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This unique source of data is found in the Community Health Status Indicators Reports (CHSI) funded by HHS' Health Resources and Services Administration (HRSA) and produced in collaboration with the National Association of County and City Health Officials (NACCHO), the National Association of State and Territorial Health Officials (ASTHO) and the Public Health Foundation (PHF). The data covers the period from 1988 to 1998.

"We encourage counties to compare their health status with the nation and 'peer counties' with similar characteristics and challenges, identify strengths and areas needing improvement, and share solutions for improving public health," said HRSA Administrator Claude Earl Fox, M.D., M.P.H. "In responding to requests from local and state public health leaders for more data, we wanted the project to be a bottom-up effort, with city, county, state and public health representatives involved in producing the reports and helping to guide the process. Community planning efforts have historically been hindered by the lack of comprehensive data at the local level. The CHSI reports help to fill this gap, but do not serve as a substitute for rigorous community needs assessment."

The reports use existing national data or estimates that are available on all U.S. counties. Each county's report has demographic information with some 20 to 50 "peer" counties with similar population size, density, age distribution and poverty levels. For some indicators, estimates are derived from national data sources and adjusted to reflect the demographic and socioeconomic characteristics of individual counties and should be interpreted with caution. "This is a major effort that turns complex data into potentially useful information for assisting communities in their efforts to improve the public's health," said Ron Bialek, president of the PHF, a national, nonprofit organization dedicated to achieving healthy communities through applied research, training and technical assistance. Counties can measure themselves against their peer counties and all U.S. counties in relation to life expectancy, causes of death, the percent of adults who report fair or poor health, and the average number of unhealthy days reported for a month. And they can see how their county compares to peer counties' rates of infectious diseases such as hepatitis and measles.

"We hope that local public health officials will find the CHSI Reports useful in structuring dialogue with their communities about health and health status," said NACCHO Executive Director Tom Milne. "For some, the reports may also be a starting point for community health assessment, planning and further data development -- for others, one more source of data to consider in improving their community's health status." NACCHO represents the nation's 3,000 public health agencies through policy development, resources and programs, and support for local public health practice and systems that protect and improve the health of communities.

Birth outcomes, including low birth weight babies, unmarried mothers, and prenatal care, as well as death data, including breast cancer, homicide and heart disease can be compared with peer counties, the nation and federal Healthy People 2010 targets.

Earlier this month, the reports were sent to county health officials for review and to provide contact information and supplemental local data to the CHSI Web site as an addendum to their county report. Local health officials also are encouraged to let the CHSI Project Team know where improvements can be made in how data are portrayed and to identify gaps where better local, state and national data would be helpful.

"Empowering communities with health information and mobilizing partnerships to improve health status are essential public health services," said ASTHO Executive Director George E. Hardy, Jr., M.D., M.P.H. "ASTHO is pleased to be part of this groundbreaking effort to present community data in a compelling way." ASTHO is a nonprofit public health organization that represents the leaders of state and territorial health agencies.

HRSA sends some $4.7 billion annually to communities and states for health centers, HIV/AIDS primary care and support services, maternal and child health programs, and training a diverse health professions' workforce for medically underserved communities. Its 100% Access and Zero Health Disparities program is supporting some 200 "communities in action" building public/private sector coalitions and leveraging existing resources to improve access to care.

With a new $25 million Community Access Program, HRSA will fund about 20 communities this fiscal year to build integrated health care networks to serve uninsured and underinsured residents. State Planning Grants totaling $15 million also will go to states this fiscal year to learn more about causes of uninsurance and propose strategies for improving access to health insurance.

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