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 | 122.7 (120.8, 124.6) | N/A | 3,328 |
rising ![]() |
0.9 (0.6, 1.1) |
US (SEER+NPCR) 1 | 105.2 (105.0, 105.5) | N/A | 202,435 |
stable ![]() |
0.1 (-0.1, 0.3) |
Wayne County 7 | 152.2 (122.4, 187.2) | 18 (1, 96) | 18 |
stable ![]() |
11.9 (-0.1, 28.0) |
Floyd County 7 | 176.9 (152.7, 203.8) | 1 (1, 42) | 39 |
rising ![]() |
6.5 (1.7, 17.5) |
Green County 7 | 168.7 (126.2, 221.1) | 4 (1, 102) | 11 |
rising ![]() |
5.0 (1.1, 9.7) |
Owen County 7 | 143.7 (105.4, 191.6) | 27 (1, 115) | 9 |
rising ![]() |
4.8 (2.1, 7.9) |
Monroe County 7 | 166.4 (123.3, 219.4) | 5 (1, 109) | 10 |
rising ![]() |
4.5 (1.0, 8.5) |
Daviess County 7 | 112.7 (100.9, 125.5) | 90 (42, 111) | 67 |
rising ![]() |
4.3 (1.8, 8.8) |
Lewis County 7 | 160.3 (123.2, 204.9) | 8 (1, 106) | 13 |
rising ![]() |
3.4 (1.0, 6.1) |
Morgan County 7 | 114.0 (84.7, 150.5) | 87 (6, 118) | 10 |
rising ![]() |
3.3 (0.4, 6.6) |
Rockcastle County 7 | 157.2 (124.0, 196.6) | 12 (1, 106) | 16 |
rising ![]() |
3.3 (0.9, 6.1) |
Cumberland County 7 | 171.4 (115.1, 245.2) | 3 (1, 115) | 6 |
stable ![]() |
3.1 (-0.4, 6.7) |
Hart County 7 | 151.9 (120.6, 188.7) | 19 (1, 104) | 16 |
rising ![]() |
3.1 (1.1, 5.4) |
Boyle County 7 | 110.6 (89.4, 135.2) | 94 (20, 117) | 19 |
rising ![]() |
3.0 (1.1, 4.9) |
Livingston County 7 | 152.8 (107.2, 211.0) | 17 (1, 115) | 7 |
stable ![]() |
3.0 (-1.6, 8.1) |
Taylor County 7 | 159.7 (131.0, 192.5) | 9 (1, 88) | 22 |
stable ![]() |
2.8 (-0.1, 6.0) |
Lincoln County 7 | 155.0 (127.2, 187.0) | 13 (1, 88) | 22 |
rising ![]() |
2.7 (0.5, 5.1) |
Marion County 7 | 157.5 (126.5, 193.7) | 11 (1, 99) | 18 |
rising ![]() |
2.7 (0.7, 5.0) |
Estill County 7 | 130.3 (97.7, 170.3) | 48 (1, 117) | 11 |
stable ![]() |
2.6 (-0.6, 6.1) |
Bath County 7 | 145.3 (108.6, 190.2) | 26 (1, 112) | 11 |
stable ![]() |
2.4 (-0.1, 5.1) |
Owsley County 7 | 158.3 (97.7, 242.6) | 10 (1, 118) | 4 |
stable ![]() |
2.4 (-2.0, 7.3) |
Crittenden County 7 | 93.9 (59.4, 140.8) | 112 (10, 118) | 5 |
stable ![]() |
2.3 (-1.2, 6.1) |
Washington County 7 | 113.4 (80.8, 154.5) | 88 (5, 118) | 8 |
stable ![]() |
2.2 (-0.1, 4.6) |
Adair County 7 | 146.4 (115.4, 183.0) | 23 (1, 108) | 16 |
stable ![]() |
2.0 (-0.3, 4.4) |
Whitley County 7 | 138.2 (116.4, 162.9) | 31 (4, 101) | 29 |
rising ![]() |
2.0 (0.2, 3.8) |
Hancock County 7 | 86.4 (54.0, 130.7) | 116 (18, 118) | 4 |
stable ![]() |
1.9 (-3.3, 7.5) |
