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Related Experiment Video

Updated: Mar 30, 2026

Determining Gender-Based Differences in Retinal and Choroidal Thickness in Underweight Individuals via Swept-Source Optical Coherence Tomography
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County Health Rankings: Relationships Between Determinant Factors and Health Outcomes.

Carlyn M Hood1, Keith P Gennuso1, Geoffrey R Swain2

  • 1Population Health Institute, University of Wisconsin-Madison, Madison, Wisconsin.

American Journal of Preventive Medicine
|November 4, 2015
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Summary

Socioeconomic factors significantly influence population health outcomes, contributing 47% to health composite scores. Addressing social and economic determinants is crucial for improving public health across the U.S.

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Area of Science:

  • Public Health
  • Health Services Research
  • Health Policy

Background:

  • The County Health Rankings (CHR) offers data on four key health factors: healthy behaviors, clinical care, physical environment, and socioeconomic conditions.
  • These factors are assessed alongside health outcomes like length and quality of life for nearly every U.S. county.

Purpose of the Study:

  • To empirically determine the association strength between CHR health factors and health outcomes.
  • To evaluate the performance of CHR model factor weightings across different states.

Main Methods:

  • Utilized 2015 CHR data for 45 states, compiling 35 measures into composite scores for health factors and outcomes.
  • Employed hierarchical linear regression modeling to estimate factor contributions to health outcomes.
  • Controlled for county population size, rural/urban status, and demographic distributions (gender, race, age).

Main Results:

  • Socioeconomic factors showed the largest contribution to health outcomes (47%), followed by health behaviors (34%), clinical care (16%), and physical environment (3%).
  • The CHR model demonstrated varying performance across states but received broad empirical support for its structure and weightings.

Conclusions:

  • Findings support prioritizing investments in social and economic determinants of health for substantial population health improvements.
  • Highlights the need for healthcare providers and educational institutions to address these determinants.