The County Health Rankings show us that where we live matters to our health. The health of a community depends on many different factors - ranging from health behaviors, education and jobs, to quality of health care, to the environment.

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What We Rank

Ranked Places

The County Health Rankings are based on counties and county equivalents (ranked places). Any entity that has its own Federal Information Processing Standard (FIPS) county code is included in the Rankings. The FIPS county code is a five-digit code where the first 2 digits represent the state and the remaining 3 digits designate county or county equivalent. Certain major cities, such as Baltimore and St. Louis, are considered county equivalents and have their own FIPS county code. Other cities, such as Milwaukee, do not have a FIPS code and are not individually ranked.

We recognize that not all states use a county system but we are currently unable to alter the data to reflect the existing governance structures in all states. We encourage communities within each county of a state to use the Rankings as a starting point to delve more deeply into data that are more relevant for your particular governance structure. The Rankings may be used to initiate a community health assessment or to draw attention to thorough assessments that have already been completed. In addition to the Rankings and underlying measures, this web site also provides information to help communities think about the factors that influence their health and ways to take action to address these factors. 

Unranked Places

We try to rank all counties or county equivalents with a FIPS code. Unfortunately, we were unable to rank 107 counties or county equivalents due to insufficient data. For some additional counties, there are some individual measures where there was not a large enough sample size to report data for a particular measure. In this situation, the overall rank of the county does not include the measures that had too small of a sample size.

In several measures, the County Health Rankings use the average of multiple years of data, giving equal weight to each observation year. This allows even small, sparsely populated counties to have a larger sample size to base the measure on. Also, for some units that have missing data for only a few measures, we use the average of all counties in that state. These two strategies allow us to rank some units that we might otherwise not be able to rank.

Ranking Within States

We only rank counties and county equivalents within a state. 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, not to produce a list of the healthiest 10 or 20 counties in the nation and only focus on that. The goal of the County Health Rankings, coupled with data comparability and availability issues across states, means that we can only provide county rankings within states.

In general, we discourage comparisons between states. However, if you wish to compare counties across the nation, we have prepared guidelines to describe which measures can be compared across states. There are also other resources available to you. One is the Community Health Status Indicators (CHSI) Database which the Human Resource Services Administration (HRSA) put together. The CHSI database is periodically updated and provides a valuable resource for counties that are interested in comparing themselves to peer counties with similar demographics.