The primary goal of the Tracking Disparities in the Effective Delivery of Health Services project is to develop, apply and refine methods that enhance health agencies, policy-makers, researchers, and analysts'ability to track disparities in the effective delivery of interventions to improve population health. The two specific aims towards achieving this goal are: (1) to use all available data to estimate the coverage and effective coverage of a range of key health interventions for each of the 39 counties in the State of Washington over the period 2000 to 2008 and (2) to develop a set of standardized training tools and protocols that can be used as a template for estimating effective coverage in other settings. Statistical approaches will be used to determine the coverage, and where possible, the effective coverage of a range of key interventions for each of the 39 counties in Washington State. Interventions will include both personal and non-personal interventions, including, for example, community-based education to reduce population exposure to key risk factors such as tobacco, inpatient management of major disease such as myocardial infarction and stroke as well as outpatient management of risk factors such as high blood pressure and lipids. Based on the methods used to estimate coverage and effective coverage a suite of tools and training materials will be created to allow implementation of these approaches in other locations around the world. Measuring not just aggregate levels of coverage, but disparities in coverage and effective coverage is the goal of this proposal. Stewards of health systems can improve the health of their populations by delivering effective interventions. Measures of coverage and effective coverage of the treatment of non-communicable disease and the associated risk factors, particularly in developed county settings, capture the population in need of an intervention, the utilization of a health service by those in need, and the quality of the intervention being delivered by the health system.