Chapter 7.3 · Where illness keeps company · Report

Multiple chronic conditions

Weighted by adults, census tracts in the most deprived tenth were high on 5.7 of nine modeled chronic-condition prevalences on average in 2022, against 0.5 in the least deprived tenth, a count for tracts and not people.

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

Multiple chronic conditions

Label

Where illness keeps company

Chapter

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

Question

Which chronic conditions are high in the same neighborhoods, and how does that overlap change with deprivation?

Dek

Grain

neighborhoods

Status

published

Published

9 October 2026

Updated

not revised

Data sources

CDC PLACES. CDC PLACES 2024 release, census tracts, crude prevalence among adults of nine conditions (BRFSS 2022); years: 2024 release (tracts); 2025 release (ZCTAs, 2023 data year); weights: adult population of the tract
Area Deprivation Index. Neighborhood Atlas Area Deprivation Index, 2023, national percentile; years: 2023 release (version 4.0.1; built on ACS 2019-2023); weights: adult population of the tract
American Community Survey. ACS 2019-2023 tract shares used to approximate the model's inputs; years: 2019-2023 (5-year); weights: adult population of the tract
USALEEP life expectancy. NCHS small-area life expectancy at birth, 2010-2015, 2020 tracts; years: 2010-2015; weights: ACS 2019-2023 tract population
Published estimates from cited studies. Estimates quoted in the causal box (Ludwig and coauthors 2011); years: as reported in each study; weights: as reported in the study

Canonical URL

https://vishalsingh.org/zipcode/multiple-chronic-conditions

Markdown

https://vishalsingh.org/zipcode/multiple-chronic-conditions/report.md

BibTeX

@misc{singh2026multiplechronicconditions,
  author = {Singh, Vishal},
  title = {Multiple chronic conditions},
  year = {2026},
  url = {https://vishalsingh.org/zipcode/multiple-chronic-conditions},
  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
mean number of the nine conditions that are high, population-weighted mean over a tenth of tracts, bootstrap interval over counties	adults in the most deprived tenth of tracts by ADI national percentile	BRFSS 2022 (PLACES 2024 release); ADI 2023	5.7	95% CI 5.5 to 5.8	8,213 tracts	adult population of the tract (PLACES)	CDC PLACES	cnt_d10
mean number of the nine conditions that are high, population-weighted mean over a tenth of tracts, bootstrap interval over counties	adults in the least deprived tenth of tracts by ADI national percentile	BRFSS 2022 (PLACES 2024 release); ADI 2023	0.5	95% CI 0.4 to 0.6	8,274 tracts	adult population of the tract (PLACES)	CDC PLACES	cnt_d1
definition: a tract is high on a condition when its prevalence is in the highest 25% of tracts, ties at their mean rank	census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	25%			none (a definition)	CDC PLACES	cut_pct
difference between the population-weighted mean count of high conditions in the most and the least deprived tenth of tracts, bootstrap interval over counties (draws shared)	adults in the most deprived tenth of tracts compared with the least deprived tenth	BRFSS 2022 (PLACES 2024 release); ADI 2023	5.2	95% CI 5.0 to 5.4	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES	cnt_diff
count of tracts	census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023	82,781			none (full count)	CDC PLACES	n_tracts
mean of the population-weighted Pearson correlations over the 36 pairs of conditions, bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	+0.49	95% CI 0.48 to 0.51	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES	r_mean
count of measure ids in the staged tract file	health measures that PLACES publishes for tracts	PLACES 2024 release	40			none (full count)	CDC PLACES	n_places_measures
definition: the number of conditions in the count	PLACES health outcome measures that cover all adults and have an estimate in every state	PLACES 2024 release	9			none (a definition)	CDC PLACES	n_conditions

Findings

Weighted by adults, a tract in the most deprived tenth of census tracts is in the highest 25% of all tracts for the prevalence of 5.7 (95% CI 5.5 to 5.8) of nine chronic conditions on average, against 0.5 (95% CI 0.4 to 0.6) in the least deprived tenth, a difference of 5.2 (95% CI 5.0 to 5.4) conditions. Across 82,781 tracts, the average correlation between the prevalences of two of the conditions is +0.49 (95% CI 0.48 to 0.51). This chapter asks which conditions are high in the same neighborhoods and how that overlap changes with deprivation. It is a chapter about places and says nothing about how many conditions any one person has.

The data are modeled estimates from CDC PLACES, which gives each tract one prevalence for each condition among adults and holds no record of any person.[1] In surveys that ask each adult about each condition, multiple chronic conditions means having two or more of them,[2] and a tract estimate cannot be turned into that count. A tract can be high on several conditions while no resident has more than one, and a tract can be high on none while some residents have several. A count of conditions in this chapter is a count of tract prevalences above a stated cutoff.

PLACES publishes 40 measures for tracts. The 9 conditions used here are the health outcome measures that cover all adults and have a tract estimate in every state: arthritis, cancer (non-skin) or melanoma, current asthma, coronary heart disease, COPD, depression, diagnosed diabetes, obesity and stroke. PLACES lists obesity, a measure of body weight, with the health outcomes. High blood pressure and high cholesterol (among adults ever screened) are left out because the 2024 release has no tract estimate of either for Florida. The last section gives the number of tracts and a check on high blood pressure outside Florida.

A tract is high on a condition when its prevalence is in the highest 25% of tracts, with each tract counted once, and the count of a tract is the number of the nine conditions on which it is high. Means, correlations and shares of adults are population-weighted by the adults in each tract, and counts and shares of tracts count each tract once. Deprivation is ranked on the Area Deprivation Index (ADI), a national percentile built from American Community Survey (ACS) data.[3]

The PLACES 2024 release uses survey responses from 2022, and from 2021 for blood pressure. 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.

Stroke, diabetes, COPD and heart disease are high in the same tracts

The strongest correlations join stroke, diabetes, COPD, coronary heart disease and arthritis (Table 1). Across tracts the prevalence of stroke correlates +0.90 (95% CI 0.89 to 0.92) with diabetes, +0.90 (95% CI 0.89 to 0.90) with COPD and +0.86 (95% CI 0.85 to 0.87) with heart disease, and the pairs among stroke, diabetes, COPD and heart disease run from +0.74 to +0.90.

Arthritis correlates +0.90 (95% CI 0.89 to 0.91) with heart disease. At the other end, cancer and depression have the weakest correlations with the rest, and depression correlates only +0.06 (95% CI 0.01 to 0.11) with diabetes. The mean correlation of cancer with the other eight conditions is +0.22 (95% CI 0.19 to 0.25) and that of depression is +0.26 (95% CI 0.22 to 0.30), against +0.68 (95% CI 0.66 to 0.69) for COPD.

Of the 36 pairs, 32 have an interval entirely above zero and 2 have one entirely below it, cancer with asthma (−0.13 (95% CI −0.20 to −0.07)) and cancer with obesity (−0.11 (95% CI −0.18 to −0.05)).

One principal component accounts for 59.0% (95% CI 57.9% to 60.2%) of the variance of the nine standardized prevalences, so most of the difference between tracts in these conditions follows a single shared pattern. Every correlation here is between modeled estimates and is partly built in by the inputs the model shares across conditions, a point the section on the model's inputs takes up.

Table 1. Stroke, diabetes, COPD and heart disease are high in the same tracts, with correlations from +0.74 to +0.90, while cancer correlates −0.13 with asthma

The correlations of cancer follow the age of the residents. PLACES gives crude prevalence, and across tracts the prevalence of cancer correlates +0.81 (95% CI 0.79 to 0.83) with the ACS share of residents aged 65 and over, against +0.64 (95% CI 0.61 to 0.66) for arthritis, +0.64 (95% CI 0.61 to 0.66) for heart disease, +0.23 (95% CI 0.19 to 0.26) for diabetes and −0.17 (95% CI −0.21 to −0.14) for depression.

Cancer correlates 0.00 (95% CI −0.07 to 0.07) with the ADI. It correlates +0.74 (95% CI 0.72 to 0.75) with arthritis and +0.63 (95% CI 0.60 to 0.66) with heart disease, the two other conditions that line up with age, and close to zero with diabetes (+0.05 (95% CI 0.00 to 0.11)) and depression (0.00 (95% CI −0.07 to 0.06)). Two features of a tract therefore line up with the conditions. One is the age of its residents, which lines up with cancer, arthritis and heart disease. The other is deprivation, taken up in the sections below.

Asthma correlates +0.64 (95% CI 0.59 to 0.69) with obesity. The modeled asthma estimates are set against air pollution in Chapter 6.1, Air pollution, and here asthma is one of nine conditions.

The same pattern can be counted. For the tracts that are high on stroke, the mean number of the other eight conditions that are also high is 4.9 (95% CI 4.8 to 5.0), and for tracts high on COPD it is 4.9 (95% CI 4.9 to 5.0) (Table 2). For tracts high on depression it is 3.1 (95% CI 3.0 to 3.3) and for tracts high on cancer 2.5 (95% CI 2.4 to 2.6). If the conditions were unrelated across tracts, each mean would be 2.0. Weighting tracts by adults instead of counting each once moves each mean by 0.34 conditions or less.

Table 2. Tracts high on stroke are also high on 4.9 of the other eight conditions on average, against 2.5 for tracts high on cancer and 2.0 if the conditions were independent

More tracts are high on all nine or on none than unrelated conditions give

Table 3 counts, for each tract, the conditions on which it is high. 34.0% (95% CI 30.7% to 37.1%) of tracts are high on none of the nine, where unrelated conditions with the same shares of high tracts would leave 7.4%. At the other end 892 tracts, 1.1% (95% CI 0.9% to 1.3%) of the total, are high on all nine, where unrelated conditions would give 0.3 tracts.

Tracts high on 5 or more of the nine make up 21.3% (95% CI 19.3% to 23.3%) of tracts against 4.9% for unrelated conditions. The benchmark is a reference point and not a hypothesis anyone held. It is the distribution that independent draws would give, with each condition's observed share of high tracts. Real tracts are not independent draws, in part because the model fits every condition to the same inputs.

Weighted by adults, 38.1% of adults live in tracts that are high on none and 17.1% in tracts that are high on 5 or more. Large tracts are therefore somewhat less likely to be high on many conditions.

Table 3. 34.0% of tracts are high on none of the nine conditions and 892 tracts are high on all nine, where independent conditions would give 0.3 tracts

The cutoff is a choice, and the numbers depend on it. By construction a tract is high on 2.3 conditions on average at the chapter's cutoff, and ties at the cutoff move the share of tracts that is high on a single condition between 24.0% and 25.6%.

Table 4 repeats the count with other cutoffs. With the stricter cutoff of the highest 10% of tracts, 64.9% of tracts are high on none and 14 are high on all nine, against 0.0 expected for unrelated conditions.

With the looser cutoff of the highest 33.3% the figures are 23.4%, 2,679 and 4.5. The number of tracts that are high on all nine exceeds the unrelated benchmark under every cutoff, and the share that is high on none depends strongly on the cutoff.

Table 4. Tracts are high on all nine conditions more often than independent conditions would give under every cutoff, from 14 tracts against 0.0 at the strictest to 2,679 against 4.5 at the loosest

The count rises across the deprivation index, and the overlap does not strengthen

Table 5 orders tracts on the ADI and shows the mean count in each tenth. It is 0.5 (95% CI 0.4 to 0.6) in the least deprived tenth and 5.7 (95% CI 5.5 to 5.8) in the most deprived, a difference of 5.2 (95% CI 5.0 to 5.4), and it rises at every step, with the two largest steps at the deprived end. The share of adults who live in tracts high on 5 or more conditions is 0.8% (95% CI 0.3% to 1.6%) in the least deprived tenth and 72.5% (95% CI 69.9% to 75.1%) in the most deprived.

