County by County Blog

Project updates, commentaries, events and news about health across the nation from the County Health Rankings & Roadmaps team.

Making the most out of community data: County Health Rankings Research Projects

Publication date
September 23, 2016

How can County Health Rankings data be applied to community health or influencing policy? In January of 2015 we released a call for research applications to look into that question, and we selected five proposals. With that work concluding, here are some of the key take-homes from this research. We’ll be sharing much more about these projects in the coming months as the findings are presented at conferences, in journals, and other venues.

Extending the Rankings to ZIP code level
Reliable data for a wide variety of health metrics are available nationally, for states, and (of course) for counties, but smaller areas such as ZIP codes is another story. Washington University in St. Louis and the Missouri Hospital Association developed local measures of population health for Missouri counties using data available at the ZIP code level. Data collected by hospitals as well as market research data by Nielsen Claritas were combined and calculated in alignment with the CHR approach. When scaled up, these ZIP code rankings correlated with the County Health Rankings and show a path to refine the health snapshot at the local level. Going to APHA? See more about this project there.

Does wealth sync with health?
Arizona State University researchers using the Rankings data found that while community wealth does correlate with health, it is offset in some cases by the ways counties choose to invest, such as targeting resources to public health initiatives/policies and community health centers. The implications of this show that spending among existing public services may dramatically impact a community’s health. Going to APHA? See more about this project there.

Mining data to support actionable decisions
Using the Rankings data, the New York Academy of Medicine brought “big data” procedures (machine learning data mining techniques) to identify clusters of counties with different levels of health outcomes based on complex interactions of various health factors that may be related to these outcomes. These analyses offer a straightforward method which may help local county/city officials better design and calibrate actionable and tractable areas to target policies for local health improvement. Going to APHA? See more about this project there.

The Rankings’ impact on policy decisions
Whether through local health officers or media, news of a county’s ranking can spur change in the form of laws or regulations. But how does that happen? Drexel University’s research explored how the Rankings are used by communities, finding that rankings are useful for educating and raising awareness and are key for local health departments and groups with limited resources working to target their health improvement efforts. Another finding points to Rankings data as a helpful tool for engaging political officials on the need for broader action in partnership with those outside of healthcare when it comes to directing policy decisions that influence community health.

The role of economic stress in well-being
Washington State University and Clemson University in collaboration with Healthways investigated the degree to which county-level factors influence the effect of economic stressors, such as job insecurity or living from one paycheck to the next, on individual well-being outcomes as measured by the nationally representative Gallup-Healthways Well-being Index. Financial and professional concerns have a big impact on psychological well-being and can reveal health impacts beyond just employment statistics. Initial findings suggest that in healthier counties, the effects of income-related stress are diminished while the effects of employment-related stress are magnified in such contexts. This might mean, for example, that in a healthier community experiencing job instability may affect a person’s social contacts or sense of identity and cause more stress compared to a person in a less healthy community. Workplace stress is also the topic of this recent report from the Robert Wood Johnson Foundation.

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