USER DOCUMENTATION FOR THE AREA RESOURCE FILE (ARF) AS OF FEBRUARY 1995 Office of Research and Planning Bureau of Health Professions Page 001 ARF USER DOCUMENTATION -------------------------------------------CONTENTS-------------------------------------- I. DATA ELEMENT DESCRIPTIONS AND REFERENCES . . . . . . . . . . . . . . . . 4 A. CODES AND CLASSIFICATIONS. . . . . . . . . . . . . . . . . . . . . . . . 4 A-1) Header for ARF . . . . . . . . . . . . . . . . . . . . . . . . . . 4 A-2) State and County Codes . . . . . . . . . . . . . . . . . . . . . . 4 A-3) MSA, PMSA and CMSA Codes, Names and Levels; SMSA Code and Name; Rural/Urban Continuum Code; AMA County Group Code; and Census County Group Code . . . . . . . . . . . . . . . . . . . 9 A-4) Economic Area Codes. . . . . . . . . . . . . . . . . . . . . . . . 16 A-5) Federal Region Code and Census Region and Division Codes and Names. . . . . . . . . . . . . . . . . . . . . . . . . . 17 A-6) Health Service Area (HSA) Codes and Name . . . . . . . . . . . . . 18 A-7) Professional Standards Review Organization (PSRO) Code . . . . . . 22 A-8) Mathematica Policy Research Sampling Unit Codes. . . . . . . . . . 23 A-9) Medicare Prevailing Charges Locality Codes . . . . . . . . . . . . 25 A-10) Veterans Administration Codes. . . . . . . . . . . . . . . . . . . 28 A-11) Contiguous Counties. . . . . . . . . . . . . . . . . . . . . . . . 28 A-12) Health Care Service Area Codes . . . . . . . . . . . . . . . . . . 30 A-13) Area Health Education Center (AHEC) Code and Name. . . . . . . . . 30 B. HEALTH PROFESSIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 B-1) Physicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 B-2) Dentists and Dental Hygienists . . . . . . . . . . . . . . . . . . 39 B-3) Optometrists . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 B-4) Pharmacists. . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 B-5) Podiatrists. . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 B-6) Veterinarians. . . . . . . . . . . . . . . . . . . . . . . . . . . 44 B-7) Nurses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 B-8) Physician Assistants and Nurse Practitioners . . . . . . . . . . . 47 B-9) Occupational Therapists. . . . . . . . . . . . . . . . . . . . . . 49 B-10) Decennial Census Occupation Data. . . . . . . . . . . . . . . . . . 49 B-11) National Health Service Corps (NHSC) Sites . . . . . . . . . . . . 50 B-12) Critical Shortage Codes. . . . . . . . . . . . . . . . . . . . . . 50 C. HEALTH FACILITIES. . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 C-1) Hospital Type. . . . . . . . . . . . . . . . . . . . . . . . . . . 53 C-2) Hospital Services (or Facilities). . . . . . . . . . . . . . . . . 55 C-3) Hospital Employment. . . . . . . . . . . . . . . . . . . . . . . . 55 C-4) Nursing Homes. . . . . . . . . . . . . . . . . . . . . . . . . . . 56 C-5) Health Maintainance Organizations. . . . . . . . . . . . . . . . . 60 Page 002 D. UTILIZATION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 D-1) Utilization Rate . . . . . . . . . . . . . . . . . . . . . . . . . 65 D-2) Inpatient Days . . . . . . . . . . . . . . . . . . . . . . . . . . 65 D-3) Outpatient Visits. . . . . . . . . . . . . . . . . . . . . . . . . 65 D-4) Surgical Operations. . . . . . . . . . . . . . . . . . . . . . . . 65 E. EXPENDITURES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66 E-1) Hospital Expenditures. . . . . . . . . . . . . . . . . . . . . . . 66 E-2) Medicare Expenditure Data. . . . . . . . . . . . . . . . . . . . . 66 E-3) Medicare Prevailing Charges Data . . . . . . . . . . . . . . . . . 67 F. POPULATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 F-1) Population Counts and Number of Families and Households. . . . . . 70 F-2) Population Percents. . . . . . . . . . . . . . . . . . . . . . . . 75 F-3) Population Estimates . . . . . . . . . . . . . . . . . . . . . . . 76 F-4) Labor Force. . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 F-5) Census Total Incomes . . . . . . . . . . . . . . . . . . . . . . . 79 F-6) Per Capita Incomes . . . . . . . . . . . . . . . . . . . . . . . . 79 F-7) Income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 F-8) Persons and Families Below Poverty Level . . . . . . . . . . . . . 85 F-9) Median Family Income . . . . . . . . . . . . . . . . . . . . . . . 86 F-10) Household Income . . . . . . . . . . . . . . . . . . . . . . . . . 88 F-11) Aid to Families with Dependent Children and General Assistance . . 88 F-12) 5-Year Infant Mortality Rates. . . . . . . . . . . . . . . . . . . 92 F-13) Infant Mortality Data. . . . . . . . . . . . . . . . . . . . . . . 93 F-14) Mortality Data . . . . . . . . . . . . . . . . . . . . . . . . . . 