2010-2012 National Surveys on Drug Use and Health:
Guide to Substate Tables and Summary
of Small Area Estimation Methodology

Section A: Overview

A.1. Introduction

This document provides a guide on the development and presentation of model-based small area estimates of the prevalence of substance use and mental disorders in substate regions based on data from the combined 2010-2012 National Surveys on Drug Use and Health (NSDUHs). The estimates along with this document and other related information are available at https://www.samhsa.gov/data/sites/default/files/substate2k12-StateTabs/NSDUHsubstateStateTabsTOC2012.htm.

An annual survey of the civilian, noninstitutionalized population aged 12 or older, NSDUH is sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). It collects information from persons residing in households, noninstitutionalized group quarters (e.g., shelters, rooming houses, dormitories), and civilians living on military bases. In 2010-2012, NSDUH collected data from 206,222 respondents aged 12 or older and was designed to obtain representative samples from the 50 States and the District of Columbia. The survey is planned and managed by SAMHSA's Center for Behavioral Health Statistics and Quality (CBHSQ). Data collection and analysis were conducted under contract with RTI International.1

This marks the sixth time2 that estimates for substate regions (also referred to as planning regions or substate areas) in all 50 States and the District of Columbia have been presented by SAMHSA. Here, substate-level small area estimates are provided for 25 binary (0, 1) substance use or mental health measures, using combined data from the 2010-2012 NSDUHs for persons aged 12 or older (or persons 18 or older for the four mental disorders, and persons aged 12 to 20 for underage alcohol and binge alcohol use). For a list of outcomes for which substate level estimates are available, refer to Table A1 in Appendix A. These substate estimates are available at https://www.samhsa.gov/data/sites/default/files/substate2k12-StateTabs/NSDUHsubstateStateTabsTOC2012.htm. The list of products (e.g., tables, maps, substate region definitions) related to the 2010-2012 substate estimates is provided in Section A.2.

Estimates for 384 substate regions were generated using the 2010-2012 NSDUH data. These substate regions were defined by officials from each of the 50 States and the District of Columbia and were typically based on the substance abuse treatment planning regions specified by the States in their applications for the Substance Abuse Prevention and Treatment Block Grant (SABG) administered by SAMHSA. The SABG program provides financial and technical assistance to the 50 States, the District of Columbia, and other jurisdictions to support substance abuse prevention and treatment programs and to promote public health. States use NSDUH substate estimates for a variety of purposes, including strategic planning and program development, production of epidemiological profiles for briefing State legislatures and informing the public, allocating funds to substate areas based on the need for services, and other uses. More information on defining these regions is available in Section A.3.

Section A.4 discusses the methodological changes that were introduced in the 2002 NSDUH. An unanticipated result of these changes was that the prevalence rates for 2002 were in general substantially higher than those for 2001. As a result, the 1999-2001 substate estimates are not comparable with the other substate estimates.

Section B provides information on the small area estimation (SAE) methodology used to produce substate estimates. Section C includes the population estimates and the combined 2010, 2011, and 2012 NSDUH sample sizes and response rates for each substate region. Users may find the population estimates helpful in calculating the prevalence estimate for any combination of substate regions or to determine the number of people using a particular substance in a substate region. For example, the number of persons aged 12 or older who used marijuana in the past month in Alabama's Region 1 (56,612 persons) can be obtained by multiplying the prevalence rate (5.07 percent from Table 3) in the "2010-2012 NSDUH Substate Regions: Excel Tables" (see https://www.samhsa.gov/data/sites/default/files/substate2k12-StateTabs/NSDUHsubstateStateTabsTOC2012.htm) and the population estimate from Table C1 (1,116,614) in this document. Section D lists the references cited in this document, and Section E provides a list of contributors to the production of the 2010-2012 substate estimates.

A.2. Presentation of Findings

The following products associated with the 2010-2012 substate estimates are available at https://www.samhsa.gov/data/sites/default/files/substate2k12-StateTabs/NSDUHsubstateStateTabsTOC2012.htm:

Note that other products may be added to the 2010-2012 NSDUH substate homepage at a later date.

A.3. Formation and Ranking of Substate Regions

The substate regions for each State were developed in a series of communications during the fall of 2013 between SAMHSA staff and State officials responsible for the SABG application. There is extensive variation in the size and use of substate regions across States. In some States, the substate regions are used more for administrative purposes rather than for planning purposes. The goal of the project was to provide substate-level estimates showing the geographic distribution of substance use prevalence for regions that States would find useful for planning and reporting purposes. The final substate region boundaries were based on the State's recommendations, assuming that the NSDUH sample sizes were large enough to provide estimates with adequate precision. Most States defined regions in terms of counties or groups of counties. A few States defined the regions in terms of census tracts. Several States also requested estimates for aggregate substate regions, along with the estimates for their substate regions. An aggregate substate region is made up of two or more substate regions. These substate region definitions are available in a document titled "2010-2012 NSDUH Substate Region Definitions" (see https://www.samhsa.gov/data/sites/default/files/substate2k12-StateTabs/NSDUHsubstateStateTabsTOC2012.htm as listed above in Section A.2). Some of the States (specifically, New Hampshire, New York, North Carolina, Texas, and Washington) wanted the maps to be produced only for the aggregate regions. For example, New York has 15 substate regions, and those 15 regions were combined to create 4 aggregate regions that are used in the maps. Hence, for each measure, maps were produced for 363 regions and not for 384 regions.

These 363 substate regions used in the maps were ranked from lowest to highest for each measure and were divided into seven categories designed to represent distributions that are somewhat symmetric, like a normal distribution. Colors were assigned to all substate regions such that the third having the lowest prevalence are in blue (121 substate regions), the middle third are in white (121 substate regions), and the third with the highest prevalence are in red (121 substate regions). The only exceptions were the three perception-of-risk outcomes shown in Figure 4 (marijuana), Figure 11 (alcohol), and Figure 16 (cigarettes) of the national maps, which have the highest estimates represented in blue and the lowest represented in red. To further distinguish among the substate regions that display relatively higher prevalence, the "highest" third in red has been further subdivided into (a) dark red for the 16 substate regions with the highest estimates, (b) medium red for the 33 substate regions with the next highest estimates, and (c) light red for the 72 substate regions in the third highest group. The "lowest" third is categorized in a similar way using three distinct shades of blue. In some cases, a group (or category) could have more or fewer substate regions because two (or more) substate regions have the same estimate (to two decimal places). When such ties occurred at the "boundary" between two groups, all substate regions with the same estimate were assigned to the lower group. These national maps are available at https://www.samhsa.gov/data/sites/default/files/substate2k12-StateTabs/NSDUHsubstateStateTabsTOC2012.htm as listed in Section A.2.

The 2010-2012 substate estimates and corresponding Bayesian CIs are available in the "2010-2012 NSDUH Substate Regions: Excel Tables" (as mentioned in Section A.2, see https://www.samhsa.gov/data/sites/default/files/substate2k12-StateTabs/NSDUHsubstateStateTabsTOC2012.htm). These tables also contain a sort order number and a map-group indicator (= 1 for the Nation, = 2 for census regions, = 3 for States, = 4 if a region is part of the 363 mapping regions, and = 5 for all other substate/aggregate regions not included on the maps).

In addition to the substate region estimates, comparable estimates are provided for the 50 States and the District of Columbia and also for the four census regions. Design-based estimates and corresponding CIs for the Nation are also included. Because these estimates are based on 3 consecutive years of data, they are not directly comparable with the annually published State, census region, or national estimates that are based on only 2 consecutive years of NSDUH data. The U.S. Census Bureau defines the census regions as follows:

Northeast Region - Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont.
Midwest Region - Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin.
South Region - Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, and West Virginia.
West Region - Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming.

A.4. Comparability with Past Estimates

For the 2002 NSDUH, a number of methodological changes were introduced, including a $30 incentive for participating in the survey, additional training for interviewers to encourage adherence to survey protocols, a change in the survey name, and a shift to the 2000 decennial census (from the 1990 census) as a basis for population counts used in sample selection, weighting, and estimation. Additional information on these methodological changes is available in a report by the Office of Applied Studies (OAS, 2005a).3 An unanticipated result of these changes was that the prevalence rates for 2002 were in general substantially higher than the 2001 prevalence rates. The jump in the prevalence rates between 2001 and 2002 was more than the usual year-to-year change. Because of the changes in the survey that took place in 2002, substate estimates for 1999-2001 are not comparable with the other substate estimates. It is not possible to separate the effect of the methodological changes from the true trends in substance use.

However, estimates from 2002-2004, 2004-2006, 2006-2008, 2008-2010, and 2010-2012 are comparable for outcome measures that were defined in a similar manner and for substate regions defined consistently across these time periods. Table A1 in Appendix A lists the outcome measures for which substate estimates were produced using 2010-2012 NSDUH data and shows the outcome measures that remained comparable over time (indicated as "Yes" in the table) since 2002-2004.

It is useful to note that the 2002-2004 to 2008-2010 substate estimates were produced using predictors from the 2000 census; also, the survey weights used population projections from the 2000 census. The 2010-2012 estimates, on the other hand, were produced using 2010 census data. Hence, when reviewing changes between 2008-2010 and 2010-2012, it is important to note that they may be confounded with changes due to differences in the source of predictors and population projections (referred to as "census effects"). Similar caution should be used when reviewing changes between 2002-2004 and 2010-2012. The impact of such census effects on national and State estimates is discussed in Section B.4.3 in Appendix B of the 2011 NSDUH national findings report (CBHSQ, 2012) and the "2011-2012 NSDUH: Impact of Using 2010 Census Data on 2010-2011 Small Area Estimates" at https://www.samhsa.gov/data/report/2011-2012-nsduh-state-estimates-substance-use-and-mental-disorders.

During regular data collection and processing checks for the 2011 NSDUH, data errors were identified. These errors were falsified cases submitted by field interviewers that affected the data for Pennsylvania (2006 to 2010) and Maryland (2008 and 2009). Cases with erroneous data were removed from the data files, and the remaining cases were reweighted to provide representative estimates (for more details on this data error, refer to Section A.7 of the "2011-2012 NSDUH Guide to State Tables and Summary of Small Area Estimation Methodology" at https://www.samhsa.gov/data/report/2011-2012-nsduh-state-estimates-substance-use-and-mental-disorders). The 2008-2010 and the 2010-2012 substate estimates exclude data based on falsified cases.

Table A1. – Outcomes, by Survey Year, for Which Substate Small Area Estimates Are Available
Measure 2002-2004 2004-2006 2006-2008 2008-2010 2010-2012
Yes = available; No = not available.
NOTE: The measures included in the 1999-2001 substate small area estimation (SAE) report are not included here. Because of the changes in the survey that took place in 2002, the 1999-2001 estimates are not comparable with the 2002-2004 or subsequent year estimates. Estimates using the combined 2002-2004, 2004-2006, 2006-2008, and 2008-2010 data can be found at https://www.samhsa.gov/data/data-we-collect/nsduh-national-survey-drug-use-and-health.
1 The marijuana incidence definition used here employs a simpler form of the at-risk population based on the model-based methodology. This model-based average annual incidence rate for first use of marijuana is defined as follows: Average annual marijuana initiation rate = 100 × {[X1 ÷ (0.5 × X1 + X2)] ÷ 2}, where X1 is the number of marijuana initiates in the past 24 months and X2 is the number of persons who never used marijuana. Both X1 and X2 are based on binary measures that correspond to questions with a "yes" or "no" response option. For details on calculating the average annual rate of first use of marijuana from NSDUH data, see Section A.8 in Appendix A of the 2009-2010 State estimates report (Hughes, Muhuri, Sathe, & Spagnola, 2012).
2 Dependence or abuse is based on definitions found in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). For more details on these measures, see Section B.4.2 in Appendix B of the 2012 NSDUH national findings report (Center for Behavioral Health Statistics and Quality [CBHSQ], 2013b).
3 Because of questionnaire changes, SPD estimates in 2002-2004 are not comparable with the 2004-2006 SPD estimates. For details, see Section B.7 of the report on Substate Estimates from the 2004-2006 National Surveys on Drug Use and Health (Office of Applied Studies [OAS], 2008). Additional questionnaire changes were made in 2008 that affected past year SPD trends. However, revised past year SPD measures were created for 2005 through 2007 that are comparable with the 2008 through 2012 past year SPD measure. Substate small area estimates for 2006-2008, 2008-2010, and 2010-2012 were not created for this measure.
4 Questions used to determine MDE were added in 2004. The 2004-2006 MDE estimates are not comparable with the 2006-2008 and subsequent year estimates. For details on MDE, see Sections B.4.2 and B.4.4 in Appendix B of the 2012 NSDUH mental health findings report (CBHSQ, 2013a).
5 The mental illness measures are based on a predictive model and are not direct measures of diagnostic status (i.e., a small subsample of the respondents received a clinical follow-up, and these responses along with questionnaire data were used to create predictive models for all of the respondents). For details about these measures and the predictive models, see Section B.4.3 in Appendix B of the 2012 NSDUH mental health findings report (CBHSQ, 2013a).
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health, 2002-2012.
Illicit Drug Use in the Past Month Yes Yes Yes Yes Yes
Marijuana Use in the Past Year Yes Yes Yes Yes Yes
Marijuana Use in the Past Month Yes Yes Yes Yes Yes
Perceptions of Great Risk of Smoking Marijuana Once a Month Yes Yes Yes Yes Yes
First Use of Marijuana1 Yes Yes Yes Yes Yes
Illicit Drug Use Other Than Marijuana in the Past Month Yes Yes Yes Yes Yes
Cocaine Use in the Past Year Yes Yes Yes Yes Yes
Nonmedical Use of Pain Relievers in the Past Year Yes Yes Yes Yes Yes
Alcohol Use in the Past Month Yes Yes Yes Yes Yes
Underage Past Month Use of Alcohol (among Persons Aged 12 to 20) Yes Yes Yes Yes Yes
Binge Alcohol Use in the Past Month Yes Yes Yes Yes Yes
Underage Past Month Binge Alcohol Use (among Persons Aged 12 to 20) Yes Yes Yes Yes Yes
Perceptions of Great Risk of Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week Yes Yes Yes Yes Yes
Tobacco Product Use in the Past Month Yes Yes Yes Yes Yes
Cigarette Use in the Past Month Yes Yes Yes Yes Yes
Perceptions of Great Risk of Smoking One or More Packs of Cigarettes per Day Yes Yes Yes Yes Yes
Alcohol Dependence or Abuse in the Past Year2 Yes Yes Yes Yes Yes
Alcohol Dependence in the Past Year2 Yes Yes Yes Yes Yes
Illicit Drug Dependence or Abuse in the Past Year2 Yes Yes Yes Yes Yes
Illicit Drug Dependence in the Past Year2 Yes Yes Yes Yes Yes
Dependence or Abuse of Illicit Drugs or Alcohol in the Past Year2 Yes Yes Yes Yes Yes
Needing But Not Receiving Treatment for Illicit Drug Use in the Past Year Yes Yes Yes Yes Yes
Needing But Not Receiving Treatment for Alcohol Use in the Past Year Yes Yes Yes Yes Yes
Serious Psychological Distress (SPD) in the Past Year3 Yes Yes No No No
Had at Least One Major Depressive Episode (MDE) in the Past Year4 No Yes Yes Yes Yes
Serious Mental Illness (SMI) in the Past Year5 No No No Yes Yes
Any Mental Illness (AMI) in the Past Year5 No No No Yes Yes
Had Serious Thoughts of Suicide in the Past Year No No No Yes Yes
Table A2. – NSDUH Substate Region Counts and Overlap, by State and Estimation Period
State 2002-2004 2008-2010 2010-2012
Number
of
Substate
Regions1		 Number
of Map
Regions2		 Number
of
Substate
Regions1		 Number
of Map
Regions2		 Number
of
Substate
Regions1		 Number
of Map
Regions2		 Number of
Substate
Regions
Overlapping
with
2002-20043		 Number of
Substate
Regions
Overlapping
with
2008-20103
1 Number of regions only include the main substate regions and not the aggregate regions.
2 More information on the map regions can be found in Section A.3.
3 The names of some of the substate regions have changed across the time periods. However, as long as the two regions are made of the same counties or tracts, they are included in the count of overlapping regions.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health, 2002-2012.
Total U.S. 357 340 383 362 384 363 283 371
Alabama 4 4 4 4 4 4 4 4
Alaska 4 4 4 4 4 4 1 4
Arizona 4 4 4 4 4 4 4 4
Arkansas 7 7 8 8 8 8 3 8
California 15 15 27 27 27 27 4 27
Colorado 5 5 5 5 5 5 5 5
Connecticut 5 5 5 5 5 5 5 5
Delaware 4 4 4 4 4 4 4 4
District of Columbia 8 8 8 8 8 8 8 8
Florida 14 14 18 18 18 18 8 18
Georgia 5 5 6 6 6 6 0 6
Hawaii 3 3 4 4 4 4 2 4
Idaho 7 7 7 7 7 7 7 7
Illinois 5 5 5 5 5 5 5 5
Indiana 8 8 8 8 8 8 8 8
Iowa 6 6 6 6 6 6 6 6
Kansas 6 6 6 6 6 6 6 6
Kentucky 6 6 6 6 6 6 6 6
Louisiana 7 7 5 5 6 6 5 4
Maine 7 7 7 7 8 8 3 6
Maryland 7 7 9 9 9 9 4 9
Massachusetts 6 6 6 6 6 6 6 6
Michigan 16 16 15 15 15 15 11 15
Minnesota 6 6 6 6 6 6 6 6
Mississippi 7 7 7 7 7 7 7 7
Missouri 7 7 7 7 7 7 7 7
Montana 5 5 5 5 5 5 5 5
Nebraska 5 5 6 6 6 6 4 6
Nevada 3 3 3 3 4 4 2 2
New Hampshire 5 3 5 3 5 3 5 5
New Jersey 4 4 4 4 4 4 4 4
New Mexico 5 5 5 5 5 5 5 5
New York 15 4 15 4 15 4 15 15
North Carolina 4 4 12 11 12 11 0 12
North Dakota 5 5 5 5 5 5 5 5
Ohio 21 21 21 21 21 21 21 21
Oklahoma 7 7 7 7 7 7 7 7
Oregon 5 5 6 6 6 6 4 6
Pennsylvania 13 13 13 13 13 13 9 13
Rhode Island 4 4 4 4 4 4 4 4
South Carolina 4 4 4 4 4 4 4 4
South Dakota 7 7 7 7 5 5 0 0
Tennessee 7 7 7 7 7 7 5 5
Texas 15 11 15 11 15 11 15 15
Utah 6 6 6 6 6 6 6 6
Vermont 4 4 4 4 4 4 4 4
Virginia 5 5 5 5 5 5 3 5
Washington 6 6 6 3 6 3 6 6
West Virginia 8 8 6 6 6 6 2 6
Wisconsin 6 6 6 6 6 6 4 6
Wyoming 9 9 9 9 9 9 9 9