Knott County 7 | 134.4 (101.8, 174.1) | 41 (1, 115) | 12 |
stable ![]() |
1.9 (-1.1, 4.9) |
Larue County 7 | 137.6 (104.4, 178.0) | 35 (1, 113) | 12 |
stable ![]() |
1.9 (-1.0, 5.1) |
McLean County 7 | 121.5 (82.9, 171.7) | 69 (1, 118) | 6 |
stable ![]() |
1.9 (-0.8, 4.8) |
Perry County 7 | 161.9 (135.1, 192.4) | 7 (1, 75) | 26 |
rising ![]() |
1.9 (0.3, 3.5) |
Clark County 7 | 152.8 (130.6, 177.8) | 16 (1, 77) | 34 |
rising ![]() |
1.8 (0.6, 3.2) |
Harlan County 7 | 147.2 (121.3, 177.0) | 22 (1, 95) | 23 |
stable ![]() |
1.8 (-0.3, 4.0) |
Lee County 7 | 132.7 (88.5, 191.4) | 43 (1, 118) | 6 |
stable ![]() |
1.8 (-3.8, 7.6) |
Lyon County 7 | 146.2 (100.6, 206.6) | 24 (1, 117) | 7 |
stable ![]() |
1.8 (-2.2, 6.0) |
Russell County 7 | 154.5 (121.9, 193.1) | 14 (1, 105) | 16 |
stable ![]() |
1.8 (-2.4, 6.3) |
Metcalfe County 7 | 118.3 (81.7, 165.3) | 78 (2, 118) | 7 |
stable ![]() |
1.7 (-2.3, 5.9) |
Ohio County 7 | 120.1 (96.0, 148.3) | 70 (10, 115) | 17 |
stable ![]() |
1.7 (-0.2, 3.7) |
Graves County 7 | 121.5 (101.5, 144.2) | 68 (14, 113) | 26 |
stable ![]() |
1.6 (-1.1, 4.6) |
Henderson County 7 | 110.2 (93.1, 129.4) | 96 (32, 116) | 30 |
stable ![]() |
1.5 (-0.2, 3.2) |
Trimble County 7 | 130.0 (89.6, 182.4) | 50 (1, 118) | 7 |
stable ![]() |
1.5 (-3.1, 6.9) |
Bullitt County 7 | 137.7 (123.7, 152.7) | 34 (10, 81) | 72 |
rising ![]() |
1.4 (0.1, 2.9) |
Calloway County 7 | 122.7 (102.0, 146.2) | 63 (13, 111) | 26 |
stable ![]() |
1.4 (-1.4, 4.5) |
Hopkins County 7 | 114.3 (96.8, 134.0) | 85 (28, 114) | 30 |
stable ![]() |
1.4 (-0.7, 3.5) |
Breathitt County 7 | 147.8 (112.4, 190.9) | 21 (1, 111) | 12 |
stable ![]() |
1.3 (-1.5, 4.2) |
Caldwell County 7 | 104.2 (73.5, 143.3) | 103 (10, 118) | 8 |
stable ![]() |
1.3 (-1.8, 4.6) |
Grayson County 7 | 120.0 (96.8, 147.0) | 71 (11, 115) | 19 |
stable ![]() |
1.3 (-0.6, 3.4) |
Logan County 7 | 141.3 (116.0, 170.4) | 29 (2, 103) | 22 |
stable ![]() |
1.3 (-0.7, 3.2) |
Lawrence County 7 | 132.7 (101.4, 170.5) | 42 (2, 115) | 12 |
stable ![]() |
1.2 (-1.9, 4.5) |
Martin County 7 | 118.8 (86.4, 159.6) | 76 (3, 118) | 9 |
stable ![]() |
1.2 (-2.0, 4.6) |
Pendleton County 7 | 135.1 (102.3, 175.0) | 37 (1, 115) | 12 |
stable ![]() |
1.2 (-1.8, 4.2) |
Todd County 7 | 110.2 (78.5, 150.0) | 95 (8, 118) | 8 |
stable ![]() |
1.2 (-3.1, 5.9) |
Webster County 7 | 104.2 (74.7, 141.3) | 104 (8, 118) | 8 |
stable ![]() |
1.2 (-1.6, 3.9) |
