State Cancer Profiles

Interpretation of Death Rates Data

Death Rate Report for North Dakota by County

All Cancer Sites, 2016-2020

All Races (includes Hispanic), Both Sexes, All Ages

Sorted by Rate

Explanation of Column Headers

Objective - The objective of 122.7 is from the Healthy People 2020 project done by the Centers for Disease Control and Prevention.

Death Rate (95% Confidence Interval) - The death rate is based upon 100,000 people and is for 5 year(s). Rates are age-adjusted by 5-year age groups to the 2000 U.S. standard million population (the Healthy People 2020 goals are based on rates adjusted using different methods but the differences should be minimal).

Recent Trends - This is an interpretation of the AAPC:

• 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.

AAPC (95% Confidence Interval) - The Average Annual Percent Change is the change in rate over time. These AAPCs are based upon APCs that were calculated by Joinpoint Regression Program

Other Notes

• Larger confidence intervals indicate less stability of the data. This is often due to low counts that are not quite low enough to be suppressed.
• Data is currently being suppressed if there are fewer than 16 counts for the time period.

Line by Line Interpretation of the Report

North Dakota

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 142.0 with a 95% confidence interval from 138.4 to 145.6 and 1,295 average annual deaths over 2016-2020.
• CI*Rank⋔ : N/A
• Recent Trend : The trend is falling because the trend is -1.3 with a 95% confidence interval from -1.4 to -1.1.

United States

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 149.4 with a 95% confidence interval from 149.3 to 149.6 and 599,666 average annual deaths over 2016-2020.
• CI*Rank⋔ : N/A
• Recent Trend : The trend is falling because the trend is -2.0 with a 95% confidence interval from -2.2 to -1.8.

Rolette County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 202.1 with a 95% confidence interval from 168.7 to 240.0 and 27 average annual deaths over 2016-2020.
• CI*Rank⋔ : 1 (1, 18)
• Recent Trend : The trend is falling because the trend is -1.1 with a 95% confidence interval from -1.9 to -0.2.

Sioux County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 174.3 with a 95% confidence interval from 112.7 to 255.4 and 6 average annual deaths over 2016-2020.
• CI*Rank⋔ : 2 (1, 48)
• Recent Trend : The trend is stable because the trend is -1.7 with a 95% confidence interval from -4.1 to 0.8.

Grand Forks County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 168.1 with a 95% confidence interval from 154.4 to 182.6 and 117 average annual deaths over 2016-2020.
• CI*Rank⋔ : 3 (2, 23)
• Recent Trend : The trend is falling because the trend is -0.9 with a 95% confidence interval from -1.3 to -0.5.

Wells County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 167.7 with a 95% confidence interval from 125.5 to 223.1 and 13 average annual deaths over 2016-2020.
• CI*Rank⋔ : 4 (1, 45)
• Recent Trend : The trend is stable because the trend is -0.7 with a 95% confidence interval from -1.7 to 0.4.

Adams County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 163.7 with a 95% confidence interval from 110.2 to 240.9 and 7 average annual deaths over 2016-2020.
• CI*Rank⋔ : 5 (1, 47)
• Recent Trend : The trend is stable because the trend is -1.1 with a 95% confidence interval from -2.4 to 0.2.

Williams County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 162.1 with a 95% confidence interval from 141.2 to 185.1 and 47 average annual deaths over 2016-2020.
• CI*Rank⋔ : 6 (2, 34)
• Recent Trend : The trend is falling because the trend is -0.6 with a 95% confidence interval from -1.1 to -0.1.

Eddy County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 161.7 with a 95% confidence interval from 110.9 to 234.7 and 7 average annual deaths over 2016-2020.
• CI*Rank⋔ : 7 (1, 47)
• Recent Trend : The trend is stable because the trend is 0.7 with a 95% confidence interval from -0.6 to 2.1.

McHenry County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 161.2 with a 95% confidence interval from 123.8 to 207.7 and 14 average annual deaths over 2016-2020.
• CI*Rank⋔ : 8 (1, 44)
• Recent Trend : The trend is stable because the trend is -0.7 with a 95% confidence interval from -1.8 to 0.3.

Nelson County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 159.2 with a 95% confidence interval from 117.3 to 218.2 and 10 average annual deaths over 2016-2020.
• CI*Rank⋔ : 9 (1, 45)
• Recent Trend : The trend is stable because the trend is -1.4 with a 95% confidence interval from -2.8 to 0.1.

Mercer County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 158.2 with a 95% confidence interval from 126.8 to 195.8 and 19 average annual deaths over 2016-2020.
• CI*Rank⋔ : 10 (1, 42)
• Recent Trend : The trend is stable because the trend is -0.5 with a 95% confidence interval from -1.4 to 0.4.

