General Questions
1. What is the Health Value Dashboard?
The Health Policy Institute of Ohio Health Value Dashboard is a collection of tools and resources that compare Ohio’s performance to all other states on measures of population health, healthcare spending and the factors that influence health.
There are 122 ranked metrics in the 2026 Dashboard. The Dashboard examines Ohio’s rank and trend performance relative to other states across seven categories of metrics, referred to as “domains:” population health, healthcare spending, access to care, healthcare system, public health and prevention, social and economic environment and physical environment. In addition, through a series of population spotlights, the Dashboard highlights gaps in factors and outcomes for some of Ohio’s most disadvantaged populations. Health value is a composite measure of population health outcome metrics and healthcare spending metrics.
HPIO released previous editions in 2014, 2017, 2019, 2021, 2023, and 2024. In 2024, HPIO decided to publish the Dashboard in even years to better align with the development of the biennial state operating budget. The 2026 Health Value Dashboard is the seventh edition of this publication. It includes:
- A four-page SNAPSHOT with a summary of findings from the 2026 Health Value Dashboard
- A 16-page KEY FINDINGS publication with Dashboard data and closer looks at Ohio populations that face the greatest challenges to achieving good health
- A 24-page DATA BOOK with full ranked data tables for 100+ metrics and disaggregated data for many metrics
2. How was the Dashboard initially developed?
In 2013, HPIO convened the Health Value Dashboard Advisory Group to advise on the development of the Pathway to Improved Health Value conceptual framework on which the Dashboard is based. The framework defines health value and outlines the systems and environments that affect health.
Since 2013, HPIO has convened the Advisory Group to inform selection and updating of metrics and advise on the layout, methodology and disaggregated data components. The Advisory Group includes stakeholders from a wide array of sectors and public and private organizations across Ohio. HPIO’s Equity Advisory Group provides feedback on the population spotlights and other methodology components in the Dashboard.
Since 2017, HPIO has contracted with researchers at the Voinovich School of Leadership and Public Affairs at Ohio University to assist with analysis.
3. Why does HPIO produce the Dashboard?
Improving health and addressing healthcare spending growth are concerns shared by policymakers and private sector leaders and Ohioans in general. Many Ohioans face barriers to being healthy, and collecting and sharing publicly available data provides insights into the wide variety of factors that influence health and healthcare spending. Rankings are an important starting place to understand Ohio’s performance relative to other states. The Dashboard also highlights evidence-informed policies that can be implemented at the state and local levels to address Ohio’s health challenges and move the state toward achieving health equity.
4. How is the Dashboard different from other scorecards and rankings that are out there?
Unlike other similar tools, the HPIO Dashboard places an emphasis on the healthcare spending. In fact, as far as we know, the Health Policy Institute of Ohio was the first in the nation to develop a state ranking of “health value,” placing equal emphasis on population health outcomes and healthcare spending. The Dashboard also provides a more comprehensive look at other factors that impact population health outcomes and healthcare spending.
Still, Ohio’s rank on health outcomes is similar across scorecards:
*Rank for specific domains: America’s Health Rankings: Health Outcomes; Commonwealth: Healthy Lives; Sharecare: Physical; HPIO Health Value Dashboard: Population Health
The emphasis on health equity through the population spotlights, disaggregated data tables and data appendix is another distinguishing element of the Dashboard. The 2026 Dashboard disaggregates data for 36 metrics by race/ethnicity, disability status, educational attainment and/or income, and sexual orientation and gender identity as available.
The Dashboard uses disparity ratios to assess the extent of disparities and inequities in Ohio, comparing all groups to the rest of the state (e.g., Black Ohioans compared to non-Black Ohioans). Prior Dashboards used disparity ratios that compared a disadvantaged group to the group that most consistently experiences the best outcomes and is systematically advantaged (e.g., Black Ohioans compared to white Ohioans).
In addition, the Dashboard provides estimates of the potential impact of eliminating disparities. These estimates are expressed as the number of people potentially impacted. For example, if the disparity in those unable to see a doctor due to cost that exists between Ohioans with disabilities and those without disabilities were eliminated, 265,815 Ohioans with disabilities would not have to go without health care due to cost. See the Dashboard methodology for more information.
Finally, the Dashboard uses the data in each of the domains and disaggregated data to elevate key findings which are specifically tailored to an Ohio policymaking context. This is unlike other similar tools, which maintain a national perspective
5. How does the 2026 Dashboard compare to the 2024 Dashboard?
The 2026 Dashboard:
- Changes the methodology for numbers of years included in the trend from up to three to up to ten
- Changes the methodology for calculating disparity ratios, comparing each group to the rest of the state.
