California Health Maps is an interactive mapping tool of health data for geographies beyond the county level in California. You can map cancer incidence for 12 of the most common invasive cancer sites and filter by sex and race/ethnicity. Visit Learn to review methodology, data sources, and more.
According to California Department of Public Health guidelines, cancer incidence rates cannot be reported if based on <15 cancer cases and/or a population of <10,000 to ensure confidentiality and stable statistical rates.
California
Health Maps
California
Demographics
Selected Area
Statewide
Population
% Non-Hispanic White
% Non-Hispanic Black
% Hispanic
% Asian/Pacific Islander
% Foreign Born
% Rural
% Over Age 65
Socioeconomic Status
Healthcare Access and Use
Selected Area
Statewide
% Uninsured
% Routine Checkups
% Delayed Care
% Colorectal Cancer Screening
% Mammograms
% Cervical Cancer Screening
% Preventive Care (Men, 65+ years)
% Preventive Care (Women, 65+ years)
Health and Well-Being
Selected Area
Statewide
% Obesity
% Food Insecure
% Physical Activity
% Smoking
Data Sources
California Cancer Registry, 2012-2016
PLACES Project. Centers for Disease Control and Prevention, 2020
The California Health Maps project aims to provide data for geographies beyond the county level to better serve cancer control, public health, and policy efforts.
California Health Maps allows users to interactively map health data for California at different geographic levels: census tract aggregation zones, medical service study areas (MSSAs), census designated places, congressional districts, state senate districts, state assembly districts, and counties.
California Health Maps include 5-year and 10-year cancer incidence rates based on the most current data for 12 of the most common invasive cancer sites by sex and race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, and non-Hispanic Asian/Pacific Islander).
It also includes selected population sociodemographic data based on 2010 Census and 2008-2012 American Community Survey data, and health and well-being, and health care access and use data from CDC PLACES Project and the
2015-2016 California Health Interview Survey.
On this website, data are shown by cancer reporting zone. These zones have been designed so that they have a minimum population, have similar demographic and socioeconomic characteristics, and are geographically compact (they minimize the distance between different parts of the zone). The minimum population for each zone is 50,000 people.
Counties with larger populations (more than 100,000 people) were divided into multiple zones by combining adjacent census tracts. For the rest of the state, adjacent counties and parts of counties were combined to form zones. Three demographic and socioeconomic characteristics were used to determine similarity: the percent minority population (percent of the population who are not non-Hispanic White), percent of the population with incomes below poverty, and the proportion of the population living in urban and rural areas.
We used population data from Census 2010 and Census 2010 tract geographies to construct the zones. Poverty data came from the American Community Survey 2012-2016 5-year data. We used a software zone design program called AZTool to identify aggregations of adjacent tracts and counties that optimize the three objectives: a target population of 50,000, geographic compactness, and similarity in terms of minority population, poverty, and urbanicity characteristics.
Medical Service Study Areas (MSSAs)
As defined by California's Office of Statewide Health Planning and Development (OSHPD) in 2013, "MSSAs are sub-city and sub-county geographical units used to organize and display population, demographic and physician data" (Source). Each census tract in CA is assigned to a given MSSA. The most recent MSSA dataset (2014) was used. Spatial data are available via OSHPD at the California Open Data Portal.
Census Designated Places
Census designated places are bounded areas designating cities, towns, unincorporated populations, and other "settled concentrations of populations" (more information at the Census website). 2010 data were used.
Congressional Districts
111th Congressional districts define the boundaries around areas which are represented by the U.S. House of Representatives (more information at the Census website). California Health Maps uses boundaries for the 111th Congress, happening from 2009-2011 and overlapping in time with the other 2010 data used.
State Senate Districts
2010 California State Senate districts define the boundaries of areas represented in the CA state senate (more information at the Census website).
State Assembly Districts
2010 California State Assembly districts define the boundaries of areas represented in the CA state assembly (more information at the Census website).
Counties
2010 California Counties define the boundaries of the 58 California Counties. Spatial data are available from NHGIS (IPUMS NHGIS, University of Minnesota, www.nhgis.org).
