Methodology & References – Women’s Health Report Card



The Alliance for a Just Society’s 2014 Women’s Health Report Card ranks and grades states on a wide range of measures relating to women’s health. It assesses states’ performance in three subject areas: health coverage for women, women’s access to health care, and women’s health status and outcomes. Each section includes a range of data points, and incorporates data on race and ethnicity where available.

Within each subject area (coverage, access, and outcomes), states were ranked from 1 to 50 on each data point (1 being best, 50 being worst). These rankings were averaged and the results were re-ranked to produce a subject-wide ranking for each state, with a corresponding subject grade (A through F). The three subject-wide rankings were then averaged and the results were re-ranked to produce final rankings of states’ overall performance on women’s health issues, with corresponding final grades.

To look more closely at race-based differences in women’s health within states, racial disparity ratios were calculated for black, Latina, Asian/Pacific Islander, and American Indian/Alaska Native women for a subset of the data points. These figures were calculated by dividing the data point for the selected racial group in a state by the corresponding data point for the overall population of women in that state to produce a ratio that measures race-based differences. Based on this approach, an uninsured racial disparity ratio of, for example, 1.33 for black women in Missouri means the uninsured rate for black women was 33 percent higher than for women overall in Missouri. A diabetes racial disparity ratio of 2.00 for Latina women in Michigan means the diabetes rate for Latinas was twice as high as for women overall in Michigan.

There were occasional ties in the rankings, both in subject areas and in the final rankings, producing some repeat numbers (and some absent numbers) in the 1-50 rankings. For example, Maryland and New York tied for #8 in coverage (so there was no #9 in coverage), Ohio and South Carolina tied for #40 in outcomes (so there was no #41 in outcomes), and Hawaii and Vermont tied for #3 in the final rankings (so there was no #4 in the final rankings).

For some measures, results were not available for each racial group in all 50 states. While all available results were included in the 50-state tables, in cases where fewer than 34 (two thirds) of the states reported results for a particular racial group, rankings were not calculated (and therefore were not factored into the subject-wide rankings) because they would not serve as a meaningful proxy for a 50-state ranking. In cases where results were available for 34 or more (but not all) states for a particular measure and racial group, rankings were calculated for the states that reported results and these rankings were factored into the subject-wide rankings for those states; states that did not report results did not receive a ranking, so this measure and group did not factor into these states’ subject-wide rankings. 

In a few cases (for example, in the table for women’s life expectancy by race), states that reported the same result for a particular group after rounding received different rankings because the rankings were based on the more precise (unrounded) underlying data points.


1 “30 Achievements in Women’s Health in 30 Years (1984 – 2014),” Office on Women’s Health, U.S. Department of Health and Human Services, accessed September 29, 2014 at:

2 These tallies do not include Indiana and Utah, where Medicaid expansion plans were being debated at the time of this report’s publication. See Kaiser Family Foundation, “Status of State Action on the Medicaid Expansion Decision,” accessed September 29, 2014 at:

3 Ibid.

4 Ibid.

5 Ibid.


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Home / Introduction

Executive Summary & Report Card

Subject Areas

•  Health Coverage for Women

•  Women’s Access to Health Care

•  Women’s Health Outcomes

Discussion of State Rankings, Grades and Racial Disparity Ratios

State Reports


Methodology & References



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Kathy Mulady