How Reliable Are County and Regional Health Rankings?

How Reliable Are County and Regional Health Rankings? Surveillance system indicators of morbidity, mortality, or behaviors are used to provide regional information for ever-smaller areas, most recently for ranking counties. These rankings are thought to provide information about the relative standing of regions and provide information about problem areas and the success of programs. We investigate the ability of such rankings to reliably assess health. We assess the reliability of several ranked health indices used at the county level and the consistency of an index's quality across different states. Reliability is assessed using an index of reliability, simulations, and the ability of an index to consistently identify the top 10 % (worst) counties within a state. There is marked variability across measures to provide consistent ranks, across states, and, many times, across states for a particular measure. A few health measures do consistently well, e.g., Teen Birth, Chlamydia, and Years of Potential Life Lost rates. While a few health rankings appear worthy of use for policy and in the identification of local problems, in general, they are not consistent across regions. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Prevention Science Springer Journals

How Reliable Are County and Regional Health Rankings?

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Publisher
Springer US
Copyright
Copyright © 2013 by Society for Prevention Research
Subject
Medicine & Public Health; Public Health; Health Psychology; Child and School Psychology
ISSN
1389-4986
eISSN
1573-6695
D.O.I.
10.1007/s11121-012-0320-3
Publisher site
See Article on Publisher Site

Abstract

Surveillance system indicators of morbidity, mortality, or behaviors are used to provide regional information for ever-smaller areas, most recently for ranking counties. These rankings are thought to provide information about the relative standing of regions and provide information about problem areas and the success of programs. We investigate the ability of such rankings to reliably assess health. We assess the reliability of several ranked health indices used at the county level and the consistency of an index's quality across different states. Reliability is assessed using an index of reliability, simulations, and the ability of an index to consistently identify the top 10 % (worst) counties within a state. There is marked variability across measures to provide consistent ranks, across states, and, many times, across states for a particular measure. A few health measures do consistently well, e.g., Teen Birth, Chlamydia, and Years of Potential Life Lost rates. While a few health rankings appear worthy of use for policy and in the identification of local problems, in general, they are not consistent across regions.

Journal

Prevention ScienceSpringer Journals

Published: Feb 12, 2013

References

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