Measuring the spatial distribution of health rankings in the United States. (2nd September 2021)

• Record Type: Journal Article
• Authors: Davis, Will; Gordan, Alexander; Tchernis, Rusty
• Is Part Of: Health economics. Volume 30:Number 11(2021)
• Page Start: 2921
• Page End: 2936
• Publication Date: 2021-09-02
• Subjects: county health rankings -- economic mobility -- factor analysis -- health inequality; Medical economics -- Periodicals; Economics, Medical -- Periodicals; Health Care Costs -- Periodicals; Health Policy -- economics -- Periodicals; Health Services -- economics -- Periodicals; 362.1
• DOI: 10.1002/hec.4416
• Languages: English
• ISSNs: 1057-9230

Abstract

Abstract: We rank counties in the United States 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 Bayesian factor analysis model that estimates data‐driven weights for our rankings, incorporates county population sizes into the level of rank uncertainty, and allows for spillovers of health stock across county lines. We find that demographic and economic variation explains a large portion of the variation in health rankings. We address the importance of uncertainty caused by imputation of missing data and show that there is a substantial quantity of uncertainty in rankings throughout the rank distribution. Analyzing the health of counties both within and across state lines shows notable degrees of disparity in county health. While we find some disagreement between the ranks of our model and the CHRs, we show that there is additional information gained by utilizing the rankings produced by both methods.