Incidence Rates Table
County![]() |
Age-Adjusted Incidence Rate† cases per 100,000 (95% Confidence Interval) ![]() |
CI*Rank⋔ (95% Confidence Interval) ![]() |
Average Annual Count![]() |
Recent Trend |
Recent 5-Year Trend‡ in Incidence Rates (95% Confidence Interval) ![]() |
---|---|---|---|---|---|
Kentucky 7 | 128.3 (126.3, 130.2) | N/A | 3,616 |
rising ![]() |
0.6 (0.4, 0.8) |
US (SEER+NPCR) 1 | 128.1 (127.9, 128.3) | N/A | 253,845 |
rising ![]() |
0.4 (0.3, 0.5) |
Webster County 7 | 80.9 (56.4, 113.6) | 118 (42, 118) | 7 |
stable ![]() |
-1.0 (-3.7, 1.8) |
Magoffin County 7 | 82.9 (56.2, 118.7) | 117 (30, 118) | 7 |
stable ![]() |
-0.1 (-3.6, 3.6) |
McCreary County 7 | 83.5 (59.7, 114.2) | 116 (46, 118) | 9 |
stable ![]() |
-1.4 (-4.1, 1.3) |
Larue County 7 | 87.4 (61.8, 120.6) | 115 (23, 118) | 8 |
stable ![]() |
0.3 (-3.3, 4.1) |
Breathitt County 7 | 89.1 (63.1, 123.3) | 114 (28, 118) | 8 |
stable ![]() |
1.2 (-2.2, 4.7) |
Meade County 7 | 90.0 (70.4, 113.6) | 113 (52, 118) | 15 |
stable ![]() |
0.2 (-2.1, 2.4) |
Leslie County 7 | 91.4 (62.9, 130.1) | 112 (10, 118) | 7 |
stable ![]() |
0.6 (-2.1, 3.5) |
Simpson County 7 | 92.4 (69.3, 121.3) | 111 (26, 118) | 11 |
stable ![]() |
-0.3 (-2.9, 2.4) |
Casey County 7 | 92.5 (68.0, 123.7) | 110 (26, 118) | 11 |
stable ![]() |
-1.2 (-3.3, 0.9) |
Breckinridge County 7 | 92.6 (69.5, 121.3) | 109 (34, 118) | 12 |
stable ![]() |
-1.4 (-3.5, 0.9) |
Metcalfe County 7 | 92.8 (62.0, 134.6) | 108 (8, 118) | 6 |
stable ![]() |
-0.6 (-3.4, 2.3) |
Livingston County 7 | 94.5 (63.7, 137.2) | 107 (6, 118) | 7 |
stable ![]() |
-1.0 (-4.4, 2.5) |
Letcher County 7 | 94.7 (73.9, 120.2) | 106 (34, 118) | 16 |
stable ![]() |
-1.9 (-3.9, 0.2) |
Russell County 7 | 96.0 (72.4, 125.5) | 105 (19, 118) | 12 |
stable ![]() |
1.2 (-2.0, 4.4) |
Hart County 7 | 100.7 (75.9, 131.2) | 104 (14, 118) | 12 |
stable ![]() |
-1.2 (-3.5, 1.1) |
Barren County 7 | 100.7 (84.1, 119.8) | 103 (38, 117) | 29 |
stable ![]() |
-0.8 (-2.6, 1.0) |
Rowan County 7 | 101.7 (78.3, 130.1) | 102 (12, 118) | 14 |
stable ![]() |
-1.1 (-3.3, 1.1) |
Ballard County 7 | 101.7 (68.7, 147.7) | 101 (3, 118) | 7 |
stable ![]() |
-0.6 (-4.9, 3.9) |
Bell County 7 | 101.8 (82.1, 125.3) | 100 (26, 118) | 20 |
stable ![]() |
-1.6 (-3.5, 0.4) |
Trigg County 7 | 101.9 (76.8, 134.1) | 99 (9, 118) | 12 |
stable ![]() |
-2.2 (-4.5, 0.1) |
Muhlenberg County 7 | 104.0 (84.8, 126.6) | 98 (24, 117) | 23 |
stable ![]() |
-1.3 (-2.6, 0.1) |
Wolfe County 7 | 104.4 (66.3, 157.9) | 97 (1, 118) | 5 |
stable ![]() |
0.6 (-3.3, 4.7) |
Fulton County 7 | 105.0 (62.0, 167.8) | 96 (1, 118) | 4 |
stable ![]() |
-2.5 (-5.0, 0.2) |
Carter County 7 | 107.2 (87.0, 131.1) | 95 (20, 117) | 21 |
stable ![]() |
0.2 (-1.7, 2.1) |
Jackson County 7 | 107.2 (78.1, 144.5) | 94 (3, 118) | 10 |
stable ![]() |
-0.4 (-2.9, 2.2) |
Clinton County 7 | 109.2 (76.5, 152.5) | 93 (2, 118) | 8 |
stable ![]() |
1.2 (-2.7, 5.3) |
Wayne County 7 | 109.3 (84.7, 139.2) | 92 (7, 118) | 15 |
stable ![]() |
0.1 (-2.2, 2.5) |
Todd County 7 | 109.9 (77.9, 151.0) | 91 (2, 118) | 8 |
stable ![]() |
1.5 (-1.8, 4.9) |