Part of this gradient is mechanical. The ADI is built from ACS data, and the PLACES model applies survey responses to each tract's census population using inputs from the same census sources, so conditions and index move together partly by design. The gradient of each condition taken one at a time belongs to Chapter 7.1, Health behaviors and the supply of care, and the count here adds only that the conditions which rise are high in the same tracts.

Table 5. Weighted by adults, a tract in the most deprived tenth is high on 5.7 of nine conditions on average, against 0.5 in the least deprived tenth

The conditions do not go together more closely where deprivation is higher. Inside the least deprived tenth the mean correlation among the nine is +0.40 (95% CI 0.37 to 0.44), and inside the most deprived tenth it is +0.34 (95% CI 0.32 to 0.36), a difference of +0.06 (95% CI 0.03 to 0.11) with the least deprived tenth higher. Inside the second to the ninth tenth it lies between +0.35 and +0.36.

After the mean of each ADI tenth is subtracted, the average correlation across all tracts is +0.36 (95% CI 0.35 to 0.38), against +0.49 before. Holding the ADI tenth fixed therefore removes part of the overlap, and a correlation remains in every tenth. The count of high conditions rises with deprivation, while the overlap among the conditions inside a tenth is smaller in the most deprived tenth than in the least deprived.

An approximation of the model's census inputs leaves most of the overlap in place

Part of every correlation among the PLACES estimates in this chapter is built into the estimates. PLACES fits a model to survey responses, using the age, sex, race, ethnicity and education of each respondent, a county measure of poverty, and state and county effects, and applies it to the census population of each tract.[1] Conditions that are modeled from the same inputs move together wherever the inputs move, whatever the residents do. Within a county the model gives tracts different values only through the composition of their residents.

The data cannot take the model apart, but the ACS can approximate its inputs. The approximation needs ACS shares, and the ACS file lacks three of them for the District of Columbia, so this section leaves out the 203 tracts that lack a share, among them the 201 tracts of the District of Columbia. Every other statistic in the chapter includes them.

For each condition, a weighted regression on 8 ACS tract shares, their squares and pairwise products, a county poverty rate and state effects reproduces 79% to 90% of the variance of tract prevalence, counting the part the state effects carry. The average correlation among the residuals is +0.47 (95% CI 0.46 to 0.48), against +0.49 (95% CI 0.48 to 0.51) for the conditions themselves on the same tracts and +0.49 on all tracts (Table 6).

With county effects in place of state effects and county poverty, the fit reproduces 62% to 85% of the variance within counties. The average correlation among its residuals is +0.52 (95% CI 0.51 to 0.52), higher than the raw value on the same tracts.

Gradient-boosted trees fitted to the same inputs, scored on counties they did not see, reproduce 75% to 90% of the variance and leave a mean correlation of +0.45 (95% CI 0.44 to 0.47). Holding the state fixed gives +0.48 (95% CI 0.47 to 0.50) and holding the county fixed gives +0.43 (95% CI 0.42 to 0.43).

Table 6. An approximation of the model's census inputs leaves the average correlation among the nine conditions at +0.47, against +0.49 in the raw data

These numbers show that the inputs which can be measured here do not remove the overlap. They do not show that the overlap is real. The fits approximate the model and are not the model. The ACS file has no sex shares and no age groups beyond the shares under 18 and at 65 and over, the model works from individual respondents and not tract shares, and its county and state effects are fitted to each condition separately from the same survey. Whatever the conditions share and the fit misses, such as the age mix inside the older group, stays in the residuals and keeps them correlated. What the comparison supports is narrower. The shared part of the PLACES estimates is not a simple function of the census shares that were available, and the data cannot say how much of it comes from the model's other inputs and how much from the neighborhoods.

Where tracts are high on many conditions

Tracts that are high on many conditions are not spread evenly. Of the variance of the count, 22.4% lies between states and 29.8% between counties within states, a total of 52.2% between counties, and 47.8% lies between tracts within counties. As the section on the model's inputs explains, the within-county part reflects the composition of residents.

Table 7 maps, for each county, the share of adults who live in tracts that are high on 5 or more conditions. In 1,229 of the 3,128 counties with a value, 50% or more of adults do.

By Census region the share is 25.8% of adults in the South, 20.2% in the Midwest, 8.5% in the Northeast and 7.0% in the West, against 17.1% nationally, and in West Virginia it is 81.7%. The counties with large shares cluster in the South and in parts of the Midwest.

Table 7. In 1,229 counties, 50% or more of adults live in tracts that are high on 5 or more conditions, and 25.8% of adults in the South do, against 7.0% in the West

Life expectancy is shorter in tracts that are high on more conditions

Death records give a check that does not depend on the PLACES model. USALEEP life expectancy at birth, built from deaths in 2010 to 2015, is 80.2 (95% CI 80.0 to 80.4) years in tracts that are high on none of the nine and 74.1 (95% CI 73.9 to 74.3) years in tracts that are high on eight, a gap of 6.1 (95% CI 5.8 to 6.3) years (Table 8). In tracts that are high on all nine it is 75.2 (95% CI 74.9 to 75.4) years, 1.0 (95% CI 0.8 to 1.3) years above tracts that are high on eight, and the data here do not say why.

Tracts high on all nine differ in composition. The share of residents aged 65 and over is 22.6% (95% CI 22.3% to 22.9%) in tracts high on all nine against 18.9% (95% CI 18.6% to 19.2%) at eight, and the Black alone share is 2.7% (95% CI 2.2% to 3.1%) against 14.9% (95% CI 12.9% to 16.9%).

Across 77,934 tracts the count correlates −0.48 (95% CI −0.49 to −0.46) with life expectancy, and −0.25 (95% CI −0.27 to −0.22) once each tract is compared with the mean of its county. Within a county, tracts that are high on seven conditions differ from the county mean by −1.9 (95% CI −2.2 to −1.7) years, against +0.6 (95% CI 0.5 to 0.7) years for tracts that are high on none. Within a county the count varies only through the composition of tract residents, which also moves life expectancy, so this comparison does not isolate the conditions.

Life expectancy at birth is built from death rates at each age, so the age mix of a tract does not move it the way it moves crude prevalence, which makes this a check on whether the count reflects more than age. The two sources cover different years, 2010 to 2015 and 2022, and a correlation between them does not show that the conditions shorten lives.

Table 8. Life expectancy at birth is 6.1 years shorter in tracts that are high on eight conditions than in tracts that are high on none

What a randomized offer to move shows about two of the conditions

Causal evidenceRandomized housing-voucher experiment

Moving to Opportunity and measured obesity and diabetes

The tract patterns above do not say whether living in a high-poverty neighborhood changes health. One randomized study measured two of the nine conditions, with a definition that matches PLACES for one and not for the other. From 1994 to 1998 the Department of Housing and Urban Development randomly offered women with children in public housing in high-poverty tracts one of three things: a voucher usable only in low-poverty tracts, with moving counseling; an ordinary voucher; or no new offer. Of the women offered the low-poverty voucher, 48% used it to move, and every estimate below compares women by the offer they were randomized to (intention-to-treat) and not by whether they moved. A survey from 2008 to 2010 measured height, weight and glycated hemoglobin.[4]

Compared with the group offered no voucher, the group offered the low-poverty voucher differed in the prevalence of extreme obesity (a body mass index of 40 or more) by −3.4 (95% CI −6.4 to −0.4) points and in the prevalence of glycated hemoglobin of 6.5% or more by −4.3 (95% CI −7.8 to −0.8) points, intervals that exclude zero. Obesity as PLACES defines it, a body mass index of 30 or more, differed by −1.2 (95% CI −5.4 to 3.0) points, an interval that includes zero. The glycated hemoglobin cutoff counts diabetes that has not been diagnosed, while PLACES counts diagnosed diabetes. The group offered ordinary vouchers did not differ significantly from the group offered nothing.

The study measured two conditions and not a count of conditions, enrolled volunteers for a program, and does not show what a move would do to the number of conditions that are high in a tract.

The count of high conditions rises under all four rankings

Table 9 repeats the count by tenth of tracts under four rankings, over the 75,596 tracts that have all four. Ranked by the ADI, the mean count is 0.4 (95% CI 0.3 to 0.5) in the least deprived tenth and 5.7 (95% CI 5.5 to 5.8) in the most deprived, and under the standardized index it runs from 0.5 (95% CI 0.4 to 0.5) to 4.5 (95% CI 4.1 to 4.8), lower in the most deprived tenth than under the ADI. Ranked by median household income it runs from 0.4 (95% CI 0.3 to 0.4) to 5.2 (95% CI 5.0 to 5.3), and by bachelor's degree share from 0.5 (95% CI 0.4 to 0.5) to 4.3 (95% CI 3.8 to 4.6), and under each ranking the tenth means rise in order (rank correlations of +1.00, +1.00 and +1.00). None of the three changes the gradient under the book's rule (Chapter 9.1, How far one ranking goes), and all four rankings, like the PLACES model, draw on ACS measures of the same tracts.

Table 9. The count of chronic conditions that are high in a tract is steadily worse toward the more deprived end under the ADI and under each of the three other rankings

What these data cannot show

A count of high conditions describes a tract and not a person. A correlation across places can differ widely in size from the correlation among the people who live in them,[5] so the overlap here cannot be read as people carrying several conditions at once, and no figure in this chapter says how many conditions an adult has. Drawing that conclusion from place data is ecological inference. The count of conditions per person comes from surveys that ask each adult, and Chapter 7.2, Health behaviors, person by person uses one for behaviors.

The PLACES values are modeled estimates, the tract file has no intervals, and the bands in this chapter describe the sampling of counties and not the model's own uncertainty. CDC advises against using the estimates to rank the overall health of an area or to track change at the local level, and this chapter does neither.[6] It does compare conditions with each other and with the ADI, and every such comparison carries the shared inputs described above. The approximations show that measured census shares do not remove the overlap, but they cannot separate what the model builds in from what the neighborhoods contribute. The staged tract file holds crude prevalence only, so age is part of every pattern, most visibly for cancer, arthritis and heart disease.

High is relative. A tract in the highest 25% of tracts for a condition is high compared with other tracts and not high by any clinical standard, and the cutoff moves every count, as the table shows. High blood pressure and high cholesterol are left out because the 2024 release has no estimate of either for the 5,077 tracts of Florida. Outside Florida the mean correlation of high blood pressure with the nine conditions is +0.65 (95% CI 0.64 to 0.67), against +0.51 among the nine on the same tracts, so it follows the same shared pattern.

Of the 83,522 tracts with PLACES estimates, 82,781 also have an ADI rank, and the other 741 are left out. Counties are the clusters of the bootstrap, 3,129 of them, with Connecticut's planning regions standing in for its counties, while the map draws Connecticut as its eight legacy counties. The map has 15 gray counties with no tract in the sample, and 990 counties have fewer than 5 tracts, so their shares move in large steps. Puerto Rico is not covered by PLACES and is not drawn.

The conditions are measured once, in 2022, so the data say nothing about which condition comes first, whether tracts move into or out of the high group, or whether living in a tract changes any of the prevalences. The ADI describes 2019 to 2023 and the life expectancy check describes 2010 to 2015, so the sources do not describe one moment.

