Mortality > Table
Death Rates Table
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) |
---|---|---|---|---|---|---|---|
Virginia | N/A | Yes | 44.4 (43.8, 45.0) | N/A | 4,221 | falling | -1.7 (-2.0, -0.7) |
United States | N/A | Yes | 45.0 (44.9, 45.1) | N/A | 161,722 | falling | -2.1 (-2.4, -1.9) |
Petersburg City | Urban | Yes | 94.9 (80.0, 111.9) | 1 (1, 25) | 33 | stable | 1.3 (-1.7, 11.5) |
Hopewell City | Urban | Yes | 90.4 (73.4, 110.4) | 2 (1, 39) | 21 | stable | -0.3 (-1.1, 0.5) |
King and Queen County | Urban | Yes | 90.1 (60.6, 130.9) | 3 (1, 94) | 7 | stable | -1.0 (-2.5, 0.4) |
Martinsville City | Rural | Yes | 88.9 (69.3, 113.0) | 4 (1, 61) | 15 | stable | 0.0 (-1.0, 1.2) |
Norton City | Rural | Yes | 86.9 (51.0, 141.4) | 5 (1, 130) | 4 |
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Dickenson County | Rural | Yes | 86.5 (66.6, 111.2) | 6 (1, 64) | 14 | stable | -0.6 (-1.8, 0.6) |
Sussex County | Urban | Yes | 86.1 (62.8, 116.0) | 7 (1, 81) | 10 | falling | -1.5 (-2.9, -0.2) |
Galax City | Rural | Yes | 85.0 (57.9, 121.7) | 8 (1, 108) | 7 | stable | 2.7 (-0.4, 17.5) |
Buchanan County | Rural | Yes | 82.0 (66.3, 101.0) | 9 (1, 54) | 21 | stable | -0.1 (-1.0, 0.9) |
Covington City | Rural | Yes | 78.9 (50.7, 119.1) | 10 (1, 123) | 6 | stable | 0.6 (-1.2, 2.6) |
Wise County | Rural | Yes | 78.6 (66.4, 92.5) | 11 (1, 53) | 32 | stable | -0.9 (-1.8, 0.1) |
Colonial Heights City | Urban | Yes | 77.0 (59.7, 97.9) | 12 (1, 80) | 15 | stable | 5.3 (-1.2, 24.4) |
Tazewell County | Rural | Yes | 76.4 (65.1, 89.4) | 13 (2, 52) | 36 | stable | 0.9 (-0.1, 3.5) |
Craig County | Urban | Yes | 76.3 (46.7, 121.3) | 14 (1, 123) | 5 |
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Waynesboro City | Urban | Yes | 75.6 (60.2, 93.9) | 15 (1, 75) | 18 | stable | -0.4 (-1.3, 0.6) |
Russell County | Rural | Yes | 74.7 (61.2, 90.9) | 16 (2, 64) | 25 | stable | -0.6 (-1.4, 0.2) |
Danville City | Rural | Yes | 74.7 (63.3, 87.6) | 17 (2, 55) | 36 | stable | -0.9 (-1.8, 0.0) |
Smyth County | Rural | Yes | 74.6 (61.7, 89.7) | 18 (2, 62) | 26 | falling | -1.3 (-2.1, -0.6) |
Lancaster County | Rural | Yes | 73.7 (49.2, 107.4) | 19 (1, 120) | 9 | falling | -2.3 (-3.8, -1.0) |
Brunswick County | Rural | Yes | 73.6 (57.2, 94.2) | 20 (1, 86) | 15 | stable | -1.0 (-2.0, 0.0) |
Scott County | Urban | Yes | 73.4 (58.4, 91.7) | 21 (1, 78) | 19 | falling | -1.1 (-1.9, -0.3) |
Emporia City | Rural | Yes | 72.9 (44.6, 113.6) | 22 (1, 129) | 5 |
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Cumberland County | Rural | Yes | 72.2 (49.3, 102.8) | 23 (1, 117) | 8 | stable | -0.8 (-2.1, 0.8) |
Franklin City | Rural | Yes | 70.3 (48.7, 99.7) | 24 (1, 123) | 8 | stable | -1.0 (-2.4, 0.3) |
Lee County | Rural | Yes | 70.0 (56.1, 87.0) | 25 (2, 84) | 19 | stable | -0.4 (-1.4, 0.7) |
Henry County | Rural | Yes | 68.8 (58.6, 80.4) | 26 (6, 69) | 39 | stable | -0.1 (-0.7, 0.6) |
