America's Health Rankings: Selection and review of health metrics

Background: America's Health Rankings has ranked the relative general population health of the 50 states since 1990. Over that period of time, our understanding of public health and the important determinants of population health have evolved, and new, improved sources of data have become available. This creates twin challenges in maintaining an on-going dashboard of health; 1) how to maintain comparability with prior years and 2) how to include new and improved metrics. Objectives/Purpose: The purpose of the Scientific Advisory Committee (SAC) is to guide and shape the index. They are challenged with balancing the continuity of historical data with current public health research and data sources. The SAC also assists with message framing for the target audiences to improve the probability that publication of the index will result in tangible improvement in public health in a state. Methods: A Scientific Advisory Committee hosted by University of North Carolina at Chapel Hill consisting of experts from across the country, meets annually to review metrics in the existing index, considers new data sources and investigates new metrics. The suggestion of new and revised metrics is guided by prior year's experience, suggestions from users, participant expertise and recent publications. Suggestions made by the SAC are then modeled for impact on the rankings and a final determination of changes to the index is made for the subsequent year. Results: The SAC process allows America's Health Rankings to evolve over time to ensure included metrics remain pertinent and meaningful. This maintains the usefulness of the dashboard and retains comparability to prior years. Discussion / Conclusions: The Scientific Advisory Board ensures the integrity of our constantly evolving dashboard. The SAC allows the public to retain confidence in the index yet allows the index to incorporate current knowledge and new understandings of the public health field.