{
  "slug": "vermont-county-primary-care-access-2026",
  "title": "Vermont County Primary-Care Access & Health-Burden Scorecard",
  "summary": "A county-level targeting index for Vermont, fusing adult chronic-disease and social-risk prevalence (CDC PLACES) with federally designated primary-care provider shortages (HRSA). Ranks all 14 counties by combined need so a health department or rural-health office can see where high burden and thin provider supply overlap.",
  "state": "Vermont",
  "category": "Public Health & Risk",
  "tags": [
    "public-health",
    "health-access",
    "geospatial-risk",
    "government-data",
    "vermont"
  ],
  "publishedDate": "2026-08-01",
  "accessAxisLabel": "Access & SDOH barriers",
  "generatedAt": "2026-08-01T06:59:14+00:00",
  "dataVintage": {
    "places": "PLACES: Local Data for Better Health, County Data, 2025 release (measure year 2023)",
    "hpsa": "HRSA Primary Care HPSA detail extract, accessed 2026-08-01",
    "acs": "ACS 2019-2023 5-year estimates"
  },
  "methodology": "A Health-Burden axis is built from CDC PLACES crude adult prevalence (diagnosed diabetes, obesity, high blood pressure, coronary heart disease, fair or poor self-rated health, frequent physical distress). An Access & SDOH barriers axis combines uninsured (adults 18-64), below poverty (acs), households without a vehicle (acs) (Census ACS measures join CDC PLACES here). Each measure is min-max normalized across the state's counties to 0-100, then averaged within its axis. A Provider-Shortage axis scales each county's worst designated primary-care HPSA score against the HRSA 0-26 severity scale. The combined Targeting-Priority Index is the equal-weighted mean of the three axes. PLACES values are model-based estimates with confidence intervals (carried per county), not direct counts. Scores are relative WITHIN Vermont: a 100 marks the worst county in the state on that axis, not a national benchmark.",
  "limitations": [
    "Scores are intra-state relative, not absolute or cross-state comparable.",
    "These candidate measures were unavailable for Vermont in this release (BRFSS SDOH-module participation varies by state), so they are excluded from the index: Lack of reliable transportation, Food insecurity, Housing insecurity.",
    "PLACES values are small-area model-based estimates with confidence intervals, not direct counts.",
    "HPSA aggregation takes the worst designated primary-care score per county; geographic, population-group, and facility designations are pooled.",
    "Equal axis weighting is a transparent default, not a calibrated policy model.",
    "Socioeconomic measures are ACS 2019-2023 5-year estimates; ACS estimates carry margins of error not reflected in the composite.",
    "This is informational analysis of public data, not clinical, individual, or actuarial advice."
  ],
  "sources": [
    {
      "name": "CDC PLACES — Local Data for Better Health (County Data)",
      "dataset": "PLACES: Local Data for Better Health, County Data, 2025 release (measure year 2023)",
      "url": "https://www.cdc.gov/places/",
      "apiUrl": "https://data.cdc.gov/resource/swc5-untb.json",
      "accessedDate": "2026-08-01"
    },
    {
      "name": "HRSA — Primary Care Health Professional Shortage Areas",
      "dataset": "Shortage Area HPSA detail (Primary Care discipline, designated)",
      "url": "https://data.hrsa.gov/data/download",
      "accessedDate": "2026-08-01"
    },
    {
      "name": "U.S. Census Bureau — American Community Survey (5-year)",
      "dataset": "ACS 2019-2023 5-year estimates",
      "url": "https://www.census.gov/programs-surveys/acs/",
      "apiUrl": "https://api.census.gov/data/2023/acs/acs5",
      "accessedDate": "2026-08-01"
    }
  ],
  "measures": {
    "burden": [
      {
        "id": "DIABETES",
        "label": "Diagnosed diabetes"
      },
      {
        "id": "OBESITY",
        "label": "Obesity"
      },
      {
        "id": "BPHIGH",
        "label": "High blood pressure"
      },
      {
        "id": "CHD",
        "label": "Coronary heart disease"
      },
      {
        "id": "GHLTH",
        "label": "Fair or poor self-rated health"
      },
      {
        "id": "PHLTH",
        "label": "Frequent physical distress"
      }
    ],
    "access": [
      {
        "id": "ACCESS2",
        "label": "Uninsured (adults 18-64)"
      },
      {
        "id": "ACS_POVERTY",
        "label": "Below poverty (ACS)"
      },
      {
        "id": "ACS_NOVEHICLE",
        "label": "Households without a vehicle (ACS)"
      }
    ]
  },
  "stats": {
    "counties": 14,
    "countiesWithHpsa": 13,
    "countiesWithHpsaPct": 93,
    "medianDiabetes": 9.7,
    "diabetesMin": {
      "county": "Chittenden",
      "value": 6.6
    },
    "diabetesMax": {
      "county": "Essex",
      "value": 12.5
    },
    "medianUninsured": 6.1
  },
  "keyFindings": [
    "13 of Vermont's 14 counties (93%) fall within a federally designated primary-care Health Professional Shortage Area.",
    "Adult diagnosed-diabetes prevalence ranges from 6.6% in Chittenden County to 12.5% in Essex County, a 5.9-point spread within a single state.",
    "Essex County carries the highest combined targeting-priority index (72.8/100), led by its health burden score.",
    "The median county uninsured rate (adults 18-64) is 6.1%, and the median adult diabetes prevalence is 9.7%."
