Rankings Calculation

The ranking is a composite index of all core measures included in the report. Tables 2, 4 and 5 of the Measure, Wights and Directions list the core measures that comprise each of the three state rankings reports. The ranking of each measure is the ordering of states according to value. Ties in values are assigned equal ranks. 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 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, while states that perform 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 states and the District of Columbia is used. For measures from the Behavioral Risk Factor Surveillance System (BRFSS), the median of all states and the District of Columbia 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 overall 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 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. 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. For measure weights, see Measures, Weights and Direction.
It’s important to note that the rankings are a relative measure of health. Not all changes in rank translate into actual declines or improvements in health.

Data Considerations

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. The edition year is not the same as data year(s). The most recent data available is used. For some measures, multiple years of data are combined to have sufficient sample size. Values and rankings from prior years are updated on our website to reflect known errors or updates from the reporting source. Error bars on graphs represent the 95 percent confidence interval.


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