Section B: Substate Region Estimation Methodology

The survey-weighted hierarchical Bayes (SWHB) methodology used in the production of State estimates from the 1999 to 2012 National Surveys on Drug Use and Health (NSDUHs) also was used in the production of the 2010-2012 substate estimates. The SWHB methodology is described by Folsom, Shah, and Vaish (1999). A general model description is given in Section B.1. A brief discussion of the precision of the estimates and interpretation of the Bayesian confidence intervals (CIs) is given in Section B.2. The goals of the small area estimation (SAE) modeling, the general model description, and the implementation of SAE modeling remain the same and are described in Appendix E of the 2001 State report (Wright, 2003).

Small area estimates obtained using the SWHB methodology are design consistent (i.e., for States or substate areas with large sample sizes, the small area estimates are close to the corresponding robust design-based estimates). The substate small area estimates when aggregated by using the appropriate population totals result in national small area estimates that are very close to the national design-based estimates. However, for many reasons, including internal consistency, it is desirable to have the national small area estimates exactly match the national design-based estimates. Beginning in 2002, exact benchmarking was introduced (see Appendix A, Section A.4, in Wright & Sathe, 2005). The 2010-2012 substate small area estimates have been benchmarked to the national design-based estimates.

B.1. General SAE Model Description

The model described here to produce the 2010-2012 substate small area estimates is the same logistic mixed4 hierarchical Bayes (HB) model that was used to produce the 2008‑2010 substate small area estimates (see "2008-2010 National Survey on Drug Use and Health: Overview and Summary of Substate Region Estimation Methodology" at https://www.samhsa.gov/data/sites/default/files/Substate2k10-NSDUHsubstateStates2010/NSDUHsubstate51StateTOC2010.htm). The following model was used:

The model is given by the equation: log of pi sub a, i, j, k divided by 1 minus pi sub a, i, j, k and is equal to the sum of three terms. The first term is given by x transpose sub a, i, j, k times beta sub a. The second term is eta sub a, i. And the third term is nu sub a, i, j. Here, pi sub a, i, j, k is the probability of engaging in the behavior of interest by person-k belonging to age group-a in substate region-j of State-i. The x sub a, i, j, k denotes a vector of auxiliary variables associated with age group-a, and the beta sub a denotes the associated vector of regression parameters. The eta sub a, i and the nu sub a, i, j denote, respectively, the vectors of random effects at the State and substate region levels.,

where pi sub a, i, j, k is the probability of engaging in the behavior of interest (e.g., using marijuana in the past month, or cocaine use in past year) for person-k belonging to age group-a in substate region-j of State-i.

Let x sub a, i, j, k denote a p sub a times 1 vector of the auxiliary (predictor) variables associated with age group-a (12 to 17, 18 to 25, 26 to 34, and 35 or older) and Beta sub a denote the associated vector of the regression parameters. The age group-specific vectors of the auxiliary variables are defined for every block group in the Nation and also include person-level demographic variables, such as race/ethnicity and gender. The auxiliary variables include block group, census tract, county, and State-level data. These predictor variables include demographic and socioeconomic data from the American Community Survey, population projections obtained from Claritas, food stamp participation rates from the U.S. Census Bureau, Uniform Crime Report arrest totals from the Federal Bureau of Investigation, per capita income from the Bureau of Economic Analysis, unemployment rates from the Bureau of Labor Statistics, mortality rates from the National Center for Health Statistics, treatment rates from the National Survey of Substance Abuse Treatment Service, and Block Grant awards, cost of services, and total taxable resources from the Substance Abuse and Mental Health Services Administration. For a complete list of predictors, refer to Section B of the "2011-2012 NSDUH Guide to State Tables and Summary of Small Area Estimation Methodology" at https://www.samhsa.gov/data/report/2011-2012-nsduh-state-estimates-substance-use-and-mental-disorders.

The vectors An eta sub i is a transposed vector of values eta sub 1, i and so on until eta sub capital A, i. and A nu sub i, j is a vector of transposed values nu sub 1, i, j and so on until nu sub capital A, i, j., defined as State- and substate-level random effects, respectively, are assumed to be mutually independent with An eta sub i is normally distributed with mean 0 and variance denoted by matrix capital D sub eta. and A nu sub i, j is normally distributed with mean 0 and variance denoted by matrix captal D sub nu. where A is the total number of individual age groups modeled (generally, Capital A equals 4.). For HB estimation purposes, an improper uniform prior distribution is assumed for Beta sub a, and proper Wishart prior distributions are assumed for inverse of capital D sub eta. and inverse of capital D sub nu.. The HB solution for pi sub a, i, j, k involves a series of complex Markov Chain Monte Carlo (MCMC) steps to generate values of the desired fixed and random effects from the underlying joint distribution. The basic process is described in Folsom et al. (1999), Shah, Barnwell, Folsom, and Vaish (2000), and Wright (2003). Once the required number of MCMC samples for the parameters of interest are generated and tested for convergence properties (see Raftery & Lewis, 1992), the small area estimates for each age group × race/ethnicity × gender cell within a block group can be obtained. These block group-level small area estimates then can be aggregated using the appropriate population projections to form substate- and State-level small area estimates for the desired age group(s). These small area estimates then are benchmarked to the national design-based estimates (for details on exact benchmarking, see Section B.6 of the "2011-2012 NSDUH Guide to State Tables and Summary of Small Area Estimation Methodology" at https://www.samhsa.gov/data/report/2011-2012-nsduh-state-estimates-substance-use-and-mental-disorders).

Because the objective here was to produce small area estimates for substate regions, it was decided to ratio adjust the person-level sampling weights to match population projections available from Claritas at the substate × age group × gender level. These adjusted sampling weights are used in the estimation because they reflect the demography of the substate regions better than the unadjusted weights. This ratio adjustment was done at the substate region (384 regions) × age group (12 to 17, 18 to 25, 26 to 34, and 35 or older) × gender (male and female) level collectively over 3 years (2010, 2011, and 2012) of data.

The SAE methodology used here tends to borrow strength from both the national model and the State-level random effects. Estimates for substate regions with smaller sample sizes tend to be shrunk more toward the corresponding State and national prevalence estimates than substate regions with larger sample sizes. This methodology tends to cluster the small sample substate estimates around their State prevalence estimates. Thus, relatively high estimates for substate regions with small sample sizes tend to shrink toward the State prevalence estimates, while relatively low estimates tend to increase toward the State prevalence estimates. On the other hand, for substate regions with large sample sizes, the methodology produces estimates that are close to the weighted average of the sample data in that substate region. In addition, these estimates are design consistent so that, as the sample size for a substate region increases, the estimate approaches the corresponding design-based estimate.

B.2. Precision, Comparison, and Validation of the Estimates

The primary purpose of producing substate estimates is to give policy officials and data users a better perspective on the range of prevalence estimates within and across States. Because the data were collected in a consistent manner by field interviewers who adhered to the same procedures and administered the same questions across all States and substate regions, the results are comparable within and across the 50 States and the District of Columbia.

The 95 percent Bayesian CI associated with each estimate provides a measure of the accuracy of the estimate. It defines the range within which the true value can be expected to fall 95 percent of the time. For example, the estimated prevalence of past month use of marijuana in Region 1 in Alabama is 5.1 percent, and the 95 percent CI ranges from 3.8 to 6.7 percent.5 Therefore, the probability is 0.95 that the true value is within that range. The CI indicates the uncertainty due to both sampling variability and model bias. The key assumption underlying the validity of the CIs is that the State- and substate-level error (or bias correction) terms in the models behave like random effects with zero means and common variance components.

When comparing prevalence rates for two substate regions, it is tempting and often convenient to look at their 95 percent Bayesian CIs to decide whether the difference in the two substate regions' prevalence rates is significant. If the two Bayesian CIs overlap, one would conclude that the difference is not statistically significant. If the two Bayesian CIs do not overlap, it implies that the two substate regions prevalence rates are significantly different from each other. However, as discussed in Schenker and Gentleman (2001), the method of overlapping Bayesian CIs is more conservative (i.e., it rejects the null hypothesis of no difference less often) than the standard method based on z statistics when the null hypothesis is true. For details on the z statistics method to test the differences between the estimates of two substate regions, refer to Section B.12 (which describes the test for two State estimates) of the "2011-2012 NSDUH Guide to State Tables and Summary of Small Area Estimation Methodology" at https://www.samhsa.gov/data/report/2011-2012-nsduh-state-estimates-substance-use-and-mental-disorders. The same test can be extended to test the differences between two substate regions' prevalence rates. Note that the referenced test assumes zero correlation between the two estimates. Two substate regions in one State (or across States) are likely correlated, but the test can still be used knowing that the resulting test will be more conservative than if the correlation was accounted for. This is still a better alternative than using the overlapping CI test. Even if Bayesian CIs for two substate regions overlap, the two prevalence rates may be declared significantly different by the test based on z statistics. Hence, the method of overlapping Bayesian CIs is not recommended to test the equivalence of two substate prevalence rates. A detailed description of the method of overlapping CIs and its comparison with the standard methods for testing of a hypothesis is given in Schenker and Gentleman (2001) and Payton, Greenstone, and Schenker (2003).

A comparison of the standard errors (SEs) among substate regions with small (n ≤ 500), medium (500 < n ≤ 1,000), and large (n > 1,000) sample sizes for certain measures shows that the small area estimates behave in predictable ways. Regardless of whether the substate region is from 1 of the 8 States with a large annual sample size (3,000 to 4,000) or 1 of the 43 other States (n = 900 annually), the sizes of the CIs are very similar and are primarily a function of the sample size of the substate region and the prevalence estimate of the measure. Substate regions with large sample sizes had the smallest SEs. For past month use of alcohol, where the national prevalence for all persons aged 12 or older was 51.8 percent (for 2010-2012), the average relative standard error (RSE)6 was about 5.1 percent, and the RSE for substate regions with a large sample size was about 3.2 percent. For substate regions with a medium sample size, the average RSE was 4.4 percent; for small sample sizes, the average RSE was 5.8 percent. For past month use of marijuana (with a national prevalence of 7.0 percent), the average RSE was 9.4 percent for substate regions with large samples. For medium sample sizes, the average RSE was 12.5 percent, and for small samples, the RSE was 15.7 percent, whereas the overall national average RSE was 14.2 percent. Substance use measures with lower prevalence rates, such as past year use of cocaine (1.7 percent nationally), displayed larger average RSEs. For substate regions with large sample sizes, the average RSE was 15.2 percent. For those with medium sample sizes, the average RSE was 18.5 percent, and for those with small sample sizes, the average RSE was 20.6 percent.

The SAE methodology used for producing the 2010-2012 substate region estimates was previously validated for the NSDUH State-by-age group small area estimates (Wright, 2002). This validation exercise used direct estimates from pairs of large sample States (n = 7,200) as internal benchmarks. These internal benchmarks were compared with small area estimates based on random subsamples (n = 900) that mimicked a single year small State sample. The associated age group-specific small area estimates were based on sample sizes targeted at n = 300. Therefore, validation of the State-by-age group small area estimates should lend some validity to the small sample size substate small area estimates.

