The source of data is represented by The Big Cities Health Coalition (BCHC), a forum for the leaders of America’s largest metropolitan health departments to exchange strategies and jointly address issues to promote and protect the health and safety of the people they serve. BCHC is a project of the National Association of County and City Health Officials (NACCHO), which represents the nation’s 2,800 local governmental health departments.
Most of the data come directly from cities, while some were secured from the U.S. Census or other similar publicly available dataset where city data were available. For the most part, jurisdictions reported their three most recent years of data, which were 2012, 2013, and 2014. Data prior to 2010 were not included, even if it meant a jurisdiction only had two years of data available. The nature of the data varies considerably. When data were not provided or available, the appropriate space was left blank. Not all health departments were able to provide data for all indicators and, in cases where denominators were too small, certain rates for subpopulations were not displayed.
Most data were reviewed by individual cities as well. Where sample sizes allow, indicators are broken down into subpopulations for race and ethnicity categories. For most jurisdictions, the default options were White (Non-Hispanic), Black (Non-Hispanic), Hispanic, Asian/Pacific Islander, American Indian/Alaska Native, and Other. In areas where certain populations were too small, the various subpopulations were included in the “other” category with any additional racial/ethnic minorities. In many of the California cities, as well as Seattle, reported numbers only represent Asians; Pacific Islanders are not included. Some jurisdictions also report mixed-race numbers, and where they do, those numbers are reported as “Multi-racial”.
In most cases, the 2000 standard population age was used. The ratio used as a denominator is the population from a location, year, of specified gender and race/ethnicity and is multiplied by 10,000.
Asthma Emergency Department (ED) visits rates are reported per 10,000 people, using 2010 U.S. Census figures, age-adjusted to the year 2000 standard population (except where noted). ICD-9-CM Codes include: 493.0 – Extrinsic asthma; 493.1 – Intrinsic asthma; 493.2 – Chronic obstructive asthma; 493.8 – Other forms of asthma; 493.9 – Asthma unspecified.
Firearm Related Emergency Department (ED) Visit Rate are per 100,000 people, using 2010 Census figures, age-adjusted to the year 2000 standard population. ICD-9-CM Codes included: E922.0-E922.3, E922.8, E922.9 – Accident caused by firearm missile; E955.0-E955.4 – Suicide and self-inflicted injury by firearms; E965.0-E965.4 – Assault by firearms; E985.0-E985.4 – Injury by firearms, undetermined whether accidentally, or purposefully inflicted; E970 – Injury due to legal intervention by firearms; E979.4 – Terrorism involving firearms.
Dataset contains the BCHC requested methodology for every indicator, along with sources of data used by the BCHC member and notes about the methods and data. In order to ease the comparison of the health conditions or injuries caused by the estimated values of age-adjusted ED visits rates that were determined, health conditions or injury causes included in the assessment or in the requested methodology were accompanied by the list of all ICD-9 corresponding codes.