4,044
Fair or poor health	75.8	22.7	9.2	8.3	10.4	1.69	4,194
Fair or poor health	80.7	23.7	10.3	9.3	11.4	1.76	4,171
Fair or poor health	85.9	25.3	11.9	10.9	13.0	1.88	4,183
Fair or poor health	91.3	27.8	14.4	13.3	15.6	2.07	4,206
Fair or poor health	97.1	32.9	19.5	18.4	20.6	2.45	4,007
Annual checkup	3.5	74.0	−0.1	−0.6	0.4	1.00	4,307
Annual checkup	8.7	74.3	0.1	−0.4	0.8	1.00	3,967
Annual checkup	13.7	74.3	0.2	−0.7	1.2	1.00	4,246
Annual checkup	18.5	74.2	0.1	−0.9	1.2	1.00	3,872
Annual checkup	23.3	74.5	0.3	−0.6	1.3	1.00	4,314
Annual checkup	28.2	74.8	0.7	−0.4	1.7	1.01	4,197
Annual checkup	33.0	74.8	0.7	−0.4	1.6	1.01	4,082
Annual checkup	37.7	75.0	0.8	−0.3	1.8	1.01	4,179
Annual checkup	42.5	75.3	1.1	0.0	2.1	1.01	3,944
Annual checkup	47.3	75.6	1.5	0.3	2.5	1.02	4,245
Annual checkup	52.1	75.7	1.6	0.4	2.5	1.02	4,090
Annual checkup	56.8	76.0	1.8	0.7	2.8	1.02	4,228
Annual checkup	61.5	76.0	1.9	0.7	2.9	1.02	4,008
Annual checkup	66.2	76.4	2.2	1.1	3.2	1.03	4,297
Annual checkup	71.0	76.6	2.4	1.2	3.4	1.03	4,044
Annual checkup	75.8	76.7	2.5	1.4	3.5	1.03	4,194
Annual checkup	80.7	77.0	2.9	1.7	3.9	1.04	4,171
Annual checkup	85.9	77.2	3.1	1.9	4.1	1.04	4,183
Annual checkup	91.3	77.4	3.3	2.1	4.3	1.04	4,206
Annual checkup	97.1	78.2	4.0	2.8	5.0	1.05	4,007

Views: Points above the least deprived tenth (every row); Multiple of the least deprived tenth (every row).

Note: PLACES values are modeled estimates. They are built from BRFSS survey responses with census and American Community Survey inputs (county poverty, the age, sex, race and ethnicity of each tract's residents, and education), with state and county random effects, and the Area Deprivation Index is built from American Community Survey data too, so part of each gradient here is mechanical. Within a county, tract values differ through the demographic composition of tracts. The tract file has no intervals; the bands are 95% intervals for the weighted mean from a bootstrap over counties (replicates and seed in the methods note).

Note: PLACES 2024 release: BRFSS 2022 for most measures and BRFSS 2021 for blood pressure, blood pressure medicine, high cholesterol and cholesterol screening. Values are crude prevalence among adults, not age-adjusted, so differences in age structure move them.

Note: The zero line is the weighted mean of the least deprived tenth of tracts. Tenths hold 8,118 to 8,511 tracts, because tied ranks fall in the same tenth, and twentieths hold fewer, so the first points sit slightly below the line. The food insecurity panel covers fewer tracts, because that question was asked in only some states, so its first points reflect which states fall in each twentieth.

Note: The twelve measures are this book's selection from the 40 that PLACES publishes for tracts: conditions and behaviors that the first edition followed, insurance and food insecurity, and the checkup. Tract means weight each tract by all its adults, including for the measures that cover only some ages, such as insurance and tooth loss, because the file carries no population for them.

Note: Panel scales are shared, so the prevalence in each twentieth is in the table under Show data.

Source: CDC PLACES 2024 release (BRFSS 2022) and Area Deprivation Index 2023; modeled estimates, population-weighted (adults in each tract)

Data: vishalsingh.org/zipcode/report/health-behaviors-and-the-supply-of-care/figures/twelve_outcome_gradients.json

Table 2. Binge drinking is higher in higher-income tracts in 50 of 51 states, while the other measures are lower in higher-income tracts in all 51 states

Points of prevalence per doubling of tract median household income, one dot per state and measure, adults, with controls for the age, Black and Hispanic shares of residents, 2022

