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  • 1.  Age Adjusted Death Rates at the County level

    Posted 10-10-2025 07:29 PM

    Hello all,

    Within the last year, CDC Wonder stopped providing age-adjusted death rates at the county level. This is what is posted as the reason on CDC Wonder:

    • Standard age-adjusted rates (calculated with standard populations) are only available for Ten-Year Age Groups.
    • Age-adjusted rates are not available at the county level for analysis of mortality by Single Race, including analysis of Urbanization categories for counties, because the populations are weighted to the 10-year age groups, and county-level population estimates are not available for the "<1 year" and "1-4 years" age categories.

    However, some states, particularly those more densely populated, have published multi-year (ex: 2020-2023) age-adjusted death rates for the leading causes of death, including stratified rates by race when the population is large enough. My questions are.

    1. Is it a resource/staffing issue that allows some states to make these calculations and not others?
    2. Are there other factors (ex: population density, local demographic data collection, use of other age proxys, etc.) that allow this to be possible in some places and not others?
    3. Does CDC Wonder's description of the Census changes imply that age-adjusting death rates will not be reliable below the state level analysis during this 10 year period?

    Any and all insights are greatly appreciated.



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    Danielle Walters
    www.35thStreetConsulting.com
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  • 2.  RE: Age Adjusted Death Rates at the County level

    Posted 10-11-2025 10:09 AM

    The NCI SEER program has single age populations for counties https://seer.cancer.gov/popdata/download.html and there are death files:

    The 2023 death data is here:

    https://ftp.cdc.gov/pub/Health_Statistics/NCHS/Datasets/DVS/mortality/mort2023us.zip

    You can use this data to get county level (age) adjusted death rates.  You can find the formulas in most introductory  epidemiology text books.

    I haven't looked at the files recently but they probably also have sex and race

    Best,

    Dave Dorer



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    David Dorer
    Dorer Community Service Foundation
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  • 3.  RE: Age Adjusted Death Rates at the County level

    Posted 10-11-2025 02:12 PM

    Dear Danielle,

    I took a look and the NCHS mortality vital stats dataset that I referenced and it only goes to the state level.  The SEER database has county level all cause mortality data.  You need this to calculate relative survival. You need to sign a data use agreement to access the SEER data.  I don't think that you can access the data for commercial use without special permission.

    Dave Dorer



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    David Dorer
    Dorer Community Service Foundation
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  • 4.  RE: Age Adjusted Death Rates at the County level

    Posted 10-11-2025 04:06 PM
    Thank you so much for your response and assistance. This is very helpful to me and good to know. It seems clear that with some effort and appropriate access that county level analysis is possible. 

    Danielle Walters, MPH

    At the intersection of health and community development.

    A New Jersey Certified WBE and SBE
    "A leader is best when people barely know he exists, when his work is done, his aim fulfilled, they will say: we did it ourselves...."   - Lao Tzu







  • 5.  RE: Age Adjusted Death Rates at the County level

    Posted 10-12-2025 12:04 AM

    Dear Danielle

    Here are the Populations Estimates Program (PEP) US Census components of change (births, deaths, and migration) by county.

    The csv file is currently blocked.  You can read the pdf data dictionary.

    https://www2.census.gov/programs-surveys/popest/datasets/2020-2024/counties/totals/co-est2024-alldata.csv

    https://www2.census.gov/programs-surveys/popest/technical-documentation/file-layouts/2020-2024/CO-EST2024-ALLDATA.pdf

    Dave



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    David Dorer
    Dorer Community Service Foundation
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  • 6.  RE: Age Adjusted Death Rates at the County level

    Posted 10-12-2025 10:30 AM

    SEER  has death data for County x Age x Sex x Race x Hispanic for 2019-2023.  You can't download all variables at the same time.  You can do State x Age x Sex x Race x Hisapanic and then adjust the state level table by the county marginals for example by County x Age x Sex

    If you are using the data in a for-profit commercial context you need a commercial license.  Email seerstat@imsweb.com and ask about details.

    Dave



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    David Dorer
    Dorer Community Service Foundation
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  • 7.  RE: Age Adjusted Death Rates at the County level

    Posted 10-13-2025 12:24 PM
    Hi David,

    Thank you again for the detail - this is extremely helpful. Our use of age-adjusted death rates is all non-profit/educational in nature. However, I will explore options with SEER just in case. 

    We've started to hear comments that age-adjusted death rates below the state level are no longer possible or valid, which didn't make sense to me. It seems as though some states have the capacity and resources to take that extra step and calculate and publish age-adjusted rates at the county level, while others may not. Your information gives me more confidence in referencing the county-level age-adjusted rates that are publicly available, and confidence that we can calculate them ourselves if they are not. Thank you!

    Best,
    Danielle






  • 8.  RE: Age Adjusted Death Rates at the County level

    Posted 10-14-2025 05:51 PM

    Some larger states or states with better data infrastructure can carry out their own demographic programs. (I think LA County has its own demographic program, FWIW.)

    CDC is being extremely conservative, and since they are not responsible for the projections or estimates that states may be producing, they cannot endorse them. They basically say, "We did not produce this data so we don't trust it." That's quite fair.

    Reductions in force at CDC will negatively affect their ability to produce statistical products. We have seen that other agencies in similar situations had to drop some series, some surveys, and/or some degree of detail in producing their reports and estimates (https://www.amstat.org/the-nations-data-at-risk-year-two-ongoing-monitoring).


    Dave provided everything else there is to say about the problem.



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    Stas Kolenikov
    NORC
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