Interpretation of Rate/Trend Comparison by Cancer Data
Death Rate/Trend Comparison by Cancer, 2016-2020
Minnesota Counties versus United States
Prostate
All Races, Male
Sorted by priority index
Explanation of Column HeadersState/County - The site and sex combination for this comparison.
Priority Index 1 - The priority index is based upon the direction of the trend and the rate comparison. An index of 1 is the highest priority - that trend is rising and the rate is already higher. An index of 9 is the lowest priority - the trend is falling and the rate is already lower.
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
United States
- Recent Trend(2) : The trend is stable because the trend is -0.5 with a 95% confidence interval from -0.9 to 0.0.
- Rate : The death rate is 18.8 with a 95% confidence interval from 18.7 to 18.9 and 31,337 average annual deaths.
Minnesota
- Recent Trend(2) : The trend is stable because the trend is -0.6 with a 95% confidence interval from -2.3 to 1.1.
- Rate : The death rate is 19.6 with a 95% confidence interval from 18.9 to 20.3 and 571 average annual deaths.
Crow Wing County
- Priority Index(1) : The priority index is 5.
- Recent Trend(2) : The trend is falling because the trend is -1.5 with a 95% confidence interval from -2.6 to -0.3.
- County Death Rate Compared to US Rate : This death rate is higher compared to the US rate
- Rate : The death rate is 26.5 with a 95% confidence interval from 20.1 to 34.5 and 12 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.4
St. Louis County
- Priority Index(1) : The priority index is 5.
- Recent Trend(2) : The trend is falling because the trend is -2.4 with a 95% confidence interval from -3.1 to -1.6.
- County Death Rate Compared to US Rate : This death rate is higher compared to the US rate
- Rate : The death rate is 22.9 with a 95% confidence interval from 19.2 to 27.1 and 28 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.2
Brown County
- Priority Index(1) : The priority index is 6.
- Recent Trend(2) : The trend is stable because the trend is -1.5 with a 95% confidence interval from -3.0 to 0.0.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 27.5 with a 95% confidence interval from 18.0 to 41.1 and 5 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.5
Cass County
- Priority Index(1) : The priority index is 6.
- Recent Trend(2) : The trend is stable because the trend is -1.7 with a 95% confidence interval from -3.4 to 0.0.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 18.8 with a 95% confidence interval from 11.8 to 29.5 and 5 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.0
Dakota County
- Priority Index(1) : The priority index is 6.
- Recent Trend(2) : The trend is stable because the trend is 10.4 with a 95% confidence interval from -2.5 to 25.1.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 17.6 with a 95% confidence interval from 15.0 to 20.6 and 33 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 0.9
Goodhue County
- Priority Index(1) : The priority index is 6.
- Recent Trend(2) : The trend is stable because the trend is -1.6 with a 95% confidence interval from -3.2 to 0.2.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 18.1 with a 95% confidence interval from 12.1 to 26.5 and 6 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.0
Aitkin County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -2.0 with a 95% confidence interval from -3.8 to -0.1.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 19.7 with a 95% confidence interval from 11.8 to 35.2 and 4 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.0
Anoka County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -3.2 with a 95% confidence interval from -4.2 to -2.2.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 17.5 with a 95% confidence interval from 14.6 to 20.8 and 27 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 0.9
Blue Earth County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -1.5 with a 95% confidence interval from -2.7 to -0.3.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 24.4 with a 95% confidence interval from 17.1 to 33.6 and 8 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.3
Carlton County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -2.5 with a 95% confidence interval from -4.0 to -0.9.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 23.5 with a 95% confidence interval from 15.0 to 35.3 and 5 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.3
Carver County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -3.7 with a 95% confidence interval from -5.2 to -2.2.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 19.7 with a 95% confidence interval from 13.9 to 27.0 and 8 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.0
Chisago County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -3.1 with a 95% confidence interval from -5.1 to -1.2.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 21.7 with a 95% confidence interval from 14.5 to 31.1 and 6 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.2
Clay County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -4.0 with a 95% confidence interval from -5.7 to -2.3.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 16.9 with a 95% confidence interval from 10.8 to 25.1 and 5 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 0.9
Douglas County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -1.8 with a 95% confidence interval from -3.2 to -0.4.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 17.4 with a 95% confidence interval from 11.3 to 26.1 and 5 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 0.9
Freeborn County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -3.7 with a 95% confidence interval from -5.6 to -1.7.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 16.5 with a 95% confidence interval from 10.1 to 26.3 and 4 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 0.9
Hennepin County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -2.7 with a 95% confidence interval from -3.2 to -2.2.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 20.0 with a 95% confidence interval from 18.3 to 21.7 and 112 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.1
Isanti County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -3.2 with a 95% confidence interval from -4.5 to -1.8.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 25.0 with a 95% confidence interval from 16.3 to 36.7 and 5 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.3