Behavior	State	Points per doubling	Lower limit of the 95% interval	Upper limit of the 95% interval	Tracts
Current smoking	Alabama	−5.29	−6.54	−4.05	1,423
Current smoking	Alaska	−8.13	−10.80	−5.45	173
Current smoking	Arizona	−5.12	−7.05	−3.18	1,725
Current smoking	Arkansas	−6.01	−7.17	−4.85	818
Current smoking	California	−3.66	−4.10	−3.23	9,003
Current smoking	Colorado	−2.88	−3.61	−2.15	1,423
Current smoking	Connecticut	−3.76	−4.87	−2.65	870
Current smoking	Delaware	−3.63	−5.14	−2.13	256
Current smoking	District of Columbia	−2.38	−3.45	−1.32	201
Current smoking	Florida	−4.95	−5.54	−4.36	5,053
Current smoking	Georgia	−5.70	−6.27	−5.14	2,766
Current smoking	Hawaii	−3.96	−4.52	−3.40	419
Current smoking	Idaho	−3.30	−4.00	−2.59	453
Current smoking	Illinois	−4.67	−5.93	−3.42	3,239
Current smoking	Indiana	−5.07	−6.55	−3.60	1,678
Current smoking	Iowa	−4.47	−5.64	−3.31	890
Current smoking	Kansas	−5.16	−6.46	−3.87	811
Current smoking	Kentucky	−7.14	−7.89	−6.38	1,287
Current smoking	Louisiana	−6.01	−6.60	−5.43	1,352
Current smoking	Maine	−5.80	−6.68	−4.91	399
Current smoking	Maryland	−4.84	−5.75	−3.92	1,449
Current smoking	Massachusetts	−3.95	−5.70	−2.20	1,585
Current smoking	Michigan	−5.85	−6.69	−5.01	2,869
Current smoking	Minnesota	−4.56	−5.34	−3.78	1,497
Current smoking	Mississippi	−5.77	−7.25	−4.29	865
Current smoking	Missouri	−6.34	−7.36	−5.31	1,644
Current smoking	Montana	−6.65	−8.29	−5.00	315
Current smoking	Nebraska	−3.80	−4.23	−3.37	550
Current smoking	Nevada	−4.54	−5.64	−3.44	767
Current smoking	New Hampshire	−4.38	−5.14	−3.62	347
Current smoking	New Jersey	−4.31	−4.87	−3.75	2,154
Current smoking	New Mexico	−6.93	−8.55	−5.31	594
Current smoking	New York	−4.70	−5.23	−4.17	5,182
Current smoking	North Carolina	−5.40	−6.02	−4.78	2,628
Current smoking	North Dakota	−4.04	−6.23	−1.86	227
Current smoking	Ohio	−6.77	−7.24	−6.30	3,129
Current smoking	Oklahoma	−6.30	−7.23	−5.36	1,189
Current smoking	Oregon	−4.57	−5.48	−3.66	991
Current smoking	Pennsylvania	−5.51	−5.98	−5.05	3,377
Current smoking	Rhode Island	−4.53	−5.11	−3.94	246
Current smoking	South Carolina	−5.61	−6.44	−4.78	1,301
Current smoking	South Dakota	−7.73	−10.72	−4.74	242
Current smoking	Tennessee	−6.64	−7.92	−5.36	1,675
Current smoking	Texas	−4.35	−4.98	−3.73	6,802
Current smoking	Utah	−1.76	−2.66	−0.86	707
Current smoking	Vermont	−3.95	−5.08	−2.83	192
Current smoking	Virginia	−4.66	−5.25	−4.07	2,152
Current smoking	Washington	−3.93	−4.54	−3.32	1,767
Current smoking	West Virginia	−5.86	−7.73	−3.99	543
Current smoking	Wisconsin	−4.04	−4.66	−3.42	1,523
Current smoking	Wyoming	−2.44	−5.45	0.56	159
Obesity	Alabama	−4.19	−5.38	−3.00	1,423
Obesity	Alaska	−5.44	−6.79	−4.08	173
Obesity	Arizona	−2.94	−4.29	−1.60	1,725
Obesity	Arkansas	−4.27	−5.48	−3.06	818
Obesity	California	−4.02	−5.36	−2.69	9,003
Obesity	Colorado	−1.90	−3.21	−0.58	1,423
Obesity	Connecticut	−5.18	−7.75	−2.61	870
Obesity	Delaware	−3.57	−4.88	−2.26	256
Obesity	District of Columbia	−1.46	−2.58	−0.33	201
Obesity	Florida	−5.09	−5.94	−4.24	5,053
Obesity	Georgia	−6.05	−7.26	−4.83	2,766
Obesity	Hawaii	−3.12	−3.40	−2.84	419
Obesity	Idaho	−3.29	−4.95	−1.62	453
Obesity	Illinois	−4.31	−5.85	−2.77	3,239
Obesity	Indiana	−3.79	−5.61	−1.96	1,678
Obesity	Iowa	−3.37	−4.61	−2.12	890
Obesity	Kansas	−4.54	−5.89	−3.19	811
Obesity	Kentucky	−5.33	−6.31	−4.34	1,287
Obesity	Louisiana	−5.19	−6.09	−4.30	1,352
Obesity	Maine	−6.92	−8.25	−5.60	399
Obesity	Maryland	−5.11	−7.78	−2.45	1,449
Obesity	Massachusetts	−3.57	−5.94	−1.20	1,585
Obesity	Michigan	−5.40	−6.53	−4.27	2,869
Obesity	Minnesota	−5.36	−6.53	−4.18	1,497
Obesity	Mississippi	−4.27	−5.67	−2.86	865
Obesity	Missouri	−4.95	−6.98	−2.93	1,644
Obesity	Montana	−5.67	−8.49	−2.85	315
Obesity	Nebraska	−3.15	−4.74	−1.56	550
Obesity	Nevada	−3.67	−4.87	−2.48	767
Obesity	New Hampshire	−2.80	−4.04	−1.56	347
Obesity	New Jersey	−5.19	−6.17	−4.22	2,154
Obesity	New Mexico	−5.71	−6.82	−4.61	594
Obesity	New York	−5.19	−6.80	−3.59	5,182
Obesity	North Carolina	−4.68	−5.96	−3.40	2,628
Obesity	North Dakota	−2.65	−4.32	−0.98	227
Obesity	Ohio	−5.73	−6.28	−5.18	3,129
Obesity	Oklahoma	−4.94	−6.09	−3.79	1,189
Obesity	Oregon	−3.21	−4.36	−2.07	991
Obesity	Pennsylvania	−4.76	−5.47	−4.05	3,377
Obesity	Rhode Island	−3.64	−5.39	−1.90	246
Obesity	South Carolina	−5.64	−6.83	−4.46	1,301
Obesity	South Dakota	−4.30	−5.52	−3.08	242
Obesity	Tennessee	−5.61	−7.06	−4.16	1,675
Obesity	Texas	−3.87	−4.48	−3.25	6,802
Obesity	Utah	−1.56	−2.61	−0.51	707
Obesity	Vermont	−3.52	−4.60	−2.43	192
Obesity	Virginia	−4.49	−5.82	−3.17	2,152
Obesity	Washington	−5.22	−7.57	−2.88	1,767
Obesity	West Virginia	−3.40	−4.67	−2.14	543
Obesity	Wisconsin	−3.44	−4.32	−2.57	1,523
Obesity	Wyoming	−3.13	−7.58	1.33	159
Diagnosed diabetes	Alabama	−2.33	−3.32	−1.34	1,423
Diagnosed diabetes	Alaska	−2.87	−3.89	−1.84	173
Diagnosed diabetes	Arizona	−2.22	−3.76	−0.69	1,725
Diagnosed diabetes	Arkansas	−2.85	−3.87	−1.84	818
Diagnosed diabetes	California	−1.35	−1.71	−0.98	9,003
Diagnosed diabetes	Colorado	−0.76	−1.28	−0.25	1,423
Diagnosed diabetes	Connecticut	−1.76	−2.78	−0.74	870
Diagnosed diabetes	Delaware	−0.86	−2.34	0.62	256
Diagnosed diabetes	District of Columbia	−0.39	−0.92	0.13	201
Diagnosed diabetes	Florida	−2.46	−3.01	−1.90	5,053
Diagnosed diabetes	Georgia	−2.57	−3.04	−2.09	2,766
Diagnosed diabetes	Hawaii	−1.82	−2.94	−0.70	419
Diagnosed diabetes	Idaho	−1.23	−2.01	−0.46	453
Diagnosed diabetes	Illinois	−1.71	−2.59	−0.83	3,239
Diagnosed diabetes	Indiana	−1.57	−2.43	−0.72	1,678
Diagnosed diabetes	Iowa	−1.28	−2.25	−0.31	890
Diagnosed diabetes	Kansas	−1.75	−2.43	−1.07	811
Diagnosed diabetes	Kentucky	−3.07	−3.50	−2.63	1,287
Diagnosed diabetes	Louisiana	−3.08	−3.65	−2.51	1,352
Diagnosed diabetes	Maine	−2.38	−2.91	−1.86	399
Diagnosed diabetes	Maryland	−1.72	−2.41	−1.03	1,449
Diagnosed diabetes	Massachusetts	−1.43	−2.19	−0.66	1,585
Diagnosed diabetes	Michigan	−2.11	−2.63	−1.60	2,869
Diagnosed diabetes	Minnesota	−1.59	−1.96	−1.22	1,497
Diagnosed diabetes	Mississippi	−3.08	−4.13	−2.04	865
Diagnosed diabetes	Missouri	−2.30	−2.85	−1.76	1,644
Diagnosed diabetes	Montana	−2.87	−3.85	−1.90	315
Diagnosed diabetes	Nebraska	−0.99	−1.47	−0.52	550
Diagnosed diabetes	Nevada	−2.04	−2.93	−1.14	767
Diagnosed diabetes	New Hampshire	−1.35	−1.94	−0.75	347
Diagnosed diabetes	New Jersey	−1.46	−1.94	−0.99	2,154
Diagnosed diabetes	New Mexico	−3.61	−4.53	−2.69	594
Diagnosed diabetes	New York	−2.24	−2.87	−1.61	5,182
Diagnosed diabetes	North Carolina	−2.41	−2.95	−1.87	2,628
Diagnosed diabetes	North Dakota	−1.70	−3.17	−0.23	227
Diagnosed diabetes	Ohio	−2.58	−2.99	−2.18	3,129
Diagnosed diabetes	Oklahoma	−2.95	−3.68	−2.23	1,189
Diagnosed diabetes	Oregon	−1.38	−2.13	−0.62	991
Diagnosed diabetes	Pennsylvania	−1.91	−2.22	−1.59	3,377
Diagnosed diabetes	Rhode Island	−2.01	−2.55	−1.47	246
Diagnosed diabetes	South Carolina	−2.82	−3.47	−2.18	1,301
Diagnosed diabetes	South Dakota	−3.14	−4.61	−1.67	242
Diagnosed diabetes	Tennessee	−2.84	−3.76	−1.91	1,675
Diagnosed diabetes	Texas	−1.86	−2.42	−1.29	6,802
Diagnosed diabetes	Utah	−0.38	−1.20	0.45	707
Diagnosed diabetes	Vermont	−1.09	−1.61	−0.57	192
Diagnosed diabetes	Virginia	−1.49	−1.94	−1.05	2,152
Diagnosed diabetes	Washington	−1.41	−1.93	−0.89	1,767
Diagnosed diabetes	West Virginia	−2.40	−3.84	−0.95	543
Diagnosed diabetes	Wisconsin	−1.03	−1.50	−0.55	1,523
Diagnosed diabetes	Wyoming	−1.02	−2.99	0.94	159
Frequent mental distress	Alabama	−4.47	−4.82	−4.12	1,423
Frequent mental distress	Alaska	−4.04	−5.03	−3.04	173
Frequent mental distress	Arizona	−4.21	−5.30	−3.11	1,725
Frequent mental distress	Arkansas	−4.24	−4.78	−3.70	818
Frequent mental distress	California	−3.34	−3.76	−2.93	9,003
Frequent mental distress	Colorado	−3.44	−4.15	−2.73	1,423
Frequent mental distress	Connecticut	−3.41	−3.88	−2.93	870
Frequent mental distress	Delaware	−3.95	−5.59	−2.31	256
Frequent mental distress	District of Columbia	−3.02	−4.58	−1.45	201
Frequent mental distress	Florida	−3.51	−3.82	−3.20	5,053
Frequent mental distress	Georgia	−4.03	−4.25	−3.80	2,766
Frequent mental distress	Hawaii	−2.41	−2.82	−2.00	419
Frequent mental distress	Idaho	−4.19	−5.20	−3.17	453
Frequent mental distress	Illinois	−3.42	−3.79	−3.05	3,239
Frequent mental distress	Indiana	−4.33	−4.68	−3.98	1,678
Frequent mental distress	Iowa	−4.31	−5.00	−3.62	890
Frequent mental distress	Kansas	−3.96	−4.35	−3.57	811
Frequent mental distress	Kentucky	−4.11	−4.41	−3.80	1,287
Frequent mental distress	Louisiana	−3.71	−4.17	−3.25	1,352
Frequent mental distress	Maine	−3.60	−4.13	−3.07	399
Frequent mental distress	Maryland	−3.93	−4.17	−3.69	1,449
Frequent mental distress	Massachusetts	−3.54	−3.83	−3.26	1,585
Frequent mental distress	Michigan	−4.30	−4.59	−4.00	2,869
Frequent mental distress	Minnesota	−3.95	−4.32	−3.58	1,497
Frequent mental distress	Mississippi	−3.82	−4.30	−3.34	865
Frequent mental distress	Missouri	−4.22	−4.65	−3.79	1,644
Frequent mental distress	Montana	−4.06	−4.83	−3.29	315
Frequent mental distress	Nebraska	−3.52	−3.99	−3.06	550
Frequent mental distress	Nevada	−2.82	−3.21	−2.42	767
Frequent mental distress	New Hampshire	−3.46	−4.09	−2.83	347
Frequent mental distress	New Jersey	−3.18	−3.63	−2.73	2,154
Frequent mental distress	New Mexico	−4.02	−4.70	−3.34	594
Frequent mental distress	New York	−2.93	−3.35	−2.50	5,182
Frequent mental distress	North Carolina	−3.89	−4.14	−3.64	2,628
Frequent mental distress	North Dakota	−3.91	−4.69	−3.13	227
Frequent mental distress	Ohio	−4.71	−4.99	−4.43	3,129
Frequent mental distress	Oklahoma	−4.33	−4.60	−4.06	1,189
Frequent mental distress	Oregon	−4.19	−4.87	−3.50	991
Frequent mental distress	Pennsylvania	−3.60	−3.82	−3.38	3,377
Frequent mental distress	Rhode Island	−2.93	−3.65	−2.22	246
Frequent mental distress	South Carolina	−3.80	−4.32	−3.28	1,301
Frequent mental distress	South Dakota	−4.69	−5.57	−3.81	242
Frequent mental distress	Tennessee	−4.32	−4.50	−4.14	1,675
Frequent mental distress	Texas	−3.83	−4.11	−3.55	6,802
Frequent mental distress	Utah	−3.80	−5.22	−2.38	707
Frequent mental distress	Vermont	−4.37	−5.55	−3.19	192
Frequent mental distress	Virginia	−3.86	−4.08	−3.63	2,152
Frequent mental distress	Washington	−4.30	−4.64	−3.96	1,767
Frequent mental distress	West Virginia	−4.42	−5.08	−3.77	543
Frequent mental distress	Wisconsin	−4.26	−4.76	−3.76	1,523
Frequent mental distress	Wyoming	−3.49	−4.43	−2.55	159
No leisure-time physical activity	Alabama	−8.26	−9.49	−7.02	1,423
No leisure-time physical activity	Alaska	−7.43	−9.28	−5.57	173
No leisure-time physical activity	Arizona	−6.01	−7.81	−4.22	1,725
No leisure-time physical activity	Arkansas	−9.36	−10.76	−7.97	818
No leisure-time physical activity	California	−5.16	−5.83	−4.48	9,003
No leisure-time physical activity	Colorado	−3.81	−4.54	−3.07	1,423
No leisure-time physical activity	Connecticut	−5.60	−6.98	−4.22	870
No leisure-time physical activity	Delaware	−6.14	−7.34	−4.95	256
No leisure-time physical activity	District of Columbia	−3.05	−3.82	−2.27	201
No leisure-time physical activity	Florida	−7.40	−8.10	−6.70	5,053
No leisure-time physical activity	Georgia	−8.61	−9.48	−7.73	2,766
No leisure-time physical activity	Hawaii	−4.83	−7.09	−2.57	419
No leisure-time physical activity	Idaho	−6.49	−7.48	−5.50	453
No leisure-time physical activity	Illinois	−6.54	−7.55	−5.53	3,239
No leisure-time physical activity	Indiana	−7.30	−8.70	−5.91	1,678
No leisure-time physical activity	Iowa	−7.56	−8.65	−6.46	890
No leisure-time physical activity	Kansas	−6.53	−7.42	−5.63	811
No leisure-time physical activity	Kentucky	−9.02	−9.63	−8.41	1,287
No leisure-time physical activity	Louisiana	−8.32	−9.14	−7.50	1,352
No leisure-time physical activity	Maine	−8.03	−9.35	−6.70	399
No leisure-time physical activity	Maryland	−6.69	−7.77	−5.62	1,449
No leisure-time physical activity	Massachusetts	−5.93	−7.56	−4.29	1,585
No leisure-time physical activity	Michigan	−7.22	−8.06	−6.37	2,869
No leisure-time physical activity	Minnesota	−6.25	−6.85	−5.65	1,497
No leisure-time physical activity	Mississippi	−8.38	−10.04	−6.72	865
No leisure-time physical activity	Missouri	−8.13	−8.97	−7.29	1,644
No leisure-time physical activity	Montana	−8.17	−9.75	−6.58	315
No leisure-time physical activity	Nebraska	−5.56	−6.21	−4.91	550
No leisure-time physical activity	Nevada	−5.65	−7.08	−4.22	767
No leisure-time physical activity	New Hampshire	−5.29	−6.12	−4.46	347
No leisure-time physical activity	New Jersey	−5.76	−6.59	−4.92	2,154
No leisure-time physical activity	New Mexico	−7.85	−9.10	−6.59	594
No leisure-time physical activity	New York	−6.95	−8.08	−5.82	5,182
No leisure-time physical activity	North Carolina	−7.53	−8.25	−6.82	2,628
No leisure-time physical activity	North Dakota	−6.37	−8.10	−4.63	227
No leisure-time physical activity	Ohio	−8.44	−8.88	−8.00	3,129
No leisure-time physical activity	Oklahoma	−9.23	−10.46	−7.99	1,189
No leisure-time physical activity	Oregon	−5.06	−5.98	−4.14	991
No leisure-time physical activity	Pennsylvania	−6.93	−7.46	−6.40	3,377
No leisure-time physical activity	Rhode Island	−5.88	−6.26	−5.50	246
No leisure-time physical activity	South Carolina	−8.46	−9.27	−7.64	1,301
No leisure-time physical activity	South Dakota	−7.28	−9.25	−5.30	242
No leisure-time physical activity	Tennessee	−8.52	−9.83	−7.21	1,675
No leisure-time physical activity	Texas	−6.93	−7.78	−6.07	6,802
No leisure-time physical activity	Utah	−3.44	−4.31	−2.56	707
No leisure-time physical activity	Vermont	−5.43	−6.39	−4.47	192
No leisure-time physical activity	Virginia	−5.79	−6.42	−5.16	2,152
No leisure-time physical activity	Washington	−5.31	−6.22	−4.40	1,767
No leisure-time physical activity	West Virginia	−8.03	−9.68	−6.37	543
No leisure-time physical activity	Wisconsin	−6.16	−6.64	−5.68	1,523
No leisure-time physical activity	Wyoming	−4.84	−8.10	−1.57	159
Binge drinking	Alabama	1.26	0.97	1.54	1,423
Binge drinking	Alaska	1.02	0.43	1.61	173
Binge drinking	Arizona	0.91	0.37	1.44	1,725
Binge drinking	Arkansas	1.97	1.23	2.71	818
Binge drinking	California	0.66	−0.07	1.40	9,003
Binge drinking	Colorado	0.65	−0.18	1.47	1,423
Binge drinking	Connecticut	0.15	−0.40	0.70	870
Binge drinking	Delaware	0.95	0.63	1.28	256
Binge drinking	District of Columbia	0.92	0.13	1.70	201
Binge drinking	Florida	1.18	0.86	1.49	5,053
Binge drinking	Georgia	1.35	0.96	1.75	2,766
Binge drinking	Hawaii	0.97	0.41	1.53	419
Binge drinking	Idaho	1.16	0.71	1.61	453
Binge drinking	Illinois	1.54	0.70	2.38	3,239
Binge drinking	Indiana	1.20	0.61	1.79	1,678
Binge drinking	Iowa	1.49	1.23	1.76	890
Binge drinking	Kansas	0.65	0.22	1.07	811
Binge drinking	Kentucky	1.99	1.73	2.24	1,287
Binge drinking	Louisiana	2.33	1.81	2.84	1,352
Binge drinking	Maine	1.74	0.89	2.59	399
Binge drinking	Maryland	−0.77	−1.71	0.17	1,449
Binge drinking	Massachusetts	0.51	−0.26	1.27	1,585
Binge drinking	Michigan	1.12	0.41	1.84	2,869
Binge drinking	Minnesota	0.63	−0.05	1.32	1,497
Binge drinking	Mississippi	1.41	0.90	1.92	865
Binge drinking	Missouri	1.88	1.42	2.34	1,644
Binge drinking	Montana	2.18	1.44	2.93	315
Binge drinking	Nebraska	0.91	0.58	1.23	550
Binge drinking	Nevada	0.89	0.19	1.59	767
Binge drinking	New Hampshire	1.12	0.05	2.20	347
Binge drinking	New Jersey	0.36	−0.19	0.90	2,154
Binge drinking	New Mexico	1.59	1.17	2.02	594
Binge drinking	New York	1.37	0.26	2.48	5,182
Binge drinking	North Carolina	1.57	0.96	2.18	2,628
Binge drinking	North Dakota	1.94	1.42	2.46	227
Binge drinking	Ohio	1.67	1.25	2.09	3,129
Binge drinking	Oklahoma	1.68	0.95	2.41	1,189
Binge drinking	Oregon	1.01	0.59	1.43	991
Binge drinking	Pennsylvania	1.16	0.68	1.63	3,377
Binge drinking	Rhode Island	1.13	0.64	1.62	246
Binge drinking	South Carolina	2.25	1.24	3.26	1,301
Binge drinking	South Dakota	1.32	0.46	2.18	242
Binge drinking	Tennessee	1.99	1.39	2.60	1,675
Binge drinking	Texas	0.89	0.49	1.28	6,802
Binge drinking	Utah	1.44	0.99	1.89	707
Binge drinking	Vermont	1.21	0.28	2.15	192
Binge drinking	Virginia	0.04	−0.72	0.79	2,152
Binge drinking	Washington	0.37	−0.17	0.92	1,767
Binge drinking	West Virginia	1.62	1.11	2.14	543
Binge drinking	Wisconsin	1.43	0.91	1.95	1,523
Binge drinking	Wyoming	0.82	−0.66	2.30	159

Note: Each dot is a regression across the tracts of one state, and every state has at least 60 tracts with all the variables. The intervals use counties as clusters; Delaware and the District of Columbia use HC3 errors because they have too few counties for cluster-robust errors. The strip medians are printed on the chart.

Note: PLACES values are modeled estimates. They are built from BRFSS survey responses with census and American Community Survey inputs (county poverty, the age, sex, race and ethnicity of each tract's residents, and education), with state and county random effects, and the Area Deprivation Index is built from American Community Survey data too, so part of each gradient here is mechanical. Within a county, tract values differ through the demographic composition of tracts. Income comes from the same survey, and the controls remove only the age, Black and Hispanic shares. Race-alone shares include Hispanic residents, and median household income is top-coded in the survey.

Note: These are differences between tracts within a state. They do not describe what any person does.