Roanoke City | Urban | Yes | 68.7 (61.6, 76.4) | 27 (9, 53) | 75 | falling | -1.1 (-1.7, -0.5) |
Prince Edward County | Rural | Yes | 67.5 (51.1, 87.7) | 28 (2, 109) | 13 | stable | -0.8 (-1.7, 0.1) |
Wythe County | Rural | Yes | 67.4 (55.2, 81.9) | 29 (4, 81) | 24 | falling | -1.4 (-2.4, -0.4) |
Madison County | Rural | Yes | 67.1 (48.5, 91.1) | 30 (1, 114) | 10 | stable | -0.5 (-1.6, 0.7) |
Halifax County with South Boston City | Rural | Yes | 66.8 (54.8, 80.9) | 31 (5, 83) | 26 | stable | -1.0 (-2.1, 0.0) |
Patrick County | Rural | Yes | 65.6 (50.1, 85.4) | 32 (2, 105) | 15 | stable | -0.8 (-2.1, 0.6) |
Northampton County | Rural | Yes | 63.7 (45.2, 88.4) | 33 (3, 121) | 10 | falling | -1.4 (-2.5, -0.3) |
Alleghany County and Clifton Forge City | Rural | Yes | 63.2 (46.6, 84.6) | 34 (2, 113) | 12 | stable | -1.1 (-2.2, 0.0) |
Page County | Rural | Yes | 62.5 (49.9, 77.8) | 35 (6, 102) | 19 | stable | -0.4 (-1.3, 0.5) |
Portsmouth City | Urban | Yes | 61.7 (54.8, 69.4) | 36 (17, 75) | 62 | falling | -1.4 (-1.9, -1.0) |
Warren County | Urban | Yes | 61.2 (51.4, 72.5) | 37 (11, 92) | 31 | falling | -1.7 (-2.4, -0.9) |
Lynchburg City | Urban | Yes | 61.1 (52.3, 70.9) | 38 (14, 85) | 38 | falling | -1.6 (-2.4, -0.7) |
Essex County | Rural | Yes | 60.6 (41.9, 86.2) | 39 (3, 124) | 8 | stable | -1.4 (-2.8, 0.0) |
Fairfax City | Urban | Yes | 60.2 (47.5, 75.5) | 40 (7, 108) | 16 | falling | -2.8 (-4.7, -1.2) |
Bristol City | Urban | Yes | 60.1 (44.8, 79.3) | 41 (5, 117) | 11 | stable | -0.7 (-1.9, 0.5) |
Staunton City | Urban | Yes | 59.6 (47.0, 74.9) | 42 (9, 108) | 17 | stable | -0.9 (-1.8, 0.0) |
Amherst County | Urban | Yes | 59.6 (48.6, 72.7) | 43 (11, 104) | 23 | falling | -1.8 (-2.6, -0.9) |
Giles County | Urban | Yes | 59.5 (44.5, 78.5) | 44 (5, 118) | 12 | falling | -1.4 (-2.5, -0.3) |
Nottoway County | Rural | Yes | 58.5 (43.9, 77.2) | 45 (6, 120) | 11 | falling | -1.2 (-2.1, -0.3) |
Washington County | Urban | Yes | 58.4 (49.6, 68.6) | 46 (18, 92) | 36 | falling | -1.6 (-2.3, -0.8) |
Pittsylvania County | Rural | Yes | 58.2 (49.9, 67.6) | 47 (17, 93) | 43 | falling | -1.1 (-1.8, -0.4) |
Norfolk City | Urban | Yes | 58.0 (53.4, 62.8) | 48 (28, 75) | 132 | falling | -2.1 (-2.5, -1.7) |
Mecklenburg County | Rural | Yes | 57.9 (46.9, 71.1) | 49 (11, 109) | 23 | falling | -1.7 (-2.4, -1.0) |
Charlotte County | Rural | Yes | 57.3 (39.6, 81.1) | 50 (4, 128) | 8 | falling | -1.6 (-3.1, -0.2) |
Bath County | Rural | Yes | 57.2 (32.1, 100.9) | 51 (1, 130) | 3 |
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Accomack County | Rural | Yes | 57.1 (46.4, 69.9) | 52 (14, 110) | 24 | falling | -1.7 (-2.4, -1.0) |
Grayson County | Rural | Yes | 57.1 (42.0, 77.0) | 53 (6, 121) | 11 | falling | -1.2 (-2.3, -0.1) |
Mathews County | Urban | Yes | 57.1 (35.0, 89.8) | 54 (2, 130) | 5 | stable | -1.7 (-3.7, 0.2) |
Frederick County | Urban | Yes | 57.1 (50.5, 64.4) | 55 (24, 88) | 59 | stable | 3.3 (-1.1, 12.0) |
