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May 20
Improving Health with Data: The 2014 County Health Rankings & Roadmaps


The University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation just released the annual County Health Rankings & Roadmap for 2014 that puts counties and the health of their residents center stage.  The annual rankings are part of a program launched in 2010 to show how counties are doing and where they can improve on health.  This year, the measurement tool has six new indicators and an interactive map for easier exploration of the data.

The 2014 County Health Rankings assessment tool includes 34 different ranked measures that influence the health of Americans, such as smoking, high school graduation rates, employment, obesity and access to exercise.  The rankings are based on measurements of two components: 29 health factors, elements that influence health; and five health outcomes, showing the results of health behavior.  These measures come mostly from public sources such as the U.S. Census Bureau, the National Center for Health Statistics and other units of the Centers for Disease Control and PreventionThe health factors examine the health behavior of county residents like smoking and drug use, access and quality of clinical care, social and economic factors and the quality of the physical environment.  The five health outcomes range from a measure of health-related quality of life, the number of low birth weight children to premature deaths.  The University of Wisconsin Population Health Institute creates six summary scores which sum into either a health factors summary score or a health outcomes summary score, based on a weighting of the indicators.  These two final summary scores then go into the final ranking for each county within its state.

Across the nation, the rankings show some concerning disparities in residents’ health among counties.  People in the healthiest counties are twice as likely to live longer than those in the least healthy counties.  The tool also highlights the significant interaction between socio-economic factors and health outcomes.  Though teen births have fallen 25 percent between 2007 and 2011 across the country, there are twice as many teen births in the least healthy counties compared to the healthiest.  The authors also found that smoking rates dropped from 21 to 18 percent between 2005 and 2012.

The 2014 County Health Rankings are available on an interactive map at , where users can compare overall rankings between counties in the same state and view the indicators that generated the rankings for each county.  In Texas, for example, Tarrant County is in the top 25 percent of counties in the state for resident health.  Tarrant County is ranked low for its physical environment, which includes air and water quality as well as housing and transportation, but it outperforms almost all other Texas counties in terms of health behaviors, such as smoking, obesity, and access to exercise.

The rankings have a companion program called the Roadmaps to Health Action Center, which aims to motivate and help communities implement solutions to improve the health of their residents.  The Action Center features guides, tools and stories of success.  The Robert Wood Johnson Foundation Culture of Health Prize 2014 winners will be announced in June for communities coming together to find health solutions across sectors.  One such success story is Gem County, Idaho.  Motivated by a low ranking for their health behavior category in 2010, the county formed a partnership called the Gem County Community Health Connection to address problems in tobacco use, obesity and chronic disease.  Originally ranked last in health behavior out of the 44 Idaho counties in 2010, they moved up to 32nd in this year’s ranking.

Together, the 2014 County Health Rankings interactive tool and its companion Roadmaps to Health Action Center show the health status of residents in counties across the country, and how counties can help their residents to improve their health, whether it is increasing access to exercise facilities or improving the quality of drinking water.  The County Health Rankings and Roadmaps are the right tools for county leaders to assess problems with the health level of their residents and help their county residents have healthier lives.


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