Overall Approach

The primary aims of the Healthy Communities' indicator system are to inform and facilitate positive change. To inform, we must provide accurate, reliable, and timely data at a geographically-meaningful level. We accomplish this by selecting sources that meet the following criteria:

• a validated methodology for data collection and analysis
• scheduled, regular publication of findings
• focus on data values for small geographic areas, such as counties and postal codes that are available for all county-level locations in the U.S or locally through our community partners

Methods

Through the Healthy Communities indicator system, community members have easy access to critical information about their community. The status of the community can be displayed in several ways that are easy to understand.

Regional Comparison Indicators

For indicators that are meaningfully displayed as an objective value that can be compared to other communities, the local value is assigned a status (green=excellent, yellow=fair, or red=poor) based on how the local value ranks in comparison to other communities. These indicators compare a community's measure to a distribution of other relevant geographies. Indicators are assigned green values if the value is better than or equal to the 50th percentile, yellow between the 50th percentile and the 25th percentile, and red less than the 25th percentile. In this ranking approach, the median is the value that provides the cut-off between green and yellow ranking.

Regional Comparison Indicator example: The infant mortality rate in all 3077 US counties is collected and the rate of infant mortality (number of infant deaths/100 births) is put in a spreadsheet. The rates are ordered from lowest to highest. The 50th percentile or median value is the rate of the 1,539th value in the list of values (3077 / 2 = 1538.5, standard rounding rules round the number to 1539). Often the distribution of counties within a state or other regions must be used instead of US counties because the data is not available nationally. The cut-off point between yellow and red is the 75th percentile, or the 2,309 value in the list of values.

Average Comparison Indicators

For indicators that are not meaningfully displayed as an objective value (i.e. median home value), a subjective indicator dial (tri-color gradation dial if direction matters or blue/white if it doesn't) which simply shows how the community is doing compared to the median value. The average comparison indicator is a useful way to present community data compared to the state or national median value and allow the user to interpret the local indicator value.

Average Comparison Indicator Example: In a community the median home price is above the median home value compared to 39 other counties in the state. The fact that the median home value is above the median can be interpreted in two ways, depending on the end-users perspective: if you are selling your home, high median values may be a beneficial, but if you are trying to purchase a home, high median values may be a negative.

Time Period Comparison Indicators

These indicators show how an outcome varies over a significant amount of time, a commonly accepted period in the field, as indicated in the description. These indicators really have three states: getting better, getting worse, or stayed the same. These indicators are typically used when distribution data is not available to calculate a comparison distribution. They are also useful to highlight when a measure compares favorably to other communities, but the measure is actually moving in the wrong direction.

Time Period Comparison Indicator Example: In community A, the % of the population that is overweight or obese is 50.5% and this percentage has been growing over the last three years. The yearly percentages exceed the CDC 2010 Healthy People goal for healthy weight (<40% of adult population overweight or obese), though the local value (50.5%) is still better than the median value where 61.3% of adult population is overweight or obese in the state. In this case, a time period comparison indicator can be used to show that the community trend is increasing and there is a growing percentage of the adult population that is either overweight or obese.

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