Measuring the Spatial Distribution of Health Rankings in the United States

We rank counties in the United States of America with respect to population health. We utilize the five observable county health variables used to construct the University of Wisconsin Population Health Institute’s County Health Rankings (CHRs). Our method relies on a factor analysis model to directly compute weights for our rankings, incorporate county population sizes into the variances, and allow for spillovers of health stock across county lines. We find that demographic and economic variation explain a large portion of the variation in health rankings. We address the importance of uncertainty caused by imputation of missing data and show that the use of rankings leads to inherently greater uncertainty. Analyzing the health of counties both within and across state lines shows substantial degrees of disparity. We find some disagreement between our ranks and the CHRs, but we show that much can be learned by combining results from both methods.