- Adds 40 new metrics to the following domains, moves 4 metrics to different domains, and removes 34 metrics. For a complete list of added, moved and removed metrics, see the methodology.
Questions about metrics, correlations, and methodology
6. How many metrics are in the Dashboard and where does the data come from?
- There are 122 ranked metrics in the 2026 Dashboard. Each of these metrics is ranked against all 50 states and D.C. Metrics with more than 10 missing states were not included in the main domains of the Dashboard.
- There are 36 disaggregated metrics in the 2026 Dashboard, disaggregated by race and ethnicity, educational attainment, income, sexual orientation, gender identity and/or disability status depending on data availability. Thirty-six metrics were disaggregated by race and ethnicity, 19 by education, 24 by income, 22 by disability status and 8 by sexual orientation and/or gender identity (i.e., LGBTQ+ identity).
- All Dashboard data comes from public sources. Some data was obtained from state agencies. The 2026 Dashboard includes data from 61 unique sources. See data appendix for additional source information.
7. How are age, poverty and other factors correlated with a state’s rank on health value, population health and healthcare spending?
HPIO ran a series of correlation analyses to determine the strength of relationships between specific factors and health value rank, population health rank and healthcare spending rank (displayed in the table below).
The correlation between the percent of a state’s population age 65 and older and ranks for health value, population health and healthcare spending were not significant. This means that states with a higher percentage of adults ages 65 and older do not necessarily have worse health value, worse health outcomes or higher healthcare spending (measured on a per-person basis).
Child and adult poverty, however, did correlate with population health rank and health value rank, indicating that poverty plays a role in driving health outcomes and health value. There were no significant correlations of these factors to health care spending.
8. Which domains most strongly correlate with population health and healthcare spending ranks?
The social and economic environment and physical environment domains were most strongly correlated with population health. Healthcare system and public health and prevention were also moderately correlated with population health. There were no significant correlations with the healthcare spending domain.
9. Where can I find information about metrics (e.g., sources, years, descriptions)?
See the data appendix for information about individual metrics in the ranked and disaggregated data tables.
10. Where can I find more information about the methods used in the Dashboard?
See the Dashboard process and methodology document for more information, including:
- Information about the Health Policy Institute of Ohio and the history of the Health Value Dashboard
- Metric selection process
- Data gaps and limitations
- Ranking and trend methodology
- Methodology for assessing health disparities and inequities.
11. How do I interpret disparity ratios?
Disparity ratios for the 2026 Dashboard were calculated by dividing the rate of the group of interest (e.g., Hispanic Ohioans) to the rate for the rest of Ohio (all Ohioans who are not Hispanic).
For example, 24.2% of Ohio adults who are Hispanic report frequent mental distress. 16.7% of the rest of Ohio adults (i.e., non-Hispanic Ohioans) reported frequent mental distress.
The Hispanic/Rest of Ohio disparity ratio for frequent mental distress is 24.2%/16.7% = 1.4
This means that frequent mental distress rates for Hispanic Ohioans is 1.4 times higher than the rest of the state.
The rate or prevalence for the ‘Rest of Ohio’ reference is different for each group. For example, the ‘Rest of Ohio’ value for Black Ohioans is calculated as all eligible Ohioans who are not Black (i.e., any other race besides Black). These new ‘Rest of Ohio’ reference groups are often not publicly available, requiring custom survey analysis with R software or calculations with underlying population estimates. To see these underlying values, please see the data appendix.
Questions about 2026 Dashboard findings
12. Where does Ohio rank?
- Ohio ranks 43 out of 50 states and the District of Columbia (D.C.) on health value— a combination of population health and healthcare spending metrics. This means that Ohioans are living less healthy lives and spending more on health care than people in most other states.
- Ohio ranks in the bottom half of states on 61% of metrics and in the top half on 39% of metrics.
13. How is Ohio’s health value rank determined?
- Health value is calculated by equally weighting population health and healthcare spending metrics. The diagram below shows Ohio’s rank on the value factor domains (population health and healthcare spending), which are combined to calculate Ohio’s rank on health value.
- The Dashboard also includes ranks for the contributing factor domains (access to care, healthcare system, public health and prevention, social and economic environment and physical environment). The diagram below shows Ohio’s rank on these domains.
- The contributing factor domain ranks are not included in the calculation of the health value rank. Rather, the contributing factor domain ranks provide information about how Ohio performs compared to other states on a wide range of factors that are relevant to health outcomes and healthcare spending.