Hancock County 7 | 110.1 (73.9, 159.2) | 90 (1, 118) | 6 |
|
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Carlisle County 7 | 111.0 (62.1, 184.8) | 89 (1, 118) | 4 |
stable ![]() |
0.1 (-3.6, 3.9) |
Edmonson County 7 | 112.2 (81.2, 152.3) | 88 (2, 118) | 10 |
stable ![]() |
-0.5 (-3.4, 2.6) |
Bath County 7 | 112.4 (79.3, 154.9) | 87 (2, 118) | 8 |
stable ![]() |
-0.2 (-2.9, 2.5) |
Logan County 7 | 112.9 (91.0, 138.7) | 86 (9, 115) | 20 |
stable ![]() |
-0.3 (-2.4, 1.8) |
Morgan County 7 | 113.0 (81.2, 154.4) | 85 (2, 118) | 9 |
stable ![]() |
2.6 (-1.1, 6.5) |
Johnson County 7 | 113.1 (89.6, 141.4) | 84 (6, 116) | 17 |
stable ![]() |
-0.2 (-2.0, 1.7) |
Lee County 7 | 113.3 (70.6, 174.3) | 83 (1, 118) | 5 |
stable ![]() |
-0.3 (-4.1, 3.6) |
Clay County 7 | 113.5 (88.4, 144.1) | 82 (6, 117) | 15 |
stable ![]() |
0.5 (-1.2, 2.2) |
Martin County 7 | 113.8 (79.9, 158.5) | 81 (1, 118) | 8 |
stable ![]() |
1.8 (-0.8, 4.4) |
Montgomery County 7 | 114.2 (92.9, 139.2) | 80 (8, 114) | 21 |
stable ![]() |
-0.4 (-2.4, 1.7) |
Lawrence County 7 | 114.5 (85.6, 150.5) | 79 (2, 118) | 12 |
stable ![]() |
0.3 (-2.3, 3.0) |
Bourbon County 7 | 114.6 (90.6, 143.7) | 78 (6, 115) | 17 |
stable ![]() |
-1.8 (-4.9, 1.4) |
Harrison County 7 | 114.7 (89.2, 145.7) | 77 (3, 116) | 15 |
stable ![]() |
0.6 (-1.9, 3.3) |
Butler County 7 | 115.0 (83.1, 155.7) | 76 (1, 118) | 9 |
stable ![]() |
0.5 (-2.0, 3.1) |
Carroll County 7 | 115.5 (80.5, 161.3) | 75 (1, 118) | 8 |
stable ![]() |
-1.1 (-4.0, 1.9) |
Crittenden County 7 | 115.6 (77.9, 166.2) | 74 (1, 118) | 7 |
stable ![]() |
-2.3 (-5.5, 1.0) |
Marion County 7 | 116.5 (89.7, 149.2) | 73 (3, 117) | 14 |
stable ![]() |
-1.8 (-3.7, 0.2) |
Monroe County 7 | 116.7 (83.3, 160.3) | 72 (1, 118) | 9 |
stable ![]() |
1.1 (-1.2, 3.4) |
Calloway County 7 | 117.0 (97.5, 139.6) | 71 (9, 112) | 28 |
stable ![]() |
-0.9 (-2.7, 0.9) |
Grayson County 7 | 117.7 (94.5, 145.2) | 70 (5, 114) | 20 |
stable ![]() |
0.9 (-1.5, 3.4) |
Warren County 7 | 117.8 (106.2, 130.2) | 69 (26, 98) | 80 |
stable ![]() |
-0.7 (-1.6, 0.1) |
Owsley County 7 | 118.6 (69.0, 193.1) | 68 (1, 118) | 4 |
|
|
Graves County 7 | 119.4 (100.2, 141.5) | 67 (7, 110) | 30 |
stable ![]() |
0.1 (-1.3, 1.5) |
Harlan County 7 | 119.6 (96.9, 146.2) | 66 (4, 114) | 22 |
stable ![]() |
-0.1 (-2.9, 2.8) |
Pike County 7 | 119.7 (104.8, 136.3) | 65 (13, 100) | 51 |
stable ![]() |
-0.3 (-1.5, 0.9) |
Boyd County 7 | 119.7 (103.0, 138.6) | 64 (10, 104) | 41 |
stable ![]() |
-0.1 (-1.5, 1.3) |
Ohio County 7 | 119.8 (95.8, 148.4) | 63 (4, 114) | 19 |
stable ![]() |
1.6 (-0.1, 3.3) |
Knox County 7 | 120.0 (99.8, 143.4) | 62 (7, 110) | 26 |
stable ![]() |
0.5 (-1.4, 2.4) |
Washington County 7 | 121.0 (88.8, 161.9) | 61 (1, 118) | 10 |
stable ![]() |
1.4 (-1.7, 4.6) |
Adair County 7 | 121.0 (93.5, 154.3) | 60 (2, 116) | 15 |
rising ![]() |
2.6 (0.2, 5.0) |
Garrard County 7 | 121.1 (95.3, 152.6) | 59 (3, 115) | 16 |
stable ![]() |
0.5 (-1.7, 2.8) |
Laurel County 7 | 121.2 (106.1, 138.1) | 58 (12, 102) | 49 |
stable ![]() |
0.3 (-0.7, 1.2) |
Nelson County 7 | 122.0 (103.8, 142.5) | 57 (7, 106) | 34 |
