2013 NCHS Urban-Rural Classification Scheme for Counties

Area of Science:

• Public Health
• Biostatistics
• Sociology

Background:

• The National Center for Health Statistics (NCHS) Urban-Rural Classification Scheme for Counties is crucial for understanding health variations.
• Previous versions, like the 2006 scheme, have been instrumental in analyzing health differences based on geographic characteristics.
• Updating this classification is essential to reflect current demographic and geographic realities.

Purpose of the Study:

• To detail the development of the 2013 NCHS Urban-Rural Classification Scheme for Counties.
• To apply the updated scheme to health measures and demonstrate urban-rural health differences.
• To compare the 2013 scheme with the 2006 scheme using national health data.

Main Methods:

• The 2013 NCHS scheme methodology mirrors the 2006 scheme but utilizes 2010 census data.
• Counties are assigned to six levels based on metropolitan/micropolitan/noncore status, metropolitan statistical area (MSA) population size, and principal city location within large MSAs.
• The 2013 and 2006 schemes were applied to data from the National Vital Statistics System (NVSS) and National Health Interview Survey (NHIS).

Main Results:

• County urban-rural assignments under the 2013 NCHS scheme are highly similar to those from the 2006 NCHS scheme.
• Application to NVSS and NHIS data confirmed the utility of the six categories for monitoring health differences across the urbanization spectrum.
• Substantial health measure differences were observed between residents of large central and large fringe metropolitan counties.

Conclusions:

• The updated 2013 NCHS Urban-Rural Classification Scheme for Counties maintains consistency with the 2006 scheme.
• The classification system effectively demonstrates and monitors health disparities across diverse community types.
• Health outcomes vary significantly by urbanization level, with residents of large fringe metro counties generally experiencing better health than those in less urban areas.