{
  "slug": "west-virginia-county-primary-care-access-2026",
  "title": "West Virginia County Primary-Care Access & Health-Burden Scorecard",
  "summary": "A county-level targeting index for West Virginia, fusing adult chronic-disease and social-risk prevalence (CDC PLACES) with federally designated primary-care provider shortages (HRSA). Ranks all 55 counties by combined need so a health department or rural-health office can see where high burden and thin provider supply overlap.",
  "state": "West Virginia",
  "category": "Public Health & Risk",
  "tags": [
    "public-health",
    "health-access",
    "geospatial-risk",
    "government-data",
    "west virginia"
  ],
  "publishedDate": "2026-08-01",
  "accessAxisLabel": "Access & SDOH barriers",
  "generatedAt": "2026-08-01T06:59:18+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), lack of reliable transportation, food insecurity, housing insecurity, 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 West Virginia: 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.",
    "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": "LACKTRPT",
        "label": "Lack of reliable transportation"
      },
      {
        "id": "FOODINSECU",
        "label": "Food insecurity"
      },
      {
        "id": "HOUSINSECU",
        "label": "Housing insecurity"
      },
      {
        "id": "ACS_POVERTY",
        "label": "Below poverty (ACS)"
      },
      {
        "id": "ACS_NOVEHICLE",
        "label": "Households without a vehicle (ACS)"
      }
    ]
  },
  "stats": {
    "counties": 55,
    "countiesWithHpsa": 55,
    "countiesWithHpsaPct": 100,
    "medianDiabetes": 16.9,
    "diabetesMin": {
      "county": "Monongalia",
      "value": 10.8
    },
    "diabetesMax": {
      "county": "McDowell",
      "value": 21.6
    },
    "medianUninsured": 8.9
  },
  "keyFindings": [
    "55 of West Virginia's 55 counties (100%) fall within a federally designated primary-care Health Professional Shortage Area.",
    "Adult diagnosed-diabetes prevalence ranges from 10.8% in Monongalia County to 21.6% in McDowell County, a 10.8-point spread within a single state.",
    "McDowell County carries the highest combined targeting-priority index (93.0/100), led by its health burden score.",
    "The median county uninsured rate (adults 18-64) is 8.9%, and the median adult diabetes prevalence is 16.9%."
  ],
  "counties": [
    {
      "fips": "54047",
      "name": "McDowell",
      "population": 17439,
      "priorityIndex": 93.0,
      "burdenScore": 97.0,
      "accessScore": 93.5,
      "shortageScore": 88.5,
      "topDriver": "Health burden",
      "hpsaMaxScore": 23,
      "hpsaDesignations": 7,
      "raw": {
        "DIABETES": 21.6,
        "OBESITY": 46.2,
        "BPHIGH": 51.0,
        "CHD": 11.8,
        "GHLTH": 37.0,
        "PHLTH": 22.2,
        "ACCESS2": 13.9,
        "LACKTRPT": 14.4,
        "FOODINSECU": 28.6,
        "HOUSINSECU": 19.4,
        "ACS_POVERTY": 30.9,
        "ACS_NOVEHICLE": 9.9
      },
      "ci": {
        "DIABETES": {
          "lo": 19.0,
          "hi": 24.3
        },
        "OBESITY": {
          "lo": 37.9,
          "hi": 54.7
        },
        "BPHIGH": {
          "lo": 46.4,
          "hi": 55.5
        },
        "CHD": {
          "lo": 10.5,
          "hi": 13.2
        },
        "GHLTH": {
          "lo": 32.5,
          "hi": 41.7
        },
        "PHLTH": {
          "lo": 19.6,
          "hi": 25.0
        },
        "ACCESS2": {
          "lo": 11.1,
          "hi": 17.0
        },
        "LACKTRPT": {