93 F-15) Cancer Mortality Rate Data . . . . . . . . . . . . . . . . . . . . 95 F-16) Morbidity Data . . . . . . . . . . . . . . . . . . . . . . . . . . 95 F-17) Natality Data. . . . . . . . . . . . . . . . . . . . . . . . . . . 95 F-18) Births in Hospitals. . . . . . . . . . . . . . . . . . . . . . . . 96 F-19) Education. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96 F-20) Census Housing Data. . . . . . . . . . . . . . . . . . . . . . . . 97 F-21) Veteran Population . . . . . . . . . . . . . . . . . . . . . . . . 98 F-22) Retail Trade . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 F-23) Family Income. . . . . . . . . . . . . . . . . . . . . . . . . . . 98 G. ENVIRONMENT. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99 G-1) Land Area. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99 G-2) Population Centroid. . . . . . . . . . . . . . . . . . . . . . . . 99 G-3) Climatic Data. . . . . . . . . . . . . . . . . . . . . . . . . . . 99 G-4) Water Hardness Index . . . . . . . . . . . . . . . . . . . . . . . 100 G-5) Farm Data. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101 Page 003 II. TECHNICAL INFORMATION. . . . . . . . . . . . . . . . . . . . . . . . . . 102 A) Tape Specifications. . . . . . . . . . . . . . . . . . . . . . . . 102 B) Missing Values on the ARF. . . . . . . . . . . . . . . . . . . . . 102 C) Flags Contained on the ARF . . . . . . . . . . . . . . . . . . . . 102 D) Criteria for Data Inclusion on the ARF . . . . . . . . . . . . . . 103 III. DOCUMENTATION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104 A) Technical Documentation of ARF . . . . . . . . . . . . . . . . . . 104 B) COBOL and PL/1 Layouts of ARF. . . . . . . . . . . . . . . . . . . 104 Page 004 I. DATA ELEMENT DESCRIPTIONS AND REFERENCES A. CODES AND CLASSIFICATIONS A-1) Header for ARF The 45-character header for ARF was placed at the beginning of each record to enhance the use of the county file. The header includes the State and County Code, Date of the File, Date of Creation, and File Length. The file length equals the length of the file without the 45-byte header. Therefore the actual record length is the file length plus 45 bytes. A-2) State and County Codes FIPS State Code: This code was established by National Bureau of Standards, U.S. Department of Commerce in 1968. It is standard throughout the Federal government and published in "Federal Information Processing Standards Publication June 15, 1970". The basic structure is a sequential ascending two digit number, with spaces for all possible new states. The following table lists the FIPS State Code, the three-character State Name Abbreviation used on ARF and the State Name: FIPS CODE ABBREVIATION STATE + _________ ____________ _____ 01 ALA Alabama 02 ALK Alaska 04 ARI Arizona 05 ARK Arkansas 06 CAL California 08 COL Colorado 09 CON Connecticut 10 DEL Delaware 11 D C District of Columbia 12 FLA Florida 13 GA Georgia 15 HAW Hawaii 16 IDA Idaho 17 ILL Illinois 18 IND Indiana 19 IOW Iowa 20 KAN Kansas Page 005 FIPS CODE ABBREVIATION STATE + _________ ____________ _____ 21 KY Kentucky 22 LA Louisiana 23 ME Maine 24 MD Maryland 25 MAS Massachusetts 26 MIC Michigan 27 MIN Minnesota 28 MIS Mississippi 29 MO Missouri 30 MON Montana 31 NEB Nebraska 32 NEV Nevada 33 N H New Hampshire 34 N J New Jersey 35 N M New Mexico 36 N Y New York 37 N C North Carolina 38 N D North Dakota 39 OH Ohio 40 OKL Oklahoma 41 ORG Oregon 42 PA Pennsylvania 44 R I Rhode Island 45 S C South Carolina 46 S D South Dakota 47 TEN Tennessee 48 TEX Texas 49 UTH Utah 50 VT Vermont 51 VA Virginia 53 WAS Washington 54 W V West Virginia 55 WIS Wisconsin 56 WYO Wyoming GSA 1967 State and County Codes: This code preceded FIPS. Like FIPS, the basic structure of the GSA State Codes is a sequential ascending two-digit number; however, no spaces are included for additions. Alaska and Hawaii are listed as States 50 and 51 rather than in alphabetical order. The GSA - 1967 State Codes are on the file for indexing only. **NOTE: The GSA County Codes are not available for Virginia independent cities. Refer to A-2. Page 006 AHA State Code: This two-digit code was established by the American Hospital Association. The first digit identifies the region of the country (as defined by AHA), and the second digit identifies the state within the region. Modified FIPS County Codes: The FIPS County Codes were established by National Bureau of Standards, U.S. Department of Commerce in 1968, and are published in "Federal Information Processing Standards Publication - Counties and County Equivalents of the United States and the District of Columbia". The current version of this publication is No. 6-4 dated August 31, 1990. The basic structure of the codes is sequential, ascending, three-digit odd numbers. The County Codes used in the Area Resource File are those published in FIPS except as noted below: 1) No County Codes have been entered for Alaska, since it is expected that in analysis, the state will always be handled in its entirety. 