Cancer incidence rates
Incidence rates for zones, MSSAs, census designated places, congressional districts, state senate districts, and state assembly districts were calculated using case counts from the California Cancer Registry. Population data from 2010 Census and SEER census tract estimates by race/origin (controlling to vintage 2019) were used to estimate population denominators. State rates were computed based on data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program, to take advantage of annual population data from the National Center for Health Statistics. Cancer case numerator data in SEER are equivalent to cancer case numerator data from the California Cancer Registry.
Data reallocation for Census Designated Places, Congressional Districts, and Legislative Districts
For Census Designated Places, Congressional Districts, State Senate Districts and State Assembly Districts, data were transformed from census tract geographies to each of the different geographic area units. Spatial data for each census area unit are available from NHGIS (IPUMS NHGIS, University of Minnesota, www.nhgis.org), and spatial crosswalks used to convert data to each geography from census tracts are available at Missouri Census Data Center (MCDC). The geographic correspondence engine created by MCDC provides a weighting variable based on 2010 census population, which was used to reallocate population numbers and case numbers between disparate but overlapping geographic areas. The reallocated numbers for each census tract were then used to calculate population weighted averages for the larger geography.
The California Cancer Registry (CCR) is California's statewide population-based cancer surveillance system. It collects information about almost all cancers diagnosed in California. The CCR is recognized as one of the leading cancer registries in the world, and has been the cornerstone of a substantial amount of research on cancer in the California population. To date the CCR has collected detailed information on over 7 million cases of cancer among Californians diagnosed from 1988 forward, and more than 175,000 new cases are added annually.
The California Cancer Registry is established in accordance with California Health and Safety (HSC) code, sections 103875-103885, requiring that cancer information be reported by law. HSC code section 100330 is also passed, requiring that all information collected remains confidential, patient identities kept anonymous, and patients informed, in accordance with California Code of Regulations, Title 17, Section 2593. Under this authority, all health care providers and facilities providing diagnostic or treatment services to cancer patients in California are required to report information about such patients to the state cancer registry, via the regional registries. The Department has designated the three regional cancer registries in California, the Cancer Registry of Greater California, the Los Angeles Cancer Surveillance System, and the Greater Bay Area Cancer Registry as its agents for the purpose of collecting such data on behalf of this registry. The three California registries are part of the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) Program.
As we are reporting cancer incidence rates for small areas, the minimum reporting requirements allow us to report rates for the top 12 cancer sites.
We plan to update California Health Maps to include the most current 5-year and 10-year cancer incidence data as they become available, typically in the Spring of each year.
It takes several years for cancer incidence data for an entire population to be considered “complete,” that is, when a cancer registry is confident that all new cases of cancer have been reported. Selected population sociodemographic data and population estimates for calculating cancer incidence rates are from the 2010 Census short form, the most recent year of complete census data. Additional sociodemographic data are from the 2008-2012 American Community Survey; although more current American Community Survey data are available, these years were selected to more closely correspond to the other sociodemographic data and the population estimate data used for calculating cancer incidence rates.
Census tract aggregation zones are developed based on combining adjacent census tracts on the basis of similarity in population sociodemographic characteristics: poverty, rurality, and racial/ethnic minority (i.e., non-White) composition. Zones are required to have a minimum population of 50,000. In total, there are 578 zones for California. Zones vary in population size from 51,229 to 98,764 with the number of census tracts ranging from 5 to 25. These areas are generally smaller than a county, but larger than census tract to help provide additional options for understanding disease burden and better facilitate public health and policy planning.
The census tract aggregation zones were developed by the California Health Maps team including partners at Westat and the National Cancer Institute as part of a collaborative effort to provide cancer data at small (generally smaller than county) area levels. Stakeholder input was gathered and incorporated in the development process.
Counties in California can span up to hundreds of miles and include large and diverse populations. Surveillance of cancer burden at these large geographic scales may not be meaningful nor adequate for identifying areas with higher disease rates. This information can be used by cancer centers, healthcare organizations, community organizations, and policy makers better serve cancer control, public health, and policy efforts.
For the purposes of determining voting districts and congressional Representation, the U.S. Census is required by the Constitution to count everyone in the country every 10 years, but they do a lot more than that. The American Community Survey has been conducted by the U.S. Census Bureau since 2005 and provides detailed population and housing information replacing data previously collected on the Census long form.
According to California Department of Public Health guidelines, cancer incidence rates cannot be reported if based on <15 cancer cases and/or a population <10,000 to ensure confidentiality and stable statistical rates.
