Where the data comes from
Public data, and anyone can reproduce it.
There is no private or proprietary data behind the Atlas. Every person on the map comes from a free, public U.S. government health survey. The whole pipeline — download, combine, score, check — is scripted, so anyone can run it and get the same map.
The source: NHANES
The map is built on NHANES, the CDC’s National Health and Nutrition Examination Survey — one of the most trusted pictures of American health. It is already de-identified and released to the public. We use the 2013–2014 cycle, the most recent one that pairs lab work, a week of wearable-measured activity, and symptom questionnaires on the same people.
Our working sample is the 3,919 adultswho have complete data across all three kinds of measurement — body, behavior, and how they feel.
Exactly which pieces we use
For each person we pull three kinds of measurement — body, behavior, and how they feel — and join them on the NHANES respondent ID (SEQN), so every reading describes the same individual. That is what lets us see the full picture instead of one lab at a time:
| Kind | What it is |
|---|---|
| Who | Age, sex, and race/ethnicity, plus the survey weights that let this sample stand in for the whole country (file DEMO_H). |
| Body | Standard blood, metabolic, and inflammation labs — the measurable signs of what is happening inside (CBC_H, BIOPRO_H, GHB_H). |
| Behavior | About a week of activity from a wrist-worn monitor — what the body actually does day to day, not what someone remembers doing (PAXDAY_H). |
| Feelings | Tested questionnaires on physical functioning, mood, sleep, and self-rated health — how people actually feel day to day (PFQ_H, DPQ_H, HSQ_H, SLQ_H). |
| Conditions | Self-reported doctor-diagnosed medical conditions (MCQ_H) — used only to check the map, never to build it. |
The pipeline, start to finish
- Download the public NHANES files directly from the CDC.
- Combine them per person on the respondent ID, keeping only adults with all three kinds of measurement.
- Score each person’s burden from the combined signals.
- Sort everyone into five equal burden groups.
- Checkthe result against diagnosed conditions — weighting the sample so it represents the country, and accounting for age, sex, race, and weight — see how we know it’s real.
Reproducible by design
The download-to-map pipeline is committed as a small, self-contained project with its scripts, a data manifest, and the validation output. Because the inputs are public and the steps are code, the map is not a claim you have to take on faith — it is something anyone with the scripts can rebuild from scratch.
Sources
- CDC NHANES 2013–2014
Source cycle for every respondent in this atlas. Variable files combined: DEMO_H (demographics), CBC_H (complete blood count), BIOPRO_H (biochemistry profile), GHB_H (glycohemoglobin), PFQ_H (physical functioning), DPQ_H (depression screener), HSQ_H (current health status), SLQ_H (sleep disorders), PAXDAY_H (physical activity monitor), and MCQ_H (medical conditions).
- CDC — National Health and Nutrition Examination Survey (NHANES)
Program landing page: survey design, purpose, and how NHANES data collection works.
- NCHS — NHANES Analytic Guidelines
Official guidance on survey weighting and variance estimation; the basis for the survey-weighted (chronicWt) rates reported in this brief.
- NCHS — Public-Use Linked Mortality Files (through 2019)
Independent death-certificate linkage (National Death Index) used only to VALIDATE the burden strata — never to build the score. Basis for the Cox mortality analysis (NHANES 2013–2014 respondents followed through December 2019).