Health and Health Determinant Metrics for Cities: A Comparison of County and City-Level Data

Abstract

What is already known on this topic? Many local health departments develop city-level public health policies but lack city-level health data. This lack causes reliance on county-level data, which may misrepresent city populations. What is added by this report? We found substantial and highly variable city-county differences within and across 4 public health metrics, suggesting use of county-level data may mischaracterize health metrics in cities. What are the implications for public health practice? Use of county data to proxy city measures could hamper municipal public health policymaking. Public health officials concerned with cities should use city-level data whenever possible.

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