Arthritis

CDC Arthritis Data and Statistics

• Arthritis-related data on: prevalence, projections, and work limitations by sex on a national and state level (when the state provides - Wisconsin is included)

Asthma

CDC Asthma: Data and Surveillance
National Health Interview Survey Data
State Profiles
Trends 2001-2010

• Prevalence of asthma by age, race, sex, etc on the national level.

Diabetes

American Diabetes Association

CDC's Diabetes Data and Trends

• Diabetes stats on national, state, and county level
• Indicators include prevalence, duration, treatment, complications, risk factors, etc by age, sex, and race.

Heart Disease

AHA Heart and Stroke Statistics

AHA Heart Disease and Stroke 2012 Statistical Update

Atherosclerosis Risk in Communities

• Epidemiological study sponsored by the National Heart, Lung, and Blood Institute (NHLBI). Unfortunately, data from the study is not published on the website.  Researchers must contact the NHLBI in order to obtain the datasets.
• There is a link to all their articles through PubMed on the home page.

CDC Heart Disease Facts and Statistics

• Facts on heart disease at a national level including risk factors and cardiac care

CDC Heart Disease (Fast Stats)

• Fast stats on heart disease including morbidity, health & hospice care, etc on a national level - most by sex, age, and race

National Heart Lung and Blood Institute, Incidence and Prevalence Chartbook

• Chart book presents largely unpublished estimates of incidence and prevalence from six community cohort studies and one surveillance study. By race, age, sex at a national level

Renal

CDC Kidney Disease (Fast Stats)

Kidney Disease Statistics for the United States from the National Kidney and Urologic Diseases Clearinghouse

US Renal Data System Estimates

• Collects, analyzes, and distributes information about end-stage renal disease (ESRD) in the United States.

HIV/AIDS

AHRQ (Agency for Healthcare Research & Quality): HIV & AIDS Costs & Use

• HIVNet tool allows one to create data sets on inpatient/outpatient admissions and visits and costs for each.

CDC HIV/AIDS Statistics and Surveillance

• State, National, and Global stats on HIV/AIDS cases by race, sex, transmission category

United Nations (UNAIDS): Knowledge Center

• Monitors country progress, yearly AIDS epidemic updates, fast facts about HIV, and other publications which may contain statistics.

MRSA

CDC Healthcare-Associated Methicillin Resistant Staphylococcus aureus (MRSA): Data and Statistics

• Provides in-depth stats on mrsa prevalence with indicators such as location and hospital type.

Sexually Transmitted Diseases (STDs)

CDC Sexually Transmitted Diseases: Data & Statistics

• Trends and annual reports on sexually transmitted diseases and specifically on Chlamydia, gonococcal isolate, and syphilis.

Influenza

CDC Flu Activity & Surveillance

CDC FastStats Influenza

Aging

Data and Statistics on Older Americans
CDC Older Americans

• Contains facts and figures on life expectancy, health care, home health, hospice, etc on the national level.

AgingStats

• Contains facts and figures on economics, health risks, health care, literacy, etc on the national level.

Center for Demography of Health and Aging - nationally and state level (includes Wisconsin study)

• Does not contain any data itself, but has links to the Wisconsin Longitudinal Study, Nat'l survey of families and households, and links to raw data sources, gov't agencies, CAAR reports, and other web resources

National Nursing Home Survey

• Data about nursing homes, the services which are provided, their staff, and their residents.

National Institute on Aging

• Includes links to resources and datasets which provide facts and figures on various aspects of the aging such as population, housing, and health.

Children/Youth/Teens

Maternal & Child Health Information Resource Center (US Dept of Health & Human Services): Child Health USA

• Ex. Infant and neonatal mortality rate by state, and by race of mother and others from TOC.

Child Trends Data Bank

• Ex. Interdisciplinary info on development, social factors, education, special health needs, etc.

Child and Adolescent Health Measurement Initiative (CAHMI): Data Resource Center for Child & Adolescent Health

• Data on state and national levels of various health factors affecting children, such as health, health care, family, school, etc
• Allows for comparisons between state and national or state and state levels

March of Dimes: Peristats (Maternal and Infant Health Data)

• Ability to create maps, graphs, quick fact lists, and general summaries by choosing a state and indicators.  Indicators include birth weights, infant mortality rates, prenatal care, multiple deliveries, delivery methods, etc

Robert Wood Johnson Foundation

• Contains data for each state on gaps in children's general health status, in infant mortality, and social factors affecting children's health.

