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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 Evaluation Massachusetts Department of Public Health December 2004. What is the BRFSS?.
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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 Evaluation Massachusetts Department of Public Health December 2004
What is the BRFSS? • Random digit dial telephone survey • Adults ages 18 and older • Collaboration between CDC and States • Massachusetts BRFSS since 1986 • Data are weighted: provide population-based estimates of health • Sample Size: 7,000 - 8,000 annually Source: Massachusetts BRFSS
NUTRITION & EXERCISE CANCER SCREENING HEALTH CARE ACCESS TOBACCO WEIGHT BRFSS DRUG &ALCOHOL INJURY DIABETES 50 OTHER TOPICS ASTHMA CHOLESTEROL Source: Massachusetts BRFSS
Flu Vaccination Overweight or Obesity Tobacco Use Binge Drinking Mammogram HIV Testing Topics to be covered
Trend in the percentage of adults, ages 65+, who have had a flu vaccine in the past year, 1993-2003 Source: Massachusetts BRFSS Note: Dotted line signifies year in which question was not asked.
Percentage of adults who received a flu or pneumonia vaccine by race/ethnicity, 2001-2003 Source: Massachusetts BRFSS
MDPH Program HighlightsImmunization Program • 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 • Standing Orders Project to vaccinate hospital in-patients • Flu vaccination of health care workers Source: MDPH Immunization Program
Adult Overweight or Obese by Height 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 Source: Massachusetts BRFSS *BMI (Body Mass Index): weight in kilograms height in meters squared
Adult Overweight or Obese by Height Overweight Obese HeightBMI* 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 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 Source: Massachusetts BRFSS
Percentage of adults who are obese, by sex and race/ethnicity, 2003 Source: Massachusetts BRFSS Rates are age adjusted to the US 2000 standard population.
MDPH Program Highlights: Massachusetts Overweight Prevention and Control Initiative (MOPCI) • Statewide: partnering with public and private organizations to coordinate overweight prevention and control efforts • Communities: working with communities to implement walk/bike to school and work initiatives • Schools: working with schools to increase student awareness and participation in healthy eating and physical activity before, during, and after school • Worksites: working with employers to support improved nutrition and increased participation in physical activity for their employees Source: Massachusetts Overweight Prevention and Control Initiative
Trend in the percentage of women, ages 40+, who had a mammogram in past 2 years, 2003 Source: Massachusetts BRFSS Note: Dotted line signifies year in which question was not asked.
Trend in the percentage of women, ages 40+, who had a mammogram in past 2 years by insurance status, 2003 * 2000 data only Source: Massachusetts BRFSS
Percentage of women, ages 40+, who had a mammogram in the past 2 years, by disability status, 2003 Source: Massachusetts BRFSS Rates are age adjusted to the US 2000 standard population.
MDPH Program Highlights:Breast Cancer Screening • Increase in mammograms among women ages 40+ after program inception. • Better access to care needed for people with disabilities. • More outreach needed to Hispanic women. Source: Massachusetts Women’s Health Network
Trend in the percentage of binge drinkers among adults, 1990-2003 Source: Massachusetts BRFSS Note: Dotted line signifies year in which question was not asked.
Percentage of binge drinkers among adults, by household income, 2003 Source: Massachusetts BRFSS
MDPH Program Highlights:Binge Drinking • MA monitors binge drinking because of the associated high risk behaviors • 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)). • Both BRFSS and NSDUH show similar patterns by demographic group. • 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
Percentage of current smokers among adults, 1986-2003 Source: Massachusetts BRFSS
Percentage of current smokers among adults and young adults, 1986-2003 Source: Massachusetts BRFSS
Percentage of current smokers among adults, by household income, 1986-2003 Source: Massachusetts BRFSS
MDPH Program Highlights:Tobacco Control Program • Implementation of smokefree workplace laws • Monitoring illegal cigarette sales to minors via statewide compliance check program • Working with health care systems to determine smoking status of patients and refer smokers to quit line • 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
Percentage of adults, ages 18-64, who report ever being tested for HIV, by risk status, 1993-2003 100 80 60 % ever tested 40 20 0 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 ever tested ever tested and high risk behavior Source: Massachusetts BRFSS
MDPH Program HighlightsHIV/AIDS Bureau Counseling and Testing Program • The general population have multiple opportunities for HIV testing, including private health care and life insurance application processes. • Publicly funded HIV testing and counseling programs are required to identify and target high risk populations for testing. • Public and clinical education programs emphasize the importance of knowing one’s risk and HIV testing as the point of access to HIV care. • 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. • 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
Summary • Important to examine trends to inform program development • 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 Report • Overall health measures: health status, quality of life • Access and Utilization: insurance coverage, access to care • Risk factors and preventive behaviors: physical activity, nutrition, hypertension, cholesterol awareness • Chronic conditions: diabetes, CVD, asthma, disability • Cancer screening • Childhood health: dental sealant, access to care, asthma • 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