Tables

Table 1. Stroke, diabetes, COPD and heart disease are high in the same tracts, with correlations from +0.74 to +0.90, while cancer correlates −0.13 with asthma

Population-weighted Pearson correlations between the tract prevalence of nine chronic conditions among adults, 82,781 census tracts, 2022

conf_high	conf_low	measure	n	other	r
n/a	n/a	Cancer	n/a	Cancer	1
0.755	0.718	Cancer	82,781	Arthritis	0.738
0.655	0.601	Cancer	82,781	Coronary heart disease	0.629
0.362	0.297	Cancer	82,781	COPD	0.332
0.287	0.203	Cancer	82,781	Stroke	0.246
0.106	−0.002	Cancer	82,781	Diabetes	0.052
−0.050	−0.180	Cancer	82,781	Obesity	−0.112
−0.069	−0.196	Cancer	82,781	Asthma	−0.127
0.057	−0.067	Cancer	82,781	Depression	−0.002
0.755	0.718	Arthritis	82,781	Cancer	0.738
n/a	n/a	Arthritis	n/a	Arthritis	1
0.914	0.888	Arthritis	82,781	Coronary heart disease	0.902
0.823	0.800	Arthritis	82,781	COPD	0.812
0.759	0.713	Arthritis	82,781	Stroke	0.736
0.635	0.520	Arthritis	82,781	Diabetes	0.577
0.531	0.421	Arthritis	82,781	Obesity	0.479
0.422	0.315	Arthritis	82,781	Asthma	0.374
0.305	0.197	Arthritis	82,781	Depression	0.253
0.655	0.601	Coronary heart disease	82,781	Cancer	0.629
0.914	0.888	Coronary heart disease	82,781	Arthritis	0.902
n/a	n/a	Coronary heart disease	n/a	Coronary heart disease	1
0.891	0.874	Coronary heart disease	82,781	COPD	0.883
0.875	0.851	Coronary heart disease	82,781	Stroke	0.863
0.763	0.710	Coronary heart disease	82,781	Diabetes	0.737
0.518	0.433	Coronary heart disease	82,781	Obesity	0.477
0.382	0.282	Coronary heart disease	82,781	Asthma	0.335
0.223	0.117	Coronary heart disease	82,781	Depression	0.172
0.362	0.297	COPD	82,781	Cancer	0.332
0.823	0.800	COPD	82,781	Arthritis	0.812
0.891	0.874	COPD	82,781	Coronary heart disease	0.883
n/a	n/a	COPD	n/a	COPD	1
0.904	0.887	COPD	82,781	Stroke	0.896
0.803	0.738	COPD	82,781	Diabetes	0.771
0.719	0.666	COPD	82,781	Obesity	0.694
0.641	0.569	COPD	82,781	Asthma	0.607
0.462	0.374	COPD	82,781	Depression	0.420
0.287	0.203	Stroke	82,781	Cancer	0.246
0.759	0.713	Stroke	82,781	Arthritis	0.736
0.875	0.851	Stroke	82,781	Coronary heart disease	0.863
0.904	0.887	Stroke	82,781	COPD	0.896
n/a	n/a	Stroke	n/a	Stroke	1
0.917	0.887	Stroke	82,781	Diabetes	0.902
0.675	0.623	Stroke	82,781	Obesity	0.649
0.580	0.507	Stroke	82,781	Asthma	0.545
0.193	0.109	Stroke	82,781	Depression	0.151
0.106	−0.002	Diabetes	82,781	Cancer	0.052
0.635	0.520	Diabetes	82,781	Arthritis	0.577
0.763	0.710	Diabetes	82,781	Coronary heart disease	0.737
0.803	0.738	Diabetes	82,781	COPD	0.771
0.917	0.887	Diabetes	82,781	Stroke	0.902
n/a	n/a	Diabetes	n/a	Diabetes	1
0.734	0.647	Diabetes	82,781	Obesity	0.691
0.456	0.356	Diabetes	82,781	Asthma	0.403
0.105	0.010	Diabetes	82,781	Depression	0.058
−0.050	−0.180	Obesity	82,781	Cancer	−0.112
0.531	0.421	Obesity	82,781	Arthritis	0.479
0.518	0.433	Obesity	82,781	Coronary heart disease	0.477
0.719	0.666	Obesity	82,781	COPD	0.694
0.675	0.623	Obesity	82,781	Stroke	0.649
0.734	0.647	Obesity	82,781	Diabetes	0.691
n/a	n/a	Obesity	n/a	Obesity	1
0.686	0.592	Obesity	82,781	Asthma	0.641
0.459	0.350	Obesity	82,781	Depression	0.407
−0.069	−0.196	Asthma	82,781	Cancer	−0.127
0.422	0.315	Asthma	82,781	Arthritis	0.374
0.382	0.282	Asthma	82,781	Coronary heart disease	0.335
0.641	0.569	Asthma	82,781	COPD	0.607
0.580	0.507	Asthma	82,781	Stroke	0.545
0.456	0.356	Asthma	82,781	Diabetes	0.403
0.686	0.592	Asthma	82,781	Obesity	0.641
n/a	n/a	Asthma	n/a	Asthma	1
0.660	0.572	Asthma	82,781	Depression	0.618
0.057	−0.067	Depression	82,781	Cancer	−0.002
0.305	0.197	Depression	82,781	Arthritis	0.253
0.223	0.117	Depression	82,781	Coronary heart disease	0.172
0.462	0.374	Depression	82,781	COPD	0.420
0.193	0.109	Depression	82,781	Stroke	0.151
0.105	0.010	Depression	82,781	Diabetes	0.058
0.459	0.350	Depression	82,781	Obesity	0.407
0.660	0.572	Depression	82,781	Asthma	0.618
n/a	n/a	Depression	n/a	Depression	1

Note: PLACES values are modeled estimates. A model fitted to survey responses is applied to each tract's census population, so every condition's estimate depends on the same age, sex, race, ethnicity and education inputs and on county and state effects, and correlations across tracts are partly built in. The tract file carries no intervals, and the intervals shown here come from a bootstrap over counties.

Note: The diagonal is one by construction and has no interval. Values are crude prevalence among adults, not adjusted for age, so the age mix of a tract moves them.

Note: The nine conditions are the PLACES health outcome measures that cover all adults and have an estimate in every state. High blood pressure and high cholesterol are left out because the 2024 tract release has no estimate of either for 5,077 Florida tracts; outside Florida the mean correlation of high blood pressure with the nine is +0.65.

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

Data: vishalsingh.org/zipcode/report/multiple-chronic-conditions/figures/condition_correlations.json

Table 2. Tracts high on stroke are also high on 4.9 of the other eight conditions on average, against 2.5 for tracts high on cancer and 2.0 if the conditions were independent

Mean number of the other eight conditions that are also high in a tract, for tracts in the highest 25% of tracts on each condition, 2022

condition	conf_high	conf_low	estimate	n
Arthritis	4.65	4.48	4.57	20,620
Cancer	2.64	2.39	2.51	21,087
Asthma	3.91	3.55	3.73	20,589
Coronary heart disease	4.82	4.63	4.73	21,177
COPD	4.98	4.86	4.92	21,048
Depression	3.31	2.96	3.12	20,971
Diabetes	4.69	4.03	4.35	20,549
Obesity	4.15	3.86	3.99	20,885
Stroke	5.04	4.77	4.90	19,866

Note: Weighting tracts by adults moves each mean by 0.34 conditions or less.

Source: CDC PLACES 2024 release (BRFSS 2022) and ADI 2023; modeled estimates, unweighted (each tract counted once)

Data: vishalsingh.org/zipcode/report/multiple-chronic-conditions/figures/others_high.json

Table 3. 34.0% of tracts are high on none of the nine conditions and 892 tracts are high on all nine, where independent conditions would give 0.3 tracts

Tracts by the number of the nine conditions whose prevalence is in the highest 25% of tracts, observed and expected if the conditions were independent, 82,781 tracts, 2022

conf_high	conf_low	count	n	series	share
37.10	30.75	0	82,781	Observed	33.98
21.61	19.41	1	82,781	Observed	20.52
12.31	10.49	2	82,781	Observed	11.37
7.64	6.64	3	82,781	Observed	7.13
6.23	5.26	4	82,781	Observed	5.74
5.77	4.83	5	82,781	Observed	5.30
6.61	5.37	6	82,781	Observed	5.97
6.03	4.69	7	82,781	Observed	5.31
4.12	3.16	8	82,781	Observed	3.61
1.29	0.900	9	82,781	Observed	1.08
n/a	n/a	0	n/a	If conditions were independent	7.44
n/a	n/a	1	n/a	If conditions were independent	22.42
n/a	n/a	2	n/a	If conditions were independent	30.01
n/a	n/a	3	n/a	If conditions were independent	23.43
n/a	n/a	4	n/a	If conditions were independent	11.76
n/a	n/a	5	n/a	If conditions were independent	3.93
n/a	n/a	6	n/a	If conditions were independent	0.880
n/a	n/a	7	n/a	If conditions were independent	0.130
n/a	n/a	8	n/a	If conditions were independent	0.010
n/a	n/a	9	n/a	If conditions were independent	0

Note: The count is a count of tract prevalences above a cutoff, not a count of conditions in any person. PLACES values are modeled estimates. A model fitted to survey responses is applied to each tract's census population, so every condition's estimate depends on the same age, sex, race, ethnicity and education inputs and on county and state effects, and correlations across tracts are partly built in. The tract file carries no intervals, and the intervals shown here come from a bootstrap over counties.

Note: Tied values fall on one side of the cutoff, so the share of tracts that is high on one condition runs from 24.0% to 25.6%. The benchmark is a Poisson-binomial distribution with those shares. Shares of adults living in these tracts differ from shares of tracts (for example 38.1% of adults live in tracts that are high on none).

Source: CDC PLACES 2024 release (BRFSS 2022) and ADI 2023; modeled estimates, unweighted (each tract counted once)

Data: vishalsingh.org/zipcode/report/multiple-chronic-conditions/figures/high_count_distribution.json

Table 4. Tracts are high on all nine conditions more often than independent conditions would give under every cutoff, from 14 tracts against 0.0 at the strictest to 2,679 against 4.5 at the loosest

Count of high conditions per tract when a tract is high on a condition if it is in the highest 10%, 20%, 25% or 33.3% of tracts, 82,781 tracts, 2022

A tract is high on a condition if it is in the	Mean high conditions	Tracts high on none (%)	Tracts high on five or more (%)	Expected if independent (%)	Tracts high on all nine	Expected if independent
Highest 10% of tracts	0.90	64.9	6.2	0.1	14	0.00
Highest 20% of tracts	1.80	42.7	15.8	2.0	360	0.04
Highest 25% of tracts (used in this chapter)	2.26	34.0	21.3	4.9	892	0.32
Highest third of tracts	3.02	23.4	30.9	14.8	2,679	4.47

Source: CDC PLACES 2024 release (BRFSS 2022) and ADI 2023; modeled estimates, unweighted (each tract counted once)

Data: vishalsingh.org/zipcode/report/multiple-chronic-conditions/figures/cutoff_sensitivity.json

Table 5. Weighted by adults, a tract in the most deprived tenth is high on 5.7 of nine conditions on average, against 0.5 in the least deprived tenth

Population-weighted mean number of the nine conditions that are high, by tenth of tracts on the ADI national percentile, 82,781 tracts, 2022

conf_high	conf_low	decile	estimate	measure	n_units
0.550	0.380	1	0.450	count	8,274
0.700	0.550	2	0.620	count	8,118
1	0.780	3	0.880	count	8,511
1.10	0.920	4	1.01	count	8,261
1.39	1.19	5	1.29	count	8,189
1.83	1.60	6	1.71	count	8,318
2.46	2.22	7	2.34	count	8,305
3.34	3.07	8	3.21	count	8,238
4.49	4.21	9	4.35	count	8,354
5.81	5.52	10	5.66	count	8,213
1.57	0.310	1	0.800	share	8,274
1.62	0.850	2	1.19	share	8,118
3.33	2.08	3	2.67	share	8,511
4.93	3.49	4	4.19	share	8,261
7.79	5.88	5	6.79	share	8,189
12.89	10.27	6	11.53	share	8,318
20.66	17.07	7	18.80	share	8,305
33.81	29.22	8	31.48	share	8,238
51.73	46.65	9	49.11	share	8,354
75.09	69.88	10	72.53	share	8,213

Views: Mean number of high conditions (measure = count); Adults in tracts high on five or more (measure = share).

