HEALTHY PEOPLE 2020 MIDCOURSE REVIEW

CHAPTER II

Reader’s GuideIntroduction II–2SelectedFindings II–2

FigureII–1.ExampleofSelectedFindingsfromChapter21:HeartDiseaseandStroke II–2ObjectiveandDataSourceTable II–2

FigureII–2.ExampleObjectiveandDataSourceTablefromChapter10:EarlyandMiddleChildhood II–3

MidcourseProgressTableforMeasurableObjectives II–3FigureII–3.AssessmentofMidcourseProgressforMeasurableObjectives II–4FigureII–4.ExampleMidcourseProgressTablefromChapter36:RespiratoryDiseases II–5

MidcourseHealthDisparitiesTableforPopulation-basedObjectives II–6FigureII–5.ExampleMidcourseHealthDisparitiesTablefromChapter4:BloodDisordersandBloodSafety II–7

MidcourseMaps II–8FigureII–6.ExampleMidcourseMapComparingStatestotheNationalTarget II–8FigureII–7.ExampleMidcourseMapThatDoesNotCompareStatestotheNationalTarget II–9

SuggestedCitation II–9

II–2 HEALTHYPEOPLE2020MIDCOURSEREVIEW

Introduction

ThisGuideprovidesinformationforunderstandingandinterpretingdatapresentedintheHealthyPeople2020MidcourseReview,specificallyinChapterIV:LeadingHealthIndicatorsandChapters1–42,thetopicareachapters.Thesechaptersincludetexthighlightingselectedmidcoursefindings,aswellasthefollowingmidcoursetablesandmaps,asapplicable:

� Objectiveanddatasourcetable,� Midcourseprogresstableformeasurableobjectives,� Midcoursehealthdisparitiestableforpopulation-basedobjectives,and� Stateorcountylevelmapsforselectedobjectives.

Selected Findings

Selectedfindingshighlighttheprogressofobjectivesthatmetorexceededthe2020targets,wereimproving,orweregettingworseatmidcourse(FigureII–1).Objectivesthatdemonstratedlittleornodetectablechangegenerallyarenothighlighted.However,allobjectiveswithmidcoursehealthdisparitiesdataoramaparehighlighted.

Objective and Data Source Table

Anobjectiveisidentifiedbyitstopicareaabbreviationandanobjectivenumber(FigureII–2).Forinstance,EMC-1isthefirstobjectiveintheEarlyandMiddleChildhoodTopicArea.MeasurableobjectiveshadanationalbaselinevalueasoftheMidcourseReview.Thetrafficlighticon ,disparitiesicon ,andmapicon

indicatetheavailabilityofobjectivedatainthechapter’smidcourseprogresstable,themidcoursehealthdisparitiestable,oramap,respectively.

Midcoursedataavailabilityisnotapplicableforobjectivesmarkedas“Developmental”or“Archived.”AsoftheMidcourseReview,developmentalobjectivesdidnothaveanationalbaselinevalueandarchivedobjectiveswerenolongerbeingmonitoredduetolackofdatasource,changesinscience,orreplacementwithotherobjectives.Datasourcesfordevelopmentalobjectivesorarchivedobjectivesthatwerepreviouslydevelopmentalaremarkedas“Potential.”

Selected Findings

Heart Disease and Stroke Mortality� Theage-adjustedrateofcoronary heart disease deaths(HDS-2)declinedfrom129.2per100,000populationin2007to102.6in2013,exceedingthe2020target(Table21–2).» In2011–2013,age-adjustedcoronaryheartdiseasedeathrates(HDS-2)variedbycounty.Therewere1,315counties(outof3,131totalwithreliabledata)thatmetorexceededthenationaltarget(Map21–1).

» In2013,therewerestatisticallysignificantdisparitiesbysex,raceandethnicity,andgeographiclocationintheage-adjustedrateofcoronaryheartdiseasedeaths(Table21–3,HDS-2).

Bulletreportingobjectiveprogressstatusatmidcourse

Bulletindicatingthatamapisavailable

Bulletreportingwhetherhealthdisparities,ifapplicable,werestatisticallysignificant

Figure II–1. Example of Selected Findings from Chapter 21: Heart Disease and Stroke

ChapterII•Reader’s Guide II–3

Midcourse Progress Table for Measurable Objectives

Assessmentofanobjective’smidcourseprogressdependedonseveralfactors,includingtheavailabilityofabaselineormidcoursedatapoint,atarget,thedirectionofmovement,thepercentageofchangefromthebaselineortowardthetarget,theavailabilityofstandarderrors,andstatisticalsignificance(FigureII–3).

