PolicyMap and Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System, Health Outcome Estimates and Risk Factor Estimates

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Details Chronic health conditions (arthritis, asthma, COPD, depression, diabetes, high blood pressure, hypertension, stroke, heart disease, heart disease and heart attacks), weight (overweight, obesity), self-assessed health status (poor, good, very good/excellent), self-assessed mental and physical health, fruit and vegetable consumption, alcohol consumption, tobacco use, primary doctor, routine checkup within last year, HIV test, flu vaccine
Topics Health-risk behavior, diabetes and related risk factors, physical health, access to health care, perceived health, chronic health conditions
Source 2017 and 2018 CDC Behavioral Risk Factor Surveillance System; 2010 Decennial Census; 2017 and 2018 Census ACS PUMS 5-year estimates; 2009 Metropolitan and Micropolitan Census
Years Available 2017, 2018
Geographies census tract, ZCTA, county, state, nation
Public Edition or Subscriber-only premium subscriber-only
Download Available yes
For more information http://www.cdc.gov/brfss/annual_data/annual_data.htm
Last updated on PolicyMap November 2020

Description:

PolicyMap’s Health Outcome Estimates and Risk Factor Estimates were created using data from the CDC’s Behavioral Risk Factor Surveillance System (BRFSS), the U.S. Census Bureau’s 2010 Decennial Census, 2017 and 2018 ACS PUMS 5-year estimates, and 2009 Metropolitan and Micropolitan Census delineations. The census tract estimates were calculated using a multilevel model with post-stratification based on demographic and geographic characteristics. Predicted responses were then post-stratified using Census population estimates for sex, age, racial/ethnic groups, education attainment, and metro area status. PolicyMap developed this model based on the methods used by the CDC and Robert Wood Johnson Foundation to create the 500 Cities Project data. State and national estimates are calculated directly from the BRFSS survey response data using CDC’s recommended weighting methodology. County estimates were caclulated by aggregating census tract estimates, and may not add up to state totals. Data was suppressed for geographies with adult populations less than 10.

Diabetes and Related Risk Factors: BRFSS includes questions on diabetes and related risk factors, including body mass index (BMI) classification, physical activity, and fruit and vegetable consumption. Respondents were considered to have diabetes if they responded “yes” to the question “Has a doctor ever told you that you have diabetes?” Women who only had diabetes during pregnancy were not included. Both type 1 and type 2 diabetes are included. Respondents were considered obese if their BMI (as determined by height and weight) was 30 or greater. Respondents were overweight if their BMI was 25 or greater. Respondents were asked how many times per day, week, or month they consumed fruit and vegetables, including 100 percent pure fruit juices, green leafy or lettuce salads, potatoes (not including fried potatoes), and other fruit and vegetables. Respondents reporting less than one serving of fruit or vegetable per day were recorded as having a low consumption, and those reporting five or more servings per day as having a high consumption.

Chronic Conditions: The BRFSS survey asks respondents their health status for common chronic conditions. Respondents were asked if a doctor, nurse, or other health professional has ever told them they had the condition. Chronic health conditions selected for PolicyMap include arthritis, asthma, Chronic Obstructive Pulmonary Disease (COPD), depression, high cholesterol, hypertension (high blood pressure), heart disease (coronary heart disease and angina), heart disease and heart attacks, and stroke. COPD, emphysema, and chronic bronchitis are grouped together due to high comorbidity among these conditions. To calculate the estimated asthma rate, survey responses are limited to adults who have been told they currently have asthma; respondents indicating they have formerly received an asthma diagnosis are not included.

Access to Health Care: Survey respondents were asked to report on their access to, and utilization of, health care resources. Respondents were asked to report if there was a person they considered to be their personal doctor or health care provider. To calculate the personal doctor indicator, responses of “Yes, only one” and “More than one” were included. Regular health screenings are recommended by CDC to diagnose and prevent health conditions. Respondents were asked to indicate the length of time since their last routine physical exam or checkup (not an exam for a specific injury, illness, or condition); responses of 12 months or fewer were used to calculate the annual checkup indicator. Respondents were asked if they had received the flu vaccine in the past 12 months, including a shot in the arm or intradermal injection; and nasal spray, mist, or drop. Since 2010, CDC has recommended that all adults be vaccinated for the flu, particularly those at risk of serious complications. To assess the HIV test rate, the BRFSS survey has respondents state if they have ever been tested for HIV. Respondents were asked not to count tests that were part of a blood donation.