Note: Tenths hold equal numbers of tracts except where tied ranks fall in one tenth. Values are crude prevalence among adults, not adjusted for age, so the age mix of a tract moves them.

Note: Across all the tracts in the comparison, weighted by adults, a tract is high on 2.0 of the nine conditions on average.

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

Data: vishalsingh.org/zipcode/report/multiple-chronic-conditions/figures/high_count_by_adi.json

Table 6. An approximation of the model's census inputs leaves the average correlation among the nine conditions at +0.47, against +0.49 in the raw data

Mean of the 36 pairwise population-weighted correlations among the nine conditions across 82,781 tracts, 2022, under seven comparisons

conf_high	conf_low	estimate	group	n	stage
0.511	0.477	0.495	Compared within groups of tracts	82,781	All tracts
0.498	0.471	0.484	Compared within groups of tracts	82,781	Within states
0.435	0.418	0.427	Compared within groups of tracts	82,781	Within counties
0.377	0.346	0.361	Compared within groups of tracts	82,781	Within tenths of the ADI
0.476	0.460	0.468	After approximating the model's inputs	82,578	Census shares, county poverty and state effects removed
0.521	0.511	0.516	After approximating the model's inputs	82,578	Census shares removed within counties
0.469	0.441	0.455	After approximating the model's inputs	82,578	Flexible fit (trees) on the same inputs and state

Note: The approximation regresses each condition on 8 ACS tract shares (ages 65 and over and under 18, white, Black, Asian and Hispanic residents, and adults with a college degree and with no more than high school), with squares and pairwise products, and removes state or county effects. It uses a county poverty rate in place of the model's measure of county poverty. The ACS file has no sex shares, and the model also uses fitted county and state effects for each condition. The fit explains 79% to 90% of the variance of each condition, counting the state effects, and the tree fit 75% to 90% out of sample. With county effects the fit explains 62% to 85% of the variance within counties. The three adjusted rows leave out the 203 tracts that lack an ACS input, among them the 201 tracts of the District of Columbia, whose ACS file lacks three of the shares; on the tracts they use, the raw average correlation is +0.49.

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

Data: vishalsingh.org/zipcode/report/multiple-chronic-conditions/figures/correlation_stages.json

Table 7. In 1,229 counties, 50% or more of adults live in tracts that are high on 5 or more conditions, and 25.8% of adults in the South do, against 7.0% in the West

Share of adults living in tracts that are high on 5 or more of the nine conditions, by county, population-weighted, 2022

No inline rows: the values of Table 7 are in /data/multiple-chronic-conditions/adults_high_count_map.json.

Note: A county's share is a full count of its tracts and moves in large steps when the county has few tracts: 990 counties have fewer than 5 tracts. Gray counties have no tract in the sample. Puerto Rico is not covered by PLACES and is not drawn. Alaska is drawn, and Connecticut appears under its eight legacy counties, to which its tracts are assigned.

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

Data: vishalsingh.org/zipcode/report/multiple-chronic-conditions/figures/adults_high_count_map.json

Table 8. Life expectancy at birth is 6.1 years shorter in tracts that are high on eight conditions than in tracts that are high on none

Population-weighted mean tract life expectancy at birth by number of high conditions, 77,934 tracts, deaths in 2010 to 2015, institutional tracts dropped

conf_high	conf_low	count	estimate	measure	n_units
80.37	79.98	0	80.18	level	26,431
80	79.64	1	79.82	level	15,948
78.50	78.18	2	78.33	level	8,632
78.19	77.78	3	77.97	level	5,599
77.32	76.79	4	77.06	level	4,541
76.72	76.18	5	76.45	level	4,162
76.38	75.96	6	76.16	level	4,602
74.84	74.35	7	74.59	level	4,248
74.30	73.94	8	74.12	level	2,898
75.41	74.93	9	75.17	level	873
0.660	0.460	0	0.560	dev	26,417
0.800	0.610	1	0.700	dev	15,927
−0.230	−0.480	2	−0.350	dev	8,612
−0.180	−0.560	3	−0.360	dev	5,567
−0.770	−1.25	4	−1	dev	4,511
−1.02	−1.50	5	−1.26	dev	4,135
−0.980	−1.29	6	−1.14	dev	4,572
−1.70	−2.16	7	−1.94	dev	4,219
−1.60	−2	8	−1.80	dev	2,889
−0.290	−0.640	9	−0.470	dev	871

Views: Life expectancy (years) (measure = level); Difference from the county mean (measure = dev).

Note: Tract life expectancy covers 2010 to 2015 and the conditions cover 2022, so the two describe different years. USALEEP estimates were area-weighted from 2010 tracts onto 2020 tracts and suit comparisons of groups of tracts, not single tracts. The within-county view leaves out counties with a single USALEEP tract in the sample. Connecticut tracts carry planning-region codes in PLACES, which serve as its counties for the bootstrap.

Note: Within a county the count varies only through the composition of tract residents, which also moves life expectancy. Life expectancy is not affected by the age mix of a tract the way crude prevalence is, which makes it a check on whether the count reflects more than age. The count itself comes from PLACES modeled estimates and carries the caveats in the notes to the earlier figures.

Source: CDC PLACES 2024 release (BRFSS 2022), USALEEP life expectancy 2010-2015 (area-weighted onto 2020 tracts) and ACS 2019-2023; modeled estimates, population-weighted (ACS tract population)

Data: vishalsingh.org/zipcode/report/multiple-chronic-conditions/figures/life_expectancy_by_count.json

Table 9. The count of chronic conditions that are high in a tract is steadily worse toward the more deprived end under the ADI and under each of the three other rankings

Mean number of high conditions (of nine) by tenth of tracts ranked four ways, over the 75,596 tracts that have all four rankings

bin	conf_high	conf_low	estimate	n_units	ranking
1	0.490	0.339	0.402	7,551	Area Deprivation Index
2	0.701	0.537	0.611	7,563	Area Deprivation Index
3	0.936	0.765	0.845	7,489	Area Deprivation Index
4	1.09	0.907	0.998	7,757	Area Deprivation Index
5	1.37	1.17	1.27	7,485	Area Deprivation Index
6	1.85	1.61	1.73	7,513	Area Deprivation Index
7	2.46	2.23	2.35	7,658	Area Deprivation Index
8	3.38	3.10	3.24	7,419	Area Deprivation Index
9	4.49	4.20	4.34	7,618	Area Deprivation Index
10	5.81	5.53	5.66	7,543	Area Deprivation Index
1	0.534	0.420	0.474	7,559	Standardized index
2	0.732	0.576	0.654	7,560	Standardized index
3	0.978	0.813	0.898	7,559	Standardized index
4	1.29	1.09	1.19	7,560	Standardized index
5	1.69	1.45	1.57	7,560	Standardized index
6	2.22	1.91	2.06	7,559	Standardized index
7	2.80	2.41	2.60	7,560	Standardized index
8	3.40	2.89	3.15	7,559	Standardized index
9	3.90	3.30	3.60	7,560	Standardized index
10	4.81	4.12	4.47	7,560	Standardized index
1	0.435	0.344	0.386	7,560	Median household income
2	0.646	0.502	0.569	7,558	Median household income
3	0.866	0.691	0.775	7,560	Median household income
4	1.18	0.972	1.07	7,560	Median household income
5	1.53	1.30	1.41	7,560	Median household income
6	2.05	1.78	1.91	7,560	Median household income
7	2.77	2.45	2.60	7,555	Median household income
8	3.34	2.98	3.16	7,564	Median household income
9	4.23	3.87	4.05	7,560	Median household income
10	5.32	5.00	5.16	7,559	Median household income
1	0.522	0.405	0.458	7,558	Bachelor's degree share
2	0.714	0.569	0.640	7,557	Bachelor's degree share
3	0.928	0.758	0.843	7,566	Bachelor's degree share
4	1.19	1.00	1.10	7,560	Bachelor's degree share
5	1.60	1.37	1.49	7,553	Bachelor's degree share
6	2.10	1.83	1.96	7,559	Bachelor's degree share
7	2.78	2.45	2.62	7,562	Bachelor's degree share
8	3.46	3.03	3.25	7,569	Bachelor's degree share
9	4.22	3.65	3.94	7,548	Bachelor's degree share
10	4.64	3.85	4.25	7,564	Bachelor's degree share

Note: Least and most deprived tenth: ADI 0.4 and 5.7, rank correlation +1.00; standardized index 0.5 and 4.5, +1.00; median household income 0.4 and 5.2, +1.00; bachelor's degree share 0.5 and 4.3, +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: CDC PLACES 2024 release (BRFSS 2022) and ADI 2023; modeled estimates, population-weighted (adults in each tract); ADI 2023 and ACS 2019-2023 tract tables (B19013, B15003 and the 15 rebuilt ADI measures)

Data: vishalsingh.org/zipcode/report/multiple-chronic-conditions/figures/alt_rankings.json

All estimates

Every fact in facts.json (146), sorted by id. The same values as JSON: facts.json.

