A cross-sectional study on health differences between rural and non-rural U.S. counties using the County Health Rankings

Anderson, Timothy J.; Saman, Daniel M.; Lipsky, Martin S.; Lutfiyya, M. Nawal

doi:10.1186/s12913-015-1053-3

Table 1 County Health Rankings Model: Measures and Data Sources

From: A cross-sectional study on health differences between rural and non-rural U.S. counties using the County Health Rankings

	Measure	Data source
Health outcomes
ᅟMortality 50 %*	Premature death	National center for health statistics
ᅟMorbidity 50 %	Poor or fair health	Behavioral risk factor surveillance system
	Poor physical health days	Behavioral risk factor surveillance system
	Poor mental health days	Behavioral risk factor surveillance system
	Low birth weight	Behavioral risk factor surveillance system
Health factors
Health behaviors (30 %)
ᅟTobacco use	Adult smoking	Behavioral risk factor surveillance system
ᅟDiet & exercise	Adult obesity	National center for chronic disease prevention and health promotion (NCCDPHP)
ᅟDiet & exercise	Physical inactivity	NCCDPHP
ᅟAlcohol & drug use	Excessive drinking	Behavioral risk factor surveillance system
ᅟSexual activity	STI data	National center for HIV/AIDS, viral hepatitis, STD, and TB prevention
ᅟSexual activity	Teen births	National center for health statistics
Clinical care (20 %)
ᅟAccess to care	Uninsured	Small area health insurance estimates
	Primary care physicians	HRSA area resource file
	Dentists	HRSA area resource file
ᅟQuality of care	Preventable hospital stays	Medicare/dartmouth institute
	Diabetic screening	Medicare/dartmouth institute
	Mammography screening	Medicare/dartmouth institute
Social economic factors (40 %)
ᅟEducation	High school graduation	Data.gov, supplemented w/ national center for education statistics
ᅟEducation	Some college	American community survey
ᅟEmployment	Unemployment	Bureau of labor statistics
ᅟIncome	Children in poverty	Small area income and poverty estimates
ᅟFamily and social support	Inadequate social support	Behavioral risk factor surveillance system
ᅟFamily and social support	Children in single parent households	American community survey
ᅟCommunity safety	Violent crime	FBI Uniform crime reporting
ᅟCommunity safety	Injury deaths	CDC Wonder
Physical environment (10 %)
ᅟAir and water quality	Air pollution - particulate matter	CDC Wonder
ᅟAir and water quality	Drinking water violations	Safe drinking water information system
ᅟBuilt environment	Limited access to health foods	USDA food environment atlas
	Fast food restaurants	County business patterns
	Access to recreational facilities	County business patterns

Policies and Programs
Federal, state and local programs believed to target health outcomes directly or attribute to health factors which cause outcomes
*Percentages indicate weights based on comparative importance within an outcome/factor and data quality

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ISSN: 1472-6963

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