2) Most independent cities have been included in their original counties because much of the data on the file is only available for counties and can not be separated into county and independent city segments. The following are carried as independent cities but have been recoded in the ARF modified FIPS as noted: ARF MODIFIED COUNTY STATE FIPS FIPS Baltimore City Maryland 007 510 St. Louis City Missouri 191 510 Carson City Nevada 025 510 The following cities have been combined into their original counties. Therefore on the ARF, all the data for the city is included in the original county (e.g., the independent city of Bristol, Va, is added into Washington county.) ARF ORIGINAL MODIFIED CITY STATE COUNTIES FIPS FIPS Columbus Georgia Muscogee 215 510 Kalawao County Hawaii Maui 009 005 Bedford Virginia Bedford 019 515 Bristol Virginia Washington 191 520 Page 007 Buena Vista Virginia Rockbridge 163 530 Charlottesville Virginia Albemarle 003 540 Clifton Forge Virginia Alleghany 005 560 Colonial Heights Virginia Chesterfield 041 570 Covington Virginia Alleghany 005 580 Danville Virginia Pittsylvania 143 590 Emporia Virginia Greensville 081 595 Fairfax Virginia Fairfax 059 600 Falls Church Virginia Fairfax 059 610 Franklin Virginia Southampton 175 620 Fredericksburg Virginia Spotsylvania 177 630 Galax Virginia Grayson 077 640 Harrisonburg Virginia Rockingham 165 660 Hopewell Virginia Prince George 149 670 Lexington Virginia Rockbridge 163 678 Lynchburg Virginia Campbell 031 680 Manassas Virginia Prince William 153 683 Manassas Park Virginia Prince William 153 685 Martinsville Virginia Henry 089 690 Norfolk Virginia Norfolk 129* 710 Norton Virginia Wise 195 720 Petersburg Virginia Dinwiddie 053 730 Poquoson Virginia York 199 735 Portsmouth Virginia Norfolk 129* 740 Radford Virginia Montgomery 121 750 Richmond Virginia Henrico 087 760 Roanoke Virginia Roanoke 161 770 Salem Virginia Roanoke 161 775 South Boston Virginia Halifax 083 780 Staunton Virginia Augusta 015 790 Suffolk Virginia Suffolk City 123** 800 Waynesboro Virginia Augusta 015 820 Williamsburg Virginia James City 095 830 Winchester Virginia Frederick 069 840 **NOTE: *FIPS does not have a code for Norfolk since it is no longer a county. The ARF designation of Norfolk County (ARF Mod FIPS Code 51129) includes the independent cities of Norfolk and Portsmouth, Virginia. **Nansemond county was revised to Nansemond city December 15, 1973. Nansemond city became a part of the city of Suffolk December 15, 1979. Suffolk independent city is recoded into 51123 on the ARF. As of November 1984, the following Virginia independent cities are treated as county equivalents, and as such, are maintained as separate entities on ARF: CITY (NEW MOD FIPS CODE) FORMER COUNTY ALLOCATION (OLD MOD FIPS CODE) Alexandria (51510) Arlington (51013) Chesapeake (51550) Norfolk (51129) Hampton (51650) Hampton/Newport News City (51084) Newport News (51700) Hampton/Newport News City (51084) Virginia Beach (51810) Norfolk (51129) Page 008 To the extent possible, historical data on ARF at the time of the change have been modified to separate data for these independent cities from data for their former counties. Where independent city data could not be broken out from county data, this fact has been noted in the sections of this User Documentation which describe the individual data elements and/or sources. Where this has occurred, the data are reported on ARF in the original county (or for Hampton/Newport News Cities, in Newport News-51650) and the city is zero-filled. FIPS Publication Change Notices put out by the U.S. Department of Commerce, National Technical Information Service state: 1) In January 1983, LaPaz County, Arizona (04012) was formed from the northern portion of Yuma County, Arizona (04027, which still exists with reduced boundaries). As of February 1995, LaPaz County and Yuma County are carried as separate records on the ARF. The new LaPaz County (04012) record should be combined with Yuma County (04027) when comparing data with historic files for consistency. 2) In June 1981, Cibola County, New Mexico (35006) was formed from portions of Valencia County, New Mexico (35061, which still exists with reduced boundaries). As of February 1995, Cibola County and Valencia County are carried as separate records on the ARF. The new Cibola County (35006) record should be combined with Valencia County (35061) when comparing data with historic files for consistency. 