Dinwiddie County | Urban | Yes | 56.3 (45.0, 69.9) | 56 (12, 114) | 20 | falling | -1.5 (-2.4, -0.5) |
Westmoreland County | Rural | Yes | 56.1 (42.2, 73.8) | 57 (9, 121) | 13 | falling | -1.9 (-2.6, -1.1) |
Hampton City | Urban | Yes | 56.1 (50.4, 62.2) | 58 (28, 86) | 81 | stable | -0.6 (-1.7, 5.0) |
Shenandoah County | Rural | Yes | 55.8 (46.5, 66.5) | 59 (19, 104) | 28 | stable | -0.9 (-1.6, 2.5) |
Salem City | Urban | Yes | 55.3 (42.9, 70.6) | 60 (10, 118) | 15 | falling | -1.6 (-2.5, -0.8) |
Newport News City | Urban | Yes | 54.5 (49.7, 59.7) | 61 (35, 87) | 102 | falling | -1.6 (-2.0, -1.1) |
Richmond County | Rural | Yes | 53.8 (35.6, 79.9) | 62 (5, 130) | 6 | falling | -3.1 (-4.7, -1.7) |
Campbell County | Urban | Yes | 53.8 (45.5, 63.2) | 63 (25, 107) | 34 | falling | -1.4 (-2.1, -0.7) |
Louisa County | Rural | Yes | 53.7 (44.4, 64.6) | 64 (20, 112) | 28 | falling | -1.3 (-2.2, -0.2) |
New Kent County | Urban | Yes | 53.7 (41.9, 68.1) | 65 (17, 118) | 16 | stable | 1.0 (-3.0, 19.7) |
Gloucester County | Urban | Yes | 53.5 (44.1, 64.6) | 66 (20, 113) | 27 | falling | -1.4 (-2.3, -0.4) |
Orange County | Rural | Yes | 53.4 (43.4, 65.1) | 67 (21, 114) | 23 | falling | -1.6 (-2.3, -0.8) |
Suffolk City | Urban | Yes | 52.9 (46.7, 59.7) | 68 (33, 97) | 57 | falling | -2.2 (-2.7, -1.6) |
King William County | Urban | Yes | 52.8 (39.6, 69.5) | 69 (12, 123) | 12 | falling | -2.6 (-4.0, -1.1) |
Appomattox County | Urban | Yes | 52.8 (38.1, 71.7) | 70 (9, 124) | 9 | stable | -0.8 (-2.3, 0.9) |
Fredericksburg City | Urban | Yes | 52.5 (40.2, 67.4) | 71 (16, 120) | 13 | falling | -3.4 (-4.7, -2.1) |
Pulaski County | Urban | Yes | 51.8 (42.1, 63.3) | 72 (22, 115) | 22 | falling | -0.9 (-1.6, -0.1) |
Franklin County | Urban | Yes | 51.0 (42.9, 60.3) | 73 (28, 112) | 35 | falling | -1.7 (-2.6, -0.8) |
Buena Vista City | Rural | Yes | 50.8 (28.0, 85.3) | 74 (1, 130) | 3 | stable | -0.7 (-6.3, 13.2) |
Lunenburg County | Rural | Yes | 49.9 (33.9, 71.7) | 75 (11, 130) | 7 | falling | -1.8 (-3.5, -0.2) |
King George County | Rural | Yes | 49.8 (38.9, 63.0) | 76 (22, 121) | 15 | falling | -1.7 (-3.1, -0.1) |
Greensville County | Rural | Yes | 49.5 (33.9, 71.1) | 77 (11, 130) | 7 | stable | -0.6 (-2.1, 0.9) |
Amelia County | Urban | Yes | 49.1 (34.5, 68.7) | 78 (13, 129) | 9 | falling | -2.3 (-3.9, -0.8) |
Buckingham County | Rural | Yes | 49.0 (36.3, 65.5) | 79 (18, 127) | 11 | falling | -1.4 (-2.6, -0.2) |
Middlesex County | Rural | Yes | 49.0 (34.0, 71.0) | 80 (10, 130) | 8 | falling | -1.7 (-2.9, -0.4) |
Richmond City | Urban | Yes | 48.1 (44.0, 52.6) | 81 (54, 104) | 110 | falling | -4.7 (-8.1, -3.6) |
Caroline County | Rural | Yes | 48.0 (38.2, 59.7) | 82 (30, 122) | 18 | falling | -2.1 (-3.3, -0.9) |
Fluvanna County | Urban | Yes | 47.9 (37.6, 60.7) | 83 (26, 123) | 16 | falling | -1.4 (-2.4, -0.3) |