Burke County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 158.0 with a 95% confidence interval from 102.6 to 237.9 and 5 average annual deaths over 2016-2020.
• CI*Rank⋔ : 11 (1, 48)
• Recent Trend : The trend is falling because the trend is -1.7 with a 95% confidence interval from -3.1 to -0.2.

Barnes County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 157.8 with a 95% confidence interval from 131.6 to 188.6 and 28 average annual deaths over 2016-2020.
• CI*Rank⋔ : 12 (1, 40)
• Recent Trend : The trend is stable because the trend is -0.8 with a 95% confidence interval from -1.6 to 0.0.

Traill County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 157.7 with a 95% confidence interval from 126.7 to 194.9 and 20 average annual deaths over 2016-2020.
• CI*Rank⋔ : 13 (1, 42)
• Recent Trend : The trend is stable because the trend is -0.1 with a 95% confidence interval from -0.8 to 0.6.

Walsh County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 156.6 with a 95% confidence interval from 130.7 to 186.9 and 28 average annual deaths over 2016-2020.
• CI*Rank⋔ : 14 (2, 40)
• Recent Trend : The trend is stable because the trend is 1.6 with a 95% confidence interval from -1.9 to 5.3.

Dickey County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 156.5 with a 95% confidence interval from 120.4 to 202.2 and 13 average annual deaths over 2016-2020.
• CI*Rank⋔ : 15 (1, 45)
• Recent Trend : The trend is stable because the trend is -0.7 with a 95% confidence interval from -1.8 to 0.4.

Cavalier County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 156.0 with a 95% confidence interval from 112.9 to 213.2 and 11 average annual deaths over 2016-2020.
• CI*Rank⋔ : 16 (1, 46)
• Recent Trend : The trend is falling because the trend is -1.4 with a 95% confidence interval from -2.5 to -0.3.

Morton County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 154.2 with a 95% confidence interval from 136.9 to 173.1 and 62 average annual deaths over 2016-2020.
• CI*Rank⋔ : 17 (3, 36)
• Recent Trend : The trend is falling because the trend is -1.3 with a 95% confidence interval from -1.9 to -0.6.

Hettinger County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 154.0 with a 95% confidence interval from 104.7 to 223.4 and 7 average annual deaths over 2016-2020.
• CI*Rank⋔ : 18 (1, 48)
• Recent Trend : The trend is stable because the trend is -1.1 with a 95% confidence interval from -2.7 to 0.5.

Benson County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 149.4 with a 95% confidence interval from 110.6 to 197.6 and 11 average annual deaths over 2016-2020.
• CI*Rank⋔ : 19 (1, 46)
• Recent Trend : The trend is stable because the trend is 0.3 with a 95% confidence interval from -1.1 to 1.7.

Divide County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 148.4 with a 95% confidence interval from 96.8 to 223.7 and 6 average annual deaths over 2016-2020.
• CI*Rank⋔ : 20 (1, 48)
• Recent Trend : The trend is rising because the trend is 5.5 with a 95% confidence interval from 0.8 to 10.5.

Ramsey County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 148.0 with a 95% confidence interval from 122.9 to 177.4 and 26 average annual deaths over 2016-2020.
• CI*Rank⋔ : 21 (2, 43)
• Recent Trend : The trend is falling because the trend is -1.0 with a 95% confidence interval from -1.8 to -0.1.

Bottineau County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 146.3 with a 95% confidence interval from 114.2 to 186.2 and 16 average annual deaths over 2016-2020.
• CI*Rank⋔ : 22 (1, 46)
• Recent Trend : The trend is stable because the trend is -0.9 with a 95% confidence interval from -2.3 to 0.5.

Renville County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 144.2 with a 95% confidence interval from 96.5 to 213.0 and 6 average annual deaths over 2016-2020.
• CI*Rank⋔ : 23 (1, 48)
• Recent Trend : The trend is stable because the trend is -0.1 with a 95% confidence interval from -1.7 to 1.7.

Pembina County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 143.4 with a 95% confidence interval from 115.1 to 178.5 and 19 average annual deaths over 2016-2020.
• CI*Rank⋔ : 24 (2, 45)
• Recent Trend : The trend is falling because the trend is -1.9 with a 95% confidence interval from -2.8 to -1.0.

McLean County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 142.9 with a 95% confidence interval from 116.1 to 175.0 and 22 average annual deaths over 2016-2020.
• CI*Rank⋔ : 25 (3, 45)
• Recent Trend : The trend is falling because the trend is -1.5 with a 95% confidence interval from -2.3 to -0.6.