Section C: Sample Sizes, Response Rates, and Population Estimates

140103
Table C1. – Sample Sizes, Weighted Screening and Interview Response Rates, and Population Estimates, by Substate Region, for Persons Aged 12 or Older: 2010, 2011, and 2012 NSDUHs
State/Substate Region Total
Selected DUs		 Total Eligible
DUs		 Total
Completed
Screeners		 Weighted DU
Screening
Response
Rate
(Percentage)		 Total
Selected		 Total
Responded		 Population
Estimate		 Weighted
Interview
Response
Rate
(Percentage)		 Weighted
Overall
Response
Rate
(Percentage)
DU = dwelling unit; ECBH = East Carolina Behavioral Health; SPA = service planning area.
NOTE: For substate region definitions, see the "2010-2012 National Survey on Drug Use and Health Substate Region Definitions" at https://www.samhsa.gov/data/sites/default/files/substate2k12-StateTabs/NSDUHsubstateStateTabsTOC2012.htm.
NOTE: To compute the pooled 2010-2012 weighted response rates, the three samples were combined, and the individual-year weights were used for the pooled sample. Thus, the response rates presented here are weighted across 3 years of data rather than being a simple average of the 2010, 2011, and 2012 individual response rates.
NOTE: The total responded column represents the combined sample size from the 2010, 2011, and 2012 NSDUHs.
NOTE: The population estimate is the simple average of the 2010, 2011, and 2012 population counts for persons aged 12 or older. Because of rounding, the sum of the substate region population counts within a State may not exactly match the State population count listed in the table.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2010, 2011, and 2012 (2010 Data - Revised March 2012).
Total United States 632,660 524,411 456,931 87.15% 261,189 206,222 258,022,633 73.99% 64.48%
Northeast 137,629 115,246 94,082 80.55% 52,334 39,880 46,933,885 70.75% 56.99%
Midwest 171,491 144,090 126,933 88.54% 73,208 57,701 55,781,496 74.33% 65.81%
South 200,775 163,105 145,011 89.38% 79,998 64,635 95,354,570 75.77% 67.72%
West 122,765 101,970 90,905 87.47% 55,649 44,006 59,952,682 73.43% 64.23%
Alabama 10,229 8,016 7,272 90.73% 3,974 3,162 3,984,825 73.68% 66.85%
Region 1 2,486 1,995 1,801 90.34% 915 703 1,116,614 72.44% 65.44%
Region 2 2,892 2,311 2,084 90.20% 1,174 904 1,279,889 69.96% 63.10%
Region 3 1,983 1,566 1,425 91.15% 817 670 708,318 78.19% 71.26%
Region 4 2,868 2,144 1,962 91.60% 1,068 885 880,003 76.36% 69.94%
Alaska 7,109 5,499 4,925 89.59% 3,254 2,602 569,188 76.75% 68.76%
Anchorage 2,776 2,452 2,205 89.90% 1,420 1,154 233,365 77.75% 69.90%
Northern 1,592 1,110 997 89.83% 759 591 126,422 75.23% 67.58%
South Central 1,780 1,246 1,079 86.72% 681 523 149,601 72.61% 62.96%
Southeast 961 691 644 93.38% 394 334 59,801 84.02% 78.45%
Arizona 8,157 6,351 5,704 89.91% 3,414 2,775 5,315,250 77.20% 69.41%
Maricopa 4,704 3,927 3,515 89.72% 2,187 1,744 3,157,764 74.47% 66.82%
Pima 1,233 984 875 88.97% 482 393 828,236 80.60% 71.71%
Rural North 1,440 926 841 90.66% 432 366 611,131 84.60% 76.70%
Rural South 780 514 473 92.10% 313 272 718,119 81.67% 75.22%
Arkansas 8,058 6,580 6,046 91.84% 3,495 2,731 2,411,712 72.45% 66.53%
Catchment Area 1 1,335 1,146 1,038 90.66% 632 470 383,659 68.68% 62.27%
Catchment Area 2 933 723 670 92.73% 320 250 295,424 74.20% 68.80%
Catchment Area 3 1,008 834 787 94.42% 465 345 325,678 62.40% 58.92%
Catchment Area 4 648 545 488 89.36% 314 246 213,032 75.37% 67.36%
Catchment Area 5 1,109 868 808 93.19% 504 397 358,876 73.85% 68.82%
Catchment Area 6 580 451 428 94.67% 235 204 175,272 82.92% 78.50%
Catchment Area 7 669 548 531 96.82% 271 220 190,213 75.69% 73.28%
Catchment Area 8 1,776 1,465 1,296 88.35% 754 599 469,558 74.89% 66.17%
California 28,235 24,624 20,631 83.78% 14,210 10,963 31,072,295 71.45% 59.87%
Region 1R 887 694 597 86.10% 323 252 810,075 74.64% 64.26%
Region 2R 1,037 683 581 85.31% 378 300 843,954 77.90% 66.46%
Region 3R (Sacramento) 1,037 923 765 83.11% 461 364 1,175,383 74.68% 62.07%
Region 4R 1,342 1,168 991 84.91% 538 402 1,091,126 71.19% 60.45%
Region 5R (San Francisco) 685 632 485 76.83% 280 199 724,726 59.76% 45.91%
Region 6 (Santa Clara) 1,381 1,263 1,030 81.12% 575 410 1,486,034 67.65% 54.87%
Region 7R (Contra Costa) 771 704 589 83.72% 350 271 881,890 70.25% 58.81%
Region 8R (Alameda) 1,174 1,039 860 82.99% 587 444 1,273,423 68.04% 56.46%
Region 9R (San Mateo) 574 520 416 79.75% 250 157 607,111 56.13% 44.76%
Region 10 788 709 622 87.87% 445 325 1,042,670 66.57% 58.49%
Region 11 (Los Angeles) 7,026 6,401 5,279 82.58% 3,828 2,912 8,191,257 70.71% 58.39%
LA SPA 1 and 5 814 731 542 74.07% 337 248 873,845 68.61% 50.82%
LA SPA 2 1,516 1,393 1,071 76.93% 728 528 1,795,788 68.46% 52.67%
LA SPA 3 1,234 1,137 1,005 88.44% 711 538 1,465,076 69.84% 61.77%
LA SPA 4 808 724 551 76.92% 389 299 957,493 73.29% 56.38%
LA SPA 6 671 612 554 90.31% 477 366 785,175 68.97% 62.28%
LA SPA 7 735 678 598 88.23% 531 423 1,050,390 73.87% 65.18%
LA SPA 8 1,248 1,126 958 85.09% 655 510 1,263,490 72.87% 62.01%
Region 12R 474 420 378 89.74% 267 224 688,579 76.43% 68.60%
Regions 13 and 19R 1,669 1,220 1,041 85.28% 917 740 1,945,003 75.31% 64.22%
Region 13 (Riverside) 1,543 1,114 937 84.08% 805 632 1,803,111 73.23% 61.58%
Region 19R (Imperial) 126 106 104 98.05% 112 108 141,892 96.42% 94.54%
Region 14 (Orange) 2,259 2,064 1,745 84.45% 1,185 902 2,539,281 70.18% 59.27%
Region 15R (Fresno) 702 622 512 82.34% 378 311 745,539 72.07% 59.35%
Region 16R (San Diego) 2,537 2,110 1,752 83.04% 1,210 924 2,615,099 72.28% 60.02%
Region 17R 1,082 952 784 81.66% 610 501 1,155,052 78.98% 64.50%
Region 18R (San Bernardino) 1,252 1,127 1,025 90.82% 890 722 1,652,267 74.64% 67.79%
Region 20R 686 612 539 88.16% 373 311 758,116 74.66% 65.83%
Region 21R 872 761 640 83.99% 365 292 845,712 75.18% 63.14%
Colorado 8,727 7,234 6,413 88.77% 3,458 2,752 4,212,300 76.71% 68.10%
Region 1 1,098 922 814 88.39% 469 375 556,709 77.73% 68.70%
Regions 2 and 7 4,468 3,839 3,336 87.47% 1,843 1,439 2,346,846 74.76% 65.39%
Region 3 1,573 1,344 1,204 88.25% 660 528 620,341 77.22% 68.15%
Region 4 712 449 420 94.05% 190 163 229,033 82.95% 78.01%
Regions 5 and 6 876 680 639 93.99% 296 247 459,371 80.69% 75.84%
Connecticut 8,134 7,091 5,944 83.61% 3,612 2,841 3,016,679 73.30% 61.29%
Eastern 1,078 944 808 85.35% 548 460 372,544 80.11% 68.38%
North Central 2,206 1,997 1,694 84.73% 981 764 845,229 69.92% 59.25%
Northwestern 1,396 1,152 889 75.46% 582 475 521,628 72.12% 54.42%
South Central 1,942 1,682 1,495 88.97% 816 615 710,013 72.53% 64.53%
Southwest 1,512 1,316 1,058 80.72% 685 527 567,265 75.46% 60.92%
Delaware 8,313 6,744 5,919 87.71% 3,318 2,682 759,824 78.03% 68.44%
Kent 1,413 1,222 1,058 86.55% 632 501 135,887 74.78% 64.73%
New Castle (excluding Wilmington City) 3,803 3,325 2,922 87.76% 1,691 1,364 392,016 79.95% 70.17%
Sussex 2,204 1,479 1,297 87.65% 657 521 169,909 73.99% 64.85%
Wilmington City 893 718 642 89.58% 338 296 62,012 85.13% 76.26%
District of Columbia 14,795 12,104 9,849 80.56% 3,302 2,797 534,932 81.73% 65.84%
Ward 1 1,769 1,499 1,268 85.09% 390 337 66,156 84.80% 72.16%
Ward 2 2,342 1,856 1,468 78.22% 457 357 71,591 78.30% 61.24%
Ward 3 1,946 1,598 1,284 78.07% 407 338 72,323 82.34% 64.28%
Ward 4 1,544 1,361 1,102 80.76% 400 317 66,318 72.95% 58.91%
Ward 5 2,053 1,729 1,355 78.30% 473 407 66,618 81.58% 63.87%
Ward 6 1,677 1,331 1,125 81.62% 315 266 70,782 80.84% 65.98%
Ward 7 1,585 1,251 1,048 83.90% 361 315 61,063 88.20% 74.00%
Ward 8 1,879 1,479 1,199 81.34% 499 460 60,081 89.14% 72.51%
Florida 39,928 30,967 27,009 86.88% 13,980 11,228 16,144,570 74.26% 64.52%
Region A - Northwest 4,191 3,279 2,994 90.98% 1,608 1,332 1,165,069 80.71% 73.43%
Circuit 1 2,397 1,943 1,768 90.63% 956 791 583,155 80.71% 73.14%
Circuit 2 929 717 650 90.58% 375 314 331,657 83.20% 75.36%
Circuit 14 865 619 576 92.52% 277 227 250,257 76.21% 70.51%
Region B - Northeast 5,406 4,314 3,878 89.79% 1,871 1,461 2,167,074 72.89% 65.45%
Circuits 3 and 8 1,369 1,085 987 91.07% 525 411 485,319 75.44% 68.70%
Circuit 4 2,116 1,703 1,504 88.26% 766 595 939,667 71.67% 63.25%
Circuit 7 1,921 1,526 1,387 90.75% 580 455 742,089 72.35% 65.66%
Region C - Central 8,995 7,232 6,383 88.17% 3,405 2,729 4,067,448 72.47% 63.89%
Circuit 5 1,563 1,271 1,130 89.18% 500 386 910,345 70.02% 62.44%
Circuit 9 2,388 2,020 1,840 91.19% 1,151 953 1,189,884 74.70% 68.12%
Circuit 10 1,823 1,348 1,206 89.06% 646 529 614,499 76.48% 68.11%
Circuit 18 1,931 1,614 1,372 84.96% 724 552 831,879 66.57% 56.55%
Circuit 19 1,290 979 835 84.94% 384 309 520,841 73.69% 62.59%
Region D - Southeast 6,691 4,986 4,204 83.83% 2,208 1,744 2,629,793 72.35% 60.64%
Circuit 15 (Palm Beach) 3,187 2,225 1,827 81.38% 962 729 1,140,784 68.62% 55.84%
Circuit 17 (Broward) 3,504 2,761 2,377 85.91% 1,246 1,015 1,489,009 75.11% 64.53%
Region E - Sun Coast 10,039 7,319 6,228 84.94% 2,893 2,302 3,908,836 73.51% 62.44%
Circuit 6 2,998 2,192 1,813 82.62% 743 570 1,204,274 69.05% 57.04%
Circuit 12 1,811 1,334 1,152 86.44% 456 356 649,671 71.13% 61.49%
Circuit 13 (Hillsborough) 2,425 2,114 1,813 85.93% 1,095 895 1,043,373 76.64% 65.86%
Circuit 20 2,805 1,679 1,450 85.42% 599 481 1,011,517 77.03% 65.80%
Region F - Southern
   (Circuits 11 and 16)		 4,606 3,837 3,322 86.53% 1,995 1,660 2,206,350 79.17% 68.50%
Georgia 7,005 5,929 5,345 90.28% 3,357 2,673 7,937,335 75.32% 68.00%
Region 1 1,742 1,459 1,288 88.57% 861 693 2,053,597 77.03% 68.23%
Region 2 1,082 915 852 93.33% 512 432 1,035,486 80.90% 75.50%
Region 3 2,022 1,737 1,549 89.24% 995 786 2,342,663 74.20% 66.22%
Region 4 585 502 462 92.34% 277 207 495,344 68.73% 63.47%
Region 5 622 531 478 90.07% 228 177 898,897 71.11% 64.05%
Region 6 952 785 716 91.15% 484 378 1,111,348 73.67% 67.15%
Hawaii 8,908 7,674 6,352 82.41% 3,841 2,862 1,123,500 69.34% 57.14%
Hawaii Island 1,455 1,201 975 81.23% 518 396 152,588 72.68% 59.04%
Honolulu 6,147 5,407 4,444 81.71% 2,759 2,039 787,623 67.87% 55.46%
Kauai and Maui 1,306 1,066 933 87.61% 564 427 183,289 73.16% 64.10%
Kauai 516 367 338 92.16% 185 140 55,634 75.51% 69.59%
Maui 790 699 595 85.30% 379 287 127,655 71.93% 61.36%
Idaho 7,161 5,827 5,488 94.13% 3,373 2,749 1,279,209 77.83% 73.26%
Region 1 1,071 754 699 92.54% 416 313 179,896 74.64% 69.07%
Region 2 673 530 506 95.46% 265 218 91,191 81.52% 77.81%
Region 3 1,020 882 839 94.45% 546 446 201,505 78.30% 73.95%
Region 4 1,815 1,592 1,477 93.06% 810 677 362,848 77.46% 72.08%
Region 5 1,059 829 787 94.86% 523 432 148,586 80.95% 76.79%
Region 6 725 633 591 93.41% 368 305 131,646 77.74% 72.62%
Region 7 798 607 589 97.17% 445 358 163,537 75.87% 73.73%
Illinois 33,771 29,280 22,982 78.50% 14,562 10,936 10,646,439 70.22% 55.13%
Region I (Cook) 13,810 12,098 8,402 69.47% 5,537 4,070 4,318,958 68.29% 47.44%
Region II 9,529 8,485 6,956 81.94% 4,793 3,616 3,348,716 71.02% 58.19%
Region III 4,098 3,444 3,011 87.64% 1,769 1,383 1,214,045 73.78% 64.66%
Region IV 2,661 2,271 1,956 86.15% 1,052 787 758,857 71.55% 61.64%
Region V 3,673 2,982 2,657 89.04% 1,411 1,080 1,005,862 70.54% 62.81%
Indiana 7,709 6,406 5,900 92.07% 3,417 2,723 5,373,546 73.56% 67.72%
Central 1,602 1,367 1,245 90.71% 709 534 1,400,214 67.02% 60.79%
East 733 622 581 93.54% 307 245 459,963 78.32% 73.26%
North Central 998 822 753 91.93% 465 395 763,903 82.45% 75.80%
Northeast 793 622 567 90.96% 363 277 529,213 72.21% 65.68%
Northwest 972 854 764 89.17% 485 393 612,011 77.27% 68.90%
Southeast 1,008 855 805 94.04% 412 330 579,681 69.94% 65.77%
Southwest 692 580 540 93.17% 269 211 424,148 73.52% 68.49%
West 911 684 645 94.54% 407 338 604,412 72.67% 68.70%
Iowa 7,762 6,681 6,228 93.06% 3,387 2,758 2,556,633 77.59% 72.21%
Central 1,527 1,377 1,262 91.39% 659 513 456,906 73.98% 67.61%
North Central 870 741 697 93.98% 342 268 286,330 73.63% 69.20%
Northeast 1,804 1,591 1,465 92.08% 840 700 622,007 80.02% 73.68%
Northwest 1,233 972 925 94.86% 520 428 394,323 78.71% 74.67%
Southeast 1,619 1,402 1,315 93.82% 713 582 541,877 77.74% 72.93%
Southwest 709 598 564 93.90% 313 267 255,190 80.93% 76.00%
Kansas 7,517 6,429 5,844 90.94% 3,374 2,712 2,323,227 76.02% 69.14%
Kansas City Metro 2,490 2,245 2,020 90.04% 1,213 951 774,604 73.00% 65.73%
Northeast 1,246 1,033 927 89.90% 530 429 448,227 77.70% 69.85%
South Central 849 717 665 92.75% 395 318 291,521 80.08% 74.27%
Southeast 631 472 437 92.43% 233 194 157,848 78.46% 72.52%
West 1,005 828 771 93.03% 412 321 252,511 72.33% 67.29%
Wichita (Sedgwick) 1,296 1,134 1,024 90.43% 591 499 398,515 80.17% 72.50%
Kentucky 8,054 6,742 6,241 92.57% 3,406 2,726 3,627,784 75.51% 69.90%
Adanta, Cumberland River, and Lifeskills 1,611 1,297 1,212 93.44% 648 515 610,387 74.33% 69.45%
Bluegrass, Comprehend, and North Key 2,256 1,915 1,762 91.95% 965 756 1,059,413 73.76% 67.82%
Communicare and River Valley 861 745 687 92.32% 370 306 401,238 77.75% 71.77%
