How CHR&R Measures Are Selected

Ranked measures

There are two main considerations in the process of selecting measures that will be used for ranking the health of communities. First and foremost, we aim for measures that meet our program's goals and objectives as well as measures that are innovative to meet community needs. Considerations specific to this purpose are listed in the first column of the table below. Subsequently, a measure must be technically and analytically feasible to be included in our model and not be limited by availability, cost, validity, coverage, or other matter. Considerations we have specific to this concern are listed in the second column of the table below.

CHR&R Program Goals/Objectives & Innovating to Meet Community Needs
Technical/Analytical Feasibility
  • The measure reflects important aspects of population health that can be improved (modifiable factors).
  • The measure and its association to health can be effectively communicated to the media, communities, and other key audiences.
  • With the mindset that fewer measures are better than more, any new measure must bring added value without diluting the model.
  • Measures for health outcomes will generally not be changed to ensure consistency, but measures for factors can be expanded, pared, or revised.
  • New measures must fall within one of the factor areas in the model.
  • The measure speaks to a current or emerging health issue that CHR&R could/should engage in and has the potential to make CHR&R more relevant to a strategic new set of partners.
  • The metric is a more precise measure of the intended construct and/or refines the construct dimensions based on improved understanding of its relation to health (e.g., CHR measures community safety with injury deaths because a more proximal measure is unavailable).
  • The measure keeps CHR&R aligned with other metric initiatives (e.g., America’s Health Rankings).
  • The measure will advance efforts to address health equity.
  • The measure and its association to health are scientifically supported in the literature and/or by analysis of CHR data.
  • The measure draws from data that are available at the county level.
  • The measure draws from data sources that are valid, reliable, recognized and used by others.
  • The measure has been tested and used by others in the field.
  • The measure draws from data available for nearly all counties nationwide and puts the interests of counties and states ahead of national coverage (i.e. – the ideal is not to have missing data clustered within a particular state).
  • Data to populate the measure have a short time lag (recently available within the past 3-5 years).
  • Data to populate the measure will be collected regularly (ideally annually but at least every 3-5 years) and made public by the data stewards.
  • Data to populate the measure are available for free or at low cost.
  • The measure can be ranked (e.g., it has ordinal value).
  • The measure can be broken down by geographic or population subgroups.

Additional measures

We provide many additional measures for counties to further explore health in their community that did not qualify to be a ranked measure for one or more reasons listed above. Additional measures are categorized by health focus area and can be found for health outcomes, health behaviors, clinical care, social and economic factors, and physical environment in the county snapshot.

Demographic measures 

We provide demographic measures for counties to give background and context for understanding ranked measures. Demographic data on age structure, racial make-up, gender, and rurality for the county and the state can be found in the county snapshot.

State-specific measures

We offer states the opportunity to provide measures specific to their state. Please contact us if you’re interested for your state.