3) In September 1979, Ste. Genevieve, Missouri (29193) was renumbered so that the county falls in alphabetical order. The FIPS State and County Code is now 29186. 4) In September 1979, Washabaugh County, South Dakota (46131) merged with Jackson County, South Dakota (46071). The merged entity retains the name of Jackson and the code of 46071. On ARF, historical data for Washabaugh County have been combined with Jackson County. 5) Yellowstone National Park (Part), Wyoming (56047) was dropped as an entity. The county was dropped from ARF, and all non-zero fields were weighted by population and split between Park County, Wyoming (56029), and Teton County, Wyoming (56039). 6) In June 1970, Ormsby County was incorporated as the independent city of Carson City, Nevada. Carson City is recoded to 32025 on the ARF. Page 009 A-3) MSA, PMSA and CMSA Codes, Names and Levels; SMSA Code and Name; Rural/Urban Continuum Code; AMA County Group Code; and Census County Group Code. MSA, PMSA and CMSA Codes, Names and Levels: The Metropolitan Areas (MAs) were announced by the Office of Management and Budget in OMB Bulletin No. 93-05 to be effective December 31, 1992. They reflect the MA standards published on March 30, 1990 and the demographic data drawn from the 1990 Decennial Census. The previous term "Standard Metropolitan Statistical Area" (SMSA) was changed to describe two metropolitan areas, Metropolitan Statistical Area (MSA) and Primary Metropolitan Statistical Area (PMSA). An area is defined as an MSA if there is a city with a population of at least 50,000 or if there is an urbanized area of at least 50,000 population with a total metropolitan population of at least 100,000. In addition to the county containing the central city, an MSA may include additional counties having close economic/social ties to the central county. MSA's comprise entire counties, except for the six New England states, where towns/cities are the units of definition because of the lack of county governments. Except for this base unit, the same criteria are applied to define MSA's in New England as in the rest of the country. If an area has more than one million population and meets other requirements specified in the Metropolitan Area standards published in the Federal Register (55 FR 12154-12160, + ________________ March 30, 1990), it is termed a Consolidated Metropolitan Area (CMSA), consisting of two or more major components recognized as Primary Metropolitan Statistical Areas (PMSA's). On the ARF, the fields for MSA code and PMSA code were combined into one field, MSA/PMSA Codes, as were MSA names and PMSA names combined to form MSA/PMSA Names. The Alaska MSA/PMSA is coded as 0380. However, only Anchorage, Alaska is actually contained in the MSA/PMSA. In New England, MSA/PMSA's are defined with the town instead of the county as primary unit. In order to use county figures for New England in the same manner as other parts of the country with respect to MSA/PMSA's, ARF has used the New England Metropolitan State Economic Areas or population of the towns to resolve problems of MSA/PMSA's with partial counties or counties which cross MSA/PMSA's. With this resolution, several MSA/PMSA's have been redefined and several are not present on ARF as follows: 1120 Boston, MA-NH-ME-CT + ____________________________________________________________________ Bristol County, MA (25005) Essex County, MA (25009) Hampden County, MA (25013) - Included in MSA/PMSA 8000 on the ARF Middlesex County, MA (25017) Page 010 Norfolk County, MA (25021) Plymouth County, MA (25023) Suffolk County, MA (25025) Worcester County, MA (25027) Hillsborough County, NH (33011) Merrimack County, NH (33013) Rockingham County, NH (33015) Stafford County, NH (33017) York County, ME (23031) Windham County, CT (09015) - Included in MSA/PMSA 3280 on the ARF 1200 Brockton, MA (Not Present on the ARF) + ____________________________________________________________________ Bristol County (25005) -Included in MSA/PMSA 1120 on the ARF Norfolk County (25021) -Included in MSA/PMSA 1120 on the ARF Plymouth County (25023) -Included in MSA/PMSA 1120 on the ARF 1160 Bridgeport, CT + ____________________________________________________________________ Fairfield County (09001) New Haven County (09009) - Included in MSA/PMSA 5480 on the ARF 1930 Danbury, CT (Not Present on the ARF) + ____________________________________________________________________ Fairfield County (09001) - Included in MSA/PMSA 1160 on the ARF Litchfield County (09005) - Included in MSA/PMSA 8880 on the