Frequently Asked Questions

The following citation should accompany any contents or graphics if used:   

University of Wisconsin Population Health Institute. County Health Rankings & Roadmaps 2025. www.countyhealthrankings.org. 

The following citation should accompany the image of the Model of Health or any contents used:

University of Wisconsin Population Health Institute. University of Wisconsin Population Health Institute Model of Health. County Health Rankings & Roadmaps. 2025. www.countyhealthrankings.org.

In 2025, the University of Wisconsin Public Health Institute debuted a Model of Health that names how power and societal rules shape community conditions for health. This version builds on the 2014 CHR&R Model of Health, which showed that where we live, learn, work and play influence our health. The new model guides communities to make informed decisions and take actions to build power for health and equity. You can learn about the model here.  

CHR&R is committed to creating resources and tools that support community-led efforts to accurately diagnose core problems, understand and account for historical context and implement evidence-informed solutions.

Our team members can help navigate CHR&R resources and tools to support users on their journey to build power and create healthy, equitable communities. Our team support may include informal conversations, speaking engagements, presentations and media interviews that highlight these resources and tools. Our team members are available to discuss detailed research methods, rationale and data findings related to our Annual Data Releases and database of What Works for Health strategies. Click the Contact Us button at the bottom of any page on the website to get in touch with a CHR&R team member.  

Updated data and improved website features

We updated our collection of over 80 measures of health with the most recently available data and refreshed our tools highlighting trends over time, what’s working well and areas for improvement within each county. We also added six new measures to our collection:

• % Disability: Functional Limitations
• Feelings of Loneliness
• Lack of Social and Emotional Support
• Library Access
• Access to Parks
• Adverse Climate Events

Summaries of Population Health and Well-being and Community Conditions are available in a graphic for each county to show how the county fares relative to other counties in the state and nation. These data-informed summaries are called Health Groups and allow for comparisons that support solidarity and action to improve health. Health Groups replace the ranking provided in previous years. Zoom out from the map on any state Health Snapshot to view the Health Group summaries on a national map.

Our Compare Counties tool has an exciting new update that facilitates county comparisons between places that have similar rurality or urbanicity. Learn more about our Compare Counties options.

New What Works for Health strategies

We added a new strategy to What Works for Health that focuses on community organizing in public health. Community organizing can include developing leadership, campaigning, and building power to influence decisions, agendas and worldviews.  

We also curated a list of 35 strategies that address the structural determinants of health. These solutions focus on building power and changing the rules, including laws, policies, budgets and worldviews, to improve the conditions that shape health.  

Focus on the power of narratives  

Explore the power of narrative within the strategies and solutions area of the website. The Narratives for Health page offers guidelines for shifting narratives, examples of applying narrative in public health work and ways to utilize narrative in your community.  

Tune In: New season of In Solidarity podcast  

Our podcast, In Solidarity, explores the connection between power, place and health. We’re bringing you monthly episodes on the timely issues facing and advancing public health. Tune in for interviews with experts on the ways public health can navigate the new presidential administration and on CHR&R’s new model of health, which accounts for the structural forces such as power that are shaping health in your community.  

Annual Data Report focuses on new model of health, power and structural determinants

The 2025 Annual Data Report highlights the connection between structural determinants, community conditions and our overall health. Structural determinants are the laws, policies and rules that determine whether communities have what they need to thrive. The release also marks the debut of CHR&R’s new model of health, which captures the role that power and society’s rules play in creating conditions that impact all of our health. The model encourages us to look at how these conditions came to be and the power we have to change them.  

Yes, we archive the raw data used to calculate our measures where possible and in compliance with the terms of use for each data source. We welcome conversations about data sharing – please contact us.     

Please visit the 2025 Measures page to learn more about the measure definitions, data sources, and years of data used in the 2025 Annual Data Release. Details of our data methods can be found in our 2025 Technical Document.

In 2025, County Health Rankings & Roadmaps adopted the UW Population Health Institute Model of Health. All of our measures are mapped to the new model and Health Groups are calculated for Population Health & Well-being and Community Conditions using weights applied to the new model. Please note that our Community Conditions Health Groups incorporate different measures than the Health Factors Health Groups based on the 2014 CHR&R Model of Health.

We no longer assign counties an individual rank. Each county is now assigned a Health Group to help you understand your county’s health. Our Health Groups approach allows users to find counties experiencing similar conditions, whether in their state or across the country, to collaborate and create solutions to make sure that everyone lives long and well. No county needs to outperform another to get to the top spot. This approach aligns with our vision that ALL people and places have what they need to thrive.

Health doesn’t stop at state lines. Unlike rankings, which were confined to comparisons within a single state, we can more easily explore patterns across several states and find peer counties anywhere in the country. 