Source: CDC PLACES 2024 release (BRFSS 2022) and ACS 2019-2023; modeled estimates, population-weighted (adults in each tract)

Data: vishalsingh.org/zipcode/report/health-behaviors-and-the-supply-of-care/figures/coefficient_zoo.json

Table 3. From the least to the most deprived tenth of tracts, the dental visit rate falls from 70.3% to 45.8% while the annual checkup rate rises from 74.2% to 77.8%

Adults who visited a dentist or had a routine checkup in the past year, percent, by Area Deprivation Index national percentile of the tract, 2022

conf_high	conf_low	estimate	measure	n_units	percentile
76.10	73	74.40	Annual checkup	693	1
75.42	71.84	73.47	Annual checkup	779	2
75.32	72.22	73.62	Annual checkup	587	3
75.30	72.99	74.01	Annual checkup	925	4
75.49	73.33	74.33	Annual checkup	636	5
75.67	73.40	74.46	Annual checkup	979	6
75.45	73.35	74.30	Annual checkup	607	7
75.31	73.27	74.18	Annual checkup	915	8
75.30	73.30	74.22	Annual checkup	677	9
75.64	73.39	74.42	Annual checkup	1,000	10
75.45	73.49	74.38	Annual checkup	598	11
75.94	73.39	74.58	Annual checkup	1,019	12
75.39	72.90	74.03	Annual checkup	693	13
75.74	73.59	74.63	Annual checkup	1,007	14
75.36	72.98	74.08	Annual checkup	656	15
75.32	73.07	74.13	Annual checkup	1,054	16
75.65	72.97	74.29	Annual checkup	684	17
75.20	73.14	74.12	Annual checkup	1,033	18
74.96	72.70	73.80	Annual checkup	702	19
75.70	73.47	74.58	Annual checkup	1,019	20
75.18	73.25	74.18	Annual checkup	655	21
75.39	73.71	74.55	Annual checkup	1,098	22
75.52	73.77	74.64	Annual checkup	652	23
75.17	73.45	74.31	Annual checkup	1,050	24
75.28	73.86	74.56	Annual checkup	679	25
75.39	74.06	74.72	Annual checkup	1,028	26
75.60	73.91	74.77	Annual checkup	678	27
75.54	74.17	74.86	Annual checkup	1,029	28
75.67	74.13	74.90	Annual checkup	659	29
75.64	74.31	74.98	Annual checkup	1,112	30
75.35	73.93	74.62	Annual checkup	668	31
75.39	74.19	74.79	Annual checkup	1,010	32
75.39	74.01	74.70	Annual checkup	689	33
75.41	74.28	74.84	Annual checkup	1,053	34
75.74	74.51	75.13	Annual checkup	672	35
75.51	74.30	74.88	Annual checkup	1,098	36
75.33	74.10	74.71	Annual checkup	730	37
75.58	74.42	75.01	Annual checkup	1,031	38
76.08	74.90	75.48	Annual checkup	620	39
75.63	74.54	75.08	Annual checkup	995	40
75.69	74.46	75.08	Annual checkup	709	41
75.70	74.73	75.22	Annual checkup	1,045	42
75.85	74.69	75.25	Annual checkup	690	43
75.92	74.82	75.38	Annual checkup	1,044	44
76.03	75.03	75.53	Annual checkup	689	45
76.22	75.30	75.74	Annual checkup	1,008	46
76.33	75.20	75.74	Annual checkup	655	47
75.99	75	75.50	Annual checkup	1,070	48
76.34	75.26	75.80	Annual checkup	652	49
75.98	75.02	75.48	Annual checkup	1,066	50
76.16	75.04	75.58	Annual checkup	667	51
76.44	75.51	75.98	Annual checkup	1,106	52
76.19	75.32	75.75	Annual checkup	721	53
76.28	75.26	75.75	Annual checkup	1,047	54
76.55	75.55	76.04	Annual checkup	670	55
76.34	75.42	75.87	Annual checkup	1,069	56
76.32	75.32	75.82	Annual checkup	664	57
76.63	75.65	76.15	Annual checkup	1,046	58
76.44	75.45	75.94	Annual checkup	756	59
76.47	75.54	75.98	Annual checkup	1,056	60
76.50	75.52	76	Annual checkup	672	61
76.44	75.45	75.96	Annual checkup	1,107	62
76.55	75.51	76.01	Annual checkup	679	63
76.69	75.70	76.21	Annual checkup	1,061	64
76.72	75.49	76.14	Annual checkup	699	65
76.91	76.02	76.48	Annual checkup	1,041	66
76.96	76	76.49	Annual checkup	696	67
77	76.17	76.60	Annual checkup	1,028	68
76.97	76.14	76.55	Annual checkup	679	69
76.83	76.08	76.46	Annual checkup	1,030	70
77.05	76.15	76.62	Annual checkup	711	71
77.10	76.28	76.70	Annual checkup	1,040	72
76.94	76.02	76.48	Annual checkup	678	73
76.97	76.17	76.59	Annual checkup	1,061	74
77.10	76.06	76.60	Annual checkup	721	75
77.14	76.28	76.72	Annual checkup	1,001	76
77.34	76.36	76.87	Annual checkup	666	77
77.25	76.42	76.83	Annual checkup	1,025	78
77.42	76.64	77.05	Annual checkup	698	79
77.40	76.62	77.01	Annual checkup	1,024	80
77.44	76.56	77.01	Annual checkup	663	81
77.47	76.73	77.10	Annual checkup	983	82
77.57	76.70	77.14	Annual checkup	657	83
77.59	76.84	77.23	Annual checkup	906	84
77.60	76.68	77.12	Annual checkup	629	85
77.55	76.65	77.12	Annual checkup	984	86
77.54	76.69	77.11	Annual checkup	619	87
77.85	77.17	77.51	Annual checkup	911	88
77.71	76.73	77.22	Annual checkup	648	89
77.84	76.96	77.40	Annual checkup	941	90
78.03	77.07	77.55	Annual checkup	578	91
78.03	77.10	77.57	Annual checkup	878	92
77.95	77.04	77.49	Annual checkup	589	93
77.98	76.88	77.43	Annual checkup	794	94
78.49	77.38	77.94	Annual checkup	532	95
78.56	77.55	78.05	Annual checkup	761	96
78.69	77.23	77.94	Annual checkup	536	97
78.79	77.53	78.16	Annual checkup	725	98
79.20	77.82	78.56	Annual checkup	549	99
79.66	77.53	78.70	Annual checkup	682	100
75.95	73.21	74.77	Dental visit	693	1
74.95	71.66	73.03	Dental visit	779	2
74.03	69.83	71.73	Dental visit	587	3
73.10	69.50	71.27	Dental visit	925	4
72.41	67.16	69.78	Dental visit	636	5
71.85	66.40	69.10	Dental visit	979	6
72.28	68.03	69.95	Dental visit	607	7
71.49	67.30	69.14	Dental visit	915	8
70.93	66.28	68.51	Dental visit	677	9
71.20	65.54	68.13	Dental visit	1,000	10
70.92	66.74	68.66	Dental visit	598	11
71.10	65.61	68.31	Dental visit	1,019	12
70.67	64.96	67.82	Dental visit	693	13
69.96	65.82	67.76	Dental visit	1,007	14
69.56	65.06	67.17	Dental visit	656	15
68.75	64.39	66.47	Dental visit	1,054	16
69.25	63.74	66.50	Dental visit	684	17
68.72	64.09	66.41	Dental visit	1,033	18
68.01	62.54	65.35	Dental visit	702	19
68.93	63.42	66.35	Dental visit	1,019	20
68.80	64.71	66.89	Dental visit	655	21
68.55	64.87	66.88	Dental visit	1,098	22
68.13	64.36	66.42	Dental visit	652	23
68.45	64.67	66.80	Dental visit	1,050	24
68.55	65.97	67.31	Dental visit	679	25
67.72	65.33	66.54	Dental visit	1,028	26
68.37	64.46	66.58	Dental visit	678	27
67.19	64.49	65.94	Dental visit	1,029	28
67.13	63.11	65.31	Dental visit	659	29
66.91	63.97	65.49	Dental visit	1,112	30
67.01	64.12	65.58	Dental visit	668	31
66.85	64.91	65.87	Dental visit	1,010	32
66.15	64.07	65.12	Dental visit	689	33
66.43	64.52	65.46	Dental visit	1,053	34
66.47	64.56	65.50	Dental visit	672	35
65.61	63.65	64.60	Dental visit	1,098	36
65.35	63.25	64.33	Dental visit	730	37
65.20	63.21	64.22	Dental visit	1,031	38
65.94	63.57	64.81	Dental visit	620	39
65.01	62.95	63.98	Dental visit	995	40
64.49	62.47	63.45	Dental visit	709	41
64.73	62.72	63.73	Dental visit	1,045	42
64.07	62.06	63.06	Dental visit	690	43
64.47	62.63	63.54	Dental visit	1,044	44
63.79	61.68	62.72	Dental visit	689	45
64.37	61.92	63.18	Dental visit	1,008	46
64.27	62.43	63.32	Dental visit	655	47
63.22	61.36	62.31	Dental visit	1,070	48
63.60	61.77	62.69	Dental visit	652	49
62.95	61.06	61.98	Dental visit	1,066	50
63.09	61.02	62.02	Dental visit	667	51
62.68	60.73	61.70	Dental visit	1,106	52
62.23	60.18	61.18	Dental visit	721	53
61.92	59.70	60.81	Dental visit	1,047	54
61.91	59.65	60.80	Dental visit	670	55
61.76	59.66	60.68	Dental visit	1,069	56
61.68	59.81	60.75	Dental visit	664	57
61.60	59.55	60.60	Dental visit	1,046	58
60.95	58.48	59.74	Dental visit	756	59
60.71	58.91	59.80	Dental visit	1,056	60
60.96	58.76	59.82	Dental visit	672	61
59.68	57.43	58.55	Dental visit	1,107	62
60.09	57.55	58.83	Dental visit	679	63
59.80	57.28	58.60	Dental visit	1,061	64
59.44	56.75	58.17	Dental visit	699	65
60.07	57.81	59.01	Dental visit	1,041	66
59.18	56.90	58.09	Dental visit	696	67
58.98	57.04	57.99	Dental visit	1,028	68
59.27	57.22	58.28	Dental visit	679	69
58.04	56.06	57.05	Dental visit	1,030	70
58.22	55.94	57.06	Dental visit	711	71
58.05	55.98	56.99	Dental visit	1,040	72
57.70	55.43	56.57	Dental visit	678	73
56.97	55.23	56.10	Dental visit	1,061	74
57.37	55.13	56.25	Dental visit	721	75
56.19	54.20	55.22	Dental visit	1,001	76
56.62	54.18	55.43	Dental visit	666	77
55.97	54.23	55.16	Dental visit	1,025	78
56.19	54.31	55.21	Dental visit	698	79
56.09	54.19	55.15	Dental visit	1,024	80
55.11	52.96	54.09	Dental visit	663	81
54.97	53.06	54.04	Dental visit	983	82
53.68	51.27	52.51	Dental visit	657	83
54	52.03	53.06	Dental visit	906	84
53.16	50.52	51.88	Dental visit	629	85
52.58	50.51	51.60	Dental visit	984	86
52.83	50.87	51.82	Dental visit	619	87
51.78	49.96	50.88	Dental visit	911	88
50.53	48.08	49.35	Dental visit	648	89
51.08	49.04	50.09	Dental visit	941	90
50.20	47.56	48.95	Dental visit	578	91
49.48	47.27	48.38	Dental visit	878	92
48.71	46.46	47.55	Dental visit	589	93
46.61	44.20	45.45	Dental visit	794	94
46.74	44.23	45.52	Dental visit	532	95
45.02	42.81	43.95	Dental visit	761	96
44.18	41.51	42.78	Dental visit	536	97
42.57	38.99	40.94	Dental visit	725	98
42.64	39.48	41.10	Dental visit	549	99
40.76	37.25	39.14	Dental visit	682	100

Source: CDC PLACES 2024 release (BRFSS 2022) and Area Deprivation Index 2023; modeled estimates, population-weighted (adults in each tract)

Data: vishalsingh.org/zipcode/report/health-behaviors-and-the-supply-of-care/figures/checkup_vs_dental.json

Table 4. In the most deprived tenth of tracts, the dental visit and screening tests are less common by 6.2 to 24.4 points and barriers to care are more common by 9.7 and 11.1 points

Difference in the share of adults, most deprived tenth of tracts minus least deprived tenth, percentage points, eight measures of care, 2021 and 2022

Measure	Group	Least deprived tenth (%)	Most deprived tenth (%)	Difference (points)	Lower limit of the 95% interval	Upper limit of the 95% interval	Tracts in the most deprived tenth
Annual checkup	Checkup and treatment	74.2	77.8	3.6	2.4	4.6	8,213
Blood pressure medicine, adults with high blood pressure	Checkup and treatment	73.6	79.5	5.9	4.8	6.7	7,946
Dental visit	Dental visit and screening	70.3	45.8	−24.4	−26.5	−22.5	8,213
Mammography, women ages 50 to 74	Dental visit and screening	78.8	71.7	−7.0	−7.8	−6.3	8,213
Cholesterol screening	Dental visit and screening	87.9	81.0	−6.9	−7.5	−6.3	7,946
Colorectal cancer screening, ages 45 to 75	Dental visit and screening	65.3	59.1	−6.2	−8.3	−4.4	8,213
No reliable transportation	Barriers	6.1	15.9	9.7	9.0	10.6	6,348
No health insurance, ages 18 to 64	Barriers	6.3	17.4	11.1	9.7	12.8	8,213

Note: Blood pressure medicine is the share of adults with high blood pressure who take medicine for it, and blood pressure medicine and cholesterol screening are BRFSS 2021 estimates; the other measures are BRFSS 2022. The transportation question was asked in only some states, so that row covers fewer tracts. The grouping into checkup and treatment, dental visit and screening, and barriers is this book's: PLACES files the checkup, blood pressure medicine, the dental visit and insurance together under prevention. Some measures cover only some ages (insurance, mammography, colorectal screening), and tract means weight each tract by all its adults.

Source: CDC PLACES 2024 release (BRFSS 2021 and 2022) and Area Deprivation Index 2023; modeled estimates, population-weighted (adults in each tract)

Data: vishalsingh.org/zipcode/report/health-behaviors-and-the-supply-of-care/figures/care_ledger.json

Table 5. The checkup slope is within 0.5 points of zero in all four specifications, and the dental slope is between −2.37 and −3.86 points

Slope of tract prevalence on the Area Deprivation Index national percentile, points of prevalence per ten percentiles, adults, four specifications, 2022

conf_high	conf_low	estimate	measure	n	specification
0.541	0.287	0.414	Annual checkup	82,779	All tracts
−2.08	−2.67	−2.37	Dental visit	82,779	All tracts
0.054	−0.080	−0.013	Annual checkup	82,779	Within states
−2.81	−3.14	−2.97	Dental visit	82,779	Within states
−0.190	−0.348	−0.269	Annual checkup	82,779	Within counties
−3.73	−3.99	−3.86	Dental visit	82,779	Within counties
0.006	−0.100	−0.047	Annual checkup	82,779	Within states, with age and race controls
−2.24	−2.51	−2.38	Dental visit	82,779	Within states, with age and race controls

Note: Within states and within counties, the comparison is between tracts of one state or county, with a separate baseline for each. The last row also holds constant the tract shares of residents who are ages 65 and over, Black alone and Hispanic. The standard error treats the tracts of a county as one cluster.

