The 2024 Annual Data Release used data from 2019-2021 for this measure

Data Source

"National Center for Health Statistics - Mortality Files: Data on deaths and births were provided by NCHS and drawn from the National Vital Statistics System (NVSS). These data are submitted to the NVSS by the vital registration systems operated in the jurisdictions legally responsible for registering vital events (i.e., births, deaths, marriages, divorces, and fetal deaths). In prior years of the Rankings, Premature Death was calculated by the National Center for Health Statistics, but the Mortality-All County (micro-data) file was requested this year. This allowed us to calculate Premature Death and Life Expectancy ourselves. While most calculations of mortality rates can be downloaded from CDC WONDER, the calculation of Years of Potential Life Lost and Life Expectancy requires raw data files."

Measure Methods

• "Premature Death is a rate: Rates measure the number of events (i.e., deaths, births) in a given period (generally one or more years) divided by the average number of people at risk during that period. Rates help us compare data across counties with different population sizes. All the years of potential life lost in a county during three years are summed and divided by the county's total population during that same period. This value is multiplied by 100,000 to calculate the years of potential life lost under 75 per 100,000 people."

• "Premature Death is age-adjusted: Age is a non-modifiable risk factor, and poor health outcomes are more likely as age increases. We report an age-adjusted rate to compare counties with differing age structures fairly. YPLL is age-adjusted to the 2000 US population."

• "Premature Death is a rare event (statistically speaking): Premature death is a relatively rare event in most counties. Counties with smaller populations can see a lot of change in their rates of premature death data from year to year. Such changes are usually due to normal variation and are not necessarily caused by any change in the county's underlying risk of premature death. To help determine if the premature death change in a county is due to normal variation or real change, we recommend examining the provided error margins. Error margins are statistical tools that can aid the interpretation of measure variation. If the error margins overlap year to year, the variation in premature death is less likely to reflect real underlying changes."

• "What deaths count toward Premature Death?: Deaths are counted in the county where the individual lived, regardless of where the death occurred."

• "Some data are suppressed: A missing value is reported for counties with fewer than 20 deaths in the three-year timeframe."

• "Measure limitations: YPLL can be difficult for public health practitioners to interpret and communicate with others. For example, the Florida Health Department’s Epidemiology Bureau found that county public health units often do not understand how to interpret YPLL. Deaths occurring after the age limit are not acknowledged in measures of premature death. Because of this, YPLL can fail to completely capture the burden of chronic disease, especially if the age cut-off is set too low."

• "Numerator: The numerator is the cumulative number of years of potential life lost from deaths among county residents under age 75 over three years."

• "Denominator: The denominator is the aggregate population under age 75 for the three years from the bridged-race postcensal estimates of the July 1 resident population released by the National Center for Health Statistics. Please note the release of postcensal bridged-race population estimates ceased with the release of the Vintage 2020 estimates."

• "Can This Measure Be Used to Track Progress? This measure can be used to track progress with some caveats. Premature death is a long-term health outcome; the effects of interventions might not be reflected in this measure for years or even decades after a program or policy is implemented. Premature death is also a relatively rare event, especially in small counties. Statistics depend on large numbers of events to detect small changes, meaning that small changes in small communities may be difficult to detect. It is important to note that the estimate provided in the County Health Rankings is a 3-average. Sometimes, single-year YPLL estimates may better measure progress over time."

Source: Premature Death | County Health Rankings & Roadmaps

References

• Centers for Disease Control and Prevention. Premature mortality in the United States: Public health issues in using years of potential life lost. Morbidity and Mortality Weekly Report. 1986;35(suppl 2):1S-11S.

• McDonnell S, Vossberg K, Hopkins RS, Mittan B. Using YPLL in health planning. Public Health Reports. 1998;113:55-61.

• Dranger E, Remington P. YPLL: A Summary Measure of Premature Mortality Used in Measuring the Health of Communities. Madison, WI: University of Wisconsin Population Health Institute. 2004; 5(7).