  ],
  "counties": [
    {
      "fips": "50009",
      "name": "Essex",
      "population": 6010,
      "priorityIndex": 72.8,
      "burdenScore": 96.8,
      "accessScore": 86.9,
      "shortageScore": 34.6,
      "topDriver": "Health burden",
      "hpsaMaxScore": 9,
      "hpsaDesignations": 1,
      "raw": {
        "DIABETES": 12.5,
        "OBESITY": 34.2,
        "BPHIGH": 39.9,
        "CHD": 9.5,
        "GHLTH": 21.7,
        "PHLTH": 16.7,
        "ACCESS2": 8.1,
        "LACKTRPT": null,
        "FOODINSECU": null,
        "HOUSINSECU": null,
        "ACS_POVERTY": 14.3,
        "ACS_NOVEHICLE": 5.1
      },
      "ci": {
        "DIABETES": {
          "lo": 10.6,
          "hi": 14.7
        },
        "OBESITY": {
          "lo": 26.9,
          "hi": 42.2
        },
        "BPHIGH": {
          "lo": 35.3,
          "hi": 44.6
        },
        "CHD": {
          "lo": 8.1,
          "hi": 10.8
        },
        "GHLTH": {
          "lo": 17.6,
          "hi": 25.9
        },
        "PHLTH": {
          "lo": 14.2,
          "hi": 19.5
        },
        "ACCESS2": {
          "lo": 6.0,
          "hi": 10.6
        },
        "LACKTRPT": {
          "lo": null,
          "hi": null
        },
        "FOODINSECU": {
          "lo": null,
          "hi": null
        },
        "HOUSINSECU": {
          "lo": null,
          "hi": null
        }
      },
      "rank": 1
    },
    {
      "fips": "50021",
      "name": "Rutland",
      "population": 60271,
      "priorityIndex": 55.4,
      "burdenScore": 66.6,
      "accessScore": 68.7,
      "shortageScore": 30.8,
      "topDriver": "Access & SDOH barriers",
      "hpsaMaxScore": 8,
      "hpsaDesignations": 1,
      "raw": {
        "DIABETES": 10.3,
        "OBESITY": 35.5,
        "BPHIGH": 36.5,
        "CHD": 7.5,
        "GHLTH": 16.8,
        "PHLTH": 14.3,
        "ACCESS2": 6.6,
        "LACKTRPT": null,
        "FOODINSECU": null,
        "HOUSINSECU": null,
        "ACS_POVERTY": 12.0,
        "ACS_NOVEHICLE": 6.9
      },
      "ci": {
        "DIABETES": {
          "lo": 8.7,
          "hi": 11.9
        },
        "OBESITY": {
          "lo": 30.4,
          "hi": 40.4
        },
        "BPHIGH": {
          "lo": 33.1,
          "hi": 39.9
        },
        "CHD": {
          "lo": 6.4,
          "hi": 8.5
        },
        "GHLTH": {
          "lo": 13.9,
          "hi": 19.9
        },
        "PHLTH": {
          "lo": 12.3,
          "hi": 16.5
        },
        "ACCESS2": {
          "lo": 4.8,
          "hi": 8.8
        },
        "LACKTRPT": {
          "lo": null,
          "hi": null
        },
        "FOODINSECU": {
          "lo": null,
          "hi": null
        },
        "HOUSINSECU": {
          "lo": null,
          "hi": null
        }
      },
      "rank": 2
    },
    {
      "fips": "50003",
      "name": "Bennington",
      "population": 37183,
      "priorityIndex": 52.0,
      "burdenScore": 55.4,
      "accessScore": 62.2,
      "shortageScore": 38.5,
      "topDriver": "Access & SDOH barriers",
      "hpsaMaxScore": 10,
      "hpsaDesignations": 4,
      "raw": {
        "DIABETES": 10.0,
        "OBESITY": 30.5,
        "BPHIGH": 35.6,
        "CHD": 7.3,
        "GHLTH": 15.8,
        "PHLTH": 13.9,
        "ACCESS2": 6.1,
        "LACKTRPT": null,
        "FOODINSECU": null,
        "HOUSINSECU": null,
        "ACS_POVERTY": 11.4,
        "ACS_NOVEHICLE": 7.3
      },
      "ci": {