Source: CDC PLACES 2024 release (BRFSS 2022) and Area Deprivation Index 2023; modeled estimates, population-weighted (adults in each tract)

Data: vishalsingh.org/zipcode/report/health-behaviors-and-the-supply-of-care/figures/checkup_specifications.json

Table 6. The dental visit rate falls with deprivation in all 51 states, and the checkup slope is within 0.5 points of zero in 42

Slope of tract prevalence on the Area Deprivation Index national percentile within each state, points of prevalence per ten percentiles, adults, 2022

conf_high	conf_low	estimate	measure	n	state
0.287	−0.038	0.124	Annual checkup	1,421	AL
−3.48	−4.00	−3.74	Dental visit	1,421	AL
−0.261	−0.862	−0.561	Annual checkup	172	AK
−3.07	−4.31	−3.69	Dental visit	172	AK
−0.227	−0.620	−0.423	Annual checkup	1,723	AZ
−3.07	−3.86	−3.46	Dental visit	1,723	AZ
0.808	0.004	0.406	Annual checkup	818	AR
−3.02	−4.22	−3.62	Dental visit	818	AR
−0.276	−0.857	−0.566	Annual checkup	8,982	CA
−3.36	−4.11	−3.74	Dental visit	8,982	CA
0.182	−0.677	−0.248	Annual checkup	1,420	CO
−2.96	−3.81	−3.38	Dental visit	1,420	CO
−0.135	−0.604	−0.369	Annual checkup	872	CT
−2.67	−4.46	−3.57	Dental visit	872	CT
−0.197	−0.605	−0.401	Annual checkup	253	DE
−3.36	−4.10	−3.73	Dental visit	253	DE
2.11	1.32	1.71	Annual checkup	201	DC
−5.57	−7.38	−6.47	Dental visit	201	DC
0.188	−0.244	−0.028	Annual checkup	5,034	FL
−2.59	−3.24	−2.92	Dental visit	5,034	FL
0.604	0.140	0.372	Annual checkup	2,767	GA
−3.09	−3.42	−3.26	Dental visit	2,767	GA
−0.061	−0.477	−0.269	Annual checkup	414	HI
−2.46	−3.31	−2.88	Dental visit	414	HI
−0.009	−1.13	−0.567	Annual checkup	453	ID
−1.34	−3.51	−2.43	Dental visit	453	ID
0.631	−0.232	0.199	Annual checkup	3,239	IL
−2.34	−3.09	−2.71	Dental visit	3,239	IL
−0.035	−0.262	−0.149	Annual checkup	1,671	IN
−3.12	−3.83	−3.47	Dental visit	1,671	IN
0.241	−0.148	0.047	Annual checkup	887	IA
−2.41	−3.12	−2.77	Dental visit	887	IA
−0.075	−0.353	−0.214	Annual checkup	811	KS
−2.67	−3.47	−3.07	Dental visit	811	KS
−0.028	−0.136	−0.082	Annual checkup	1,285	KY
−3.35	−3.87	−3.61	Dental visit	1,285	KY
0.488	0.144	0.316	Annual checkup	1,352	LA
−3.52	−4.38	−3.95	Dental visit	1,352	LA
0.492	−0.013	0.239	Annual checkup	399	ME
−2.43	−2.95	−2.69	Dental visit	399	ME
0.577	0.043	0.310	Annual checkup	1,451	MD
−3.08	−3.73	−3.41	Dental visit	1,451	MD
0.696	−0.341	0.177	Annual checkup	1,576	MA
−2.09	−3.89	−2.99	Dental visit	1,576	MA
0.273	−0.206	0.034	Annual checkup	2,872	MI
−2.62	−3.82	−3.22	Dental visit	2,872	MI
0.025	−0.332	−0.154	Annual checkup	1,492	MN
−2.27	−3.09	−2.68	Dental visit	1,492	MN
0.600	0.173	0.387	Annual checkup	867	MS
−1.43	−1.88	−1.66	Dental visit	867	MS
0.092	−0.300	−0.104	Annual checkup	1,641	MO
−3.25	−3.68	−3.47	Dental visit	1,641	MO
0.947	−0.482	0.232	Annual checkup	316	MT
−1.91	−2.95	−2.43	Dental visit	316	MT
−0.204	−0.497	−0.350	Annual checkup	547	NE
−2.60	−3.78	−3.19	Dental visit	547	NE
−0.251	−0.963	−0.607	Annual checkup	767	NV
−3.17	−4.51	−3.84	Dental visit	767	NV
−0.002	−1.06	−0.530	Annual checkup	346	NH
−2.23	−3.10	−2.67	Dental visit	346	NH
0.441	−0.353	0.044	Annual checkup	2,155	NJ
−2.61	−4.18	−3.40	Dental visit	2,155	NJ
−0.335	−0.969	−0.652	Annual checkup	595	NM
−3.23	−4.19	−3.71	Dental visit	595	NM
0.446	−0.068	0.189	Annual checkup	5,196	NY
0.164	−1.22	−0.526	Dental visit	5,196	NY
0.287	0.009	0.148	Annual checkup	2,625	NC
−2.88	−3.25	−3.06	Dental visit	2,625	NC
0.909	0.246	0.577	Annual checkup	225	ND
−1.50	−2.73	−2.11	Dental visit	225	ND
0.211	−0.126	0.043	Annual checkup	3,131	OH
−3.34	−3.77	−3.56	Dental visit	3,131	OH
−0.009	−0.331	−0.170	Annual checkup	1,186	OK
−3.65	−4.21	−3.93	Dental visit	1,186	OK
0.642	−0.513	0.065	Annual checkup	990	OR
−2.56	−3.59	−3.07	Dental visit	990	OR
0.236	−0.079	0.079	Annual checkup	3,374	PA
−2.40	−3.33	−2.86	Dental visit	3,374	PA
−0.463	−0.992	−0.727	Annual checkup	244	RI
−3.26	−5.87	−4.56	Dental visit	244	RI
0.431	0.043	0.237	Annual checkup	1,295	SC
−2.89	−3.56	−3.22	Dental visit	1,295	SC
0.101	−0.535	−0.217	Annual checkup	242	SD
−2.33	−3.80	−3.07	Dental visit	242	SD
0.378	−0.036	0.171	Annual checkup	1,669	TN
−2.51	−3.76	−3.14	Dental visit	1,669	TN
0.009	−0.387	−0.189	Annual checkup	6,789	TX
−3.33	−3.95	−3.64	Dental visit	6,789	TX
0.010	−0.821	−0.405	Annual checkup	705	UT
−2.99	−3.90	−3.45	Dental visit	705	UT
0.796	−0.182	0.307	Annual checkup	192	VT
−1.99	−2.73	−2.36	Dental visit	192	VT
0.495	0.226	0.361	Annual checkup	2,141	VA
−2.27	−2.67	−2.47	Dental visit	2,141	VA
−0.002	−0.490	−0.246	Annual checkup	1,757	WA
−2.96	−3.68	−3.32	Dental visit	1,757	WA
0.392	−0.083	0.154	Annual checkup	543	WV
−2.31	−3.79	−3.05	Dental visit	543	WV
0.676	−0.430	0.123	Annual checkup	1,520	WI
−2.36	−4.15	−3.25	Dental visit	1,520	WI
−0.048	−0.920	−0.484	Annual checkup	158	WY
−1.72	−2.84	−2.28	Dental visit	158	WY

Note: States are shown by their postal codes. Delaware, Hawaii and the District of Columbia have too few counties for cluster-robust errors, so their intervals use HC3 errors, and the District of Columbia is a single county. Every state has at least 158 tracts, above the floor of 60, so none is dropped.

Source: CDC PLACES 2024 release (BRFSS 2022) and Area Deprivation Index 2023; modeled estimates, population-weighted (adults in each tract)

Data: vishalsingh.org/zipcode/report/health-behaviors-and-the-supply-of-care/figures/checkup_slopes_by_state.json

Table 7. Residents per primary care physician rise from 1,159 to 2,730 and per dentist from 1,131 to 3,055 between the least and most deprived tenths of counties

Residents per provider, pooled over the counties in each tenth of counties ranked on the county Area Deprivation Index, providers counted in 2021 (physicians), 2022 (dentists) and 2023 (mental health providers)

Provider	County deprivation decile	Residents per provider	Lower limit of the 95% interval	Upper limit of the 95% interval	Providers	Residents	Counties	Counties with no provider in the decile
Primary care physicians	1	1,159	1,093	1,205	113,749	131,811,420	312	7
Primary care physicians	2	1,335	1,221	1,449	46,027	61,434,044	313	5
Primary care physicians	3	1,389	1,286	1,511	30,365	42,189,945	313	7
Primary care physicians	4	1,411	1,309	1,512	22,741	32,087,932	312	10
Primary care physicians	5	1,529	1,365	1,737	13,522	20,679,797	314	17
Primary care physicians	6	1,656	1,458	1,877	8,739	14,471,394	312	29
Primary care physicians	7	1,894	1,660	2,148	5,756	10,903,268	313	19
Primary care physicians	8	2,083	1,905	2,249	4,293	8,942,931	315	38
Primary care physicians	9	2,593	2,394	2,828	2,130	5,522,704	312	35
Primary care physicians	10	2,730	2,452	3,018	1,403	3,830,042	312	53
Dentists	1	1,131	1,074	1,232	116,844	132,162,193	312	10
Dentists	2	1,439	1,304	1,583	43,139	62,071,203	313	4
Dentists	3	1,425	1,351	1,552	29,869	42,550,714	313	13
Dentists	4	1,494	1,388	1,624	21,574	32,224,541	312	11
Dentists	5	1,622	1,473	1,848	12,745	20,677,282	314	21
Dentists	6	1,776	1,586	1,984	8,145	14,463,884	312	27
Dentists	7	1,949	1,775	2,169	5,585	10,883,473	313	22
Dentists	8	2,454	2,196	2,718	3,638	8,928,681	315	30
Dentists	9	2,713	2,533	2,920	2,026	5,496,600	312	31
Dentists	10	3,055	2,638	3,533	1,240	3,788,578	312	58
Mental health providers	1	250	221	307	528,315	132,162,193	312	2
Mental health providers	2	351	290	415	176,791	62,071,203	313	2
Mental health providers	3	372	312	436	114,486	42,550,714	313	11
Mental health providers	4	364	310	425	88,447	32,224,541	312	9
Mental health providers	5	402	339	517	51,406	20,677,282	314	16
Mental health providers	6	463	363	604	31,271	14,463,884	312	26
Mental health providers	7	483	407	612	22,524	10,883,473	313	18
Mental health providers	8	551	426	746	16,210	8,928,681	315	32
Mental health providers	9	641	505	837	8,572	5,496,600	312	38
Mental health providers	10	550	382	882	6,883	3,788,578	312	52

Note: Counties with no recorded provider stay in: they add residents and no providers. County Health Rankings leaves their published ratio blank above a population cutoff that differs by provider type and reports a rate of 0 below it, and the first edition of this chapter dropped them. Primary care physicians are practicing non-federal physicians under age 75 in general practice, family medicine, internal medicine and pediatrics; dentists are those with a National Provider Identifier; mental health providers include psychiatrists, psychologists, social workers, counselors, therapists and mental health nurse practitioners. Providers are counted where they practice, not by the care patients receive.

Note: Deciles hold about the same number of counties, 15 small counties with no deprivation rank are outside them (so the counts of counties with no provider in the table are smaller than the counts in the text, which cover all counties), and Puerto Rico is not covered.

Note: Across all the counties in the comparison, there are 1,334 residents per primary care physician.

Source: County Health Rankings 2024 (provider counts from AMA, CMS and NPPES files, 2021-2023) and Area Deprivation Index 2023; full counts, pooled ratios

Data: vishalsingh.org/zipcode/report/health-behaviors-and-the-supply-of-care/figures/people_per_provider.json

Table 8. Residents per mental health provider exceed 3,200 in 275 counties, and 91.6% of those counties have a mostly rural population

Residents per mental health provider by county, providers counted in 2023, on a scale that doubles at each step

No inline rows: the values of Table 8 are in /data/health-behaviors-and-the-supply-of-care/mental_health_provider_map.json.

Note: Gray counties have no mental health provider recorded in 2023; County Health Rankings leaves the ratio blank for them. They are not missing data, and their tooltip says so. Puerto Rico is not drawn. Alaska is drawn, and Connecticut appears under its eight legacy counties.

Note: Providers are counted where they practice and each county's residents are the denominator, so a county next to a large city can look thin while its residents are served across the county line.

Source: County Health Rankings 2024 (CMS National Provider Identifier file, 2023); full counts, county ratios

Data: vishalsingh.org/zipcode/report/health-behaviors-and-the-supply-of-care/figures/mental_health_provider_map.json

Table 9. Residents per primary care physician is steadily worse toward the more deprived end under the ADI and under each of the three other rankings

Residents per primary care physician by tenth of counties ranked four ways, over the 3,125 counties that have all four rankings

bin	conf_high	conf_low	estimate	n_units	ranking
1	1210.2	1099.9	1163.7	312	Area Deprivation Index
2	1446.7	1202.1	1322.5	313	Area Deprivation Index
3	1486.1	1275.4	1368.9	312	Area Deprivation Index
4	1525.9	1332.6	1430.3	313	Area Deprivation Index
5	1763.5	1353.0	1532.7	312	Area Deprivation Index
6	1799.8	1472.4	1618.0	313	Area Deprivation Index
7	2167.6	1702.9	1921.7	312	Area Deprivation Index
8	2183.3	1878	2036.3	313	Area Deprivation Index
9	2899.6	2479.4	2673.4	312	Area Deprivation Index
10	3037.9	2473.2	2748.7	313	Area Deprivation Index
1	1170.1	1036.5	1093.8	312	Standardized index
2	1442.1	1209.2	1316.6	313	Standardized index
3	1373.7	1215.9	1279.7	312	Standardized index
4	1515.3	1281.3	1409.3	313	Standardized index
5	1638.0	1450.9	1532.5	312	Standardized index
6	1806.3	1462.2	1620.4	313	Standardized index
7	1851.3	1470.4	1648.1	312	Standardized index
8	2220.0	1813.4	2033.2	313	Standardized index
9	2549.1	2062.8	2275.0	312	Standardized index
10	2973.2	2513.8	2687.5	313	Standardized index
1	1174.8	1041.1	1104.0	312	Median household income
2	1480.2	1288.7	1377.4	313	Median household income
3	1541.3	1308.0	1422.2	312	Median household income
4	1442.7	1254.4	1346.0	313	Median household income
5	1621.0	1397.2	1501.7	312	Median household income
6	1766.7	1431.4	1588.2	313	Median household income
7	1870.8	1494.3	1664.4	312	Median household income
8	2100.5	1780.2	1953.9	313	Median household income
9	2679.2	2321.4	2495.9	312	Median household income
10	2920.6	2385.9	2615.3	313	Median household income
1	1060.4	965.3	1009.7	312	Bachelor's degree share
2	1354.3	1220.3	1279.7	313	Bachelor's degree share
3	1510.0	1342.3	1422.8	312	Bachelor's degree share
4	1801.7	1592.9	1690.5	313	Bachelor's degree share
5	1937.6	1628.6	1766.4	312	Bachelor's degree share
6	2287.0	1875.0	2058.4	313	Bachelor's degree share
7	2417.3	2074.7	2235.9	312	Bachelor's degree share
8	2668.3	2334.0	2495.9	313	Bachelor's degree share
9	2881.0	2467.9	2651.0	312	Bachelor's degree share
10	3804.9	3227.7	3519.8	313	Bachelor's degree share

Note: Least and most deprived tenth: ADI 1,164 and 2,749, rank correlation +1.00; standardized index 1,094 and 2,687, +0.99; median household income 1,104 and 2,615, +0.96; bachelor's degree share 1,010 and 3,520, +1.00.

