How do you calculate ranks for measures where the county rates are not statistically significant different from one another?

The major goal of the Rankings is to raise awareness about the many factors that influence health and that health varies from place to place. We encourage communities to focus on the strengths and challenges within their own community and use the Rankings as a call to action. The Rankings are based on summary measures of the indicators, using z-scores (not ranks) to standardize each measure to the same scale. We do not suggest that the ranks themselves represent statistically significant differences from county to county. We do not rank the individual measures. To de-emphasize the differences between individual county ranks, we provide quartile maps for the summary ranks and specific measures for each state. These maps can be used to draw attention to areas of a state with better or worse health, rather than specific discussions of small differences in rank. For those users who wish drill down within the Rankings and determine whether a county's performance on a specific measure is significantly different from that of another county or the state's mean, we provide confidence intervals for most measures, where applicable.