TY - JOUR
T1 - Making sense of state health data
T2 - The case of Kentucky
AU - Costich, Julia F.
PY - 2012/9
Y1 - 2012/9
N2 - OBJECTIVE: State health rankings present oversimplified and potentially damaging accounts of health status. Using the example of Kentucky, this article illustrates the realities masked by rankings that use averages and fail to account for social determinants of health. METHODS: Findings from a range of publicly available data are combined to shed light on factors that influence or are associated with health status indicators, including demographic data, health services utilization, health system elements, poverty, and educational attainment. RESULTS: Despite its low overall performance, Kentucky includes counties with health status that is equal to the highest-ranking states. Poverty and loss of healthy, working-age populations are closely associated with low health status, as are low rates of high school graduation. CONCLUSIONS: Rankings that average health status indicators across widely diverse areas may yield findings that are only marginally relevant for health policy development. A high burden of morbidity pulls resources from population health to high-cost health services, challenging the viability of long-range initiatives; however, a comprehensive approach to health status improvement will be necessary to bring more southern US states like Kentucky into higher-ranking positions.
AB - OBJECTIVE: State health rankings present oversimplified and potentially damaging accounts of health status. Using the example of Kentucky, this article illustrates the realities masked by rankings that use averages and fail to account for social determinants of health. METHODS: Findings from a range of publicly available data are combined to shed light on factors that influence or are associated with health status indicators, including demographic data, health services utilization, health system elements, poverty, and educational attainment. RESULTS: Despite its low overall performance, Kentucky includes counties with health status that is equal to the highest-ranking states. Poverty and loss of healthy, working-age populations are closely associated with low health status, as are low rates of high school graduation. CONCLUSIONS: Rankings that average health status indicators across widely diverse areas may yield findings that are only marginally relevant for health policy development. A high burden of morbidity pulls resources from population health to high-cost health services, challenging the viability of long-range initiatives; however, a comprehensive approach to health status improvement will be necessary to bring more southern US states like Kentucky into higher-ranking positions.
KW - health status rankings
KW - social determinants of health
KW - state health policy
UR - http://www.scopus.com/inward/record.url?scp=84865965850&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84865965850&partnerID=8YFLogxK
U2 - 10.1097/SMJ.0b013e31826415ef
DO - 10.1097/SMJ.0b013e31826415ef
M3 - Article
C2 - 22948326
AN - SCOPUS:84865965850
SN - 0038-4348
VL - 105
SP - 468
EP - 473
JO - Southern Medical Journal
JF - Southern Medical Journal
IS - 9
ER -