Note: The standardized index applies the ADI's coefficients to its measures after standardizing each one, so home value and income carry less weight than in the ADI. Income and degree share are single census measures, each ranked from the highest value to the lowest.

Source: County Health Rankings 2024 (provider counts from AMA, CMS and NPPES files, 2021-2023) and Area Deprivation Index 2023; full counts, pooled ratios; ADI 2023 and ACS 2019-2023 tract tables (B19013, B15003 and the 15 rebuilt ADI measures)

Data: vishalsingh.org/zipcode/report/health-behaviors-and-the-supply-of-care/figures/alt_rankings.json

All estimates

Every fact in facts.json (134), sorted by id. The same values as JSON: facts.json.

Fact id	Value	Unit	Estimand	Population	Period	Interval	n	Weights	Source	Note
age_col_hi	75	years of age	age limit of the measure's population (a definition)	adults covered by the PLACES measure of colorectal cancer screening	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (definition)	CDC PLACES
age_col_lo	45	years of age	age limit of the measure's population (a definition)	adults covered by the PLACES measure of colorectal cancer screening	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (definition)	CDC PLACES
age_ins_hi	64	years of age	age limit of the measure's population (a definition)	adults covered by the PLACES measure of no health insurance	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (definition)	CDC PLACES
age_ins_lo	18	years of age	age limit of the measure's population (a definition)	adults covered by the PLACES measure of no health insurance	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (definition)	CDC PLACES
age_mam_hi	74	years of age	age limit of the measure's population (a definition)	adults covered by the PLACES measure of mammography	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (definition)	CDC PLACES
age_mam_lo	50	years of age	age limit of the measure's population (a definition)	adults covered by the PLACES measure of mammography	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (definition)	CDC PLACES
age_teeth	65	years of age	age limit of the measure's population (a definition)	adults covered by the PLACES measure of all teeth lost	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (definition)	CDC PLACES
alt_adi_least	1,164	Residents per primary care physician	residents of the counties divided by their primary care physicians (a pooled ratio; counties with no physician add residents and no physicians); 95% intervals from a bootstrap over states	the least deprived tenth of counties ranked by Area Deprivation Index, among the counties with all four rankings	primary care physicians in 2021; residents in the same year; rankings from ACS 2019-2023	95% CI 1,100 to 1,210	312 counties	none (pooled ratio of counts)	County Health Rankings
alt_adi_most	2,749	Residents per primary care physician	residents of the counties divided by their primary care physicians (a pooled ratio; counties with no physician add residents and no physicians); 95% intervals from a bootstrap over states	the most deprived tenth of counties ranked by Area Deprivation Index, among the counties with all four rankings	primary care physicians in 2021; residents in the same year; rankings from ACS 2019-2023	95% CI 2,473 to 3,038	313 counties	none (pooled ratio of counts)	County Health Rankings
alt_adi_rho	+1.00	rank correlation	Spearman rank correlation between bin order and bin mean, each bin counted once	the bins of counties ranked by Area Deprivation Index	primary care physicians in 2021; residents in the same year; rankings from ACS 2019-2023			each bin counted once	County Health Rankings
alt_degree_least	1,010	Residents per primary care physician	residents of the counties divided by their primary care physicians (a pooled ratio; counties with no physician add residents and no physicians); 95% intervals from a bootstrap over states	the least deprived tenth of counties ranked by Bachelor's degree share, among the counties with all four rankings	primary care physicians in 2021; residents in the same year; rankings from ACS 2019-2023	95% CI 965 to 1,060	312 counties	none (pooled ratio of counts)	County Health Rankings
alt_degree_most	3,520	Residents per primary care physician	residents of the counties divided by their primary care physicians (a pooled ratio; counties with no physician add residents and no physicians); 95% intervals from a bootstrap over states	the most deprived tenth of counties ranked by Bachelor's degree share, among the counties with all four rankings	primary care physicians in 2021; residents in the same year; rankings from ACS 2019-2023	95% CI 3,228 to 3,805	313 counties	none (pooled ratio of counts)	County Health Rankings
alt_degree_rho	+1.00	rank correlation	Spearman rank correlation between bin order and bin mean, each bin counted once	the bins of counties ranked by Bachelor's degree share	primary care physicians in 2021; residents in the same year; rankings from ACS 2019-2023			each bin counted once	County Health Rankings
alt_income_least	1,104	Residents per primary care physician	residents of the counties divided by their primary care physicians (a pooled ratio; counties with no physician add residents and no physicians); 95% intervals from a bootstrap over states	the least deprived tenth of counties ranked by Median household income, among the counties with all four rankings	primary care physicians in 2021; residents in the same year; rankings from ACS 2019-2023	95% CI 1,041 to 1,175	312 counties	none (pooled ratio of counts)	County Health Rankings
alt_income_most	2,615	Residents per primary care physician	residents of the counties divided by their primary care physicians (a pooled ratio; counties with no physician add residents and no physicians); 95% intervals from a bootstrap over states	the most deprived tenth of counties ranked by Median household income, among the counties with all four rankings	primary care physicians in 2021; residents in the same year; rankings from ACS 2019-2023	95% CI 2,386 to 2,921	313 counties	none (pooled ratio of counts)	County Health Rankings
alt_income_rho	+0.96	rank correlation	Spearman rank correlation between bin order and bin mean, each bin counted once	the bins of counties ranked by Median household income	primary care physicians in 2021; residents in the same year; rankings from ACS 2019-2023			each bin counted once	County Health Rankings
alt_n_places	3,125	counties	count of counties in the common sample of the ranking comparison	counties with the outcome and all four rankings	primary care physicians in 2021; residents in the same year; rankings from ACS 2019-2023			none (full count)	County Health Rankings
alt_rho_cut	0.9	absolute rank correlation	threshold between a steady and an uneven gradient	the rule for changed gradients (docs/RANKING_SWITCH_RULE.md)	primary care physicians in 2021; residents in the same year; rankings from ACS 2019-2023			none (a fixed rule)	County Health Rankings
alt_rho_margin	0.1	absolute rank correlation	smallest move in the rank correlation that counts as a change of shape	the rule for changed gradients (docs/RANKING_SWITCH_RULE.md)	primary care physicians in 2021; residents in the same year; rankings from ACS 2019-2023			none (a fixed rule)	County Health Rankings
alt_std_least	1,094	Residents per primary care physician	residents of the counties divided by their primary care physicians (a pooled ratio; counties with no physician add residents and no physicians); 95% intervals from a bootstrap over states	the least deprived tenth of counties ranked by Standardized index, among the counties with all four rankings	primary care physicians in 2021; residents in the same year; rankings from ACS 2019-2023	95% CI 1,037 to 1,170	312 counties	none (pooled ratio of counts)	County Health Rankings
alt_std_most	2,687	Residents per primary care physician	residents of the counties divided by their primary care physicians (a pooled ratio; counties with no physician add residents and no physicians); 95% intervals from a bootstrap over states	the most deprived tenth of counties ranked by Standardized index, among the counties with all four rankings	primary care physicians in 2021; residents in the same year; rankings from ACS 2019-2023	95% CI 2,514 to 2,973	313 counties	none (pooled ratio of counts)	County Health Rankings
alt_std_rho	+0.99	rank correlation	Spearman rank correlation between bin order and bin mean, each bin counted once	the bins of counties ranked by Standardized index	primary care physicians in 2021; residents in the same year; rankings from ACS 2019-2023			each bin counted once	County Health Rankings
bpmed_ratio	1.08	ratio of prevalence, most deprived tenth to least deprived tenth	weighted mean prevalence in the most deprived tenth of tracts over that in the least deprived tenth, bootstrap interval over counties	adults: taking medicine for high blood pressure, among adults with high blood pressure	BRFSS 2021 (PLACES 2024 release); ADI 2023	95% CI 1.06 to 1.09	7,946 tracts	adult population of the tract (PLACES)	CDC PLACES
care_dent_all	1,361	residents per dentist	residents of all counties divided by their providers, bootstrap interval over states	residents of all counties in County Health Rankings 2024	dentists in 2022	95% CI 1,261 to 1,476	3,143 counties	none (pooled ratio of counts)	County Health Rankings
care_dent_d1	1,131	residents per dentist	residents of the counties divided by their providers (a pooled ratio; counties with no provider add residents and no providers), bootstrap interval over states	residents of counties in the least deprived tenth of counties by county ADI	dentists in 2022; residents in the same year	95% CI 1,074 to 1,232	312 counties	none (pooled ratio of counts)	County Health Rankings
care_dent_d10	3,055	residents per dentist	residents of the counties divided by their providers (a pooled ratio; counties with no provider add residents and no providers), bootstrap interval over states	residents of counties in the most deprived tenth of counties by county ADI	dentists in 2022; residents in the same year	95% CI 2,638 to 3,533	312 counties	none (pooled ratio of counts)	County Health Rankings
care_dent_mult	2.7	ratio of residents per dentist, most deprived tenth of counties to least deprived tenth	pooled residents per provider in the most deprived tenth of counties over that in the least deprived tenth, bootstrap interval over states	residents of counties	dentists in 2022	95% CI 2.3 to 3.1	312 counties	none (pooled ratio of counts)	County Health Rankings
care_dent_r	−0.52	correlation coefficient	county-population-weighted correlation between the county ADI and providers per 100,000 residents (counties with no provider count as zero), bootstrap interval over states	residents of counties with an ADI rank: county ADI against dentists per 100,000 residents	dentists in 2022	95% CI −0.61 to −0.41	3,128 counties	county residents (CHR denominator for the provider measure)	County Health Rankings
care_dent_r_unw	−0.35	correlation coefficient	unweighted correlation between the county ADI and providers per 100,000 residents (counties with no provider count as zero), bootstrap interval over states	counties with an ADI rank: county ADI against dentists per 100,000 residents, each county counted once	dentists in 2022	95% CI −0.45 to −0.27	3,128 counties	none (each county counts once)	County Health Rankings
care_fei_bot	6.1	food environment index (0 worst, 10 best)	county-population-weighted mean of the county index, bootstrap interval over states	residents of the most deprived tenth of counties	2019 and 2021	95% CI 5.7 to 6.6	306 counties	county population	County Health Rankings
care_fei_r	−0.66	correlation coefficient	county-population-weighted correlation, bootstrap interval over states	residents of counties with an ADI rank: county ADI against the food environment index	2019 and 2021	95% CI −0.74 to −0.59	3,094 counties	county population	County Health Rankings
care_fei_r_unw	−0.51	correlation coefficient	unweighted correlation, bootstrap interval over states	counties with an ADI rank: county ADI against the food environment index, each county counted once	2019 and 2021	95% CI −0.58 to −0.45	3,094 counties	none (each county counts once)	County Health Rankings
care_fei_top	8.6	food environment index (0 worst, 10 best)	county-population-weighted mean of the county index, bootstrap interval over states	residents of the least deprived tenth of counties	2019 and 2021	95% CI 8.5 to 8.8	308 counties	county population	County Health Rankings
care_mh_all	319	residents per mental health provider	residents of all counties divided by their providers, bootstrap interval over states	residents of all counties in County Health Rankings 2024	mental health providers in 2023	95% CI 274 to 382	3,143 counties	none (pooled ratio of counts)	County Health Rankings
care_mh_d1	250	residents per mental health provider	residents of the counties divided by their providers (a pooled ratio; counties with no provider add residents and no providers), bootstrap interval over states	residents of counties in the least deprived tenth of counties by county ADI	mental health providers in 2023; residents in the same year	95% CI 221 to 307	312 counties	none (pooled ratio of counts)	County Health Rankings
care_mh_d10	550	residents per mental health provider	residents of the counties divided by their providers (a pooled ratio; counties with no provider add residents and no providers), bootstrap interval over states	residents of counties in the most deprived tenth of counties by county ADI	mental health providers in 2023; residents in the same year	95% CI 382 to 882	312 counties	none (pooled ratio of counts)	County Health Rankings
care_mh_mult	2.2	ratio of residents per mental health provider, most deprived tenth of counties to least deprived tenth	pooled residents per provider in the most deprived tenth of counties over that in the least deprived tenth, bootstrap interval over states	residents of counties	mental health providers in 2023	95% CI 1.5 to 3.5	312 counties	none (pooled ratio of counts)	County Health Rankings
care_mh_r	−0.42	correlation coefficient	county-population-weighted correlation between the county ADI and providers per 100,000 residents (counties with no provider count as zero), bootstrap interval over states	residents of counties with an ADI rank: county ADI against mental health providers per 100,000 residents	mental health providers in 2023	95% CI −0.53 to −0.26	3,128 counties	county residents (CHR denominator for the provider measure)	County Health Rankings
care_mh_r_unw	−0.33	correlation coefficient	unweighted correlation between the county ADI and providers per 100,000 residents (counties with no provider count as zero), bootstrap interval over states	counties with an ADI rank: county ADI against mental health providers per 100,000 residents, each county counted once	mental health providers in 2023	95% CI −0.44 to −0.23	3,128 counties	none (each county counts once)	County Health Rankings
care_pcp_all	1,334	residents per primary care physician	residents of all counties divided by their providers, bootstrap interval over states	residents of all counties in County Health Rankings 2024	primary care physicians in 2021	95% CI 1,276 to 1,406	3,143 counties	none (pooled ratio of counts)	County Health Rankings
care_pcp_d1	1,159	residents per primary care physician	residents of the counties divided by their providers (a pooled ratio; counties with no provider add residents and no providers), bootstrap interval over states	residents of counties in the least deprived tenth of counties by county ADI	primary care physicians in 2021; residents in the same year	95% CI 1,093 to 1,205	312 counties	none (pooled ratio of counts)	County Health Rankings
care_pcp_d10	2,730	residents per primary care physician	residents of the counties divided by their providers (a pooled ratio; counties with no provider add residents and no providers), bootstrap interval over states	residents of counties in the most deprived tenth of counties by county ADI	primary care physicians in 2021; residents in the same year	95% CI 2,452 to 3,018	312 counties	none (pooled ratio of counts)	County Health Rankings