Fact id	Value	Unit	Estimand	Population	Period	Interval	n	Weights	Source	Note
age_old	65	years of age	definition: the age at which the ACS share of older residents starts	residents in the ACS share used as an input	ACS 2019-2023			none (a definition)	American Community Survey
age_young	18	years of age	definition: the age below which the ACS share of children is counted	residents in the ACS share used as an input	ACS 2019-2023			none (a definition)	American Community Survey
all_exp	0.3	tracts	number of tracts expected to be high on all nine conditions if they were independent across tracts (Poisson-binomial with the observed share high on each)	census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (a benchmark)	CDC PLACES
all_n	892	tracts	count of tracts that are high on all nine conditions	census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (full count)	CDC PLACES
all_share	1.1%	percent of tracts	share of tracts that are high on all nine conditions, bootstrap interval over counties	census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 0.9% to 1.3%	82,781 tracts	none (each tract counts once)	CDC PLACES
alt_adi_least	0.4	Mean number of high conditions (of nine)	adult-weighted mean number of the nine conditions that are high; 95% intervals from a bootstrap over counties	the least deprived tenth of tracts ranked by Area Deprivation Index, among the tracts with all four rankings	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023	95% CI 0.3 to 0.5	7,551 tracts	adult population of the tract (PLACES)	CDC PLACES
alt_adi_most	5.7	Mean number of high conditions (of nine)	adult-weighted mean number of the nine conditions that are high; 95% intervals from a bootstrap over counties	the most deprived tenth of tracts ranked by Area Deprivation Index, among the tracts with all four rankings	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023	95% CI 5.5 to 5.8	7,543 tracts	adult population of the tract (PLACES)	CDC PLACES
alt_adi_rho	+1.00	rank correlation	Spearman rank correlation between bin order and bin mean, each bin counted once	the bins of tracts ranked by Area Deprivation Index	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023			each bin counted once	CDC PLACES
alt_degree_least	0.5	Mean number of high conditions (of nine)	adult-weighted mean number of the nine conditions that are high; 95% intervals from a bootstrap over counties	the least deprived tenth of tracts ranked by Bachelor's degree share, among the tracts with all four rankings	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023	95% CI 0.4 to 0.5	7,558 tracts	adult population of the tract (PLACES)	CDC PLACES
alt_degree_most	4.3	Mean number of high conditions (of nine)	adult-weighted mean number of the nine conditions that are high; 95% intervals from a bootstrap over counties	the most deprived tenth of tracts ranked by Bachelor's degree share, among the tracts with all four rankings	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023	95% CI 3.8 to 4.6	7,564 tracts	adult population of the tract (PLACES)	CDC PLACES
alt_degree_rho	+1.00	rank correlation	Spearman rank correlation between bin order and bin mean, each bin counted once	the bins of tracts ranked by Bachelor's degree share	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023			each bin counted once	CDC PLACES
alt_income_least	0.4	Mean number of high conditions (of nine)	adult-weighted mean number of the nine conditions that are high; 95% intervals from a bootstrap over counties	the least deprived tenth of tracts ranked by Median household income, among the tracts with all four rankings	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023	95% CI 0.3 to 0.4	7,560 tracts	adult population of the tract (PLACES)	CDC PLACES
alt_income_most	5.2	Mean number of high conditions (of nine)	adult-weighted mean number of the nine conditions that are high; 95% intervals from a bootstrap over counties	the most deprived tenth of tracts ranked by Median household income, among the tracts with all four rankings	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023	95% CI 5.0 to 5.3	7,559 tracts	adult population of the tract (PLACES)	CDC PLACES
alt_income_rho	+1.00	rank correlation	Spearman rank correlation between bin order and bin mean, each bin counted once	the bins of tracts ranked by Median household income	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023			each bin counted once	CDC PLACES
alt_n_places	75,596	tracts	count of tracts in the common sample of the ranking comparison	tracts with the outcome and all four rankings	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023			none (full count)	CDC PLACES
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)	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023			none (a fixed rule)	CDC PLACES
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)	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023			none (a fixed rule)	CDC PLACES
alt_std_least	0.5	Mean number of high conditions (of nine)	adult-weighted mean number of the nine conditions that are high; 95% intervals from a bootstrap over counties	the least deprived tenth of tracts ranked by Standardized index, among the tracts with all four rankings	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023	95% CI 0.4 to 0.5	7,559 tracts	adult population of the tract (PLACES)	CDC PLACES
alt_std_most	4.5	Mean number of high conditions (of nine)	adult-weighted mean number of the nine conditions that are high; 95% intervals from a bootstrap over counties	the most deprived tenth of tracts ranked by Standardized index, among the tracts with all four rankings	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023	95% CI 4.1 to 4.8	7,560 tracts	adult population of the tract (PLACES)	CDC PLACES
alt_std_rho	+1.00	rank correlation	Spearman rank correlation between bin order and bin mean, each bin counted once	the bins of tracts ranked by Standardized index	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023			each bin counted once	CDC PLACES
blk_c8	14.9%	percent of residents Black alone	population-weighted mean of the ACS share of residents Black alone, bootstrap interval over counties	residents of tracts that are high on 8 of the nine conditions, USALEEP tracts in the sample	ACS 2019-2023	95% CI 12.9% to 16.9%	2,898 tracts	ACS 2019-2023 tract population	American Community Survey
blk_c9	2.7%	percent of residents Black alone	population-weighted mean of the ACS share of residents Black alone, bootstrap interval over counties	residents of tracts that are high on 9 of the nine conditions, USALEEP tracts in the sample	ACS 2019-2023	95% CI 2.2% to 3.1%	873 tracts	ACS 2019-2023 tract population	American Community Survey
bp_florida	5,077	tracts	count of tracts with no high blood pressure estimate	Florida census tracts	PLACES 2024 release (BRFSS 2021 for blood pressure)			none (full count)	CDC PLACES
bp_nine_r	+0.51	correlation coefficient (mean of the 36 pairs)	mean pairwise correlation among the nine conditions on the same tracts	adults living in tracts outside Florida with all ten estimates	BRFSS 2022 (PLACES 2024 release); ADI 2023		77,544 tracts	adult population of the tract (PLACES)	CDC PLACES
bp_r	+0.65	correlation coefficient (mean over the nine conditions)	mean of the correlations of high blood pressure with the nine conditions, bootstrap interval over counties	adults living in tracts outside Florida with all ten estimates	BRFSS 2021 and 2022 (PLACES 2024 release)	95% CI 0.64 to 0.67	77,544 tracts	adult population of the tract (PLACES)	CDC PLACES
cnt_d1	0.5	conditions (of nine)	mean number of the nine conditions that are high, population-weighted mean over a tenth of tracts, bootstrap interval over counties	adults in the least deprived tenth of tracts by ADI national percentile	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 0.4 to 0.6	8,274 tracts	adult population of the tract (PLACES)	CDC PLACES
cnt_d10	5.7	conditions (of nine)	mean number of the nine conditions that are high, population-weighted mean over a tenth of tracts, bootstrap interval over counties	adults in the most deprived tenth of tracts by ADI national percentile	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 5.5 to 5.8	8,213 tracts	adult population of the tract (PLACES)	CDC PLACES
cnt_diff	5.2	conditions (of nine)	difference between the population-weighted mean count of high conditions in the most and the least deprived tenth of tracts, bootstrap interval over counties (draws shared)	adults in the most deprived tenth of tracts compared with the least deprived tenth	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 5.0 to 5.4	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
cnt_mean	2.3	conditions (of nine)	mean number of high conditions per tract; it equals nine times the share high, so a result of the cutoff	census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023		82,781 tracts	none (each tract counts once)	CDC PLACES
cut_fifth	20%	percent of tracts	definition: a cutoff of the sensitivity check, the highest 20% of tracts	census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (a definition)	CDC PLACES
cut_pct	25%	percent of tracts	definition: a tract is high on a condition when its prevalence is in the highest 25% of tracts, ties at their mean rank	census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (a definition)	CDC PLACES
cut_tenth	10%	percent of tracts	definition: a cutoff of the sensitivity check, the highest 10% of tracts	census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (a definition)	CDC PLACES
cut_third	33.3%	percent of tracts	definition: a cutoff of the sensitivity check, the highest 33.3% of tracts	census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (a definition)	CDC PLACES
dc_tracts	201	tracts	count of tracts; the ACS file lacks the under-18, white-alone and Asian-alone shares for the District of Columbia	tracts of the District of Columbia in the sample	ACS 2019-2023			none (full count)	American Community Survey
few_k	5	tracts	definition: a county with fewer tracts than this has a share that moves in large steps	counties on the map	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (a definition)	CDC PLACES
ge5_d1	0.8%	percent of adults	share of adults living in tracts that are high on five or more conditions, population-weighted mean over a tenth of tracts, bootstrap interval over counties	adults in the least deprived tenth of tracts by ADI national percentile	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 0.3% to 1.6%	8,274 tracts	adult population of the tract (PLACES)	CDC PLACES
ge5_d10	72.5%	percent of adults	share of adults living in tracts that are high on five or more conditions, population-weighted mean over a tenth of tracts, bootstrap interval over counties	adults in the most deprived tenth of tracts by ADI national percentile	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 69.9% to 75.1%	8,213 tracts	adult population of the tract (PLACES)	CDC PLACES
ge5_exp	4.9%	percent of tracts	share of tracts expected to be high on five or more conditions if they were independent across tracts	census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (a benchmark)	CDC PLACES
ge5_share	21.3%	percent of tracts	share of tracts that are high on five or more conditions, bootstrap interval over counties	census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 19.3% to 23.3%	82,781 tracts	none (each tract counts once)	CDC PLACES
ge5_share_w	17.1%	percent of adults	share of adults living in tracts that are high on five or more conditions	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023		82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
half_pct	50%	percent of adults	definition: a county where half of adults or more live in such tracts	counties where the share of adults in tracts high on five or more conditions reaches this level	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (a definition)	CDC PLACES
high_share_max	25.6%	percent of tracts	largest share of tracts that is high on one condition	census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023		82,781 tracts	none (each tract counts once)	CDC PLACES
high_share_min	24.0%	percent of tracts	smallest share of tracts that is high on one condition; tied values fall on one side of the cutoff	census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023		82,781 tracts	none (each tract counts once)	CDC PLACES
le_c0	80.2	years of life expectancy at birth	population-weighted mean tract life expectancy, bootstrap interval over counties	residents of tracts that are high on 0 of the nine conditions, USALEEP tracts in the sample, institutional tracts dropped	deaths in 2010 to 2015 (USALEEP, area-weighted onto 2020 tracts); PLACES 2024 release	95% CI 80.0 to 80.4	26,431 tracts	ACS 2019-2023 tract population	USALEEP life expectancy
le_c8	74.1	years of life expectancy at birth	population-weighted mean tract life expectancy, bootstrap interval over counties	residents of tracts that are high on 8 of the nine conditions, USALEEP tracts in the sample, institutional tracts dropped	deaths in 2010 to 2015 (USALEEP, area-weighted onto 2020 tracts); PLACES 2024 release	95% CI 73.9 to 74.3	2,898 tracts	ACS 2019-2023 tract population	USALEEP life expectancy
le_c9	75.2	years of life expectancy at birth	population-weighted mean tract life expectancy, bootstrap interval over counties	residents of tracts that are high on 9 of the nine conditions, USALEEP tracts in the sample, institutional tracts dropped	deaths in 2010 to 2015 (USALEEP, area-weighted onto 2020 tracts); PLACES 2024 release	95% CI 74.9 to 75.4	873 tracts	ACS 2019-2023 tract population	USALEEP life expectancy
le_gap	6.1	years of life expectancy at birth	difference in population-weighted mean tract life expectancy, bootstrap interval over counties (draws shared)	residents of tracts that are high on none of the nine conditions compared with tracts that are high on eight	deaths in 2010 to 2015 (USALEEP, area-weighted onto 2020 tracts); PLACES 2024 release	95% CI 5.8 to 6.3	29,329 tracts	ACS 2019-2023 tract population	USALEEP life expectancy
le_r	−0.48	correlation coefficient	population-weighted correlation of the count of high conditions with tract life expectancy, bootstrap interval over counties	residents of USALEEP tracts in the sample	deaths in 2010 to 2015 (USALEEP, area-weighted onto 2020 tracts); PLACES 2024 release	95% CI −0.49 to −0.46	77,934 tracts	ACS 2019-2023 tract population	USALEEP life expectancy
le_r_dev	−0.25	correlation coefficient	population-weighted correlation of the count of high conditions with tract life expectancy minus the county mean, bootstrap interval over counties	residents of USALEEP tracts in counties with at least two such tracts	deaths in 2010 to 2015 (USALEEP, area-weighted onto 2020 tracts); PLACES 2024 release	95% CI −0.27 to −0.22	77,720 tracts	ACS 2019-2023 tract population	USALEEP life expectancy
le_rebound	1.0	years of life expectancy at birth	difference in population-weighted mean tract life expectancy, bootstrap interval over counties (draws shared)	residents of tracts high on all nine conditions compared with tracts high on eight	deaths in 2010 to 2015 (USALEEP, area-weighted onto 2020 tracts); PLACES 2024 release	95% CI 0.8 to 1.3	3,771 tracts	ACS 2019-2023 tract population	USALEEP life expectancy
