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Four primary considerations drove the design of America's
Health: State Health Rankings and the selection of the individual components:
1. The overall rankings had to represent a broad range of
issues that affect a population's health;
2. Individual components needed to use common health measurement
criteria;
3. Data had to be available at a state level; and
4. Data had to be current and updated periodically.
While not perfect, the measures selected are believed to
be the best available indicators of the various components of healthiness at
this time and are consistent with past reports.
The Methods Review Group
suggested that for discussion purposes, the components be clustered into categories
that reflect the policies, practices and behaviors of a state and its population
and the outcomes. For clarity, we have divided the risk factors into three
groups: Personal Behaviors, Community Environment and Health Policies. These
three groups of measures influence the health outcomes of a state, and improving
these inputs will eventually improve outcomes. Several measures, especially
those for the various risk factors, could be placed in multiple categories.
We placed each measure in a single category but acknowledge that many risk
factors are really a combination of personal behaviors, the community environment
and policy issues.
Each component is assigned a weight that determines its percentage
of the overall score. The weights are based on input from a panel of health
experts. Risk factors account for 57.5 percent of the results, and outcomes
account for 42.5 percent.
Several concerns emerged when developing the components.
These include: 1) interdependence of the different measures; 2) disguising
the effects of individual components by the overall ranking; 3) an inability
to adjust all data by age and race; 4) a reliance on several types of mortality
data; and 5) the use of indirect measures to estimate some effects on health.
These concerns cannot be addressed directly by adjusting the methodology, however,
assigning weights to the individual components can mitigate their impact.
Description of Components
Table 10 is a summary of each of the components
in America's Health: State Health Rankings. A short discussion of each
component immediately follows. The data for each year are the most current
data available at the time the report was compiled.
Table 10 Summary Description
of Components
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Percentage of population
that smokes on a regular basis. This is an indication of known, addictive,
health-adverse behaviors within the population. ( Table
18) |
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Number of deaths per
100,000,000 miles driven in a state. It is a proxy indicator for excessive
drug and alcohol use within a population. ( Table
19) |
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Percentage of the population
estimated to be obese, with a body mass index (BMI) of 30.0 or higher.
Obesity is known to contribute to a variety of diseases, including heart
disease, diabetes and general poor health. ( Table
20) |
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Percentage of persons who graduate
in four years from a high school with a regular degree. It is an indication
of the consumer's ability to learn about, create and maintain a
healthy lifestyle and to understand and access health care when required. ( Table
21) |
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The number of murders, rapes,
robberies and aggravated assaults per 100,000 population. It reflects
an aspect of overall lifestyle within a state and its associated health
risks. ( Table 22) |
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Percentage of the population
that does not have health insurance privately, through their employer
or the government. This is another indicator of the ability to access
care as needed, especially preventive care. ( Table
23) |
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Number of AIDS, tuberculosis
and hepatitis cases reported to the Centers for Disease Control and Prevention
per 100,000 population. This is an indication of the toll that infectious
disease is placing on the population. ( Table
24) |
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The percentage of persons under
age 18 who live in households that are at or below the poverty threshold.
Poverty is an indication of the lack of access by this vulnerable population
to health care. ( Table
25) |
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Number of fatalities from
occupational injuries per 100,000 workers. This measure reflects job
safety as a part of public health. ( Table 26) |
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The percentage of the total
state health budget allocated to public health. This is an indicator
of the priority public health has among other health programs within
a state. ( Table
27) |
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The dollars spent on public
or population health per resident of the state. This indicates the actual
financial commitment a state has made to public health. ( Table
28) |
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Percentage of pregnant women
receiving adequate prenatal care, as defined by the Kessner Index. This
measures how well women are receiving the care they require for a healthy
pregnancy and development of the fetus. ( Table
29) |
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Number of days in the previous
30 days when a person indicates their activities are limited due to
physical
or mental difficulties. This is a general indication of the population's
ability to function on a day-to-day basis. ( Table
30) |
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Number of deaths due to all
cardiovascular diseases, including heart disease and strokes, per 100,000
population. This is an indication of the toll that these types of diseases
place on the population. ( Table
31) |
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Number of deaths due to all
causes of cancer per 100,000 population. This is an indication of the
toll cancer is placing on the population. ( Table
32) |
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Number of deaths per 100,000
population.This is an overall indicator of health of a population as
it
measures death from all causes. ( Table
33) |
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Number of infant deaths (before
age 1) per 1,000 live births. This is an indication of the prenatal
care,
access and birth process for both child and mother. ( Table
34) |
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Number of years of potential
life lost prior to age 75 per 100,000 population. This is an indication
of the number of useful years of life that are not available to a population
due to early death. ( Table
35) |
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