          "lo": 12.5,
          "hi": 16.6
        },
        "FOODINSECU": {
          "lo": 24.1,
          "hi": 33.5
        },
        "HOUSINSECU": {
          "lo": 16.6,
          "hi": 22.6
        }
      },
      "rank": 1
    },
    {
      "fips": "54059",
      "name": "Mingo",
      "population": 22023,
      "priorityIndex": 82.8,
      "burdenScore": 89.2,
      "accessScore": 78.4,
      "shortageScore": 80.8,
      "topDriver": "Health burden",
      "hpsaMaxScore": 21,
      "hpsaDesignations": 4,
      "raw": {
        "DIABETES": 20.4,
        "OBESITY": 43.5,
        "BPHIGH": 50.1,
        "CHD": 11.5,
        "GHLTH": 35.0,
        "PHLTH": 22.4,
        "ACCESS2": 11.7,
        "LACKTRPT": 12.6,
        "FOODINSECU": 25.1,
        "HOUSINSECU": 16.8,
        "ACS_POVERTY": 29.9,
        "ACS_NOVEHICLE": 11.6
      },
      "ci": {
        "DIABETES": {
          "lo": 17.8,
          "hi": 23.3
        },
        "OBESITY": {
          "lo": 35.8,
          "hi": 51.5
        },
        "BPHIGH": {
          "lo": 45.8,
          "hi": 54.6
        },
        "CHD": {
          "lo": 10.1,
          "hi": 13.1
        },
        "GHLTH": {
          "lo": 30.3,
          "hi": 40.5
        },
        "PHLTH": {
          "lo": 19.6,
          "hi": 25.8
        },
        "ACCESS2": {
          "lo": 8.9,
          "hi": 15.1
        },
        "LACKTRPT": {
          "lo": 10.6,
          "hi": 14.7
        },
        "FOODINSECU": {
          "lo": 20.6,
          "hi": 29.9
        },
        "HOUSINSECU": {
          "lo": 13.9,
          "hi": 19.9
        }
      },
      "rank": 2
    },
    {
      "fips": "54013",
      "name": "Calhoun",
      "population": 5959,
      "priorityIndex": 75.4,
      "burdenScore": 89.2,
      "accessScore": 64.0,
      "shortageScore": 73.1,
      "topDriver": "Health burden",
      "hpsaMaxScore": 19,
      "hpsaDesignations": 2,
      "raw": {
        "DIABETES": 21.1,
        "OBESITY": 40.8,
        "BPHIGH": 51.4,
        "CHD": 12.5,
        "GHLTH": 34.0,
        "PHLTH": 22.0,
        "ACCESS2": 10.6,
        "LACKTRPT": 11.3,
        "FOODINSECU": 22.5,
        "HOUSINSECU": 14.8,
        "ACS_POVERTY": 33.4,
        "ACS_NOVEHICLE": 8.6
      },
      "ci": {
        "DIABETES": {
          "lo": 18.4,
          "hi": 24.1
        },
        "OBESITY": {
          "lo": 32.3,
          "hi": 49.4
        },
        "BPHIGH": {
          "lo": 46.8,
          "hi": 56.0
        },
        "CHD": {
          "lo": 11.1,
          "hi": 14.2
        },
        "GHLTH": {
          "lo": 29.2,
          "hi": 38.6
        },
        "PHLTH": {
          "lo": 19.1,
          "hi": 25.0
        },
        "ACCESS2": {
          "lo": 8.2,
          "hi": 13.4
        },
        "LACKTRPT": {
          "lo": 9.6,
          "hi": 13.2
        },
        "FOODINSECU": {
          "lo": 18.4,
          "hi": 26.7
        },
        "HOUSINSECU": {
          "lo": 12.2,
          "hi": 17.5
        }
      },
      "rank": 3
    },
    {
      "fips": "54101",
      "name": "Webster",
      "population": 8045,
      "priorityIndex": 75.4,
      "burdenScore": 81.5,
      "accessScore": 56.1,
      "shortageScore": 88.5,
      "topDriver": "Provider shortage",
      "hpsaMaxScore": 23,
      "hpsaDesignations": 2,
      "raw": {
        "DIABETES": 19.5,
        "OBESITY": 42.9,
        "BPHIGH": 49.9,
        "CHD": 11.5,
        "GHLTH": 31.8,
        "PHLTH": 20.9,
        "ACCESS2": 10.4,
        "LACKTRPT": 10.2,
