By Bridget Booske Catlin, PhD, MHSA
It’s ranking season again (and I’m not talking about NCAA basketball) – the 2012 County Health Rankings will be available tomorrow (April 3, 2012). Since this is our third year of releasing the Rankings for all 50 states, we are fielding questions such as what has changed since last year? If not much has changed, why should anyone pay attention?
Has anything changed in the ranks? The answer is yes and no. Yes, in that there is fair amount of movement in rank among counties in the middle quartiles of each state. No, in terms of movement among the healthiest and least healthy counties. We purposely keep our measures of health outcomes the same each year – the only thing that changes is that we update our data – this means that for our primary health outcome measure, premature death, we add one year and remove the oldest of the three years of data on which it is based – so, only a third of the measure changes. For our other health outcome measures that are based on seven years of data (allowing us to report ranks for all but the 100 or so least-populous counties in the nation), this means we only change one-seventh of the data on which these measures are based.
Our Health Factors are a different story. Here we tend to make minor changes in measures for each of the four factors (health behaviors, clinical care, social and economic, and physical environment) as we find new and better measures or are able to draw on improvements in existing county-level measures. For example, this year we have added a measure of physical inactivity, expanded our measure of the uninsured to include children, improved our high school graduation measure, changed to a measure of limited access to healthy foods (to be more closely aligned with the idea of food deserts), and added a measure reflecting fast food restaurants. With these changes, most counties are likely to see a change in their Health Factors ranks.
So, why do we rank every year? We release updated data (and ranks) every year to continue our call to action. The Rankings are a starting point for new conversations across the nation that draw in people from all walks of life. Each year, more people are drawn in. They reach an “ah-ha” moment that healthy places are important for us all, and that having health care coverage for all is just a beginning step toward that goal.
How can we measure progress toward our goal of becoming a healthier nation, county by county? While looking at ranks is useful, the best way to measure progress is to look at change in the specific measures. Each year, we publish updated data so counties can begin to monitor progress in specific areas. For the first time this year, we’ve included graphs to show trends (progress or lack thereof) in each county’s premature death rates over the most recent 10 years. Each county can compare their trend line to that for their state and for the nation as a whole. As we accumulate enough data for other measures, we will add more information like this in future years.
The inclusion of premature death trends is just one of several new features at www.countyhealthrankings.org this year. Be sure to check out the site and use our new interactive maps. And don’t miss the brand new County Health Roadmaps section with information on the Roadmaps to Health Prize, the Roadmaps to Health Community Grants, and our Roadmaps to Health Action Center (more to come on that in the next blog post later this week).
Bridget Booske Catlin, PhD, MHSA directs the County Health Rankings & Roadmaps program at the University of Wisconsin Population Health Institute.