Health is a result of our personal behaviors, our individual genetic predisposition to disease, the environment and the community in which we live, the clinical care we receive and the policies and practices of our health care and prevention systems. Each of us, individually, as a community, and as a society, strives to optimize these health determinants, so that all of us can have a long, disease-free and robust life regardless of race, gender or socio-economic status.

This report looks at the four groups of health determinants that can be affected:

1. Personal behaviors include the everyday activities we do that affect our personal health. It includes habits and practices we develop as individuals and families that have an effect on our personal health and on our utilization of health resources. These behaviors are modifiable with effort by the individual supported by community, policy and clinical interventions.
2. Community & environment reflects the reality that the daily conditions in which we live our lives have a great effect on achieving optimal individual health.
3. 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.
4. Clinical care reflects the quality, appropriateness and cost of the care we receive at doctors’ offices, clinics and hospitals.

All health determinants are intertwined and must work together to be effective. For example, an initiative that addresses tobacco cessation requires not only efforts on the part of the individual but also support from the community in the form of public and health policies that promote non-smoking and the availability of effective counseling and care at clinics. Similarly, sound prenatal care requires individual effort, access to and availability of prenatal care coupled with high quality of health care services.

America’s Health Rankings™ combines individual measures of each of these determinants with the resultant health outcomes into one, comprehensive view of the health of a state. Additionally, it discusses health determinants separately from health outcomes.

America’s Health Rankings™ employs a unique methodology, developed and periodically reviewed by a panel of leading public health scholars, which balances the contributions of various factors, such as smoking, binge drinking, high school graduation rates, children in poverty, access to care and incidence of preventable disease, to a state’s health. The report is based on data from the U.S. Departments of Health and Human Services, Commerce, Education and Labor; U.S. Environmental Protection Agency; the American Medical Association; the Dartmouth Atlas Project; and the Trust for America’s Health.

Purpose

The ultimate purpose of America’s Health Rankings™ is to stimulate action by individuals, communities, public health professionals, health industry employees and public administration and health officials to improve the health of the population of the United States. We do this by promoting public conversation concerning health in our states, as well as providing information to facilitate citizen participation. We encourage participation in all elements: personal behaviors, community, environment, clinical care, and public and health policies. Each person individually, and in their capacity as an employee, employer, voter, community volunteer, health official or elected official, can contribute to the advancement of the healthiness of their state. Proven, effective and innovative actions can improve the health of people in every state whether the state is first or 50th.