TheTechnicalNotesprovidemoreinformationontheHealthyPeople2020measuresofprogress.

Eachchapter’sMidcourseProgressTable(FigureII–4)includesiconsindicatinganobjective’sstatusatmidcourse,aswellastheobjectivedataandprogressassessmentdetails.

Explanation of the Midcourse Progress Table� ObjectiveRD-1.1isinformational ( ).» Findings:Therateofasthmadeathsamongchildrenandadultsunderage35yearswas3.4permillionpopulationin2007.In2013,theratewas3.7permillionpopulation.Thisobjectiveisinformationalonlyandno2020targethasbeenset.

» Progressassessment:Atargetwasnotsetforthisobjective,soprogresstowardtargetattainmentcouldnotbeassessed.

� ObjectiveRD-1.2wasgetting worse( ).» Findings:Therateofasthmadeathsamongadultsaged35–64increasedbetween2007and2013,from11.0to12.0permillionpopulation,movingawayfromthebaselineand2020targetof4.9permillionpopulation.

Objective Number Objective Statement Data Sources

Midcourse Data Availability

EMC-1 (Developmental) Increase the proportion of children who are ready for school in all five domains of healthy development: physical development, social-emotional development, approaches to learning, language, and cognitive development

(Potential) National Survey of Children’s Health (NSCH), HRSA/MCHB and CDC/NCHS Not Applicable

EMC-2.1 (Archived) Increase the proportion of parents who report a close relationship with their child

(Potential) National Survey of Adoptive Parents (NSAP), ASPE; National Survey of Children’s Health (NSCH), HRSA/MCHB and CDC/NCHS

Not Applicable

EMC-2.2 Increase the proportion of parents who use positive communication with their child

National Survey of Children’s Health (NSCH), HRSA/MCHB and CDC/NCHS

EMC-2.3 Increase the proportion of parents who read to their young child

National Survey of Children’s Health (NSCH), HRSA/MCHB and CDC/NCHS

Table 10–1. Early and Middle Childhood ObjectivesLEGEND

Data for this objective are available in this chapter’s Midcourse Progress Table.

Disparities data for this objective are available, and this chapter includes a Midcourse Health Disparities Table.

A state or county level map for this objective is available at the end of the chapter.

Not ApplicableMidcourse data availability is not applicable for developmental and archived objectives. Developmental objectives did not have a national baseline value. Archived objectives are no longer being monitored due to lack of data source, changes in science, or replacement with other objectives.

Figure II–2. Example Objective and Data Source Table from Chapter 10: Early and Middle Childhood

II–4 HEALTHYPEOPLE2020MIDCOURSEREVIEW

Little or no detectable changeObjectives that did not meet any of the previous criteria demonstrated little or no detectable change.

The objective was not measurable. Therefore, progress could not be assessed and the objective was not included in the midcourse progress table.

InformationalProgress toward the target could not be assessed.

Baseline onlyProgress toward the target could not be assessed.

Target met or exceededThe midcourse value was equal to or exceeded the target.

ImprovingMovement was toward the target and the percentage of targeted change achieved was statistically significant, or the objective had achieved 10% or more of the targeted change, if standard errors were not available.

Getting worseMovement was away from the baseline and target and the percentage change relative to the baseline was statistically significant, or the objective had moved 10% or more relative to the baseline, if standard errors were not available.

No

Yes

Yes

Yes

Yes

Yes

Yes

No

No

No

No

No

No

Was a 2020 targetavailable?

Was amidcourse data point

available?

Was the target met or exceeded?

Was the objectiveimproving?

Was the objective getting worse?

Wasa national baseline

value available?

