Magazine features that claim to list the nation’s healthiest cities should be viewed with some skepticism, says a study by researchers from the Centers for Disease Control and Prevention.
“Ranking studies often attract media and government attention and are taken seriously, regardless of their designs and limitations,” say Sandra A. Ham, M.S., and colleagues in the American Journal of Public Health. “Nevertheless, controversies exist about whether ratings accurately reflect the ‘livability’ of cities and the extent to which such reports can be misleading.”
The ideal way to compute these rankings would be to start with environmental and behavioral measures weighted to account for their roles in producing health or illness, the researchers say.
But this ideal system doesn’t exist. Everything from geography to the interpretation of data may serve to undermine the credibility of the lists, Ham says.
For instance, health authorities gather some information at the state level, some only within cities, and some by metropolitan statistical area — a city and its surrounding counties.
“State-level averages may not adequately represent the health situation in any of the state’s cities,” she says, adding that combining published reports from various sources only obscures data. Rankings also oversimplify the complex interactions among behavior, environment, health conditions and population dynamics.