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A graphical representation of the percentage of adults with diabetes in the U.S. from 1999 to 2012 is presented.

A graph is presented that shows the percentage of uninsured adults who did not have health coverage from 2009-2011 in the U.S.

A chart is presented that shows the percentage of adults aged 18-64 years who reported fair or poor health in the U.S. based on the National Health Interview Survey from 2008 to 2010.

Objectives: This report details the National Center for Health Statistics' (NCHS) development of the 2006 NCHS Urban-Rural Classification Scheme for Counties and provides some examples of how the scheme can be used to describe differences in health measures by urbanization level., Methods: The 2006 NCHS urban-rural classification scheme classifies all U.S. counties and county-equivalents into six levels--four for metropolitan counties and two for nonmetropolitan counties. The Office of Management and Budget's delineation of metropolitan and nonmetropolitan counties forms the foundation of the scheme. The NCHS scheme also uses the cut points of the U.S. Department of Agriculture Rural-Urban Continuum Codes to subdivide the metropolitan counties based on the population of their metropolitan statistical area (MSA): large, for MSA population of 1 million or more; medium, for MSA population of 250,000-999,999; and small, for MSA population below 250,000. Large metro counties were further separated into large central and large fringe metro categories using classification rules developed by NCHS. Nonmetropolitan counties were assigned to two levels based on the Office of Management and Budget's designated micropolitan or noncore status. The 2006 scheme was applied to data from the National Vital Statistics System (NVSS) and the National Health Interview Survey (NHIS) to illustrate its ability to capture health differences by urbanization level., Results and Conclusions: Application of the 2006 NCHS scheme to NVSS and NHIS data shows that it identifies important health disparities among communities, most notably those for inner city and suburban communities. The design of the NCHS Urban-Rural Classification Scheme for Counties makes it particularly well-suited for assessing and monitoring health differences across the full urbanization continuum.

The past decade has brought many changes to the home health care industry, largely as a result of Medicare policy changes. These policy reforms include a new payment system, eligibility restrictions, and stringent fraud and abuse enforcement. In addition, Medicare now pays for home health care based on the location of the beneficiary, not the agency. To examine the impact of these changes on access to care, we evaluated the degree to which beneficiaries are served by agencies outside of their county. We constructed an analytical file by linking the 1997 five percent Medicare Standard Analytical File home health claims file to the Provider of Services file to obtain the characteristics of the beneficiaries' primary agency. This beneficiary-level analytical file included information on 162,241 Medicare home health users - including 43,488 rural residents - of 9,410 home health agencies. We examined the characteristics of rural beneficiaries served by urban agencies as compared with those served by rural agencies. Our findings demonstrate that urban agencies - either directly or through their branch offices - play an important role in providing home health care to rural Medicare beneficiaries.