Objective

Figure II–3. Assessment of Midcourse Progress for Measurable Objectives

ChapterII•Reader’s Guide II–5

Objective Description

Baseline Value (Year)

Midcourse Value (Year) Target

Movement Toward Target

Movement Away From Baseline

Movement Statistically Significant

Asthma

RD-1.1 Asthma deaths among children and adults (per million population, <35 years)

3.4 (2007)

3.7 (2013)

RD-1.2 Asthma deaths among adults (per million population, 35–64 years)

11.0 (2007)

12.0 (2013)

4.9 9.1%  

Yes

RD-1.3 Asthma deaths among adults (per million population, 65+ years)

43.4 (2007)

35.7 (2013)

21.5 35.2% Yes

RD-2.1 Hospitalizations for asthma among children (per 10,000 population, <5 years)

41.4 (2007)

33.1 (2010)

18.2 35.8% No

RD-7.1 Persons with asthma receiving written asthma plans from health care providers (age-adjusted, percent)

33.4% (2008)

40.5% (2013)

36.8% 208.8% Yes

RD-7.6 Persons with asthma who have had at least one routine medical follow-up visit in the past 12 months (age-adjusted, percent)

57.2% (2013)

60.4%

Table 36–2. Midcourse Progress for Measurable Respiratory Diseases Objectives

LEGEND

Target met or exceeded Improving Little or no

detectable change Getting worse Baseline only

Informational

» Progressassessment:Therateofasthmadeathsamongadultsaged35–64increasedby1.0permillionpopulation(12.0minus11.0).Themovementawayfromthebaseline,measuredusingthemagnitude of percentage change from the baseline,was9.1%(1.0dividedby11.0).Themagnitudeofpercentagechangefromthebaselinewasstatisticallysignificant;therefore,theobjectiveissaidtohaveworsened.

� ObjectiveRD-1.3wasimproving( ).» Findings:Between2007and2013,therateofasthmadeathsamongadultsaged65andoverdecreasedfrom43.4to35.7permillionpopulation,movingtowardthe2020targetof21.5permillionpopulation.

» Progressassessment:Therateofasthmadeathsamongadultsaged65andoverdecreasedby7.7permillionpopulation(43.4minus35.7).Thedifferencebetweenthebaselineand2020targetwas21.9permillionpopulation(43.4minus21.5).Themovement

towardthetarget,measuredusingthepercent of targeted change achieved,was35.2%(7.7dividedby21.9).Thepercentoftargetedchangeachievedwasstatisticallysignificant;therefore,theobjectiveissaidtohaveimproved.

� ObjectiveRD-2.1demonstratedlittle or no detectable change( ).» Findings:Therateofhospitalizationsforasthmaamongchildrenunderage5yearsdemonstratedlittleornodetectablechangefrom2007to2010(41.4and33.1per10,000population,respectively).

» Progressassessment:Therateofhospitalizationforasthmaamongchildrenunderage5yearsdecreasedby8.3per10,000population(41.4minus33.1).Thedifferencebetweenthebaselineand2020targetwas23.2per10,000population(41.4minus18.2).Themovementtowardthetarget,measuredusingthepercent of targeted change achieved,was35.8%(8.3dividedby23.2).Thepercentoftargetedchangeachievedwasnot

Figure II–4. Example of Midcourse Progress Table from Chapter 36: Respiratory Diseases

II–6 HEALTHYPEOPLE2020MIDCOURSEREVIEW

statisticallysignificant;therefore,theobjectiveissaidtohavedemonstratedlittleornodetectablechange.

� ObjectiveRD-7.1met or exceededthe2020target( ).» Findings:Between2008and2013,theage-adjustedproportionofpersonswithasthmareceivingwrittenasthmaplansfromhealthcareprovidersincreasedfrom33.4%to40.5%,exceedingthe2020targetof36.8%.

» Progressassessment:In2013,theage-adjustedproportionofpersonswithasthmawhoreceivedwrittenasthmaplansfromhealthcareprovidersexceededthetargetof36.8%.Therefore,theobjectiveissaidtohavemetorexceededthe2020target.The7.1percentagepointincrease(40.5%minus33.4%),dividedbythe3.4percentagepointdifferencebetweenthebaselineandtarget(36.8%minus33.4%),resultsin208.8%oftargetedchangeachieved.Thepercentoftargetedchangeachievedwasstatisticallysignificant.

» Note:Fortheobjectivesthatmetorexceededthetargetatbaseline,thepercentoftargetedchangeachievedisnotshownintheMidcourseProgressTable.

� ObjectiveRD-7.6had baseline onlydata( ).» Findings:In2013,theage-adjustedproportionofpersonswithasthmawhohadatleastoneroutinemedicalfollow-upvisitinthepast12monthswas57.2%.Datawerenotavailablebeyondthebaseline,soprogresstowardthe2020targetcouldnotbeassessed.

