County Health Rankings & Roadmaps, A Healthier Nation, County by County

The County Health Rankings models and measures

Our Approach

The County Health Rankings model of population health

What can I do?

Action Center

Explore guides and tools for improving health.

What Works for Health

Explore programs and policies that work!

What can I learn from others?

Reports

Key findings from the last four years of County Health Rankings and other national reports.

County-by-County Blog

Project updates, commentaries, events and news about health across the nation from the County Health Rankings & Roadmaps team.

Prepare to prioritize

It’s important to remember that no one priority-setting method is best all of the time. Your decision will depend on the size of the team you’re working with, the amount of time you have, and how much community participation you want. A good priority setting process will clearly define your criteria for comparing options, the processes you’ll use to prioritize options, and how you’ll make final decisions.

Criteria for comparing options
Criteria express the values, standards, and basic ideas your team will consider when making choices and deciding priorities.1 Try to limit yourself to no more than four or five criteria to select your priorities.
Keep your guiding question handy as you think about criteria.

Following are some questions to help you identify potential criteria:

  • Who is affected?
  • How many people are affected?
  • Are there groups that are affected more than others?
  • Where are the greatest opportunities for improvement?
  • How severe are the effects? Based on the County Health Rankings model, how much does this issue contribute to health outcomes?
  • What are the consequences of not intervening?
  • Are there strategies that have been shown to effectively address this issue?
  • What does the community think? Do they support this issue?
  • What do policymakers think? Do they support this issue?
  • What assets and resources can partners bring to address this issue?
  • How long will it take to reach an outcome?
  • What are the potential negative impacts of addressing the problem?
  • What has been tried before? What were the barriers and successes of those attempts?

Processes to prioritize options
First Things First: Prioritizing Health Problems describes five prioritization methods:

  • Multi-voting – use when you need to narrow down a long list of issues to a top few.
  • Strategy grids – use when you have limited resources but want maximum impact.
  • Nominal Group Technique – use when you want to generate many ideas in a short time with input from many people, and you want to reduce the final list of ideas.
  • Hanlon Method – use to generate an objective list of health priorities based on baseline data and numerical values.
  • Prioritization Matrix – use to evaluate ideas against a large number of criteria or when you want to focus on only one priority health issue.

Roles and processes to make the final choices
The Role of a Facilitator suggests some factors and options to consider when deciding the process you will use to make group decisions.

  • The number of participants. If you have a large group, you might consider using smaller “break-out” groups.
  • The level of participation you want to ensure. If you’re concerned about participation, giving participants time in the agenda to write down their thoughts may be a good strategy.
  • The background and positions of the participants.
  • How well participants know the subject and each other.
  • The time you have available.²

In addition to a formal process, some communities will take their potential priority issues to the public for their input. There are a variety of ways to get input from the public such as holding community forums, making presentations to various community organizations, and conducting community surveys.

1.    Forest LB, McKenna C, Donovan J. Connections:  A "How To" Handbook for Developing Extension Long-Range Plans and Major Problems. Madison, WI; 1986 April 1986.
2.    MindTools.com. The Role of a Facilitator: Guiding an event through to a successful conclusion. In. London: Mind Tools Ltd; 2012.