The Robert Wood Johnson Foundation's Aligning Forces for Quality (AF4Q) program commissioned a special report by the Dartmouth Atlas Project to highlight the uneven quality of health care being delivered across America and the need to improve the quality of care and reduce disparities in health in every community. Aligning Forces for Quality is working to lift the overall quality of health care in targeted communities across America, and provide models for national reform.

The report demonstrates that in U.S. health care, it's not only who you are that matters, it's also where you live. The findings highlight the importance of understanding health and health care within a local context - and of efforts to explore and address the underlying causes of disparities within and across regions.

December 2008 update
The AF4Q report was updated in December 2008. Included are data for Dartmouth Atlas hospital service areas, as well as data updates through 2006.

• Updated report
• Methods and definitions
• Data tables
  • States
  • Hospital referral regions
  • AF4Q regions
  • Hospital service areas
  • Hospital service areas within AF4Q regions

    Cincinnati, OH	Minnesota
    Cleveland, OH	Puget Sound, WA
    Detroit, MI	South Central Pennsylvania
    Humboldt County, CA	Western Michigan
    Kansas City, MO	Western New York
    Maine	Willamette Valley, Oregon
    Memphis, TN	Wisconsin

Original files available for download

• Full report
• Executive summary
• Data tables
• Methods and definitions
• Frequently asked questions