care_pcp_mult	2.4	ratio of residents per primary care physician, most deprived tenth of counties to least deprived tenth	pooled residents per provider in the most deprived tenth of counties over that in the least deprived tenth, bootstrap interval over states	residents of counties	primary care physicians in 2021	95% CI 2.1 to 2.6	312 counties	none (pooled ratio of counts)	County Health Rankings
care_pcp_r	−0.41	correlation coefficient	county-population-weighted correlation between the county ADI and providers per 100,000 residents (counties with no provider count as zero), bootstrap interval over states	residents of counties with an ADI rank: county ADI against primary care physicians per 100,000 residents	primary care physicians in 2021	95% CI −0.46 to −0.35	3,128 counties	county residents (CHR denominator for the provider measure)	County Health Rankings
care_pcp_r_unw	−0.37	correlation coefficient	unweighted correlation between the county ADI and providers per 100,000 residents (counties with no provider count as zero), bootstrap interval over states	counties with an ADI rank: county ADI against primary care physicians per 100,000 residents, each county counted once	primary care physicians in 2021	95% CI −0.43 to −0.32	3,128 counties	none (each county counts once)	County Health Rankings
care_ph_hi	4,012	preventable hospital stays per 100,000 Medicare enrollees	county-population-weighted mean of the county rate, bootstrap interval over states	Medicare enrollees in the most deprived tenth of counties	2021	95% CI 3,608 to 4,435	305 counties	county population (enrollee counts are not in the staged file)	County Health Rankings
care_ph_lo	2,370	preventable hospital stays per 100,000 Medicare enrollees	county-population-weighted mean of the county rate, bootstrap interval over states	Medicare enrollees in the least deprived tenth of counties	2021	95% CI 2,188 to 2,599	304 counties	county population (enrollee counts are not in the staged file)	County Health Rankings
care_ph_r	+0.46	correlation coefficient	county-population-weighted correlation, bootstrap interval over states	Medicare enrollees in counties with an ADI rank: county ADI against preventable hospital stays	2021	95% CI 0.31 to 0.56	3,067 counties	county population	County Health Rankings
care_ph_r_unw	+0.38	correlation coefficient	unweighted correlation, bootstrap interval over states	counties with an ADI rank: county ADI against preventable hospital stays, each county counted once	2021	95% CI 0.30 to 0.46	3,067 counties	none (each county counts once)	County Health Rankings
cat_band	0.5	points of prevalence per ten-point step in the ADI national percentile	half-width of the band around zero used to call a slope small (a definition)	the checkup slopes of the states	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (rule)	CDC PLACES
cat_checkup_maxabs	+1.7	points of prevalence per ten-point step in the ADI national percentile	population-weighted slope of tract prevalence on the ADI national percentile, times ten; the interval is HC3 because the District of Columbia is a single county	the state with the largest routine checkup slope in absolute value (District of Columbia), adults	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 1.3 to 2.1	201 tracts	adult population of the tract (PLACES)	CDC PLACES
cat_checkup_med	+0.03	points of prevalence per ten-point step in the ADI national percentile	median of the state estimates, each a population-weighted slope of tract prevalence on the ADI national percentile, times ten	states and the District of Columbia with at least 60 tracts that have an ADI rank and both measures, routine checkup in the past year	BRFSS 2022 (PLACES 2024 release); ADI 2023		51 states	adult population of the tract (PLACES)	CDC PLACES	A median of 51 estimates; each state's interval is in the figure.
cat_checkup_signeg	18	states	count of states whose 95% interval for the routine checkup slope lies below zero	states and the District of Columbia with at least 60 tracts that have an ADI rank and both measures	BRFSS 2022 (PLACES 2024 release); ADI 2023		51 states	none (full count)	CDC PLACES
cat_checkup_sigpos	10	states	count of states whose 95% interval for the routine checkup slope lies above zero	states and the District of Columbia with at least 60 tracts that have an ADI rank and both measures	BRFSS 2022 (PLACES 2024 release); ADI 2023		51 states	none (full count)	CDC PLACES
cat_checkup_small	42	states	count of states whose routine checkup slope is within the band around zero	states and the District of Columbia with at least 60 tracts that have an ADI rank and both measures	BRFSS 2022 (PLACES 2024 release); ADI 2023		51 states	none (full count)	CDC PLACES
cat_checkup_span	23	states	count of states whose 95% interval for the routine checkup slope includes zero	states and the District of Columbia with at least 60 tracts that have an ADI rank and both measures	BRFSS 2022 (PLACES 2024 release); ADI 2023		51 states	none (full count)	CDC PLACES
cat_dental_med	−3.2	points of prevalence per ten-point step in the ADI national percentile	median of the state estimates, each a population-weighted slope of tract prevalence on the ADI national percentile, times ten	states and the District of Columbia with at least 60 tracts that have an ADI rank and both measures, dental visit in the past year	BRFSS 2022 (PLACES 2024 release); ADI 2023		51 states	adult population of the tract (PLACES)	CDC PLACES	A median of 51 estimates; each state's interval is in the figure.
cat_dental_negn	51	states	count of states whose dental visit slope on the ADI is negative	states and the District of Columbia with at least 60 tracts that have an ADI rank and both measures	BRFSS 2022 (PLACES 2024 release); ADI 2023		51 states	none (full count)	CDC PLACES
cat_dental_signeg	50	states	count of states whose 95% interval for the dental visit slope lies below zero	states and the District of Columbia with at least 60 tracts that have an ADI rank and both measures	BRFSS 2022 (PLACES 2024 release); ADI 2023		51 states	none (full count)	CDC PLACES
cat_dental_small	0	states	count of states whose dental visit slope is within the band around zero	states and the District of Columbia with at least 60 tracts that have an ADI rank and both measures	BRFSS 2022 (PLACES 2024 release); ADI 2023		51 states	none (full count)	CDC PLACES
cat_floor	60	tracts	minimum number of tracts with every variable for a state to enter (an inclusion rule that drops no state)	states in the state slopes and the coefficient zoo	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (rule)	CDC PLACES
cat_min_tracts	158	tracts	smallest state tract count	the state with the fewest tracts that have an ADI rank and both measures	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (full count)	CDC PLACES
cat_n_states	51	states	count of states and the District of Columbia	states and the District of Columbia with at least 60 tracts that have an ADI rank and both measures	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (full count)	CDC PLACES
checkup_hi	77.8%	percent of adults	weighted mean of the tract prevalence in a tenth of tracts (equal numbers of tracts), bootstrap interval over counties	adults in the most deprived tenth of tracts by ADI national percentile: routine checkup in the past year	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 77.3% to 78.2%	8,213 tracts	adult population of the tract (PLACES)	CDC PLACES
checkup_lo	74.2%	percent of adults	weighted mean of the tract prevalence in a tenth of tracts (equal numbers of tracts), bootstrap interval over counties	adults in the least deprived tenth of tracts by ADI national percentile: routine checkup in the past year	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 73.2% to 75.3%	8,274 tracts	adult population of the tract (PLACES)	CDC PLACES
checkup_ratio	1.05	ratio of prevalence, most deprived tenth to least deprived tenth	weighted mean prevalence in the most deprived tenth of tracts over that in the least deprived tenth, bootstrap interval over counties	adults: routine checkup in the past year	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 1.03 to 1.06	8,213 tracts	adult population of the tract (PLACES)	CDC PLACES
chr_cut_dent	4,000	residents	population above which the staged ratio is blank and below which it holds a negative population, read from the file and rounded to the nearest thousand	counties with no recorded dentist	dentists in 2022			none (rule)	County Health Rankings
chr_cut_mh	1,000	residents	population above which the staged ratio is blank and below which it holds a negative population, read from the file and rounded to the nearest thousand	counties with no recorded mental health provider	mental health providers in 2023			none (rule)	County Health Rankings
chr_cut_pcp	2,000	residents	population above which the staged ratio is blank and below which it holds a negative population, read from the file and rounded to the nearest thousand	counties with no recorded primary care physician	primary care physicians in 2021			none (rule)	County Health Rankings
dep_delta	4.8	percentage points of adults, higher in the most deprived tenth of tracts	difference between the weighted mean prevalence of the least deprived and the most deprived tenth of tracts by ADI national percentile, bootstrap interval over counties (draws shared by the two means)	adults: depression	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 4.1 to 5.6	8,213 tracts	adult population of the tract (PLACES)	CDC PLACES
dep_ratio	1.25	ratio of prevalence, most deprived tenth to least deprived tenth	weighted mean prevalence in the most deprived tenth of tracts over that in the least deprived tenth, bootstrap interval over counties	adults: depression	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 1.21 to 1.30	8,213 tracts	adult population of the tract (PLACES)	CDC PLACES
diab_hi	17.5%	percent of adults	weighted mean of the tract prevalence in a tenth of tracts (equal numbers of tracts), bootstrap interval over counties	adults in the most deprived tenth of tracts by ADI national percentile: diagnosed diabetes	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 17.3% to 17.9%	8,213 tracts	adult population of the tract (PLACES)	CDC PLACES
diab_lo	9.5%	percent of adults	weighted mean of the tract prevalence in a tenth of tracts (equal numbers of tracts), bootstrap interval over counties	adults in the least deprived tenth of tracts by ADI national percentile: diagnosed diabetes	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 9.0% to 9.9%	8,274 tracts	adult population of the tract (PLACES)	CDC PLACES
flat_bpmed_delta	5.9	percentage points of adults, higher in the most deprived tenth of tracts	difference between the weighted mean prevalence of the least deprived and the most deprived tenth of tracts by ADI national percentile, bootstrap interval over counties (draws shared by the two means)	adults: taking medicine for high blood pressure, among adults with high blood pressure	BRFSS 2021 (PLACES 2024 release); ADI 2023	95% CI 4.8 to 6.7	7,946 tracts	adult population of the tract (PLACES)	CDC PLACES
flat_checkup_delta	3.6	percentage points of adults, higher in the most deprived tenth of tracts	difference between the weighted mean prevalence of the least deprived and the most deprived tenth of tracts by ADI national percentile, bootstrap interval over counties (draws shared by the two means)	adults: routine checkup in the past year	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 2.4 to 4.6	8,213 tracts	adult population of the tract (PLACES)	CDC PLACES
flat_chol_delta	6.9	percentage points of adults, lower in the most deprived tenth of tracts	difference between the weighted mean prevalence of the least deprived and the most deprived tenth of tracts by ADI national percentile, bootstrap interval over counties (draws shared by the two means)	adults: cholesterol screening in the past five years	BRFSS 2021 (PLACES 2024 release); ADI 2023	95% CI 6.2 to 7.5	7,946 tracts	adult population of the tract (PLACES)	CDC PLACES
flat_colon_delta	6.2	percentage points of adults, lower in the most deprived tenth of tracts	difference between the weighted mean prevalence of the least deprived and the most deprived tenth of tracts by ADI national percentile, bootstrap interval over counties (draws shared by the two means)	adults: colorectal cancer screening up to date, ages 45 to 75	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 4.4 to 8.2	8,213 tracts	adult population of the tract (PLACES)	CDC PLACES
flat_dental_d1	70.3%	percent of adults	weighted mean of the tract prevalence in a tenth of tracts (equal numbers of tracts), bootstrap interval over counties	adults in the least deprived tenth of tracts by ADI national percentile: dental visit in the past year	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 68.5% to 72.1%	8,274 tracts	adult population of the tract (PLACES)	CDC PLACES
flat_dental_d10	45.8%	percent of adults	weighted mean of the tract prevalence in a tenth of tracts (equal numbers of tracts), bootstrap interval over counties	adults in the most deprived tenth of tracts by ADI national percentile: dental visit in the past year	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 45.0% to 46.6%	8,213 tracts	adult population of the tract (PLACES)	CDC PLACES
flat_dental_delta	24.4	percentage points of adults, lower in the most deprived tenth of tracts	difference between the weighted mean prevalence of the least deprived and the most deprived tenth of tracts by ADI national percentile, bootstrap interval over counties (draws shared by the two means)	adults: dental visit in the past year	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 22.5 to 26.5	8,213 tracts	adult population of the tract (PLACES)	CDC PLACES
flat_mammo_delta	7.0	percentage points of adults, lower in the most deprived tenth of tracts	difference between the weighted mean prevalence of the least deprived and the most deprived tenth of tracts by ADI national percentile, bootstrap interval over counties (draws shared by the two means)	adults: mammography in the past two years, women ages 50 to 74	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 6.3 to 7.8	8,213 tracts	adult population of the tract (PLACES)	CDC PLACES
flat_notrans_delta	9.7	percentage points of adults, higher in the most deprived tenth of tracts	difference between the weighted mean prevalence of the least deprived and the most deprived tenth of tracts by ADI national percentile, bootstrap interval over counties (draws shared by the two means)	adults: lack of reliable transportation in the past 12 months	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 9.0 to 10.5	6,348 tracts	adult population of the tract (PLACES)	CDC PLACES
flat_uninsured_d1	6.3%	percent of adults	weighted mean of the tract prevalence in a tenth of tracts (equal numbers of tracts), bootstrap interval over counties	adults in the least deprived tenth of tracts by ADI national percentile: no health insurance, ages 18 to 64	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 5.7% to 6.8%	8,274 tracts	adult population of the tract (PLACES)	CDC PLACES
flat_uninsured_d10	17.4%	percent of adults	weighted mean of the tract prevalence in a tenth of tracts (equal numbers of tracts), bootstrap interval over counties	adults in the most deprived tenth of tracts by ADI national percentile: no health insurance, ages 18 to 64	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 16.1% to 18.9%	8,213 tracts	adult population of the tract (PLACES)	CDC PLACES
flat_uninsured_delta	11.1	percentage points of adults, higher in the most deprived tenth of tracts	difference between the weighted mean prevalence of the least deprived and the most deprived tenth of tracts by ADI national percentile, bootstrap interval over counties (draws shared by the two means)	adults: no health insurance, ages 18 to 64	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 9.7 to 12.7	8,213 tracts	adult population of the tract (PLACES)	CDC PLACES
map_hi_n	275	counties	count of counties with more residents per provider than the break	counties with at least one recorded mental health provider	mental health providers in 2023			none (full count)	County Health Rankings