        "DIABETES": {
          "lo": 8.4,
          "hi": 11.8
        },
        "OBESITY": {
          "lo": 25.8,
          "hi": 35.8
        },
        "BPHIGH": {
          "lo": 32.1,
          "hi": 39.3
        },
        "CHD": {
          "lo": 6.2,
          "hi": 8.5
        },
        "GHLTH": {
          "lo": 12.8,
          "hi": 19.1
        },
        "PHLTH": {
          "lo": 11.8,
          "hi": 16.3
        },
        "ACCESS2": {
          "lo": 4.5,
          "hi": 8.1
        },
        "LACKTRPT": {
          "lo": null,
          "hi": null
        },
        "FOODINSECU": {
          "lo": null,
          "hi": null
        },
        "HOUSINSECU": {
          "lo": null,
          "hi": null
        }
      },
      "rank": 3
    },
    {
      "fips": "50005",
      "name": "Caledonia",
      "population": 30610,
      "priorityIndex": 51.4,
      "burdenScore": 57.1,
      "accessScore": 73.9,
      "shortageScore": 23.1,
      "topDriver": "Access & SDOH barriers",
      "hpsaMaxScore": 6,
      "hpsaDesignations": 1,
      "raw": {
        "DIABETES": 10.1,
        "OBESITY": 31.3,
        "BPHIGH": 34.9,
        "CHD": 7.1,
        "GHLTH": 17.2,
        "PHLTH": 13.8,
        "ACCESS2": 6.6,
        "LACKTRPT": null,
        "FOODINSECU": null,
        "HOUSINSECU": null,
        "ACS_POVERTY": 12.6,
        "ACS_NOVEHICLE": 7.3
      },
      "ci": {
        "DIABETES": {
          "lo": 8.6,
          "hi": 11.8
        },
        "OBESITY": {
          "lo": 26.1,
          "hi": 36.6
        },
        "BPHIGH": {
          "lo": 31.3,
          "hi": 38.5
        },
        "CHD": {
          "lo": 6.2,
          "hi": 8.2
        },
        "GHLTH": {
          "lo": 14.2,
          "hi": 20.4
        },
        "PHLTH": {
          "lo": 11.8,
          "hi": 16.0
        },
        "ACCESS2": {
          "lo": 5.0,
          "hi": 8.8
        },
        "LACKTRPT": {
          "lo": null,
          "hi": null
        },
        "FOODINSECU": {
          "lo": null,
          "hi": null
        },
        "HOUSINSECU": {
          "lo": null,
          "hi": null
        }
      },
      "rank": 4
    },
    {
      "fips": "50011",
      "name": "Franklin",
      "population": 50994,
      "priorityIndex": 48.8,
      "burdenScore": 57.4,
      "accessScore": 58.3,
      "shortageScore": 30.8,
      "topDriver": "Access & SDOH barriers",
      "hpsaMaxScore": 8,
      "hpsaDesignations": 2,
      "raw": {
        "DIABETES": 9.6,
        "OBESITY": 36.9,
        "BPHIGH": 34.0,
        "CHD": 6.8,
        "GHLTH": 16.0,
        "PHLTH": 13.5,
        "ACCESS2": 6.8,
        "LACKTRPT": null,
        "FOODINSECU": null,
        "HOUSINSECU": null,
        "ACS_POVERTY": 10.1,
        "ACS_NOVEHICLE": 6.3
      },
      "ci": {
        "DIABETES": {
          "lo": 8.1,
          "hi": 11.3
        },
        "OBESITY": {
          "lo": 32.0,
          "hi": 42.2
        },
        "BPHIGH": {
          "lo": 30.7,
          "hi": 37.4
        },
        "CHD": {
          "lo": 5.8,
          "hi": 7.8
        },
        "GHLTH": {
          "lo": 13.0,
          "hi": 19.0
        },
        "PHLTH": {
          "lo": 11.5,
          "hi": 15.6
        },
        "ACCESS2": {
          "lo": 5.1,
          "hi": 9.0
        },
        "LACKTRPT": {
          "lo": null,
          "hi": null
        },
        "FOODINSECU": {
          "lo": null,
          "hi": null
        },