        "FOODINSECU": 19.8,
        "HOUSINSECU": 13.7,
        "ACS_POVERTY": 22.1,
        "ACS_NOVEHICLE": 12.8
      },
      "ci": {
        "DIABETES": {
          "lo": 16.8,
          "hi": 22.4
        },
        "OBESITY": {
          "lo": 34.4,
          "hi": 51.8
        },
        "BPHIGH": {
          "lo": 45.2,
          "hi": 54.6
        },
        "CHD": {
          "lo": 10.0,
          "hi": 13.2
        },
        "GHLTH": {
          "lo": 26.9,
          "hi": 36.8
        },
        "PHLTH": {
          "lo": 18.1,
          "hi": 24.1
        },
        "ACCESS2": {
          "lo": 7.9,
          "hi": 13.5
        },
        "LACKTRPT": {
          "lo": 8.5,
          "hi": 11.9
        },
        "FOODINSECU": {
          "lo": 15.7,
          "hi": 23.9
        },
        "HOUSINSECU": {
          "lo": 11.1,
          "hi": 16.3
        }
      },
      "rank": 4
    },
    {
      "fips": "54043",
      "name": "Lincoln",
      "population": 19701,
      "priorityIndex": 72.7,
      "burdenScore": 76.9,
      "accessScore": 52.8,
      "shortageScore": 88.5,
      "topDriver": "Provider shortage",
      "hpsaMaxScore": 23,
      "hpsaDesignations": 2,
      "raw": {
        "DIABETES": 18.5,
        "OBESITY": 45.6,
        "BPHIGH": 47.2,
        "CHD": 10.4,
        "GHLTH": 31.1,
        "PHLTH": 20.6,
        "ACCESS2": 10.4,
        "LACKTRPT": 10.7,
        "FOODINSECU": 20.6,
        "HOUSINSECU": 14.8,
        "ACS_POVERTY": 20.6,
        "ACS_NOVEHICLE": 9.1
      },
      "ci": {
        "DIABETES": {
          "lo": 16.2,
          "hi": 21.1
        },
        "OBESITY": {
          "lo": 37.9,
          "hi": 53.3
        },
        "BPHIGH": {
          "lo": 43.0,
          "hi": 51.5
        },
        "CHD": {
          "lo": 9.2,
          "hi": 11.8
        },
        "GHLTH": {
          "lo": 26.7,
          "hi": 35.7
        },
        "PHLTH": {
          "lo": 18.0,
          "hi": 23.4
        },
        "ACCESS2": {
          "lo": 7.9,
          "hi": 13.3
        },
        "LACKTRPT": {
          "lo": 8.9,
          "hi": 12.6
        },
        "FOODINSECU": {
          "lo": 16.4,
          "hi": 25.1
        },
        "HOUSINSECU": {
          "lo": 12.1,
          "hi": 17.5
        }
      },
      "rank": 5
    },
    {
      "fips": "54109",
      "name": "Wyoming",
      "population": 20277,
      "priorityIndex": 71.1,
      "burdenScore": 79.7,
      "accessScore": 52.9,
      "shortageScore": 80.8,
      "topDriver": "Provider shortage",
      "hpsaMaxScore": 21,
      "hpsaDesignations": 4,
      "raw": {
        "DIABETES": 18.7,
        "OBESITY": 44.6,
        "BPHIGH": 49.7,
        "CHD": 10.7,
        "GHLTH": 32.0,
        "PHLTH": 20.6,
        "ACCESS2": 10.5,
        "LACKTRPT": 10.6,
        "FOODINSECU": 20.6,
        "HOUSINSECU": 14.4,
        "ACS_POVERTY": 22.6,
        "ACS_NOVEHICLE": 8.8
      },
      "ci": {
        "DIABETES": {
          "lo": 16.2,
          "hi": 21.3
        },
        "OBESITY": {
          "lo": 36.5,
          "hi": 52.8
        },
        "BPHIGH": {
          "lo": 45.2,
          "hi": 54.2
        },
        "CHD": {
          "lo": 9.3,
          "hi": 12.2
        },
        "GHLTH": {
          "lo": 27.1,
          "hi": 36.9
        },
        "PHLTH": {
          "lo": 17.7,
          "hi": 23.6
        },
        "ACCESS2": {
          "lo": 7.9,
          "hi": 13.6
        },
        "LACKTRPT": {
          "lo": 8.8,
          "hi": 12.5
        },
        "FOODINSECU": {
