Death Rates Table
Death Rate Report for Georgia by County
All Cancer Sites, 2019-2023
Black Non-Hispanic, Both Sexes, All Ages
Sorted by Count
County
|
2023 Rural-Urban Continuum Codes Φ
|
Met Healthy People Objective of 122.7? |
Age-Adjusted Death Rate † deaths per 100,000 (95% Confidence Interval)
|
CI*Rank ⋔ (95% Confidence Interval)
|
Average Annual Count
|
Recent Trend |
Recent 5-Year Trend ‡ in Death Rates (95% Confidence Interval)
|
|---|---|---|---|---|---|---|---|
| Georgia | N/A | No | 161.5 (159.4, 163.6) | N/A | 5,130 |
falling 
|
-1.9 (-2.0, -1.7) |
| United States | N/A | No | 166.5 (165.9, 167.1) | N/A | 70,844 |
falling
|
-2.0 (-2.0, -1.9) |
| Haralson County | Urban | No | 186.1 (106.6, 303.7) | 45 (1, 130) | 3 |
|
|
| Bacon County | Rural | No | 234.4 (132.9, 378.7) | 13 (1, 130) | 3 |
|
|
| Clinch County | Rural | No | 160.9 (93.5, 265.3) | 89 (1, 130) | 3 |
|
|
| Atkinson County | Rural | No | 201.7 (121.0, 323.7) | 28 (1, 130) | 4 |
stable 
|
-2.2 (-5.4, 0.9) |
| Berrien County | Rural | No | 179.9 (108.1, 281.9) | 58 (1, 130) | 4 |
stable
|
-1.9 (-4.9, 1.3) |
| Montgomery County | Rural | No | 156.6 (95.6, 244.8) | 96 (3, 130) | 4 |
falling
|
-29.3 (-50.4, -0.6) |
| Walker County | Urban | No | 135.9 (82.7, 209.8) | 118 (8, 130) | 4 |
falling
|
-4.3 (-7.6, -1.4) |
| Jeff Davis County | Rural | No | 159.2 (99.6, 243.6) | 92 (3, 130) | 4 |
stable
|
-2.4 (-6.0, 1.4) |
| Jenkins County | Rural | Yes | 108.7 (68.0, 166.1) | 128 (41, 130) | 4 |
falling
|
-3.6 (-6.9, -0.8) |
| Irwin County | Rural | No | 175.9 (112.3, 264.0) | 65 (1, 130) | 4 |
falling
|
-2.6 (-5.2, -0.2) |
| Jasper County | Urban | Yes | 117.9 (74.6, 180.3) | 124 (27, 130) | 4 |
falling
|
-14.1 (-20.6, -10.0) |
| Oglethorpe County | Urban | No | 128.2 (81.3, 195.6) | 122 (15, 130) | 4 |
|
|
| Pike County | Urban | No | 185.7 (117.8, 282.9) | 47 (1, 130) | 4 |
stable
|
-0.2 (-3.9, 3.6) |
| Crawford County | Urban | No | 144.3 (88.3, 224.7) | 111 (4, 130) | 5 |
|
|
| Johnson County | Rural | No | 133.3 (85.0, 200.1) | 119 (15, 130) | 5 |
stable
|
-0.3 (-3.1, 2.8) |
| Miller County | Rural | No | 255.6 (162.4, 383.9) | 4 (1, 126) | 5 |
stable
|
0.8 (-3.0, 5.2) |
| Wilcox County | Rural | No | 144.6 (93.2, 216.0) | 110 (10, 130) | 5 |
falling
|
-2.7 (-5.1, -0.3) |
| Franklin County | Rural | No | 240.9 (155.4, 357.5) | 8 (1, 127) | 5 |
|
|
| Wilkinson County | Rural | Yes | 115.5 (74.0, 173.7) | 125 (33, 130) | 5 |
falling
|
-3.0 (-6.0, -0.1) |
| Pierce County | Rural | No | 272.3 (175.6, 402.9) | 2 (1, 127) | 5 |
|
|
| Candler County | Rural | No | 177.6 (114.0, 264.1) | 62 (2, 130) | 5 |
|
|
| Charlton County | Rural | No | 214.1 (139.4, 313.1) | 17 (1, 129) | 5 |
|
|
| Bleckley County | Rural | No | 260.6 (168.4, 381.5) | 3 (1, 126) | 5 |
stable
|
-1.9 (-5.7, 1.9) |
| Lincoln County | Urban | No | 178.5 (116.8, 265.0) | 61 (1, 130) | 5 |
falling
|
-3.8 (-6.1, -1.8) |
| Chattooga County | Rural | No | 204.0 (137.3, 293.7) | 26 (1, 127) | 6 |
stable
|
1.5 (-1.9, 5.6) |
| Pulaski County | Rural | No | 151.2 (100.7, 219.6) | 101 (7, 130) | 6 |
stable
|
19.0 (-7.9, 44.1) |
| Stephens County | Rural | No | 152.3 (102.4, 219.5) | 100 (9, 130) | 6 |
