| 2021 Message to the Field

It is a pivotal time in the nation as we face the COVID-19 pandemic and renewed calls for racial justice. For more than a decade, the County Health Rankings have examined the multiple factors that impact how long and how well we live and have shown there are stark differences in health and opportunity by place. COVID-19 has exacerbated these differences. While all are suffering, those who came into the pandemic with the fewest opportunities are likely to exit it with an even greater burden. This crisis has only deepened the avoidable and unfair gaps that Black, Latino, Indigenous, and some Asian-American communities faced pre-COVID-19 in jobs with fair pay, housing, education, and more.

The County Health Rankings & Roadmaps provides data, evidence, guidance, and examples to elevate how the conditions where we live, learn, work, and play shape health. We are continuously examining the role we can play to support communities’ efforts to improve health and increase equity.

As we look to the future, we will:

Listen and learn: We will engage in conversations with leaders on the ground. We commit to listening to, learning from, and working with partners dedicated to advancing health equity. We will also be more intentional about drawing from the lived experiences and expertise of those most directly impacted by barriers to opportunity.
Take a fresh look at the County Health Rankings model: As we explore ways to use data to communicate the historical drivers and current manifestations of racial and spatial inequities in counties across the nation, we will revisit the Rankings model and assess what changes are needed to highlight fundamental causes of health.
Explore new data sources and measures: We will investigate new sources and measures to more effectively capture differences in opportunities as we take a deeper dive into the drivers of health and equity.
Broaden and enhance What Works for Health solutions: We will expand and improve What Works for Health, our searchable menu of more than 400 evidence-informed policies and strategies, by adding more topic-focused curated lists. We will also work to refine our evidence ratings to offer even more context about how each policy impacts equity. These efforts will be increasingly important to offering solutions that reshape community conditions.

The Rankings have expanded the nation’s understanding about what impacts health. The ranking of counties has always served as a way to start that conversation locally. In the past, we have reported on spatial inequities within states and the differences in health outcomes and factors between urban, suburban, and rural areas. In more recent years, there has been a more explicit focus on the intersection of race, place, and health with measures such as income inequality and residential segregation. Our suite of resources, which include Action Learning Guides, webinars, and the guidance offered to communities throughout the years through coaching assistance, have increasingly emphasized the underlying factors that create disparities and hinder equity.

COVID-19 has exposed and exacerbated inequities in health and well-being. And while the Rankings do not measure COVID-19 risk, they do help to show the root causes that contribute to poor health. Creating conditions for everyone to thrive requires looking to multi-layered social, economic, and structural factors that run much longer and deeper in communities than mask-wearing or safer at home orders. We are committed to addressing the deeper systemic issues.

We know data alone is not sufficient to advance change. As we evolve our model, data, and measures; leverage partner relationships; synthesize perspectives from the most impacted communities; and improve our tools and website, we believe all of these efforts will work together to contribute to transformative change and action across the nation.

We have learned so much from this work over the last 10 years. The path forward requires our continued work—together—to ensure all have the opportunity to thrive. For this year’s Rankings, we have refreshed the data with the most currently available information which you can explore here. And we are still available to answer questions about the data and resources. With this release, we offer our state and local public health partners data while acknowledging the time and space they may need to focus on their COVID-19 response efforts. Next year’s 2022 County Health Rankings will return to our usual Rankings release approach and will contribute to the important conversation about equitable opportunity for all.

For questions about 2021 data source changes, visit our FAQs.