America's Health Rankings
Encyclopedia
America's Health Rankings is an annual report that measures the overall healthiness of the United States using a comprehensive set of related health determinants and outcomes. The report provides state-specific rankings from 1 to 50 across a variety of national health benchmarks. State rankings are determined by evaluating four factors: behaviors, the environment and the community in which people live, the decisions made by public and health policies and practices of the government and clinical care received. America's Health Rankings is the result of a partnership between United Health Foundation, the American Public Health Association
and Partnership for Prevention.
and Partnership for Prevention.
and Partnership for Prevention, commissioned the University of North Carolina at Chapel Hill School of Public Health
to undertake an ongoing review of America's Health Rankings. The Scientific Advisory Committee, currently led by Thomas Ricketts, Ph.D., M.P.H., was charged with conducting a thorough review of the current index and recommending improvements that would maintain the value of the comparative, longitudinal information; reflect the evolving role and science of public health; utilize new or improved measures of health as they become available and acceptable; and incorporate new methods as feasible.
In addition, the committee continues to work on issues concerning improved environmental health indicators, methods of expressing variability within the rankings, oral health indicators, mental health indicators, improved health disparities, improved cost measures, quality of care measures and international benchmarking.
, Commerce
, Education
and Labor
; U.S. Environmental Protection Agency; the American Medical Association
; the Dartmouth Atlas Project; and the Trust for America's Health.
The methodology underlying America's Health Rankings reflects the evolving expectations and role of health in society and the ability to measure various aspects of health. The methodology has evolved over the report's history to capture these changes.
For each measure, the raw data as obtained from the stated sources and adjusted for age, as appropriate, is presented and referred to as "value." All age-adjusted data utilizes the population profile for the middle year of data. For example, if the data is from 2006 to 2008, the standard population is set at 2007.
The score for each state is based on the following formula: State value subtracted by national mean, divided by the standard deviation of all state values.
Often referred to as a "Z-score," this score indicates the number of standard deviations a state is above or below the national mean. States with higher value than the national average will have a positive score, while those with lower values will have a negative score.
defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
This report looks at the four groups of health determinants that can be affected:
Behaviors
Community and Environment
Public Health Policies
Clinical Care
Outcomes
American Public Health Association
The American Public Health Association is Washington, D.C.-based professional organization for public health professionals in the United States. Founded in 1872 by Dr. Stephen Smith, APHA has more than 30,000 members worldwide...
and Partnership for Prevention.
Purpose
The purpose of America's Health Rankings is to stimulate action by individuals, communities, health care professionals, elected officials and employers to improve the health of the population of the United States.History
America's Health Rankings was first published in 1990 and ranked the relative healthiness of states populations based on 16 measures of health. As of 2010, up to 40 measures are used to evaluate a comprehensive profile of the overall health of each state. America's Health Rankings is released in partnership with United Health Foundation, American Public Health AssociationAmerican Public Health Association
The American Public Health Association is Washington, D.C.-based professional organization for public health professionals in the United States. Founded in 1872 by Dr. Stephen Smith, APHA has more than 30,000 members worldwide...
and Partnership for Prevention.
Scientific Advisory Committee
In 2002, United Health Foundation, in concert with the American Public Health AssociationAmerican Public Health Association
The American Public Health Association is Washington, D.C.-based professional organization for public health professionals in the United States. Founded in 1872 by Dr. Stephen Smith, APHA has more than 30,000 members worldwide...
and Partnership for Prevention, commissioned the University of North Carolina at Chapel Hill School of Public Health
University of North Carolina at Chapel Hill School of Public Health
The University of North Carolina at Chapel Hill Gillings School of Global Public Health provides teaching, conducts research, and delivers service to people across North Carolina, the United States and around the world. Ranked the top public school of public health, the School's mission is to...
to undertake an ongoing review of America's Health Rankings. The Scientific Advisory Committee, currently led by Thomas Ricketts, Ph.D., M.P.H., was charged with conducting a thorough review of the current index and recommending improvements that would maintain the value of the comparative, longitudinal information; reflect the evolving role and science of public health; utilize new or improved measures of health as they become available and acceptable; and incorporate new methods as feasible.
In addition, the committee continues to work on issues concerning improved environmental health indicators, methods of expressing variability within the rankings, oral health indicators, mental health indicators, improved health disparities, improved cost measures, quality of care measures and international benchmarking.
Methodology
America's Health Rankings employs a unique methodology, developed and annually reviewed by the Scientific Advisory Committee, a panel of leading public health scholars, which balances the contributions of various factors, such as smoking, obesity, binge drinking, high school graduation rates, children in poverty, access to care and incidence of preventable disease, in evaluation of the overall health of a state's population. The report is based on data from the U.S. Departments of Health and Human ServicesUnited States Department of Health and Human Services
The United States Department of Health and Human Services is a Cabinet department of the United States government with the goal of protecting the health of all Americans and providing essential human services. Its motto is "Improving the health, safety, and well-being of America"...
