Overview

The America’s Health Rankings Health Disparities Report was developed with guidance from a National Advisory Committee—comprised of leading public health and health equity experts—which informed the selection of health measures and other methodological features of the report. For more information on the Advisory Committee, click here.

Model for Measuring America’s Health

America’s Health Rankings is built upon the World Health Organization definition of health: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

Measures

The America’s Health Rankings Health Disparities Report is based on a set of 30 measures from the America’s Health Rankings platform of nearly 300 health-related measures.
Measures were selected based on four criteria:
  • Inclusion of a breadth of social and economic factors, physical environment, clinical care, health behavior and health outcome measures critical to addressing health disparities and advancing health equity.
  • Availability of national and state data with sufficient sample sizes to produce reliable estimates for subpopulation groups.
  • Availability of multiple years of data for trends analysis.
  • Inclusion of actionable measures—or those amenable to change by policy or intervention to achieve measurable improvements in health and health equity.

Subpopulation Groups

This report highlights disparities by four key subpopulation groups. For more details on selected subpopulation groups and limitations, see our methodology.
Race and Ethnicity. Data are provided for seven racial and ethnic groups. All groups other than Hispanic, are non-Hispanic:
  • American Indian or Alaska Native
  • Asian or Pacific Islander
  • Black or African American
  • Hispanic or Latino
  • Multiracial
  • Other
  • White
Gender. This report includes data for females and males.
Educational Attainment. Data by educational attainment are categorized as:
  • Less than a high school education
  • High school graduate
  • Some college
  • College graduate
Geography. Where available, differences were assessed between metropolitan (largely urban and suburban areas) and non-metropolitan areas (rural areas).

Data Analysis

Depending on the data source, three to five years of data were pooled across three time periods between 2003-2019 to produce reliable estimates. For all indicators, state and nationally-representative population estimates were produced, along with their confidence intervals using methods appropriate for each data source. Estimates were created for the nation, 50 states and District of Columbia as a whole and for subpopulation groups. Subpopulation analyses were conducted by race and ethnicity, gender, education and if available by geography. For data sources and more detailed methodology, click here.

Interpreting Health Disparities Data

The America’s Health Rankings Health Disparities Report includes a wealth of data highlighting the breadth, depth and persistence of health disparities across the U.S. These data are captured in multiple ways throughout the report. Following is an overview of key terms and concepts to help guide the use and understanding of these data.
Are health disparities high or low?
  • High or wide disparities indicate that health and well-being vary significantly by subpopulation groups. Some groups have better outcomes, whereas others have poorer outcomes resulting in wide gaps.
  • Low or narrow disparities indicate one of two different scenarios. First, low disparities may indicate that all subpopulations are faring well, with good outcomes. Conversely, low disparities may indicate all subpopulations are faring poorly, with poor outcomes.
Are health disparities growing, narrowing or persistent?
  • Growing or increasing disparities indicate that the gap between subpopulation groups is widening. This can happen when the outcome of one group improves, while the same outcome of another group worsens over time.
  • Narrowing or decreasing disparities indicate that the gap between subpopulation groups is becoming smaller. This can happen when groups historically faring poorly improve and begin to achieve similar outcomes as those with the best outcomes. This can also happen when the outcomes of subpopulation groups historically faring well begin to worsen, as other groups improve.
  • Persistent disparities indicate that gaps between subpopulation groups remain unchanged, despite progress or lack thereof for some or all groups.

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