» Progressassessment:Theobjectiveonlyhadonedatapoint,soprogresstowardtargetattainmentcouldnotbeassessed.

Midcourse Health Disparities Table for Population-based Objectives

ThemostcommonlyreportedpopulationgroupsinHealthyPeople2020aredefinedbythefollowingcharacteristics:sex,raceandethnicity,educationalattainment,familyincome,disabilitystatus,andgeographiclocation.Populationcharacteristicsandgroupsmayvarybydatasourceorbyobjectiveduetosurveydesign,datacollectionconstraints,orotherconsiderations.TheTechnicalNotesprovidemoreinformationontheseissues.

Midcoursehealthdisparitieswereassessedusingthesummarydisparityratioatthemidcoursedatapointwheredatawereavailable.Forobjectiveswithbaselinedataonly,thesummarydisparityratiowasexaminedatbaseline.Thesummarydisparityratioisaratiocomparingthemostfavorablegroupratetotheaverageratefortheothergroups.Whentherewereonlytwogroups(e.g.,maleandfemale),thesummarydisparityratiowassimplytheratioofthehighertothelowerrate.Statisticalsignificanceofthesummarydisparityratiowascalculatedwhenstandarderrorswereavailable(FigureII–5).

IntheMidcourseHealthDisparitiesTable:

� Bluecells( )indicatethepopulationgroupwiththemostfavorable(leastadverse)rate.� Redcells( )indicatethepopulationgroupwiththeleastfavorable(mostadverse)rate.� Greycells( )indicatethatdataareavailable,butthispopulationgroupdidnothavethehighestorlowestrate.� Whitecells( )indicatethatdatawerenotavailableforthisgroup.� Letteredfootnotes(e.g.,a,b,c)indicatecellswherethepopulationgroupisdifferentfromthecolumnlabel.Pleaseseethefootnotesattheendofthetopicareachapters’MidcourseHealthDisparitiesTables.� Anasterisk(*)indicatessummarydisparityratiosthatwerestatisticallysignificant.� Adagger(†)indicatessummarydisparityratiosthatwerenottestedforstatisticalsignificance.� Summarydisparityratioswithneitheranasterisknoradaggerwerenotstatisticallysignificant.

Explanation of the Midcourse Health Disparities Table� ObjectiveBDBS-15disparityby sex:» Findings:In2014,thedisparitybysexintheproportionofpersonswithvonWillebranddisease(VWD)seeninspecialtycarecenterswhowerediagnosedbyage21wasnottestedforstatisticalsignificance.

» Redandbluecellinterpretation:In2014,amongpersonswithVWDseeninspecialtycarecenters,themalepopulationhadthehigherandmorefavorable( )proportionofpersonswhowerediagnosedbyage21,whereasthefemalepopulationhadthelowerandlessfavorable( )proportion.

ChapterII•Reader’s Guide II–7

» Summarydisparityratiointerpretation:TheproportionofmaleswithVWDseeninspecialtycarecenterswhowerediagnosedbyage21was1.304times,or30.4%greaterthan,theproportionoffemaleswithVWDseeninspecialtycarecenterswhowerediagnosedbyage21.Thesummarydisparityratiowasnottestedforstatisticalsignificance,becausestandarderrorsofthedatawerenotavailable.

� ObjectiveBDBS-16disparity by race:» Findings:In2008,thedisparitybyraceintheproportionofpersonswithhemophiliawhodevelopedreducedjointmobilityduetobleedingintojointswasnotstatisticallysignificant.

» Footnoteinterpretation:Footnoteaoverridesthe“Black,notHispanic”and“White,notHispanic”columnlabelsandindicatesthatthedataforthosecellsincludepersonsofHispanicorigin.

» Blue,red,andwhitecellinterpretation:In2008,amongpersonswithhemophilia,theblackpopulationhadthelowerandmorefavorable( )proportionofpersonswhodevelopedreducedjointmobilityduetobleedingintojoints,whereasthe

whitepopulationhadthehigherandlessfavorable( )proportion.Datawerenotavailable( )forotherracialandethnicgroups.

» Summarydisparityratiointerpretation:Theproportionofthewhitepopulationwithhemophiliawhodevelopedreducedjointmobilityduetobleedingintojointswas1.029times,or2.9%greaterthan,theproportionoftheblackpopulationwithhemophiliawhodevelopedreducedjointmobilityduetobleedingintojoints.Thesummarydisparityratiowasnotstatisticallysignificant.