led_c0	+0.6	years of life expectancy at birth, relative to the mean of the tract's county	population-weighted mean difference between tract life expectancy and the population-weighted mean of its county, bootstrap interval over counties	residents of tracts that are high on 0 of the nine conditions, in counties with at least two USALEEP tracts	deaths in 2010 to 2015 (USALEEP, area-weighted onto 2020 tracts); PLACES 2024 release	95% CI 0.5 to 0.7	26,417 tracts	ACS 2019-2023 tract population	USALEEP life expectancy
led_c7	−1.9	years of life expectancy at birth, relative to the mean of the tract's county	population-weighted mean difference between tract life expectancy and the population-weighted mean of its county, bootstrap interval over counties	residents of tracts that are high on 7 of the nine conditions, in counties with at least two USALEEP tracts	deaths in 2010 to 2015 (USALEEP, area-weighted onto 2020 tracts); PLACES 2024 release	95% CI −2.2 to −1.7	4,219 tracts	ACS 2019-2023 tract population	USALEEP life expectancy
many_k	5	conditions	definition: five or more of the nine conditions, a majority	census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (a definition)	CDC PLACES
mto_bmi_extreme	40	body mass index	definition: the lowest body mass index counted as extreme obesity	women with children in public housing in high-poverty tracts, randomized to a voucher offer from 1994 to 1998, measured 2008 to 2010	measured 2008 to 2010			none (a definition)	Published estimates from cited studies
mto_bmi_obese	30	body mass index	definition: the lowest body mass index counted as obesity, the PLACES definition	women with children in public housing in high-poverty tracts, randomized to a voucher offer from 1994 to 1998, measured 2008 to 2010	measured 2008 to 2010			none (a definition)	Published estimates from cited studies
mto_hba1c_cut	6.5%	percent glycated hemoglobin	definition: the lowest glycated hemoglobin counted as diabetes in the study	women with children in public housing in high-poverty tracts, randomized to a voucher offer from 1994 to 1998, measured 2008 to 2010	measured 2008 to 2010			none (a definition)	Published estimates from cited studies
mto_itt_extreme	−3.4	percentage points of women with body mass index of 40 or more	intention-to-treat difference in prevalence between women randomly offered a voucher usable only in low-poverty tracts (with counseling) and women offered no voucher, reported by Ludwig and coauthors (2011, New England Journal of Medicine 365(16)): 4,498 women with children in public housing in high-poverty tracts in Baltimore, Boston, Chicago, Los Angeles and New York, randomized 1994 to 1998 and measured in a survey from 2008 to 2010; copied from the paper and not computed in this build	women with children in public housing in high-poverty tracts, randomized to a voucher offer from 1994 to 1998, measured 2008 to 2010	randomized 1994 to 1998, measured 2008 to 2010	95% CI −6.4 to −0.4		none (reported estimate)	Published estimates from cited studies	A published estimate, not a result of this build.
mto_itt_hba1c	−4.3	percentage points of women with glycated hemoglobin of 6.5% or more	intention-to-treat difference in prevalence between women randomly offered a voucher usable only in low-poverty tracts (with counseling) and women offered no voucher, reported by Ludwig and coauthors (2011, New England Journal of Medicine 365(16)): 4,498 women with children in public housing in high-poverty tracts in Baltimore, Boston, Chicago, Los Angeles and New York, randomized 1994 to 1998 and measured in a survey from 2008 to 2010; copied from the paper and not computed in this build	women with children in public housing in high-poverty tracts, randomized to a voucher offer from 1994 to 1998, measured 2008 to 2010	randomized 1994 to 1998, measured 2008 to 2010	95% CI −7.8 to −0.8		none (reported estimate)	Published estimates from cited studies	A published estimate, not a result of this build.
mto_itt_obese	−1.2	percentage points of women with body mass index of 30 or more	intention-to-treat difference in prevalence between women randomly offered a voucher usable only in low-poverty tracts (with counseling) and women offered no voucher, reported by Ludwig and coauthors (2011, New England Journal of Medicine 365(16)): 4,498 women with children in public housing in high-poverty tracts in Baltimore, Boston, Chicago, Los Angeles and New York, randomized 1994 to 1998 and measured in a survey from 2008 to 2010; copied from the paper and not computed in this build	women with children in public housing in high-poverty tracts, randomized to a voucher offer from 1994 to 1998, measured 2008 to 2010	randomized 1994 to 1998, measured 2008 to 2010	95% CI −5.4 to 3.0		none (reported estimate)	Published estimates from cited studies	A published estimate, not a result of this build.
mto_takeup	48%	percent of women offered the low-poverty voucher	share of the low-poverty voucher group that used the voucher to move, reported by Ludwig and coauthors (2011, New England Journal of Medicine 365(16)); copied from the paper and not computed in this build	women with children in public housing in high-poverty tracts, randomized to a voucher offer from 1994 to 1998, measured 2008 to 2010	randomized 1994 to 1998			none (reported estimate)	Published estimates from cited studies	A published estimate, not a result of this build.
n_acs_dropped	203	tracts	count of sample tracts left out of the approximation only	sample tracts that lack at least one of the ACS inputs of the approximation	ACS 2019-2023			none (full count)	American Community Survey
n_acs_shares	8	ACS tract shares	definition: the number of ACS shares in the approximation	census tract shares used to approximate the model's inputs	ACS 2019-2023			none (a definition)	American Community Survey
n_cl_counties	3,129	counties	number of bootstrap clusters	counties (Connecticut planning regions) with a tract in the sample	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (full count)	CDC PLACES
n_conditions	9	conditions	definition: the number of conditions in the count	PLACES health outcome measures that cover all adults and have an estimate in every state	PLACES 2024 release			none (a definition)	CDC PLACES
n_dropped	741	tracts	count of tracts left out	census tracts with a PLACES estimate that have no ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (full count)	Area Deprivation Index
n_few_tracts	990	counties	count of counties with fewer tracts in the sample than the definition above, where the share moves in large steps	counties on the map	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (full count)	CDC PLACES
n_half	1,229	counties	count of counties with a population-weighted tract share of 50% or more	counties where at least half of adults live in tracts that are high on five or more conditions	BRFSS 2022 (PLACES 2024 release); ADI 2023			adult population of the tract (PLACES)	CDC PLACES
n_le_tracts	77,934	tracts	count of tracts	tracts in the sample with a USALEEP life expectancy estimate that is not institutional	deaths in 2010 to 2015 (USALEEP, area-weighted onto 2020 tracts); PLACES 2024 release			none (full count)	USALEEP life expectancy
n_map_counties	3,128	counties	count of counties drawn with a value (Connecticut as its eight legacy counties)	counties and county equivalents on the map with at least one tract in the sample	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (full count)	CDC PLACES
n_map_gray	15	counties	count of counties drawn gray	counties on the map sprite with no tract in the sample	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (full count)	CDC PLACES
n_neg_pairs	2	pairs of conditions	count of pairs whose 95% bootstrap interval lies below zero	pairs among the nine conditions with an interval entirely below zero	BRFSS 2022 (PLACES 2024 release); ADI 2023		36 pairs of conditions	adult population of the tract (PLACES)	CDC PLACES
n_pairs	36	pairs of conditions	definition: nine choose two	pairs among the nine conditions	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (a definition)	CDC PLACES
n_places_measures	40	measures	count of measure ids in the staged tract file	health measures that PLACES publishes for tracts	PLACES 2024 release			none (full count)	CDC PLACES
n_places_tracts	83,522	tracts	count of tracts	2020 census tracts with a CDC PLACES 2024 release estimate for all nine conditions	PLACES 2024 release			none (full count)	CDC PLACES
n_pos_pairs	32	pairs of conditions	count of pairs whose 95% bootstrap interval lies above zero	pairs among the nine conditions with an interval entirely above zero	BRFSS 2022 (PLACES 2024 release); ADI 2023		36 pairs of conditions	adult population of the tract (PLACES)	CDC PLACES
n_tracts	82,781	tracts	count of tracts	census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023			none (full count)	CDC PLACES
none_exp	7.4%	percent of tracts	share of tracts expected to be high on none if the nine conditions were independent across tracts (Poisson-binomial with the observed share high on each)	census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (a benchmark)	CDC PLACES
none_share	34.0%	percent of tracts	share of tracts that are high on none of the nine conditions, bootstrap interval over counties	census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 30.7% to 37.1%	82,781 tracts	none (each tract counts once)	CDC PLACES
none_share_w	38.1%	percent of adults	share of adults living in tracts that are high on none of the nine conditions	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023		82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
oh_cancer	2.5	other conditions (of eight) that are also high	mean number of the other eight conditions that are also high, bootstrap interval over counties	tracts high on cancer	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 2.4 to 2.6	21,087 tracts	none (each tract counts once)	CDC PLACES
oh_copd	4.9	other conditions (of eight) that are also high	mean number of the other eight conditions that are also high, bootstrap interval over counties	tracts high on COPD	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 4.9 to 5.0	21,048 tracts	none (each tract counts once)	CDC PLACES
oh_depression	3.1	other conditions (of eight) that are also high	mean number of the other eight conditions that are also high, bootstrap interval over counties	tracts high on depression	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 3.0 to 3.3	20,971 tracts	none (each tract counts once)	CDC PLACES
oh_indep	2.0	other conditions (of eight) that are also high	expected number of the other eight conditions that are also high if the conditions were independent across tracts	a tract that is high on one condition	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (a benchmark)	CDC PLACES
oh_stroke	4.9	other conditions (of eight) that are also high	mean number of the other eight conditions that are also high, bootstrap interval over counties	tracts high on stroke	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 4.8 to 5.0	19,866 tracts	none (each tract counts once)	CDC PLACES
oh_wdiff	0.34	other conditions (of eight) that are also high	largest absolute difference, over the nine conditions, between the mean weighted by adults and the mean counting each tract once	tracts high on one condition	BRFSS 2022 (PLACES 2024 release); ADI 2023			adult population of the tract (PLACES)	CDC PLACES
p65_c8	18.9%	percent of residents aged 65 and over	population-weighted mean of the ACS share of residents aged 65 and over, bootstrap interval over counties	residents of tracts that are high on 8 of the nine conditions, USALEEP tracts in the sample	ACS 2019-2023	95% CI 18.6% to 19.2%	2,898 tracts	ACS 2019-2023 tract population	American Community Survey
p65_c9	22.6%	percent of residents aged 65 and over	population-weighted mean of the ACS share of residents aged 65 and over, bootstrap interval over counties	residents of tracts that are high on 9 of the nine conditions, USALEEP tracts in the sample	ACS 2019-2023	95% CI 22.3% to 22.9%	873 tracts	ACS 2019-2023 tract population	American Community Survey
pc1_share	59.0%	percent of the variance of the standardized prevalences	share of the variance on the first principal component of the nine standardized prevalences, bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 57.9% to 60.2%	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
r2_flex_max	90%	percent of the variance of tract prevalence	largest weighted out-of-fold R squared of the nine tree fits, folds by county	adults living in census tracts with an estimate for all nine conditions and an ADI rank and every ACS input of the approximation	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023		82,578 tracts	adult population of the tract (PLACES)	CDC PLACES
r2_flex_min	75%	percent of the variance of tract prevalence	smallest weighted out-of-fold R squared of the nine tree fits, folds by county	adults living in census tracts with an estimate for all nine conditions and an ADI rank and every ACS input of the approximation	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023		82,578 tracts	adult population of the tract (PLACES)	CDC PLACES
r2_max	90%	percent of the variance of tract prevalence	largest weighted R squared of the nine fits on the ACS shares, county poverty and state effects	adults living in census tracts with an estimate for all nine conditions and an ADI rank and every ACS input of the approximation	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023		82,578 tracts	adult population of the tract (PLACES)	CDC PLACES
r2_min	79%	percent of the variance of tract prevalence	smallest weighted R squared of the nine fits on the ACS shares, county poverty and state effects	adults living in census tracts with an estimate for all nine conditions and an ADI rank and every ACS input of the approximation	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023		82,578 tracts	adult population of the tract (PLACES)	CDC PLACES
r2w_max	85%	percent of the variance of tract prevalence within counties	largest weighted within-county R squared of the nine fits on the ACS shares with county effects	adults living in census tracts with an estimate for all nine conditions and an ADI rank and every ACS input of the approximation	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023		82,578 tracts	adult population of the tract (PLACES)	CDC PLACES
r2w_min	62%	percent of the variance of tract prevalence within counties	smallest weighted within-county R squared of the nine fits on the ACS shares with county effects	adults living in census tracts with an estimate for all nine conditions and an ADI rank and every ACS input of the approximation	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023		82,578 tracts	adult population of the tract (PLACES)	CDC PLACES
r65_arth	+0.64	correlation coefficient	population-weighted correlation of the tract prevalence of arthritis with the ACS share of residents aged 65 and over, bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023	95% CI 0.61 to 0.66	82,779 tracts	adult population of the tract (PLACES)	CDC PLACES
r65_cancer	+0.81	correlation coefficient	population-weighted correlation of the tract prevalence of cancer with the ACS share of residents aged 65 and over, bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023	95% CI 0.79 to 0.83	82,779 tracts	adult population of the tract (PLACES)	CDC PLACES
