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 came 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 denominator for the population from a location, year, of specified gender and race/ethnicity is multiplied by 100,000.
HIV/AIDS data include HIV Diagnoses Rate and AIDS Diagnoses Rate in a given year, as well as Persons Living with HIV/AIDS Rate (which includes those who have both HIV and AIDS). Each of these indicators report the crude rate per 100,000 population, using 2010 U.S. Census figure (except where noted)and ICD-10 codes B20-B24 were asigned.
TB Incidence is reported as a crude rate per 100,000 people, using 2010 U.S. Census figures (except where noted).
Laboratory-confirmed infections caused by salmonella or Shiga Toxin-Producing E. coli are crude rates per 100,000 people, using 2010 Census figures.
Percent of children tested under age 6 with elevated blood lead levels was calculated by cities. “Elevated” was defined by the CDC standard, children who had blood lead levels of 5 ug/dl and over. The numerator is the number of children with elevated blood levels and the Denominator is the number of children under 6 screened.
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 for which the estimated values morbidity rates were determined, with those included and specified in the methodology, these are accompanied by the list of all ICD-10 corresponding codes.