Discounting Health Grades for Disparity: The 2021 Wisconsin Population Health and Equity Report Card
TOOLS FOR PUBLIC HEALTH PRACTICE — Volume 20 — April 6, 2023
PEER PREVIEW
In the self-reported health distribution, no state earned an A letter grade. Twenty-one earned a B (Colorado, Minnesota, Utah, Nebraska, South Dakota, Hawaii, Vermont, Maryland, Massachusetts, New Hampshire, Connecticut, New Jersey, North Dakota, Wyoming, Washington, Rhode Island, Alaska, New York, Maine, Idaho, Iowa); 16 earned a C (Wisconsin, Montana, Virginia, Illinois, Oregon, Kansas, Delaware, Pennsylvania, North Carolina, Florida, New Mexico, California, Arizona, Ohio, Michigan, Georgia); 7 earned a D (Texas, Indiana, Missouri, Tennessee, South Carolina, Nevada, and Oklahoma); and 6 earned an F (Louisiana, Mississippi, Alabama, Arkansas, Kentucky, and West Virginia). In the grade distribution for mortality, both Hawaii and California earned an A; 14 states earned a B (New York, Connecticut, Minnesota, Colorado, Florida, New Jersey, Arizona, Massachusetts, Washington, North Dakota, Utah, Vermont, Oregon, Rhode Island); 22 earned a C (Maryland, Virginia, New Hampshire, Alaska, Illinois, Wisconsin, Nebraska, South Dakota, Idaho, Iowa, Texas, Wyoming, Delaware, Montana, New Mexico, Nevada, Pennsylvania, Maine, Kansas, North Carolina, Michigan, Georgia); 5 earned a D (Missouri, South Carolina, Indiana, Ohio, Louisiana); and 7 earned an F (Tennessee, Arkansas, Oklahoma, Alabama, Kentucky, West Virginia, and Mississippi).Figure 2. Two choropleth maps of the US showing each state’s letter grade for 2 distributions, self-reported health and mortality, assessed in state health report cards (tools that summarize actionable data and communicate key messages to policy makers and practitioners). Grades are A, B, C, D, and F. Grade cut-offs were assigned by using the national mean and SD of rates of self-reported health (percentage of the population reporting fair or poor health) and mortality (deaths per 100,000 population). The same cut-offs for SD relative to the national mean were used to assign grades for both distributions: A, >1.5 SD better; B, >0.5 to ≤1.5 SD better; C, ≤0.5 SD better and <0.5 SD worse; D, ≥0.5 to <1.5 SD worse; and F, ≥1.5 SD worse than the national mean. [A text version of this figure is available.]
Figure 1. Two geographic grade distributions, self-reported health and mortality, assessed in state health report cards (tools that summarize actionable data and communicate key messages to policy makers and practitioners). Grades are A, B, C, D, and F. Grade cut-offs were assigned by using the national mean and SD of rates of self-reported health (percentage of the population reporting fair or poor health) and mortality (deaths per 100,000 population). States at the top of each column have higher grades and lower rates of mortality or fair/poor health than the states below them. The same cut-offs for SD relative to the national mean were used to assign grades for both distributions: A, >1.5 SD better; B, >0.5 SD to ≤1.5 SD better; C, ≤0.5 SD better and <0.5 SD worse; D, ≥0.5 SD to <1.5 SD worse; and F, ≥1.5 SD worse than the national mean.
In the first map, self-reported health, no state earned an A letter grade. Twenty-one earned a B (Alaska, Connecticut, Colorado, Hawaii, Idaho, Iowa, Maine, Maryland, Massachusetts, Minnesota, Nebraska, New Hampshire, New Jersey, New York, North Dakota, Rhode Island, South Dakota, Utah, Vermont, Washington, Wyoming,); 16 earned a C (Wisconsin, Montana, Virginia, Illinois, Oregon, Kansas, Delaware, Pennsylvania, North Carolina, Florida, New Mexico, California, Arizona, Ohio, Michigan, Georgia); 7 earned a D (Texas, Indiana, Missouri, Tennessee, South Carolina, Nevada, and Oklahoma); and 6 earned an F (Louisiana, Mississippi, Alabama, Arkansas, Kentucky, and West Virginia). In the second map, mortality, both Hawaii and California earned an A. Fourteen states earned a B (New York, Connecticut, Minnesota, Colorado, Florida, New Jersey, Arizona, Massachusetts, Washington, North Dakota, Utah, Vermont, Oregon, Rhode Island); 22 earned a C (Maryland, Virginia, New Hampshire, Alaska, Illinois, Wisconsin, Nebraska, South Dakota, Idaho, Iowa, Texas, Wyoming, Delaware, Montana, New Mexico, Nevada, Pennsylvania, Maine, Kansas, North Carolina, Michigan, Georgia); 5 earned a D (Missouri, South Carolina, Indiana, Ohio, Louisiana); and 7 earned an F (Tennessee, Arkansas, Oklahoma, Alabama, Kentucky, West Virginia, and Mississippi).
Figure 2. Two choropleth maps of the US showing each state’s letter grade for 2 distributions, self-reported health and mortality, assessed in state health report cards (tools that summarize actionable data and communicate key messages to policy makers and practitioners). Grades are A, B, C, D, and F. Grade cut-offs were assigned by using the national mean and SD of rates of self-reported health (percentage of the population reporting fair or poor health) and mortality (deaths per 100,000 population). The same cut-offs for SD relative to the national mean were used to assign grades for both distributions: A, >1.5 SD better; B, >0.5 to ≤1.5 SD better; C, ≤0.5 SD better and <0.5 SD worse; D, ≥0.5 to <1.5 SD worse; and F, ≥1.5 SD worse than the national mean.
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