scorecard_health_county
Health domain county scorecard v1. One row per US county, ~40 columns across 4 groups: mortality, chronic disease/self-reported health, access, and Medicare utilization. 12 north-star metrics with paired national percentile and state rank columns (24 window-function columns total). North-star metrics: premature_death_ypll_per_100k, drug_overdose_deaths_per_100k, suicide_deaths_per_100k, firearm_deaths_per_100k, cardiovascular_deaths_per_100k, cancer_mortality_per_100k, pct_adults_diabetes, pct_adults_fair_poor_health, pct_uninsured, pct_adults_had_checkup, medicare_standardized_per_capita. Reliability tiers by group: A = all mortality metrics (CHR/NCI SEER), Medicare cost (CMS PUF) B = pct_uninsured (SAHIE regression model) C = all PLACES metrics (BRFSS small-area model) Percentile convention: 0–1, higher = higher raw value. For "bad" metrics (mortality, disease burden, uninsured) use 1 - _national_pctile. Known limitations (v1): - CHR mortality rates are crude (not age-adjusted) except cardiovascular + cancer. - WONDER suppression: counties with <10 deaths show NULL (tracked by pct_mortality_metrics_suppressed). - deaths_of_despair excludes alcohol-induced mortality (v1.1 addition). - pct_adults_had_checkup is a positive proxy: 1 - (value/100) gives no-checkup rate. - No life expectancy, infant mortality, or primary care density in v1.
tier —composite_index
overview
overview
All 3,222 US counties. Mixed reliability tiers within row (A/B/C - see description).
current vintage — Mixed: CHR 2025, PLACES 2025, SAHIE 2022, CMS 2022
history — Snapshot only
provenance
source & licensing
authority
University of Wisconsin Population Health Institute
dataset
County Health Rankings
license
—
citation
County Health Rankings 2025 + CDC PLACES + EPA AQS + NHTSA FARS + CMS Medicare GV PUF + ACS SAHIE + SSA + HRSA AHRF.
schema
fields
| name | type | definition |
|---|---|---|
| _ingested_at | timestamp | Timestamp when this record was written to BigQuery.Pipeline metadata field. |
| _reference_date | date | Pipeline metadata field.Pipeline metadata field. |
| _scorecard_version | string | Pipeline metadata field.Pipeline metadata field. |
| alcohol_mortality_per_100k | float64 · rate per 100k | Age-adjusted rate of deaths attributable to alcohol use per 100,000 residents, including liver disease and alcohol poisoning. Higher values indicate greater alcohol-related mortality. |
| cancer_mortality_per_100k | float64 · rate per 100k | Age-adjusted rate of deaths due to cancer per 100,000 residents. Higher values indicate greater cancer mortality burden in the county. |
| cardiovascular_deaths_per_100k | float64 · rate per 100k | Age-adjusted rate of deaths due to cardiovascular disease per 100,000 residents. Higher values indicate a greater burden of heart disease and stroke mortality. |
| country_id | string | ISO alpha-2 country code (always 'US' for domestic tables). |
| county_idkey | string | 5-character FIPS code identifying the county.Joins dim.counties on county_id. |
| county_name | string | Human-readable county name corresponding to county_id. |
| deaths_of_despair_per_100k | float64 · rate per 100k | Combined age-adjusted rate of deaths from drug overdose, alcohol, and suicide per 100,000 residents. Higher values indicate greater mortality from socially driven causes of despair. |
| dentists_per_100k | float64 · rate per 100k | Number of actively practicing dentists per 100,000 county residents. Higher values indicate better oral health care supply and geographic access. |
| drug_overdose_deaths_per_100k | float64 · rate per 100k | Age-adjusted rate of deaths attributable to drug overdose per 100,000 residents. Higher values indicate a greater burden of fatal overdose in the county. |
| dual_enrollment_pct | float64 · percent (0–100) | Percentage of Medicare beneficiaries who are also enrolled in Medicaid (dual eligibles), a proxy for low-income status among the elderly and disabled. Higher values indicate greater socioeconomic vulnerability in the Medicare population. |
| er_visits_per_1000_benes | float64 · rate per 100k | Emergency room visits per 1,000 Medicare beneficiaries. Higher values may indicate worse access to primary care or higher severity of illness in the Medicare population. |
| firearm_deaths_per_100k | float64 · rate per 100k | Age-adjusted rate of deaths involving firearms per 100,000 residents, including homicide, suicide, and unintentional causes. Higher values indicate greater firearm mortality burden. |
| frequent_mental_distress_pct | float64 · percent (0–100) | Percentage of adults reporting 14 or more days of poor mental health in the past 30 days. Higher values indicate a greater share of the population experiencing frequent mental distress. |