falling
|
-2.9 (-5.8, -0.1) |
| Treutlen County | Rural | No | 300.8 (201.1, 432.7) | 1 (1, 108) | 6 |
rising 
|
2.7 (0.3, 5.8) |
| Calhoun County | Rural | No | 167.8 (115.0, 238.1) | 79 (3, 130) | 6 |
stable
|
-1.2 (-4.9, 2.5) |
| Evans County | Rural | No | 218.5 (149.5, 307.7) | 16 (1, 127) | 6 |
stable
|
-1.3 (-4.3, 1.7) |
| Lamar County | Rural | Yes | 112.4 (76.5, 159.8) | 126 (47, 130) | 6 |
falling
|
-2.8 (-5.6, -0.1) |
| Madison County | Urban | No | 189.3 (129.0, 269.0) | 42 (2, 129) | 6 |
stable
|
-2.2 (-4.9, 0.8) |
| Marion County | Urban | No | 183.3 (125.4, 264.0) | 53 (1, 130) | 6 |
stable
|
-2.2 (-5.0, 0.8) |
| Seminole County | Rural | No | 181.2 (123.3, 258.0) | 54 (2, 129) | 6 |
stable
|
-2.2 (-5.5, 0.9) |
| Long County | Urban | No | 204.7 (133.3, 297.5) | 24 (1, 129) | 7 |
stable
|
-0.8 (-4.1, 3.2) |
| Stewart County | Urban | No | 225.5 (157.5, 317.1) | 15 (1, 127) | 7 |
stable
|
0.5 (-1.6, 2.6) |
| Whitfield County | Urban | No | 155.0 (106.8, 218.1) | 99 (8, 130) | 7 |
stable
|
-1.4 (-4.6, 2.0) |
| Taylor County | Rural | No | 200.6 (139.2, 281.4) | 31 (1, 127) | 7 |
falling
|
-3.2 (-5.4, -1.1) |
| Talbot County | Urban | No | 175.6 (121.4, 247.9) | 66 (3, 129) | 8 |
falling
|
-2.4 (-4.3, -0.6) |
| Turner County | Rural | No | 210.3 (147.3, 291.7) | 19 (1, 125) | 8 |
stable
|
-1.5 (-3.3, 0.5) |
| Twiggs County | Urban | No | 194.0 (135.3, 271.0) | 37 (1, 126) | 8 |
stable
|
-1.1 (-3.0, 0.7) |
| Cook County | Rural | No | 167.4 (119.3, 228.4) | 80 (5, 130) | 8 |
stable
|
-2.5 (-5.3, 0.1) |
| Bryan County | Urban | No | 166.8 (117.2, 228.9) | 81 (5, 129) | 8 |
stable
|
-1.8 (-5.6, 2.3) |
| Dooly County | Rural | No | 124.0 (89.6, 168.7) | 123 (41, 130) | 8 |
stable
|
-1.8 (-4.0, 0.6) |
| Forsyth County | Urban | Yes | 112.2 (77.9, 155.3) | 127 (54, 130) | 8 |
|
|
| Jackson County | Rural | No | 168.7 (120.8, 228.4) | 78 (5, 128) | 9 |
falling
|
-3.0 (-5.3, -0.7) |
| Morgan County | Urban | No | 149.0 (107.5, 202.7) | 106 (14, 130) | 9 |
falling
|
-2.7 (-4.5, -1.0) |
| Appling County | Rural | No | 251.2 (181.2, 339.4) | 5 (1, 112) | 9 |
stable
|
-0.1 (-2.6, 2.8) |
| Randolph County | Rural | No | 158.7 (113.9, 217.3) | 93 (8, 129) | 9 |
falling
|
-3.3 (-6.3, -0.8) |
| Telfair County | Rural | No | 180.4 (130.7, 243.7) | 57 (4, 127) | 9 |
stable
|
-1.4 (-4.1, 1.3) |
| McIntosh County | Urban | No | 160.2 (112.7, 222.9) | 90 (5, 130) | 9 |
stable
|
-2.2 (-5.2, 0.5) |
| Jones County | Urban | Yes | 99.8 (73.6, 133.4) | 129 (94, 130) | 10 |
falling
|
-3.6 (-5.9, -1.3) |
| Lee County | Urban | No | 186.4 (133.5, 251.5) | 44 (2, 127) | 10 |
stable
|
-1.0 (-4.7, 3.5) |
| Putnam County | Rural | No | 150.7 (110.4, 201.5) | 103 (17, 130) | 10 |
stable
|
-1.5 (-3.5, 0.7) |
| Hart County | Rural | No | 184.7 (137.0, 244.2) | 50 (4, 125) | 10 |
stable
|
0.7 (-1.9, 8.0) |
| Tattnall County | Rural | No | 189.6 (139.3, 251.6) | 41 (3, 126) | 10 |
stable
|
-2.3 (-5.1, 0.3) |
| Warren County | Rural | No | 238.7 (177.6, 316.8) | 10 (1, 111) | 10 |
stable
|
-1.6 (-4.6, 1.3) |
| Dodge County | Rural | No | 163.8 (122.7, 214.6) | 87 (10, 128) | 11 |
stable
|
-1.1 (-3.3, 1.3) |