Four Rivers and Pennyroyal 655 531 500 94.29% 303 259 345,240 83.20% 78.44%
Kentucky River, Mountain, and Pathways 950 701 650 92.45% 319 252 410,202 69.40% 64.17%
Seven Counties 1,721 1,553 1,430 92.20% 801 638 801,303 77.03% 71.02%
Louisiana 10,460 8,274 7,700 93.06% 4,338 3,553 3,722,105 77.83% 72.43%
Regions 1 and 10 2,543 1,919 1,729 89.88% 932 710 706,411 72.51% 65.17%
Region 1 1,368 889 825 91.95% 498 394 352,062 76.94% 70.75%
Region 10 (Jefferson) 1,175 1,030 904 88.22% 434 316 354,349 68.49% 60.42%
Regions 2 and 9 2,168 1,801 1,698 94.29% 1,050 885 987,733 80.14% 75.57%
Region 3 1,111 963 905 93.14% 557 471 328,132 78.24% 72.87%
Regions 4, 5, and 6 2,751 2,173 2,044 93.77% 1,061 851 963,590 75.50% 70.80%
Regions 7 and 8 1,887 1,418 1,324 93.44% 738 636 736,239 82.29% 76.90%
Maine 10,761 7,779 7,095 91.09% 3,273 2,727 1,148,238 79.80% 72.69%
Aroostook/Downeast 1,530 948 897 94.55% 423 379 138,063 85.38% 80.73%
Aroostook 477 391 372 95.05% 189 176 62,140 88.62% 84.23%
Downeast 1,053 557 525 94.25% 234 203 75,923 82.99% 78.22%
Central 1,388 1,002 915 91.51% 435 371 150,059 83.53% 76.44%
Cumberland 1,876 1,600 1,377 85.91% 654 519 244,635 73.91% 63.50%
Midcoast 1,211 764 708 92.87% 226 201 128,267 87.32% 81.09%
Penquis 1,468 1,047 989 94.44% 490 414 148,343 83.73% 79.08%
Western 1,721 1,267 1,155 90.56% 558 474 168,052 82.45% 74.67%
York 1,567 1,151 1,054 91.40% 487 369 170,819 68.29% 62.42%
Maryland 7,682 6,659 5,336 80.21% 3,291 2,681 4,854,548 77.08% 61.82%
Anne Arundel 738 625 481 76.78% 251 197 453,905 72.20% 55.43%
Baltimore City 991 812 662 81.39% 409 372 518,769 87.02% 70.83%
Baltimore County 997 910 710 78.32% 430 352 683,475 80.79% 63.27%
Montgomery 1,245 1,164 926 79.71% 549 450 815,400 77.39% 61.69%
North Central 504 459 380 83.10% 271 224 382,789 78.32% 65.08%
Northeast 584 523 425 80.98% 281 216 408,466 73.77% 59.73%
Prince George's 950 790 612 77.54% 413 314 715,984 71.85% 55.71%
South 923 716 575 80.28% 328 275 464,143 74.70% 59.97%
West 750 660 565 85.78% 359 281 411,617 75.67% 64.91%
Massachusetts 9,599 8,310 7,091 85.34% 3,632 2,860 5,609,094 74.75% 63.79%
Boston 1,140 955 822 86.01% 459 376 685,206 77.25% 66.44%
Central 1,183 1,064 925 86.78% 464 374 725,897 75.26% 65.32%
Metrowest 1,963 1,760 1,441 81.96% 695 544 1,296,349 74.33% 60.92%
Northeast 1,872 1,724 1,482 85.91% 782 620 1,096,931 76.60% 65.81%
Southeast 2,197 1,724 1,461 84.94% 726 529 1,087,031 69.74% 59.23%
Western 1,244 1,083 960 88.41% 506 417 717,681 78.70% 69.58%
Michigan 33,545 26,876 23,147 86.16% 13,834 11,030 8,293,400 75.24% 64.83%
Detroit City 2,535 1,783 1,495 84.05% 940 770 570,227 75.31% 63.30%
Genesee 1,525 1,243 1,078 87.00% 632 525 350,662 76.66% 66.69%
Kalamazoo 2,209 1,785 1,635 91.66% 922 734 569,863 74.58% 68.36%
Kent 1,707 1,526 1,312 85.42% 871 720 496,825 77.17% 65.92%
Lakeshore 2,365 1,934 1,753 90.34% 1,116 907 585,459 77.94% 70.41%
Macomb 2,786 2,497 2,013 80.43% 1,219 906 713,180 70.09% 56.38%
Mid South 3,126 2,490 2,152 86.40% 1,227 1,009 782,810 80.89% 69.89%
Northern 3,484 2,094 1,905 90.93% 964 801 732,439 81.90% 74.47%
Oakland 3,577 3,160 2,698 85.47% 1,622 1,261 1,022,173 74.37% 63.57%
Pathways and Western 1,395 978 881 90.12% 459 387 269,983 80.44% 72.49%
Riverhaven 1,299 1,028 905 88.20% 515 423 292,793 76.12% 67.14%
Saginaw 631 545 470 86.51% 295 236 167,466 72.62% 62.83%
Southeast 3,930 3,439 2,776 80.79% 1,715 1,317 1,041,865 70.94% 57.32%
St. Clair 1,049 877 759 86.73% 469 356 248,071 74.45% 64.58%
Washtenaw 1,927 1,497 1,315 88.06% 868 678 449,584 71.63% 63.08%
Minnesota 7,738 6,616 6,059 91.62% 3,401 2,788 4,466,309 79.57% 72.91%
Regions 1 and 2 1,002 754 696 92.38% 275 207 450,847 67.26% 62.14%
Regions 3 and 4 1,261 1,012 947 93.53% 556 457 765,424 81.81% 76.51%
Regions 5 and 6 1,460 1,229 1,172 95.48% 639 531 845,687 80.51% 76.87%
Region 7A (Hennepin) 1,611 1,468 1,289 87.72% 740 615 984,859 78.71% 69.05%
Region 7B (Ramsey) 662 528 481 91.08% 304 259 431,945 84.25% 76.73%
Region 7C 1,742 1,625 1,474 90.91% 887 719 987,548 80.91% 73.56%
Mississippi 8,516 6,771 6,294 93.09% 3,649 3,020 2,414,032 77.53% 72.17%
Region 1 1,913 1,508 1,403 92.97% 815 657 546,513 77.13% 71.71%
Region 2 950 726 687 94.07% 403 338 304,081 78.09% 73.46%
Region 3 1,220 935 883 94.29% 467 393 341,162 79.26% 74.74%
Region 4 1,501 1,249 1,139 91.27% 691 586 440,189 78.99% 72.10%
Region 5 413 335 318 94.82% 166 136 148,982 73.15% 69.36%
Region 6 940 766 734 96.18% 425 366 249,222 81.88% 78.75%
Region 7 1,579 1,252 1,130 90.82% 682 544 383,883 73.14% 66.43%
Missouri 8,022 6,652 6,144 92.40% 3,418 2,748 4,971,283 74.43% 68.77%
Central 1,127 854 798 93.32% 456 388 675,065 76.45% 71.34%
Eastern 2,728 2,380 2,221 93.35% 1,189 932 1,729,869 70.85% 66.14%
Eastern (St. Louis City and County) 1,879 1,621 1,509 93.13% 793 612 1,096,613 68.35% 63.65%
Eastern (excluding St. Louis) 849 759 712 93.82% 396 320 633,256 76.71% 71.97%
Northwest 1,756 1,461 1,345 92.15% 827 683 1,200,418 78.98% 72.78%
Northwest (Jackson) 1,041 845 774 91.73% 477 411 550,219 87.25% 80.03%
Northwest (excluding Jackson) 715 616 571 92.71% 350 272 650,199 69.18% 64.14%
Southeast 1,049 838 780 93.13% 448 358 593,998 75.21% 70.04%
Southwest 1,362 1,119 1,000 89.43% 498 387 771,933 73.70% 65.91%
Montana 9,083 7,348 6,883 93.76% 3,440 2,751 838,424 76.95% 72.14%
Region 1 790 601 581 96.77% 294 251 65,879 84.17% 81.46%
Region 2 1,243 937 888 94.91% 439 352 118,971 80.36% 76.27%
Region 3 1,953 1,684 1,558 92.51% 759 624 172,776 80.07% 74.07%
Region 4 2,210 1,705 1,586 93.30% 824 657 221,975 75.46% 70.40%
Region 5 2,887 2,421 2,270 93.70% 1,124 867 258,823 72.69% 68.11%
Nebraska 7,439 6,294 5,857 92.97% 3,468 2,754 1,514,441 72.77% 67.66%
Regions 1 and 2 871 654 613 93.71% 360 295 156,131 75.24% 70.51%
Region 1 450 333 312 93.75% 174 139 73,010 75.25% 70.54%
Region 2 421 321 301 93.68% 186 156 83,121 75.22% 70.47%
Region 3 928 801 753 94.00% 447 382 186,771 78.06% 73.38%
Region 4 853 667 633 94.88% 353 279 169,851 74.82% 70.99%
Region 5 1,842 1,550 1,424 91.63% 840 666 373,563 73.55% 67.39%
Region 6 2,945 2,622 2,434 92.79% 1,468 1,132 628,124 69.51% 64.50%
Nevada 7,153 5,622 5,240 94.31% 3,442 2,768 2,247,750 73.95% 69.74%
Clark - Region 1 4,874 3,727 3,488 94.76% 2,346 1,888 1,616,158 73.08% 69.25%
Region 3 1,014 823 770 93.80% 429 341 277,589 78.55% 73.68%
Capital District 521 456 424 93.27% 236 189 131,765 79.59% 74.24%
Rural/Frontier 493 367 346 94.51% 193 152 145,824 77.25% 73.01%
Washoe - Region 2 1,265 1,072 982 91.74% 667 539 354,003 74.28% 68.14%
New Hampshire 9,225 7,467 6,509 87.13% 3,647 2,813 1,135,243 73.37% 63.93%
Central 2,558 2,001 1,782 88.84% 1,017 799 322,597 71.06% 63.13%
Central 1 1,300 1,014 915 90.01% 564 443 158,831 70.75% 63.69%
Central 2 1,258 987 867 87.64% 453 356 163,766 71.42% 62.59%
Northern 1,566 980 895 91.34% 446 348 148,818 79.44% 72.56%
Southern 5,101 4,486 3,832 85.41% 2,184 1,666 663,827 73.05% 62.39%
Southern 1 (Rockingham) 1,922 1,687 1,457 86.37% 844 629 254,529 70.91% 61.24%
Southern 2 3,179 2,799 2,375 84.83% 1,340 1,037 409,298 74.38% 63.10%
New Jersey 7,538 6,451 5,664 87.84% 3,441 2,715 7,393,186 74.52% 65.46%
Central 1,823 1,437 1,242 86.72% 683 538 1,704,991 75.60% 65.57%
Metropolitan 1,852 1,668 1,457 87.39% 949 757 1,772,630 74.35% 64.97%
Northern 2,390 2,065 1,812 87.71% 1,095 866 2,364,215 74.92% 65.71%
Southern 1,473 1,281 1,153 89.83% 714 554 1,551,350 73.08% 65.65%
New Mexico 7,859 6,006 5,617 93.60% 3,352 2,729 1,697,244 77.05% 72.12%
Region 1 1,634 1,345 1,253 93.11% 822 677 349,305 79.75% 74.25%
Region 2 1,296 824 780 94.42% 376 318 247,487 80.15% 75.67%
Region 3 (Bernalillo) 2,135 1,778 1,647 92.82% 952 760 551,846 75.40% 69.98%
Region 4 1,125 867 792 92.05% 482 386 213,666 76.44% 70.37%
Region 5 1,669 1,192 1,145 95.84% 720 588 334,940 74.56% 71.46%
New York 42,293 36,171 26,660 73.18% 15,451 10,837 16,434,638 65.04% 47.60%
Region A 17,863 15,528 9,918 63.65% 6,088 4,075 6,919,074 61.09% 38.89%
Region 1 2,772 2,446 1,911 78.22% 1,275 952 1,128,476 70.08% 54.82%
Region 2 6,072 5,292 3,423 64.49% 2,210 1,470 2,486,246 60.99% 39.33%
Region 3 4,648 3,865 2,060 52.94% 1,005 670 1,411,346 62.62% 33.15%
Region 4 4,371 3,925 2,524 64.33% 1,598 983 1,893,006 54.87% 35.29%
Region B 9,635 8,598 6,462 73.73% 4,075 2,790 4,260,131 64.53% 47.58%
Region 5 5,020 4,550 3,509 74.34% 2,326 1,583 2,401,292 65.65% 48.81%
Region 6 2,617 2,382 1,664 70.14% 949 622 1,138,653 58.84% 41.27%
Region 7 1,998 1,666 1,289 77.10% 800 585 720,186 68.75% 53.01%
Region C 10,583 8,992 7,604 84.45% 4,004 2,978 3,923,816 69.07% 58.33%
Region 8 2,256 1,939 1,649 85.19% 919 666 858,024 66.46% 56.61%
Region 9 2,390 1,962 1,656 84.22% 927 706 816,591 68.79% 57.93%
Region 10 1,218 1,044 895 85.76% 427 339 380,283 74.32% 63.73%
Region 11 2,176 1,892 1,612 85.06% 908 662 897,029 72.47% 61.64%
Region 12 2,543 2,155 1,792 82.86% 823 605 971,889 66.55% 55.14%
Region D 4,212 3,053 2,676 86.66% 1,284 994 1,331,617 76.09% 65.94%
Region 13 1,503 901 803 88.75% 402 305 412,153 71.97% 63.87%
Region 14 1,094 829 714 86.07% 363 273 457,033 74.79% 64.37%
Region 15 1,615 1,323 1,159 85.65% 519 416 462,431 79.62% 68.20%
North Carolina 8,365 6,868 6,220 90.52% 3,323 2,756 7,947,416 77.68% 70.32%
Alliance 1,612 1,403 1,281 91.02% 690 566 1,367,974 77.77% 70.78%
Cardinal Innovations 1,140 993 895 90.56% 472 388 1,157,794 77.68% 70.35%
CenterPoint/Guilford 708 587 500 85.48% 277 238 854,600 83.12% 71.05%
CenterPoint 265 227 195 86.08% 114 99 445,433 83.08% 71.51%
Guilford 443 360 305 85.06% 163 139 409,167 83.15% 70.73%
CoastalCare 520 426 382 90.13% 211 168 513,049 69.02% 62.20%
Eastpointe 795 677 642 94.81% 354 295 673,365 73.41% 69.60%
ECBH 592 351 336 95.60% 177 147 508,413 78.09% 74.65%
MeckLINK 567 507 449 88.27% 259 191 761,618 69.23% 61.11%
Partners 813 698 647 92.63% 380 336 750,775 84.90% 78.64%
Sandhills 657 496 433 86.16% 226 177 457,197 68.61% 59.12%
Smoky Mountain 368 246 223 90.82% 124 113 456,336 85.53% 77.68%
Western Highlands 593 484 432 89.39% 153 137 446,295 88.35% 78.97%
North Dakota 9,748 7,829 7,357 93.98% 3,477 2,753 571,272 74.66% 70.16%
Badlands and West Central 2,406 1,951 1,853 95.05% 778 611 153,852 73.33% 69.70%
Lake Region and South Central 1,466 1,144 1,083 94.93% 473 395 80,246 81.36% 77.23%
North Central and Northwest 1,979 1,414 1,328 93.84% 653 497 105,557 71.24% 66.85%
Northeast 1,307 1,089 1,018 93.19% 549 460 74,595 77.18% 71.93%
Southeast 2,590 2,231 2,075 93.01% 1,024 790 157,023 73.66% 68.51%
Ohio 33,124 28,302 25,466 89.87% 14,157 11,113 9,614,579 73.98% 66.49%
Boards 2, 46, 55, and 68 1,332 1,152 1,039 90.69% 643 513 428,056 75.92% 68.85%
Boards 3, 52, and 85 964 845 803 95.00% 431 343 315,269 73.05% 69.39%
Boards 4 and 78 732 634 588 92.84% 296 239 262,286 80.32% 74.57%
Boards 5 and 60 917 773 732 94.63% 440 360 284,808 74.17% 70.19%
Boards 7, 15, 41, 79, and 84 1,552 1,280 1,185 92.27% 705 574 391,422 76.94% 71.00%
Boards 8, 13, and 83 1,452 1,284 1,121 87.42% 664 512 409,156 75.31% 65.84%
Board 9 (Butler) 1,110 966 820 84.49% 469 347 303,597 70.23% 59.34%
Board 12 958 837 748 89.53% 444 338 289,211 71.88% 64.36%
Boards 18 and 47 4,904 4,014 3,654 91.10% 1,839 1,494 1,316,042 74.69% 68.05%
Boards 20, 32, 54, and 69 973 869 837 96.33% 454 352 285,725 74.11% 71.39%
Boards 21, 39, 51, 70, and 80 1,413 1,261 1,099 86.97% 649 509 458,108 76.52% 66.55%
Boards 22, 74, and 87 1,193 1,024 941 91.73% 514 381 324,467 71.99% 66.04%
Boards 23 and 45 1,080 912 829 90.98% 501 412 310,984 79.01% 71.88%
Board 25 (Franklin) 3,282 2,817 2,336 81.96% 1,303 996 965,798 71.35% 58.48%
Boards 27, 71, and 73 1,400 1,164 1,081 92.89% 595 456 412,149 67.75% 62.94%
Boards 28, 43, and 67 1,478 1,284 1,205 93.79% 629 523 411,568 81.27% 76.22%
Board 31 (Hamilton) 2,342 1,998 1,709 85.68% 961 731 662,258 73.39% 62.88%
Board 48 (Lucas) 1,085 906 831 92.03% 499 380 363,259 67.06% 61.71%
Boards 50 and 76 1,887 1,630 1,528 93.84% 802 632 517,691 72.70% 68.22%
Board 57 (Montgomery) 1,492 1,268 1,100 87.05% 638 501 448,241 74.26% 64.64%
Board 77 (Summit) 1,578 1,384 1,280 92.58% 681 520 454,485 73.26% 67.83%
Oklahoma 8,200 6,572 5,971 90.89% 3,490 2,721 3,072,507 73.87% 67.13%
Central 817 715 658 92.11% 392 290 382,491 69.79% 64.29%
East Central 759 630 586 93.15% 355 273 355,850 72.12% 67.18%
Northeast 1,392 1,111 1,036 93.18% 557 429 396,247 74.32% 69.25%
Northwest and Southwest 1,260 848 791 93.25% 447 353 442,614 76.54% 71.38%
Oklahoma County 1,641 1,354 1,182 87.60% 712 563 583,385 75.51% 66.15%
Southeast 1,252 1,008 922 91.30% 523 408 423,122 69.51% 63.46%
Tulsa County 1,079 906 796 87.84% 504 405 488,798 77.70% 68.26%
Oregon 7,879 6,932 6,336 91.31% 3,489 2,781 3,268,476 76.04% 69.43%