Healthy Youth Youth Risk Behavior Surveillance System - From the CDC and state, territorial, tribal, and local surveys conducted by state, territorial, and local education and health agencies and tribal governments.

• Monitors priority health-risk behaviors in youth and young-adults, especially obesity and asthma

Men

NCHS FasStats Men's Health

• Quick stats on men's issues including population, health status, health care, risk factors, and morality (coverage levels and indicators vary depending on the data which the fact is pulled from)

Minority Groups

Office of Minority Health Data and Statistics

• Data and statistics on specific ethnic and racial groups

Office of Minority Health Disparities

Women

Office on Women''s Health (US Dept of Health & Human Services): Quick Health Data Online

• Contains data on women's health access, disease, maternal health, mental health , mortality, reproductive health, violence and others. Data can be manipulated by nation, region, state, and county.

Birth, Death, Vital

CDC Births/Natality

• Contains quick facts on births, birth weights, etc on a national level. Contains links to more statistics and charts for births.

CDC Deaths/Mortality

• Contains quick facts on causes, age, education, marital status, etc on a national level.

CDC Life Expectancy

• Contains quick facts on life expectancy with regards to age, sex, and race at a national level

CDC Vital Stats

• Provides access to tables and data files on births and deaths on a national, state, and county level

NCHS Mortality Tables

• Detailed mortality tables prepared by the Division of Vital Statistics and the National Center for Health Statistics. These tables include data on age, race, sex, cause-of-death, life expectancy, and infant mortality.

US Census Bureau, International Database (IDB)

• Choice of indicators such as population, fertility, births, deaths, etc in any country used to create html or spreadsheets.

FAQ: Underweight Babies at Birth

Chronic Disease Tracking Risks and Behaviors

CDC's Chronic Disease Prevention & Health Promotion's Tracking conditions and risk behaviors site

• Includes data, customizable tables, and stats on various indicators such as physical activity, nutrition, tobacco & alcohol, cancer, cardiovascular disease, diabetes, oral health, and other on a national and state level.

General Health Statistics

The Commonwealth Fund: Charts (State Scorecard, ChartCart, Performance Snapshots) - add information here from the "Topics" tab to give idea of coverage.

• Data coverage includes health insurance, medicare, health system performance, health care quality, child health, care of the elderly, state and international health policy,

Global Health Facts (The Kaiser Family Foundation)

• Contains global data on HIV/AIDS, TB, Malaria, avian flu, polio, obesity, smoking, water, programs and funding, demography and population and other topics.

Henry J. Kaiser Foundation

• Provides fact sheets on health coverage, HIV/AIDS, medicare, minority health, prescription drugs and others.

Kaiser Family Foundation: State Health Facts

• Contains data for each state on categories such as demographics and the economy, health coverage, Medicaid, health status (which includes many subcategories), women's health, minority health, and HIV/AIDS

The Robert Wood Johnson Foundation

• Contains publications from research done on addiction, disparities, health insurance coverage, end of life & palliative care, cancer, eating disorders, and many others.
• This site does not provide raw data or stats. It leads to articles that contain statistics.

State Snapshots

• State-specific health care quality information, including strengths, weaknesses, and opportunities for improvement.

United Health Foundation - Resources Page (America's Health Rankings)

• Contains America's Health Rankings where states are ranked according to several factors. Determinants such as smoking, drinking, obesity, education, public and health policy, crime, poverty, and health outcomes such as premature death, poor mental health days, cancer deaths and more are combined to give each state a score.

Alcohol, Drugs

US Dept of Health & Human Services, Office of Applied Studies: National Survey on Drug Use & Health

• Provides data on substance use based on age, sex, race/ethnicity, education, employment on national level
• Contains data on the prevalence and treatment of mental health problems

Substance Abuse and Mental Health Data Archive (US Dept of Health & Human Services)

• Is the same National Survey on Drug Use & Health as previous entry.  A more complicated site which allows one to create tables with the data
• Has other surveys with information regarding treatment episode data and treatment outcome studies.

