We present [CII] 158um measurements from over 15,000 resolved regions within 54 nearby galaxies of the KINGFISH program to investigate the so-called [CII] line cooling deficit long known to occur in galaxies with different luminosities. The [CII]/TIR ratio ranges from above 1% to below 0.1% in the sample, with a mean value of 0.48+-0.21%. We find that the surface density of 24um emission dominates this trend, with [CII]/TIR dropping as nuInu{24um} increases. Deviations from this overall decline are correlated with changes in the gas phase metal abundance, with higher metallicity associated with deeper deficits at a fixed surface brightness. We supplement the local sample with resolved [CII] measurements from nearby luminous infrared galaxies and high redshift sources from z=1.8-6.4, and find that star formation rate density drives a continuous trend of deepening [CII] deficit across six orders of magnitude in SFRD. The tightness of this correlation suggests that an approximate star formation rate density can be estimated directly from global measurements of [CII]/TIR, and a relation is provided to do so. Several low-luminosity AGN hosts in the sample show additional and significant central suppression of [CII]/TIR, but these deficit enhancements occur not in those AGN with the highest X-ray luminosities, but instead those with the highest central starlight intensities. Taken together, these results demonstrate that the [CII] cooling line deficit in galaxies likely arises from local physical phenomena in interstellar gas.
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