Health of the States

Research Report

Health of the States

How U.S. States Compare in Health Status and the Factors that Shape Health


The Health of the States (HOTS) project is a detailed analysis of state rankings on 39 health outcomes, and correlations between those health outcomes and 123 determinants of health spanning five domains: health care, health behaviors, social and economic factors, the physical and social environment, and public policies and spending. The project was conducted in partnership with the Center on Society and Health at VCU and was funded by the Robert Wood Johnson Foundation.

The work is unprecedented in its breadth and depth – offering a more comprehensive and layered picture of health in every state than any resource to date. The Summary Report details how states rank on each of 39 health outcomes, allowing each state to see where it is doing well and which diseases deserve greater priority. Perhaps more importantly, readers can also explore the conditions that best correlate with better health.

The series of reports offer a detailed examination of a wide range of drivers of health, looking extensively at health care conditions and health behaviors—such as tobacco use and physical activity—while also studying physical and social conditions in neighborhoods that influence behaviors and health (such as walkability or residential segregation), socioeconomic factors ranging from education and income to incarceration and food insecurity, and per capita spending by states on income support, education, and infrastructure.

In the coming months, we will be releasing a series of supplemental reports that will unpack these findings, presenting dozens of maps and more detailed data on how these factors affect health across the life course, from infancy to old age. These Spotlight reports will focus on:

To read more about our methods, see The Health of the States: Spotlight on Methods.

Cross-Center Initiative

Cross-Center Initiative: 
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