Self-Assessed Health: To determine self-assessed (perceived) health, respondents were asked to rate their overall health as poor, fair, good, very good, or excellent. Self-assessed health status can be a reliable estimate of population health and well-being. Respondents were also asked how many days in the last 30 days they experienced poor mental or physical health. Responses of 14 or more poor mental or physical health days were reported.

Health-Risk Behaviors: Health-risk behaviors are those that contribute to negative health outcomes, such as illness or injury. BRFSS includes questions relating to use of tobacco and alcohol products. Risk behaviors can be underreported due to social desirability bias in response to survey questions. To calculate current smoker status, respondents were asked to indicate if they now smoke cigarettes “every day,” “some days,” or “not at all.” Current smokers are considered those who smoke at least some days. Respondents were also asked if they had smoked at least 100 cigarettes (equivalent to five packs) in their lifetime. Current or former smoking status is associated with negative health outcomes. Consumption of alcoholic beverages was assessed by asking respondents how many drinks they consumed during the past 30 days. A drink is equivalent to a 12-ounce beer, 5-ounce glass of wine, or single shot of liquor. The definitions of heavy drinking and binge drinking differ for males and females: heavy drinking for men is more than two drinks per day, and one or more drinks per day for women; binge drinking refers to 5 or more drinks per occasion for men, and four or more drinks per occasion for women.

Available Data Layers & Indicators (27)
Estimated percent of adults ever diagnosed with a stroke in 2018.
Estimated percent of adults ever diagnosed with arthritis in 2018.
Estimated percent of adults ever diagnosed with chronic obstructive pulmonary disease, emphysema, or chronic bronchitis in 2018.
Estimated percent of adults ever diagnosed with depression in 2018.
Estimated percent of adults ever diagnosed with diabetes in 2018.
Estimated percent of adults ever diagnosed with heart disease in 2018.
Estimated percent of adults ever diagnosed with heart disease or a heart attack in 2018.
Estimated percent of adults ever diagnosed with high blood pressure (hypertension) in 2017.
Estimated percent of adults ever diagnosed with high cholesterol in 2017.
Estimated percent of adults ever tested for HIV in 2018.
Estimated percent of adults reporting a physical checkup in the past year in 2018.
Estimated percent of adults reporting fair or poor health in the past 30 days in 2018.
Estimated percent of adults reporting fourteen or more days of poor mental health in the past 30 days in 2018.
Estimated percent of adults reporting fourteen or more days of poor physical health in the past 30 days in 2018.
Estimated percent of adults reporting to be obese (a body mass index of 30 or greater) in 2018.
Estimated percent of adults reporting to be overweight (a body mass index greater than 24.9) in 2018.
Estimated percent of adults reporting to be physically inactive in the past 30 days in 2017.
Estimated percent of adults reporting to eat five or more servings of fruit/vegetables per day in 2017.
Estimated percent of adults reporting to eat five or more servings of fruit/vegetables per day in 2018.
Estimated percent of adults reporting to eat less than one serving of fruit/vegetables per day in 2017.
Estimated percent of adults reporting to eat less than one serving of fruit/vegetables per day in 2018.
Estimated percent of adults reporting to engage in heavy drinking in 2018.
Estimated percent of adults reporting to have a personal doctor or health care provider in 2018.
Estimated percent of adults reporting to have asthma in 2018.
Estimated percent of adults reporting to meet physical activity recommendations in the past 30 days in 2017.
Estimated percent of adults reporting very good or excellent health in the past 30 days in 2018.
Estimated percent of adults vaccinated for the flu in the past year in 2018.