We have not reported small-area level cancer incidence data for smaller racial/ethnic groups or non-binary genders due to small cancer case counts and population estimates at the zone levels to ensure confidentiality and stable statistical rates. In addition, at this time, some of these data are not consistently collected within the California Cancer Registry nor available in population estimate data.
Studies have shown that where we live (and work and learn) affect our opportunities for physical activity, social engagement and support, access to healthy and affordable food, and exposure to stress and harmful chemicals. These factors can influence opportunities for health promotion and disease prevention.
Cancer is a group of diseases with many possible causes including genetic and clinical factors as well as social determinants of health. Common risk factors for cancer include smoking and tobacco use, diet and physical activity, sun and other types of radiation, viruses (e.g., HPV, Hepatitis B and C), chronic inflammation, and environmental exposures. Neighborhoods may influence cancer through multiple pathways including material deprivation, psychosocial mechanisms, health behaviors, and access to resources.
The neighborhood data are provided to characterize the zones based on several key social and built environment attributes. These are cross-sectional data on neighborhoods and cancer incidence so inferences regarding causes of cancer cannot be made. We have provided these data for the zones to help provide additional context for the observed cancer incidence rates. For example, a zone may have high colorectal cancer incidence rates; understanding the population-level characteristics of that zone can help community organizations and healthcare facilities target their screening and prevention programs toward the predominant populations within the zone.
The California Health Interview Survey (CHIS) is the largest state health survey in the nation. It is a web and telephone survey that asks questions on a wide range of health topics. CHIS is conducted on a continuous basis allowing the survey to generate timely one-year estimates. CHIS provides representative data on all 58 counties in California and provides a detailed picture of the health and health care needs of California's large and diverse population.
The CDC PLACES project is a collaboration between CDC, the Robert Wood Johnson Foundation, and the CDC Foundation. PLACES is an extension of the original 500 Cities Project that provided city and census tract estimates for chronic disease risk factors, health outcomes, and clinical preventive services use for the 500 largest US cities. Data sources used to generate these measures include Behavioral Risk Factor Surveillance System (BRFSS) data, Census Bureau data, and American Community Survey (ACS) estimates.
Aggregation: Collections of smaller units grouped together for the purposes of statistical reporting. See Methodology for more information.
Age-Adjusted Incidence Rate (AAIR): Age-adjustment is a statistical method that allows comparisons of incidence rates to be made between populations with different age distributions. This is important since the incidence of most cancers increases with age. An age-adjusted cancer incidence (or death) rate is defined as the number of new cancers (or deaths) per 100,000 population that would occur in a certain period of time if that population had a 'standard' age distribution. In the California Health Maps, incidence rates are age-adjusted using the U.S. 2000 Standard Population.
Breast Cancer Screening: Percent of women aged 50-74 years who have received a mammogram in the past 2 years. Source: PLACES Project. Centers for Disease Control and Prevention, 2020.
Cervical Cancer Screening: Percent of women between the ages of 21 and 65 living within a census tract who reported having had a
cervical screening test, and the type of test depends on age of female respondent. For those 21-29, the test used is a pap test, whereas for those 30-65 years old, either pap test alone,
HPV test alone, or a combination can be recommended. Data does not include women who reported having a hysterectomy. Source: PLACES Project. Centers for Disease Control and Prevention, 2020.
Confidence Interval: A statistical measure of the precision of the observed incidence rate. The lower confidence interval (LCI) and upper confidence interval (UCI) provide a range within which the true rate is thought to be with 95% confidence. Rates based on larger numbers are subject to less variation.
Colorectal Cancer Screening: Percent of adults aged 50–75 years who have received a fecal occult blood test (FOBT) within the past year, a sigmoidoscopy within the past 5 years and a FOBT within the past 3 years, or a colonoscopy within the past 10 years. Source: PLACES Project. Centers for Disease Control and Prevention, 2020.
Data Suppression: According to California Department of Public Health guidelines, cancer incidence rates cannot be reported if based on fewer than 15 cancer cases and/or 10,000 population counts. Incidence rates with fewer than 15 cases and/or 10,000 population-at-risk for a given cancer site/sex/racial or ethnic group are not shown to ensure confidentiality and stable statistical rates.
Delayed Care: Percent of adults who delayed or did not get medicine/medical services in the past year. Source: California Health Interview Survey, 2015-2016.