NIAAA (Nat'l Institute on Alcohol Abuse & Alcoholism: Data/Statistical Tables

• Alcohol-related data on: economics, mental & physical health conditions, risk behaviors, short-stay hospital discharges, per capital alcohol consumption, and traffic crashes - by race, age, sex on a mostly national level.

NIDA (Nat'l Institute on Drugs and Alcohol) Drug Pubs

Misuse of Prescription Drugs (SAMHSA)

• Data from the 2002, 2003, and 2004 National Surveys on Drug Use and Health. Report from the Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies (OAS).

Immunizations

CDC Vaccines & Immunizations: Statistics and Surveillance

• Provides charts and graphs of immunization data for children and adults on national, state, and some county/city area levels.

Injury

CDC's Web-based Injury Statistics Query and Reporting System

OSHA Statistics and Data

OSHA Injury, Illness Incidence Rates

Insurance Institute for Highway Safety

• Includes crash,injury, fatality statistics in relation to many factors.

Falls Among Older Adults

Fall Injury Episodes Among Noninstitutionalized Older Adults in the U.S.

Sports Injuries

Nutrition

National Health and Nutrition Examination Survey (NHANES)

• A program of studies that assesses the health and nutritional status of adults and children in the US. The survey com­bines interviews and physical examinations. The NHANES interview includes demographic, socioeconomic, dietary, and health-related questions. The examination consists of medical, dental, and physiological measure­ments, as well as laboratory tests.
• An SAS viewer is needed to open up the data for viewing (download free viewer)

Obesity

CDC Overweight and Obesity: Trends   (Possibly add more detailed stats links for obesity.)

• Contains obesity stats on adults and children on national and state levels, by age, gender, and race

World Health Organization: Global Database on Body Mass Index

• Provides both national and sub-national adult underweight, overweight and obesity prevalence rates by country and gender. Data is provided in maps, tables, graphs and downloadable documents.

FAQ: Percentage of Adults Overweight in the US

Physical Activity

CDC U.S. Physical Activity Statistics

• National and state level data on physical activity by age, gender, education and race.  Includes a special study of metropolitan areas.

Reproductive Health

CDC Reproductive Health: Data and Statistics

• Statistics on abortion, assisted reproductive technology, hysterectomies, infant health, maternal health, women's reproductive health, teen pregnancy, and tobacco use and pregnancy on a national level.

Sexually Transmitted Diseases (STDs)

CDC Sexually Transmitted Diseases: Surveillance & Statistics

• Trends and annual reports on sexually transmitted diseases and specifically on Chlamydia, gonococcal isolate, and syphilis.

Smoking & Tobacco

CDC Smoking & Tobacco Use: Data & Statistics

• State, national and global data on smoking and tobacco use. Including adult and youth data, cessation and interventions, economics, health effects, secondhand smoke, smokeless tobacco, and the tobacco industry.

Traffic Safety

National Highway Traffic Safety Administration

Violence

American Bar Association Commission on Domestic Violence: Key Statistics

Bureau of Justice Statistics, US Department of Justice: Family Violence Statistics

Aging/Geriatrics

Data and Statistics on Older Americans
CDC Older Americans

• Contains facts and figures on life expectancy, health care, home health, hospice, etc on the national level.

AgingStats

• Contains facts and figures on economics, health risks, health care, literacy, etc on the national level.

Center for Demography of Health and Aging - nationally and state level (includes Wisconsin study)

• Does not contain any data itself, but has links to the Wisconsin Longitudinal Study, Nat'l survey of families and households, and links to raw data sources, gov't agencies, CAAR reports, and other web resources

National Nursing Home Survey

• Data about nursing homes, the services which are provided, their staff, and their residents.

National Institute on Aging

• Includes links to resources and datasets which provide facts and figures on various aspects of the aging such as population, housing, and health.

Alcohol, Drugs

US Dept of Health & Human Services, Office of Applied Studies: National Survey on Drug Use & Health

• Provides data on substance use based on age, sex, race/ethnicity, education, employment on national level
• Contains data on the prevalence and treatment of mental health problems

Substance Abuse and Mental Health Data Archive (US Dept of Health & Human Services)

• Is the same National Survey on Drug Use & Health as previous entry.  A more complicated site which allows one to create tables with the data
• Has other surveys with information regarding treatment episode data and treatment outcome studies.