          "lo": 16.4,
          "hi": 25.1
        },
        "HOUSINSECU": {
          "lo": 11.7,
          "hi": 17.2
        }
      },
      "rank": 6
    },
    {
      "fips": "54045",
      "name": "Logan",
      "population": 30827,
      "priorityIndex": 69.9,
      "burdenScore": 76.1,
      "accessScore": 52.9,
      "shortageScore": 80.8,
      "topDriver": "Provider shortage",
      "hpsaMaxScore": 21,
      "hpsaDesignations": 5,
      "raw": {
        "DIABETES": 18.2,
        "OBESITY": 45.0,
        "BPHIGH": 47.8,
        "CHD": 10.2,
        "GHLTH": 31.7,
        "PHLTH": 20.5,
        "ACCESS2": 10.1,
        "LACKTRPT": 10.8,
        "FOODINSECU": 20.2,
        "HOUSINSECU": 14.6,
        "ACS_POVERTY": 21.4,
        "ACS_NOVEHICLE": 9.6
      },
      "ci": {
        "DIABETES": {
          "lo": 15.7,
          "hi": 20.7
        },
        "OBESITY": {
          "lo": 37.8,
          "hi": 52.9
        },
        "BPHIGH": {
          "lo": 43.4,
          "hi": 52.3
        },
        "CHD": {
          "lo": 8.9,
          "hi": 11.7
        },
        "GHLTH": {
          "lo": 27.2,
          "hi": 36.6
        },
        "PHLTH": {
          "lo": 17.8,
          "hi": 23.5
        },
        "ACCESS2": {
          "lo": 7.5,
          "hi": 13.1
        },
        "LACKTRPT": {
          "lo": 9.0,
          "hi": 12.8
        },
        "FOODINSECU": {
          "lo": 16.1,
          "hi": 24.7
        },
        "HOUSINSECU": {
          "lo": 11.9,
          "hi": 17.5
        }
      },
      "rank": 7
    },
    {
      "fips": "54015",
      "name": "Clay",
      "population": 7783,
      "priorityIndex": 69.5,
      "burdenScore": 74.9,
      "accessScore": 52.7,
      "shortageScore": 80.8,
      "topDriver": "Provider shortage",
      "hpsaMaxScore": 21,
      "hpsaDesignations": 1,
      "raw": {
        "DIABETES": 18.8,
        "OBESITY": 41.9,
        "BPHIGH": 48.4,
        "CHD": 10.8,
        "GHLTH": 31.0,
        "PHLTH": 20.5,
        "ACCESS2": 10.2,
        "LACKTRPT": 10.5,
        "FOODINSECU": 20.4,
        "HOUSINSECU": 14.1,
        "ACS_POVERTY": 24.9,
        "ACS_NOVEHICLE": 8.8
      },
      "ci": {
        "DIABETES": {
          "lo": 16.3,
          "hi": 21.4
        },
        "OBESITY": {
          "lo": 33.3,
          "hi": 50.6
        },
        "BPHIGH": {
          "lo": 43.6,
          "hi": 52.8
        },
        "CHD": {
          "lo": 9.5,
          "hi": 12.2
        },
        "GHLTH": {
          "lo": 26.5,
          "hi": 35.6
        },
        "PHLTH": {
          "lo": 17.9,
          "hi": 23.2
        },
        "ACCESS2": {
          "lo": 7.6,
          "hi": 13.3
        },
        "LACKTRPT": {
          "lo": 8.7,
          "hi": 12.3
        },
        "FOODINSECU": {
          "lo": 16.3,
          "hi": 24.8
        },
        "HOUSINSECU": {
          "lo": 11.5,
          "hi": 16.9
        }
      },
      "rank": 8
    },
    {
      "fips": "54087",
      "name": "Roane",
      "population": 13743,
      "priorityIndex": 68.4,
      "burdenScore": 77.3,
      "accessScore": 51.1,
      "shortageScore": 76.9,
      "topDriver": "Health burden",
      "hpsaMaxScore": 20,
      "hpsaDesignations": 6,
      "raw": {
        "DIABETES": 19.4,
        "OBESITY": 41.6,
        "BPHIGH": 49.1,
        "CHD": 11.0,
        "GHLTH": 31.8,
        "PHLTH": 20.5,
        "ACCESS2": 10.3,
        "LACKTRPT": 10.4,
        "FOODINSECU": 20.3,
        "HOUSINSECU": 13.9,
        "ACS_POVERTY": 20.2,
        "ACS_NOVEHICLE": 9.9