Nelson County | Urban | Yes | 47.5 (33.6, 66.4) | 84 (18, 130) | 9 | stable | -0.7 (-2.2, 0.8) |
Rockbridge County | Rural | Yes | 47.2 (35.5, 62.2) | 85 (23, 126) | 13 | falling | -2.1 (-3.2, -1.0) |
Chesapeake City | Urban | Yes | 47.1 (43.4, 51.0) | 86 (60, 105) | 129 | falling | -2.1 (-2.6, -1.6) |
Bedford City and County | Urban | Yes | 47.0 (40.8, 54.1) | 87 (48, 115) | 49 | falling | -1.6 (-2.1, -1.0) |
Culpeper County | Urban | Yes | 46.4 (38.7, 55.4) | 88 (41, 121) | 27 | falling | -1.9 (-2.6, -1.2) |
Isle of Wight County | Urban | Yes | 46.3 (37.6, 56.6) | 89 (38, 122) | 23 | falling | -2.3 (-3.1, -1.4) |
Radford City | Urban | Yes | 45.9 (29.1, 68.9) | 90 (10, 130) | 5 | stable | -1.0 (-2.9, 1.0) |
Floyd County | Urban | Yes | 45.8 (32.0, 64.4) | 91 (15, 130) | 8 | stable | -1.4 (-3.0, 0.4) |
Spotsylvania County | Urban | Yes | 45.8 (41.0, 50.9) | 92 (58, 113) | 72 | falling | -2.0 (-2.5, -1.5) |
Winchester City | Urban | Yes | 45.1 (34.8, 57.7) | 93 (32, 126) | 14 | falling | -2.1 (-3.1, -1.1) |
Prince George County | Urban | Yes | 44.4 (35.4, 55.0) | 94 (41, 125) | 18 | falling | -2.1 (-3.0, -1.0) |
Bland County | Rural | Yes | 44.2 (25.4, 75.3) | 95 (8, 130) | 3 |
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Hanover County | Urban | Yes | 44.2 (39.1, 49.8) | 96 (61, 118) | 60 | falling | -2.0 (-2.5, -1.4) |
Goochland County | Urban | Yes | 43.7 (33.4, 56.7) | 97 (37, 128) | 15 | falling | -1.9 (-3.2, -0.5) |
Southampton County | Rural | Yes | 43.4 (32.4, 58.0) | 98 (35, 130) | 12 | falling | -2.0 (-3.0, -0.9) |
Virginia Beach City | Urban | Yes | 43.4 (40.7, 46.2) | 99 (76, 112) | 208 | stable | -1.0 (-3.2, 0.9) |
Rockingham County | Urban | Yes | 43.1 (37.2, 49.9) | 100 (59, 121) | 41 | falling | -1.4 (-1.9, -0.9) |
Henrico County | Urban | Yes | 43.1 (40.0, 46.3) | 101 (77, 113) | 159 | falling | -2.2 (-2.4, -1.9) |
Carroll County | Rural | Yes | 42.6 (33.2, 54.4) | 102 (39, 129) | 16 | falling | -1.0 (-2.0, -0.1) |
Charles City County | Urban | Yes | 42.4 (26.2, 69.8) | 103 (13, 130) | 5 |
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Charlottesville City | Urban | Yes | 42.1 (33.7, 52.1) | 104 (48, 127) | 18 | stable | 13.0 (-2.9, 23.9) |
Roanoke County | Urban | Yes | 42.0 (36.7, 48.1) | 105 (66, 122) | 48 | falling | -1.3 (-1.9, -0.7) |
Manassas City | Urban | Yes | 41.3 (33.0, 51.0) | 106 (47, 128) | 18 | falling | -2.1 (-3.2, -0.9) |
Montgomery County | Urban | Yes | 41.2 (35.1, 48.0) | 107 (60, 123) | 35 | falling | -1.7 (-2.4, -0.9) |
Chesterfield County | Urban | Yes | 40.8 (38.0, 43.8) | 108 (84, 117) | 166 | falling | -1.9 (-2.2, -1.6) |
Augusta County | Urban | Yes | 40.6 (34.9, 47.1) | 109 (69, 123) | 40 | falling | -1.7 (-2.5, -0.8) |
Harrisonburg City | Urban | Yes | 40.5 (31.8, 50.9) | 110 (52, 129) | 15 | falling | -3.2 (-4.5, -2.0) |
Fauquier County | Urban | Yes | 40.3 (34.4, 47.0) | 111 (69, 124) | 37 | falling | -2.3 (-3.3, -1.3) |