stable ![]() |
0.2 (-1.1, 1.4) |
Whitley County 7 | 122.9 (102.9, 145.8) | 56 (5, 108) | 28 |
stable ![]() |
0.1 (-1.3, 1.5) |
Pendleton County 7 | 123.2 (92.7, 161.3) | 55 (1, 116) | 12 |
stable ![]() |
0.5 (-1.9, 3.1) |
Estill County 7 | 124.0 (94.3, 161.2) | 54 (1, 116) | 13 |
stable ![]() |
-1.1 (-3.4, 1.2) |
Pulaski County 7 | 124.1 (109.6, 140.0) | 53 (10, 95) | 58 |
stable ![]() |
0.5 (-0.6, 1.7) |
Hickman County 7 | 124.4 (69.6, 206.8) | 52 (1, 118) | 4 |
stable ![]() |
-1.2 (-5.4, 3.2) |
Bullitt County 7 | 124.8 (111.0, 139.8) | 51 (11, 95) | 63 |
stable ![]() |
0.0 (-1.4, 1.4) |
Cumberland County 7 | 125.8 (79.2, 190.5) | 50 (1, 118) | 5 |
|
|
Franklin County 7 | 126.0 (108.8, 145.1) | 49 (5, 100) | 42 |
stable ![]() |
-1.0 (-2.6, 0.6) |
Rockcastle County 7 | 126.1 (97.2, 161.4) | 48 (1, 114) | 14 |
stable ![]() |
1.6 (-0.7, 4.0) |
Caldwell County 7 | 126.2 (93.3, 167.6) | 47 (1, 116) | 11 |
stable ![]() |
-0.4 (-2.8, 2.1) |
Gallatin County 7 | 126.2 (85.1, 181.1) | 46 (1, 118) | 6 |
stable ![]() |
-0.6 (-4.5, 3.5) |
Lyon County 7 | 126.5 (84.4, 185.8) | 45 (1, 118) | 8 |
stable ![]() |
1.2 (-2.9, 5.4) |
Madison County 7 | 127.5 (113.4, 142.9) | 44 (8, 92) | 62 |
stable ![]() |
-0.3 (-1.3, 0.6) |
Lincoln County 7 | 127.6 (103.9, 155.5) | 43 (2, 108) | 22 |
stable ![]() |
1.6 (-0.1, 3.3) |
Powell County 7 | 128.2 (93.5, 172.1) | 42 (1, 116) | 10 |
stable ![]() |
0.2 (-2.4, 2.9) |
Hopkins County 7 | 128.4 (110.8, 148.3) | 41 (4, 99) | 41 |
stable ![]() |
0.2 (-1.3, 1.7) |
Mercer County 7 | 128.5 (103.2, 158.7) | 40 (2, 110) | 20 |
stable ![]() |
1.1 (-0.5, 2.8) |
Taylor County 7 | 129.0 (104.9, 157.3) | 39 (2, 107) | 22 |
stable ![]() |
2.1 (-0.3, 4.6) |
Union County 7 | 129.7 (97.2, 170.2) | 38 (1, 116) | 12 |
stable ![]() |
4.8 (-0.6, 10.3) |
Christian County 7 | 129.9 (112.7, 148.9) | 37 (4, 93) | 44 |
rising ![]() |
9.1 (1.0, 17.9) |
Bracken County 7 | 130.1 (90.2, 183.1) | 36 (1, 118) | 7 |
stable ![]() |
-0.5 (-3.7, 2.9) |
Menifee County 7 | 130.2 (82.7, 196.6) | 35 (1, 118) | 6 |
stable ![]() |
1.4 (-2.0, 5.0) |
Daviess County 7 | 130.6 (118.0, 144.3) | 34 (6, 81) | 85 |
stable ![]() |
0.5 (-0.8, 1.8) |
Jessamine County 7 | 130.6 (113.1, 150.2) | 33 (4, 94) | 42 |
stable ![]() |
0.3 (-1.0, 1.6) |
Shelby County 7 | 130.7 (112.7, 151.0) | 32 (4, 97) | 39 |
stable ![]() |
0.9 (-0.4, 2.1) |
Lewis County 7 | 131.0 (98.3, 171.9) | 31 (1, 115) | 12 |
stable ![]() |
1.9 (-0.7, 4.6) |
Allen County 7 | 131.7 (106.0, 162.4) | 30 (1, 107) | 19 |
stable ![]() |
1.3 (-1.2, 3.9) |
Mason County 7 | 132.2 (103.4, 167.1) | 29 (1, 111) | 16 |
stable ![]() |
0.8 (-1.2, 3.0) |
Henry County 7 | 132.9 (101.9, 170.9) | 28 (1, 113) | 14 |
stable ![]() |
1.8 (-0.3, 3.9) |
Anderson County 7 | 133.3 (107.3, 164.2) | 27 (1, 106) | 19 |
stable ![]() |
-1.1 (-3.1, 1.1) |
Marshall County 7 | 133.9 (112.0, 159.3) | 26 (2, 101) | 31 |
stable ![]() |
0.5 (-1.0, 2.0) |
Campbell County 7 | 134.0 (120.7, 148.5) | 25 (5, 81) | 79 |
stable ![]() |
0.4 (-0.3, 1.1) |
Perry County 7 | 134.9 (111.0, 162.9) | 24 (1, 100) | 24 |
stable ![]() |
1.6 (-0.6, 3.7) |