NIAAA (Nat'l Institute on Alcohol Abuse & Alcoholism: Data/Statistical Tables

• Alcohol-related data on: economics, mental & physical health conditions, risk behaviors, short-stay hospital discharges, per capital alcohol consumption, and traffic crashes - by race, age, sex on a mostly national level.

NIDA (Nat'l Institute on Drugs and Alcohol) Drug Pubs

Misuse of Prescription Drugs (SAMHSA)

• Data from the 2002, 2003, and 2004 National Surveys on Drug Use and Health. Report from the Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies (OAS).

Arthritis

CDC Arthritis Data and Statistics

• Arthritis-related data on: prevalence, projections, and work limitations by sex on a national and state level (when the state provides - Wisconsin is included)

Asthma

CDC Asthma: Data and Surveillance
CDC 2006 Asthma Data

• Prevalence of asthma by age, race, sex, etc on the national level.

Behavioral/Mental

Behavioral Risk Factor Surveillance System (BRFSS)

• Contains data from an on-going telephone health survey which has tracked health conditions and risk behaviors in the US since 1984 (data is collected from all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and Guam.

Birth, Death, Vital

CDC Vital Stats

• Provides access to tables and data files on births and deaths on a national, state, and county level

http://www.cdc.gov/nchs/fastats/deaths.htm - CDC Deaths/Mortality

• Contains quick facts on causes, age, education, marital status, etc on a national level.

CDC Mortality Tables

• Detailed mortality tables prepared by the Division of Vital Statistics and the National Center for Health Statistics. These tables include data on age, race, sex, cause-of-death, life expectancy, and infant mortality.

CDC Life Expectancy

• Contains quick facts on life expectancy with regards to age, sex, and race at a national level

CDC Births/Natality

• Contains quick facts on births, birth weights, etc on a national level.  Contains links to more statistics and charts for births.

US Census Bureau, International Database (IDB)

• Choice of indicators such as population, fertility, births, deaths, etc in any country used to create html or spreadsheets.

Blood Disorders

CDC Bleeding and Clotting Disorders Surveillance

• Disorder Surveillance, risk factors by age, race, etc at national and regional levels.

Cancer:

Cancer Statistics, 2010

• Annual special issue of CA: A Cancer Journal of Clinicians covering cancer incidence, mortality, and survival based on incidence data.

CDC Cancer Data

• Facts and figures by year, site, state, race, sex, age, ect at global, national, and state levels.  Links to other organizations providing cancer statistics.

National Cancer Institute statistics

Children/Youth/Teens:

Maternal & Child Health Information Resource Center (US Dept of Health & Human Services): Child Health USA

• Ex. Infant and neonatal mortality rate by state, and by race of mother and others from TOC.

Child Trends Data Bank

• Ex. Interdisciplinary info on development, social factors, education, special health needs, etc.

Child and Adolescent Health Measurement Initiative (CAHMI): Data Resource Center for Child & Adolescent Health

• Data on state and national levels of various health factors affecting children, such as health, health care, family, school, etc
• Allows for comparisons between state and national or state and state levels

March of Dimes: Peristats (Maternal and Infant Health Data)

• Ability to create maps, graphs, quick fact lists, and general summaries by choosing a state and indicators.  Indicators include birth weights, infant mortality rates, prenatal care, multiple deliveries, delivery methods, etc

From the Robert Wood Johnson Foundation

• Contains data for each state on gaps in children's general health status, in infant mortality, and social factors affecting children's health.

YRBSS: Youth Risk Behavior Surveillance System

• From the CDC and state, territorial, tribal, and local surveys conducted by state, territorial, and local education and health agencies and tribal governments.
• Monitors priority health-risk behaviors in youth and young-adults, especially obesity and asthma

Chronic Disease Tracking Risks and Behaviors

CDC's Chronic Disease Prevention & Health Promotion's Tracking conditions and risk behaviors site

• Includes data, customizable tables, and stats on various indicators such as physical activity, nutrition, tobacco & alcohol, cancer, cardiovascular disease, diabetes, oral health, and other on a national and state level.