        "HOUSINSECU": {
          "lo": null,
          "hi": null
        }
      },
      "rank": 5
    },
    {
      "fips": "50025",
      "name": "Windham",
      "population": 45966,
      "priorityIndex": 48.3,
      "burdenScore": 44.4,
      "accessScore": 62.1,
      "shortageScore": 38.5,
      "topDriver": "Access & SDOH barriers",
      "hpsaMaxScore": 10,
      "hpsaDesignations": 4,
      "raw": {
        "DIABETES": 9.8,
        "OBESITY": 25.9,
        "BPHIGH": 32.5,
        "CHD": 7.1,
        "GHLTH": 16.3,
        "PHLTH": 13.3,
        "ACCESS2": 6.3,
        "LACKTRPT": null,
        "FOODINSECU": null,
        "HOUSINSECU": null,
        "ACS_POVERTY": 12.0,
        "ACS_NOVEHICLE": 6.4
      },
      "ci": {
        "DIABETES": {
          "lo": 8.2,
          "hi": 11.5
        },
        "OBESITY": {
          "lo": 21.6,
          "hi": 30.7
        },
        "BPHIGH": {
          "lo": 29.3,
          "hi": 36.0
        },
        "CHD": {
          "lo": 6.1,
          "hi": 8.2
        },
        "GHLTH": {
          "lo": 13.4,
          "hi": 19.6
        },
        "PHLTH": {
          "lo": 11.3,
          "hi": 15.5
        },
        "ACCESS2": {
          "lo": 4.6,
          "hi": 8.4
        },
        "LACKTRPT": {
          "lo": null,
          "hi": null
        },
        "FOODINSECU": {
          "lo": null,
          "hi": null
        },
        "HOUSINSECU": {
          "lo": null,
          "hi": null
        }
      },
      "rank": 6
    },
    {
      "fips": "50027",
      "name": "Windsor",
      "population": 58101,
      "priorityIndex": 43.7,
      "burdenScore": 40.0,
      "accessScore": 37.2,
      "shortageScore": 53.8,
      "topDriver": "Provider shortage",
      "hpsaMaxScore": 14,
      "hpsaDesignations": 1,
      "raw": {
        "DIABETES": 9.5,
        "OBESITY": 28.8,
        "BPHIGH": 33.2,
        "CHD": 6.7,
        "GHLTH": 14.3,
        "PHLTH": 12.2,
        "ACCESS2": 5.7,
        "LACKTRPT": null,
        "FOODINSECU": null,
        "HOUSINSECU": null,
        "ACS_POVERTY": 8.7,
        "ACS_NOVEHICLE": 6.1
      },
      "ci": {
        "DIABETES": {
          "lo": 7.9,
          "hi": 11.1
        },
        "OBESITY": {
          "lo": 24.3,
          "hi": 33.4
        },
        "BPHIGH": {
          "lo": 29.9,
          "hi": 36.5
        },
        "CHD": {
          "lo": 5.8,
          "hi": 7.8
        },
        "GHLTH": {
          "lo": 11.6,
          "hi": 17.3
        },
        "PHLTH": {
          "lo": 10.2,
          "hi": 14.2
        },
        "ACCESS2": {
          "lo": 4.3,
          "hi": 7.7
        },
        "LACKTRPT": {
          "lo": null,
          "hi": null
        },
        "FOODINSECU": {
          "lo": null,
          "hi": null
        },
        "HOUSINSECU": {
          "lo": null,
          "hi": null
        }
      },
      "rank": 7
    },
    {
      "fips": "50019",
      "name": "Orleans",
      "population": 27516,
      "priorityIndex": 43.4,
      "burdenScore": 68.4,
      "accessScore": 61.7,
      "shortageScore": 0.0,
      "topDriver": "Health burden",
      "hpsaMaxScore": 0,
      "hpsaDesignations": 0,
      "raw": {
        "DIABETES": 10.7,
        "OBESITY": 33.2,
        "BPHIGH": 36.0,
        "CHD": 7.6,
        "GHLTH": 18.3,
        "PHLTH": 14.7,
        "ACCESS2": 7.1,
        "LACKTRPT": null,
        "FOODINSECU": null,
        "HOUSINSECU": null,