ARF 5350 Nashua, NH (Not Present on the ARF) + ____________________________________________________________________ Hillsborough County (33011) - Included in MSA/PMSA 1120 on the ARF Rockingham County (33015) - Included in MSA/PMSA 1120 on the ARF 5480 New Haven-Meriden, CT + ____________________________________________________________________ Middlesex County (09007) - Included in MSA/PMSA 3280 on the ARF New Haven County (09009) 3280 Hartford, CT + ____________________________________________________________________ Hartford County (09003) Litchfield County (09005) - Included in MSA/PMSA 8880 on the ARF Middlesex County (09007) New London County (09011) - Included in MSA/PMSA 5520 on the ARF Tolland County (09013) Windham County (09015) Page 011 5520 New London-Norwich, CT-RI + ____________________________________________________________________ Middlesex County, CT (09007) - Included in MSA/PMSA 3280 on the ARF New London County, CT (09011) Windham County, CT (09015) - Included in MSA/PMSA 3280 on the ARF Washington County, RI (44009) - Included in MSA/PMSA 6480 on the ARF 6480 Providence-Fall River-Warwick, RI-MA + ____________________________________________________________________ Bristol County, RI (44001) Kent County, RI (44003) Newport County, RI (44005) Providence County, RI (44007) Washington County, RI (44009) Bristol County, MA (25005) - Included in MSA/PMSA 1120 on the ARF Norfolk County, MA (25025) - Included in MSA/PMSA 1120 on the ARF Worcester County, MA (25027) - Included in MSA/PMSA 1120 on the ARF 6400 Portland, ME + ____________________________________________________________________ Cumberland County (23005) York County (23031) - Included in MSA/PMSA 1120 on the ARF 8040 Stamford-Norwalk, CT (Not Present on the ARF) + ____________________________________________________________________ Fairfield County (09001) - Included in MSA/PMSA 1160 on the ARF 8880 Waterbury, CT + ____________________________________________________________________ Litchfield County (09005) New Haven County (09009) - Included in MSA/PMSA 5480 on the ARF MSA's and PMSA's are categorized by their 1990 population as follows: 1 = Level A = Areas of 1 million or more 2 = Level B = Areas of 250,000 to 999,999 3 = Level C = Areas of 100,000 to 249,999 4 = Level D = Areas of less than 100,000 Page 012 SMSA Code and Name: This code, established by the National Bureau of Standards, U.S. Department of Commerce, was first issued in 1949 as Standard Metropolitan Areas. The Standard Metro- politan Statistical Area (SMSA) codes were posted from the Federal Information Processing Standards (FIPS) Publication 8-4, June 30, 1974, prepared by the U.S. Department of Commerce, National Bureau of Standards with the exception of the SMSA's as follows: 1) In New England, SMSA's are defined with the town instead of the county as the primary unit. In order to use county figures for New England in the same manner as other parts of the country with respect to SMSA's, ARF has used the New England Metropolitan State Economic Areas instead of SMSA's. Definitions of and codes for these areas follow: 0002 - Lewiston-Auburn, ME + ________________________________________ Androscoggin County (23001) 0004 - New London-Groton-Norwich, CT + ________________________________________ New London County (09011) 1120 - Boston, MA + ________________________________________ Essex County (25009) Middlesex County (25017) Norfolk County (25021) Suffolk County (25025) 1160 - Bridgeport, CT + ________________________________________ Fairfield County (09001) 1200 - Brockton, MA + ________________________________________ Plymouth County (25023) 2480 - Fall River-New Bedford, MA + ________________________________________ Bristol County (25005) 3280 - Hartford, CT + ________________________________________ Hartford County (09003) 4760 - Manchester, NH + ________________________________________ Hillsborough County (33011) Page 013 5480 - New Haven-West Haven, CT + ________________________________________ New Haven County (09009) 6320 - Pittsfield, MA + ________________________________________ Berkshire County (25003) 6400 - Portland, ME + ________________________________________ Cumberland County (23005) 6480 - Providence-Warwick-Pawtucket, RI-MA + ________________________________________ Bristol County (44001) Kent County (44003) Providence County (44007) 8000 - Springfield-Chicopee-Holyoke, MA-CT + ________________________________________ Hampden County (25013) Hampshire County (25015) 9240 - Worcester, MA + ________________________________________ Worcester County (25027) 2) Georgia SMSA with exception is: 1800 - Columbus, GA-AL + ________________________________________ Muscogee County (13215) still included because it contains Columbus, GA. 3) Virginia SMSA with exception is: 6140 - Petersburg-Colonial Heights-Hopewell, VA + ________________________________________ Colonial Heights City (51570) excluded; it is part of Chesterfield County (51041), which is in another SMSA. The updated 1975 SMSA Codes are from the Office of Management and Budget (OMB) Revised Circular A-46. The 1979 SMSA Codes are from the Federal Information Processing Standards (FIPS) Publication 8-4, June 30, 1974 and from Change Notices 6, 7 and 8, dated December 11, 1978, May 4, 1979 and November 23, 1979 respectively. The updates include new designations, redefinitions and changes of titles. The 1980 SMSA Codes and Names are from the Federal Information Processing Standards (FIPS) Publication 8-4, June 30, 1974 Change Notice 9, dated August 1, 1981. The SMSA Names have been abbreviated so as not to exceed 35 characters. Page 014 Rural/Urban Continuum Code: The 1994 Rural/Urban Continuum Codes are from "Rural-Urban Continuum Codes for Metro and Nonmetro Counties", Department of Agriculture. The codes form a classification scheme that distinguishes metropolitan counties by size and nonmetropolitan counties by degree of urbanization or proximity to metropolitan areas. All U.S. counties and county equivalents are grouped according to the official metropolitan status announced by the Office of Management and Budget in June 1993, when the current population and commuting criteria were first applied to results of the 1990 Census of Population. The 1994 codes are a revised version of the 1993 Rural/Urban Continuum Codes. NAME DESCRIPTION CODE Metropolitan Counties: Large Metropolitan: Central counties of metro areas 00 Central Counties of 1 million population or more Fringe Counties: Fringe counties of metro areas 01 of 1 million population or more Medium Metropolitan: Counties in metro areas of 250,000 02 to 1 million population Lesser Metropolitan: Counties in metro areas of fewer 03 than 250,000 population Nonmetropolitan Counties Urbanized: Urban population of 20,000 or more, 04 Adjacent to MSA adjacent to a metro area Not Adjacent to MSA: Urban population of 20,000 or more, 05 not adjacent to a metro area Less Urbanized: Urban population of 2,500 to 19,999 06 Adjacent to MSA adjacent to a metro area Not Adjacent to SMSA: Urban population of 2,500 to 19,999 07 not adjacent to a metro area Thinly Populated: Completely rural or fewer than 2,500 08 Adjacent to MSA urban population, adjacent to a metro area Not Adjacent to MSA: Completely rural or fewer than 2,500 09 urban population, not adjacent to a metro area Missing Value: 99 Page 015 **NOTE: 1) Adjacent = Counties physically adjacent to one or more MSA's and having at least 2 percent of the employed labor force in the nonmetropolitan county commuting to central metropolitan counties. 2) Data for Alaska were reported by boroughs and census areas in the source data. Alaska is carried as one total area (02001) on the ARF, therefore it was given a missing value code (99). 3) Data were not reported for Yellowstone Park, Montana (30113). 4) The rural/urban code for Virginia counties which include independent cities are based on the characteristics of the county plus each city (or cities) combined with that county. The combinations made on the source data are consistent with the ARF except as noted below: - The code for Carroll County, Virginia (51035) includes characteristics from the Virginia city of Galax which is normally included in Grayson County (51077). - Arlington County, Virginia (51013) and Alexandria City (51510) have the same code reflecting the combined characteristics of Arlington - Alexandria. - Chesapeake City, Virginia (51550) and Norfolk/Portsmouth cities (51129) have the same code reflecting the combined characteristics of Chesapeake - Norfolk - Portsmouth. - York County, Virginia (51199-which also includes Poquoson), Hampton City (51650) and Newport News City (51700) have the same code reflecting the combined characteristics of York-Poquoson-Hampton-Newport News. AMA County Group Code: The 1978 codes were obtained from "Physician Distribution and Medical Licensure in the U.S., 1978", Center for Health Services Research and Development, published by the American Medical Association (AMA). These codes consist of nine classifications based on Sales & Marketing Management's population estimates and SMSA definitions. They were developed by AMA's Department of Survey Research. The former "County Group Classification" of five groups was revised in 1967 to include nine categories, and was renamed the "Demographic County Classification". DEMOGRAPHIC