Surveillance for Certain Health Behaviors and Conditions Among States and Selected Local Areas — Behavioral Risk Factor Surveillance System, United States, 2013 and 2014

Abstract

ProblemChronic diseases and conditions (e.g., heart diseases, stroke, arthritis, and diabetes) are the leading causes of morbidity and mortality in the United States. These conditions are costly to the U.S. economy, yet they are often preventable or controllable. Behavioral risk factors (e.g., excessive alcohol consumption, tobacco use, poor diet, frequent mental distress, and insufficient sleep) are linked to the leading causes of morbidity and mortality. Adopting positive health behaviors (e.g., staying physically active, quitting tobacco use, obtaining routine physical checkups, and checking blood pressure and cholesterol levels) can reduce morbidity and mortality from chronic diseases and conditions. Monitoring the health risk behaviors, chronic diseases and conditions, access to health care, and use of preventive health services at multilevel public health points (states, territories, and metropolitan and micropolitan statistical areas [MMSA]) can provide important information for development and evaluation of health intervention programs.Reporting Period2013 and 2014.Description of the SystemThe Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing, state-based, random-digit–dialed telephone survey of noninstitutionalized adults aged ≥18 years residing in the United States. BRFSS collects data on health risk behaviors, chronic diseases and conditions, access to health care, and use of preventive health services and practices related to the leading causes of death and disability in the United States and participating territories. This is the first BRFSS report to include age-adjusted prevalence estimates. For 2013 and 2014, these age-adjusted prevalence estimates are presented for all 50 states, the District of Columbia, the Commonwealth of Puerto Rico, Guam, and selected MMSA.ResultsAge-adjusted prevalence estimates of health status indicators, health care access and preventive practices, health risk behaviors, chronic diseases and conditions, and cardiovascular conditions vary by state, territory, and MMSA. Each set of proportions presented refers to the range of age-adjusted prevalence estimates of selected BRFSS measures as reported by survey respondents.The following are estimates for 2013. Adults reporting frequent mental distress: 7.7%–15.2% in states and territories and 6.3%–19.4% in MMSA. Adults with inadequate sleep: 27.6%–49.2% in states and territories and 26.5%–44.4% in MMSA. Adults aged 18–64 years having health care coverage: 66.9%–92.4% in states and territories and 60.5%–97.6% in MMSA. Adults identifying as current cigarette smokers: 10.1%–28.8% in states and territories and 6.1%–33.6% in MMSA. Adults reporting binge drinking during the past month: 10.5%–25.2% in states and territories and 7.2%–25.3% in MMSA. Adults with obesity: 21.0%–35.2% in states and territories and 12.1%–37.1% in MMSA. Adults aged ≥45 years with some form of arthritis: 30.6%–51.0% in states and territories and 27.6%–52.4% in MMSA. Adults aged ≥45 years who have had coronary heart disease: 7.4%–17.5% in state...

Cancer Statistics for Hispanics/Latinos, 2018

“…Cancer patterns in Puerto Rico likely reflect underlying cancer risk factors as well as differences in health care access and infrastructure; however, data on risk factors and cancer screening prevalence are limited to data from the Behavioral Risk Factor Surveillance System (BRFSS), which are not directly comparable to estimates from NHIS and NHANES previously presented herein. A recent analysis of BRFSS data for all races/ethnicities combined found lower current cigarette smoking prevalence in Puerto Rico (11%) than in any US state except Utah (9%) in 2015, 94 which may reflect the effects of high cigarette excise taxes in the territory. However, prevalence is similar or higher for other risk factors associated with urbanization, such as obesity (30% for both Puerto Rico and median US), physical inactivity (47% versus 26% US median), and diabetes (27% versus 16%).…”

“…93 Additionally, colorectal cancer screening and cervical cancer screening are substantially lower in Puerto Rico compared with the US overall. 94 Conversely, higher use of the PSA test in the territory compared to the continental US and Hawaii overall has been reported. 90 While this likely influences prostate cancer incidence rates in the territory, it does not explain the higher mortality rates.…”

“…However, prevalence is similar or higher for other risk factors associated with urbanization, such as obesity (30% for both Puerto Rico and median US), physical inactivity (47% versus 26% US median), and diabetes (27% versus 16%) . Additionally, colorectal cancer screening and cervical cancer screening are substantially lower in Puerto Rico compared with the US overall . Conversely, higher use of the PSA test in the territory compared to the continental US and Hawaii overall has been reported .…”

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“…aged 50-75 years who are at normal CRC risk (US Preventive Service Task Force [USPSTF], 2016;"Colorectal Cancer Facts & Figures, 2017-2019. CRC screening rates have leveled off at only two thirds of those aged 50-75 years (Gamble et al, 2017). African Americans and other minorities have markedly lower screening rates (Kashini & Bush, 2016) and often are diagnosed at later stages of the disease when it is less amenable to treatment ("Colorectal Cancer Facts & Figures, 2017-2019.…”