Health Ranking of the Largest US Counties Using the Community Health Status Indicators Peer Strata and Database
Health Ranking of the Largest US Counties Using the Community Health Status Indicators Peer Strata and Database
复制标题
DOI：
10.1097/phh.0b013e318205413c
复制
发表时间：
2011-09-01
影响因子：
3.3
通讯作者：
Stanley, Jennifer
中科院分区：
文献类型：
--
作者：
Kanarek, Norma;Tsai, Hua-Ling;Stanley, Jennifer
目的：利用社区卫生状况指标（CHSI）报告的结构，我们开始分析人口健康数据，目的是验证社区卫生状况指标模块作为首要主题，并在同行阶层中对县卫生进行排名。设计、环境、参与者：在人口健康的许多方面，对美国最大的（10万）非边境县（县总数）（N = 508）进行了排名。因子分析评估CHSI模块性，方差分析证实同级地层同质性。主要结果测量：确定了10个因素。它们是生命阶段、伤害、癌症、成人行为、预防服务、环境食品和医疗保健。因为它们不构成一个因素，所以4 CHSI的综合健康指标（全因死亡率、平均预期寿命、健康状况和不健康天数）也进行了排名。结果：没有单一因素可以反映全县的卫生状况。结论：进一步总结县域卫生状况具有挑战性。我们给出了CHSI同行阶层1的排名，即100万或更多人口的地方司法管辖区。当考虑规模较小的县时，县因素内容和数据可用性可能会有所不同。社区领导人可以利用排名来进行社区健康评估和确定当地的优先事项，并最终纳入CHSI基于网络的报告。
Objective: Using the structure of the Community Health Status Indicators (CHSI) report, we embarked on analysis of population health data with the aim to validate the CHSI modules as overarching themes and to rank county health within peer strata. Design, Setting, Participants: Ranking was conducted for the largest (>100 000), nonfrontier counties (county aggregates) (N = 508) in the United States for many aspects of population health. Factor analysis was used to assess CHSI modularity and analyses of variance confirmed peer strata homogeneity. Main Outcome Measures: Ten factors were identified. They were life stage, injury, cancer, adult behaviors, preventive services, environment-food, and health care access. Because they did not contribute to a factor, 4 CHSI summary health measures (all-cause mortality, average life expectancy, health status, and unhealthy days) were also ranked. Results: No single factor emerged as reflecting overall county health. Conclusions: Further summary of county health will be challenging. We present the ranks for CHSI peer strata #1, local jurisdictions of 1 million or greater population. County factor content and data availability may differ when counties of smaller size are considered. Ranking may be utilized by community leaders for community health assessment and local priority setting, and ultimately incorporated into CHSI Web-based reports.