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Communities throughout the United States are increasingly engaged in the process of measuring health in order to address pressing health care needs, develop better programs and policies, and to improve the quality of life of their residents. These initiatives have resulted in the development of detailed health reports and shorter report cards at state and community levels. In many instances, state and local communities have used these reports to launch either wide scale and/or targeted health improvement initiatives. In the spirit of further developing innovative means for measuring the health of communities,we created the California Health Report. The California Health Report measures the health of California’s population from a new perspective. In order to provide a comprehensive and more integrative measure of population health, we utilized a model of community health that specifies the unique role of different determinants on a range of health outcomes across the life course. The multi-determinant model of community health was used to inform an empirically based selection of health outcome indicators. The outcomes were selected as indicators of community health by a panel of health experts from throughout California involved in public health and social services practices as well as academia and public program administration. Determinants of the selected outcomes were identified by reviewing empirical studies of the relationship of outcomes to determinants in the available research literature. Once outcomes and determinants could be empirically linked, we constructed basic critical pathways to identify important relationships between relevant outcomes and their structural and process determinants. This report is designed to be useful to broad audiences. The results should be of general interest to California residents and the state’s policy makers and health planners. The report offers those interested in community health improvement a more integrated picture of how health is produced and what interventions are potentially available to address deficits or to enhance their capacity to respond effectively. It also identifies a number of gaps in how we monitor the health of our state, and suggests resources that could be useful in filling those gaps.

This research was sponsored by RAND Health.

This report is part of the RAND monograph report series. The monograph/report was a product of RAND from 1993 to 2003. RAND monograph/reports presented major research findings that addressed the challenges facing the public and private sectors. They included executive summaries, technical documentation, and synthesis pieces.

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