| Polk County | Rural | No | 179.7 (134.1, 236.2) | 59 (4, 126) | 11 |
stable
|
-2.1 (-4.7, 0.5) |
| Early County | Rural | No | 189.8 (142.4, 248.1) | 40 (4, 125) | 11 |
stable
|
-0.8 (-3.6, 1.8) |
| Wilkes County | Rural | No | 190.7 (142.2, 252.3) | 39 (3, 125) | 11 |
stable
|
-0.5 (-2.5, 1.6) |
| Wayne County | Rural | No | 197.2 (146.6, 259.5) | 34 (2, 123) | 11 |
falling
|
-2.6 (-4.9, -1.0) |
| Greene County | Rural | No | 151.0 (113.5, 197.8) | 102 (19, 129) | 11 |
falling
|
-2.9 (-4.3, -1.5) |
| Butts County | Urban | No | 170.8 (129.0, 221.8) | 74 (7, 126) | 12 |
stable
|
-1.5 (-3.6, 0.7) |
| Ben Hill County | Rural | No | 183.6 (138.9, 238.1) | 52 (4, 125) | 12 |
stable
|
-1.9 (-3.9, 0.0) |
| Brooks County | Urban | No | 172.7 (130.6, 224.9) | 70 (7, 126) | 12 |
stable
|
-1.4 (-3.0, 0.1) |
| Cherokee County | Urban | Yes | 93.0 (69.3, 121.7) | 130 (105, 130) | 13 |
falling
|
-4.3 (-6.8, -1.1) |
| Camden County | Rural | No | 139.6 (107.2, 178.5) | 115 (33, 130) | 13 |
stable
|
-1.8 (-4.0, 0.6) |
| Toombs County | Rural | No | 201.5 (155.4, 256.7) | 30 (3, 118) | 13 |
stable
|
-1.8 (-4.4, 0.5) |
| Effingham County | Urban | No | 195.9 (148.7, 252.1) | 35 (3, 120) | 14 |
stable
|
-1.7 (-4.0, 0.8) |
| Macon County | Rural | No | 170.8 (132.0, 218.0) | 73 (11, 127) | 14 |
stable
|
-0.9 (-2.4, 0.7) |
| Worth County | Urban | No | 194.5 (150.4, 248.2) | 36 (4, 120) | 14 |
stable
|
-1.6 (-3.9, 0.7) |
| Monroe County | Urban | No | 201.5 (156.7, 255.5) | 29 (2, 118) | 14 |
stable
|
0.2 (-1.8, 2.4) |
| Terrell County | Urban | No | 248.7 (193.3, 315.3) | 6 (1, 89) | 14 |
falling
|
-1.9 (-3.3, -0.6) |
| Emanuel County | Rural | No | 208.1 (161.7, 263.6) | 20 (2, 117) | 15 |
stable
|
-0.8 (-2.5, 0.9) |
| Harris County | Urban | No | 184.0 (143.9, 233.1) | 51 (5, 123) | 15 |
stable
|
-0.9 (-3.2, 1.7) |
| Coffee County | Rural | No | 143.3 (111.9, 180.5) | 112 (31, 129) | 15 |
falling
|
-3.2 (-4.8, -1.5) |
| Elbert County | Rural | No | 239.8 (187.4, 302.8) | 9 (1, 93) | 15 |
stable
|
0.3 (-1.1, 1.9) |
| Grady County | Rural | No | 173.3 (135.5, 218.8) | 69 (10, 124) | 15 |
falling
|
-1.9 (-3.8, -0.1) |
| Hancock County | Rural | No | 176.7 (138.4, 223.6) | 63 (8, 124) | 15 |
stable
|
-1.2 (-3.8, 1.3) |
| Upson County | Rural | No | 188.8 (147.8, 237.8) | 43 (5, 120) | 16 |
falling
|
-1.8 (-3.4, -0.2) |
| Barrow County | Urban | No | 199.0 (154.7, 251.0) | 33 (3, 119) | 17 |
stable
|
-0.3 (-2.3, 2.2) |
| McDuffie County | Urban | No | 175.3 (138.3, 219.2) | 67 (9, 123) | 17 |
stable
|
-1.7 (-4.2, 0.8) |
| Meriwether County | Urban | No | 169.0 (133.8, 211.2) | 77 (11, 125) | 17 |
stable
|
-0.7 (-2.3, 0.9) |
| Screven County | Rural | No | 237.7 (188.0, 297.3) | 12 (1, 96) | 17 |
stable
|
-1.1 (-2.5, 0.3) |
| Hall County | Urban | No | 136.4 (108.7, 168.6) | 117 (45, 129) | 19 |
falling
|
-2.6 (-4.3, -0.8) |
| Colquitt County | Rural | No | 192.1 (154.2, 236.3) | 38 (5, 115) | 19 |
stable
|
-1.3 (-3.0, 0.3) |
| Ware County | Rural | No | 202.0 (163.1, 247.2) | 27 (4, 109) | 19 |
stable
|
-0.9 (-2.8, 1.0) |
| Burke County | Urban | No | 156.5 (125.3, 193.4) | 97 (20, 127) | 20 |
falling
|
-2.2 (-4.1, -0.5) |
| Bartow County | Urban | No | 205.6 (165.0, 252.6) | 23 (3, 106) | 20 |
