Quantifying the Impact of State Health Policy on State Population Health Outcomes.

Thirty-five years after the Institute of Medicine report, The Future of Public Health (1988), multiple authors have considered what needs to be achieved to build a robust public health system that improves health for all. A central theme is the renewed emphasis on the role of evidence-based policy. This study provides clear evidence using a ranking methodology of how important policy is to achieving better health outcomes across the United States. The purpose of this study is to assess the association of state health rankings with well-established state health outcomes. Specifically, we calculate the strength of relationship of the rankings used in a previous study to six widely referenced health outcomes. Utilizing 88 predominantly health policy-oriented data elements found online for each of the United States, a state ranking was calculated across all actual, or behavioral, causes of death using the percent weightings attributable to each actual cause. These state rankings were correlated to state health outcomes. Findings indicated that state rankings correlated highly with five of the six health outcomes, excluding disability. States having supportive health policies ranked better in terms of the actual causes of death and population health outcomes. This finding is important to the field because it quantifies the degree that robust health policies matter to population health status and how these policies may be predictive of positive health outcomes. For practitioners, this finding supports greater emphasis on policy advocacy skills and encourages increased advocacy training in schools and programs of public health.