RUPRI Center for Rural Health Policy Analysis

Rural Data Brief

Brief No. 2020-2 MARCH 2023 http://www.public-health.uiowa.edu/rupri/

 

Confirmed COVID-19 Cases, Metropolitan and Nonmetropolitan

Counties
Fred Ulirich, BA; and Keith Mueller, PhD

Report

Early COVID-19 focus was on major metropolitan areas, but rural areas of the United States
have also been hit hard by the pandemic. As of March 9, 2023, there were a total of
101,743,040 cases and 1,104,215 deaths identified in counties, with 14,325,143 cases and
200,161 deaths (about 14.1 percent of cases and 18.1 percent of deaths) reported in non-

metropolitan counties (data obtained from the Johns Hopkins University COVID-19 Data
Repository*).

Map 1. Counties with confirmed COVID-19 Cases

Counties with COVID-19 Cases
March 9, 2023
Metro cases: 87,417,897 Nonmetro cases: 14,325,143
*Metro rate: 3,158 Nonmetro rate: 3,109

 

     

|:| Ieetro, 2, 000 mazes 10K
|:| Meletro, 2,000-2,998 8 mses 10K
- heetro, 3,000-2, 488 8 mzes 10K
- Metro, 3, 5005 mses 10K
l:l Monmet, <2 000 mses 10K
|:| Monmet, 20002, 998 8 mses 10K]
- Monmet, 3,000,498 8 ses 10K]
- Monmet, 3, 500 mses /10K

NOTE: Cate, thres hold Bed
22 e A

* Confirmed cases /10,000 population based on 2018 ACS S-yr estimates.
Rural Policy Research Institute (RUPRI) Data source:Johns Hopkins University CS5E COVID-19 Data
University of lowa, College of PublicHealth https:/fgithub.com/CSSEGISandData/COVID-19

This project was supported by the Federal ™ RUPRI Center for Rural
R I I R C Office of Rural Health Policy r U ~ r I Health Policy Analysis,

Rural Health Research (FORHP), Health Resources and Services University of Iowa College

 

 

 

& Policy Centers Administration (HRSA), U.S. of Public Health,
fundedoy e Teteral ofee ol Pl eatn Poley Department of Health and Human Services MAIEAL ERRL BESEARSH (RTINS Department of Health
; (HHS) under cooperative agreement/grant Management and Policy, 145 Riverside Dr., Iowa City, IA
#1U1GRHO07633 and #U1C RH20419. The information, conclusions and 52242-2007, (319) 384-3830
opinions expressed in this policy brief are those of the authors and no http://www.public-health.uiowa.edu/rupri

 

endorsement by FORHP, HRSA, HHS is intended or should be inferred. E-mail: cph-rupri-inquiries@uiowa.edu
But as many experts have pointed out, the rate of growth in cases is very different depending
on location. Further, the stress on the health care delivery system is proportionate - a small
number of cases creates stress for low-capacity systems just as a large volume of cases
creates stress for larger capacity systems.

Note that this document reports on confirmed COVID-19 cases and those numbers will be
affected by the availability and utilization of testing resources. Recent and updated maps,
and the "progression" of cases throughout the country, can be seen on the animated map on
the RUPRI Health web site:

http://ruprihealth.org/publications/policybriefs/2020/COVID History/

Map 1 (above) displays the rates of confirmed COVID-19 cases in metropolitan and
nonmetropolitan counties. Table 1 shows metropolitan and nonmetropolitan county confirmed
case and death counts. It also depicts the rate of cases and deaths per 10,000 population
(based on the 2018 American Community Survey 5-year estimates). Finally, it shows the
number and proportion of metropolitan and nonmetropolitan counties exceeding various case
and death rate levels. Map 2 displays the rates of COVID-19 deaths in metropolitan and
nonmetropolitan counties.