Itasca County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -3.2 with a 95% confidence interval from -5.3 to -1.0.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 15.2 with a 95% confidence interval from 9.9 to 22.7 and 5 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 0.8
Kandiyohi County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -2.3 with a 95% confidence interval from -3.8 to -0.7.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 21.9 with a 95% confidence interval from 14.8 to 31.6 and 6 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.2
Mille Lacs County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -1.9 with a 95% confidence interval from -3.6 to 0.0.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 29.6 with a 95% confidence interval from 18.5 to 45.3 and 4 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.6
Morrison County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -2.5 with a 95% confidence interval from -4.4 to -0.5.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 13.8 with a 95% confidence interval from 7.8 to 23.2 and 3 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 0.7
Mower County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -2.1 with a 95% confidence interval from -3.6 to -0.6.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 26.5 with a 95% confidence interval from 18.2 to 37.5 and 7 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.4
Olmsted County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -3.9 with a 95% confidence interval from -5.1 to -2.7.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 15.3 with a 95% confidence interval from 11.7 to 19.7 and 12 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 0.8
Otter Tail County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -3.5 with a 95% confidence interval from -4.7 to -2.3.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 15.4 with a 95% confidence interval from 10.8 to 21.8 and 7 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 0.8
Pine County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -4.2 with a 95% confidence interval from -6.1 to -2.3.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 18.0 with a 95% confidence interval from 10.6 to 29.1 and 4 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.0
Polk County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -3.1 with a 95% confidence interval from -4.6 to -1.7.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 24.5 with a 95% confidence interval from 15.6 to 37.0 and 5 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.3
Ramsey County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -3.1 with a 95% confidence interval from -3.6 to -2.6.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 17.4 with a 95% confidence interval from 15.1 to 19.9 and 43 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 0.9
Rice County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -3.1 with a 95% confidence interval from -4.6 to -1.4.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 20.5 with a 95% confidence interval from 14.3 to 28.5 and 7 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.1
Scott County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -4.4 with a 95% confidence interval from -5.7 to -3.0.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 17.0 with a 95% confidence interval from 12.2 to 22.9 and 9 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 0.9
Sherburne County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -2.3 with a 95% confidence interval from -4.2 to -0.5.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 21.6 with a 95% confidence interval from 14.9 to 29.9 and 7 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.1
Stearns County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -2.2 with a 95% confidence interval from -3.1 to -1.3.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 22.5 with a 95% confidence interval from 18.2 to 27.6 and 19 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.2
Steele County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -2.6 with a 95% confidence interval from -3.9 to -1.3.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 25.6 with a 95% confidence interval from 17.1 to 37.2 and 6 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.4
Waseca County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -1.8 with a 95% confidence interval from -3.6 to 0.0.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 29.1 with a 95% confidence interval from 16.9 to 47.6 and 3 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.5
Washington County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -2.7 with a 95% confidence interval from -3.7 to -1.6.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 21.4 with a 95% confidence interval from 17.8 to 25.5 and 25 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.1
Winona County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -3.4 with a 95% confidence interval from -5.1 to -1.7.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 17.4 with a 95% confidence interval from 11.3 to 26.0 and 5 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 0.9
Wright County
- Priority Index(1) : The priority index is 8.
- Recent Trend(2) : The trend is falling because the trend is -3.7 with a 95% confidence interval from -4.8 to -2.6.
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 15.4 with a 95% confidence interval from 11.1 to 20.8 and 9 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 0.8
- Priority Index(1) : The priority index cannot be determined.
- Recent Trend(2) : **
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 14.8 with a 95% confidence interval from 8.8 to 24.0 and 4 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 0.8
- Priority Index(1) : The priority index cannot be determined.
- Recent Trend(2) : **
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 15.6 with a 95% confidence interval from 9.2 to 24.7 and 4 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 0.8
- Priority Index(1) : The priority index cannot be determined.
- Recent Trend(2) : **
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 23.9 with a 95% confidence interval from 14.7 to 36.5 and 4 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.3
- Priority Index(1) : The priority index cannot be determined.
- Recent Trend(2) : **
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 22.2 with a 95% confidence interval from 12.6 to 37.8 and 3 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.2
- Priority Index(1) : The priority index cannot be determined.