map_hi_rural	91.6%	percent of those counties	share of the counties that are majority rural (CHR percent rural above 50, 2020 census)	counties with more than 3,200 residents per mental health provider	mental health providers in 2023; rural share 2020 census		275 counties	none (each county counts once)	County Health Rankings
map_hi_sm	96.0%	percent of those counties	share of the counties in the Midwest or South Census regions	counties with more than 3,200 residents per mental health provider	mental health providers in 2023		275 counties	none (each county counts once)	County Health Rankings
map_hi_thr	3,200	residents per mental health provider	a break of the map's key (a definition)	counties on the map	mental health providers in 2023			none (rule)	County Health Rankings
map_n_gray	216	counties	count of counties with no recorded mental health provider	counties drawn on the map (Puerto Rico not drawn)	mental health providers in 2023			none (full count)	County Health Rankings
n_adi_tracts	82,781	tracts	count of tracts	census tracts with a PLACES estimate and an Area Deprivation Index rank	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (full count)	CDC PLACES
n_care_counties	3,128	counties	count of counties	counties and county equivalents in County Health Rankings 2024 with an ADI rank	2021 to 2023			none (full count)	County Health Rankings
n_chr_counties	3,143	counties	count of counties	counties and county equivalents in County Health Rankings 2024 (Puerto Rico not included)	2021 to 2023			none (full count)	County Health Rankings
n_higher_measures	34	measures	count of measures whose 95% interval for the ratio of the most deprived tenth to the least deprived tenth lies above 1	PLACES measures in the tract file	BRFSS 2022 (PLACES 2024 release); ADI 2023		40 measures	adult population of the tract (PLACES)	CDC PLACES
n_last_step	11	measures	count of measures whose largest step between neighboring twentieths of tracts, ranked by ADI, is the step into the most deprived twentieth	the twelve PLACES measures of the twelve-outcome figure	BRFSS 2022 (PLACES 2024 release); ADI 2023		12 measures	adult population of the tract (PLACES)	CDC PLACES	Point estimates of the twentieth means; the intervals of the means are in the figure.
n_less_points	4	measures	count of measures, none of them plotted in the twelve-outcome figure, whose difference in points between the most deprived and the least deprived tenth is smaller than the checkup's	PLACES measures that are higher in the most deprived tenth	BRFSS 2022 (PLACES 2024 release); ADI 2023		34 measures	adult population of the tract (PLACES)	CDC PLACES
n_no_adi	741	tracts	count of tracts	census tracts with a PLACES estimate and no Area Deprivation Index rank	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (full count)	Area Deprivation Index	The ADI is missing for tracts whose block groups are all suppressed.
n_no_adi_counties	15	counties	count of counties with no tract that has a deprivation rank and a population	counties in County Health Rankings 2024	tract ranks from ADI 2023, ACS 2019-2023 population			none (full count)	Area Deprivation Index
n_panels	12	measures	count of measures	PLACES measures in the twelve-outcome figure	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (rule)	CDC PLACES
n_places_measures	40	measures	count of measures (rule)	PLACES measures in the tract file	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (rule)	CDC PLACES
n_places_tracts	83,522	tracts	count of tracts	2020 census tracts with a CDC PLACES 2024 release estimate	PLACES 2024 release			none (full count)	CDC PLACES
n_rising	11	measures	count of measures (rule)	the twelve PLACES measures of the twelve-outcome figure other than the annual checkup	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (rule)	CDC PLACES
n_spec_tracts	82,779	tracts	count of tracts	tracts with an ADI rank, both measures and the three ACS controls	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (full count)	CDC PLACES
n_zero_dent	239	counties	count of counties with no recorded dentist	counties in County Health Rankings 2024	dentists in 2022			none (full count)	County Health Rankings
n_zero_mh	216	counties	count of counties with no recorded mental health provider	counties in County Health Rankings 2024	mental health providers in 2023			none (full count)	County Health Rankings
n_zero_pcp	232	counties	count of counties with no recorded primary care physician	counties in County Health Rankings 2024	primary care physicians in 2021			none (full count)	County Health Rankings
smk_hi	22.8%	percent of adults	weighted mean of the tract prevalence in a tenth of tracts (equal numbers of tracts), bootstrap interval over counties	adults in the most deprived tenth of tracts by ADI national percentile: current cigarette smoking	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 22.5% to 23.1%	8,213 tracts	adult population of the tract (PLACES)	CDC PLACES
smk_lo	9.1%	percent of adults	weighted mean of the tract prevalence in a tenth of tracts (equal numbers of tracts), bootstrap interval over counties	adults in the least deprived tenth of tracts by ADI national percentile: current cigarette smoking	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 8.5% to 9.6%	8,274 tracts	adult population of the tract (PLACES)	CDC PLACES
smk_mult	2.5	ratio of prevalence, most deprived tenth to least deprived tenth	weighted mean prevalence in the most deprived tenth of tracts over that in the least deprived tenth, bootstrap interval over counties	adults: current cigarette smoking	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 2.4 to 2.7	8,213 tracts	adult population of the tract (PLACES)	CDC PLACES
spec_checkup_all	+0.41	points of prevalence per ten-point step in the ADI national percentile	population-weighted least-squares slope of tract prevalence on the ADI national percentile, times ten; all tracts; cluster-robust interval with counties as clusters	adults: routine checkup in the past year, all tracts	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 0.29 to 0.54	82,779 tracts	adult population of the tract (PLACES)	CDC PLACES
spec_checkup_county	−0.27	points of prevalence per ten-point step in the ADI national percentile	population-weighted least-squares slope of tract prevalence on the ADI national percentile, times ten; county fixed effects; cluster-robust interval with counties as clusters	adults: routine checkup in the past year, within counties	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI −0.35 to −0.19	82,779 tracts	adult population of the tract (PLACES)	CDC PLACES
spec_checkup_ctrl	−0.05	points of prevalence per ten-point step in the ADI national percentile	population-weighted least-squares slope of tract prevalence on the ADI national percentile, times ten; state fixed effects and tract shares of residents ages 65 and over, Black alone and Hispanic; cluster-robust interval with counties as clusters	adults: routine checkup in the past year, within states, with age and race controls	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI −0.10 to 0.01	82,779 tracts	adult population of the tract (PLACES)	CDC PLACES
spec_checkup_maxwithin	0.27	points of prevalence per ten-point step in the ADI national percentile	largest absolute checkup slope among the specifications that hold the state or county fixed	adults: routine checkup, the three specifications within states or counties	BRFSS 2022 (PLACES 2024 release); ADI 2023		82,779 tracts	adult population of the tract (PLACES)	CDC PLACES	A point estimate; the intervals are in the figure.
spec_checkup_state	−0.01	points of prevalence per ten-point step in the ADI national percentile	population-weighted least-squares slope of tract prevalence on the ADI national percentile, times ten; state fixed effects; cluster-robust interval with counties as clusters	adults: routine checkup in the past year, within states	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI −0.08 to 0.05	82,779 tracts	adult population of the tract (PLACES)	CDC PLACES
spec_dental_all	−2.37	points of prevalence per ten-point step in the ADI national percentile	population-weighted least-squares slope of tract prevalence on the ADI national percentile, times ten; all tracts; cluster-robust interval with counties as clusters	adults: dental visit in the past year, all tracts	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI −2.66 to −2.08	82,779 tracts	adult population of the tract (PLACES)	CDC PLACES
spec_dental_county	−3.86	points of prevalence per ten-point step in the ADI national percentile	population-weighted least-squares slope of tract prevalence on the ADI national percentile, times ten; county fixed effects; cluster-robust interval with counties as clusters	adults: dental visit in the past year, within counties	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI −3.99 to −3.73	82,779 tracts	adult population of the tract (PLACES)	CDC PLACES
spec_dental_ctrl	−2.38	points of prevalence per ten-point step in the ADI national percentile	population-weighted least-squares slope of tract prevalence on the ADI national percentile, times ten; state fixed effects and tract shares of residents ages 65 and over, Black alone and Hispanic; cluster-robust interval with counties as clusters	adults: dental visit in the past year, within states, with age and race controls	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI −2.51 to −2.24	82,779 tracts	adult population of the tract (PLACES)	CDC PLACES
spec_dental_state	−2.97	points of prevalence per ten-point step in the ADI national percentile	population-weighted least-squares slope of tract prevalence on the ADI national percentile, times ten; state fixed effects; cluster-robust interval with counties as clusters	adults: dental visit in the past year, within states	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI −3.14 to −2.80	82,779 tracts	adult population of the tract (PLACES)	CDC PLACES
spec_ratio_min	8.8	ratio of absolute slopes	smallest absolute dental slope over the largest absolute checkup slope among the specifications that hold the state or county fixed	adults: dental visit slope over routine checkup slope, the three specifications within states or counties	BRFSS 2022 (PLACES 2024 release); ADI 2023		82,779 tracts	adult population of the tract (PLACES)	CDC PLACES	A ratio of two point estimates.
teeth_ratio	3.6	ratio of prevalence, most deprived tenth to least deprived tenth	weighted mean prevalence in the most deprived tenth of tracts over that in the least deprived tenth, bootstrap interval over counties	adults: all teeth lost, among adults ages 65 and over	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 3.1 to 4.1	8,213 tracts	adult population of the tract (PLACES)	CDC PLACES
tenth_max	8,511	tracts	largest count of tracts in a tenth (tied ranks fall in the same tenth)	tracts in the largest tenth by ADI national percentile	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (full count)	CDC PLACES
tenth_min	8,118	tracts	smallest count of tracts in a tenth (tied ranks fall in the same tenth)	tracts in the smallest tenth by ADI national percentile	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (full count)	CDC PLACES
us_pcp	1,334	residents per primary care physician	residents of all the counties of the tenths divided by their providers (a pooled ratio; counties with no provider add residents and no providers), bootstrap interval over states (the draws of the tenths)	residents of all the counties in the comparison: counties in County Health Rankings 2024 with an ADI rank	primary care physicians in 2021; residents in the same year	95% CI 1,276 to 1,406	3,128 counties	none (pooled ratio of counts)	County Health Rankings
zoo_binge_med	+1.2	points of prevalence per doubling of tract median household income	median of the state estimates, each a population-weighted regression across the state's tracts of tract prevalence on the log of median household income, with tract shares of residents ages 65 and over, Black alone and Hispanic as controls, times the natural log of 2	adults: binge drinking, states and the District of Columbia with at least 60 tracts that have income, the three controls and the measure	BRFSS 2022 (PLACES 2024 release); ACS 2019-2023		51 states	adult population of the tract (PLACES)	CDC PLACES	A median of the state estimates; each state's interval is in the table.
zoo_binge_posn	50	states	count of states where binge drinking is higher in higher-income tracts	states and the District of Columbia with at least 60 tracts that have income, the three controls and the measure	BRFSS 2022 (PLACES 2024 release); ACS 2019-2023		51 states	none (full count)	CDC PLACES
zoo_binge_sig	41	states	count of states whose 95% interval for the binge drinking slope lies above zero	states and the District of Columbia with at least 60 tracts that have income, the three controls and the measure	BRFSS 2022 (PLACES 2024 release); ACS 2019-2023		51 states	none (full count)	CDC PLACES
zoo_five_negn	51	states	count of states where all five other behaviors have a negative slope on income	states and the District of Columbia with at least 60 tracts that have income, the three controls and the measure	BRFSS 2022 (PLACES 2024 release); ACS 2019-2023		51 states	none (full count)	CDC PLACES
zoo_five_sigmin	47	states	smallest, over the five other behaviors, of the count of states whose 95% interval for the slope lies below zero	states and the District of Columbia with at least 60 tracts that have income, the three controls and the measure	BRFSS 2022 (PLACES 2024 release); ACS 2019-2023		51 states	none (full count)	CDC PLACES
zoo_inact_med	−6.7	points of prevalence per doubling of tract median household income	median of the state estimates, each a population-weighted regression across the state's tracts of tract prevalence on the log of median household income, with tract shares of residents ages 65 and over, Black alone and Hispanic as controls, times the natural log of 2	adults: no leisure-time physical activity, states and the District of Columbia with at least 60 tracts that have income, the three controls and the measure	BRFSS 2022 (PLACES 2024 release); ACS 2019-2023		51 states	adult population of the tract (PLACES)	CDC PLACES	A median of the state estimates; each state's interval is in the table.
zoo_n_measures	6	measures	count of measures (rule)	PLACES measures in the coefficient zoo	BRFSS 2022 (PLACES 2024 release); ACS 2019-2023			none (rule)	CDC PLACES
zoo_n_models	306	regressions	count of state-by-behavior regressions	states and the District of Columbia with at least 60 tracts that have income, the three controls and the measure	BRFSS 2022 (PLACES 2024 release); ACS 2019-2023			none (full count)	CDC PLACES
zoo_n_states	51	states	count of states and the District of Columbia	states and the District of Columbia with at least 60 tracts that have income, the three controls and the measure	BRFSS 2022 (PLACES 2024 release); ACS 2019-2023			none (full count)	CDC PLACES
zoo_obes_med	−4.3	points of prevalence per doubling of tract median household income	median of the state estimates, each a population-weighted regression across the state's tracts of tract prevalence on the log of median household income, with tract shares of residents ages 65 and over, Black alone and Hispanic as controls, times the natural log of 2	adults: obesity, states and the District of Columbia with at least 60 tracts that have income, the three controls and the measure	BRFSS 2022 (PLACES 2024 release); ACS 2019-2023		51 states	adult population of the tract (PLACES)	CDC PLACES	A median of the state estimates; each state's interval is in the table.
zoo_smoke_med	−4.7	points of prevalence per doubling of tract median household income	median of the state estimates, each a population-weighted regression across the state's tracts of tract prevalence on the log of median household income, with tract shares of residents ages 65 and over, Black alone and Hispanic as controls, times the natural log of 2	adults: current cigarette smoking, states and the District of Columbia with at least 60 tracts that have income, the three controls and the measure	BRFSS 2022 (PLACES 2024 release); ACS 2019-2023		51 states	adult population of the tract (PLACES)	CDC PLACES	A median of the state estimates; each state's interval is in the table.