Region 1 (Multnomah) 1,632 1,468 1,303 88.75% 652 512 635,607 73.54% 65.27%
Region 2 1,650 1,501 1,386 92.25% 794 593 763,623 71.99% 66.41%
Region 3 2,654 2,274 2,082 91.39% 1,203 1,001 1,024,226 79.08% 72.27%
Region 4 1,129 1,005 915 90.80% 491 390 471,173 77.25% 70.14%
Region 5 (Central) 475 399 381 95.61% 213 178 170,771 79.09% 75.62%
Region 6 (Eastern) 339 285 269 94.62% 136 107 203,076 72.75% 68.83%
Pennsylvania 32,838 28,178 22,806 80.59% 12,569 9,639 10,756,318 72.24% 58.22%
Region 1 (Allegheny) 3,406 2,951 2,477 83.80% 1,284 914 1,053,992 67.93% 56.93%
Regions 3, 8, 9, and 51 1,734 1,478 1,348 91.23% 679 486 598,452 67.25% 61.35%
Regions 4, 11, 37, and 49 2,216 1,787 1,477 82.91% 866 671 764,221 72.65% 60.23%
Regions 5, 18, 23, 24, and 46 2,046 1,751 1,063 58.97% 598 492 629,351 77.78% 45.87%
Regions 6, 12, 16, 31, 35, 45, and 47 1,930 1,654 1,419 83.37% 749 620 606,170 78.30% 65.28%
Regions 7, 13, 20, and 33 5,685 5,160 3,980 76.68% 2,261 1,730 2,088,112 71.97% 55.18%
Regions 10, 15, 27, 32, 43,and 44 1,622 1,313 1,209 92.25% 642 527 443,226 77.55% 71.54%
Regions 17 and 21 914 797 729 91.42% 395 323 311,936 74.80% 68.38%
Regions 19, 26, 28, and 42 3,763 3,441 2,663 76.73% 1,507 1,118 1,219,198 69.39% 53.24%
Regions 22, 38, 40, 41, and 48 2,170 1,759 1,550 88.10% 866 672 712,299 72.32% 63.71%
Regions 29 and 34 1,623 1,422 1,239 87.15% 644 456 546,332 65.80% 57.34%
Regions 30 and 50 1,646 1,344 1,155 85.88% 609 472 521,128 76.05% 65.31%
Region 36 (Philadelphia) 4,083 3,321 2,497 75.63% 1,469 1,158 1,261,900 74.11% 56.05%
Rhode Island 7,828 6,424 5,719 89.04% 3,403 2,768 895,756 75.29% 67.04%
Bristol and Newport 840 690 624 90.40% 323 276 114,743 76.26% 68.94%
Kent 1,243 1,103 983 89.12% 525 403 142,632 69.11% 61.59%
Providence 4,641 3,888 3,444 88.61% 2,134 1,736 528,202 76.59% 67.87%
Washington 1,104 743 668 89.90% 421 353 110,180 76.65% 68.90%
South Carolina 8,900 7,259 6,506 89.61% 3,452 2,792 3,868,769 75.12% 67.32%
Region 1 2,242 1,890 1,671 88.54% 937 734 1,008,495 74.22% 65.71%
Region 2 2,682 2,279 2,065 90.52% 1,048 891 1,158,146 78.47% 71.03%
Region 3 1,749 1,275 1,117 87.69% 562 426 673,316 69.31% 60.77%
Region 4 2,227 1,815 1,653 90.90% 905 741 1,028,812 76.12% 69.20%
South Dakota 7,530 6,339 6,003 94.74% 3,335 2,720 679,252 77.91% 73.80%
Region 1 1,852 1,588 1,477 93.07% 880 730 167,423 79.84% 74.31%
Region 2 812 665 632 95.22% 353 281 63,171 74.74% 71.16%
Region 3 1,833 1,489 1,414 94.96% 763 615 161,837 77.96% 74.03%
Region 4 1,071 891 846 94.88% 410 324 96,298 73.60% 69.83%
Region 5 1,962 1,706 1,634 95.79% 929 770 190,523 79.64% 76.29%
Tennessee 7,710 6,393 5,811 90.83% 3,332 2,739 5,344,342 77.57% 70.45%
Region 1 677 561 540 96.20% 295 256 435,188 86.62% 83.33%
Region 2 1,383 1,163 1,080 92.94% 587 458 1,002,352 75.17% 69.86%
Region 3 1,401 1,134 1,036 91.25% 559 453 801,676 74.21% 67.72%
Region 4 (Davidson) 918 760 656 86.23% 376 302 530,775 79.09% 68.20%
Region 5 1,545 1,328 1,201 89.93% 743 594 1,278,879 72.99% 65.65%
Region 6 820 657 622 94.73% 323 281 530,481 77.75% 73.65%
Region 7 (Shelby) 966 790 676 85.80% 449 395 764,990 85.88% 73.69%
Texas 27,261 22,682 20,585 90.55% 13,521 10,851 20,487,199 75.24% 68.13%
Region 1 1,084 923 864 93.65% 557 434 683,199 70.84% 66.34%
Region 2 558 436 420 96.06% 239 219 453,692 88.20% 84.72%
Region 3 6,955 6,075 5,720 94.03% 3,770 3,068 5,480,088 75.47% 70.97%
Region 3a 4,268 3,761 3,516 93.39% 2,289 1,829 3,479,181 73.49% 68.64%
Region 3bc 2,687 2,314 2,204 95.14% 1,481 1,239 2,000,906 78.92% 75.08%
Region 4 1,271 1,045 995 95.13% 573 452 918,066 72.34% 68.82%
Region 5 1,128 811 756 93.34% 501 423 633,600 80.36% 75.00%
Region 6 6,308 5,293 4,432 83.31% 3,059 2,325 4,931,443 71.15% 59.27%
Region 6a 5,527 4,672 3,915 83.37% 2,721 2,071 4,407,283 71.55% 59.65%
Region 6bc 781 621 517 82.77% 338 254 524,160 67.54% 55.90%
Region 7 3,798 2,962 2,734 92.34% 1,646 1,352 2,452,963 78.39% 72.39%
Region 7a 2,252 1,813 1,675 92.36% 975 793 1,537,261 76.29% 70.47%
Region 7bcd 1,546 1,149 1,059 92.30% 671 559 915,702 82.25% 75.92%
Region 8 2,713 2,225 1,952 88.04% 1,221 988 2,145,063 76.75% 67.57%
Region 9 621 489 465 95.02% 343 267 466,792 70.04% 66.56%
Region 10 905 837 793 94.86% 571 463 667,991 78.04% 74.03%
Region 11 1,920 1,586 1,454 91.70% 1,041 860 1,654,303 79.78% 73.15%
Region 11abd 1,327 1,066 984 92.24% 644 527 1,056,206 78.75% 72.64%
Region 11c (Hidalgo) 593 520 470 90.60% 397 333 598,096 81.60% 73.94%
Utah 5,097 4,472 4,231 94.62% 3,329 2,763 2,186,937 80.12% 75.81%
Bear River, Northeastern, Summit, Tooele, and Wasatch 803 728 696 95.81% 495 420 262,453 81.50% 78.08%
Central, Four Corners, San Juan, and Southwest 614 463 436 93.81% 312 253 267,846 77.52% 72.72%
Davis County 467 433 414 95.86% 335 302 237,120 90.05% 86.33%
Salt Lake County 1,920 1,680 1,591 94.68% 1,242 1,022 832,287 78.98% 74.78%
Utah County 814 733 682 93.25% 620 495 394,615 80.18% 74.76%
Weber, Morgan 479 435 412 94.50% 325 271 192,616 75.18% 71.05%
Vermont 9,413 7,375 6,594 89.46% 3,306 2,680 544,733 78.26% 70.01%
Champlain Valley 3,449 2,895 2,620 90.76% 1,414 1,116 216,621 76.16% 69.12%
Rural Northeast 2,141 1,713 1,408 82.31% 689 562 128,520 78.09% 64.27%
Rural Southeast 2,303 1,625 1,477 90.64% 687 561 113,560 77.37% 70.12%
Rural Southwest 1,520 1,142 1,089 95.47% 516 441 86,032 85.23% 81.37%
Virginia 7,911 7,008 6,138 87.56% 3,296 2,721 6,653,466 78.20% 68.47%
Region 1 1,349 1,208 1,116 92.55% 670 580 1,035,111 82.44% 76.30%
Region 2 1,966 1,810 1,550 85.40% 849 699 1,836,987 78.73% 67.24%
Region 3 1,316 1,134 1,006 88.46% 562 464 1,147,276 75.35% 66.66%
Region 4 1,305 1,185 999 84.51% 509 411 1,139,214 80.73% 68.23%
Region 5 1,975 1,671 1,467 87.77% 706 567 1,494,878 74.44% 65.34%
Washington 8,286 7,180 6,479 90.02% 3,666 2,784 5,673,430 71.60% 64.45%
Region 1 1,691 1,404 1,332 94.77% 706 539 1,236,099 71.33% 67.60%
East 1 (previously Region 1) 994 788 745 94.42% 376 277 710,676 67.66% 63.89%
East 2 (previously Region 2) 697 616 587 95.22% 330 262 525,423 76.95% 73.27%
Region 2 3,995 3,508 3,082 87.58% 1,730 1,321 2,601,950 73.00% 63.93%
North 1 (previously Region 3) 1,553 1,296 1,161 89.71% 682 531 950,244 74.59% 66.92%
North 2 (previously Region 4) 2,442 2,212 1,921 86.38% 1,048 790 1,651,706 72.14% 62.31%
Region 3 2,600 2,268 2,065 90.95% 1,230 924 1,835,381 69.83% 63.51%
West 1 (previously Region 5) 1,219 1,051 963 91.58% 634 480 881,921 72.16% 66.08%
West 2 (previously Region 6) 1,381 1,217 1,102 90.43% 596 444 953,460 67.54% 61.07%
West Virginia 9,388 7,537 6,769 89.47% 3,474 2,802 1,589,205 75.94% 67.94%
Region I 748 622 542 87.64% 261 200 127,860 64.33% 56.38%
Region II 1,152 960 829 86.35% 430 326 222,844 72.15% 62.30%
Region III 907 771 695 90.00% 327 276 146,282 78.26% 70.44%
Region IV 1,925 1,578 1,364 85.00% 831 690 346,586 81.42% 69.21%
Region V 2,878 2,368 2,197 92.62% 1,105 885 454,080 74.80% 69.28%
Region VI 1,778 1,238 1,142 92.24% 520 425 291,552 78.60% 72.50%
Wisconsin 7,586 6,386 5,946 92.92% 3,378 2,666 4,771,114 75.92% 70.55%
Milwaukee 1,128 999 921 91.70% 554 433 777,508 72.75% 66.71%
Northeastern 1,928 1,656 1,547 93.39% 916 718 1,031,063 78.53% 73.34%
Northern 697 513 477 92.78% 238 189 413,733 77.31% 71.72%
Southeastern 1,225 1,052 957 90.78% 531 393 968,628 69.16% 62.79%
Southern 1,434 1,195 1,109 92.69% 656 538 927,185 79.16% 73.37%
Western 1,174 971 935 96.26% 483 395 652,997 78.76% 75.81%
Wyoming 9,111 7,201 6,606 91.75% 3,381 2,727 468,680 76.29% 69.99%
Judicial District 1 (Laramie) 1,539 1,314 1,161 88.08% 513 404 76,579 74.59% 65.70%
Judicial District 2 1,014 743 689 92.66% 376 312 44,987 77.07% 71.41%
Judicial District 3 1,229 955 904 94.79% 558 455 66,322 78.06% 73.99%
Judicial District 4 735 567 523 92.40% 269 227 31,755 78.20% 72.26%
Judicial District 5 958 708 636 90.12% 265 221 45,067 78.51% 70.75%
Judicial District 6 837 691 653 94.70% 374 287 48,840 71.79% 67.98%
Judicial District 7 (Natrona) 1,079 907 820 90.61% 421 338 63,133 75.32% 68.25%
Judicial District 8 759 624 591 94.75% 289 237 32,747 78.53% 74.40%
Judicial District 9 961 692 629 90.55% 316 246 59,250 76.80% 69.54%
140103
Table C2. – Sample Sizes, Weighted Screening and Interview Response Rates, and Population Estimates, by Substate Region, for Persons Aged 12 to 20 and Persons Aged 18 or Older: 2010, 2011, and 2012 NSDUHs
State/Substate Region 12-20
Total
Selected		 12-20
Total
Responded		 12-20
Population
Estimate		 12-20
Weighted
Interview
Response
Rate
(Percentage)		 18+
Total
Selected		 18+
Total
Responded		 18+
Population
Estimate		 18+
Weighted
Interview
Response
Rate
(Percentage)
DU = dwelling unit; ECBH = East Carolina Behavioral Health; SPA = service planning area.
NOTE: For substate region definitions, see the "2010-2012 National Survey on Drug Use and Health Substate Region Definitions" at https://www.samhsa.gov/data/sites/default/files/substate2k12-StateTabs/NSDUHsubstateStateTabsTOC2012.htm.
NOTE: To compute the pooled 2010-2012 weighted response rates, the three samples were combined, and the individual-year weights were used for the pooled sample. Thus, the response rates presented here are weighted across 3 years of data rather than being a simple average of the 2010, 2011, and 2012 individual response rates.
NOTE: The total responded column represents the combined sample size from the 2010, 2011, and 2012 NSDUHs.
NOTE: The population estimate is the simple average of the 2010, 2011, and 2012 population counts for persons aged 12 to 20 and persons aged 18 or older. Because of rounding, the sum of the substate region population counts within a State may not exactly match the State population count listed in the table.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2010, 2011, and 2012 (2010 Data - Revised March 2012).
Total United States 112,389 94,187 38,520,150 83.78% 180,223 138,189 232,997,944 72.90%
Northeast 22,296 18,149 6,751,269 81.03% 36,412 26,929 42,644,963 69.72%
Midwest 31,555 26,329 8,329,840 83.41% 50,469 38,650 50,325,946 73.30%
South 34,983 29,829 14,165,781 85.19% 54,590 42,934 86,079,799 74.72%
West 23,555 19,880 9,273,259 83.94% 38,752 29,676 53,947,236 72.19%
Alabama 1,723 1,440 602,821 82.77% 2,734 2,125 3,598,931 72.66%
Region 1 391 318 162,713 80.68% 639 477 1,009,679 71.48%
Region 2 526 431 193,347 80.39% 794 595 1,158,203 68.80%
Region 3 350 295 117,015 84.47% 557 446 638,621 77.28%
Region 4 456 396 129,746 87.62% 744 607 792,428 75.34%
Alaska 1,389 1,153 91,346 83.30% 2,246 1,770 508,290 76.10%
Anchorage 585 497 36,922 85.75% 1,000 801 209,099 77.09%
Northern 332 266 21,876 79.04% 517 399 112,434 74.96%
South Central 304 247 24,230 82.76% 452 337 132,737 71.22%
Southeast 168 143 8,318 84.39% 277 233 54,020 83.86%
Arizona 1,523 1,298 814,074 84.90% 2,352 1,863 4,778,706 76.18%
Maricopa 983 834 494,193 84.70% 1,486 1,142 2,826,212 73.08%
Pima 201 165 121,395 81.11% 345 281 753,940 80.44%
Rural North 178 151 89,347 84.44% 301 253 554,257 84.41%
Rural South 161 148 109,139 91.15% 220 187 644,298 80.76%
Arkansas 1,536 1,261 362,442 81.72% 2,416 1,839 2,176,489 71.34%
Catchment Area 1 283 230 60,501 81.04% 451 325 345,281 67.38%
Catchment Area 2 141 115 39,400 82.16% 209 159 269,801 73.33%
Catchment Area 3 208 166 52,593 78.01% 304 212 291,306 60.31%
Catchment Area 4 139 113 31,872 80.65% 207 160 191,488 74.81%
Catchment Area 5 213 178 55,901 83.39% 368 278 325,954 72.39%
Catchment Area 6 112 96 27,002 83.72% 162 144 158,089 83.36%
Catchment Area 7 118 103 28,559 84.89% 182 142 171,264 74.54%
Catchment Area 8 322 260 66,615 82.08% 533 419 423,306 74.06%
California 6,077 5,086 4,999,389 83.42% 9,872 7,320 27,895,806 70.04%
Region 1R 124 98 118,833 78.57% 234 181 739,060 74.25%
Region 2R 167 134 136,413 82.02% 252 199 758,984 77.04%
Region 3R (Sacramento) 186 157 185,861 80.14% 326 249 1,053,628 74.28%
Region 4R 224 181 154,684 79.24% 374 272 990,082 70.63%
Region 5R (San Francisco) 81 70 57,002 86.45% 247 170 693,024 58.70%
Region 6 (Santa Clara) 189 150 207,213 80.63% 435 297 1,348,882 66.33%
Region 7R (Contra Costa) 140 123 134,972 87.88% 251 185 789,723 68.84%
Region 8R (Alameda) 199 170 176,470 87.03% 440 323 1,162,935 66.60%
Region 9R (San Mateo) 97 65 74,794 71.10% 177 110 555,833 55.16%
Region 10 206 161 179,846 78.38% 307 220 935,850 65.58%
Region 11 (Los Angeles) 1,604 1,329 1,309,291 81.97% 2,684 1,949 7,363,047 69.21%
LA SPA 1 and 5 135 112 129,511 82.41% 232 159 798,520 67.02%
LA SPA 2 302 240 270,018 77.48% 509 348 1,621,762 67.04%
LA SPA 3 284 232 233,874 81.59% 507 372 1,316,406 68.54%
LA SPA 4 126 107 117,652 85.00% 310 228 885,863 72.01%
LA SPA 6 219 180 166,274 82.77% 319 239 680,583 67.28%
LA SPA 7 243 213 195,678 83.47% 359 271 924,706 72.32%
