IntroductionExecutive SummaryFindingsOverviewState RankingsSuccessesChallengesVariations in Mortality MeasuresVariations in the Number of Health Care Providers Between and Within StatesHealth EquityComparison with Organization for Economic Cooperation and Development NationsCore MeasuresBehaviorsCommunity & EnvironmentPolicyClinical CareOutcomesSupplemental MeasuresBehaviorsCommunity & EnvironmentPolicyClinical CareOutcomesState SummariesAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingUS SummaryAppendixData Sources and MeasuresMethodology2017 Model DevelopmentScientific Advisory CommitteeThe TeamConclusion
The measures and model for America’s Health Rankings Annual Report were developed by an advisory committee, led by Anna Schenck, Ph.D., M.S.P.H. from the University of North Carolina Gillings School of Global Public Health. The advisory committee represents a variety of stakeholders including representatives from state health departments, members of the Association of State and Territorial Health Officials and the American Public Health Association, as well as experts from academic disciplines such as epidemiology and health economics.
Each year, the advisory committee reviews the model and measures to improve existing measures, integrate new data sources and make adjustments for changing availability of information. In addition to the changes implemented in 2017, the committee continues to explore new data sources that could enhance our model of population health. In particular, we are interested in state-level data for topics such as distracted driving, physical activity, nutrition and built environment.
2017 Edition Model and Measure Revisions
The following changes were made at the recommendation of the advisory committee. For data source details see Data Sources and Measures.
New Core Measure
Mental Health Providers was added to the clinical care category of the model to broaden the definition of clinical care to include mental health care in addition to primary care and dental care. Mental Health Providers is defined as the number of psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, providers that treat alcohol and other drug abuse, and advanced practice nurses specializing in mental health care per 100,000 population. With the addition of this measure to the model, the clinical care category weight was redistributed equally between the five clinical care measures.
New Supplemental Measures
Disconnected Youth was added as a supplemental community & environment measure. It is defined as the percentage of teens and young adults aged 16 to 24 who are neither working nor in school.
Neighborhood Amenities was added as a supplemental community & environment measure to represent the built environment. It is defined as the percentage of children aged 0 to 17 with access to parks or playgrounds, recreation or community centers, libraries or book mobiles, and sidewalks or walking paths.
Dedicated Health Care Provider was added as a supplemental clinical care measure. It is defined as the percentage of adults who reported having one or more people they think of as their personal doctor or health care provider.
Six+ Teeth Extractions was added as a supplemental measure to capture oral health outcomes. It is defined as the percentage of adults aged 45 to 64 who reported having six or more teeth extracted.
Measure Name Change
Lack of insurance was renamed Uninsured. The definition and data source remain the same.
Measure Methodology Change
Public Health Funding This year, rather than an average of the 50 states and the District of Columbia as was presented in previous editions, the U.S. average was calculated using the U.S. total for each of the three funding categories included in the numerator.
Immunizations-Adolescents, HPV Females & HPV Males The Advisory Committee on Immunization Practices released updated human papillomavirus (HPV) vaccination recommendations in December 2016. A new two-dose schedule is recommended for females and males who initiate the vaccination series between ages 9 and 14. Three doses are still recommended for those who initiate the vaccination series at ages 15 through 26 and for immunocompromised persons. Based on the new recommendations, the HPV immunization measures are now defined as the percentage of adolescents aged 13 to 17 who are up to date on all recommended doses of HPV vaccine. The previous definition was based on the initial three-dose series recommendation.