      },
      "ci": {
        "DIABETES": {
          "lo": 16.5,
          "hi": 22.2
        },
        "OBESITY": {
          "lo": 33.5,
          "hi": 49.7
        },
        "BPHIGH": {
          "lo": 44.3,
          "hi": 53.6
        },
        "CHD": {
          "lo": 9.5,
          "hi": 12.6
        },
        "GHLTH": {
          "lo": 26.5,
          "hi": 36.9
        },
        "PHLTH": {
          "lo": 17.4,
          "hi": 23.6
        },
        "ACCESS2": {
          "lo": 7.7,
          "hi": 13.2
        },
        "LACKTRPT": {
          "lo": 8.6,
          "hi": 12.5
        },
        "FOODINSECU": {
          "lo": 16.1,
          "hi": 24.8
        },
        "HOUSINSECU": {
          "lo": 11.1,
          "hi": 16.9
        }
      },
      "rank": 9
    },
    {
      "fips": "54089",
      "name": "Summers",
      "population": 11581,
      "priorityIndex": 63.6,
      "burdenScore": 73.9,
      "accessScore": 47.8,
      "shortageScore": 69.2,
      "topDriver": "Health burden",
      "hpsaMaxScore": 18,
      "hpsaDesignations": 2,
      "raw": {
        "DIABETES": 19.4,
        "OBESITY": 39.8,
        "BPHIGH": 48.9,
        "CHD": 11.0,
        "GHLTH": 30.9,
        "PHLTH": 20.3,
        "ACCESS2": 10.0,
        "LACKTRPT": 10.5,
        "FOODINSECU": 20.1,
        "HOUSINSECU": 14.6,
        "ACS_POVERTY": 19.2,
        "ACS_NOVEHICLE": 8.0
      },
      "ci": {
        "DIABETES": {
          "lo": 16.8,
          "hi": 22.1
        },
        "OBESITY": {
          "lo": 31.5,
          "hi": 48.2
        },
        "BPHIGH": {
          "lo": 44.4,
          "hi": 53.5
        },
        "CHD": {
          "lo": 9.5,
          "hi": 12.5
        },
        "GHLTH": {
          "lo": 26.1,
          "hi": 35.9
        },
        "PHLTH": {
          "lo": 17.4,
          "hi": 23.4
        },
        "ACCESS2": {
          "lo": 7.6,
          "hi": 12.7
        },
        "LACKTRPT": {
          "lo": 8.8,
          "hi": 12.2
        },
        "FOODINSECU": {
          "lo": 16.2,
          "hi": 24.1
        },
        "HOUSINSECU": {
          "lo": 12.1,
          "hi": 17.2
        }
      },
      "rank": 10
    },
    {
      "fips": "54019",
      "name": "Fayette",
      "population": 39072,
      "priorityIndex": 62.9,
      "burdenScore": 62.1,
      "accessScore": 41.9,
      "shortageScore": 84.6,
      "topDriver": "Provider shortage",
      "hpsaMaxScore": 22,
      "hpsaDesignations": 3,
      "raw": {
        "DIABETES": 17.9,
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        "ACS_POVERTY": 14.1,
        "ACS_NOVEHICLE": 6.0
      },
      "ci": {
        "DIABETES": {
          "lo": 13.2,
          "hi": 17.8
        },
        "OBESITY": {
          "lo": 30.8,
          "hi": 45.2
        },
        "BPHIGH": {
          "lo": 38.8,
          "hi": 47.6
        },
        "CHD": {
          "lo": 7.3,
          "hi": 9.8
        },
        "GHLTH": {
          "lo": 21.3,
          "hi": 29.9
        },
        "PHLTH": {
          "lo": 14.8,
          "hi": 19.9
        },
        "ACCESS2": {
          "lo": 7.0,
          "hi": 12.2
        },
        "LACKTRPT": {
          "lo": 7.0,
          "hi": 10.2
        },
        "FOODINSECU": {
          "lo": 12.8,
          "hi": 20.0
        },
        "HOUSINSECU": {
          "lo": 10.0,
          "hi": 14.8
        }
      },
      "rank": 50
    },
    {
      "fips": "54057",
      "name": "Mineral",
      "population": 26867,
      "priorityIndex": 38.5,
