Diabetes: Derived from "yes" response to the following question: Have you ever been told by a doctor that you have diabetes? Females who responde "yes" to having been told they had diabetes only when pregnant and those that were told they had pre-diabetes or were borderline diabetes are not included as having diabetes.

No Leisure Time for Physical Activity: Derived from "no" response to the following question: During the past 30 days, other than your regular job, did you participate in any physical activities or exercise such as running, calisthenics, golf, gardening, or walking for exercise?

Overweight: (25.0-29.9 BMI) Derived by calculating BMI using responses to the following questions: About how much do you weigh without shoes? About how tall are you without shoes?

Data acquired from the County Health Rankings website, a program of the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

What It Is:
Access to healthy foods is measured as the percent of zip codes in a county with a healthy food outlet, defined as a grocery store or produce stand/farmers’ market.

Where It Comes From:
The measure is based on data from the US Census Bureau’s Zip Code Business Patterns (2006). Healthy food outlets include grocery stores with more than four employees and produce/farmers’ markets, as defined by their North American Industrial Classification System (NAICS) codes.

Reason for Ranking:
Studies have linked the food environment to consumption of healthy food and overall health outcomes.

Data Weight:
25% of Physical Environment
2.5% of Health Factors

More Info: County Health Rankings: Built Environment

** Data for this measure were collected nationaly but there have been some limitations identified when using data nationally. Please use caution when comparing data across states.

Important Note about Nationwide Rankings: The Z-score for each county is calculated as: (the measure for a particular county) - (the average for the state) / (standard deviation for that state).

Each ranking is relative to all counties within the same state and not related to those outside the state. Z-scores for all states measured the same basic range (typically -2 to 2) and therefore the Z-scores for all counties in the US were analyzed and then divided into five quantiles. The highest quantile represents all counties that fell in the 'best' range (most negative Z-scores) regardless of state, and since these scores were derived by state, all states with five or more counties are represented in all ranges. Rhode Island (3 counties) and Hawaii (4 counties) are represented in the highest, lowest, and middle ranges only.

While the Z-score range is similar, it should be stressed that a Z-score in one state does not correlate to any other state. A county could have a low score in a particular metric (relative to its state) while the same score in the measure would be high for another state.