, Commerce
United States Department of Commerce
The United States Department of Commerce is the Cabinet department of the United States government concerned with promoting economic growth. It was originally created as the United States Department of Commerce and Labor on February 14, 1903...
, Education
United States Department of Education
The United States Department of Education, also referred to as ED or the ED for Education Department, is a Cabinet-level department of the United States government...
and Labor
United States Department of Labor
The United States Department of Labor is a Cabinet department of the United States government responsible for occupational safety, wage and hour standards, unemployment insurance benefits, re-employment services, and some economic statistics. Many U.S. states also have such departments. The...
; U.S. Environmental Protection Agency; the American Medical Association
American Medical Association
The American Medical Association , founded in 1847 and incorporated in 1897, is the largest association of medical doctors and medical students in the United States.-Scope and operations:...
; the Dartmouth Atlas Project; and the Trust for America's Health.
The methodology underlying America's Health Rankings reflects the evolving expectations and role of health in society and the ability to measure various aspects of health. The methodology has evolved over the report's history to capture these changes.
For each measure, the raw data as obtained from the stated sources and adjusted for age, as appropriate, is presented and referred to as "value." All age-adjusted data utilizes the population profile for the middle year of data. For example, if the data is from 2006 to 2008, the standard population is set at 2007.
The score for each state is based on the following formula: State value subtracted by national mean, divided by the standard deviation of all state values.
Often referred to as a "Z-score," this score indicates the number of standard deviations a state is above or below the national mean. States with higher value than the national average will have a positive score, while those with lower values will have a negative score.
Components of health
The World Health OrganizationWorld Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
This report looks at the four groups of health determinants that can be affected:
- Behaviors include everyday activities that affect personal health habits and practices individuals and families develop that have an effect on our personal health and our utilization of health resources. These behaviors are modifiable with effort by the individual supported by community, policy and clinical interventions.
- Community and environment reflects the reality that the daily conditions in which we live our lives have a great effect on achieving optimal individual health.
- Public and health policies are indicative of the availability of resources to encourage and maintain health and the extent that public and health programs reach into the general population.
- Clinical care reflects the quality, appropriateness and cost of the care we receive at doctors' offices, clinics and hospitals.
Description of measures
The 22 measures that comprise 2009 America's Health Rankings are of two types of health determinants and health outcomes. Health determinants represent those actions that can affect the future health of the population, whereas health outcomes represent the result of what has already occurred, either through death or missed days due to illness.Behaviors
- Prevalence of SmokingSmokingSmoking is a practice in which a substance, most commonly tobacco or cannabis, is burned and the smoke is tasted or inhaled. This is primarily practised as a route of administration for recreational drug use, as combustion releases the active substances in drugs such as nicotine and makes them...
: Percentage of population over age 18 that smokes on a regular basis. - Prevalence of Binge DrinkingBinge drinkingBinge drinking or heavy episodic drinking is the modern epithet for drinking alcoholic beverages with the primary intention of becoming intoxicated by heavy consumption of alcohol over a short period of time. It is a kind of purposeful drinking style that is popular in several countries worldwide,...
: Percentage of population over age 18 that has consumed alcoholic beverages excessively in the last 30 days. Binge drinking is defined as five drinks for a male and four for a female in one setting. - Prevalence of ObesityObesityObesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems...
: Percentage of the population estimated to be obese, with a body mass indexBody mass indexThe body mass index , or Quetelet index, is a heuristic proxy for human body fat based on an individual's weight and height. BMI does not actually measure the percentage of body fat. It was invented between 1830 and 1850 by the Belgian polymath Adolphe Quetelet during the course of developing...
(BMI) of 30.0 or higher. - High School Graduation: Percentage of incoming ninth graders who graduate in four years from a high school with a regular degreeAcademic degreeAn academic degree is a position and title within a college or university that is usually awarded in recognition of the recipient having either satisfactorily completed a prescribed course of study or having conducted a scholarly endeavour deemed worthy of his or her admission to the degree...
, as reported by National Center for Education StatisticsNational Center for Education StatisticsThe National Center for Education Statistics is the part of the United States Department of Education's Institute of Education Sciences that collects, analyzes, and publishes statistics on education and public school district finance information in the United States...
in compliance with the No Child Left Behind initiative.
Community and Environment
- Violent CrimeViolent crimeA violent crime or crime of violence is a crime in which the offender uses or threatens to use violent force upon the victim. This entails both crimes in which the violent act is the objective, such as murder, as well as crimes in which violence is the means to an end, such as robbery. Violent...
: The number of murders, rapes, robberies and aggravated assaults per 100,000 population. - Occupational FatalitiesOccupational fatalityAn occupational fatality is a death that occurs while a person is at work or performing work related tasks. Occupational fatalities are also commonly called “occupational deaths” or “work-related deaths/fatalities” and can occur in any industry or occupation....