        "ACS_POVERTY": 10.8,
        "ACS_NOVEHICLE": 5.7
      },
      "ci": {
        "DIABETES": {
          "lo": 9.0,
          "hi": 12.5
        },
        "OBESITY": {
          "lo": 27.8,
          "hi": 38.6
        },
        "BPHIGH": {
          "lo": 32.4,
          "hi": 39.6
        },
        "CHD": {
          "lo": 6.5,
          "hi": 8.8
        },
        "GHLTH": {
          "lo": 15.1,
          "hi": 21.8
        },
        "PHLTH": {
          "lo": 12.5,
          "hi": 16.9
        },
        "ACCESS2": {
          "lo": 5.3,
          "hi": 9.2
        },
        "LACKTRPT": {
          "lo": null,
          "hi": null
        },
        "FOODINSECU": {
          "lo": null,
          "hi": null
        },
        "HOUSINSECU": {
          "lo": null,
          "hi": null
        }
      },
      "rank": 8
    },
    {
      "fips": "50017",
      "name": "Orange",
      "population": 29943,
      "priorityIndex": 39.4,
      "burdenScore": 53.4,
      "accessScore": 34.1,
      "shortageScore": 30.8,
      "topDriver": "Health burden",
      "hpsaMaxScore": 8,
      "hpsaDesignations": 3,
      "raw": {
        "DIABETES": 9.7,
        "OBESITY": 32.6,
        "BPHIGH": 34.3,
        "CHD": 6.9,
        "GHLTH": 16.2,
        "PHLTH": 13.4,
        "ACCESS2": 6.1,
        "LACKTRPT": null,
        "FOODINSECU": null,
        "HOUSINSECU": null,
        "ACS_POVERTY": 9.4,
        "ACS_NOVEHICLE": 4.2
      },
      "ci": {
        "DIABETES": {
          "lo": 8.2,
          "hi": 11.5
        },
        "OBESITY": {
          "lo": 27.4,
          "hi": 38.0
        },
        "BPHIGH": {
          "lo": 30.7,
          "hi": 38.0
        },
        "CHD": {
          "lo": 5.9,
          "hi": 8.0
        },
        "GHLTH": {
          "lo": 13.2,
          "hi": 19.7
        },
        "PHLTH": {
          "lo": 11.3,
          "hi": 15.6
        },
        "ACCESS2": {
          "lo": 4.5,
          "hi": 8.1
        },
        "LACKTRPT": {
          "lo": null,
          "hi": null
        },
        "FOODINSECU": {
          "lo": null,
          "hi": null
        },
        "HOUSINSECU": {
          "lo": null,
          "hi": null
        }
      },
      "rank": 9
    },
    {
      "fips": "50013",
      "name": "Grand Isle",
      "population": 7467,
      "priorityIndex": 31.7,
      "burdenScore": 45.7,
      "accessScore": 3.3,
      "shortageScore": 46.2,
      "topDriver": "Provider shortage",
      "hpsaMaxScore": 12,
      "hpsaDesignations": 1,
      "raw": {
        "DIABETES": 9.7,
        "OBESITY": 30.7,
        "BPHIGH": 35.5,
        "CHD": 6.7,
        "GHLTH": 14.3,
        "PHLTH": 12.3,
        "ACCESS2": 5.5,
        "LACKTRPT": null,
        "FOODINSECU": null,
        "HOUSINSECU": null,
        "ACS_POVERTY": 7.6,
        "ACS_NOVEHICLE": 1.7
      },
      "ci": {
        "DIABETES": {
          "lo": 8.1,
          "hi": 11.4
        },
        "OBESITY": {
          "lo": 24.2,
          "hi": 37.6
        },
        "BPHIGH": {
          "lo": 31.2,
          "hi": 39.9
        },
        "CHD": {
          "lo": 5.8,
          "hi": 7.8
        },
        "GHLTH": {
          "lo": 11.5,
          "hi": 17.4
        },
        "PHLTH": {
          "lo": 10.4,
          "hi": 14.5
        },
        "ACCESS2": {
          "lo": 4.1,
          "hi": 7.3
        },
        "LACKTRPT": {
          "lo": null,
          "hi": null
        },
        "FOODINSECU": {
