Surveillance of Chronic Disease-Related Health Behaviors

1. Surveillance of Chronic Disease-Related Health Behaviors Dr. Robin Vanderpool Research Assistant Professor UK College of Public Health Dept of Health Behavior September 23, 2008 CPH 711 Chronic Epidemiology

4. Behavioral Surveillance • Personal health behaviors play a major role in premature morbidity and mortality. • Tobacco use • Alcohol use • Diet • High cholesterol, obesity • Physical inactivity • Obesity, high blood pressure • Stress • Cancer screenings • Asthma management • Immunizations • Medication compliance Actual causes of ~40% of all deaths

5. Chronic Epi text, Figure 3.2, pg. 57 Health Risk Factors Chronic Conditions Chronic Diseases Death

6. Behavioral Surveillance • Monitor trends in risk factors / health behaviors / health practices = PREVALENCE • Person, place, time • Capacity for data collection, analysis, and dissemination • Identify groups of people at-risk for chronic disease or who experience fewer benefits from interventions = health disparities • Develop accurate communication / targeted messages

7. Behavioral Surveillance • Design relevant and appropriate interventions • Inform our prevention efforts at all three levels • Primary • Ex. Smoking prevention & cessation • Secondary • Ex. Mammography • Tertiary • Ex. Diabetic foot and eye exams • Measure the effect of program interventions and policies = evaluation • Identify new emerging risk factors / behaviors that influence chronic disease

8. Behavioral Surveillance • Usually based on self-report; telephone or in-person surveys • Primarily quantitative data, population-based • Who, what, when, where • Person, place, time • Qualitative data, individual-focused • Why and how

9. Chronic Disease Indicators • Cross-cutting set of 90 indicators that were developed by consensus and that allows states and territories to uniformly define, collect, and report chronic disease data that are: • Important to public health practice • Available at the state level

10. Chronic Disease Indicators • CDI are divided into 7 categories that represent a wide spectrum of conditions and risk factors as well as social context: • Physical activity and nutrition • Tobacco and alcohol use • Cancer • Cardiovascular disease • Diabetes • Overarching conditions (e.g., poverty, life expectancy, health insurance, HS education) • Other diseases and risk factors (e.g., asthma, COPD, end-stage renal disease, oral health)

11. Behavioral Risk Factor Surveillance System (BRFSS) • CDC program • World’s largest, on-going telephone health survey system • Administered at the state level • www.cdc.gov/brfss

12. Behavioral Risk Factor Surveillance System (BRFSS) • Collects information on health risk behaviors, preventive health practices, and health care access primarily related to chronic disease and injury • Identify emerging health problems, establish and track health objectives, and develop and evaluate public health policies and programs

21. Youth Behavioral Risk Surveillance System (YRBSS) • CDC program • Developed in 1990 to monitor priority health risk behaviors that contribute markedly to the leading causes of death, disability, and social problems among youth and adults in the US • http://www.cdc.gov/HealthyYouth/yrbs/index.htm

22. YRBSS (cont.) • Determine the prevalence of health risk behaviors. • Collect trend data. • Examine the co-occurrence of health risk behaviors. • Provide comparable national, state, & local data. • Provide comparable data among subpopulations of youth. • Monitor progress toward achieving the Healthy People 2010 objectives and other program indicators.

23. Percentage of High School Students Who Drank > 3 Glasses/Day of Milk,* by Sex** & Race/Ethnicity,*** 2005 * During the 7 days preceding the survey ** M > F*** W > H > B National Youth Risk Behavior Survey, 2005

24. National Health Interview Survey (NHIS) • CDC program • Principal source of information on the health of the civilian, non-institutionalized population of the US • Monitor trends in illness and disability and to track progress toward achieving national health objectives.

25. NHIS (cont.) • Used by the public health research community for epidemiologic and policy analysis of such timely issues as characterizing those with various health problems, determining barriers to accessing and using appropriate health care, and evaluating Federal health programs. • Estimates are presented for selected chronic conditions and mental health characteristics, functional limitations, health status, health behaviors, health care access and utilization, and HIV testing

30. Additional CDC Behavioral Surveillance Activities • National Health and Nutrition Examination Survey (NHANES) • National Survey of Family Growth • National Immunization Survey • National Asthma Survey • National Survey of Children’s Health • National Health Interview Survey on Disability • Aging Studies

31. NCI’s Health Information National Trends Survey (HINTS) • Provides updates on changing patterns, needs, and information opportunities in health • Identifies changing communications trends and practices • Assesses cancer information access and usage • Provides information about how cancer risks are perceived • Offers a testbed to researchers to test new theories in health communication

36. Healthy People 2010 • Provides a framework for prevention for the Nation. • Statement of national health objectives designed to identify the most significant preventable threats to health and to establish national goals to reduce these threats.  • Two goals: Increase quality and years of healthy life & eliminate health disparities

41. Questions? Contact Information: Robin Vanderpool, DrPH, CHES robin@cis.uky.edu 219-9063 ext. 7467