Greenup County 7 | 138.8 (117.0, 163.6) | 30 (4, 100) | 29 |
stable ![]() |
1.1 (-0.7, 2.9) |
Harrison County 7 | 135.2 (105.7, 170.2) | 36 (1, 114) | 15 |
stable ![]() |
1.1 (-1.5, 3.8) |
Jefferson County 7 | 119.7 (115.3, 124.3) | 73 (49, 87) | 563 |
rising ![]() |
1.1 (0.6, 2.6) |
Mercer County 7 | 126.3 (99.5, 158.0) | 54 (4, 115) | 15 |
stable ![]() |
1.1 (-1.3, 3.7) |
Nelson County 7 | 138.2 (119.3, 159.1) | 33 (6, 95) | 39 |
stable ![]() |
1.1 (-0.4, 2.8) |
Carlisle County 7 | 122.7 (70.0, 198.7) | 62 (1, 118) | 3 |
stable ![]() |
1.0 (-4.2, 6.7) |
Clinton County 7 | 109.6 (74.3, 155.5) | 98 (5, 118) | 6 |
stable ![]() |
1.0 (-2.7, 4.9) |
Hardin County 7 | 129.8 (117.9, 142.5) | 51 (18, 89) | 88 |
rising ![]() |
1.0 (0.4, 1.6) |
Kenton County 7 | 122.0 (112.6, 131.9) | 66 (36, 95) | 126 |
rising ![]() |
1.0 (0.3, 1.8) |
Leslie County 7 | 117.6 (82.2, 163.2) | 81 (2, 118) | 7 |
stable ![]() |
1.0 (-3.2, 5.2) |
Boone County 7 | 109.9 (100.2, 120.2) | 97 (52, 109) | 95 |
rising ![]() |
0.9 (0.3, 1.6) |
McCracken County 7 | 122.4 (107.1, 139.2) | 64 (22, 105) | 47 |
stable ![]() |
0.9 (-0.2, 2.1) |
Butler County 7 | 165.8 (127.3, 212.2) | 6 (1, 100) | 13 |
stable ![]() |
0.8 (-2.4, 4.1) |
Letcher County 7 | 149.5 (121.1, 182.4) | 20 (1, 100) | 19 |
stable ![]() |
0.8 (-1.8, 3.4) |
Woodford County 7 | 121.6 (98.3, 148.8) | 67 (10, 116) | 19 |
stable ![]() |
0.8 (-1.4, 3.1) |
Boyd County 7 | 131.3 (113.1, 151.6) | 46 (11, 100) | 37 |
stable ![]() |
0.7 (-0.8, 2.2) |
Franklin County 7 | 111.5 (95.4, 129.5) | 92 (33, 114) | 35 |
stable ![]() |
0.7 (-1.1, 2.6) |
Jessamine County 7 | 124.4 (108.0, 142.6) | 59 (18, 104) | 42 |
stable ![]() |
0.7 (-0.5, 2.0) |
Madison County 7 | 124.2 (111.2, 138.3) | 60 (22, 100) | 68 |
stable ![]() |
0.7 (-0.4, 1.8) |
Spencer County 7 | 129.1 (102.5, 160.8) | 53 (5, 113) | 16 |
stable ![]() |
0.7 (-2.1, 3.9) |
Allen County 7 | 117.2 (91.8, 147.3) | 83 (12, 116) | 15 |
stable ![]() |
0.6 (-1.9, 3.2) |
Barren County 7 | 118.2 (100.3, 138.4) | 79 (22, 112) | 31 |
stable ![]() |
0.6 (-1.2, 2.5) |
Clay County 7 | 118.5 (93.7, 147.9) | 77 (8, 116) | 16 |
stable ![]() |
0.6 (-1.7, 2.8) |
Edmonson County 7 | 119.6 (86.4, 161.5) | 74 (3, 118) | 9 |
stable ![]() |
0.6 (-2.6, 4.0) |
Johnson County 7 | 131.8 (106.0, 162.0) | 45 (4, 112) | 18 |
stable ![]() |
0.6 (-1.6, 2.9) |
Fleming County 7 | 122.3 (91.2, 160.4) | 65 (5, 118) | 10 |
stable ![]() |
0.5 (-2.4, 3.4) |
