Sources for Health Equity Evaluation Measures

Rural communities can identify evaluation measures from a range of sources. More information on evaluation measures for rural communities addressing health inequities can be found in the Social Determinants of Health in Rural Communities Toolkit.

The County Health Rankings & Roadmaps website describes indicators related to many underlying factors that affect health equity, such as housing, transit, income, and education.
The Bay Area Regional Health Inequities Initiative developed a guide for leveraging social determinants of health indicators to advance health equity. Indicators are divided into different areas, including economic, service, social, and physical domains. The guide includes 72 priority indicators, potential data sources, data analysis strategies, and considerations and recommendations for using the indicators.
The Funders Forum on Accountable Health, a project of the George Washington University Milken Institute School of Public Health, developed a framework for measuring health equity impacts of Accountable Communities for Health. The framework document includes several appendices that list potential metrics and sources.
With funding from Robert Wood Johnson Foundation and the Kresge Foundation, NeighborWorks America developed tools that describe evaluation measures for community development and health. The tools focus on health status, beliefs, attitudes, and behaviors; individual factors and influences; environmental factors; community demographics and social factors; healthcare service availability, quality, and cultural sensitivity; and collaboration and partnerships.
In addition to measures on specific conditions that contribute to health equity, communities may find it helpful to develop a single composite metric that scores equity in their community. A summary health equity score can simplify reporting and reduce the number of indicators.
- For example, U.S. News & World Report and the Aetna Foundation developed a Healthiest Communities tool that includes an overarching equity score based on measures of educational equity, health equity, income equity, and social equity.
- Similarly, the Public Health Alliance of Southern California developed a Healthy Places Index that provides an overall score and indicators that include economic, education, housing, healthcare access, transportation, social, and environmental factors.
- CDC/ATSDR's Social Vulnerability Index (SVI) provides information about 15 social factors at the census tract level, including measures related to poverty and housing.
- HRSA and the University of Wisconsin-Madison offer the Area Deprivation Index (ADI) to visualize factors of neighborhood disadvantage at the census tract and county level.
The Assessment for Advancing Community Transformation is a tool developed in collaboration by 100 Million Healthier Lives/Institute for Healthcare Improvement, County Health Rankings & Roadmaps, and the Georgia Health Policy Center. The tool helps communities assess collaborations to improve health equity.
Ripple Effect Mapping is an approach that can help assess how policy, systems, and environmental changes influence health equity. Ripple Effect Mapping also helps to visualize complex programs and processes.
100 Million Healthier Lives and the National Committee on Vital and Health Statistics supported a collaboration of more than 100 organizations and communities to develop the Well Being In the Nation (WIN) measures. The WIN measures evaluate health and well-being across sectors and include core measures and leading indicators.

Resources to Learn More

The Determinants of Equity: Identifying Indicators to Establish a Baseline of Equity in King County
Document
Describes how community-level indicators created for King County, Washington, are useful in developing a baseline of conditions to better understand the impact of the social determinants of health.
Author(s): Beatty, A. & Foster, D.
Organization(s): University of Washington, King County Office of Performance, Strategy and Budget
Date: 1/2015

Evaluating Progress in Promoting Health Equity: A Review of Methods and Tools for Measurement
Document
A detailed analysis of the National Collaborative on Childhood Obesity Research (NCCOR) registry tool, or NCCOR-R tool, offering consistency in the use of tools and methods for research in childhood obesity and obesity prevention programs. Includes discussion on other tools and methods used for monitoring progress.
Organization(s): Institute of Medicine, Committee on Evaluating Progress of Obesity Prevention Effort, Food and Nutrition Board
Date: 12/2013

A Field Guide to Ripple Effects Mapping
Document
Describes Ripple Effects Mapping and provides steps for implementing the Ripple Effects Mapping process.
Author(s): Chazdon, S., Emery, M., Hansen, D., et al.
Organization(s): University of Minnesota
Date: 10/2017

Health Equity Tools 2.0, 2016
Document
Presents a list of health equity tools with descriptions, applications, and evaluations. Tools are categorized into different areas of application such as health impact assessment tools, indicators and measurement, community engagement, and population-specific approaches.
Author(s): Pauly, B., MacDonald, M., Hancock, T., et al.
Date: 2016

The Rhode Island Health Equity Measures
Document
Describes the health equity indicators used by the State of Rhode Island to evaluate progress toward achieving health equity.
Organization(s): Rhode Island Department of Health Community Health Assessment Group