LA SPA 8 295 245 196,283 83.73% 448 332 1,135,206 71.12%
Region 12R 129 109 120,676 80.54% 164 136 609,070 74.99%
Regions 13 and 19R 463 398 365,029 84.66% 606 466 1,706,767 73.47%
Region 13 (Riverside) 395 332 337,800 82.93% 545 407 1,582,718 71.38%
Region 19R (Imperial) 68 66 27,229 97.25% 61 59 124,049 96.58%
Region 14 (Orange) 484 402 404,091 83.27% 842 616 2,280,159 68.93%
Region 15R (Fresno) 177 162 143,962 92.03% 251 192 653,119 69.26%
Region 16R (San Diego) 526 435 402,017 84.15% 830 612 2,371,540 70.91%
Region 17R 319 273 222,563 86.46% 367 291 1,009,020 77.48%
Region 18R (San Bernardino) 418 364 320,454 86.60% 582 454 1,442,460 72.79%
Region 20R 199 180 143,850 89.69% 229 183 664,886 72.69%
Region 21R 145 125 141,369 87.70% 274 215 767,737 74.40%
Colorado 1,387 1,169 573,028 83.79% 2,433 1,876 3,815,726 75.93%
Region 1 179 145 83,033 77.75% 344 274 503,563 77.82%
Regions 2 and 7 733 615 310,897 84.63% 1,303 977 2,127,418 73.54%
Region 3 282 239 88,996 82.86% 444 342 558,469 76.72%
Region 4 82 73 32,535 90.42% 126 107 207,254 82.41%
Regions 5 and 6 111 97 57,567 86.57% 216 176 419,021 79.99%
Connecticut 1,530 1,290 449,374 84.78% 2,559 1,956 2,724,401 72.09%
Eastern 233 208 62,059 89.52% 428 352 339,686 79.27%
North Central 409 343 121,680 84.71% 658 498 763,612 68.35%
Northwestern 270 241 77,009 88.93% 386 299 467,802 69.97%
South Central 343 275 103,046 82.16% 618 455 646,111 71.61%
Southwest 275 223 85,580 81.12% 469 352 507,190 74.76%
Delaware 1,397 1,175 108,053 84.63% 2,276 1,815 690,455 77.51%
Kent 292 242 21,081 83.67% 406 315 122,415 73.88%
New Castle (excluding Wilmington City) 717 592 59,387 83.11% 1,162 934 354,902 79.81%
Sussex 236 208 18,939 87.80% 476 361 156,768 72.93%
Wilmington City 152 133 8,646 88.66% 232 205 56,370 85.00%
District of Columbia 1,427 1,274 62,488 88.37% 2,241 1,840 503,390 81.13%
Ward 1 136 128 6,698 95.11% 320 273 63,979 84.57%
Ward 2 128 100 7,599 76.22% 435 340 70,752 78.35%
Ward 3 114 98 6,555 86.65% 313 258 69,075 82.19%
Ward 4 176 152 6,818 86.60% 241 179 61,608 71.81%
Ward 5 231 210 8,466 87.58% 302 248 62,304 80.76%
Ward 6 103 94 4,514 91.53% 232 190 67,974 80.21%
Ward 7 224 195 10,158 87.47% 170 148 54,745 88.26%
Ward 8 315 297 11,682 94.92% 228 204 52,952 88.24%
Florida 6,268 5,357 2,189,991 85.33% 9,488 7,380 14,761,339 73.21%
Region A - Northwest 763 654 174,457 84.88% 1,042 835 1,068,061 79.87%
Circuit 1 474 401 84,388 81.82% 585 466 532,099 79.87%
Circuit 2 168 151 57,812 91.46% 272 220 306,497 82.26%
Circuit 14 121 102 32,257 82.30% 185 149 229,465 75.54%
Region B - Northeast 767 632 311,109 82.77% 1,327 1,016 1,978,747 72.24%
Circuits 3 and 8 218 166 75,956 76.17% 378 299 448,592 75.54%
Circuit 4 322 271 137,839 86.52% 525 397 850,413 70.58%
Circuit 7 227 195 97,313 83.81% 424 320 679,743 71.61%
Region C - Central 1,595 1,374 562,708 86.37% 2,214 1,706 3,708,486 71.00%
Circuit 5 214 178 100,582 84.09% 341 252 842,730 68.67%
Circuit 9 547 475 195,322 86.34% 751 607 1,073,848 73.32%
Circuit 10 307 270 86,286 87.94% 428 339 558,549 75.38%
Circuit 18 362 309 115,170 86.51% 442 315 756,508 64.40%
Circuit 19 165 142 65,348 85.75% 252 193 476,851 72.34%
Region D - Southeast 923 781 348,577 84.40% 1,506 1,142 2,397,598 71.12%
Circuit 15 (Palm Beach) 412 332 143,263 80.63% 661 483 1,046,586 67.34%
Circuit 17 (Broward) 511 449 205,315 87.70% 845 659 1,351,012 73.91%
Region E - Sun Coast 1,337 1,153 486,642 85.95% 2,026 1,556 3,591,815 72.49%
Circuit 6 326 269 139,503 81.70% 486 357 1,111,719 67.84%
Circuit 12 193 162 70,828 84.52% 304 229 602,261 70.17%
Circuit 13 (Hillsborough) 568 501 160,137 87.85% 828 659 942,558 75.71%
Circuit 20 250 221 116,174 88.17% 408 311 935,277 76.05%
Region F - Southern
   (Circuits 11 and 16)		 883 763 306,499 86.15% 1,373 1,125 2,016,632 78.57%
Georgia 1,466 1,240 1,246,043 84.63% 2,282 1,761 7,113,489 74.26%
Region 1 380 313 320,702 81.61% 582 464 1,831,220 76.50%
Region 2 218 194 167,557 88.22% 348 287 931,880 80.27%
Region 3 422 363 349,722 87.24% 705 534 2,106,754 72.76%
Region 4 106 88 81,066 82.24% 189 133 444,984 67.17%
Region 5 90 77 142,445 86.95% 162 121 811,735 69.58%
Region 6 250 205 184,553 81.40% 296 222 986,915 72.42%
Hawaii 1,602 1,280 149,952 79.97% 2,669 1,937 1,024,926 68.52%
Hawaii Island 238 192 20,592 81.07% 339 258 138,599 72.30%
Honolulu 1,130 899 105,524 79.33% 1,942 1,394 719,982 66.99%
Kauai and Maui 234 189 23,836 81.74% 388 285 166,345 72.36%
Kauai 81 65 7,150 82.95% 122 90 50,570 75.00%
Maui 153 124 16,687 81.17% 266 195 115,775 70.98%
Idaho 1,487 1,272 206,690 85.84% 2,249 1,779 1,140,300 76.71%
Region 1 187 144 25,687 76.00% 268 196 162,051 74.13%
Region 2 95 81 13,941 87.37% 193 157 84,006 80.99%
Region 3 248 215 35,444 85.14% 358 280 177,028 76.87%
Region 4 367 319 54,583 87.32% 551 450 324,470 76.34%
Region 5 254 218 24,246 85.32% 320 258 131,849 80.22%
Region 6 159 144 22,427 92.82% 238 187 116,280 75.58%
Region 7 177 151 30,362 88.10% 321 251 144,614 74.62%
Illinois 6,128 4,941 1,603,841 80.73% 10,141 7,326 9,582,639 68.92%
Region I (Cook) 2,236 1,785 614,743 80.14% 3,972 2,797 3,909,027 66.87%
Region II 2,139 1,740 548,511 81.08% 3,193 2,301 2,966,327 69.61%
Region III 737 600 189,439 82.11% 1,261 971 1,104,924 73.04%
Region IV 435 337 108,420 77.03% 742 545 688,822 70.89%
Region V 581 479 142,728 82.99% 973 712 913,540 68.97%
Indiana 1,480 1,262 827,280 85.08% 2,362 1,819 4,832,703 72.27%
Central 310 256 208,772 82.99% 480 342 1,252,850 65.08%
East 129 108 71,629 83.25% 231 184 417,621 78.44%
North Central 194 169 117,665 87.07% 328 276 684,892 81.97%
Northeast 154 127 84,849 83.11% 256 187 470,607 70.90%
Northwest 221 190 93,622 86.41% 317 247 547,399 76.04%
Southeast 170 148 84,260 84.89% 298 231 520,844 68.56%
Southwest 113 97 62,228 86.30% 174 130 383,787 72.20%
West 189 167 104,254 87.37% 278 222 554,705 70.65%
Iowa 1,472 1,247 367,880 84.47% 2,283 1,825 2,315,143 76.91%
Central 257 214 64,291 83.70% 446 336 412,238 73.06%
North Central 166 135 44,472 81.56% 212 163 261,325 72.51%
Northeast 357 304 90,377 85.04% 597 495 563,543 79.71%
Northwest 248 212 56,375 84.56% 330 264 355,786 77.84%
Southeast 321 272 77,162 82.90% 467 372 492,354 77.17%
Southwest 123 110 35,203 91.31% 231 195 229,897 80.23%
Kansas 1,444 1,238 361,811 85.70% 2,317 1,794 2,087,093 74.82%
Kansas City Metro 525 437 118,812 82.98% 841 638 694,920 71.91%
Northeast 200 173 70,748 85.09% 395 307 405,279 76.64%
South Central 207 175 45,848 84.74% 236 180 261,609 78.83%
Southeast 104 89 24,628 87.27% 154 128 142,723 77.81%
West 165 148 39,484 89.76% 287 209 226,507 70.39%
Wichita (Sedgwick) 243 216 62,291 89.48% 404 332 356,056 79.03%
Kentucky 1,500 1,252 507,519 83.46% 2,311 1,812 3,287,915 74.67%
Adanta, Cumberland River, and Lifeskills 279 233 87,827 82.26% 452 345 552,857 73.17%
Bluegrass, Comprehend, and North Key 415 343 152,407 82.94% 692 538 960,481 73.19%
Communicare and River Valley 168 145 57,455 87.36% 239 191 361,192 76.48%
Four Rivers and Pennyroyal 127 111 46,828 86.60% 208 175 314,461 82.73%
Kentucky River, Mountain, and Pathways 137 115 55,288 85.62% 220 172 373,505 68.23%
Seven Counties 374 305 107,714 81.46% 500 391 725,420 76.39%
Louisiana 1,876 1,630 566,276 87.12% 2,955 2,345 3,354,095 76.70%
Regions 1 and 10 391 328 96,032 84.87% 641 464 645,840 71.06%
Region 1 230 198 50,015 84.15% 328 247 322,576 75.74%
Region 10 (Jefferson) 161 130 46,017 85.88% 313 217 323,264 66.99%
Regions 2 and 9 487 429 155,593 88.12% 708 583 887,255 79.04%
Region 3 260 231 51,434 87.51% 354 288 293,363 76.68%
Regions 4, 5, and 6 428 365 148,963 84.17% 744 583 863,718 74.71%
Regions 7 and 8 310 277 114,253 90.52% 508 427 663,918 81.29%
Maine 1,457 1,262 152,923 86.94% 2,239 1,838 1,050,301 79.18%
Aroostook/Downeast 209 189 17,149 90.50% 295 265 126,922 85.04%
Aroostook 87 83 8,120 94.34% 141 130 56,825 87.96%
Downeast 122 106 9,029 87.92% 154 135 70,097 82.82%
Central 190 165 19,994 87.07% 296 252 136,865 83.33%
Cumberland 269 237 32,872 87.90% 448 337 223,551 72.61%
Midcoast 84 77 15,312 92.68% 167 148 117,578 87.16%
Penquis 210 178 21,782 82.61% 330 275 136,621 83.55%
Western 257 219 23,183 86.62% 371 317 153,400 82.16%
York 238 197 22,632 84.35% 332 244 155,363 66.71%
Maryland 1,353 1,161 667,492 85.55% 2,276 1,807 4,392,346 76.10%
Anne Arundel 92 77 58,669 86.31% 183 139 412,948 70.75%
Baltimore City 157 150 67,237 94.60% 299 266 477,159 85.95%
Baltimore County 163 133 89,826 82.53% 311 255 623,999 80.68%
Montgomery 231 208 103,657 90.55% 362 282 735,352 76.02%
North Central 126 108 56,672 86.92% 175 144 339,829 77.69%
Northeast 119 100 56,666 80.15% 189 136 368,342 72.49%
Prince George's 155 122 108,217 78.72% 303 231 644,329 71.45%
South 150 137 69,910 90.76% 208 164 417,518 72.55%
West 160 126 56,637 78.11% 246 190 372,870 75.03%
Massachusetts 1,614 1,327 777,724 81.64% 2,431 1,871 5,112,243 74.08%
Boston 161 140 93,954 87.64% 369 295 643,895 76.33%
Central 208 179 107,570 86.58% 303 237 653,619 74.08%
Metrowest 323 261 170,764 81.24% 417 319 1,180,160 73.59%
Northeast 365 292 149,371 78.59% 495 393 993,794 76.46%
Southeast 335 261 145,418 75.66% 511 360 987,293 69.24%
Western 222 194 110,647 88.60% 336 267 653,482 77.78%
Michigan 6,024 5,030 1,273,796 83.64% 9,537 7,445 7,472,567 74.36%
Detroit City 432 374 107,696 87.63% 659 528 504,543 73.90%
Genesee 278 247 54,929 89.20% 428 346 313,957 75.42%
Kalamazoo 432 365 88,014 83.08% 574 433 514,455 73.19%
Kent 334 293 78,714 87.47% 630 509 444,496 76.18%
Lakeshore 494 408 95,883 82.93% 739 595 524,631 77.30%
Macomb 514 412 99,632 80.15% 866 619 644,705 69.11%
Mid South 519 437 127,775 83.21% 848 681 709,411 80.39%
Northern 394 328 103,467 83.74% 681 571 668,896 81.91%
Oakland 711 578 145,462 82.09% 1,085 828 918,697 73.56%
Pathways and Western 195 173 36,430 89.14% 313 259 248,412 79.81%
Riverhaven 219 189 41,691 87.03% 353 282 264,396 74.84%
Saginaw 119 100 26,799 82.60% 208 162 151,176 71.63%
Southeast 772 629 154,772 82.06% 1,194 893 935,490 69.78%
St. Clair 198 158 37,053 79.84% 332 247 222,294 74.00%
Washtenaw 413 339 75,479 82.56% 627 492 407,009 71.14%
Minnesota 1,455 1,247 633,949 85.26% 2,331 1,853 4,040,193 78.75%
Regions 1 and 2 113 92 62,075 80.50% 193 140 411,304 66.02%
Regions 3 and 4 253 216 114,124 86.11% 372 297 689,633 81.19%
Regions 5 and 6 283 244 123,812 85.47% 427 347 766,018 79.82%
Region 7A (Hennepin) 272 241 122,532 89.56% 548 444 903,152 77.75%
Region 7B (Ramsey) 139 123 61,251 89.11% 212 176 394,357 83.41%
Region 7C 395 331 150,155 81.65% 579 449 875,728 80.22%
Mississippi 1,597 1,387 377,309 86.61% 2,480 2,007 2,164,645 76.46%
Region 1 354 295 86,916 82.99% 552 441 489,031 76.62%
Region 2 187 167 48,220 89.31% 270 216 271,936 76.46%
Region 3 201 178 55,486 87.62% 330 271 306,392 78.18%
Region 4 304 265 69,327 86.90% 456 386 393,140 78.39%
Region 5 71 61 21,955 89.19% 116 94 134,021 71.90%
Region 6 195 175 38,273 90.03% 282 238 224,653 80.78%
Region 7 285 246 57,133 85.30% 474 361 345,472 71.34%
Missouri 1,425 1,205 723,658 84.17% 2,372 1,855 4,494,236 73.37%
Central 195 179 104,909 91.49% 316 261 614,030 75.22%
Eastern 496 416 252,358 83.46% 828 623 1,558,771 69.41%
Eastern (St. Louis City and County) 327 271 158,439 81.67% 554 409 992,435 66.89%
Eastern (excluding St. Louis) 169 145 93,919 87.14% 274 214 566,336 75.37%
Northwest 323 273 172,252 84.94% 600 488 1,084,204 78.25%
Northwest (Jackson) 180 157 76,282 87.80% 351 302 498,572 87.28%
Northwest (excluding Jackson) 143 116 95,970 81.75% 249 186 585,632 67.47%
Southeast 207 172 83,652 82.08% 289 227 538,562 74.55%
Southwest 204 165 110,487 79.90% 339 256 698,669 72.85%
Montana 1,493 1,258 118,210 84.26% 2,352 1,834 763,923 76.23%
Region 1 130 111 9,350 84.91% 190 161 59,431 83.94%
Region 2 190 158 17,686 82.00% 293 231 107,598 80.30%
Region 3 328 284 23,773 86.71% 496 396 156,631 79.39%
Region 4 348 295 31,514 85.68% 596 467 203,577 74.69%
Region 5 497 410 35,887 82.43% 777 579 236,686 71.69%
Nebraska 1,458 1,255 228,037 86.25% 2,469 1,878 1,367,430 71.17%
Regions 1 and 2 169 144 22,660 84.45% 244 195 141,135 74.26%
Region 1 78 63 10,501 80.61% 119 92 66,306 74.38%
Region 2 91 81 12,159 88.32% 125 103 74,830 74.13%
Region 3 177 161 28,390 91.59% 313 257 168,324 76.52%
Region 4 159 145 25,880 92.33% 242 176 152,581 72.35%
Region 5 369 310 55,749 84.64% 619 480 341,660 72.48%
Region 6 584 495 95,358 84.54% 1,051 770 563,729 67.62%
Nevada 1,381 1,198 352,426 88.45% 2,572 2,010 2,028,107 72.44%
Clark - Region 1 904 795 253,039 90.32% 1,746 1,354 1,457,468 71.23%
Region 3 178 144 42,235 80.87% 306 242 250,062 78.43%
Capital District 93 76 18,882 81.45% 178 141 119,537 79.46%
Rural/Frontier 85 68 23,353 80.34% 128 101 130,526 77.08%
Washoe - Region 2 299 259 57,152 86.62% 520 414 320,576 73.22%