Table 1. Metropolitan and Nonmetropolitan Counties. Confirmed cases, deaths, and rates

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Metropolitan Nonmetropolitan

Counties (total) 1,166 1,976
Population (2010 census) 276,820,000 46,082,565

Counties w/ confirmed cases 1,165 (99.9%) 1,972 (99.8%)
Counties w/ deaths 1,165 (99.9%) 1,961 (99.2%)
Confirmed cases 87,417,897 (31.6%) 14,325,143 (31.1%)
Deaths 904,054 (0.3%) 200,161 (0.4%)
Cases/10K population 3,158 3,109
Deaths/10K population 32.66 43.44

Counties w/ 1000+ cases/10K 1,163 (99.7%) 1,970 (99.7%)
Counties w/ 1500+ cases/10K 1,159 (99.4%) 1,944 (98.4%)
Counties w/ 2000+ cases/10K 1,001 (85.8%) 1,519 (76.9%)
Counties w/ 5+ deaths/10K 1,165 (99.9%) 1,957 (99.0%)
Counties w/ 10+ deaths/10K 1,161 (99.6%) 1,930 (97.7%)
Counties w/ 25+ deaths/10K 914 (78.4%) 1,738 (88.0%)
Counties w/ 50+ deaths/10K 186 (16.0%) 758 (38.4%)

 

 

 

 

 

Data sources: COVID-19 case and death data from the COVID-19 Data Repository by the Center for Systems
Science and Engineering (CSSE) at Johns Hopkins University. Population data from the 2018 American
Community Survey 5-yr estimates.

 

*COVID-19 case and death data for this ongoing report were previously obtained from USAFacts.org. Reports
after 8/15/2020 use data from the COVID-19 Data Repository by the Center for Systems Science and Engineering
(CSSE) at Johns Hopkins University. Similarly, previous reports had used population data from the U.S. 2010
decennial Census. Current reports utilize data from the Census Bureau's 2018 American Community Survey 5-
year population estimates.

 

Additional changes were made to the report starting 4/26/2021 to better account for the Utah practice of
providing aggregated incidence and mortality data for less populous counties.

All data in this brief are based on county-level counts to facilitate metropolitan/nonmetropolitan reporting. Cases
and deaths that could not be attributed to a county are excluded. This means that national figures are
undercounts.
Map 2. Counties with COVID-19 Deaths
Counties with COVID-19 Deaths

 

March 9, 2023
Metro deaths: 904,054 Nonmetro deaths: 200,161
*Metro rate; 32.66 Nonmetro rate; 43.44

   
 

{
A [ werm. 30eatmioox

- Metro, 23948 deaths /10K
- hetro., 348 8 deaths /10K

- NMetro, 50+ demthe /10K
:l Monmet., <23 death /10K

- Monmet., 25348 death /10K
- Monmet., 3548 8 deathe /10K

- Honmet. S0F denthe /10K

NOTE: Category thres holds we e revaed|
s mfiflm: e port.

*Deaths /10,000 population based on 2018 ACS S-yr estimates.
Rural Policy Research Institute (RUPRI) Data source:lohns Hopkins University C55E COVID-19 Data
https://github.com/CSSEGISandData/COVID-19

 

 

University of lowa, College of PublicHealth

 

Data for this ongoing report has been sourced - since August 2020 - from the Johns Hopkins
Coronavirus Resource Center. Citing consistent declines in public reporting of pandemic data
from U.S. states, Johns Hopkins announced that it would cease data collection and reporting
activities on March 10, 2023. We too have observed increasingly inconsistent data reporting

and support that decision. The loss of this valuable data resource, coupled with the

impending expiration of the public health emergency (currently set to expire May 11, 2023)
has led to our decision to conclude regular reporting of COVID-19 incidence and mortality

with this issue.
Map 3. State Metropolitan/Nonmetropolitan COVID-19 One-week Case Rates

 

Metropolitan/Nonmetropolitan COVID-19 Cases

New cases for week ending: March 9, 2023

Metropolitan case rate
Monmetropolitan case rate

State case rate=national median
{ower5.50 cases/ 10,000 population)

 

*Cases /10,000 population based an 2018 ACS S-yrestimates.
Rural Policy Research Institute (RUPRI) Datasource:Johns Hopkins University C55E COVID-19 Data
University of lowa, College of Public Health https://github.com/CSSEGISandData/COVID-19