The County Health Rankings are a key component of the Mobilizing Action Toward Community Health (MATCH) project. MATCH is a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

The www.CountyHealthRankings.org site provides access to the 50 state reports, ranking each county within the 50 states according to its health outcomes and the multiple health factors that determine a county’s health. Each county receives a summary rank for its health outcomes and health factors and also for the four different types of health factors: health behaviors, clinical care, social and economic factors, and the physical environment. Each county can also drill down to see specific county-level data (as well as state benchmarks) for the measures upon which the rankings are based.

Brief History

The University of Wisconsin's Population Health Institute has been ranking the health of Wisconsin counties for years. In 2010, they wanted to launch this data online. CountyHealthRankings.org provided the first look at the overall health of local communities across the country. While other studies have ranked entire states on health factors, this was the first to reveal the impact of multiple health factors in nearly every U.S. county.

Upon launch, the County Health Rankings received substantial media attention, including stories by CNN, MSNBC, Business Week, the Washington Post, NPR, USA Today, and hundreds of local media outlets. In the days immediately following its initial launch in 2010, the site served over 3,000 requests per second and over one million pages were accessed in the first 24 hours.

Redesign

After a successful launch in 2010, PHI and RWJF saw the opportunity to improve the sites usability and to incorporate new elements in order to encourage more users to take action. We improved the delivery of the data on the site, enhanced the user experience, and updated the rankings. Our user experience team also reviewed the site’s architecture for usability flaws and to improve the visual design and focused on providing a task-oriented, user-centric interface for users to take action and share their story.

User-centric interface

The University of Wisconsin-Madison spent time soliciting feedback from users throughout the year through various audience research activities. This led to a careful review of the initial homepage layout, navigation labels, and information architecture. The addition of the Action Steps section allows users to easily self identify with content on the site and to identify clears steps to contribute their expertise or knowledge to their community. In the Your Stories section, you can read about successes and share your own stories. This area serves as a place for counties to showcase how the County Health Rankings prompted them to change and allows people to share stories around the findings.

User-focused data portability

Another focus area was to improve the portability of the data on the site. This also more of MATCH’s key audiences to discover, download and use the data. We improved the various maps on the site and launched a mobile version. The site also allows users to download the entire national data file and data files, maps and summary reports for each state. Users can also access archived rankings.

Architecture and Functionality

For the 2011 release, we enhanced the technical architecture to help the site stay responsive during high traffic. In order to accommodate the almost 125,000 visitors to County Health Rankings on the day it launched we used Varnish to cache the output for anonymous users. Tweaking the VCL file to white-list cookies instead of removing them allowed us to achieve the high cache hit level we needed to push the nearly 40 Mbps from the web server.

The site’s purpose is to showcase the data via maps and tables. Periodically the University of Wisconsin updates their rankings based on new information or changes to their statistical model. This required the data that powers the CountyHealthRankings.org website to be separate from the normal Drupal data model.

The design for the site present a few challenges for typical Drupal page layouts and with the front-end implementation. The state page layout called of the state pages that combined different data outputs into one page. We utilized Panels and several custom CTools Content Types, Arguments and Contexts to output data from the database. The design itself called for use of CSS3 and other JavaScript in order to achieve the look on pages like the Action Center and the homepage. The site also heavily uses maps on the homepage and on the state pages to visualize the data. The homepage map is custom built in Flash. The state navigation and data displays use FusionMaps combined with custom XML outputs based on data from the database.

Mobile Version

Creating the mobile version of the CHR site required customization because the entirety of the CountyHealthRankings.org site was cached behind Varnish, and so normal browser detection methods were not available. Instead we configured Varnish to detect mobile user agents and redirect them to the mobile subdomain m.countyhealthrankings.org. This triggered a custom PURL callback that set a request variable and changed the default theme to our mobile optimized theme. This request variable was then used by a custom Panels Access Plugin to provide different variants for mobile users.

Module Use

We used 77 contributed modules and wrote 2 custom modules for this project.

Data Access

The data for the site PHI wanted to update the data over time so we wrote data access components so this could be accomplished easily and separated the data from the Drupal architecture. To show this data we wrote a number of data mappers in a module that would query this database and perform simple calculations for the data output.

Mobile

As referenced above, we wrote a custom module that uses PURL to allow us to vary the site based on a user’s subdomain.

Team

Additional Information

Forum One is a digital communications firm focused on driving progress on issues of importance such as health, education, the environment, and international development.

We provide internet strategy, online community and collaboration, user experience and design, and innovative website and application development for influential organizations around the world. Over the past few years we have built over 60 websites on Drupal. We work for the some of the largest non-profits, foundations and government agencies including the Bill & Melinda Gates Foundation, SCORE, World Bank, Robert Wood Johnson Foundation, Aspen Institute, Center for Strategic and International Studies, Center for American Progress, Environmental Protection Agency, Department of Education, and the Center for Disease Control and Prevention.