New Hampshire 1,673 1,357 174,864 82.55% 2,535 1,934 1,031,401 72.71%
Central 482 414 50,922 88.05% 753 586 295,017 70.10%
Central 1 286 245 26,786 88.60% 437 345 145,956 70.19%
Central 2 196 169 24,136 87.11% 316 241 149,061 70.00%
Northern 200 158 21,955 81.60% 315 251 137,307 79.95%
Southern 991 785 101,987 79.82% 1,467 1,097 599,077 72.26%
Southern 1 (Rockingham) 390 305 37,379 78.55% 555 401 228,982 69.90%
Southern 2 601 480 64,608 80.62% 912 696 370,094 73.72%
New Jersey 1,487 1,242 1,075,093 84.39% 2,355 1,799 6,678,841 73.41%
Central 305 247 248,936 80.58% 448 343 1,534,599 74.83%
Metropolitan 400 342 266,768 87.04% 658 507 1,601,944 73.04%
Northern 458 391 332,626 86.96% 765 585 2,141,474 73.71%
Southern 324 262 226,764 81.31% 484 364 1,400,824 72.05%
New Mexico 1,430 1,247 259,066 86.65% 2,337 1,832 1,526,696 75.84%
Region 1 349 311 58,448 88.98% 572 457 309,260 78.78%
Region 2 152 138 32,239 92.01% 261 210 225,667 78.66%
Region 3 (Bernalillo) 371 309 79,082 82.14% 710 549 500,482 74.36%
Region 4 216 185 35,414 85.96% 321 249 190,316 75.21%
Region 5 342 304 53,884 87.19% 473 367 300,971 72.98%
New York 6,393 4,910 2,360,688 76.59% 10,893 7,323 14,947,367 63.89%
Region A 2,373 1,805 912,107 76.34% 4,512 2,866 6,352,469 59.71%
Region 1 583 476 198,154 81.35% 858 603 1,006,535 68.47%
Region 2 939 688 352,034 74.24% 1,619 1,039 2,259,630 59.66%
Region 3 286 234 129,454 79.49% 821 520 1,341,482 61.79%
Region 4 565 407 232,466 74.65% 1,214 704 1,744,822 53.39%
Region B 1,778 1,307 653,512 72.46% 2,722 1,788 3,817,199 63.60%
Region 5 1,004 719 361,577 71.18% 1,564 1,037 2,153,515 65.09%
Region 6 398 286 174,401 69.72% 640 392 1,017,274 57.35%
Region 7 376 302 117,534 80.02% 518 359 646,410 67.39%
Region C 1,709 1,367 595,718 80.79% 2,755 1,978 3,565,654 67.84%
Region 8 418 325 125,167 80.13% 591 418 781,502 65.17%
Region 9 407 334 128,898 82.33% 630 462 739,533 67.22%
Region 10 160 133 62,304 81.59% 328 253 349,318 73.33%
Region 11 381 291 139,195 77.62% 627 443 811,738 71.76%
Region 12 343 284 140,155 82.75% 579 402 883,564 65.01%
Region D 533 431 199,351 80.51% 904 691 1,212,045 75.77%
Region 13 173 140 61,645 80.55% 280 204 375,809 71.01%
Region 14 139 109 67,727 78.60% 261 195 416,844 74.67%
Region 15 221 182 69,979 81.74% 363 292 419,393 79.58%
North Carolina 1,448 1,271 1,129,907 87.39% 2,244 1,808 7,192,124 76.62%
Alliance 278 241 203,680 86.06% 465 371 1,230,189 77.02%
Cardinal Innovations 213 181 171,676 85.46% 310 250 1,040,943 76.67%
CenterPoint/Guilford 112 97 124,776 85.79% 202 171 772,965 82.58%
CenterPoint 56 50 63,020 89.96% 76 65 402,688 82.32%
Guilford 56 47 61,756 81.49% 126 106 370,277 82.77%
CoastalCare 83 74 68,161 88.50% 152 114 473,222 66.63%
Eastpointe 168 152 99,133 88.09% 229 182 605,360 71.48%
ECBH 90 78 70,810 87.50% 115 94 465,547 77.05%
MeckLINK 107 90 107,484 84.82% 177 123 687,306 67.58%
Partners 177 162 105,982 91.13% 240 209 676,167 84.23%
Sandhills 102 91 65,474 88.20% 151 107 411,050 66.24%
Smoky Mountain 64 59 60,398 92.94% 88 82 419,373 85.49%
Western Highlands 54 46 52,332 86.15% 115 105 410,002 88.56%
North Dakota 1,487 1,267 85,491 85.59% 2,415 1,853 522,286 73.70%
Badlands and West Central 311 263 21,362 84.27% 522 392 140,126 71.97%
Lake Region and South Central 231 202 11,497 87.38% 301 246 72,607 80.83%
North Central and Northwest 291 236 15,228 80.05% 433 315 96,440 70.21%
Northeast 263 244 12,552 93.30% 432 353 68,966 76.11%
Southeast 391 322 24,852 83.44% 727 547 144,147 72.94%
Ohio 6,300 5,202 1,446,972 82.65% 9,643 7,405 8,679,993 73.07%
Boards 2, 46, 55, and 68 301 254 66,502 84.93% 420 329 384,220 75.05%
Boards 3, 52, and 85 206 177 51,528 85.88% 285 220 280,152 71.88%
Boards 4 and 78 134 104 36,573 77.09% 193 160 237,293 80.80%
Boards 5 and 60 238 205 48,619 86.57% 305 249 258,091 73.13%
Boards 7, 15, 41, 79, and 84 345 288 52,964 82.83% 561 454 356,246 76.44%
Boards 8, 13, and 83 312 247 63,027 80.36% 421 321 364,343 74.62%
Board 9 (Butler) 179 147 50,948 82.33% 349 249 272,623 69.35%
Board 12 220 175 45,493 82.31% 286 215 262,549 70.62%
Boards 18 and 47 768 662 190,551 85.95% 1,243 977 1,189,342 73.40%
Boards 20, 32, 54, and 69 221 182 43,762 82.21% 281 213 255,951 73.36%
Boards 21, 39, 51, 70, and 80 315 255 69,210 80.46% 388 300 409,712 76.18%
Boards 22, 74, and 87 221 173 50,573 78.56% 364 261 293,769 71.04%
Boards 23 and 45 225 191 50,414 84.95% 313 249 277,561 77.98%
Board 25 (Franklin) 533 439 143,769 81.88% 925 686 878,697 70.32%
Boards 27, 71, and 73 277 224 59,853 79.86% 394 292 372,081 66.19%
Boards 28, 43, and 67 286 245 64,150 85.96% 425 348 371,345 80.70%
Board 31 (Hamilton) 407 325 98,114 79.73% 663 490 600,266 72.57%
Board 48 (Lucas) 246 204 55,887 83.73% 341 254 328,774 65.57%
Boards 50 and 76 348 290 74,345 83.25% 552 423 469,030 71.53%
Board 57 (Montgomery) 277 226 64,545 81.69% 426 327 406,889 73.35%
Board 77 (Summit) 241 189 66,145 78.46% 508 388 411,060 73.07%
Oklahoma 1,487 1,210 462,381 81.16% 2,389 1,817 2,769,565 73.00%
Central 167 131 60,108 78.05% 272 191 344,819 68.18%
East Central 159 127 54,862 77.12% 232 172 318,181 71.46%
Northeast 236 186 62,178 78.59% 392 299 357,243 73.98%
Northwest and Southwest 209 169 66,793 81.13% 293 227 399,709 75.88%
Oklahoma County 291 239 83,770 84.16% 485 379 528,277 74.64%
Southeast 215 183 62,254 85.33% 356 264 381,549 67.87%
Tulsa County 210 175 72,416 81.63% 359 285 439,787 77.30%
Oregon 1,501 1,266 445,060 83.96% 2,388 1,838 2,976,378 75.12%
Region 1 (Multnomah) 231 197 71,681 82.93% 491 374 589,817 72.82%
Region 2 361 280 108,779 77.33% 522 378 685,867 71.27%
Region 3 548 472 153,380 85.51% 814 659 931,528 78.18%
Region 4 206 180 59,393 87.79% 336 252 431,333 76.12%
Region 5 (Central) 81 72 22,616 89.58% 150 121 154,610 78.05%
Region 6 (Eastern) 74 65 29,211 89.70% 75 54 183,223 70.09%
Pennsylvania 5,298 4,341 1,557,934 82.64% 8,727 6,492 9,785,061 71.24%
Region 1 (Allegheny) 518 400 136,989 77.98% 917 628 969,666 66.97%
Regions 3, 8, 9, and 51 292 221 87,160 75.33% 459 320 547,488 66.44%
Regions 4, 11, 37, and 49 361 303 114,464 85.44% 609 458 690,120 71.46%
Regions 5, 18, 23, 24, and 46 256 224 89,215 88.21% 404 323 573,666 76.75%
Regions 6, 12, 16, 31, 35, 45, and 47 310 264 98,097 83.95% 542 446 558,605 78.12%
Regions 7, 13, 20, and 33 948 792 308,139 84.70% 1,551 1,138 1,879,717 70.66%
Regions 10, 15, 27, 32, 43,and 44 266 226 60,201 86.19% 436 348 403,502 76.60%
Regions 17 and 21 174 155 49,291 89.64% 262 201 282,653 72.54%
Regions 19, 26, 28, and 42 696 544 178,554 78.25% 979 713 1,100,799 68.66%
Regions 22, 38, 40, 41, and 48 395 318 92,055 79.82% 591 449 651,777 71.43%
Regions 29 and 34 266 205 80,711 75.95% 437 295 494,259 64.68%
Regions 30 and 50 244 196 70,847 83.59% 430 328 477,200 75.42%
Region 36 (Philadelphia) 572 493 192,213 86.64% 1,110 845 1,155,610 72.96%
Rhode Island 1,415 1,231 128,522 86.95% 2,405 1,899 817,097 74.14%
Bristol and Newport 143 133 16,114 93.43% 220 180 104,822 74.27%
Kent 211 180 17,605 83.26% 369 269 130,087 67.88%
Providence 890 767 76,773 86.32% 1,524 1,210 481,780 75.59%
Washington 171 151 18,029 88.80% 292 240 100,408 75.61%
South Carolina 1,476 1,249 543,202 84.71% 2,368 1,881 3,511,346 74.20%
Region 1 412 327 145,439 79.53% 661 518 912,765 73.77%
Region 2 441 396 169,888 90.19% 734 609 1,047,533 77.38%
Region 3 230 187 89,688 80.63% 378 278 612,680 68.24%
Region 4 393 339 138,188 86.62% 595 476 938,369 74.99%
South Dakota 1,414 1,218 96,191 86.07% 2,291 1,829 614,500 77.18%
Region 1 389 338 22,773 86.42% 588 476 151,850 79.00%
Region 2 148 130 8,536 88.50% 249 194 56,702 74.00%
Region 3 324 274 24,289 85.36% 534 421 147,016 77.26%
Region 4 145 124 14,379 82.26% 285 216 86,948 72.77%
Region 5 408 352 26,215 86.63% 635 522 171,985 79.14%
Tennessee 1,422 1,227 773,174 86.29% 2,327 1,866 4,840,718 76.55%
Region 1 111 95 56,726 85.01% 210 183 398,720 86.75%
Region 2 259 208 138,249 80.43% 401 306 913,357 74.41%
Region 3 227 198 112,422 88.19% 396 310 730,952 72.87%
Region 4 (Davidson) 144 114 67,674 76.07% 279 224 490,912 79.19%
Region 5 334 291 197,428 88.01% 504 387 1,144,887 71.29%
Region 6 160 150 77,954 93.53% 208 173 479,746 75.85%
Region 7 (Shelby) 187 171 122,721 92.83% 329 283 682,145 84.73%
Texas 5,930 5,066 3,379,427 85.35% 9,204 7,166 18,231,553 73.98%
Region 1 243 208 114,991 85.00% 384 290 612,927 69.60%
Region 2 84 80 69,889 96.10% 169 153 411,412 87.59%
Region 3 1,664 1,451 881,362 87.42% 2,535 1,993 4,868,168 73.95%
Region 3a 960 832 558,952 87.47% 1,562 1,202 3,089,077 71.84%
Region 3bc 704 619 322,410 87.35% 973 791 1,779,091 77.67%
Region 4 261 219 136,457 85.33% 381 294 827,014 70.99%
Region 5 242 208 95,637 87.14% 332 276 571,922 79.44%
Region 6 1,305 1,058 802,109 80.38% 2,101 1,543 4,378,870 69.94%
Region 6a 1,144 929 720,444 80.37% 1,873 1,376 3,911,419 70.37%
Region 6bc 161 129 81,665 80.49% 228 167 467,451 66.04%
Region 7 681 587 394,376 86.01% 1,174 943 2,216,612 77.43%
Region 7a 386 342 234,638 87.00% 685 533 1,389,243 74.94%
Region 7bcd 295 245 159,738 84.74% 489 410 827,369 82.05%
Region 8 552 479 354,972 87.03% 806 626 1,909,451 75.21%
Region 9 163 137 75,630 86.55% 251 196 418,473 69.24%
Region 10 249 218 128,388 88.14% 386 301 582,316 76.68%
Region 11 486 421 325,618 86.09% 685 551 1,434,388 78.84%
Region 11abd 284 242 198,330 84.35% 437 352 923,089 78.10%
Region 11c (Hidalgo) 202 179 127,287 88.45% 248 199 511,300 80.20%
Utah 1,309 1,156 381,301 87.50% 2,377 1,909 1,919,693 78.77%
Bear River, Northeastern, Summit, Tooele, and Wasatch 198 181 47,498 87.67% 349 283 228,695 79.62%
Central, Four Corners, San Juan, and Southwest 135 120 47,346 91.71% 210 160 235,146 75.34%
Davis County 137 122 43,150 88.59% 237 213 205,079 90.14%
Salt Lake County 485 427 130,711 86.89% 891 711 738,626 77.62%
Utah County 229 194 80,897 83.96% 456 354 342,064 79.31%
Weber, Morgan 125 112 31,699 90.53% 234 188 170,083 73.39%
Vermont 1,429 1,189 74,147 84.00% 2,268 1,817 498,250 77.75%
Champlain Valley 601 492 32,719 83.28% 988 763 197,921 75.42%
Rural Northeast 305 260 16,865 85.55% 470 379 117,345 77.62%
Rural Southeast 288 241 13,425 84.10% 470 381 104,053 76.80%
Rural Southwest 235 196 11,138 83.72% 340 294 78,932 85.37%
Virginia 1,489 1,283 970,964 85.54% 2,196 1,772 6,033,779 77.37%
Region 1 323 287 163,920 88.21% 464 398 935,093 81.97%
Region 2 370 324 240,710 87.15% 548 434 1,660,071 77.72%
Region 3 241 211 164,319 88.12% 395 320 1,052,640 74.21%
Region 4 247 203 172,918 82.29% 305 241 1,030,998 80.27%
Region 5 308 258 229,097 81.84% 484 379 1,354,976 73.56%
Washington 1,527 1,253 813,978 81.85% 2,566 1,873 5,142,951 70.44%
Region 1 313 252 204,239 79.60% 479 350 1,107,565 69.75%
East 1 (previously Region 1) 157 124 113,629 77.02% 261 179 641,217 65.82%
East 2 (previously Region 2) 156 128 90,610 82.22% 218 171 466,348 76.10%
Region 2 694 572 343,713 81.39% 1,226 904 2,378,221 72.15%
North 1 (previously Region 3) 285 235 137,414 81.73% 479 366 860,309 73.93%
North 2 (previously Region 4) 409 337 206,299 81.16% 747 538 1,517,912 71.21%
Region 3 520 429 266,027 83.78% 861 619 1,657,165 68.47%
West 1 (previously Region 5) 263 216 130,660 82.88% 446 326 796,402 71.02%
West 2 (previously Region 6) 257 213 135,366 84.72% 415 293 860,762 65.98%
West Virginia 1,588 1,346 216,294 84.77% 2,403 1,893 1,457,618 75.14%
Region I 117 103 17,048 86.06% 164 117 117,535 62.04%
Region II 181 147 32,769 82.22% 285 207 201,555 71.13%
Region III 150 135 19,445 87.67% 213 171 133,315 77.09%
Region IV 423 359 51,554 85.08% 634 523 320,722 81.19%
Region V 487 407 59,355 84.20% 753 591 416,223 74.01%
Region VI 230 195 36,122 84.81% 354 284 268,267 77.97%
Wisconsin 1,468 1,217 680,934 82.98% 2,308 1,768 4,317,163 75.08%
Milwaukee 232 194 113,824 84.59% 390 291 704,328 71.23%
Northeastern 421 341 143,450 81.57% 605 466 932,699 78.22%
Northern 98 81 55,877 78.73% 167 130 375,980 77.09%
Southeastern 254 195 143,386 75.53% 335 240 867,465 68.30%
Southern 266 237 128,351 89.64% 467 368 844,084 78.01%
Western 197 169 96,046 86.98% 344 273 592,606 77.76%
Wyoming 1,449 1,244 68,739 85.42% 2,339 1,835 425,735 75.38%
Judicial District 1 (Laramie) 226 190 10,941 85.14% 333 255 69,644 73.63%
Judicial District 2 134 113 8,122 81.92% 304 251 42,113 76.39%
Judicial District 3 272 229 10,611 84.23% 372 300 59,019 77.50%
Judicial District 4 121 111 4,196 91.55% 207 171 29,009 77.42%
Judicial District 5 117 102 6,434 87.84% 165 134 40,852 77.56%
Judicial District 6 166 143 7,347 83.85% 242 173 43,796 70.43%
Judicial District 7 (Natrona) 159 141 9,056 87.47% 305 232 57,454 73.91%
Judicial District 8 142 126 4,645 88.95% 182 144 29,755 77.55%
Judicial District 9 112 89 7,386 80.18% 229 175 54,093 76.28%