      "burdenScore": 42.4,
      "accessScore": 15.4,
      "shortageScore": 57.7,
      "topDriver": "Provider shortage",
      "hpsaMaxScore": 15,
      "hpsaDesignations": 1,
      "raw": {
        "DIABETES": 15.2,
        "OBESITY": 39.3,
        "BPHIGH": 43.0,
        "CHD": 8.4,
        "GHLTH": 23.5,
        "PHLTH": 16.6,
        "ACCESS2": 7.4,
        "LACKTRPT": 7.5,
        "FOODINSECU": 12.9,
        "HOUSINSECU": 10.5,
        "ACS_POVERTY": 14.3,
        "ACS_NOVEHICLE": 6.9
      },
      "ci": {
        "DIABETES": {
          "lo": 13.0,
          "hi": 17.6
        },
        "OBESITY": {
          "lo": 31.6,
          "hi": 47.6
        },
        "BPHIGH": {
          "lo": 38.5,
          "hi": 47.7
        },
        "CHD": {
          "lo": 7.3,
          "hi": 9.6
        },
        "GHLTH": {
          "lo": 19.9,
          "hi": 27.5
        },
        "PHLTH": {
          "lo": 14.2,
          "hi": 19.0
        },
        "ACCESS2": {
          "lo": 5.6,
          "hi": 9.7
        },
        "LACKTRPT": {
          "lo": 6.2,
          "hi": 8.9
        },
        "FOODINSECU": {
          "lo": 10.1,
          "hi": 16.0
        },
        "HOUSINSECU": {
          "lo": 8.5,
          "hi": 12.7
        }
      },
      "rank": 51
    },
    {
      "fips": "54079",
      "name": "Putnam",
      "population": 56962,
      "priorityIndex": 38.0,
      "burdenScore": 33.8,
      "accessScore": 3.4,
      "shortageScore": 76.9,
      "topDriver": "Provider shortage",
      "hpsaMaxScore": 20,
      "hpsaDesignations": 1,
      "raw": {
        "DIABETES": 14.1,
        "OBESITY": 38.3,
        "BPHIGH": 43.7,
        "CHD": 7.5,
        "GHLTH": 21.3,
        "PHLTH": 15.3,
        "ACCESS2": 6.9,
        "LACKTRPT": 6.9,
        "FOODINSECU": 11.9,
        "HOUSINSECU": 9.9,
        "ACS_POVERTY": 10.7,
        "ACS_NOVEHICLE": 3.9
      },
      "ci": {
        "DIABETES": {
          "lo": 12.0,
          "hi": 16.6
        },
        "OBESITY": {
          "lo": 31.7,
          "hi": 45.4
        },
        "BPHIGH": {
          "lo": 39.5,
          "hi": 48.2
        },
        "CHD": {
          "lo": 6.5,
          "hi": 8.6
        },
        "GHLTH": {
          "lo": 17.6,
          "hi": 25.2
        },
        "PHLTH": {
          "lo": 13.0,
          "hi": 17.8
        },
        "ACCESS2": {
          "lo": 5.1,
          "hi": 8.9
        },
        "LACKTRPT": {
          "lo": 5.6,
          "hi": 8.3
        },
        "FOODINSECU": {
          "lo": 9.0,
          "hi": 15.0
        },
        "HOUSINSECU": {
          "lo": 7.8,
          "hi": 12.2
        }
      },
      "rank": 52
    },
    {
      "fips": "54069",
      "name": "Ohio",
      "population": 41194,
      "priorityIndex": 36.6,
      "burdenScore": 40.4,
      "accessScore": 27.2,
      "shortageScore": 42.3,
      "topDriver": "Provider shortage",
      "hpsaMaxScore": 11,
      "hpsaDesignations": 1,
      "raw": {
        "DIABETES": 15.0,
        "OBESITY": 39.5,
        "BPHIGH": 42.5,
        "CHD": 8.3,
        "GHLTH": 22.8,
        "PHLTH": 16.2,
        "ACCESS2": 7.4,
        "LACKTRPT": 7.7,
        "FOODINSECU": 13.2,
        "HOUSINSECU": 10.6,
        "ACS_POVERTY": 15.7,
        "ACS_NOVEHICLE": 12.8
      },
      "ci": {
        "DIABETES": {
          "lo": 12.8,
          "hi": 17.4
        },
        "OBESITY": {
          "lo": 32.2,
          "hi": 47.1
        },
        "BPHIGH": {
          "lo": 38.2,
          "hi": 47.0
        },
        "CHD": {