Diabetes

CDC's Diabetes Data and Trends

• Diabetes stats on national, state, and county level
• Indicators include prevalence, duration, treatment, complications, risk factors, etc by age, sex, and race.

Diseases

CDC's National Health Interview Survey (NHIS)

• Data is collected from personal household interviews since 1957.  Contains disease and risk factor prevalence.

General Health Statistics

UW-Madison Data and Information Services Center (DISC)

• Longitudinal surveys, macroeconomic indicators, election studies, population studies, socialization patterns, poverty measures, labor force participation, public opinion polls, education and health data, and local/national/international governmental statistics are among the subjects represented.

NHQR State Snapshots

• State-specific health care quality information, including strengths, weaknesses, and opportunities for improvement.

Kaiser Family Foundation: State Health Facts

• Contains data for each state on categories such as demographics and the economy, health coverage, Medicaid, health status (which includes many subcategories), women's health, minority health, and HIV/AIDS

The Commonwealth Fund: Charts (State Scorecard, ChartCart, Performance Snapshots) - add information here from the "Topics" tab to give idea of coverage.

• Data coverage includes health insurance, medicare, health system performance, health care quality, child health, care of the elderly, state and international health policy,

The Robert Wood Johnson Foundation

• Contains publications from research done on addiction, disparities, health insurance coverage, end of life & palliative care, cancer, eating disorders, and many others.
• This site does not provide raw data or stats. It leads to articles that contain statistics.

Henry J. Kaiser Foundation

• Provides fact sheets on health coverage, HIV/AIDS, medicare, minority health, prescription drugs and others.

Global Health Facts (The Kaiser Family Foundation)

• Contains global data on HIV/AIDS, TB, Malaria, avian flu, polio, obesity, smoking, water, programs and funding, demography and population and other topics.

Heart Disease

American Heart Association Statistics

• Stats on risk factors, nutrition, quality of care, medical procedures and economic cost relating to heart disease and strokes on a national level

Atherosclerosis Risk in Communities

• Epidemiological study sponsored by the National Heart, Lung, and Blood Institute (NHLBI). Unfortunately, data from the study is not published on the website.  Researchers must contact the NHLBI in order to obtain the datasets.
• There is a link to all their articles through PubMed on the home page.

CDC Heart Disease Facts and Statistics

• Facts on heart disease at a national level including risk factors and cardiac care

CDC Heart Disease (Fast Stats)

• Fast stats on heart disease including morbidity, health & hospice care, etc on a national level - most by sex, age, and race

 National Heart Lung and Blood Institute, Incidence and Prevalence Chartbook

• Chart book presents largely unpublished estimates of incidence and prevalence from six community cohort studies and one surveillance study.  By race, age, sex at a national level

HIV/AIDS:

HIV/AIDS Statistics and Surveillance: Basic Statistics

• State, National, and Global stats on HIV/AIDS cases by race, sex, transmission category

United Nations (UNAIDS): Knowledge Center

• Monitors country progress, yearly AIDS epidemic updates, fast facts about HIV, and other publications which may contain statistics.

AHRQ (Agency for Healthcare Research & Quality): HIV & AIDS Costs & Use

• HIVNet tool allows one to create data sets on inpatient/outpatient admissions and visits and costs for each.

Hospital Utilization, Expenditures, etc

CDC, Nat'l Center for Health Statistics: National Hospital Discharge Survey and Ambulatory Surgery Data

• Data on hospital discharges, ambulatory surgery, inpatient deaths and more.

CDC, Nat'l Center for Health Statistics: National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey

• Data on ambulatory and physician office visits (does not contain information on specialties such as anesthesiology, pathology, and radiology)
• Data on hospital outpatient and emergency department visits

HCUP (pronounced "H-CUP") family of health care databases and related software tools and products is made possible by a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality (AHRQ).

• HCUP reports
• Healthcare Cost and Utilization Project
• Data on hospital inpatient and ambulatory surgery discharges and charges. Information has sections for children, nationwide, state, state ambulatory surgery, and state emergency department databases.
• Unfortunately, data is not provided free on the website and must be purchased through the HCUP-US Central Distributor

Bureau of Health Professionals (US Dept of Health & Human Services): National Center for Health Workforce Analysis

• Data on levels of employment, projected growth and key environmental factors that affect demand for health care. Details for medicine, nursing, dentistry, pharmacy, mental health and aides.
• Provides highlights from the 2000 analysis for individual states. Full copies of the analysis can be requested (for free).

