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Volume 2: No. 2, April 2005
SPECIAL TOPICS
ORIGINAL RESEARCH: FEATURED
ABSTRACT FROM THE 19TH NATIONAL CONFERENCE ON CHRONIC DISEASE
PREVENTION AND CONTROL
Measuring Population Health Disparities: The Wisconsin
County Health Rankings
Angela M. Kempf, Patrick L. Remington, Paul E. Peppard, Elizabeth A.
Dranger, David A. Kindig
Suggested citation for this article: Kempf AM, Remington
PL, Peppard PE, Dranger EA, Kindig DA. Measuring
population health disparities: the Wisconsin County Health
Rankings [abstract]. Prev Chronic Dis [serial online]
2005 Apr [date cited]. Available from: URL: http://www.cdc.gov/pcd/issues/2005/
apr/04_0142d.htm.
PEER REVIEWED
Track: Methods and Surveillance
The purpose of this project was to rank the population health
of counties in Wisconsin to promote use of local population
health information, identify disparities between counties,
encourage population health improvement, and broaden the
understanding of the determinants of health.
The Wisconsin Public Health and Health Policy Institute, with
assistance from state government, community, and university
groups, annually compiles county data and produces the
Wisconsin County Health Rankings report.
This project is modeled after the United Health
Foundation’s annual America’s Health: State Health
Rankings and is based on a population health model in which a
variety of determinants impact health outcomes. Mortality years
of potential life lost (YPLL) and self-reported health status are
used to develop a summary measure of county health outcomes. A
summary measure of health determinants is developed using 18
measures in four (weighted) categories: health care (10%), health
behaviors (40%), socioeconomic factors (40%), and physical
environment (10%). Data sources include the Centers for Disease
Control and Prevention, the U.S. Census, state vital statistics,
and the Wisconsin Department of Health and Family Services. A
draft report was developed and shared with local public health
officials in late 2003. The report was revised on the basis of
feedback, and Wisconsin County Health Rankings,
2003 was released to the public in January 2004. A survey
assessing the usefulness of the rankings was sent to all county
health officers following its release.
Significant disparities exist in the health outcomes and
determinants of Wisconsin counties. We used Pearson product
moment correlation and found that, overall, the summary
determinant and summary outcome ranks were well correlated
(r = 0.75). Compared with the healthiest counties (e.g.,
Ozaukee), the least healthy counties (e.g., Menominee) showed
greater improvement in health over time. Of the county health
officers participating in the survey of the rankings (N = 68, 94%
response rate), 82% reported that the rankings were useful to
their work, and 69% planned to use the rankings in their
communities. Suggestions received through this survey and other
more informal feedback will be incorporated into the 2004
rankings, such as the expansion and improvement of the
environmental health components and the inclusion of additional
local survey data.
The Wisconsin County Health Rankings provides a
valuable vehicle for delivering and discussing county-level
health information and for engaging stakeholders in the discussion of approaches
for reducing observed disparities. This report
will continue to be produced annually with special attention
given to improving population health measures and its use in
community health improvement efforts.
Corresponding Author: Angela M. Kempf, MA, Project
Assistant and Doctoral Student, University of Wisconsin Medical
School, Department of Population Health Sciences, Wisconsin
Public Health and Health Policy Institute, 610 Walnut St,
Suite 760, Madison, WI 53726. Telephone: 608-263-7497. E-mail: kempf@wisc.edu.
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