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Methodology




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Wellness Indicators

Weights*
Indicator
Methodology
Year
100 large
281 small
Obesity rate
Percent with body mass index greater than 35, †
Data source: Centers for Disease Control and Prevention
2012 0.098 0.107
Smoking rate
Percent current smokers, †
Data source: Centers for Disease Control and Prevention
2012 0.092 0.053
Diabetes rate

Data source: Centers for Disease Control and Prevention
2012 0.068 0.076
Binge drinking
Per capita, †
Data source: Centers for Disease Control and Prevention
2012 0.068 0.056
Alzheimer's cases
Per population 65+, †
Data sources: Alzheimer's Association, Milken Institute
2016 0.056 0.104
Caregivers
Normalized by composite score from average per capita and per population 65+ calculations, ‡
Data sources: AARP
2014 0.066 0.118
Life expectancy at 65

Data sources: Centers for Disease Control and Prevention, Milken Institute
2014 0.073 0.120
Depression
Percent of Medicare population, †
Data source: Center for Medicare and Medicaid Services
2012 0.039 0.041
Physical activity
Percent of population 65+ with no leisure time physical activity, †
Data source: Centers for Disease Control and Prevention
2012 0.084 0.101
Fitness and recreational
sports centers
Per capita, NAICS code: 71394, ‡
Data source: Census Bureau
2014 0.087 0.047
Fast-food outlets
Per capita, †
Data source: Department of Agriculture
2014 0.059 0.059
Golf courses,
ski resorts
Normalized by composite score from average per capita and per population 65+ calculations,
NAICS codes: 71391, 71392, 71393, 71395, ‡
Data source: Census Bureau
2014 0.040 0.045
Falls with injury
Percent of population 65+ with falls resulting in injury, †
Data sources: Centers for Disease Control and Prevention
2012 0.030 - -
Air quality
Average daily particulate matter 2.5 levels, †
Data sources: Centers for Disease Control and Prevention
2011 0.030 0.074
* Figures may not add up to 1 due to rounding. † The lowest value is ranked highest. ‡ The highest value is ranked highest.

A healthy lifestyle is important to maintaining high quality of life, especially for older adults. Geography can work to promote or hinder healthy behaviors such as exercising regularly, reducing junk food consumption, and limiting alcohol and cigarette use, the first steps in preventing onset and progression of disease and enhancing overall well-being. Research suggests that a social support system surrounding healthful behaviors - and social support like that provided by caregivers - can lead to healthier aging.4

Neighborhoods with numerous fitness centers or golf courses can inspire a healthy lifestyle, while an abundance of fast food restaurants can encourage the opposite. Recognizing that environment correlates to illness such as obesity and diabetes, we included such regional factors in our analysis of wellness.

Lifestyle-related health outcomes also are part of this category. We recognize that we did not include every factor driving disparities in health, such as income inequality. We looked at rates of obesity, diabetes, falls, and mental distress, common health problems affecting older adults. We also examined life expectancy. The report's health-care category quantifies access to and quality of medical services, while this category examines the health and wellness of the population.

Data for indicators about health risk factors such as obesity, diabetes, smoking, falls, mental distress, and sugary drink consumption were calculated directly from the Behavioral Risk Factor Surveillance System from the Centers for Disease Control and Prevention survey data file. Some variables changed from the 2014 report, which also used data points from CDC sources based on BRFSS but they were calculated using different statistical techniques. Additionally, availability of data for each location changes from year to year based on sampling technique.

4 Holt-Lunstad, J., Smith, T, and Layton, J., "Social relationships and mortality risk: a meta-analytic review," PLoS Med 7(7) (2010).

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