Healthcare Cost and Utilization Project (US Dept of Health & Human Services)

• National and state stats on all stays (including by payer), emergency dept visits, national stats on mental health hospitalizations, and children and information on US Hospitals

AHRQ (Agency for Healthcare Research and Quality) Medical Expenditure Panel Survey

• Provides state and national level data on chronic conditions, health insurance, medicare, health care costs, prescription drugs and more.
• Not all states are included. If the state you are looking for is not included please feel free to email that state's Department of Public Health's statistics department. (We have the examples of Illinois. If you want to include Illinois' specific information ask Tara or Ann for it)

Dartmouth Atlas of Health Care

• Documents variations in how medical resources are distributed and used in the United States. Provides comprehensive information and analysis about national, regional, and local markets, as well as individual hospitals and their affiliated physicians
• Has data tools that allow you to choose which indicators and over what regions/time frames will be represented in your results
• Coverage and indicators include hospital care intensity, per-decedent spending for inpatient hospitalizations, physician visits, skilled nursing facility stays, home health agency visits, or hospice admissions, evaluates the contributions of variation in price and volume in determining Medicare reimbursements, etc.

Wisconsin PricePoint System

• Provides basic, facility-specific information about services and charges for inpatient and outpatient services.

Immunizations

• Provides charts and graphs of immunization data for children and adults on national, state, and some county/city area levels.

Men's Health

NCHS FasStats Men's Health

• Quick stats on men's issues including population, health status, health care, risk factors, and morality (coverage levels and indicators vary depending on the data which the fact is pulled from)

MRSA:

CDC Healthcare-Associated Methicillin Resistant Staphylococcus aureus (MRSA): Data and Statistics

• Provides in-depth stats on mrsa prevalence with indicators such as location and hospital type.

Nutrition

National Health and Nutrition Examination Survey (NHANES)

• A program of studies that assesses the health and nutritional status of adults and children in the US. The survey com­bines interviews and physical examinations. The NHANES interview includes demographic, socioeconomic, dietary, and health-related questions. The examination consists of medical, dental, and physiological measure­ments, as well as laboratory tests.
• An SAS viewer is needed to open up the data for viewing (download free viewer)

Obesity

CDC Overweight and Obesity: Trends   ------------(Possibly add more detailed stats links for obesity.)

• Contains obesity stats on adults and children on national and state levels, by age, gender, and race

World Health Organization: Global Database on Body Mass Index

• Provides both national and sub-national adult underweight, overweight and obesity prevalence rates by country and gender. Data is provided in maps, tables, graphs and downloadable documents.

Physical Activity

CDC U.S. Physical Activity Statistics

• National and state level data on physical activity by age, gender, education and race. Includes a special study of metropolitan areas.

Renal

US Renal Data System Estimates

• Collects, analyzes, and distributes information about end-stage renal disease (ESRD) in the United States.

Reproductive Health

CDC Reproductive Health: Data and Statistics

• Statistics on abortion, assisted reproductive technology, hysterectomies, infant health, maternal health, women's reproductive health, teen pregnancy, and tobacco use and pregnancy on a national level.

Smoking & Tobacco

CDC Smoking & Tobacco Use: Data & Statistics

• State, national and global data on smoking and tobacco use. Includes adult and youth data, cessation and interventions, economics, health effects, secondhand smoke, smokeless tobacco, and the tobacco industry.

Sexually Transmitted Diseases (STD's)

CDC Sexually Transmitted Diseases: Surveillance & Statistics

• Trends and annual reports on sexually transmitted diseases and specifically on Chlamydia, gonococcal isolate, and syphilis.

Traffic Safety, Fatality

• Might be an interesting one to include somewhere (or not), as it has all sorts of highway, driving, fatality, seat belt use, etc. data as related to age and other factors beyond alcohol.

Women's Health

Office on Women's Health (US Dept of Health & Human Services): Quick Health Data Online

• Contains data on women's health access, disease, maternal health, mental health , mortality, reproductive health, violence and others.  Data can be manipulated by nation, region, state, and county.