摘要：United Health Foundation’s America’s Health Rankings, which ranks the states from “least healthy” to “healthiest,” receives wide press coverage and promotes discussion of public health issues. The University of Wisconsin Population Health Institute used the United Health Foundation’s model to develop the Wisconsin County Health Rankings (“ Health Rankings ”) from existing county-level data. The institute first released the rankings in 2004. A survey of the Wisconsin county health officers indicated that they intend to use the rankings for needs assessment, program planning, and discussion with county health boards. The institute implemented many of the health officers’ suggestions for improvement of the rankings in subsequent editions. The methods employed to create the rankings should be applicable in other states. RANKINGS CONTRASTING cities, states, or nations for any number of characteristics—economic, education, health, and others—are continuously being released. Such rankings often receive substantial attention. In particular, United Health Foundation’s annual America’s Health Rankings, 1 which ranks states from “least healthy” to “healthiest,” receives wide press coverage and promotes discussion of public health issues. The University of Wisconsin Population Health Institute in Madison released its first annual Wisconsin County Health Rankings (hereafter “ Health Rankings ”) report in January 2004, with the main purpose of encouraging discussion about important population health issues among Wisconsin public health and other policy communities. Our hope is that, by encouraging such discussion and raising awareness of variation in populations’ health within Wisconsin, the Health Rankings will yield an enhanced appreciation of the variety of factors that affect populations’ health and that are amenable to influence by public and private sector programs and policies. The conceptual framework underpinning the Health Rankings is based on a model of population health improvement with health outcomes produced by a set of health determinants. Public and private sector programs and policies can enhance or limit these determinants. 2 We describe briefly the design of the Health Rankings (more-detailed methods can be found elsewhere 3 ), the method of annual release, and an evaluation of the Health Rankings ’ usefulness to local public health authorities.
