County Health Rankings & Roadmaps
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| County Health Rankings & Roadmaps | |
|---|---|
| Name | County Health Rankings & Roadmaps |
| Type | Nonprofit partnership |
| Founded | 2010 |
| Headquarters | United States |
County Health Rankings & Roadmaps
The County Health Rankings & Roadmaps program produces annual assessments of population health at the county level across the United States. It is a collaboration that brings together public health, academic, and philanthropic institutions to inform policymakers, community leaders, and practitioners about local health outcomes and determinants. The program's outputs are used alongside resources from institutions such as Centers for Disease Control and Prevention, World Health Organization, and Robert Wood Johnson Foundation by stakeholders including Mayors of United States, State health departments of the United States, and community coalitions.
Overview
The program ranks nearly all United States counties and county equivalents on measures of health outcomes and health factors, providing comparative data similar to assessments produced by Kaiser Family Foundation, National Institutes of Health, and Agency for Healthcare Research and Quality. It pairs rankings with Roadmaps that feature evidence-based strategies drawn from sources such as Community Preventive Services Task Force, Institute of Medicine, and National Academy of Medicine to guide local action. Users include researchers at Harvard University, practitioners at Local health departments in the United States, and funders like the Robert Wood Johnson Foundation and W.K. Kellogg Foundation.
History and Development
The initiative launched in 2010 through a partnership between University of Wisconsin–Madison population health researchers, the Robert Wood Johnson Foundation, and various public health organizations. Early collaborators included faculty associated with University of Wisconsin School of Medicine and Public Health and staff from Trust for America's Health and Public Health Institute. Over time the program expanded its analytic team, drawing on expertise from scholars linked to Johns Hopkins University, Yale University, and University of Michigan. Major updates to methods and dissemination have coincided with policy discussions in venues such as Centers for Disease Control and Prevention conferences and briefings at the United States Capitol.
Methodology
Rankings combine measures of health outcomes (including mortality and morbidity) and health factors (including social, economic, and environmental determinants) into composite scores; the approach resembles composite indicators developed by Organisation for Economic Co-operation and Development and methods used by United Nations Development Programme. Weighting schemes assign proportions to categories such as clinical care and health behaviors, paralleling methodologies applied by Commonwealth Fund and Health Resources and Services Administration. Statistical techniques include standardization, imputation, and sensitivity analyses akin to procedures disseminated by National Center for Health Statistics and researchers at Harvard T.H. Chan School of Public Health.
Data Sources and Measures
Data for the Rankings derive from national datasets and surveys, including inputs from Behavioral Risk Factor Surveillance System, American Community Survey, National Vital Statistics System, and administrative records compiled by Centers for Medicare & Medicaid Services. Measures encompass mortality rates, self-reported health, smoking prevalence, and access to clinical care, mirroring indicators used by World Bank, United Nations, and the Global Burden of Disease. County-level socioeconomic indicators draw on U.S. Census Bureau data while environmental measures incorporate information analogous to datasets from the Environmental Protection Agency and United States Department of Agriculture.
Impact and Use
Local health departments, elected officials, and community coalitions have used the Rankings to prioritize interventions, allocate resources, and advocate for policy changes at the county and state level, in ways similar to applications of reports from Kaiser Family Foundation, Pew Charitable Trusts, and The Commonwealth Fund. Academic researchers have cited the data in studies published in journals associated with American Public Health Association, The Lancet, and New England Journal of Medicine. Nonprofit organizations such as United Way and initiatives like Healthy People have incorporated the findings into strategic planning and community health needs assessments.
Criticism and Limitations
Critics note that rankings may oversimplify complex local contexts, echoing debates around indices produced by World Health Organization and Organisation for Economic Co-operation and Development. Concerns include potential misinterpretation by policymakers, ecological fallacy risks identified by scholars at Columbia University and University of California, Berkeley, and data lag issues similar to criticisms levied at the American Community Survey. Others have argued that composite scores may obscure disparities highlighted by studies from Robert Wood Johnson Foundation and analyses in Health Affairs.
Funding and Organization
Primary funding has included grants from philanthropic institutions such as the Robert Wood Johnson Foundation and collaborations with academic partners at University of Wisconsin–Madison and public health organizations including the University of Wisconsin Population Health Institute and National Association of County and City Health Officials. The program operates through partnerships among universities, foundations, and public health entities and coordinates dissemination comparable to initiatives run by Centers for Disease Control and Prevention and National Institutes of Health.