Jackson County 7 | 130.1 (97.4, 170.4) | 49 (2, 117) | 11 |
stable ![]() |
0.5 (-2.5, 3.6) |
Breckinridge County 7 | 125.1 (97.6, 157.9) | 57 (5, 116) | 14 |
stable ![]() |
0.4 (-2.2, 2.9) |
Knox County 7 | 154.1 (129.9, 181.4) | 15 (1, 82) | 29 |
stable ![]() |
0.4 (-0.9, 1.6) |
Marshall County 7 | 124.0 (101.8, 149.6) | 61 (11, 113) | 22 |
stable ![]() |
0.4 (-1.6, 2.4) |
Rowan County 7 | 124.7 (98.1, 156.0) | 58 (6, 115) | 16 |
stable ![]() |
0.4 (-1.9, 2.8) |
Anderson County 7 | 108.9 (86.2, 135.8) | 99 (21, 117) | 16 |
stable ![]() |
0.3 (-2.2, 2.9) |
Pulaski County 7 | 129.4 (113.8, 146.6) | 52 (15, 99) | 50 |
stable ![]() |
0.3 (-0.9, 1.4) |
Fayette County 7 | 114.0 (107.4, 120.8) | 86 (54, 101) | 231 |
stable ![]() |
0.2 (-0.4, 0.8) |
Oldham County 7 | 132.2 (117.6, 148.1) | 44 (13, 90) | 61 |
stable ![]() |
0.1 (-0.8, 1.1) |
Shelby County 7 | 91.4 (77.0, 107.8) | 115 (73, 118) | 28 |
stable ![]() |
0.1 (-1.6, 1.8) |
Warren County 7 | 119.2 (108.5, 130.7) | 75 (32, 103) | 93 |
stable ![]() |
0.1 (-1.2, 1.5) |
Bell County 7 | 125.3 (101.5, 152.9) | 56 (8, 113) | 20 |
stable ![]() |
0.0 (-2.3, 2.2) |
Campbell County 7 | 111.7 (99.6, 124.9) | 91 (44, 111) | 63 |
stable ![]() |
-0.1 (-1.5, 1.2) |
Christian County 7 | 105.9 (91.1, 122.3) | 100 (46, 116) | 40 |
stable ![]() |
-0.1 (-2.2, 2.1) |
Elliott County 7 | 94.4 (59.5, 142.9) | 111 (8, 118) | 5 |
stable ![]() |
-0.1 (-3.8, 3.7) |
Ballard County 7 | 118.1 (77.6, 172.3) | 80 (1, 118) | 5 |
stable ![]() |
-0.2 (-3.8, 3.4) |
Carroll County 7 | 119.8 (84.7, 164.4) | 72 (2, 118) | 8 |
stable ![]() |
-0.2 (-3.0, 2.6) |
Gallatin County 7 | 80.6 (50.3, 122.3) | 118 (28, 118) | 4 |
stable ![]() |
-0.2 (-4.4, 4.0) |
Grant County 7 | 117.6 (94.7, 144.2) | 82 (11, 115) | 19 |
stable ![]() |
-0.2 (-2.3, 2.0) |
Union County 7 | 104.6 (75.7, 140.8) | 101 (13, 118) | 9 |
stable ![]() |
-0.4 (-3.4, 2.3) |
Muhlenberg County 7 | 94.7 (75.9, 116.8) | 109 (50, 118) | 18 |
stable ![]() |
-0.5 (-3.1, 2.1) |
Montgomery County 7 | 111.2 (90.4, 135.4) | 93 (21, 117) | 20 |
stable ![]() |
-0.8 (-2.3, 0.7) |
Nicholas County 7 | 135.0 (90.9, 193.1) | 38 (1, 118) | 6 |
stable ![]() |
-0.9 (-4.7, 2.6) |
Trigg County 7 | 94.6 (66.4, 130.7) | 110 (23, 118) | 7 |
stable ![]() |
-0.9 (-5.1, 3.2) |
Henry County 7 | 114.4 (86.1, 149.1) | 84 (8, 118) | 11 |
stable ![]() |
-1.0 (-4.5, 2.4) |
Wolfe County 7 | 138.2 (91.8, 199.5) | 32 (1, 118) | 6 |
stable ![]() |
-1.0 (-5.1, 2.8) |