Demographics: Statistical data relating to the population and particular groups within it.
Food Insecure: Percent of adults in low-income households (<200% of the Federal Poverty Line) that are hungry or at risk of hunger. Source: California Health Interview Survey, 2015-2016.
Foreign Born: Percent of residents who were born outside the United States. Source: American Community Survey, 2008-2012.
Incidence: The number of new cases of cancer diagnosed over a specified period of time (per population).
Over 65: Percent of residents age 65 years and older. Source: US Census, 2010.
Obesity: Percent of adults with a body mass index (kilograms/square meter) of 30 or greater. Source: PLACES Project. Centers for Disease Control and Prevention, 2020; California Health Interview Survey, 2015-2016 (zones only).
Physical Activity: Percent of adults that walked at least 150 minutes in the past week for either leisure or transportation. Source: California Health Interview Survey, 2015-2016.
Preventive Care: Percent of men or women 65 years and older who have received all of the following: an influenza vaccination in the past year; a pneumococcal vaccination ever; either a fecal occult blood test (FOBT) within the past year, a sigmoidoscopy within the past 5 years and a FOBT within the past 3 years, or a colonoscopy within the previous 10 years; and (for women only) a mammogram in the past 2 years. Source: PLACES Project. Centers for Disease Control and Prevention, 2020.
Race/Ethnicity: Race/ethnicity is categorized as: All races/ethnicities, Non-Hispanic (NH) White, NH Black, Asian/Pacific Islander, or Hispanic. "All races" includes all of the above, as well as other and unknown race/ethnicity and American Indian/Alaska Native. The latter two groups are not reported separately due to small numbers for many cancer sites.
Racial/Ethnic Composition: Distribution of residents' race/ethnicity (e.g., % Hispanic, % non-Hispanic White, % non-Hispanic Black, % non-Hispanic Asian/Pacific Islander). Source: US Census, 2010.
Routine Checkups: Percent of adults who report having been to a doctor for a routine checkup (e.g., a general physical exam, not an exam for a specific injury, illness, condition) in the previous year. Source: PLACES Project. Centers for Disease Control and Prevention, 2020.
Rural: Percent of residents who reside in blocks that are designated as rural. Source: US Census, 2010.
Sex: California Cancer Registry defines this field as the sex or gender of the cancer patient, and codes available are male, female, intersex, transsexual, and transgender (natal male, natal female, or not specified). However, categories beyond male and female are not consistently coded by medical reporting facilities, and population estimates for gender categories beyond male and female are not available. Thus, cancer incidence data are reported for only male and female sex at this time.
Socioeconomic Status (Neighborhood Level): A composite measure of seven indicator variables created by principal component analysis; indicators include: education, blue collar job, unemployment, household income, poverty, rent, and house value. Quintiles based on state distribution, with quintile 1 being the lowest SES and 5 being the highest. Source: American Community Survey, 2008-2012.
Uninsured: Percent of residents who did not have health insurance. Source: American Community Survey, 2008-2012.
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Therefore users will:
Use these data for health statistical reporting and analysis only.
Make no attempt to learn the identity of any person or establishment included in these data.
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Make no disclosure or other use of the identity of any person or establishment discovered inadvertently and advise California Health Maps of any such discovery.
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The number of new cases of cancer diagnosed in the selected time period.
Age-adjustment is a statistical method that allows comparisons of incidence rates to be made between populations with different age distributions. This is important since the incidence of most cancers increases with age. An age-adjusted cancer incidence (or death) rate is defined as the number of new cancers (or deaths) per 100,000 population that would occur in a certain period of time if that population had a 'standard' age distribution. In the California Health Maps, incidence rates are age-adjusted using the U.S. 2000 Standard Population.
A statistical measure of the precision of the observed incidence rate. The lower confidence interval (LCI) and upper confidence interval (UCI) provide a range within which the true rate is thought to be with 95% confidence. Rates based on larger numbers are subject to less variation.
Percent of residents who did not have health insurance. Source: American Community Survey, 2008-2012.
Distribution of residents' race/ethnicity (e.g., % Hispanic, % non-Hispanic White, % non-Hispanic Black, % non-Hispanic Asian/Pacific Islander). Source: US Census, 2010.
