Scoring Methods

State scores were calculated with a point-based algorithm developed by the CDC. Using annually published licensing ratings (see details at right), an overall state score was determined by assessing how well licensing regulations for child care centers support each of the 47 high-impact obesity prevention standards. More points were awarded when a state’s licensing regulations fully supported each of the high-impact obesity prevention standards, and fewer points were awarded when licensing regulations only partially addressed, did not address, or contradicted the obesity prevention standard.

Regulatory Point-Based Algorithm

Licensing Regulation Fully Supports Standard= 100 points
Licensing Regulation Partially Supports Standard= 70 points
Licensing Regulation Does Not Address Standard= 30 points
Licensing Regulation Contradicts Standard= 0 points

CDC calculated two types of scores for different uses:

State ECE-Licensing Ratings

The National Resource Center for Health and Safety in Child Care and Early Educationexternal icon collects, analyzes, and rates licensing regulations in all 50 states and District of Columbiia.  These ratings describe how well regulations for Center and home-based childcare programs include nationally recognized obesity prevention standards. The 2019 report and state supplements  are publicly available at: icon

First, an overall licensing score was calculated for each state. It is a summary score, representing how well a state’s center-based licensing regulations include the 47 high-impact obesity prevention standards. States stakeholders can use this overall score to gauge how well their state supports obesity prevention in ECE regulations, and they can compare themselves to other states and the nation.

Next, to provide greater detail on where a state is doing well or may have room to improve, the 47 obesity prevention standards were organized into four obesity prevention sub-domains. State-specific sub-domain scores were calculated for each of the following:

  • Healthy Infant Feeding (11 standards)
    • Breastfeeding support (n=1)
    • Infant feeding practices(n=10)
  • Nutrition (21 standards)
    • Nutrition standards (n=15)
    • Healthy mealtime practices (n=6)
  • Physical Activity (11 standards)
  • Screen Time Limits (4 standards)

An example of the infant feeding sub-domain scoring algorithm is provided below. It highlights how points are assigned and how a sub-domain score is generated.  This is the same scorecard methodology used to calculate the nutrition, physical activity, and screen time sub-domains.

Learn more about the scoring algorithm. pdf icon[PDF-243KB]