Health-Related Social Needs
Utility Shutoff Threat by County — US Rankings
CDC PLACES 2023 · Age-adjusted prevalence · All 3,144 US counties
Utility services threat captures adults whose gas, electricity, oil, or water service was threatened or shut off in the past 12 months. It is one of the sharpest indicators of acute household financial stress that PLACES tracks — by the time a utility shutoff notice is issued, a household has typically been months behind. The measure correlates closely with the housing-insecurity, food-insecurity, and transportation-barrier rankings. PLACES estimates have wider confidence intervals here than for the chronic-disease measures.
How this ranking is built
Source: CDC PLACES 2023 release. Methodology: BRFSS survey responses pooled across years, fitted with a small-area statistical model, age-adjusted to the 2000 US standard population. Confidence intervals (95%) are shown for each county — wider intervals indicate more uncertainty in the modeled estimate, typically driven by smaller populations.
Lowest Utility Services Threat / Shutoff Rates — Top 100 Counties
Counties with the lowest reported utility services threat / shutoff prevalence — these counties show the most favorable position on this measure.
Best 100 counties for Utility Services Threat / Shutoff.
Highest Utility Services Threat / Shutoff Rates — Bottom 100 CountiesCounties with the highest reported utility services threat / shutoff prevalence.
Worst 100 counties for Utility Services Threat / Shutoff.
What this ranking suggests
Utility shutoff threats are the social-driver measure most predictive of acute healthcare-system strain — emergency-department use, medication non-adherence, and pediatric hospitalization all rise when households face these pressures. Counties at the top of this ranking are typically also stressed across other social-driver rankings; the four together describe a household financial-distress profile.
Methodology notes & limitations
Estimates are statistical model outputs, not direct measurements. Small counties have wider confidence intervals; treat narrow rank differences in those rows as within-noise. Counties where the underlying population is too small to support modeling are suppressed entirely (about 1% of US counties). All measures are age-adjusted to the 2000 US standard population. The PLACES dataset uses BRFSS self-reported data — self-report introduces known direction-of-bias in some measures (BMI is under-reported; binge drinking is under-reported), but the bias is roughly uniform across counties so ranking comparability is preserved. See the methodology page for full data-pipeline documentation.
Data source: CDC PLACES 2023 release. Measure ID: SHUTUTILITY.