r65_chd	+0.64	correlation coefficient	population-weighted correlation of the tract prevalence of coronary heart disease with the ACS share of residents aged 65 and over, bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023	95% CI 0.61 to 0.66	82,779 tracts	adult population of the tract (PLACES)	CDC PLACES
r65_depr	−0.17	correlation coefficient	population-weighted correlation of the tract prevalence of depression with the ACS share of residents aged 65 and over, bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023	95% CI −0.21 to −0.14	82,779 tracts	adult population of the tract (PLACES)	CDC PLACES
r65_diab	+0.23	correlation coefficient	population-weighted correlation of the tract prevalence of diagnosed diabetes with the ACS share of residents aged 65 and over, bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023	95% CI 0.19 to 0.26	82,779 tracts	adult population of the tract (PLACES)	CDC PLACES
r_arth_chd	+0.90	correlation coefficient	population-weighted Pearson correlation of tract prevalence of arthritis and coronary heart disease, bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 0.89 to 0.91	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
r_asth_obes	+0.64	correlation coefficient	population-weighted Pearson correlation of tract prevalence of current asthma and obesity, bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 0.59 to 0.69	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
r_cancer_arth	+0.74	correlation coefficient	population-weighted Pearson correlation of tract prevalence of cancer and arthritis, bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 0.72 to 0.75	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
r_cancer_asth	−0.13	correlation coefficient	population-weighted Pearson correlation of tract prevalence of cancer and current asthma, bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI −0.20 to −0.07	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
r_cancer_chd	+0.63	correlation coefficient	population-weighted Pearson correlation of tract prevalence of cancer and coronary heart disease, bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 0.60 to 0.66	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
r_cancer_depr	0.00	correlation coefficient	population-weighted Pearson correlation of tract prevalence of cancer and depression, bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI −0.07 to 0.06	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
r_cancer_diab	+0.05	correlation coefficient	population-weighted Pearson correlation of tract prevalence of cancer and diagnosed diabetes, bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 0.00 to 0.11	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
r_cancer_obes	−0.11	correlation coefficient	population-weighted Pearson correlation of tract prevalence of cancer and obesity, bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI −0.18 to −0.05	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
r_core_max	+0.90	correlation coefficient	largest population-weighted correlation among the six pairs of coronary heart disease, COPD, diagnosed diabetes and stroke (Diabetes and Stroke), bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 0.89 to 0.92	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
r_core_min	+0.74	correlation coefficient	smallest population-weighted correlation among the six pairs of coronary heart disease, COPD, diagnosed diabetes and stroke (Coronary heart disease and Diabetes), bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 0.71 to 0.76	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
r_depr_diab	+0.06	correlation coefficient	population-weighted Pearson correlation of tract prevalence of depression and diagnosed diabetes, bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 0.01 to 0.11	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
r_mean	+0.49	correlation coefficient (mean of the 36 pairs)	mean of the population-weighted Pearson correlations over the 36 pairs of conditions, bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 0.48 to 0.51	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
r_mean_acs	+0.49	correlation coefficient (mean of the 36 pairs)	mean pairwise correlation among the nine conditions on the tracts the approximation uses, bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank and every ACS input of the approximation	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023	95% CI 0.48 to 0.51	82,578 tracts	adult population of the tract (PLACES)	CDC PLACES
r_stroke_chd	+0.86	correlation coefficient	population-weighted Pearson correlation of tract prevalence of stroke and coronary heart disease, bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 0.85 to 0.87	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
r_stroke_copd	+0.90	correlation coefficient	population-weighted Pearson correlation of tract prevalence of stroke and COPD, bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 0.89 to 0.90	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
r_stroke_diab	+0.90	correlation coefficient	population-weighted Pearson correlation of tract prevalence of stroke and diagnosed diabetes, bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 0.89 to 0.92	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
r_within_adi	+0.36	correlation coefficient (mean of the 36 pairs)	mean pairwise correlation among the nine conditions after subtracting the mean of each ADI tenth, bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 0.35 to 0.38	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
radi_cancer	0.00	correlation coefficient	population-weighted correlation of the tract prevalence of cancer with the ADI national percentile, bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI −0.07 to 0.07	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
rdec_d1	+0.40	correlation coefficient (mean of the 36 pairs)	mean pairwise correlation among the nine conditions inside one tenth of tracts, bootstrap interval over counties	adults in the least deprived tenth of tracts	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 0.37 to 0.44	8,274 tracts	adult population of the tract (PLACES)	CDC PLACES
rdec_d10	+0.34	correlation coefficient (mean of the 36 pairs)	mean pairwise correlation among the nine conditions inside one tenth of tracts, bootstrap interval over counties	adults in the most deprived tenth of tracts	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 0.32 to 0.36	8,213 tracts	adult population of the tract (PLACES)	CDC PLACES
rdec_diff	+0.06	correlation coefficient (mean of the 36 pairs), least deprived tenth minus most deprived tenth	mean pairwise correlation inside the least deprived tenth minus that inside the most deprived tenth, bootstrap interval over counties (draws shared)	adults in the least and the most deprived tenth of tracts	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 0.03 to 0.11	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
rdec_mid_max	+0.36	correlation coefficient (mean of the 36 pairs)	largest of the eight mean pairwise correlations inside the second to ninth tenth	adults in the second to ninth tenth of tracts	BRFSS 2022 (PLACES 2024 release); ADI 2023		82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
rdec_mid_min	+0.35	correlation coefficient (mean of the 36 pairs)	smallest of the eight mean pairwise correlations inside the second to ninth tenth	adults in the second to ninth tenth of tracts	BRFSS 2022 (PLACES 2024 release); ADI 2023		82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
reg_midwest	20.2%	percent of adults	share of adults living in tracts that are high on five or more conditions	adults in the Midwest Census region living in the analysis tracts	BRFSS 2022 (PLACES 2024 release); ADI 2023			adult population of the tract (PLACES)	CDC PLACES
reg_northeast	8.5%	percent of adults	share of adults living in tracts that are high on five or more conditions	adults in the Northeast Census region living in the analysis tracts	BRFSS 2022 (PLACES 2024 release); ADI 2023			adult population of the tract (PLACES)	CDC PLACES
reg_south	25.8%	percent of adults	share of adults living in tracts that are high on five or more conditions	adults in the South Census region living in the analysis tracts	BRFSS 2022 (PLACES 2024 release); ADI 2023			adult population of the tract (PLACES)	CDC PLACES
reg_west	7.0%	percent of adults	share of adults living in tracts that are high on five or more conditions	adults in the West Census region living in the analysis tracts	BRFSS 2022 (PLACES 2024 release); ADI 2023			adult population of the tract (PLACES)	CDC PLACES
rowmean_cancer	+0.22	correlation coefficient (mean over the other eight conditions)	mean of the correlations of cancer with the other eight conditions, bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 0.19 to 0.25	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
rowmean_copd	+0.68	correlation coefficient (mean over the other eight conditions)	mean of the correlations of COPD with the other eight conditions, bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 0.66 to 0.69	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
rowmean_depression	+0.26	correlation coefficient (mean over the other eight conditions)	mean of the correlations of depression with the other eight conditions, bootstrap interval over counties	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 0.22 to 0.30	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
s_adj_county	+0.52	correlation coefficient (mean of the 36 pairs)	mean pairwise correlation among the nine conditions after removing a fit on eight ACS tract shares and county effects; the fit is not refitted inside the bootstrap, so the interval conditions on it	adults living in census tracts with an estimate for all nine conditions and an ADI rank and every ACS input of the approximation	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023	95% CI 0.51 to 0.52	82,578 tracts	adult population of the tract (PLACES)	CDC PLACES
s_adj_state	+0.47	correlation coefficient (mean of the 36 pairs)	mean pairwise correlation among the nine conditions after removing a fit on eight ACS tract shares, the county poverty rate and state effects; the fit is not refitted inside the bootstrap, so the interval conditions on it	adults living in census tracts with an estimate for all nine conditions and an ADI rank and every ACS input of the approximation	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023	95% CI 0.46 to 0.48	82,578 tracts	adult population of the tract (PLACES)	CDC PLACES
s_county	+0.43	correlation coefficient (mean of the 36 pairs)	mean pairwise correlation among the nine conditions after subtracting the mean of each county; the fit is not refitted inside the bootstrap, so the interval conditions on it	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023	95% CI 0.42 to 0.43	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
s_flex	+0.45	correlation coefficient (mean of the 36 pairs)	mean pairwise correlation among the nine conditions after removing a gradient-boosted-trees fit on the ACS tract shares, the county poverty rate and the state; the fit is not refitted inside the bootstrap, so the interval conditions on it	adults living in census tracts with an estimate for all nine conditions and an ADI rank and every ACS input of the approximation	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023	95% CI 0.44 to 0.47	82,578 tracts	adult population of the tract (PLACES)	CDC PLACES
s_state	+0.48	correlation coefficient (mean of the 36 pairs)	mean pairwise correlation among the nine conditions after subtracting the mean of each state; the fit is not refitted inside the bootstrap, so the interval conditions on it	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023; ACS 2019-2023	95% CI 0.47 to 0.50	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
sens_all_tenth	14	tracts	count of tracts high on all nine conditions when a tract is high if it is in the highest 10% of tracts	census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (full count)	CDC PLACES
sens_all_third	2,679	tracts	count of tracts high on all nine conditions when a tract is high if it is in the highest 33.3% of tracts	census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (full count)	CDC PLACES
sens_exp_tenth	0.0	tracts	number of tracts expected to be high on all nine conditions if they were independent, with the highest 10% of tracts counted as high	census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (a benchmark)	CDC PLACES
sens_exp_third	4.5	tracts	number of tracts expected to be high on all nine conditions if they were independent, with the highest 33.3% of tracts counted as high	census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023			none (a benchmark)	CDC PLACES
sens_none_tenth	64.9%	percent of tracts	share of tracts high on none of the nine conditions when a tract is high if it is in the highest 10% of tracts	census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023		82,781 tracts	none (each tract counts once)	CDC PLACES
sens_none_third	23.4%	percent of tracts	share of tracts high on none of the nine conditions when a tract is high if it is in the highest 33.3% of tracts	census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023		82,781 tracts	none (each tract counts once)	CDC PLACES
us_chronic_high	2.0	conditions (of nine)	mean number of the nine conditions that are high, population-weighted mean over all the tracts of the tenths pooled, bootstrap interval over counties (the draws of the tenths)	adults in all the tracts of the comparison: census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023	95% CI 1.8 to 2.1	82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
vc_between	52.2%	percent of the variance of the tract count of high conditions	population-weighted share of the variance of the count of high conditions that lies between counties, including between states; a decomposition of every tract	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023		82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
vc_county	29.8%	percent of the variance of the tract count of high conditions	population-weighted share of the variance of the count of high conditions that lies between counties within states; a decomposition of every tract, so it has no sampling interval	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023		82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
vc_state	22.4%	percent of the variance of the tract count of high conditions	population-weighted share of the variance of the count of high conditions that lies between states; a decomposition of every tract, so it has no sampling interval	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023		82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
vc_within	47.8%	percent of the variance of the tract count of high conditions	population-weighted share of the variance of the count of high conditions that lies between tracts within counties; a decomposition of every tract, so it has no sampling interval	adults living in census tracts with an estimate for all nine conditions and an ADI rank	BRFSS 2022 (PLACES 2024 release); ADI 2023		82,781 tracts	adult population of the tract (PLACES)	CDC PLACES
wv_share	81.7%	percent of adults	share of adults living in tracts that are high on five or more conditions	adults in West Virginia living in the analysis tracts	BRFSS 2022 (PLACES 2024 release); ADI 2023			adult population of the tract (PLACES)	CDC PLACES

