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Complementary Resources

County Health Rankings and Roadmaps (of RWJ Foundation and U of WI)
The County Health Rankings (www.countyhealthrankings.org) are created through collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. They are part of the County Health Rankings: Mobilizing Action Towards Community Health web site which includes extensive background on how the ranking method and action steps and resources for addressing risks and enhancing protective factors.

Health Outcomes county rankings are based on a calculation that weighs equally mortality and morbidity.

Health Factors county rankings are determined through an equation that considers contributing factors as 30% health behaviors, 20% aspects of clinical care, 40% social and economic factors, and 10% environmental factors.

The Health Outcomes ranking is calculated based 50% on Mortality (premature death ‐ years of potential life lost before age 75 rate) and 50% on Morbidity.

Morbidity is calculated based on the sum four factors, including self‐reports by adults of overall fair or poor health, mean physically unhealthy days per month, and mean mentally unhealthy days per month, plus percent of live births with low birth weight weighted double. The equation is self‐reported health (10%) + mean physically unhealthy days per month for adults (10%) + mean mentally unhealthy days per month for adults (10%) + percent of live births with low birth weight (20%).

Health Factors are calculated based on an equation which includes health behaviors (30%), clinical care (20%), social and economic factors (40%), and environmental factors (10%).

Behavioral factors (worth 30% of overall Health Factors score) is calculated based on tobacco use (10%), diet and exercise (10%), alcohol use (5%) and sexual behavior (5%).

Clinical Care (valued as 20% of Overall Health Factors) consists of access to care (10%) plus quality of
care (10%). Access to Care, in turn, is based on percent of population under 65 without health insurance (5%) and primary care providers (5%). Quality of care is based on hospitalization for ambulatory‐care conditions per 1,000 Medicare enrollees (5%) and percent of diabetic Medicare enrollees that receive HbA1c screening (2.5%) and percent of female Medicare enrollees receiving mammogram screening (2.5%).

Social and Economic factors constitute 40% of the overall health factors score. This score is based on
valuations of education (10%), employment (10%), income (10%) family and social support (5%), and community safety (5%).

Education, in turn, is calculated based on two equally weighted factors: average freshman graduation
rate, defined as the percent of ninth grade cohort that graduates in 4 years (5%), and percent of adults
aged 25‐44 years with some pot‐secondary education (5%). Employment is the percent of population
age 16+ unemployed but seeking work (10%). Income is defined as the percent of children in poverty
(10%). Family and social support is calculated based equally on the percent of adults without social/emotional support (2.5%) and the percent of all households that are single‐parent households
(2.5%). Community safety is for Indiana is based on homicide death rate per 100K population (age-adjusted).

Environmental factors are calculated based equally on environmental quality (5%) and built environment (5%). The calculation of environmental quality is based equally on the annual number of
unhealthy air quality days due to ozone (2.5%) and the annual number of unhealthy air quality days due
to fine particulate matter (2.5%). The calculation of built environment is based equally on the percent of
zip codes in the county with healthy food outlets (2.5%) and access to recreational facilities (2.5%).