trends in health risks and behaviors
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Trends in Health Risks and Behaviors
Highlights from the 2003 Massachusetts Behavioral Risk Factor Surveillance System
Health Survey Program Center for Health Information, Statistics, Research, and
EvaluationMassachusetts Department of Public Health
December 2004
What is the BRFSS?o Random digit dial telephone survey
o Adults ages 18 and older
o Collaboration between CDC and States
o Massachusetts BRFSS since 1986
o Data are weighted: provide population-based estimates of health
o Sample Size: 7,000 - 8,000 annually
Source: Massachusetts BRFSS
BRFSS
TOBACCO
CANCER SCREENING
DRUG &ALCOHOL
ASTHMA CHOLESTEROL
NUTRITION& EXERCISE
HEALTH CARE ACCESS
INJURY
DIABETES
50 OTHER TOPICS
WEIGHT
Source: Massachusetts BRFSS
Topics to be covered
o Flu Vaccinationo Overweight or Obesityo Tobacco Useo Binge Drinkingo Mammogramo HIV Testing
Influenza (flu) Vaccine
Trend in the percentage of adults, ages 65+, who have had a flu vaccine in the past year, 1993-
2003
0
20
40
60
80
100
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
% flu
shot
Note: Dotted line signifies year in which question was not asked.
Source: Massachusetts BRFSS
State vaccine purchase and statewide immunization rates
0
10
20
30
40
50
60
70
80
1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
Perc
ent >
64 y
.o. R
ecei
ving
In
fluen
za a
nd P
nem
onia
Vac
cine
0
100
200
300
400
500
600
700
800
Num
ber o
f Dos
es o
f Sta
te S
uppl
ied
Vacc
ine
(100
0s)
Influenza BRFSS Pneumonia BRFSS Influenza Purchase Pneumonia Purchase
Percentage of adults who received a flu or pneumonia
vaccine by race/ethnicity, 2001-2003
0
20
40
60
80
100
fl u shot, 65+ pneumonnia shot, 65+
% flu
or pn
eumo
nnia
shot
White, NH
Black, NH
Hispanic
Source: Massachusetts BRFSS
MDPH Program Highlights Immunization Program
o Educational outreach • Mailing to 10,000 providers about flu vaccination recommendations• Presentations and grand rounds to health care providers• MDPH influenza web site• Partnerships and Coalitions• Promotional campaign targeting Latino and African-American
communities
o Standing Orders Project to vaccinate hospital in-patientso Flu vaccination of health care workers
Source: MDPH Immunization Program
Obesity
Overweight Obese Height BMI* 25.0-29.9 BMI* >
30
5’ 128 lbs. 153 lbs. 5’2’’ 136 164 5’4’’ 145 174 5’6’’ 155 186 5’8’’ 164 197 6’ 184 221
Adult Overweight or Obese by Height
*BMI (Body Mass Index): weight in kilograms height in meters squared
Source: Massachusetts BRFSS
Overweight Obese Height BMI* 25.0-29.9 BMI* >
30
5’ 128 lbs. 153 lbs. 5’2’’ 136 164 5’4’’5’4’’ 145145 174174 5’6’’ 155 186 5’8’’ 164 197 6’ 184 221
Adult Overweight or Obese by Height
Source: Massachusetts BRFSS *BMI (Body Mass Index): weight in kilograms height in meters squared
Trend in the percentage of adults who are overweight or
obese, 1990-2003
0
20
40
60
80
100
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
% ov
erwe
ight o
r obe
se
overweight obese
Source: Massachusetts BRFSS
Percentage of adults who are obese, by sex and
race/ethnicity, 2003
0
10
20
30
40
50
Total White, NH Black, NH Hispanic Asian, NH
% ob
ese
male f emale
Rates are age adjusted to the US 2000 standard population.Source: Massachusetts BRFSS
MDPH Program Highlights: Massachusetts Overweight Prevention
and Control Initiative (MOPCI)o Statewide: partnering with public and private organizations
to coordinate overweight prevention and control efforts
o Communities: working with communities to implement walk/bike to school and work initiatives
o Schools: working with schools to increase student awareness and participation in healthy eating and physical activity before, during, and after school
o Worksites: working with employers to support improved nutrition and increased participation in physical activity for their employees
Source: Massachusetts Overweight Prevention and Control Initiative
Breast Cancer Screening
Trend in the percentage of women, ages 40+, who had a mammogram in past 2 years,
2003
0
20
40
60
80
100
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
% ma
mmog
ram
Note: Dotted line signifies year in which question was not asked.
