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The Chronic Disease Indicators (CDI) is a cross-cutting set of 98 indicators that were developed by consensus and that allows states and territories to uniformly define, collect, and report chronic disease data that are—

  • Important to public health practice
  • Available at the state level

In addition to providing access to state-specific indicator data, the CDI Web site serves as a gateway to additional information and data resources.


CDI are divided into seven categories that represent a wide spectrum of conditions and risk factors as well as social context:

  • Physical activity and nutrition
  • Tobacco and alcohol use
  • Cancer
  • Cardiovascular disease
  • Diabetes
  • Arthritis
  • Overarching conditions
  • Other diseases and risk factors:


The Council of State and Territorial Epidemiologists (CSTE) originally worked with epidemiologists and chronic disease program directors at the state and federal level to select, prioritize, and define 73 chronic disease indicators. The first set of indicators was published in 1999, with state-specific data published the following year. In 2001 the content of both reports became available online. In 2002, CSTE adopted a revised and expanded set of indicators—Council of State and Territorial Epidemiologists Position Statement: Revise Chronic Disease Indicators (CDI)—to reflect expert and stakeholder recommendations.* PDF Icon (PDF–111K)

This site presents the most up-to-date CDI definitions. The Chronic Disease Indicators are a collaborative effort of the following organizations:


For each indicator

  • Consistent methods for conducting state-level analyses were established to provide comparable state-specific data.
  • Surveillance data are available for the majority of states.
  • A comprehensive definition was established, comprising the following elements:
    • Demographic group
    • Numerator
    • Denominator
    • Measures of frequency
    • Time period for case definition
    • Background
    • Significance
    • Limitations of indicator
    • Data resources
    • Limitations of data resources
    • Healthy People 2010 objectives


  • Indicators are related to diseases/conditions with substantial public health burden.
  • Indicators are consistent with Healthy People 2010 where possible.


The definition for each indicator includes a hyperlink to additional information and data resources. These include—

Behavioral Risk Factor Surveillance System (BRFSS)

Alcohol and Public Health

Youth Risk Behavioral Surveillance System (YRBSS)

State Tobacco Activities Tracking and Evaluation (STATE) System

National Program of Cancer Registries

State Cancer Profiles


Health-Related Quality of Life

United States Renal Data System (USRDS)*

Current Population Survey, American Community Survey

National Diabetes Surveillance System

National Oral Health Surveillance System


The Chronic Disease Indicators facilitate and standardize surveillance at both the state and national levels.

  • New Hampshire used the indicators to develop the state’s diabetes surveillance system. Twelve of the 13 measures in the state’s surveillance system were from the chronic disease indicators: Link*
  • New Mexico published a comprehensive chronic disease surveillance report that examined the available data for each indicator. Whenever possible, data were presented at the district and county level: Link* PDF Icon (PDF–525K)
  • In Ohio the indicators help to improve program evaluation by ensuring that epidemiological data are used systematically for baseline measurements in program impact and outcome objectives.
  • Oregon has used the indicators as a standardized methodology for analyzing chronic disease surveillance data. These data, in turn, have helped to guide chronic disease prevention efforts, including reduction of health disparities: Link PDF Icon (PDF–8.17MB)
  • Maine has used the chronic disease indicators as guidance for developing county-level fact sheets on cardiovascular disease: Link*
  • Georgia has calculated values for 19 health districts for most of the indicators, including race- and district-specific values for some indicators. They plan to create an Access database with standardized reports for each district, and eventually to post the District-level indicators on the Web.
  • The Chronic Disease Indicators inspired the Division of Diabetes Translation at CDC to develop a resource tool called the Diabetes Indicators and Data Sources Internet Tool. This tool contains 38 diabetes indicators and lists associated national, state and state-specific data sources. It is designed to assist diabetes programs with their surveillance and epidemiological activities: Link
  • The process of selecting the Chronic Disease Indicators provided a model for the CDC Division of Oral Health, in partnership with the Association of State and Territorial Dental Directors, to develop the National Oral Health Surveillance System (NOHSS). NOHSS includes indicators of oral health, information on state dental programs, and links to other important sources of oral health information. The NOHSS Web site contains key oral health indicators, including the CDI indicators related to oral health, and lists associated national and state data sources. Web site users can view profiles for each state, select tables and graphs for each indicator, and create comparisons between states.
  • The Steps to a HealthierUS Cooperative Agreement (Steps) Program used the Chronic Disease Indicators to identify core performance measures to track progress on intended health outcomes over time. Aligning core performance measures with the Chronic Disease Indicators enables Steps communities to compare their progress to other communities, states, and the nation as a whole.


The indicators will be reviewed periodically because of changes in data availability and public health priorities for chronic disease. As this happens, this Web site will be updated to provide states and territories with the most current tools and data to use in tracking chronic disease.

PDF Icon One or more documents on this Web page is available in Portable Document Format (PDF). You will need Acrobat Reader (a free application) to view and print these documents.

* Links to non-Federal organizations are provided solely as a service to our users. Links do not constitute an endorsement of any organization by CDC or the Federal Government, and none should be inferred. The CDC is not responsible for the content of the individual organization Web pages found at this link.



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Page last reviewed: January 6, 2009
Page last modified: January 6, 2009

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National Center for Chronic Disease Prevention and Health Promotion