Use of peer groupings to assess county public health status

Introduction The Community Health Status Indicators Project was undertaken to produce county-specific reports assessing the status of community health for local jurisdictions throughout the United States. To accomplish this assessment, the Community Health Status Indicators Project team selected peer groupings of counties to monitor and analyze the health of local communities relative to peer communities. Methods To identify peer counties, the project team used 5 categorical county demographic variables, a specified order for applying criteria, and a predetermined target for peer grouping size to subdivide counties into homogeneous subgroups called peer groupings. Results Eighty-eight peer groupings were developed with 14-58 counties in each. The average size of each peer grouping was 35 counties. All peer groupings included counties representing at least 6 states. Discussion Peer groupings are very useful for community health assessment. They convey the range of health status indicator values for similar counties, serve as a basis for expected numbers of reportable diseases, and provide a method for comparing communities with peer and U.S. medians. To maintain their usefulness, peer groupings must be updated periodically.