| hcc_risk_score | float64 · index (base year=100) | Hierarchical Condition Category (HCC) risk score reflecting the average expected health care expenditure relative to the national average Medicare beneficiary; a score of 1.0 equals the national average. Higher values indicate a sicker, higher-cost beneficiary population. |
| infant_mortality_rate | float64 · rate per 100k | Number of infant deaths (under age 1) per 100,000 live births. Higher values indicate worse early-life health outcomes; interpret in conjunction with the reliability flag. |
| infant_mortality_rate_unreliable | bool | Boolean flag indicating that the infant mortality rate estimate is statistically unreliable, typically due to small numerator counts. When true, the corresponding rate should not be used for county-level comparisons. |
| leading_tracked_cause_of_death | string | String label identifying the single largest cause of death among the mortality categories tracked in this table for the county. Provides a quick summary of the dominant driver of tracked mortality. |
| leading_tracked_cause_pct_of_tracked | float64 · percent (0–100) | Percentage of total tracked-cause deaths accounted for by the leading tracked cause of death. Higher values indicate greater concentration of tracked mortality in a single cause. |
| life_expectancy_tract_count | int64 · count | Number of census tracts included in the life expectancy estimate for this county. Lower counts may indicate that the county-level estimate covers a smaller share of the population or relies on fewer geographic units. |
| life_expectancy_years | float64 · years | Estimated average number of years a person born today in the county would be expected to live. Higher values indicate better overall population health and longevity. |
| low_birthweight_rate | float64 · percent (0–100) | Percentage of live births with a birth weight below 2,500 grams (5.5 lbs). Higher values indicate worse maternal and infant health outcomes. |
| median_age | float64 · years | Median age of county residents. Higher values indicate an older population, which is associated with greater chronic disease prevalence and health care utilization. |
| medicare_standardized_per_capita | float64 · dollars (nominal) | Medicare spending per beneficiary, standardized to remove geographic price differences, reflecting utilization rather than local price variation. Higher values indicate greater health care resource use among Medicare enrollees. |
| motor_vehicle_deaths_per_100k_crude | float64 · rate per 100k | Crude (non-age-adjusted) rate of motor vehicle crash deaths per 100,000 residents. Higher values indicate greater road fatality burden; crude rate retains sensitivity to age structure differences across counties. |
| opioid_dispensing_rate_per_100 | float64 · rate per 100k | Number of opioid prescriptions dispensed per 100 county residents per year. Higher values indicate greater opioid prescribing volume, a key supply-side driver of opioid misuse risk. |
| ozone_days_above_standard | float64 · count | Number of days per year on which ambient ozone concentration exceeded the EPA National Ambient Air Quality Standard. Higher values indicate more frequent unhealthy ozone pollution events. |
| ozone_monitor_count | int64 · count | Number of active EPA air quality monitoring stations measuring ozone in or near the county. Low counts may indicate that ozone day estimates are based on limited or modeled data. |
| pct_adults_diabetes | float64 · percent (0–100) | Percentage of adults who report having been diagnosed with diabetes. Higher values indicate a greater prevalence of diabetes among the county adult population. |
| pct_adults_fair_poor_health | float64 · percent (0–100) | Percentage of adults who self-report their general health status as fair or poor. Higher values indicate worse self-assessed population health. |
| pct_adults_high_bp | float64 · percent (0–100) | Percentage of adults who report having been diagnosed with high blood pressure (hypertension). Higher values indicate greater hypertension prevalence. |
| pct_adults_no_checkup_access | float64 · percent (0–100) | Percentage of adults who report not having had a routine medical checkup in the past year, used as a proxy for lack of preventive care access. Higher values indicate lower engagement with preventive health services. |
| pct_adults_obesity | float64 · percent (0–100) | Percentage of adults with a body mass index (BMI) of 30 or greater, classified as obese. Higher values indicate greater obesity prevalence in the county adult population. |
| pct_age_65_plus | float64 · percent (0–100) | Percentage of the county population aged 65 and older. Higher values indicate an older age structure, which affects the interpretation of crude health and mortality rates. |