stable
|
-1.1 (-2.8, 0.7) |
| Decatur County | Rural | No | 164.4 (133.3, 200.5) | 85 (17, 124) | 20 |
falling
|
-1.6 (-3.0, -0.2) |
| Crisp County | Rural | No | 238.5 (192.8, 291.6) | 11 (1, 74) | 21 |
stable
|
0.0 (-2.0, 2.2) |
| Tift County | Rural | No | 185.5 (150.9, 225.5) | 49 (8, 118) | 21 |
falling
|
-1.6 (-2.6, -0.5) |
| Washington County | Rural | No | 181.1 (147.5, 220.3) | 55 (10, 119) | 22 |
falling
|
-1.9 (-3.3, -0.5) |
| Jefferson County | Rural | No | 241.3 (196.3, 293.7) | 7 (1, 73) | 22 |
stable
|
0.0 (-2.5, 2.6) |
| Mitchell County | Rural | No | 208.0 (171.2, 250.5) | 21 (4, 103) | 24 |
stable
|
-1.5 (-3.1, 0.1) |
| Bulloch County | Rural | No | 146.9 (120.8, 176.8) | 107 (35, 126) | 25 |
falling
|
-9.6 (-22.7, -3.0) |
| Peach County | Urban | No | 204.3 (168.8, 245.0) | 25 (4, 102) | 25 |
stable
|
-1.9 (-3.7, 0.0) |
| Floyd County | Urban | No | 185.5 (153.9, 221.6) | 48 (8, 112) | 26 |
stable
|
-0.5 (-2.4, 1.6) |
| Sumter County | Rural | No | 199.8 (165.2, 239.4) | 32 (5, 104) | 28 |
stable
|
-1.1 (-2.3, 0.1) |
| Carroll County | Urban | No | 170.8 (143.3, 201.7) | 75 (18, 119) | 31 |
falling
|
-2.3 (-3.7, -0.7) |
| Baldwin County | Rural | No | 170.9 (144.7, 200.5) | 72 (21, 119) | 32 |
stable
|
-1.0 (-2.0, 0.0) |
| Laurens County | Rural | No | 170.1 (145.1, 198.2) | 76 (22, 117) | 34 |
stable
|
-1.0 (-2.5, 0.6) |
| Paulding County | Urban | No | 139.4 (116.2, 165.6) | 116 (48, 128) | 35 |
stable
|
-1.4 (-3.1, 1.2) |
| Columbia County | Urban | No | 131.3 (111.4, 153.6) | 121 (71, 128) | 35 |
stable
|
-2.3 (-4.4, 0.1) |
| Walton County | Urban | No | 229.3 (195.0, 267.7) | 14 (2, 72) | 37 |
stable
|
0.1 (-1.3, 2.0) |
| Troup County | Rural | No | 165.1 (141.4, 191.6) | 84 (28, 119) | 38 |
falling
|
-2.3 (-3.3, -1.3) |
| Liberty County | Urban | No | 176.3 (150.3, 205.2) | 64 (18, 114) | 39 |
stable
|
-1.3 (-2.5, 0.1) |
| Thomas County | Rural | No | 205.9 (177.3, 238.0) | 22 (5, 85) | 39 |
falling
|
-1.2 (-2.4, -0.1) |
| Coweta County | Urban | No | 165.6 (142.5, 191.4) | 83 (27, 116) | 41 |
falling
|
-1.9 (-3.0, -0.6) |
| Glynn County | Urban | No | 178.7 (154.7, 205.4) | 60 (18, 109) | 42 |
falling
|
-2.4 (-3.7, -1.2) |
| Fayette County | Urban | No | 132.4 (114.5, 152.4) | 120 (76, 128) | 45 |
stable
|
-1.7 (-3.1, 0.4) |
| Clarke County | Urban | No | 162.6 (141.6, 185.7) | 88 (32, 118) | 49 |
falling
|
-3.0 (-4.2, -1.9) |
| Spalding County | Urban | No | 212.8 (186.0, 242.4) | 18 (4, 72) | 50 |
stable
|
-0.4 (-1.8, 1.2) |
| Lowndes County | Urban | No | 140.6 (123.0, 159.8) | 114 (65, 126) | 50 |
falling
|
-3.1 (-3.9, -2.3) |
| Houston County | Urban | No | 150.1 (132.9, 168.7) | 104 (55, 122) | 67 |
falling
|
-2.4 (-3.3, -1.4) |
| Newton County | Urban | No | 159.6 (142.3, 178.4) | 91 (42, 117) | 75 |
falling
|
-1.7 (-2.5, -0.8) |
| Rockdale County | Urban | No | 145.7 (129.9, 162.8) | 109 (61, 123) | 75 |
falling
|
-2.8 (-3.9, -1.2) |
| Douglas County | Urban | No | 180.7 (160.5, 202.5) | 56 (21, 99) | 84 |
stable
|
-0.4 (-1.8, 1.7) |
| Dougherty County | Urban | No | 171.2 (156.1, 187.4) | 71 (32, 104) | 103 |
falling
|
-1.9 (-2.9, -1.0) |