Our Compare Counties tool has an exciting new update that facilitates county comparisons between places that have similar rurality or urbanicity. Learn more about our Compare Counties options.

Our new view of county health can be found on every county Health Snapshot. It allows you to see the range of Population Health and Well-being and Community Conditions among counties in your state, as well as how your state is doing compared to the rest of the nation. Each dot represents a county in your state, placed on a continuum from least healthy (left) to healthiest (right) in the country. Sensemaking statements accompany the graphic, describing how your county fares relative to your state and the nation, with state and national averages shown for reference with vertical dotted lines.  

Counties with similar health will be in the same shade of color. Colors are determined by using a data-informed grouping method to assign counties into Health Groups. These data-informed groupings draw on health information for all U.S. counties. There are ten unequally sized Health Groups based on meaningful similarities and differences in the health of counties nationwide. While the color range is consistent across all states, states may or may not have counties that fall within each of these Health Groups. Health Groups are defined annually and may contain different sets of counties from year to year. 

For more information on z-score methods and how Health Groups are determined, see our Working Paper on Updates to Methods and Tools for Practical Application to Improve Health and Equity.

For more information on methods, see our Technical Document. 

Some data sources have not released new data in time to be included in the Annual Data Release. In these cases, the measures feature the most recently available data. For 2025, these measures include: Primary Care Physicians, Dentists, Limited Access to Healthy Foods, Traffic Volume, Census Participation, Voter Turnout and Child Care Centers.

To see the years of data used for all measures please visit the 2025 measures page.

During the last decade, several counties have changed their name or boundary. These changes have occurred in Alaska, Connecticut, South Dakota and Virginia. Find more information about how these changes impact measures in the Annual Data Release in our 2025 Technical Document and see this information from the U.S. Census Bureau: Substantial Changes to Counties and County Equivalent Entities.  

County changes mean that data for these previous counties are no longer displayed on our website. However, data for these counties will continue to be available for previous years. 

The inclusion of people living in the United States without documentation status is specific to each data source used in the Annual Data Release. For example, data for births and deaths are provided by the National Center for Health Statistics registries and include all births and deaths in the U.S. By contrast, the American Community Survey (ACS), another major data source included in the Annual Data Release, uses self-reported survey responses. The ACS is meant to include all persons with a usual residence in the U.S., however, as with all surveys the ACS is vulnerable to non-response bias and studies have found that questions of citizenship are sensitive and can be a reason someone may choose not to complete the ACS.

College students are encouraged to report their residence in the U.S. census as the place they live most of the time during the past year (>6 months of the year). Generally, this is the city/county where their college or university is located. Find the census guidance for residential situations here.

People who are incarcerated are included in county-level counts for the following Select measures:

• Premature Death
• Low Birth Weight
• Access to Exercise Opportunities
• Mental Health Providers
• Dentists
• Air Pollution: Particulate Matter
• Injury Deaths

CHR&R data show that where you live matters to your health and that disparities exist within every state and county. We encourage communities to use the Annual Data Release as a starting point to delve more deeply into data that can highlight disparities within counties and support dialogue on differences that are systemic, unfair and unjust. Learn more about how CHR&R shares available data to understand the health of racialized groups of people. Disaggregated data do not provide an explanation for why differences exist between groups. Research increasingly demonstrates these gaps are due to structural racism. Communities can work to understand and highlight disparities by initiating a community health assessment or using CHR&R data to draw attention to thorough assessments that have already been done. 

Data at multiple geographic levels provides additional context and information.  

• America’s Health Rankings report is a health assessment tool based on state-level health indicators.   
• City Health Dashboard features data for measures of health and well-being at the city level for over 750 cities in the U.S.  
• Congressional District Health Dashboard pulls together local data on the health and well-being for each congressional district.  

You may notice that some of the following measures do not appear in your snapshot. This could mean that data are not available for your state. The following measures do not have data available in the 2025 Annual Data Release for the states listed:  

• Food Environment Index (CT)
• Drinking Water Violations (HI)
• HIV Prevalence (AK)
• Feelings of Loneliness (AR, CO, HI, IL, LA, ND, NY, OR, PA, SD, VA)
• Sexually Transmitted Infections (CT)
• Voter Turnout (AK)
• High School Graduation (ME, NM, OK)
• Reading Scores (AK, NM, NY, TX, VT, WV)
• Math Scores (AK, DC, NM, NY, VT)
• School Funding Adequacy (AK, HI, VT)
• Children Eligible for Free or Reduced Price Lunch (DC, DE, MA, MT, TN, WV)
• Lack of Social and Emotional Support (AR, CO, HI, IL, LA, ND, NY, OR, PA, SD, VA