� ObjectiveBDBS-17disparity by family income:» Findings:In2010,thedisparitybyfamilyincomeintheage-adjustedproportionofpersonsaged18andoverwhodonatedbloodwasstatisticallysignificant.

» Footnoteinterpretation:Footnote2onthefamilyincomecolumnindicatesthatthepoor,near-poor,middle,near-high,andhighincomegroupsareforpersonswhosefamilyincomeswerelessthan100%,100%–199%,200%–399%,400%–599%,andatorabove600%ofthepovertythreshold,respectively.

Figure II–5. Example Midcourse Health Disparities Table from Chapter 4: Blood Disorders and Blood Safety

Table 4–3. Midcourse Health Disparities for Population-based Blood Disorders and Blood Safety Objectives

Mostfavorable(leastadverse)andleastfavorable(mostadverse)groupratesandsummarydisparityratiosforselectedcharacteristicsatthemidcoursedatapoint

Population-based Objectives

Characteristics and Groups

Sex Race and Ethnicity Education1 Family Income2 Disability LocationM

ale

Fem

ale

Sum

mar

y Di

spar

ity R

atio

Amer

ican

Indi

an o

r Ala

ska

Nativ

e

Asia

n

Nativ

e Ha

wai

ian

or o

ther

Pac

ific

Isla

nder

Two

or m

ore

race

s

Hisp

anic

or L

atin

o

Blac

k, n

ot H

ispa

nic

Whi

te, n

ot H

ispa

nic

Sum

mar

y Di

spar

ity R

atio

Less

than

hig

h sc

hool

High

sch

ool g

radu

ate

At le

ast s

ome

colle

ge

Asso

ciat

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egre

e

4-ye

ar c

olle

ge d

egre

e

Adva

nced

deg

ree

Sum

mar

y Di

spar

ity R

atio

Poor

Near

-poo

r

Mid

dle

Near

-hig

h

High

Sum

mar

y Di

spar

ity R

atio

Pers

ons

with

dis

abili

ties

Pers

ons

with

out d

isab

ilitie

s

Sum

mar

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spar

ity R

atio

Met

ropo

litan

Nonm

etro

polit

an

Sum

mar

y Di

spar

ity R

atio

Bleeding and Clotting

BDBS-15 Persons with von Willebrand disease (VWD) diagnosed by 21 years of age (percent) (2014) 1.304† 1.178†

BDBS-16 Persons with hemophilia and reduced joint mobility due to bleeding into joints (percent) (2008) 1.242* a a 1.029

Blood Safety

BDBS-17 Persons donating blood (age-adjusted, percent, 18+ years) (2010) 1.130* 2.121* 1.756* 1.722* 2.137* 1.026

LEGEND

At the midcourse data point Group with the most favorable (least adverse) rate

Group with the least favorable (most adverse) rate

Data are available, but this group did not have the highest or lowest rate.

Data are not available for this group because the data were statistically unreliable, not collected, or not analyzed.

1Unless otherwise footnoted, data do not include persons under age 25 years.2Unless otherwise footnoted, the poor, near-poor, middle, near-high, and high income groups are for persons whose family incomes were less than 100%, 100%–199%, 200%–399%, 400%–599%, and at or above 600% of the poverty threshold, respectively. aData include persons of Hispanic origin.

II–8 HEALTHYPEOPLE2020MIDCOURSEREVIEW

» Blue,red,andgreycellinterpretation:In2010,adultswithfamilyincomesatorabove600%ofthepovertythresholdhadthehighestandmostfavorable( )age-adjustedblooddonationrate,whereasthosewithfamilyincomeslessthan100%ofthepovertythresholdhadthelowestandleastfavorable( )rate.Datawereavailableforadultswithfamilyincomesat100%–199%,200%–399%,and400%–599%ofthepovertythreshold;however,thesepopulationgroupsdidnothavethehighestorlowestrates( ).

» Summarydisparityratiointerpretation:Theage-adjustedblooddonationrateamongadultswhosefamilyincomeswereatorabove600%ofthepovertythresholdwas1.722times,or72.2%greaterthan,theaveragerateforadultsintheotherfamilyincomegroups.Theaverageratewascalculatedbyaddingtheratesforthegroupswhose

familyincomewaslessthan100%,100%–199%,200%–399%,and400%–599%,andthendividingbyfour,thenumberofgroups.Thesummarydisparityratiowasstatisticallysignificant.