COUNTY CLASSIFICATION DEFINITION 1 Non-Metropolitan Counties with 0 to 9,999 Inhabitants 2 Non-Metropolitan Counties with 10,000 to 24,999 Inhabitants 3 Non-Metropolitan Counties with 25,000 to 49,999 Inhabitants 4 Non-Metropolitan Counties with 50,000 or more Inhabitants 5 Counties Considered Potential SMSA's 6 Counties in SMSA's with 50,000 to 499,999 Inhabitants 7 Counties in SMSA's with 500,000 to 999,999 Inhabitants 8 Counties in SMSA's with 1,000,000 to 4,999,999 Inhabitants 9 Counties in SMSA's with 5,000,000 or more Inhabitants Page 016 The Standard Metropolitan Statistical Areas which are utilized in Classifications 6 through 9 are Sales & Marketing Management's SMSA definitions of the metropolitan area concept established by the United States Bureau of the Budget. Sales & Marketing Management and the Bureau of the Budget use identical SMSA definitions except for a few instances in New England where the former uses the county unit rather than the township as the geographical boundary. Demographic County Classification 5 contains "Potential SMSA's" which, as defined by Sales & Marketing Management, are considered future candidates for SMSA status. Demographic County Classifications 1 through 4 are non-metropolitan areas. **NOTE: Data for 1978 were not reported for the following counties: 02001 - Alaska 30113 - Yellowstone Park, Montana Census County Group Code: The Census County Group Codes are groups of counties smaller than a state, but larger than a county, which are geographically adjacent and have similar characteristics. There are 410 County Group Codes. These codes were extracted from the 1970 County Group Reference File obtained from the Bureau of the Census. **NOTE: 1) Data are not available for: 06039 - Madera, California 2) Norfolk, Virginia (51129) was coded as '02002', which is the Census County Group Code for Norfolk City, because it represents the greater population of the two independent cities comprising this county. A-4) Economic Area Codes BEA Economic Area Code and Name: The BEA Economic Area Code is delineated by the Bureau of Economic Analysis, U.S. Department of Commerce, revised 1977. BEA Economic Areas, originally called OBE Economic Areas, were first delineated in 1969 by the Regional Economics Division, Office of Business Economics, U.S. Department of Commerce. The areas are named for the largest SMSA or, where there is no SMSA, for the largest city. The 1977 delineation resulted in 183 areas and was based primarily on three sets of data: (1) Journey-to-work data from the 1970 Census of Population; (2) Newspaper circulation data for 1972; and (3) 1975 county commuting data developed from Social Security Administration and Internal Revenue Service records. The BEA names have been abbreviated so as not to exceed 35 characters. Page 017 A-5) Federal Region Code and Census Region and Division Codes and Names These are the codes for the ten Federal Regional Offices from the Department of Health and Human Services. The Federal Region Codes, Regional Office names and the states within each region are as follows: 01 = Boston R.O. (Maine, Vermont, Mass., Conn., R.I., N.H.) 02 = New York R.O. (N.Y., N.J., Puerto Rico, Virgin Islands) 03 = Philadelphia R.O. (Penn., Del., D.C., Maryland, Va., W. Va.) 04 = Atlanta R.O. (Ala., Fla., Georgia, Ky., Miss., N.C., S.C., Tenn.) 05 = Chicago R.O. (Ill., Indiana, Minn., Michigan, Ohio, Wisconsin) 06 = Dallas R.O. (Arkansas, N.M., Oklahoma, Texas, Louisiana) 07 = Kansas City R.O. (Iowa, Kansas, Missouri, Nebraska) 08 = Denver R.O. (Colo., Montana, N.D., S.D., Utah, Wyoming) 09 = San Francisco R.O. (Ariz., Calif., Hawaii, Nev., Trust Territories) 10 = Seattle R.O. (Alaska, Idaho, Oregon, Washington) The Census Region Codes and Names and Census Division Codes and Names were taken from the ORP HSA ACCESS System. The codes and names are as follows: ACCESS SYSTEM CODES NAME STATES INCLUDED Region Division 1 Northeast 1 New England Maine, Vermont, Massachusetts, New Hampshire, Connecticut, Rhode Island 2 Middle Atlantic New York, New Jersey, Pennsylvania 2 Midwest 3 East North Central Ohio, Michigan, Indiana, Illinois, Wisconsin 4 West North Central Minnesota, Iowa, Missouri, Kansas, Nebraska, South Dakota, North Dakota 3 South 5 South Atlantic Delaware, Maryland, District of Columbia, Virginia, West Virginia, North Carolina, South Carolina, Georgia, Florida 6 East South Central Kentucky, Tennessee, Mississippi, Alabama Page 018 ACCESS SYSTEM CODES NAME STATES INCLUDED Region Division 7 West South Central Arkansas, Louisiana, Texas, Oklahoma 4 West 8 Mountain Montana, Wyoming, Colorado, New Mexico, Arizona, Utah, Idaho, Nevada 9 Pacific