14. Did Ohio improve?
- Ohio’s health value rank is 43 in the 2026 edition. Ohio’s rank in the 2024 edition was 44. Because the metrics that go into the health value rank have changed slightly in each edition, comparing Ohio’s health value rank across editions is not recommended.
- Looking at trends relative to other states across all metrics in the Dashboard, Ohio saw more improvement than worsening. Ohio improved on 35% and worsened on 25% of metrics where trend was assessed.
- As shown in the graphic below, the healthcare system domain had the highest proportion of metrics that improved, while the healthcare spending domain had the highest proportion of metrics that worsened.
- There are no worsened metrics in three domains: public health and prevention, social and economic environment, and physical environment.
Due to the lag in data availability, the 2026 Dashboard does not reflect major policy changes to health programs such as Medicaid and the federal health insurance marketplace from the federal reconciliation bill HR 1, which is anticipated to have significant funding and enrollment impacts on these programs.
15. What are the regional differences across states?
There are some notable regional patterns in rankings:
- All states in the bottom quartile for spending (indicating higher spending) are in the northern half of the country, while states in the top quartile for spending (indicating lower spending) are primarily in the West and Southeast except for Florida and Louisiana.
- The pattern for population health shows bottom quartile states clustered in the South and Midwest, plus Maine. States with the best population health are located in the Northeast and West.
- States in the southern U.S. are more likely to be in the bottom quartiles for access to care, healthcare system, social and economic and physical environment than northern states.
- Bottom quartile in public health and prevention is concentrated in the Southeast U.S.
16. Which states had the most improvement?
The four states that improved on the highest percent of metrics from baseline to most recent year were: District of Columbia (42.1%%), Tennessee (39.4%%), Rhode Island (38.6%) and New Jersey (38.1%)
17. How does HPIO calculate trend?
Trends are measured by looking at state performance for up to ten years of available data, not by comparing ranks from one edition of the Dashboard to the next. HPIO’s trend methodology compares a state’s absolute change on a metric from baseline to most recent year to the standard deviation of all state’s values for up to ten years. For more information, see the methodology.
18. Which metrics had the largest disparity ratios across the disaggregated data in the 2026 Dashboard?
The following metrics had the largest disparity ratios:
Top five metrics with the largest gaps in outcomes
Questions about strategies to improve health value
19. How can we improve health value in Ohio?
The 2026 Health Value Dashboard highlights three key findings. Each key finding includes a set of considerations for policy progress (i.e., strategies or pending policy decisions) related to the key finding topic area. These considerations were developed based on policies, programs and services with strong evidence of effectiveness, while bearing in mind anticipated effects of recent policy decisions, such as those in HR 1. Research evidence indicates that the featured policies and programs are likely to decrease disparities, improve outcomes and, in some cases, have demonstrated cost effectiveness or cost savings. Pages 5-8 of the Findings from the 2026 Health Value Dashboard document list the considerations for policy progress, and the question below has additional details.
20. How did HPIO prioritize the policy considerations highlighted in the 2026 Dashboard?
There are many effective strategies to improve health and control healthcare spending. The example considerations for policy progress in the 2026 Dashboard are not an exhaustive list. HPIO used the following criteria to prioritize actionable considerations to elevate in the 2026 Dashboard:
- Relevance. Strategies relevant to the three key findings identified in the 2026 Dashboard (worsening mental health, rising healthcare costs, and the need for continued action to improve child well-being).
- Strength of evidence. The Dashboard elevates strategies with strong evidence of effectiveness as rated in evidence registries, such as What Works for Health and other topic-specific sources.
- Health equity. There is evidence that the policy reduces disparities or inequities or creates structural change to advance health equity, including strategies elevated in HPIO publications and state plans with a focus on eliminating disparities. HPIO referred to the disparity ratings in What Works for Health to identify programs and policies most likely to achieve health equity.
- Momentum and alignment. Strategies with momentum in Ohio’s legislature, priorities of Gov. DeWine’s administration and initiatives with strong advocacy efforts underway.
- Policy and structural change. Policy, structural and systemic changes that can be acted on by state and/or local policymakers were generally prioritized over specific programs or services.
- Clarity. Strategies that are easily explained and defined.
- Potential impact. Strategies that are being considered in the current policy landscape in Ohio but have not been fully implemented and would benefit from additional attention.
- New perspectives. Rather than repeat many of the same approaches from past editions of the Dashboard, priority was given to highlighting strategies not addressed in previous editions.