          "lo": 7.1,
          "hi": 9.5
        },
        "GHLTH": {
          "lo": 18.8,
          "hi": 27.1
        },
        "PHLTH": {
          "lo": 13.7,
          "hi": 18.8
        },
        "ACCESS2": {
          "lo": 5.5,
          "hi": 9.9
        },
        "LACKTRPT": {
          "lo": 6.3,
          "hi": 9.3
        },
        "FOODINSECU": {
          "lo": 10.0,
          "hi": 16.6
        },
        "HOUSINSECU": {
          "lo": 8.3,
          "hi": 13.0
        }
      },
      "rank": 53
    },
    {
      "fips": "54061",
      "name": "Monongalia",
      "population": 107718,
      "priorityIndex": 30.4,
      "burdenScore": 0.0,
      "accessScore": 21.9,
      "shortageScore": 69.2,
      "topDriver": "Provider shortage",
      "hpsaMaxScore": 18,
      "hpsaDesignations": 3,
      "raw": {
        "DIABETES": 10.8,
        "OBESITY": 31.9,
        "BPHIGH": 31.9,
        "CHD": 5.6,
        "GHLTH": 18.4,
        "PHLTH": 12.9,
        "ACCESS2": 7.1,
        "LACKTRPT": 8.3,
        "FOODINSECU": 12.9,
        "HOUSINSECU": 10.7,
        "ACS_POVERTY": 20.5,
        "ACS_NOVEHICLE": 7.5
      },
      "ci": {
        "DIABETES": {
          "lo": 9.3,
          "hi": 12.5
        },
        "OBESITY": {
          "lo": 26.5,
          "hi": 37.5
        },
        "BPHIGH": {
          "lo": 28.3,
          "hi": 35.4
        },
        "CHD": {
          "lo": 4.9,
          "hi": 6.4
        },
        "GHLTH": {
          "lo": 15.4,
          "hi": 21.8
        },
        "PHLTH": {
          "lo": 11.0,
          "hi": 14.9
        },
        "ACCESS2": {
          "lo": 5.2,
          "hi": 9.8
        },
        "LACKTRPT": {
          "lo": 6.7,
          "hi": 10.3
        },
        "FOODINSECU": {
          "lo": 9.8,
          "hi": 16.9
        },
        "HOUSINSECU": {
          "lo": 8.4,
          "hi": 13.2
        }
      },
      "rank": 54
    },
    {
      "fips": "54037",
      "name": "Jefferson",
      "population": 59787,
      "priorityIndex": 27.1,
      "burdenScore": 25.4,
      "accessScore": 9.8,
      "shortageScore": 46.2,
      "topDriver": "Provider shortage",
      "hpsaMaxScore": 12,
      "hpsaDesignations": 1,
      "raw": {
        "DIABETES": 13.4,
        "OBESITY": 38.3,
        "BPHIGH": 40.5,
        "CHD": 6.8,
        "GHLTH": 20.1,
        "PHLTH": 14.3,
        "ACCESS2": 7.7,
        "LACKTRPT": 7.2,
        "FOODINSECU": 12.5,
        "HOUSINSECU": 10.8,
        "ACS_POVERTY": 8.8,
        "ACS_NOVEHICLE": 5.6
      },
      "ci": {
        "DIABETES": {
          "lo": 11.6,
          "hi": 15.3
        },
        "OBESITY": {
          "lo": 31.9,
          "hi": 44.7
        },
        "BPHIGH": {
          "lo": 36.5,
          "hi": 44.4
        },
        "CHD": {
          "lo": 5.9,
          "hi": 7.7
        },
        "GHLTH": {
          "lo": 16.8,
          "hi": 23.6
        },
        "PHLTH": {
          "lo": 12.3,
          "hi": 16.5
        },
        "ACCESS2": {
          "lo": 5.9,
          "hi": 9.7
        },
        "LACKTRPT": {
          "lo": 5.9,
          "hi": 8.6
        },
        "FOODINSECU": {
          "lo": 9.8,
          "hi": 15.6
        },
        "HOUSINSECU": {
          "lo": 8.8,
          "hi": 13.1
        }
      },
      "rank": 55
    }
  ],
  "faq": [
    {
      "question": "What does the West Virginia county health-access scorecard measure?",
      "answer": "It ranks all 55 West Virginia 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": "2a7ab0fbee1b4073"
}