Washington, Oregon, California, Alaska, Hawaii A-6) Health Service Area (HSA) Codes and Name ORP has assigned a six-digit code to the 205 Health Service Areas (HSA's) designated by the Secretary of DHHS. The areas were delineated in response to the National Health Planning and Resources Development Act of 1974 (P.L.93-641). (The states of D.C., Hawaii, and Rhode Island are not included since they have claimed exemption from designating areas under Section 1536 of the Act. Final determinations on those actions are pending.) Of the 205 HSA's, 190 are entirely within state boundaries. The remaining fifteen are interstate areas. Twelve states have been designated as single statewide areas. Only 199 of the 205 designated HSA's have been included on ARF. The six-digit HSA Code is defined as follows: STX0NN Where -- + ______ ST = FIPS State Code **NOTE: A State Code of '99' has been assigned to interstate areas for sorting purposes. X = Type of Area: A = Regular State Area or Single State Area E = Exempted State Area I = Interstate Area NN = Area Number, 1 through 15 Page 019 A four-character HSA Code required by the ACCESS System has been added. This code is defined as STNN, where: ST = the two-character standard FIPS alphabetic abbreviation **NOTE: An abbreviation of 'IS' has been assigned to interstate areas. NN = Area Number, 1 through 15 a) The following states have claimed exemptions from designating HSA's: 6-DIGIT 4-CHARACTER EXEMPTED STATES HSA CODE HSA CODE + _______________ ________ ________ Dist. of Columbia 11E001 DC01 Hawaii 15E002 HA02 Rhode Island 44E003 RI03 b) There are twelve single-state HSA's: Delaware, Idaho, Maine, Mississippi, Montana, New Hampshire, Oklahoma, South Dakota, Vermont, West Virginia, Wyoming, and Puerto Rico (Puerto Rico is not included in this tabulation.) c) There are fifteen interstate HSA's defined as follows: INTERSTATE AREAS SAME AS THESE OVERLAP AREAS + ________________ ___________________________ 99I001 (IS01) Arizona A004 **NOTE: This Tri-State HSA en- Utah A002 compasses the Navajo New Mexico A002 Reservation and is not defined on the file since it does not follow county lines and contains only small parts of counties. 99I002 (IS02) Georgia A001 Tennessee A003 99I003 (IS03) Georgia A004 South Carolina A005 99I004 (IS04) Georgia A005 Alabama A007 Page 020 99I005 (IS05) Iowa A001 Nebraska A004 99I006 (IS06) Iowa A002 Nebraska A003 99I007 (IS07) Iowa A003 Illinois A010 99I008 (IS08) Kentucky A003 Ohio A001 99I009 (IS09) Minnesota A001 North Dakota A002 99I010 (IS10) Minnesota A002 Wisconsin A007 99I011 (IS11) Minnesota A003 North Dakota A003 99I012 (IS12) Missouri A001 Kansas A004 99I013 (IS13) Missouri A003 Illinois A011 99I014 (IS14) New York A004 Pennsylvania A008 99I015 (IS15) Tennessee A001 Virginia A006 d) Because the HSA covers only part of the county, the following areas are defined as follows: STATE AREA COUNTIES INCLUDED + _____________ ______ ___________________ Arizona A001 Gila (FIPS Code 04007) Maricopa (FIPS Code 04013) Pinal (FIPS Code 04021) A002 Cochise (FIPS Code 04003) Graham (FIPS Code 04009) Greenlee (FIPS Code 04011) Pima (FIPS Code 04019) Santa Cruz (FIPS Code 04023) A003 Apache (FIPS Code 04001) Coconino (FIPS Code 04005) Navajo (FIPS Code 04017) Yavapai (FIPS Code 04025) Page 021 A004 **NOTE: This area not defined (Parts of Apache (04001) and Navajo (04017) counties, Arizona are included in Arizona A003) A005 Mohave (FIPS Code 04015) Yuma (FIPS Code 04027) Connecticut A001 Fairfield (FIPS Code 09001) A002 New Haven (FIPS Code 09009) A003 Middlesex (FIPS Code 09007) New London (FIPS Code 09011) Windham (FIPS Code 09015) A004 Hartford (FIPS Code 09003) Tolland (FIPS Code 09013) A005 Litchfield (FIPS Code 09005) Illinois A006 **NOTE: This area not defined (Chicago included with Cook County (17031) in Illinois A007) A007 Cook (FIPS Code 17031) Dupage (FIPS Code 17043) Massachusetts A001 Berkshire (FIPS Code 25003) Franklin (FIPS Code 25011) Hampden (FIPS Code 25013) Hampshire (FIPS Code 25015) A002 Worchester (FIPS Code 25027) A003 Essex (FIPS Code 25009) Middlesex (FIPS Code 25017) A004 Norfolk (FIPS Code 25021) Suffolk (FIPS Code 25025) A005 Barnstable (FIPS Code 25001) Bristol (FIPS Code 25005) Dukes (FIPS Code 25007) Nantucket (FIPS Code 25019) Plymouth (FIPS Code 25023) Page 022 A006 **NOTE: This area not defined (The part counties of Essex (25009) and Middlesex (25017) are included in Massachusetts A003) New Mexico A001 All Counties in New Mexico A002 **NOTE: This area not defined (Parts of McKinley (35031) and San Juan (35045) are included in New Mexico A001) Utah A001 All Counties in Utah A002 **NOTE: This area not defined (Part of San Juan County (49037) included