| Bibb County | Urban | No | 156.5 (144.5, 169.2) | 98 (58, 113) | 135 |
falling
|
-2.2 (-2.7, -1.6) |
| Henry County | Urban | No | 156.6 (143.9, 170.2) | 95 (54, 113) | 148 |
stable
|
-0.8 (-1.5, 0.3) |
| Muscogee County | Urban | No | 163.9 (152.3, 176.1) | 86 (47, 106) | 160 |
falling
|
-2.3 (-4.3, -1.7) |
| Chatham County | Urban | No | 166.0 (155.4, 177.2) | 82 (47, 102) | 192 |
falling
|
-1.9 (-2.3, -1.5) |
| Richmond County | Urban | No | 185.9 (174.3, 198.1) | 46 (26, 76) | 215 |
falling
|
-1.6 (-2.2, -0.8) |
| Cobb County | Urban | No | 142.0 (132.5, 151.8) | 113 (80, 121) | 217 |
falling
|
-1.3 (-2.0, -0.3) |
| Clayton County | Urban | No | 157.2 (146.9, 168.0) | 94 (60, 110) | 243 |
falling
|
-1.4 (-1.9, -0.8) |
| Gwinnett County | Urban | No | 146.6 (136.9, 156.7) | 108 (76, 119) | 245 |
falling
|
-1.3 (-1.9, -0.5) |
| DeKalb County | Urban | No | 149.9 (144.3, 155.7) | 105 (79, 112) | 610 |
falling
|
-1.7 (-2.0, -1.2) |
| Fulton County | Urban | No | 174.8 (169.2, 180.5) | 68 (46, 80) | 790 |
falling
|
-2.0 (-2.2, -1.7) |
| Baker County | Rural | *** |
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| Banks County | Rural | *** |
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| Brantley County | Urban | *** |
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| Catoosa County | Urban | *** |
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| Chattahoochee County | Urban | *** |
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| Clay County | Rural | *** |
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| Dade County | Urban | *** |
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| Dawson County | Urban | *** |
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| Echols County | Urban | *** |
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| Fannin County | Rural | *** |
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| Gilmer County | Rural | *** |
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| Glascock County | Rural | *** |
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| Gordon County | Rural | *** |
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| Habersham County | Rural | *** |
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| Heard County | Urban | *** |
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| Lanier County | Urban | *** |
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| Lumpkin County | Urban | *** |
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| Murray County | Urban | *** |
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| Oconee County | Urban | *** |
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| Pickens County | Urban | *** |
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| Quitman County | Rural | *** |
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| Rabun County | Rural | *** |
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| Schley County | Rural | *** |
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| Taliaferro County | Rural | *** |
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| Towns County | Rural | *** |
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| Union County | Rural | *** |
