Tracking the overall health of the state and factors that shape wellbeing: a health indicators framework

No single measure can capture the overall health of a population or guide sound health policy, so it is useful to identify a set of measures that describe health outcomes and the factors that shape those outcomes.  Factors that affect health and wellbeing, often referred to as “determinants,” include genetics and potentially modifiable conditions such as personal behavior, socioeconomic status, and access to health care. The diagram below draws upon a basic framework developed by the Institute of Medicine (IOM) (State of the USA Health Indicators: Letter Report, Committee on the State of the USA Health Indicators, Institute of Medicine, 2008) to illustrate the categories of indicators included in the rankings and scorecards reviewed in this guide.  The boxes represent domains (sometimes referred to as “dimensions”) and sub-domains are listed within each box.