- MEASURE DETAIL
Geographic Disparity measures the variation in the age-adjusted mortality rate among counties within a state. It is the standard deviation of the three-year average, age-adjusted all-cause mortality rate for all counties within a state divided by the three-year age-adjusted all-cause mortality rate for the state. The lower the percent, the closer each county is to the state average and the more uniform the mortality rate is across the state. For counties with fewer than 20 deaths in the three-year period (about 20 to 30 counties in the United States each year), the county was assumed to have an age-adjusted death rate equal to the state’s age-adjusted death rate and thus has no effect on the geographic disparity of the state. Geographic Disparity was a new measure in the 2008 Edition. The ranks are based on the most recently available data from the CDC and the National Center for Health Statistics.
Ideally, health and mortality should be equal among the populations of every county within a state and not vary based upon where a person lives. Many factors differ among counties, including natural features such as altitude, latitude, moisture, and temperature, and man-made features such as land use, population density, roads, and communications. Yet even with these differences health should still be equal. In many states there are disparities between urban and rural settings, with better health outcomes found in urban areas. Residents of rural areas are more likely to report fair or poor health, less likely to meet recommendations for physical activity and less likely to receive preventative care than their urban counterparts. Poor access to health care plagues many rural areas in the U.S. as 77 percent of rural counties are designated as primary care health professional shortage areas. This measure indicates the health toll of differences in behaviors, access to health care, and the physical environment within a state. Uncovering inequities in mortality can help states to identify regions with particularly poor outcomes and allocate resources accordingly.
 Bennett K, Olatosi B, Probost J. Health disparities: A Rural-Urban Chart Book. Rural Health Research and Policy Centre; 2008.
 Mareck, DG. "Federal and State Initiatives to Recruit Physicians to Rural Areas." The virtual mentor 13.5 (2011):304.
- The variation in overall mortality rates among the counties within a state.
The measures tracked by America's Health Rankings are those actions that can affect the future health of the population. For a state to improve the health of its population, efforts must focus on these measures, these determinants of health.
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