Childhood Bereavement Estimation Model (CBEM)

Methodology and Sources

The CBEM represents a more comprehensive effort towards quantifying the prevalence of childhood bereavement in the U.S. than previously published. Addressing limitations of past estimations, the model extends prior research by establishing a theory-based tool which incorporates inputs that are customizable geographically, temporally, and relationally. The model generates retrospective (current) and prospective (projected) estimations utilizing consistent and publicly accessible data sources. Rather than gathering new data, the model combines reputable, existing, population-level data sources to approximate the magnitude of childhood bereavement. The model is flexible, providing estimates over different regions with varying levels of detail (e.g., national, state, metropolitan). The CBEM introduces binomial distribution and life table methodologies to better estimate the phenomenon of childhood bereavement. The model utilizes the most recent U.S. vital statistics to generate estimates of the number of youth at specified ages who have already experienced the death of a parent or sibling as well as the number projected to experience such a loss. The information presented on this site and in the accompanying materials aggregates data from 2012 to 2016. The information will be updated annually as new data are available.

The CBEM considers population statistics from the U.S. Census Bureau and mortality statistics from the U.S. Center for Disease Control (CDC). To protect privacy, data are often suppressed when there is a probability the individuals represented by the data could be uniquely identified. The threshold for data suppression in the CDC WONDER database is less than 10.  In the CBEM reports available on this website, data suppression was circumvented by combining mortality statistics from 2012-2016. If there are 10–19 deaths per age range, the death rate is considered unreliable, however the CBEM can be run using this unreliable death rate. Any CBEM results provided with unreliable data are clearly noted and interpreted with caution.

County Level Metro, Urban/Suburban, and Rural Categorization

Data sources used to extract CBEM inputs meet the following minimum requirements:

1. Publicly available

2. Population-level

3. National, state, and county statistics

4. From reliable and reputable entities

Meeting all the requirements, the 2013 U.S. Department of Agriculture Economic Research Service (USDA ERA) Rural-Urban Continuum Codes (RUCC) were applied to determine county-level categorizations of Metro, Urban/Suburban, and Rural. The classification system assesses population size, degree of urbanization, and proximity to metropolitan areas in categorizing U.S. counties. One of nine codes, three metro and six nonmetro, is assigned to each U.S. county allowing for analysis beyond the Office of Management and Budget’s metro and nonmetro categories. The system is updated each decennial. For the purposes of the CBEM National and State reports, the nine RUCC listed below were grouped into three categories Metro, Urban/Suburban, and Rural. The table below provides the original and CBEM classifications.

CBEM Categorization


USDA ERS Description



Counties in metro areas of 1 million population or more


Counties in metro areas of 250,000 to 1 million population


Counties in metro areas of fewer than 250,000 population



Urban population of 20,000 or more, adjacent to a metro area


Urban population of 20,000 or more, not adjacent to a metro area


Urban population of 2,500 to 19,999, adjacent to a metro area



Urban population of 2,500 to 19,999, not adjacent to a metro area


Completely rural or less than 2,500 urban population, adjacent to a metro area


Completely rural or less than 2,500 urban population, not adjacent to a metro area

United States Department of Agriculture Economic Research Service. 2013 Rural-Urban Continuum Codes. https://www.ers.usda.gov/data-products/rural-urban-continuum-codes/. Accessed May 23, 2018.


  1. Centers for Disease Control and Prevention, National Center for Health Statistics, CDC WONDER Online Database. http://wonder.cdc.gov/

  2. U.S. Census Bureau, Economic and Statistics Administration, US Department of Commerce, Annual Estimates of U.S. Population. https://www.census.gov/programs-surveys/popest.html

  3. Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death 1999-2016 on CDC WONDER Online Database, released December, 2017. Data are from the Multiple Cause of Death Files, 1999-2016, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. http://wonder.cdc.gov/ucd-icd10.html

  4. U.S. Department of Agriculture, 2013 Rural-Urban Continuum Codes. http://www.ers.usda.gov/data-products/rural-urban-continuum-codes.aspx

  5. U.S. Census Bureau, 2016 Small Area Income Poverty Estimates. http://www.census.gov/programs-surveys/saipe/data/tables.html

  6. Bureau of Labor Statistics, Local Area Unemployment Statistics, 2017 Annual Averages. http://www.bls.gov/lau/lastrk17.htm

  7. U.S. Census Bureau, American Community Survey 5-Year Estimates. http://www.census.gov/quickfacts/fact/table/US/PST045216

  8. Bureau of Health Workforce, Health and Human Services Administration, U.S. Dept. of Health Professionals Shortage Areas Statistics. https://ersrs.hrsa.gov/ReportServer?/HGDW_Reports/BCD_HPSA/BCD_HPSA_SCR50_Qtr_Smry_HTML&rc:Toolbar=false

The Judi’s House/JAG Institute Childhood Bereavement Estimation Model (CBEM) has been generously supported by the New York Life Foundation.