Rankings Calculation

The ranking is a composite index of all core measures included in the report. Tables 2, 4 and 6 list the core measures that comprise each of the three annual state rankings. For each measure, the most recent state-level data are presented as the value. The most current data available as of approximately two months prior to report release date are included in the analysis.
The z score for each measure is based on the following formula:
The z score indicates the number of standard deviations a state value is above or below the U.S. value. A 0.00 indicates a state has the same value as the nation. States with higher values than the U.S. value have a positive score; states below the U.S. value have a negative score. To prevent an extreme score from exerting excessive influence, the maximum score for a measure is capped at +/- 2.00. If a U.S. value is not available from the original data source for a measure, the mean of all state values is used. For measures from the Behavioral Risk Factor Surveillance System (BRFSS), the median of the state values is used for the U.S. value to conform to the Centers for Disease Control and Prevention methodology. For more details, see the BRFSS section in Data Sources and Measures.
The ranking of each measure is the ordering of states according to value, with the exception of Immunizations - Adolescents and Infectious Disease, which are ranked according to score. Ties in values are assigned equal ranks.
The overall state ranking is the ordering of each state according to its overall score. A state’s overall score is calculated by adding the products of the z score for each core measure multiplied by its assigned weight and by the direction of its correlation with overall health. If a value is not available for a state for the current edition, the value for the measure from a prior edition is used. If no value is available for the prior year, the state’s score for the measure is set to zero in the Annual Report and Senior Report and assigned the weight for the measure essentially estimating the value for that measure equal to the national average. For the Health of Women and Children Report, if a value is missing for a measure from the prior edition, no score is assigned to the measure and weights for the remaining measures in the model category are increased by the weight of the missing measure essentially estimating the score for the missing measure equal to the score for the other measures in the group. For measure weights, see Weights and Direction.
It’s important to note that not all changes in rank translate into actual declines or improvements in health. Large changes in rank may occur with only a non-significant, small change in a measure’s value.
Data presented in America’s Health Rankings® Reports are aggregated at the state level and cannot be used to make inferences at the individual level. Values and rankings from prior years are updated on our website to reflect known errors or updates from the reporting source.


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