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| Webster County | Rural | *** |
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| Wheeler County | Rural | *** |
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| White County | Rural | *** |
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Notes:
Created by statecancerprofiles.cancer.gov on 03/28/2026 1:36 am.
State Cancer Registries may provide more current or more local data.
Trend
Rising when 95% confidence interval of average annual percent change is above 0.
Stable when 95% confidence interval of average annual percent change includes 0.
Falling when 95% confidence interval of average annual percent change is below 0.
Rising when 95% confidence interval of average annual percent change is above 0.
Stable when 95% confidence interval of average annual percent change includes 0.
Falling when 95% confidence interval of average annual percent change is below 0.
† Death data provided by the National Vital Statistics System public use data file. Death rates calculated by the National Cancer Institute using SEER*Stat. Death rates are age-adjusted to the 2000 US standard population (20 age groups: <1, 1-4, 5-9, ... , 80-84, 85-89, 90+).
The Healthy People 2030 goals are based on rates adjusted using different methods but the differences should be minimal.
Population counts for denominators are based on Census populations as modified by NCI.
The US Population Data File is used with mortality data.
‡ The Average Annual Percent Change (AAPC) is based on the APCs calculated by Joinpoint. Due to data availability issues, the time period used in the calculation of the joinpoint regression model may differ for selected counties.
⋔ Results presented with the CI*Rank statistics help show the usefulness of ranks. For example, ranks for relatively rare diseases or less populated areas may be essentially meaningless because of their large variability, but ranks for more common diseases in densely populated regions can be very useful. More information about methodology can be found on the CI*Rank website.
When displaying county information, the CI*Rank for the state is not shown because it's not comparable. To see the state CI*Rank please view the statistics at the US By State level.
Healthy People 2030 Objectives provided by the Centers for Disease Control and Prevention.
Φ Rural–urban county classifications are based on the 2023 USDA Rural–Urban Continuum Codes (except for Connecticut Counties which use 2013 codes). State-level cancer rates for rural areas are calculated using cancer cases registered exclusively in rural counties, while state-level cancer rates for urban areas are calculated using cases registered exclusively in urban counties.
* Data has been suppressed to ensure confidentiality and stability of rate estimates. Counts are suppressed if fewer than 16 records were reported in a specific area-sex-race category.
If an average count of 3 is shown, the total number of cases for the time period is 16 or more which exceeds suppression threshold (but is rounded to 3).
Data for United States does not include Puerto Rico.