Hardin County 7 | 135.0 (122.1, 148.9) | 23 (5, 76) | 85 |
stable ![]() |
0.2 (-0.7, 1.1) |
Henderson County 7 | 135.1 (116.2, 156.3) | 22 (2, 91) | 40 |
rising ![]() |
1.8 (0.5, 3.1) |
Kenton County 7 | 135.4 (125.0, 146.4) | 21 (7, 70) | 134 |
stable ![]() |
0.4 (-0.4, 1.3) |
Greenup County 7 | 137.0 (116.5, 160.4) | 20 (2, 92) | 35 |
stable ![]() |
0.6 (-1.2, 2.4) |
Boyle County 7 | 138.4 (114.6, 166.0) | 19 (1, 97) | 28 |
rising ![]() |
2.8 (1.4, 4.2) |
Owen County 7 | 139.4 (101.3, 188.0) | 18 (1, 113) | 10 |
stable ![]() |
0.6 (-2.8, 4.1) |
Jefferson County 7 | 139.5 (134.7, 144.5) | 17 (9, 43) | 684 |
stable ![]() |
0.3 (0.0, 0.5) |
Clark County 7 | 139.7 (118.9, 163.4) | 16 (2, 90) | 34 |
stable ![]() |
0.5 (-1.1, 2.0) |
Boone County 7 | 140.4 (128.4, 153.3) | 15 (3, 63) | 105 |
stable ![]() |
0.5 (-0.4, 1.4) |
Scott County 7 | 141.2 (122.4, 162.2) | 14 (1, 81) | 42 |
stable ![]() |
0.9 (-0.4, 2.3) |
Knott County 7 | 142.0 (109.5, 181.6) | 13 (1, 107) | 15 |
rising ![]() |
3.2 (0.4, 6.2) |
McCracken County 7 | 142.1 (126.4, 159.4) | 12 (2, 75) | 67 |
rising ![]() |
3.5 (0.8, 6.3) |
Spencer County 7 | 142.7 (112.9, 178.5) | 11 (1, 103) | 17 |
stable ![]() |
0.9 (-0.6, 2.3) |
Fayette County 7 | 142.8 (134.8, 151.1) | 10 (4, 44) | 254 |
stable ![]() |
-0.1 (-0.8, 0.6) |
Grant County 7 | 144.6 (117.8, 175.9) | 9 (1, 95) | 21 |
stable ![]() |
0.6 (-1.3, 2.6) |
Fleming County 7 | 144.7 (111.2, 185.7) | 8 (1, 108) | 14 |
stable ![]() |
1.5 (-1.1, 4.2) |
Floyd County 7 | 144.9 (123.3, 169.3) | 7 (1, 82) | 35 |
stable ![]() |
0.8 (-0.9, 2.5) |
Woodford County 7 | 150.7 (124.7, 180.8) | 6 (1, 84) | 26 |
stable ![]() |
0.7 (-1.0, 2.4) |
Nicholas County 7 | 151.6 (104.0, 214.7) | 5 (1, 116) | 7 |
stable ![]() |
0.7 (-2.4, 3.9) |
Oldham County 7 | 151.9 (134.1, 171.6) | 4 (1, 58) | 55 |
stable ![]() |
0.5 (-0.8, 1.7) |
Green County 7 | 153.1 (112.9, 203.7) | 3 (1, 109) | 11 |
stable ![]() |
1.4 (-1.4, 4.1) |
Trimble County 7 | 155.1 (110.3, 213.1) | 2 (1, 114) | 8 |
rising ![]() |
3.3 (0.6, 6.1) |
McLean County 7 | 171.6 (127.3, 227.7) | 1 (1, 94) | 11 |
stable ![]() |
2.7 (-0.4, 5.9) |
Elliott County 7 |
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Robertson County 7 |
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Notes:
Created by statecancerprofiles.cancer.gov on 01/27/2023 7:52 pm.
State Cancer Registries may provide more current or more local data.
⋔ 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.
† Incidence rates (cases per 100,000 population per year) are age-adjusted to the 2000 US standard population (19 age groups: <1, 1-4, 5-9, ... , 80-84, 85+). Rates are for invasive cancer only (except for bladder cancer which is invasive and in situ) or unless otherwise specified. Rates calculated using SEER*Stat. Population counts for denominators are based on Census populations as modified by NCI. The US Population Data File is used for SEER and NPCR incidence rates.
‡ Incidence data come 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 area for additional information.
Rates and trends are computed using different standards for malignancy. For more information see malignant.html.
