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Comparing New York’s Counties To Others Nationwide

A Health Affairs Blog writes of New York State Health Foundation’s recently released report that uses County Health Rankings data to evaluate the performance of New York State counties nationally. Data for 2010 and 2019 for five health outcomes measures—premature death, self-reported health, poor mental health days, poor physical health days, and low birthweight—were used in their analysis. The researchers sought to establish how New York State counties ranked in health outcomes compared with all counties in all states, whether New York State counties’ national performance change over time and how did the disparity between the healthiest and least healthy counties in New York State compare to such disparities in other states.

Researchers found that, in both 2010 and 2019, New York State was among the top third of states based on its median county percentile rank. New York State’s good overall health, relative to other states, is reflected in health measures not ranked in the County Health Rankings, such as overall life expectancy. However, researchers also discovered that stagnation and declines in health outcomes can be masked by in-state ranks, such as the County Health Rankings.

The researchers note a few caveats in using County Health Ranking data to look at national performance:

  • only a subset of the County Health Rankings measures are appropriate for cross-state comparison.
  • estimates are usually multiyear rolling averages, making changes over time less clear.
  • the small population size of many counties results in unstable estimates, meaning that standard errors on multiyear averages can still be large.

Despite these caveats, the researchers write their analyses show that the Rankings data can be used effectively for a national perspective on county performance. Further, their report confirms that looking at in-state rankings alone obscures broader trends that can be used to benchmark performance and set goals for population health improvement.

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