Definitions

Modeled estimate: A figure produced by a statistical model instead of a direct count or measurement, usually for small areas where direct data are thin, borrowing strength from surveys, neighboring areas or other data. Neighboring areas can share errors, so single extremes call for caution.
Census tract: A small area drawn by the Census Bureau to stand in for a neighborhood. Boundaries are redrawn after each decennial census.
Area Deprivation Index (ADI): A score that ranks neighborhoods by income, education, employment and housing conditions drawn from the American Community Survey. In this book a higher national percentile means a more deprived neighborhood.
Fixed effects: A regression adjustment that gives each group, such as each county, its own baseline. The estimate then rests on differences within groups.
Inverse care law: The pattern that people who need medical care most tend to receive the least of it. The physician Julian Tudor Hart named it in 1971.

Methods

This chapter compares adults in tenths of census tracts ranked by the Area Deprivation Index 2023, and counties ranked the same way, on health behaviors, access to care and provider supply. The tract values are model-based estimates from CDC PLACES, built from BRFSS 2022 (2021 for four measures) with poverty, demographic and education inputs, not direct counts, and the staged tract file has no intervals. Outcome, deprivation and provider counts come from different years (provider counts are for 2021 to 2023). Tracts and counties without a deprivation rank are left out (741 tracts and 15 small counties), and a county with no recorded provider adds residents and no providers to a provider ratio. Means are weighted by the tract's adult population.

How tract prevalence is estimated

Tract prevalence is CDC PLACES, 2024 release, crude prevalence among adults: model-based estimates built from BRFSS 2022 (2021 for blood pressure, blood pressure medicine, high cholesterol and cholesterol screening) with county poverty, the age, sex, race and ethnicity of each tract's residents and education from the American Community Survey and the census, and state and county random effects, so that within a county tract values differ through demographic composition.

The staged tract file has no intervals.

Figures explained here: Figure 1, Figure 3 and Figure 4

How tracts are ranked, grouped and weighted

Deprivation is the Area Deprivation Index 2023 national percentile (1 least, 100 most deprived), and 741 tracts have no rank and are left out. Tenths hold 8,118 to 8,511 tracts (tied ranks fall in the same tenth) and twentieths fewer.

Means are weighted by the tract's adult population, including for measures that cover only some ages because the file has no population for them; counting each tract once gives similar differences.

Figures explained here: Figure 1, Figure 3 and Figure 4

How provider supply is measured

Provider supply is from County Health Rankings 2024.

Residents per provider in a group of counties is the group's residents divided by its providers, so a county with no recorded provider adds residents and no providers; the county ratios that County Health Rankings publishes are not used.

Counties are ranked on the county Area Deprivation Index, the mean of the tract percentiles weighted by 2019-2023 population, with Connecticut tracts assigned to its eight legacy counties; 15 small counties have no rank. County percent rural is from the 2020 census.

Figures explained here: Figure 7 and Figure 8

How the map is shaded and what is left out

The map shades residents per mental health provider on a scale that doubles at each step and draws counties with no recorded provider in gray.

Counties are not suppressed anywhere in this chapter, and no tract or county estimate is set to zero.

Figure explained here: Figure 8

How uncertainty is measured

Intervals for means, differences and ratios are percentile intervals from 2,000 draws of whole counties with replacement (seed 12345); differences and ratios share the draws of their two means.

Intervals for pooled ratios, county means and correlations come from the same draw scheme applied to whole states (seed 12345); correlations are reported weighted by county residents and with each county counted once.

How the slopes and the coefficient zoo are fitted

Slopes are population-weighted least-squares fits with cluster-robust errors and t intervals, counties as clusters; fixed effects are absorbed by weighted demeaning and checked against a regression with dummy variables.

The coefficient zoo fits, for each state with at least 60 tracts that have every variable, the tract prevalence of a behavior on the natural log of median household income (ACS 2019-2023) with the shares of residents ages 65 and over, Black alone and Hispanic as controls, and reports the coefficient times the natural log of 2. States with fewer than five counties use HC3 errors.

Figures explained here: Figure 2, Figure 5 and Figure 6

Four rankings of the same places

The comparison follows the book's ranking switch rule, fixed on October 28, 2026 before any of these gradients was computed. The main gradient of the chapter is recomputed under four rankings of the same places, with the outcome, period, weights, bins and intervals unchanged: the published ADI; a standardized index that applies the ADI's coefficients to its measures after standardizing each one across tracts; median household income; and the share of adults 25 and older with a bachelor's degree or more. The three alternatives come from ACS tract estimates for 2019 to 2023, the period of the ADI.

All four rankings use the same places, the 3,125 counties that have the outcome and all four rankings, so the ADI panel can differ slightly from the chapter's main figure. Tracts enter only if they have every input of the standardized index, which leaves out tracts without a median rent, home value or mortgage cost. A county takes the population-weighted mean of the ranks of its common-sample tracts, with Connecticut tracts assigned to its eight legacy counties, as for the county ADI.

A pattern counts as changed when the worse end switches sides, when the two ends differ under one ranking and not the other, or when the rank correlation of bin order and bin mean falls on the other side of 0.9 and moves by at least 0.1.

Figure explained here: Figure 9

What these data cannot show

References

Greenlund, Kurt J.; Lu, Hua; Wang, Yan; Matthews, Kevin A.; LeClercq, Jennifer M.; Lee, Benjamin; Carlson, Susan A. (2022). PLACES: Local Data for Better Health. Preventing Chronic Disease 19: 210459. doi:10.5888/pcd19.210459
Kind, Amy J. H.; Buckingham, William R. (2018). Making Neighborhood-Disadvantage Metrics Accessible: The Neighborhood Atlas. New England Journal of Medicine 378(26): 2456-2458. doi:10.1056/NEJMp1802313
Tudor Hart, Julian (1971). The Inverse Care Law. The Lancet 297(7696): 405-412. doi:10.1016/S0140-6736(71)92410-X
University of Wisconsin Population Health Institute (2024). County Health Rankings & Roadmaps Technical Documentation, Version 2. University of Wisconsin Population Health Institute (updated March 18, 2024). www.countyhealthrankings.org/sites/default/files/media/document/2024%20CHRR%20Technical%20Document_1.pdf
Finkelstein, Amy; Taubman, Sarah; Wright, Bill; Bernstein, Mira; Gruber, Jonathan; Newhouse, Joseph P.; Allen, Heidi; Baicker, Katherine; Oregon Health Study Group (2012). The Oregon Health Insurance Experiment: Evidence from the First Year. The Quarterly Journal of Economics 127(3): 1057-1106. doi:10.1093/qje/qjs020
Baicker, Katherine; Taubman, Sarah L.; Allen, Heidi L.; Bernstein, Mira; Gruber, Jonathan H.; Newhouse, Joseph P.; Schneider, Eric C.; Wright, Bill J.; Zaslavsky, Alan M.; Finkelstein, Amy N. (2013). The Oregon Experiment: Effects of Medicaid on Clinical Outcomes. New England Journal of Medicine 368(18): 1713-1722. doi:10.1056/NEJMsa1212321
Miller, Sarah; Johnson, Norman; Wherry, Laura R. (2021). Medicaid and Mortality: New Evidence from Linked Survey and Administrative Data. The Quarterly Journal of Economics 136(3): 1783-1829. doi:10.1093/qje/qjab004
Bailey, Martha J.; Goodman-Bacon, Andrew (2015). The War on Poverty's Experiment in Public Medicine: Community Health Centers and the Mortality of Older Americans. American Economic Review 105(3): 1067-1104. doi:10.1257/aer.20120070
Centers for Disease Control and Prevention (2024). PLACES Frequently Asked Questions: Using the Data. CDC PLACES website, page last reviewed August 29, 2024. www.cdc.gov/places/faqs/using-data/index.html

Provenance

Pipeline version: 0.1.0
Build script: book2/chapters/health-behaviors-and-the-supply-of-care/build.py (sha256 4dc2e47fd80746fd69982d9c8af4e068cf34d6389e02b624fecc581717ec6e6b)
Built on: 2026-10-07
Site commit: c2b1ff3309cb4a10833f884da91ac0057a66ad0a

Inputs

File	Size (bytes)	SHA-256, first 1 MB	SHA-256, last 1 MB
book2/chapters/health-behaviors-and-the-supply-of-care/gradients.py	11,771	1fe448a81ab7fbb49ae49ade9c68d93a5617e95e103be3e322c47d29884ef32f	1fe448a81ab7fbb49ae49ade9c68d93a5617e95e103be3e322c47d29884ef32f
book2/chapters/health-behaviors-and-the-supply-of-care/supply.py	7,234	315c7b776f033f7288149ae1f98c8d58b68a2483b02ad53a7d885db567199566	315c7b776f033f7288149ae1f98c8d58b68a2483b02ad53a7d885db567199566
book2/chapters/health-behaviors-and-the-supply-of-care/zoo.py	430	447ef1b703ca8e0d04d14a482e62396d4a42a497ca22ce22e92280bcb5f0bb3a	447ef1b703ca8e0d04d14a482e62396d4a42a497ca22ce22e92280bcb5f0bb3a
data/analytic/tract_atlas.parquet	39,659,925	29d5e4d943552d54aeb6ba92aadc939d9bd15bdea553c78357dbd516757be627	1e10d1ecf722340f23ee2212d4999a90250f85b65fa89b39e32db06d9472e22e
data/geo/dim_geo.parquet	1,180,921	29d5e4d943552d54aeb6ba92aadc939d9bd15bdea553c78357dbd516757be627	e58c8c488df54ab3187f5461f179322afdc49c9bd2315404003fe1272eea32c3
data/raw/acs/deprivation_components_2019_2023/tract.parquet	13,197,793	5545cde2cbe96a8b56e468d65388248a241aa6bd300d3c9e325d08d3f86b11da	5c8ec454d066988b0f1a01aaa6ed34ebfc05d162e01cf9c6bb01f9198cbaff12
data/staged/adi/adi_atlas_tract2020_2023.parquet	798,078	5e409bc212ff871def780fa27b4cf8b616d9da420b2b9f6455517eddcd8c1a95	5e409bc212ff871def780fa27b4cf8b616d9da420b2b9f6455517eddcd8c1a95
data/staged/crosswalks/ct_tract2020_to_old_county.parquet	15,842	961ef39f31596ef65fca2c67d5f2f63e533c5dc9b49745d3bb6437844e4b831d	961ef39f31596ef65fca2c67d5f2f63e533c5dc9b49745d3bb6437844e4b831d
data/staged/health/chr_county_2024.parquet	8,776,933	619795f7ecfec8aff10694b649eaee5e421dbeffbe4be47af4161b51ceefa5cd	c69357f1bcf630407bb9716cb445618838999558c019aaaf77d4681b6bf45c56
data/staged/health/places_tract2020_latest.parquet	5,919,159	af4c3b0d1205b7d84b81676a9529ef73323b2dbeb9d54e235f5efeebfad83177	a2f19029ee2ef032be87e0d5288d88d489afd52379279833f178baa021df3dbf
data/staged/ses/acs5_tract2020_2019_2023.parquet	7,232,424	5fe6f730a35225f14d5d8abfc6b9bce58b52e545f309a7eac74f1dae74d7a31c	7b4a2475b3852d3f91804716a04566ef8ceadacec2be9fb85f5eb642078efac6
data/staged/svi/svi_tract2020_2022.parquet	17,740,415	cb3860d8edc2aaf1f2a02211a58f7a0b80457eb6ad9a37b5ec8abb2d5da9da10	e371a4a696d5bed05d54ad7c5b6ca2504508805b847ec415c2322be7f66ec2b2

Outputs

File	SHA-256
facts.json	cb3c3e891db62b647d899ac6fb4e094e6cfb9eba07c7713713a4648aa23d0e0f
figures/alt_rankings.json	0e6a524e2d02f3d85fc9200381f43c0c1d9992221f13382a6b8759f7451f7cba
figures/care_ledger.json	9264b088611727b7684db2e297b63c2a18b15f90d97472765d0266ebf7ca579d
figures/checkup_slopes_by_state.json	0f2764a46daa079fb2098294ce69267ea7fc5f0365fc27d1459b59a75e04d2a8
figures/checkup_specifications.json	68902599b95a1f8f5dc1c994eac81a71a5ad566f8221b4b402c6fe25e0863cd6
figures/checkup_vs_dental.json	b16bc37d663753dd00b0c0baf5b2292305c6844a6efaf1b3a8311a90b056345f
figures/coefficient_zoo.json	597a9227664276b82f7078ef41ed4c63c1e039c4a9c1d3355a2ce8d515269bfd
figures/mental_health_provider_map.json	163018ff6047d0171e658516aebfa3e41b52300b0148fc2995948a1fb6c945cb
figures/people_per_provider.json	afc13ef7ae3be5189fe198b6a6f18723b761935c3e00a6a816c76d7fbc30dbb5
figures/twelve_outcome_gradients.json	4b7354f894718ec4f0e4ba1957343e755e6d8d2cbddbf609292392f8c050798d
meta.json	9ffc14279db5ea06a06de8e2a5fd759c65f7bb837ad43072646de38ec54c01f8
public/data/health-behaviors-and-the-supply-of-care/mental_health_provider_map.json	7f9714b1991ea8122cdb3e5663400ce3287d322f3fe3097f6cba257d65340c16
refs.json	24a7bbefb95f1ddf599fef65b29c35bfa0bdcd416815464da5e3130cd0ff49e8

Machine formats

Report (Markdown): https://vishalsingh.org/zipcode/health-behaviors-and-the-supply-of-care/report.md
Every estimate (JSON): https://vishalsingh.org/zipcode/report/health-behaviors-and-the-supply-of-care/facts.json
Table 1, figure "twelve_outcome_gradients" (JSON): https://vishalsingh.org/zipcode/report/health-behaviors-and-the-supply-of-care/figures/twelve_outcome_gradients.json
Table 2, figure "coefficient_zoo" (JSON): https://vishalsingh.org/zipcode/report/health-behaviors-and-the-supply-of-care/figures/coefficient_zoo.json
Table 3, figure "checkup_vs_dental" (JSON): https://vishalsingh.org/zipcode/report/health-behaviors-and-the-supply-of-care/figures/checkup_vs_dental.json
Table 4, figure "care_ledger" (JSON): https://vishalsingh.org/zipcode/report/health-behaviors-and-the-supply-of-care/figures/care_ledger.json
Table 5, figure "checkup_specifications" (JSON): https://vishalsingh.org/zipcode/report/health-behaviors-and-the-supply-of-care/figures/checkup_specifications.json
Table 6, figure "checkup_slopes_by_state" (JSON): https://vishalsingh.org/zipcode/report/health-behaviors-and-the-supply-of-care/figures/checkup_slopes_by_state.json
Table 7, figure "people_per_provider" (JSON): https://vishalsingh.org/zipcode/report/health-behaviors-and-the-supply-of-care/figures/people_per_provider.json
Table 8, figure "mental_health_provider_map" (JSON): https://vishalsingh.org/zipcode/report/health-behaviors-and-the-supply-of-care/figures/mental_health_provider_map.json
Table 9, figure "alt_rankings" (JSON): https://vishalsingh.org/zipcode/report/health-behaviors-and-the-supply-of-care/figures/alt_rankings.json
Payload of "mental_health_provider_map" (JSON): https://vishalsingh.org/zipcode/data/health-behaviors-and-the-supply-of-care/mental_health_provider_map.json
Index of every report: https://vishalsingh.org/zipcode/llms.txt; all reports in one file: https://vishalsingh.org/zipcode/llms-full.txt