Online Program

Sexual health rankings: A composite index and ranking of sexual health in the United States--50 states and the district of Columbia

Tuesday, November 5, 2013 : 10:30 a.m. - 10:45 a.m.

Martin Downs, MPH, Variance, LLC, Lebanon, NH
Sexual Health Rankings is a novel investigation of sexual health in the United States that aims to inform the development of population-based sexual health measures, and engage diverse stakeholders in promoting sexual health. The primary platform for Sexual Health Rankings is the Web site,, which allows users to explore the data, build community, and connect with resources to inform positive, evidence-based approaches to sexual health promotion. There is a recognized need to measure sexual health at the population level. The World Health Organization has developed a comprehensive definition of sexual health that emphasizes wellness, accounts for the determinants of health, and encompasses human rights, sexual expression and identity, and sexual pleasure. We have constructed a composite indicator of sexual health based on the WHO definition, using publicly available data. We find considerable state-level variation in sexual health outcomes--including measures of sexual satisfaction, morbidity, reproductive health, and violence--and in factors that influence sexual health--including state laws, health systems, and social and economic conditions. The first edition of Sexual Health Rankings, for the year 2012, ranks Vermont highest (no.1) in sexual health, and Mississippi as the least sexually healthy state (no. 51). The composite index is made up of 26 individual indicators. Indicator values are normalized to standard scores to enable comparison. The standard scores are weighted before being aggregated into a composite score. We identify limitations of the available data and suggest future directions for measurement of sexual health in the United States.

Learning Areas:

Advocacy for health and health education
Communication and informatics
Planning of health education strategies, interventions, and programs
Program planning
Public health or related public policy
Public health or related research

Learning Objectives:
Define sexual health holistically and positively. Compare states ranked highest and lowest by a composite index of sexual health. Identify available population-based indicators of sexual health in the United States. Discuss current needs for surveillance, monitoring, and evaluation of sexual health in the United States.

Keyword(s): Sexuality, Health Indices

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the director and lead researcher of Sexual Health Rankings, as well as an independent public health consultant. I have directed multi-year, federally and state-funded grant programs focusing on assessing community health needs and developing regional public health infrastructure in rural New Hampshire. I have also conducted research on disease surveillance strategies to advise the CDC and WHO/AFRO; and I wrote about sexual health as a professional journalist for more than a decade.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.