1 Drexel University Dornsife School of Public Health, Philadelphia, PA, USA.
Med Care Res Rev. 2019 Aug;76(4):478-496. doi: 10.1177/1077558717726115. Epub 2017 Aug 17.
Population health rankings are a common strategy to spur evidence-informed health policy making, but little is known about their uses or impacts. The study aims were to (1) understand how and why the County Health Rankings (CH-Rankings) are used in local policy contexts, (2) identify factors that influence CH-Rankings utilization, and (3) explore potentially negative impacts of the CH-Rankings. Forty-four interviews were conducted with health organization officials and public policy makers in 15 purposively selected counties. The CH-Rankings were used instrumentally to inform internal planning decisions, conceptually to educate the public and policy makers about determinants of population health, and politically to advance organizational agendas. Factors related to organizational capacity, county political ideology, and county rank influenced if, how, and why the CH-Rankings were used. The CH-Rankings sometimes had the negative impacts of promoting potentially ineffective interventions in politically conservative counties and prompting negative media coverage in some counties with poor rank.
人群健康排名是激励循证卫生决策的常用策略，但对其使用情况或影响知之甚少。本研究旨在：（1）了解县健康排名（CH-Rankings）在当地政策环境中的使用方式和原因；（2）确定影响 CH-Rankings 使用的因素；（3）探索 CH-Rankings 的潜在负面影响。在 15 个有目的选取的县，对卫生组织官员和公共政策制定者进行了 44 次访谈。CH-Rankings 被用作工具，为内部规划决策提供信息；从概念上，向公众和政策制定者传授人口健康决定因素方面的知识；并从政治上推动组织议程。与组织能力、县政治意识形态和县排名相关的因素影响了 CH-Rankings 是否使用、如何使用以及为何使用。CH-Rankings 在某些情况下产生了负面影响，例如在政治保守的县推广可能无效的干预措施，以及在一些排名较低的县引发负面媒体报道。