Richland County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 141.6 with a 95% confidence interval from 119.4 to 167.1 and 32 average annual deaths over 2016-2020.
• CI*Rank⋔ : 26 (4, 43)
• Recent Trend : The trend is falling because the trend is -1.1 with a 95% confidence interval from -1.8 to -0.5.

Sargent County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 141.3 with a 95% confidence interval from 102.4 to 192.9 and 9 average annual deaths over 2016-2020.
• CI*Rank⋔ : 27 (1, 48)
• Recent Trend : The trend is stable because the trend is -0.6 with a 95% confidence interval from -1.7 to 0.5.

McIntosh County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 139.8 with a 95% confidence interval from 91.6 to 210.9 and 9 average annual deaths over 2016-2020.
• CI*Rank⋔ : 28 (1, 48)
• Recent Trend : The trend is falling because the trend is -2.3 with a 95% confidence interval from -3.7 to -1.0.

Stutsman County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 139.4 with a 95% confidence interval from 120.6 to 160.5 and 43 average annual deaths over 2016-2020.
• CI*Rank⋔ : 29 (7, 43)
• Recent Trend : The trend is falling because the trend is -1.1 with a 95% confidence interval from -1.7 to -0.6.

Ransom County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 138.4 with a 95% confidence interval from 102.5 to 184.5 and 12 average annual deaths over 2016-2020.
• CI*Rank⋔ : 30 (2, 48)
• Recent Trend : The trend is falling because the trend is -1.6 with a 95% confidence interval from -2.6 to -0.7.

Cass County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 138.1 with a 95% confidence interval from 130.1 to 146.4 and 238 average annual deaths over 2016-2020.
• CI*Rank⋔ : 31 (16, 38)
• Recent Trend : The trend is falling because the trend is -1.7 with a 95% confidence interval from -2.1 to -1.4.

Bowman County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 137.8 with a 95% confidence interval from 95.9 to 195.8 and 8 average annual deaths over 2016-2020.
• CI*Rank⋔ : 32 (1, 48)
• Recent Trend : The trend is stable because the trend is -0.9 with a 95% confidence interval from -2.1 to 0.4.

Stark County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 136.4 with a 95% confidence interval from 118.8 to 155.7 and 47 average annual deaths over 2016-2020.
• CI*Rank⋔ : 33 (10, 43)
• Recent Trend : The trend is falling because the trend is -1.0 with a 95% confidence interval from -1.7 to -0.4.

Mountrail County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 134.5 with a 95% confidence interval from 102.1 to 173.6 and 13 average annual deaths over 2016-2020.
• CI*Rank⋔ : 34 (3, 47)
• Recent Trend : The trend is falling because the trend is -1.8 with a 95% confidence interval from -3.1 to -0.5.

Ward County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 132.0 with a 95% confidence interval from 119.9 to 145.0 and 91 average annual deaths over 2016-2020.
• CI*Rank⋔ : 35 (16, 43)
• Recent Trend : The trend is falling because the trend is -1.4 with a 95% confidence interval from -1.9 to -0.8.

Burleigh County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 129.7 with a 95% confidence interval from 120.5 to 139.4 and 156 average annual deaths over 2016-2020.
• CI*Rank⋔ : 36 (20, 43)
• Recent Trend : The trend is falling because the trend is -1.2 with a 95% confidence interval from -1.7 to -0.8.

Foster County

• Met Healthy People Objective of 122.7? : No
• Rate : The death rate is 128.9 with a 95% confidence interval from 89.6 to 183.6 and 8 average annual deaths over 2016-2020.
• CI*Rank⋔ : 37 (1, 48)
• Recent Trend : The trend is stable because the trend is -0.7 with a 95% confidence interval from -2.3 to 0.9.

Towner County

• Met Healthy People Objective of 122.7? : Yes
• Rate : The death rate is 120.6 with a 95% confidence interval from 78.2 to 187.2 and 5 average annual deaths over 2016-2020.
• CI*Rank⋔ : 38 (2, 48)
• Recent Trend : The trend is stable because the trend is -0.9 with a 95% confidence interval from -2.3 to 0.5.

Pierce County

• Met Healthy People Objective of 122.7? : Yes
• Rate : The death rate is 120.4 with a 95% confidence interval from 87.8 to 164.8 and 10 average annual deaths over 2016-2020.
• CI*Rank⋔ : 39 (5, 48)
• Recent Trend : The trend is falling because the trend is -2.0 with a 95% confidence interval from -3.3 to -0.8.

Dunn County

• Met Healthy People Objective of 122.7? : Yes
• Rate : The death rate is 119.7 with a 95% confidence interval from 79.6 to 173.4 and 6 average annual deaths over 2016-2020.
• CI*Rank⋔ : 40 (3, 48)
• Recent Trend : The trend is stable because the trend is -1.4 with a 95% confidence interval from -2.9 to 0.0.