Northumberland County | Rural | Yes | 39.6 (27.3, 58.9) | 112 (34, 130) | 8 | falling | -2.0 (-3.4, -0.7) |
Poquoson City | Urban | Yes | 39.4 (26.0, 58.3) | 113 (28, 130) | 6 | falling | -2.8 (-4.6, -1.3) |
Botetourt County | Urban | Yes | 38.2 (30.0, 48.3) | 114 (59, 130) | 17 | falling | -2.2 (-3.5, -1.0) |
Stafford County | Urban | Yes | 36.7 (32.6, 41.2) | 115 (90, 125) | 61 | falling | -2.3 (-2.9, -1.6) |
York County | Urban | Yes | 36.5 (30.6, 43.4) | 116 (82, 128) | 29 | falling | -2.6 (-3.5, -1.7) |
Powhatan County | Urban | Yes | 36.5 (28.5, 46.6) | 117 (68, 130) | 15 | falling | -2.4 (-3.5, -1.2) |
James City County | Urban | Yes | 35.1 (29.5, 41.5) | 118 (88, 130) | 32 | falling | -2.1 (-2.9, -1.1) |
Clarke County | Urban | Yes | 35.0 (24.5, 50.0) | 119 (52, 130) | 8 | falling | -2.7 (-4.4, -1.0) |
Williamsburg City | Urban | Yes | 34.6 (21.4, 54.3) | 120 (36, 130) | 5 |
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Prince William County | Urban | Yes | 34.2 (31.9, 36.6) | 121 (107, 124) | 170 | falling | -2.8 (-3.1, -2.4) |
Rappahannock County | Urban | Yes | 34.1 (18.4, 60.9) | 122 (24, 130) | 3 |
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Surry County | Urban | Yes | 32.6 (16.4, 61.1) | 123 (24, 130) | 3 | falling | -2.5 (-4.5, -0.4) |
Greene County | Urban | Yes | 30.2 (21.0, 42.6) | 124 (83, 130) | 8 | falling | -12.0 (-41.6, -1.7) |
Alexandria City | Urban | Yes | 29.0 (25.4, 33.1) | 125 (113, 130) | 47 | falling | -3.6 (-4.2, -3.1) |
Falls Church City | Urban | Yes | 28.8 (17.8, 44.5) | 126 (64, 130) | 4 |
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Albemarle County | Urban | Yes | 28.5 (24.2, 33.4) | 127 (113, 130) | 35 | falling | -2.6 (-3.3, -1.8) |
Fairfax County | Urban | Yes | 28.0 (26.7, 29.4) | 128 (120, 130) | 347 | falling | -2.5 (-2.7, -2.2) |
Loudoun County | Urban | Yes | 27.6 (25.5, 30.0) | 129 (119, 130) | 119 | falling | -3.3 (-3.8, -2.7) |
Arlington County | Urban | Yes | 27.5 (24.5, 30.8) | 130 (118, 130) | 60 | falling | -3.1 (-3.6, -2.6) |
Highland County | Rural | *** |
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Lexington City | Rural | *** |
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Manassas Park City | Urban | *** |
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Notes:
Created by statecancerprofiles.cancer.gov on 10/12/2024 11:51 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.
Φ Rural-Urban Continuum Codes provided by the USDA.
* 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.
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.
Created by statecancerprofiles.cancer.gov on 10/12/2024 11:51 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 (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.
Φ Rural-Urban Continuum Codes provided by the USDA.
* 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.
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.