- Recent Trend(2) : **
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 31.0 with a 95% confidence interval from 19.6 to 46.7 and 5 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.6
- Priority Index(1) : The priority index cannot be determined.
- Recent Trend(2) : **
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 23.7 with a 95% confidence interval from 13.7 to 38.3 and 3 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.3
- Priority Index(1) : The priority index cannot be determined.
- Recent Trend(2) : **
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 28.1 with a 95% confidence interval from 17.8 to 43.5 and 5 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.5
- Priority Index(1) : The priority index cannot be determined.
- Recent Trend(2) : **
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 16.4 with a 95% confidence interval from 9.8 to 26.1 and 4 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 0.9
- Priority Index(1) : The priority index cannot be determined.
- Recent Trend(2) : **
- County Death Rate Compared to US Rate : This death rate is similar compared to the US rate
- Rate : The death rate is 23.6 with a 95% confidence interval from 14.2 to 37.8 and 4 average annual deaths.
- Rate Ratio(3) County to US : The rate ratio is 1.3
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- Rate : *
- Rate Ratio(3) County to US : *
- Priority Index(1) : The priority index cannot be determined.
- Recent Trend(2) : **
- County Death Rate Compared to US Rate : *
- Rate : *
- Rate Ratio(3) County to US : *
- Priority Index(1) : The priority index cannot be determined.
- Recent Trend(2) : **
- County Death Rate Compared to US Rate : *
- Rate : *
- Rate Ratio(3) County to US : *
- Priority Index(1) : The priority index cannot be determined.
- Recent Trend(2) : **
- County Death Rate Compared to US Rate : *
- Rate : *
- Rate Ratio(3) County to US : *
- Priority Index(1) : The priority index cannot be determined.
- Recent Trend(2) : **
- County Death Rate Compared to US Rate : *
- Rate : *
- Rate Ratio(3) County to US : *
- Priority Index(1) : The priority index cannot be determined.
- Recent Trend(2) : **
- County Death Rate Compared to US Rate : *
- Rate : *
- Rate Ratio(3) County to US : *
- Priority Index(1) : The priority index cannot be determined.
- Recent Trend(2) : **
- County Death Rate Compared to US Rate : *
- Rate : *
- Rate Ratio(3) County to US : *
Notes:
Created by statecancerprofiles.cancer.gov on 04/28/2024 2:36 pm.
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.
Rate Comparison
Above when 95% confident the rate is above and Rate Ratio3 > 1.10
Similar when unable to conclude above or below with confidence.
Below when 95% confident the rate is below and Rate Ratio3 < 0.90
* Data has been suppressed to ensure confidentiality and stability of rate and trend estimates.
** Data are too sparse to provide stable estimates of annual rates needed to calculate trend.
1 Priority indices were created by ordering from rates that are rising and above the comparison rate to rates that are falling and below the comparison rate.
2 Recent trend in death rates is usually an Average Annual Percent Change (AAPC) based on the APCs calculated by Joinpoint Version 4.8.0.0. Due to data availability issues, the time period and/or calculation method used in the calculation of the trends may differ for selected geographic areas.
3 Rate ratio is the county rate divided by the US rate. Previous versions of this table used one-year rates for states and five-year rates for counties. As of June 2018, only five-year rates are used.
Source: 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 2020 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.
Note: 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. Suppression is used to avoid misinterpretation when rates are unstable.
State Cancer Registries may provide more current or more local data. Data presented on the State Cancer Profiles Web Site may differ from statistics reported by the State Cancer Registries (for more information).
Data for the following has been suppressed to ensure confidentiality and stability of rate and trend estimates:
Big Stone County, Chippewa County, Clearwater County, Cook County, Cottonwood County, Dodge County, Faribault County, Fillmore County, Grant County, Hubbard County, Jackson County, Kanabec County, Kittson County, Koochiching County, Lac qui Parle County, Lake County, Lake of the Woods County, Lincoln County, Mahnomen County, Marshall County, Murray County, Nicollet County, Nobles County, Norman County, Pennington County, Pipestone County, Pope County, Red Lake County, Redwood County, Renville County, Rock County, Roseau County, Sibley County, Stevens County, Swift County, Todd County, Traverse County, Wabasha County, Wadena County, Watonwan County, Wilkin County, Yellow Medicine County
Trend for the following could not be reliably determined due to small number of deaths per year:
Becker County, Beltrami County, Benton County, Houston County, Le Sueur County, Lyon County, Martin County, McLeod County, Meeker County
Interpret Rankings provides insight into interpreting cancer 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.