          "lo": null,
          "hi": null
        },
        "HOUSINSECU": {
          "lo": null,
          "hi": null
        }
      },
      "rank": 10
    },
    {
      "fips": "50015",
      "name": "Lamoille",
      "population": 26060,
      "priorityIndex": 28.9,
      "burdenScore": 32.2,
      "accessScore": 31.4,
      "shortageScore": 23.1,
      "topDriver": "Health burden",
      "hpsaMaxScore": 6,
      "hpsaDesignations": 1,
      "raw": {
        "DIABETES": 8.3,
        "OBESITY": 29.2,
        "BPHIGH": 29.4,
        "CHD": 6.0,
        "GHLTH": 14.8,
        "PHLTH": 12.6,
        "ACCESS2": 6.1,
        "LACKTRPT": null,
        "FOODINSECU": null,
        "HOUSINSECU": null,
        "ACS_POVERTY": 8.1,
        "ACS_NOVEHICLE": 4.8
      },
      "ci": {
        "DIABETES": {
          "lo": 7.0,
          "hi": 9.8
        },
        "OBESITY": {
          "lo": 24.0,
          "hi": 34.6
        },
        "BPHIGH": {
          "lo": 25.9,
          "hi": 32.8
        },
        "CHD": {
          "lo": 5.2,
          "hi": 7.0
        },
        "GHLTH": {
          "lo": 12.1,
          "hi": 18.1
        },
        "PHLTH": {
          "lo": 10.6,
          "hi": 14.8
        },
        "ACCESS2": {
          "lo": 4.5,
          "hi": 8.3
        },
        "LACKTRPT": {
          "lo": null,
          "hi": null
        },
        "FOODINSECU": {
          "lo": null,
          "hi": null
        },
        "HOUSINSECU": {
          "lo": null,
          "hi": null
        }
      },
      "rank": 11
    },
    {
      "fips": "50001",
      "name": "Addison",
      "population": 37720,
      "priorityIndex": 28.5,
      "burdenScore": 28.4,
      "accessScore": 22.6,
      "shortageScore": 34.6,
      "topDriver": "Provider shortage",
      "hpsaMaxScore": 9,
      "hpsaDesignations": 1,
      "raw": {
        "DIABETES": 8.2,
        "OBESITY": 27.3,
        "BPHIGH": 31.8,
        "CHD": 6.0,
        "GHLTH": 13.7,
        "PHLTH": 11.8,
        "ACCESS2": 5.9,
        "LACKTRPT": null,
        "FOODINSECU": null,
        "HOUSINSECU": null,
        "ACS_POVERTY": 7.4,
        "ACS_NOVEHICLE": 4.3
      },
      "ci": {
        "DIABETES": {
          "lo": 6.9,
          "hi": 9.6
        },
        "OBESITY": {
          "lo": 22.8,
          "hi": 31.9
        },
        "BPHIGH": {
          "lo": 28.4,
          "hi": 34.9
        },
        "CHD": {
          "lo": 5.1,
          "hi": 6.9
        },
        "GHLTH": {
          "lo": 11.2,
          "hi": 16.3
        },
        "PHLTH": {
          "lo": 10.0,
          "hi": 13.6
        },
        "ACCESS2": {
          "lo": 4.4,
          "hi": 7.6
        },
        "LACKTRPT": {
          "lo": null,
          "hi": null
        },
        "FOODINSECU": {
          "lo": null,
          "hi": null
        },
        "HOUSINSECU": {
          "lo": null,
          "hi": null
        }
      },
      "rank": 12
    },
    {
      "fips": "50023",
      "name": "Washington",
      "population": 60142,
      "priorityIndex": 28.4,
      "burdenScore": 29.0,
      "accessScore": 44.8,
      "shortageScore": 11.5,
      "topDriver": "Access & SDOH barriers",
      "hpsaMaxScore": 3,
      "hpsaDesignations": 1,
      "raw": {
        "DIABETES": 8.9,
        "OBESITY": 27.1,
        "BPHIGH": 30.3,
        "CHD": 6.1,
        "GHLTH": 13.8,
        "PHLTH": 11.8,
        "ACCESS2": 5.8,
        "LACKTRPT": null,
