Tuesday, May 1, 2012

Geography of Health in the US

The American Public Health Association has highlighted an updating of a very neat US health resource available on the internet--rankings of US counties by health and health predictors.

Released in April, the third annual County Health Rankings report ranks the counties within every state, using health outcomes as the primary indicators for assessing a county’s health. To assign ranking, researchers gathered data on premature death, poor physical and mental health days, smoking, physical activity rates, teen birth rates and motor vehicle deaths, among many other factors. The report also takes into account environmental factors, such as poor air quality days and access to healthy foods, and clinical indicators, such as mammography and diabetes screening rates.
“All public health is local,” said APHA member Patrick Remington, MD, MPH, co-director of the County Health Rankings project, which is sponsored by the Robert Wood Johnson Foundation. “When you focus your lens at the state level, you’re able to see even more variation…and the resolution of your view depends on what policies you’re considering. Since public health really is administered at the state and local levels, this helps people get a better look.”
This is a classic case of scale issues--relationships are often different at one geographic scale (e.g., counties) than another (e.g., states). The rankings themselves are very interesting and thought-provoking. Why, for example, is my county (San Diego) ranked 18th in the state? Since there are 52 counties in the state, that's not too bad, but the website allows you to make comparisons with other places, so that we could work out the underlying reasons for San Diego County not being closer to the top.

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