Counties were categorized into five urban/rural strata using Rural Urban Continuum Codes (RUCC) [44]. The original nine continuum codes were aggregated into five strata for this analysis: RUCC1 (original RUCC1), metropolitan urbanized, (>1 million population); RUCC2 (original RUCC2 and RUCC3), metropolitan urbanized (< 1 million population); RUCC3 (original RUCC4 and RUCC5), non-metropolitan urbanized; RUCC 4 (original RUCC6 and RUCC7), less urbanized; RUCC5 (original RUCC8 and RUCC9), thinly populated.
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