Section D: References

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (DSM-IV) (4th ed.). Washington, DC: Author.

Center for Behavioral Health Statistics and Quality. (2012). Results from the 2011 National Survey on Drug Use and Health: Summary of national findings (HHS Publication No. SMA 12-4713, NSDUH Series H-44). Rockville, MD: Substance Abuse and Mental Health Services Administration.

Center for Behavioral Health Statistics and Quality. (2013a). Results from the 2012 National Survey on Drug Use and Health: Mental health findings (HHS Publication No. SMA 13-4805, NSDUH Series H-47). Rockville, MD: Substance Abuse and Mental Health Services Administration.

Center for Behavioral Health Statistics and Quality. (2013b). Results from the 2012 National Survey on Drug Use and Health: Summary of national findings (HHS Publication No. SMA 13-4795, NSDUH Series H-46). Rockville, MD: Substance Abuse and Mental Health Services Administration.

Folsom, R. E., Shah, B., & Vaish, A. (1999). Substance abuse in states: A methodological report on model based estimates from the 1994-1996 National Household Surveys on Drug Abuse. In Proceedings of the 1999 Joint Statistical Meetings, American Statistical Association, Survey Research Methods Section, Baltimore, MD (pp. 371-375). Alexandria, VA: American Statistical Association.

Hughes, A., Muhuri, P., Sathe, N., & Spagnola, K. (2012). State estimates of substance use and mental disorders from the 2009-2010 National Surveys on Drug Use and Health (HHS Publication No. SMA 12-4703, NSDUH Series H-43). Rockville, MD: Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality.

Office of Applied Studies. (2005, September). Appendix C: Research on the impact of changes in NSDUH methods. In Results from the 2004 National Survey on Drug Use and Health: National findings (HHS Publication No. SMA 05-4062, NSDUH Series H-28, pp. 145-154). Rockville, MD: Substance Abuse and Mental Health Services Administration.

Office of Applied Studies. (2008, June). Substate estimates from the 2004-2006 National Surveys on Drug Use and Health. Rockville, MD: Substance Abuse and Mental Health Services Administration.

Payton, M. E., Greenstone, M. H., & Schenker, N. (2003). Overlapping confidence intervals or standard error intervals: What do they mean in terms of statistical significance? Journal of Insect Science, 3, 34.

Raftery, A. L., & Lewis, S. (1992). How many iterations in the Gibbs sampler? In J. M. Bernardo, J. O. Berger, A. P. Dawid, & A. F. M. Smith (Eds.), Bayesian statistics 4 (pp. 763-774). London, England: Oxford University Press.

Schenker, N., & Gentleman, J. F. (2001). On judging the significance of differences by examining the overlap between confidence intervals. American Statistician, 55(3), 182-186.

Shah, B. V., Barnwell, B. G., Folsom, R., & Vaish, A. (2000). Design consistent small area estimates using Gibbs algorithm for logistic models. In Proceedings of the 2000 Joint Statistical Meetings, American Statistical Association, Survey Research Methods Section, Indianapolis, IN (pp. 105-111). Alexandria, VA: American Statistical Association.

Wright, D. (2002, October). State estimates of substance use from the 2000 National Household Survey on Drug Abuse: Volume II. Supplementary technical appendices (HHS Publication No. SMA 02-3732, NHSDA Series H-16). Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies.

Wright, D. (2003, July). State estimates of substance use from the 2001 National Household Survey on Drug Abuse: Volume II. Individual state tables and technical appendices (HHS Publication No. SMA 03-3826, NHSDA Series H-20). Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies.

Wright, D., & Sathe, N. (2005, January). State estimates of substance use from the 2002-2003 National Surveys on Drug Use and Health (HHS Publication No. SMA 05-3989, NSDUH Series H-26). Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies.

Section E: List of Contributors

This National Survey on Drug Use and Health (NSDUH) document was prepared by the Center for Behavioral Health Statistics and Quality (CBHSQ), Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS), and by RTI International (a trade name of Research Triangle Institute), Research Triangle Park, North Carolina. Work by RTI was performed under Contract No. HHSS283201000003C.

At RTI, Neeraja S. Sathe and Kathryn Spagnola were responsible for the writing of the document, and Ralph E. Folsom and Akhil K. Vaish were responsible for the overall methodology and estimation for the model-based Bayes estimates and confidence intervals. At SAMHSA, Arthur Hughes reviewed the document and provided substantive revisions.

The following staff were responsible for generating the estimates: Akhil K. Vaish, Neeraja S. Sathe, and Kathryn Spagnola. The following staff provided other support: Brenda K. Porter, Kristen Gulledge, Jessica Roycroft, and Farrah Bullock. Ms. Spagnola also provided oversight for production of the document. Richard S. Straw edited it; Debbie Bond, Valerie Garner, and Roxanne Snaauw formatted its text and tables; and Teresa F. Bass, Kimberly Cone, Danny Occoquan, and Pamela Tuck prepared the Web versions. Justine L. Allpress, E. Andrew Jessup, and Shari B. Lambert prepared and processed the maps used in the associated files.

End Notes

1 RTI International is a trade name of Research Triangle Institute, Research Triangle Park, North Carolina.

2 Prior to this effort, substate small area estimates using the combined 1999-2001, 2002-2004, 2004-2006, 2006-2008, and 2008-2010 data have been produced by SAMHSA. These estimates can be found at https://www.samhsa.gov/data/data-we-collect/nsduh-national-survey-drug-use-and-health.

3 OAS is the former name of SAMHSA's CBHSQ.

4 The use of mixed models (fixed and random effects) allows additional error components (random effects) to be included. These account for differences between States and within-State variations that are not taken into account by the predictor variables (fixed effects) alone. These models produce estimates that are approximately represented by a weighted combination of the direct estimate from the substate data and a regression estimate from the national model, where the weights are obtained by minimizing the mean squared error of the small area estimate. It is also difficult if not impossible to produce valid mean squared errors for small area estimates based solely on a fixed-effect national regression model.

5 See Table 3 in the "2010-2012 NSDUH Substate Region Estimates: Excel Tables" at https://www.samhsa.gov/data/sites/default/files/substate2k12-StateTabs/NSDUHsubstateStateTabsTOC2012.htm.

6 The RSE of an estimate is the posterior SE divided by the estimate itself. Note that the RSEs have been calculated based on the unbenchmarked small area estimates.

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