core state pch indicators: a preliminary report of multi-state findings using data from the brfss...
TRANSCRIPT
Core State PCH Indicators: A Preliminary Report of Multi-State
Findings Using Data from the BRFSS
CDR Lauren B. Zapata, PhD , MSPHDivision of Reproductive Health, CDC
Core State PCH Indicators
Effort to improve data and surveillance activities to monitor women’s PCH
45 indicators were collaboratively identified by a committee from 7 states
CA, DE, FL, MI, NC, TX and UT
Published in MCHJ Feb 2011
Core State PCH Indicators
DOMAIN# OF INDICATORS
TOTAL BRFSSGeneral health 1 1
Social determinants of health 2 1
Health care 7 3
Reproductive health/Family Planning 8 0
Substance abuse 7 3
Nutrition/PA 5 3
Mental health 3 1
Social/emotional health 4 1
Chronic conditions 5 3
Infections 3 1
TOTAL 45 17 (38%)
BRFSS Overview
State-based system of telephone health surveys
Designed to gather information on Health risk behaviors, clinical preventive health
practices, and health-care access
Women & men 18+ years living in households General population of reproductive age women (18-44)
For many states, only source of timely data
BRFSS Overview
Data collected monthly in all 50 states, DC & US territories
430,000+ adults were interviewed in 2010
States use data to: Identify emerging health problems Establish and monitor health objectives Develop and evaluate programs and policies
http://www.cdc.gov/brfss
Purpose
Present preliminary descriptive data from a multi-state, comprehensive report summarizing the full set of PCH indicators
MMWR Surveillance Summary – Jan 2012
Several data systems:
• BRFSS, PRAMS, ASEC, NSTD, NVSS
Purpose
Present preliminary descriptive data from a multi-state, comprehensive report summarizing the full set of PCH indicators
MMWR Surveillance Summary – Jan 2012
Several data systems:
• BRFSS, PRAMS, ASEC, NSTD, NVSS
Study Questions
What is the prevalence of select PCH indicators?
Do they vary by state or by select demographic characteristics?
Methods
2009 BRFSS data from 50 states & DC
Non-pregnant women aged 18-44 years
Prevalence of select core state PCH indicators for U.S., by state, and stratified by age and race/ethnicity
Analyses conducted using SUDAAN and weighted to provide unbiased national and state estimates
Selected Indicators
Access to Health Care
Percentage of women who currently have some type of health care coverage
Utilization of Health Care
Percentage of women who had a routine checkup in the past year
Overweight and Obesity
Percentage of women who are overweight or obese based on BMI >= 25 kg/m2
Diabetes Percentage of women who have ever been told by a health care provider that they had diabetes, not including gestational diabetes
RESULTS
Access to Health CarePercentage of Women Who Currently Have Some Type
of Health Care Coverage
Non-Pregnant Women Aged 18-44 years, BRFSS, 200909
Utilization of Health CarePercentage of women who had a routine checkup
in the past year
Non-Pregnant Women Aged 18-44 years, BRFSS, 200909
Overweight & ObesityPercentage of women who are overweight or obese
based on BMI >= 25 kg/m2
Non-Pregnant Women Aged 18-44 years, BRFSS, 200909
DiabetesPercentage of women ever been told by a health care provider that they had diabetes, not including GDM
Non-Pregnant Women Aged 18-44 years, BRFSS, 200909
STRATIFIED RESULTS
Access to Health CarePercentage of Women Who Currently Have Some Type
of Health Care Coverage
Utilization of Health CarePercentage of women who had a routine checkup
in the past year
Overweight & ObesityPercentage of women who are overweight or obese
based on BMI >= 25 kg/m2
DiabetesPercentage of women ever been told by a health care provider that they had diabetes, not including GDM
Conclusions
Data provide a brief and preliminary glimpse into a forthcoming CDC surveillance summary
Findings document variations by state and demographic characteristics
Findings document need for further efforts to improve women’s PCH status
Implications
Data on the core state PCH indicators can be used by states to:
Identify needs Set priorities Evaluate implementation and impact of PCH-
related policies and initiatives
States can also use the data to compare their indicators with other states
Challenges
Increased use of cellular telephones
Increased use of call-screening devices
Decreased # of land-line telephones
Availability of the “Do Not Call Registry”
Societal concerns about privacy
Population diversity
Challenges
Strengths of BRFSS
Indicators can be monitored over time
Findings are state-representative
Data can be combined to generate national estimates
Data are timely
Allows comparisons between states
Availability of online query system
Limitations of BRFSS
Data are self-reported
Response rates are generally low and declining
Online query system does allow 2-level stratification of indicators