Source: Massachusetts BRFSS
Trend in the percentage of women, ages 40+, who had a mammogram in past 2 years by insurance status, 2003
0
20
40
60
80
100
1992-1
993
1994-1
995
1996-1
997
1998-1
999
2000-2
001*
2002-2
003
% ma
mmog
ram
insured uninsured
* 2000 data onlySource: Massachusetts BRFSS
Percentage of women, ages 40+, who had a mammogram
in the past 2 years, by disability status, 2003
60
70
80
90
100
not disabled disabled
% m
amm
ogra
m
Rates are age adjusted to the US 2000 standard population.Source: Massachusetts BRFSS
MDPH Program Highlights: Breast Cancer Screening
o Increase in mammograms among women ages 40+ after
program
inception.
o Better access to care needed for people with disabilities.
o More outreach needed to Hispanic women.
Source: Massachusetts Women’s Health Network
Binge Drinking(5 or more drinks on one occasion)
Trend in the percentage of binge drinkers among
adults, 1990-2003
0
5
10
15
20
25
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000 20
0120
0220
03
% bin
ge d
rinke
r
US MA
Note: Dotted line signifies year in which question was not asked.
Source: Massachusetts BRFSS
Percentage of binge drinkers among adults, by household
income, 2003
0
5
10
15
20
25
<$25,000 $25-34,999 $35-49,999 $50-74,999 $75,000+
% bin
ge d
rink
Source: Massachusetts BRFSS
MDPH Program Highlights:Binge Drinking
o MA monitors binge drinking because of the associated high risk behaviors
o Percentage of MA adults reporting binge drinking is consistently higher than US average on both the BRFSS and SAHMSA. (Substance Abuse Mental Health Services Administration’s National Survey on Drug Use and Health (NSDUH)).
o Both BRFSS and NSDUH show similar patterns by demographic group.
o Bureau of Substance Abuse Services funds a broad spectrum of regional and community-based prevention programs and a continuum of substance use treatment services.
Source: MDPH Bureau of Substance Abuse and Services
Cigarette Smoking
Percentage of current smokers among adults, 1986-2003
0
10
20
30
40
50
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000 20
0120
0220
03
% cu
rren
t smo
ker
Source: Massachusetts BRFSS
Percentage of current smokers among adults and young
adults, 1986-2003
0
10
20
30
40
50
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000 20
0120
0220
03
% cu
rren
t smo
ker
overall ages 18-24
Source: Massachusetts BRFSS
Percentage of current smokers among adults, by household
income, 1986-2003
0
10
20
30
40
50
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
% cu
rren
t smo
ker
<$50,000 $50,000+
Source: Massachusetts BRFSS
MDPH Program Highlights:Tobacco Control Program
o Implementation of smokefree workplace lawso Monitoring illegal cigarette sales to minors via
statewide compliance check programo Working with health care systems to determine
smoking status of patients and refer smokers to quit line
o Promoting smokefree homes and smoking cessation services to programs serving young women with children such as Healthy Start, Early Intervention, Head Start and WIC
Source: MDPH Tobacco Control Program
HIV Testing
Percentage of adults, ages 18-64, who report ever being
tested for HIV, by risk status, 1993-2003
0
20
40
60
80
100
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003
% e
ver
test
ed
ever tested ever tested and high risk behavior
Source: Massachusetts BRFSS
MDPH Program HighlightsHIV/AIDS Bureau
Counseling and Testing Programo The general population have multiple opportunities for HIV testing,
including private health care and life insurance application processes.o Publicly funded HIV testing and counseling programs are required to
identify and target high risk populations for testing.o Public and clinical education programs emphasize the importance of
knowing one’s risk and HIV testing as the point of access to HIV care.o Higher relative testing rates among high risk individuals may reflect the
impact of educational programming about HIV risk and the benefits of testing, as well as the effectiveness of targeted public test access.
o As the efficiency of the publicly funded HIV counseling and testing system increases, it remains important to maintain access to health care and anti-HIV medications for the 1,000 Massachusetts resident who yearly are newly identified with HIV.
Source: MDPH HIV/AIDS Bureau
Summaryo Important to examine trends to inform
program developmento Trends that bear watching:
• Smoking: rates stable among adults; concerns among young adults
• Mammogram: concerns among women with disabilities• Overweight/Obesity: continued rise for all; race and
gender disparities exist• Binge Drinking: Massachusetts higher than the US• HIV testing: high testing rate among high risk adults
Monitoring the Health of Massachusetts: 2003 BRFSS
Reporto Overall health measures: health status, quality of lifeo Access and Utilization: insurance coverage, access to
careo Risk factors and preventive behaviors: physical
activity, nutrition, hypertension, cholesterol awarenesso Chronic conditions: diabetes, CVD, asthma, disabilityo Cancer screeningo Childhood health: dental sealant, access to care, asthmao Others: HIV testing, illicit drug use, unwanted sexual contact
How to obtain this report? For access to reports and data:
Visit the BRFSS website: http://www.state.ma.us/dph/bhsre/cdsp/brfss/brfss.htm MassCHIP: 2003 BRFSS data will be available late in 2005
For more information about BRFSS, please contact: Zi Zhang, Director of Health Survey Program Tel: (617) 624-5623 E-mail: zi.zhang@state.ma.us
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