Casey County 7 | 93.0 (67.1, 125.4) | 113 (21, 118) | 9 |
stable ![]() |
-1.1 (-3.8, 1.5) |
Scott County 7 | 104.5 (90.5, 120.1) | 102 (49, 116) | 40 |
stable ![]() |
-1.1 (-3.1, 1.0) |
McCreary County 7 | 85.3 (63.0, 112.8) | 117 (57, 118) | 10 |
stable ![]() |
-1.6 (-3.9, 0.7) |
Bourbon County 7 | 103.4 (79.0, 132.8) | 105 (23, 118) | 12 |
stable ![]() |
-1.8 (-4.2, 0.3) |
Simpson County 7 | 92.3 (68.4, 121.8) | 114 (37, 118) | 10 |
stable ![]() |
-3.7 (-26.6, 1.7) |
Carter County 7 | 135.0 (110.5, 163.3) | 39 (3, 107) | 21 |
stable ![]() |
-5.8 (-21.7, 3.7) |
Pike County 7 | 145.8 (128.5, 164.7) | 25 (3, 73) | 52 |
stable ![]() |
-6.0 (-12.5, 0.6) |
Bracken County 7 | 131.1 (90.0, 184.3) | 47 (1, 118) | 7 |
stable ![]() |
-6.7 (-35.7, 1.0) |
Mason County 7 | 97.3 (71.7, 128.8) | 107 (27, 118) | 10 |
stable ![]() |
-8.2 (-33.6, 0.2) |
Powell County 7 | 173.1 (133.8, 220.2) | 2 (1, 96) | 13 |
stable ![]() |
-9.5 (-19.8, 3.1) |
Laurel County 7 | 112.8 (98.2, 128.9) | 89 (33, 112) | 43 |
falling ![]() |
-10.8 (-18.3, -4.2) |
Meade County 7 | 101.8 (82.2, 124.7) | 106 (36, 118) | 19 |
falling ![]() |
-11.4 (-24.4, -3.1) |
Magoffin County 7 | 94.7 (66.2, 131.5) | 108 (18, 118) | 7 |
falling ![]() |
-16.7 (-37.9, -2.6) |
Garrard County 7 | 142.9 (111.8, 179.9) | 28 (1, 111) | 15 |
stable ![]() |
-21.3 (-41.4, 1.0) |
Menifee County 7 | 125.7 (79.3, 189.4) | 55 (1, 118) | 5 |
stable ![]() |
-27.2 (-62.7, 6.7) |
Fulton County 7 | 134.9 (83.9, 204.5) | 40 (1, 118) | 4 |
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Hickman County 7 |
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Robertson County 7 |
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Notes:
Created by statecancerprofiles.cancer.gov on 11/29/2023 4:21 am.
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 - United States Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute. Based on the 2022 submission.
7 Source: SEER November 2022 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 2022 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 11/29/2023 4:21 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.
⋔ 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 - United States Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute. Based on the 2022 submission.
7 Source: SEER November 2022 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 2022 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.