        "FOODINSECU": null,
        "HOUSINSECU": null,
        "ACS_POVERTY": 9.4,
        "ACS_NOVEHICLE": 6.6
      },
      "ci": {
        "DIABETES": {
          "lo": 7.6,
          "hi": 10.6
        },
        "OBESITY": {
          "lo": 22.7,
          "hi": 31.6
        },
        "BPHIGH": {
          "lo": 27.2,
          "hi": 33.6
        },
        "CHD": {
          "lo": 5.3,
          "hi": 7.2
        },
        "GHLTH": {
          "lo": 11.4,
          "hi": 16.6
        },
        "PHLTH": {
          "lo": 10.0,
          "hi": 13.8
        },
        "ACCESS2": {
          "lo": 4.3,
          "hi": 7.8
        },
        "LACKTRPT": {
          "lo": null,
          "hi": null
        },
        "FOODINSECU": {
          "lo": null,
          "hi": null
        },
        "HOUSINSECU": {
          "lo": null,
          "hi": null
        }
      },
      "rank": 13
    },
    {
      "fips": "50007",
      "name": "Chittenden",
      "population": 169481,
      "priorityIndex": 25.4,
      "burdenScore": 0.0,
      "accessScore": 45.5,
      "shortageScore": 30.8,
      "topDriver": "Access & SDOH barriers",
      "hpsaMaxScore": 8,
      "hpsaDesignations": 1,
      "raw": {
        "DIABETES": 6.6,
        "OBESITY": 22.7,
        "BPHIGH": 25.2,
        "CHD": 4.8,
        "GHLTH": 11.4,
        "PHLTH": 10.7,
        "ACCESS2": 5.3,
        "LACKTRPT": null,
        "FOODINSECU": null,
        "HOUSINSECU": null,
        "ACS_POVERTY": 10.4,
        "ACS_NOVEHICLE": 6.9
      },
      "ci": {
        "DIABETES": {
          "lo": 5.6,
          "hi": 7.7
        },
        "OBESITY": {
          "lo": 19.5,
          "hi": 26.1
        },
        "BPHIGH": {
          "lo": 22.9,
          "hi": 27.6
        },
        "CHD": {
          "lo": 4.1,
          "hi": 5.5
        },
        "GHLTH": {
          "lo": 9.4,
          "hi": 13.6
        },
        "PHLTH": {
          "lo": 9.2,
          "hi": 12.3
        },
        "ACCESS2": {
          "lo": 3.9,
          "hi": 7.1
        },
        "LACKTRPT": {
          "lo": null,
          "hi": null
        },
        "FOODINSECU": {
          "lo": null,
          "hi": null
        },
        "HOUSINSECU": {
          "lo": null,
          "hi": null
        }
      },
      "rank": 14
    }
  ],
  "faq": [
    {
      "question": "What does the Vermont county health-access scorecard measure?",
      "answer": "It ranks all 14 Vermont counties by a combined Targeting-Priority Index that fuses adult chronic-disease and social-risk prevalence from CDC PLACES with federally designated primary-care provider shortages from HRSA, highlighting where health need and thin provider supply overlap."
    },
    {
      "question": "Which public datasets is it built from?",
      "answer": "CDC PLACES county estimates (PLACES: Local Data for Better Health, County Data, 2025 release, measure year 2023) and the HRSA Primary Care Health Professional Shortage Area detail file, both fully open federal sources accessed 2026-08-01."
    },
    {
      "question": "How should the Targeting-Priority Index be used?",
      "answer": "As a transparent first-pass screen for where to focus outreach, workforce, or program resources. Scores are relative within the state and equal-weighted by default; a real engagement would calibrate weights to a program's goals and add socioeconomic and utilization layers."
    }
  ],
  "contentHash": "74ea7d26b7205d53"
}