Definitions

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.
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.
Population-weighted: Averaged so that each place counts in proportion to its number of residents, which lets a large county move the result more than a small one. An unweighted average counts every place equally.
Principal components: A method that combines many correlated measures into a few summary scores, ordered by how much of the variation among places each captures. The first component is the single weighted combination that captures the most.
Fixed effects: A regression adjustment that gives each group, such as each county, its own baseline. The estimate then rests on differences within groups.
USALEEP: The U.S. Small-area Life Expectancy Estimates Project, a National Center for Health Statistics release of life expectancy at birth for most census tracts. It covers deaths from 2010 to 2015 only and has not been updated.
Life expectancy at birth: The average number of years a newborn would live if death rates at every age stayed as they were in the period measured. It summarizes the death rates of a period and is not a forecast for any child.
Ecological inference: Drawing conclusions about individuals from data about places or groups. A pattern across counties need not hold for the people inside them.
Bootstrap interval: A range for an estimate found by recomputing it on many random resamples of the data and reading the range from the results. It shows how much the estimate would vary from sample to sample.

Methods

The chapter compares modeled prevalences of nine chronic conditions across census tracts, from the CDC PLACES 2024 release, with correlations, means and shares of adults weighted by the adult population of each tract. A tract is high on a condition when its prevalence is in the highest 25% of tracts, and the count of high conditions describes tracts and not people. The estimates come from a model that fits every condition to shared inputs, so part of the correlation among conditions is built in; the adjustments here approximate those inputs from census data and are not the model. Life expectancy covers deaths in 2010 to 2015, a different period from the PLACES estimates.

Which tracts and conditions are compared

The tract file of CDC PLACES (2024 release) gives one modeled prevalence per condition per tract. The chapter uses nine health outcome measures that cover all adults and have an estimate in every state: arthritis, cancer (non-skin) or melanoma, current asthma, coronary heart disease, COPD, depression, diagnosed diabetes, obesity and stroke.

The sample is the tracts with all nine conditions and an ADI rank. The approximations of the model's inputs use the tracts with every ACS input, which leaves out the tracts of the District of Columbia and a few others.

Figure explained here: Figure 1

What counts as high on a condition

A tract is high on a condition when its prevalence is in the highest 25% of tracts, with tied values at their mean rank, and the count is the number of conditions on which a tract is high; it describes tracts and not people.

The benchmark for independent conditions is a Poisson-binomial distribution with each condition's observed share of high tracts.

Figures explained here: Figure 2, Figure 3 and Figure 4

How tracts are weighted and where life expectancy comes from

Correlations, means and shares of adults are weighted by the tract's adult population; counts and shares of tracts count each tract once.

Life expectancy is the USALEEP estimate for 2010 to 2015 on 2020 tracts, weighted by ACS 2019-2023 tract population.

Figures explained here: Figure 5 and Figure 8

How the model's inputs are approximated

The adjustments for the model's inputs are weighted least-squares fits of each condition on eight ACS tract shares with squares and pairwise products, with state effects and a county poverty rate (or county effects), and a gradient-boosted-trees fit with folds by county; they are fitted once and not refitted inside the bootstrap, so their intervals condition on the fit.

They approximate the PLACES model, which uses individual age, sex, race, ethnicity and education, county poverty, and county and state effects.

Figure explained here: Figure 6

How uncertainty is measured

The variance split of the count is a weighted decomposition of every tract and has no interval.

Intervals are 95% percentile intervals from a bootstrap that draws whole counties with replacement (3,129 clusters; 2,000 replicates, seed 12345), with the same draws for every statistic, so a difference has an interval from shared draws.

Figure explained here: Figure 7

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 75,596 tracts 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 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
Ward, Brian W.; Schiller, Jeannine S. (2013). Prevalence of Multiple Chronic Conditions Among US Adults: Estimates From the National Health Interview Survey, 2010. Preventing Chronic Disease 10: 120203. doi:10.5888/pcd10.120203
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
Ludwig, Jens; Sanbonmatsu, Lisa; Gennetian, Lisa; Adam, Emma; Duncan, Greg J.; Katz, Lawrence F.; Kessler, Ronald C.; Kling, Jeffrey R.; Lindau, Stacy Tessler; Whitaker, Robert C.; McDade, Thomas W. (2011). Neighborhoods, Obesity, and Diabetes: A Randomized Social Experiment. New England Journal of Medicine 365(16): 1509-1519. doi:10.1056/NEJMsa1103216
Robinson, W. S. (1950). Ecological Correlations and the Behavior of Individuals. American Sociological Review 15(3): 351-357. doi:10.2307/2087176
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/multiple-chronic-conditions/build.py (sha256 68473ef38c471eddc146bfd87b4d1844dd1a3d188dd8f118c39f671c4aabdda6)
Built on: 2026-10-09
Site commit: c2b1ff3309cb4a10833f884da91ac0057a66ad0a

Inputs

File	Size (bytes)	SHA-256, first 1 MB	SHA-256, last 1 MB
book2/chapters/multiple-chronic-conditions/conditions.py	16,370	c914a81074e57f22cee1d2ec8d1fd3e3092778970e57ba2ba1dd6513d228a6cd	c914a81074e57f22cee1d2ec8d1fd3e3092778970e57ba2ba1dd6513d228a6cd
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/places_tract2020_latest.parquet	5,919,159	af4c3b0d1205b7d84b81676a9529ef73323b2dbeb9d54e235f5efeebfad83177	a2f19029ee2ef032be87e0d5288d88d489afd52379279833f178baa021df3dbf
data/staged/life_expectancy/usaleep_tract2020.parquet	1,316,169	9c9c7f103791b75eddba74e68a89804efdf2486b6b66bb4bc02a46ba5bf8bc23	27317107be2465d9fd5e83271dea0cd6e915ee419e2802bedc28747d0a41d38f
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	4e51b97b62ba016b5bafc582e374b83382ed094ee0257de05d7d6736e14c222f
figures/adults_high_count_map.json	1486fc45cb621174c3c7e83ce34526bbd7eecbc017bdc2ae588544c7939d6902
figures/alt_rankings.json	5c95d266eb3e2f097c8cf6025e189e39af38e1c1609ca88792c64fe2e055896f
figures/condition_correlations.json	9794c4a769bbad7289cafc87765582217f5e5756bb0699f9dea84f9fa1a7fc8c
figures/correlation_stages.json	537492838d3812cdc91f6d2297e08490e84477f1fe0daec54175561dceea173a
figures/cutoff_sensitivity.json	844cb702276951831dd9fc3a6f2f3e951d3dbad95237e3f21a99cfc76dc508c8
figures/high_count_by_adi.json	fa06d9dd565c8bd59515de2b4ecca0fdc50503679b1b5e1f6f7fc8aeb2686ac8
figures/high_count_distribution.json	347bffb3a04563835b9651a4efc1fdfe8a4ae41f63a71cd4c007f9873c01218e
figures/life_expectancy_by_count.json	b01186ea160253386dad8661c62220db64e1eb83d1eebb7af007fbcc61349f08
figures/others_high.json	80fdfbcb15740d87cc147f79bd7f1674d718dd43de42094ef245cc913fc83d64
meta.json	6178ca31c08233752668d7c2cef86587894ed6b7c195c100704db6bf0070cced
public/data/multiple-chronic-conditions/adults_high_count_map.json	2f4e829c2701ecc1904b87f42b2742f16e4ed11af286db1b98875d439d65f7d2
refs.json	28ec62e2f073067cf5c0e5a00f90474110c06bf19c8ce7c6dcf10c770fffffb3

Machine formats

Report (Markdown): https://vishalsingh.org/zipcode/multiple-chronic-conditions/report.md
Every estimate (JSON): https://vishalsingh.org/zipcode/report/multiple-chronic-conditions/facts.json
Table 1, figure "condition_correlations" (JSON): https://vishalsingh.org/zipcode/report/multiple-chronic-conditions/figures/condition_correlations.json
Table 2, figure "others_high" (JSON): https://vishalsingh.org/zipcode/report/multiple-chronic-conditions/figures/others_high.json
Table 3, figure "high_count_distribution" (JSON): https://vishalsingh.org/zipcode/report/multiple-chronic-conditions/figures/high_count_distribution.json
Table 4, figure "cutoff_sensitivity" (JSON): https://vishalsingh.org/zipcode/report/multiple-chronic-conditions/figures/cutoff_sensitivity.json
Table 5, figure "high_count_by_adi" (JSON): https://vishalsingh.org/zipcode/report/multiple-chronic-conditions/figures/high_count_by_adi.json
Table 6, figure "correlation_stages" (JSON): https://vishalsingh.org/zipcode/report/multiple-chronic-conditions/figures/correlation_stages.json
Table 7, figure "adults_high_count_map" (JSON): https://vishalsingh.org/zipcode/report/multiple-chronic-conditions/figures/adults_high_count_map.json
Table 8, figure "life_expectancy_by_count" (JSON): https://vishalsingh.org/zipcode/report/multiple-chronic-conditions/figures/life_expectancy_by_count.json
Table 9, figure "alt_rankings" (JSON): https://vishalsingh.org/zipcode/report/multiple-chronic-conditions/figures/alt_rankings.json
Payload of "adults_high_count_map" (JSON): https://vishalsingh.org/zipcode/data/multiple-chronic-conditions/adults_high_count_map.json
Index of every report: https://vishalsingh.org/zipcode/llms.txt; all reports in one file: https://vishalsingh.org/zipcode/llms-full.txt