| pct_any_disability | float64 · percent (0–100) | Percentage of the county population reporting any disability, including physical, cognitive, or independent living limitations. Higher values indicate greater disability burden. |
| pct_mortality_metrics_suppressed | float64 · percent (0–100) | Percentage of mortality metric fields in this row that were suppressed due to small cell sizes or statistical unreliability. Higher values indicate that the county's mortality profile is less complete and should be interpreted with caution. |
| pct_places_metrics_low_confidence | float64 · percent (0–100) | Percentage of CDC PLACES behavioral and health status metrics in this row flagged as low-confidence, typically due to small sample sizes in the underlying survey. Higher values indicate that behavioral health estimates for this county are less reliable. |
| pct_uninsured | float64 · percent (0–100) | Percentage of the county population without any form of health insurance coverage. Higher values indicate less access to coverage and greater financial exposure to health costs. |
| pm25_annual_avg | float64 · micrograms per cubic meter | Annual average concentration of fine particulate matter (PM2.5) in the ambient air, measured in micrograms per cubic meter. Higher values indicate worse air quality and greater respiratory and cardiovascular health risk. |
| pm25_monitor_count | int64 · count | Number of active EPA air quality monitoring stations measuring PM2.5 in or near the county. Low counts may indicate that the annual average estimate is based on limited or modeled data. |
| premature_death_ypll_per_100k | float64 · rate per 100k | Years of potential life lost (YPLL) before age 75 per 100,000 residents, a summary measure of premature mortality. Higher values indicate more years of life lost to early death in the county. |
| primary_care_physicians_per_100k | float64 · rate per 100k | Number of actively practicing primary care physicians per 100,000 county residents. Higher values indicate better primary care supply and geographic access to routine medical services. |
| psychiatrists_per_100k | float64 · rate per 100k | Number of actively practicing psychiatrists per 100,000 county residents. Higher values indicate better mental health care supply in the county. |
| readmission_rate_30d | float64 · rate per 100k | Rate of hospital readmissions within 30 days of discharge per 100,000 Medicare beneficiaries. Higher values indicate worse post-discharge care quality or care coordination. |
| ssdi_beneficiaries_per_1k_workforce_proxy | float64 · rate per 100k | Number of Social Security Disability Insurance (SSDI) beneficiaries per 1,000 working-age residents, used as a proxy for the county's disability and labor force health burden. Higher values indicate greater disability-related workforce detachment. |
| state_id | string | 2-character FIPS code identifying the state.Joins dim.states on state_id. |
| suicide_deaths_per_100k | float64 · rate per 100k | Age-adjusted rate of deaths by suicide per 100,000 residents. Higher values indicate greater suicide mortality burden. |
| teen_birth_share_pct | float64 · percent (0–100) | Percentage of all live births in the county that occurred to mothers aged 15–19. Higher values indicate greater teen birth prevalence, associated with socioeconomic and educational disadvantage. |
| tobacco_use_adult | float64 · percent (0–100) | Percentage of adults who currently use tobacco products, including cigarettes, cigars, or smokeless tobacco. Higher values indicate greater tobacco use prevalence and associated chronic disease risk. |
| total_population | int64 · count | Total resident population of the county. Used as the denominator for per-capita rate calculations across other metrics in this table. |
relationships
joins
primary key
county_id
common joins
dim.geographies on county_id
demographics_scorecard_county on county_id
economy_scorecard_county on county_id
scorecard_health_county_ranked on county_id
usage
how to use this table
method
Materialized join of ~40 health metrics across mortality, chronic disease, access, and Medicare utilization. 12 north-star metrics with national + state percentile ranks. Tiers: A for mortality (CHR/NCI), Medicare cost (CMS); B for SAHIE; C for PLACES.
do not use for
Direct rate comparisons across A/B/C tiers without acknowledgment; cross-vintage trend; sub-county.
known issues
v1 limitations: CHR rates mostly crude; WONDER suppression; deaths_of_despair excludes alcohol; pct_adults_had_checkup is positive proxy. No life expectancy at v1, no infant mortality, no primary care density.
last updated · May 5, 2026