America's Health Rankings – 22 years as a dashboard for population health

Background: America's Health Rankings (AHR) has ranked the relative health of the 50 states since 1990. Initially, the public was only aware of the overall rank of their state. Ultimately, AHR evolved into a dashboard that displays 23 different metrics that are used to gauge the status and progress of each state's health. Objectives/Purpose: The purpose of AHR is to promote the discussion of population health, to define health holistically using determinants and outcomes, and to spur the public and policy makers, in concert with public health and medical professionals, to take action to improve their state's health. Methods: To describe the population health of each state, AHR uses a five component model: 1) Behaviors, 2) Community & Environment, 3) Public & Health Policy, 4) Clinical Care and 5) Health Outcomes. Within these components are 23 metrics selected by a Scientific Advisory Committee. Annually, each metric is reviewed, data is updated, a weighted z-score is calculated for each state and the states are ranked by their z-score. Results: Each year, hundreds of media outlets bring population health into the public discourse by covering AHR's annual release. In addition, the report is used by government agencies, non-profit advocacy groups and businesses as a source of readily available, comparable data. The report is also used as a benchmark for health programs initiated by states, foundations and universities. Discussion/Conclusions: America's Health Rankings allows the public to enter the dialog regarding population health and to explore how they can take action. Individuals can learn about various public health measures and their impact on population health. Through web features, individuals and organizations can visualize the health data, select areas of interest and select actions that they can take individually, as a group or as part of an organization to improve the health of their state.