All of the indicators selected for the 2011 Colorado Health Report Card are reported in a consistent manner across all or most states,1 allowing us to rank Colorado's performance relative to other states. For each indicator, the best-performing state is ranked first. Colorado ranks first – Healthy Adolescents nutrition, Healthy Adolescents sexual activity, Healthy Adults obesity and Healthy Aging immunizations – to 39th for high rates of low birth weight babies. An "adjusted rank" was calculated for the 10 indicators for which fewer than 50 states reported data. The rationale for this is that being 10th out of 30 states, for example, is not as good as being 10th out of 50 states. To illustrate how the calculation was derived, for the "abstinence from smoking during the last three months of pregnancy" indicator, Colorado ranked third among the 29 states that report data for this indicator.
To calculate an adjusted rank, we divided three by 29 and multiplied this number by 50. The resulting score yielded an adjusted rank of 5. (Scores were rounded to the nearest whole number.) The affected indicator fact sheets show actual rank and number of states reporting followed by the adjusted rank; for example, 3/29 = 5/50.
A grade is assigned to each life stage based on Colorado's average rank for all indicators included in the stage. For example, the average rank for the six Healthy Aging indicators is 14.0. The letter grade of B was assigned according to the rank/letter grade equivalencies shown in the table to the right.2
Differences Between Colorado and Other States
Data from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) were used to calculate the averages for each state for several health indicators. Statistical tests were used to determine if the average for Colorado was significantly different than the averages for other states.3 A color coding system was developed for the state ranking graph to visually demonstrate which states had averages that were not statistically different from Colorado (medium shade of orange) and which states had averages that were statistically different from Colorado's average (light shade of orange).
- Values for all 50 states are available for 28 of the 38 indicators.
- Average ranks and equivalent letter grades have not been calculated for the other 49 states.
- CHI was only able to conduct statistical tests on the raw data that came from the BRFSS. While other indicators came from surveys that had a representative sample of the population in all or most states, CHI did not have access to the raw data to calculate state averages and conduct statistical tests to determine whether or not Colorado's values significantly differed from other state values.