Logan County

• Met Healthy People Objective of 122.7? : Yes
• Rate : The death rate is 116.8 with a 95% confidence interval from 69.7 to 192.7 and 4 average annual deaths over 2016-2020.
• CI*Rank⋔ : 41 (1, 48)
• Recent Trend : The trend is stable because the trend is -0.9 with a 95% confidence interval from -2.4 to 0.5.

Kidder County

• Met Healthy People Objective of 122.7? : Yes
• Rate : The death rate is 116.4 with a 95% confidence interval from 71.9 to 183.3 and 5 average annual deaths over 2016-2020.
• CI*Rank⋔ : 42 (2, 48)
• Recent Trend : The trend is falling because the trend is -2.0 with a 95% confidence interval from -3.7 to -0.3.

McKenzie County

• Met Healthy People Objective of 122.7? : Yes
• Rate : The death rate is 116.4 with a 95% confidence interval from 87.1 to 151.7 and 11 average annual deaths over 2016-2020.
• CI*Rank⋔ : 43 (9, 48)
• Recent Trend : The trend is falling because the trend is -2.3 with a 95% confidence interval from -3.3 to -1.3.

Grant County

• Met Healthy People Objective of 122.7? : Yes
• Rate : The death rate is 105.0 with a 95% confidence interval from 67.6 to 165.3 and 5 average annual deaths over 2016-2020.
• CI*Rank⋔ : 44 (7, 48)
• Recent Trend : The trend is stable because the trend is -1.2 with a 95% confidence interval from -2.7 to 0.2.

Emmons County

• Met Healthy People Objective of 122.7? : Yes
• Rate : The death rate is 104.5 with a 95% confidence interval from 71.6 to 153.5 and 8 average annual deaths over 2016-2020.
• CI*Rank⋔ : 45 (11, 48)
• Recent Trend : The trend is falling because the trend is -2.3 with a 95% confidence interval from -3.3 to -1.3.

LaMoure County

• Met Healthy People Objective of 122.7? : Yes
• Rate : The death rate is 103.7 with a 95% confidence interval from 68.8 to 152.6 and 8 average annual deaths over 2016-2020.
• CI*Rank⋔ : 46 (10, 48)
• Recent Trend : The trend is falling because the trend is -1.4 with a 95% confidence interval from -2.5 to -0.2.

Steele County

• Met Healthy People Objective of 122.7? : Yes
• Rate : The death rate is 100.0 with a 95% confidence interval from 59.0 to 168.5 and 4 average annual deaths over 2016-2020.
• CI*Rank⋔ : 47 (6, 48)
• Recent Trend : The trend is falling because the trend is -2.2 with a 95% confidence interval from -3.8 to -0.6.

Griggs County

• Met Healthy People Objective of 122.7? : Yes
• Rate : The death rate is 99.6 with a 95% confidence interval from 62.1 to 161.5 and 5 average annual deaths over 2016-2020.
• CI*Rank⋔ : 48 (7, 48)
• Recent Trend : The trend is stable because the trend is -1.1 with a 95% confidence interval from -3.0 to 0.9.

Billings County

• Met Healthy People Objective of 122.7? : ***
• Rate : * 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).
• CI*Rank⋔ : *
• Recent Trend : * 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).

Golden Valley County

• Met Healthy People Objective of 122.7? : ***
• Rate : * 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).
• CI*Rank⋔ : *
• Recent Trend : * 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).

Oliver County

• Met Healthy People Objective of 122.7? : ***
• Rate : * 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).
• CI*Rank⋔ : *
• Recent Trend : * 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).

Sheridan County

• Met Healthy People Objective of 122.7? : ***
• Rate : * 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).
• CI*Rank⋔ : *
• Recent Trend : * 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).

Slope County

• Met Healthy People Objective of 122.7? : ***
• Rate : * 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).
• CI*Rank⋔ : *
• Recent Trend : * 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).

Notes:
Created by statecancerprofiles.cancer.gov on 06/07/2023 7:39 am.

State Cancer Registries may provide more current or more local data.

† 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 (19 age groups: <1, 1-4, 5-9, ... , 80-84, 85+). 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.

Healthy People 2030 Objectives provided by the Centers for Disease Control and Prevention.

* 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).


Please note that the data comes from different sources. Due to different years of data availability, most of the trends are AAPCs based on APCs but some are APCs calculated in SEER*Stat. Please refer to the source for each graph for additional information.

Interpret Rankings provides insight into interpreting cancer incidence statistics. When the population size for a denominator is small, the rates may be unstable. A rate is unstable when a small change in the numerator (e.g., only one or two additional cases) has a dramatic effect on the calculated rate.

Data for United States does not include Puerto Rico.

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.