Distribution of residents' race/ethnicity (e.g., % Hispanic, % non-Hispanic White, % non-Hispanic Black, % non-Hispanic Asian/Pacific Islander). Source: US Census, 2010.
Distribution of residents' race/ethnicity (e.g., % Hispanic, % non-Hispanic White, % non-Hispanic Black, % non-Hispanic Asian/Pacific Islander). Source: US Census, 2010.
Distribution of residents' race/ethnicity (e.g., % Hispanic, % non-Hispanic White, % non-Hispanic Black, % non-Hispanic Asian/Pacific Islander). Source: US Census, 2010.
Percent of residents who were born outside the United States. Source: American Community Survey, 2008-2012.
Percent of residents who reside in blocks that are designated as rural. Source: US Census, 2010.
A composite measure of seven indicator variables created by principal component analysis; indicators include: education, blue collar job, unemployment, household income, poverty, rent, and house value. Quintiles based on state distribution, with quintile 1 being the lowest SES and 5 being the highest. Source: American Community Survey, 2008-2012.
Race/ethnicity is categorized as: All races/ethnicities, Non-Hispanic (NH) White, NH Black, Asian/Pacific Islander, or Hispanic. "All races" includes all of the above, as well as other and unknown race/ethnicity and American Indian/Alaska Native. The latter two groups are not reported separately due to small numbers for many cancer sites.
California Cancer Registry defines this field as the sex or gender of the cancer patient, and codes available are male, female, intersex, transsexual, and transgender (natal male, natal female, or not specified). However, categories beyond male and female are not consistently coded by medical reporting facilities, and population estimates for gender categories beyond male and female are not available. Thus, cancer incidence data are reported for only male and female sex at this time.
All incidence rates are for invasive cancers except for urinary bladder which include both in situ and invasive cancer cases.
Percent of adults aged 50–75 years who have received a fecal occult blood test (FOBT) within the past year, a sigmoidoscopy within the past 5 years and a FOBT within the past 3 years, or a colonoscopy within the past 10 years. Source: PLACES Project. Centers for Disease Control and Prevention, 2020.
Percent of women aged 50-74 years who have received a mammogram in the past 2 years. Source: PLACES Project. Centers for Disease Control and Prevention, 2020.
Percent of men or women 65 years and older who have received all of the following: an influenza vaccination in the past year; a pneumococcal vaccination ever; either a fecal occult blood test (FOBT) within the past year, a sigmoidoscopy within the past 5 years and a FOBT within the past 3 years, or a colonoscopy within the previous 10 years. Source: PLACES Project. Centers for Disease Control and Prevention, 2020.
Percent of residents age 65 years and older. Source: US Census, 2010.
Percent of men or women 65 years and older who have received all of the following: an influenza vaccination in the past year; a pneumococcal vaccination ever; either a fecal occult blood test (FOBT) within the past year, a sigmoidoscopy within the past 5 years and a FOBT within the past 3 years, or a colonoscopy within the previous 10 years, and a mammogram in the past 2 years. Source: PLACES Project. Centers for Disease Control and Prevention, 2020.
Percent of adults who report having been to a doctor for a routine checkup (e.g., a general physical exam, not an exam for a specific injury, illness, condition) in the previous year. Source: PLACES Project. Centers for Disease Control and Prevention, 2020.
Percent of women aged 21–65 years who have not received a hysterectomy and have received a cervical screening test. Source: PLACES Project. Centers for Disease Control and Prevention, 2020.
Delayed Care: Percent of adults who delayed or did not get medicine/medical services in the past year. Source: California Health Interview Survey, 2015-2016.
Percent of adults in low-income households (<200% of the Federal Poverty Line) that are hungry or at risk of hunger. Source: California Health Interview Survey, 2015-2016.
Percent of adults that walked at least 150 minutes in the past week for either leisure or transportation. Source: California Health Interview Survey, 2015-2016.
Percent of adults with a body mass index (kilograms/square meter) of 30 or greater. Source: California Health Interview Survey, 2015-2016; PLACES Project. Centers for Disease Control and Prevention, 2020.
Non-cancer metrics are not available by sex or race/ethnicity.
Data is suppressed for geographies with ≤90% coverage. Data for delayed care from the California Health Interview Survey may be suppressed, check AskCHIS NE for availability.
Some data from the California Health Interview Survey may be suppressed, check AskCHIS NE for availability.