: Number of fatalities from occupational injuries per 100,000 workers. - Infectious DiseaseInfectious diseaseInfectious diseases, also known as communicable diseases, contagious diseases or transmissible diseases comprise clinically evident illness resulting from the infection, presence and growth of pathogenic biological agents in an individual host organism...
: Number of AIDSAIDSAcquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...
, tuberculosisTuberculosisTuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...
and hepatitisHepatitisHepatitis is a medical condition defined by the inflammation of the liver and characterized by the presence of inflammatory cells in the tissue of the organ. The name is from the Greek hepar , the root being hepat- , meaning liver, and suffix -itis, meaning "inflammation"...
(A and B) cases reported to the Centers for Disease Control and PreventionCenters for Disease Control and PreventionThe Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...
per 100,000 population. - Children in PovertyPovertyPoverty is the lack of a certain amount of material possessions or money. Absolute poverty or destitution is inability to afford basic human needs, which commonly includes clean and fresh water, nutrition, health care, education, clothing and shelter. About 1.7 billion people are estimated to live...
: The percentage of persons under age 18 who live in households at, or below, the poverty threshold. - Air PollutionAir pollutionAir pollution is the introduction of chemicals, particulate matter, or biological materials that cause harm or discomfort to humans or other living organisms, or cause damage to the natural environment or built environment, into the atmosphere....
: The average exposure of the general public to particulate matter of 2.5 micrometres or less in size.
Public Health Policies
- Lack of Health InsuranceHealth insuranceHealth insurance is insurance against the risk of incurring medical expenses among individuals. By estimating the overall risk of health care expenses among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is...
: Percentage of the population that does not have health insurance privately, with their employers or through the government. - Public HealthPublic healthPublic health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...
Funding: State funding dedicated to public health, as well as federal funding directed to states by Centers for Disease Control and Prevention and the Health Resources and Services Administration, expressed on a per capita basis. - ImmunizationImmunizationImmunization, or immunisation, is the process by which an individual's immune system becomes fortified against an agent ....
Coverage: Percentage of children ages 19 to 35 months who have received four or more doses of DPT, three or more doses of poliovirus vaccine, one or more doses of any measles-containing vaccine, three or more doses of HiB, and three or more doses of HepB vaccine.
Clinical Care
- Prenatal CarePrenatal carePrenatal care refers to the medical and nursing care recommended for women before and during pregnancy. The aim of good prenatal care is to detect any potential problems early, to prevent them if possible , and to direct the woman to appropriate specialists, hospitals, etc...
: Percentage of pregnant women receiving adequate prenatal care, as defined by Kotelchuck’s Adequacy of Prenatal Care Utilization (APNCU) Index. - Primary Care PhysiciansPrimary care physicianA primary care physician, or PCP, is a physician/medical doctor who provides both the first contact for a person with an undiagnosed health concern as well as continuing care of varied medical conditions, not limited by cause, organ system, or diagnosis....
: Number of primary care physicians (including general practice, family practice, OB-GYN, pediatrics and internal medicine) per 100,000 population. - Preventable Hospitalizations: Discharge rate among the MedicareMedicare (United States)Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over; to those who are under 65 and are permanently physically disabled or who have a congenital physical disability; or to those who meet other...
population for diagnoses that are amenable to non-hospital based care.
Outcomes
- Poor Mental Health Days: Number of days in the previous 30 days when a person indicates their activities are limited due to mental health difficulties.
- Poor Physical Health Days: Number of days in the previous 30 days when a person indicates their activities are limited due to physical health difficulties.
- Geographic Disparity: The variation among the overall mortality rates of the counties within a state. Equality among counties would be expressed by low variation.
- Infant MortalityInfant mortalityInfant mortality is defined as the number of infant deaths per 1000 live births. Traditionally, the most common cause worldwide was dehydration from diarrhea. However, the spreading information about Oral Re-hydration Solution to mothers around the world has decreased the rate of children dying...
: Number of infant deaths (before age one) per 1,000 live births. - Cardiovascular Deaths: Number of deaths due to all cardiovascular diseaseCardiovascular diseaseHeart disease or cardiovascular disease are the class of diseases that involve the heart or blood vessels . While the term technically refers to any disease that affects the cardiovascular system , it is usually used to refer to those related to atherosclerosis...
s, including heart diseaseHeart diseaseHeart disease, cardiac disease or cardiopathy is an umbrella term for a variety of diseases affecting the heart. , it is the leading cause of death in the United States, England, Canada and Wales, accounting for 25.4% of the total deaths in the United States.-Types:-Coronary heart disease:Coronary...
and strokes, per 100,000 populations. - Cancer Deaths: Number of deaths due to all causes of cancer per 100,000 population.
- Premature Death: Number of years of potential life lost prior to age 75 per 100,000 population.
External links
- America's Health Rankings
- State Health Stats
- United Health Foundation
- American Public Health Association
- Partnership for Prevention
- World Health Organization
- U.S. Department of Health and Human Services
- Centers for Disease Control and Prevention
- National Center for Health Statistics
- National Association of State Budget Officers
- U.S. Department of Commerce
- Census Bureau