^ All Stages refers to any stage in the Surveillance, Epidemiology, and End Results (SEER) summary stage.
* 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).
1 Source: National Program of Cancer Registries and Surveillance, Epidemiology, and End Results SEER*Stat Database (2001-2019) - United States Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute. Based on the 2021 submission.
7 Source: SEER November 2021 submission.
8 Source: Incidence data provided by the SEER Program. AAPCs are calculated by the Joinpoint Regression Program and are based on APCs. Data are age-adjusted to the 2000 US standard population (19 age groups: <1, 1-4, 5-9, ... , 80-84,85+). Rates are for invasive cancer only (except for bladder cancer which is invasive and in situ) or unless otherwise specified. Population counts for denominators are based on Census populations as modifed by NCI. The US Population Data File is used with SEER November 2021 data.
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 the United States does not include data from Nevada.
Data for the 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 01/27/2023 7:52 pm.
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.
⋔ 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.
† Incidence rates (cases per 100,000 population per year) are age-adjusted to the 2000 US standard population (19 age groups: <1, 1-4, 5-9, ... , 80-84, 85+). Rates are for invasive cancer only (except for bladder cancer which is invasive and in situ) or unless otherwise specified. Rates calculated using SEER*Stat. Population counts for denominators are based on Census populations as modified by NCI. The US Population Data File is used for SEER and NPCR incidence rates.
‡ Incidence data come 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 area for additional information.
Rates and trends are computed using different standards for malignancy. For more information see malignant.html.
^ All Stages refers to any stage in the Surveillance, Epidemiology, and End Results (SEER) summary stage.
* 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).
1 Source: National Program of Cancer Registries and Surveillance, Epidemiology, and End Results SEER*Stat Database (2001-2019) - United States Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute. Based on the 2021 submission.
7 Source: SEER November 2021 submission.
8 Source: Incidence data provided by the SEER Program. AAPCs are calculated by the Joinpoint Regression Program and are based on APCs. Data are age-adjusted to the 2000 US standard population (19 age groups: <1, 1-4, 5-9, ... , 80-84,85+). Rates are for invasive cancer only (except for bladder cancer which is invasive and in situ) or unless otherwise specified. Population counts for denominators are based on Census populations as modifed by NCI. The US Population Data File is used with SEER November 2021 data.
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 the United States does not include data from Nevada.
Data for the 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.