Midcourse Maps

Midcourse Maps Comparing States or Counties to the National TargetMidcoursemapsprovidestateorcountyleveldatarelatedtoselectedobjectives.Thestateorcountydatawerecomparedwiththenationaltargetwhenthestateorcountyleveldatasourceandmeasurewerethesameasthatofthenationalobjective.Forexample,FigureII–6showschildhoodimmunizationratesbystateusingthesamedatasourceasthatofthenationalobjective,

Figure II–6. Example Midcourse Map Comparing States to the National Target

Map 23–2. Children (19–35 months) Receiving 1+ Doses of Measles-Mumps-Rubella (MMR) Vaccine, by State: 2014

HealthyPeople2020ObjectiveIID-7.4•NationalTarget=90.0%•NationalRate=91.5%

NOTES: Data are for children aged 19–35 months who received at least 1 dose of the combination of measles, mumps, and rubella antigens in 2014. Data are displayed by a modified Jenks classification for U.S. states which creates categories that minimize within-group variation and maximize between-group variation. The Technical Notes provide more information on the data and methods.

DATA SOURCE: National Immunization Survey (NIS), CDC/NCIRD and CDC/NCHS

TX

CA

AZ

NV

NM

IL

KS

IANE

SD

ND

FL

OK

MO

GAAL

AR

LA

NY

NC

MS

VAKY

OH

SC

AK

Percent

States shown in greenmet the national target.

84.1–86.486.5–88.288.3–89.990.0–100.0

MT

ID

CO

OR

UT

WY

MN

WI

WA

MI

IN

PA

TN

WV

CT

HI

ME

VTNH

MA

MDNJ

RI

DEDC

ChapterII•Reader’s Guide II–9

theNationalImmunizationSurvey.Therefore,stateimmunizationrateswerecomparedtothenationaltarget:statesthatmetorexceededthenationaltargetareshowningreen.

Other Midcourse Maps Whencomparisonsbetweenthestateandnationaldatacouldbemisleadingduetodifferencesindatasources,thestatedatawerenotcomparedwiththenationaltarget.Forexample,FigureII–7showsadultobesityratesbystate.Thenationaltargetdoesnotapplysincethenationalandstatedataarefromdifferentsources,theNationalHealthandNutritionExaminationSurvey(NHANES)andtheBehavioralRiskFactorSurveillanceSystem(BRFSS),respectively.Inaddition,thenationalobjectivedataandtargetarebasedonmeasuredheight

andweight,whilethestatedataarebasedonself-reportedheightandweight.Becauseofthesedifferences,nationalandstatedatamaynotbecomparableandthestatedatawerenotcomparedwiththenationaltarget.

Thenotessectionofthemapprovidesmoreinformationregardingissuesthatmaypreventcomparisonsbetweenthestateandnationaldata.

TheTechnicalNotesprovidemoreinformationonthemappingmethodsusedintheMidcourseReview.

Suggested Citation

NationalCenterforHealthStatistics.ChapterII:Reader’sGuide.HealthyPeople2020MidcourseReview.Hyattsville,MD.2016.

Map 29–1. Adult (20+ years) Obesity Based on Self-reported Weight and Height, by State: 2013

HealthyPeople2020ObjectiveNWS-9●RelatedStateData

TX

CA

MT

AZ

ID

NV

NM

CO

OR

UT IL

WY

KS

IANE

SD

MN

ND

FL

OK

WI

MO

WA

GAAL

MI

AR

IN

LA

NY

NC

PA

MS

TN

VAKY

OH

SC

ME

WV

VT NH

CT

Percent21.3–25.3 25.4–28.128.2–31.031.1–33.533.6–35.6AK

HI

MA

NJMD

DCDE

RI

NOTES: Data are for adults aged 20 and over with obesity, defined as a body mass index at or above 30.0 kg/m2, and are age-adjusted to the 2000 standard population. National data for the objective are based on measured weight and height from the National Health and Nutrition Examination Survey (NHANES) and are the basis for setting the national target of 30.5%. State data from the Behavioral Risk Factor Surveillance System (BRFSS) are based on self-reported weight and height. Data from the NHANES (35.3% in 2009–2012) may not be directly comparable to the all-states combined data from the BRFSS (28.6% in 2013), and therefore the national target may not be applicable to individual states. Data are displayed by a Jenks classification for U.S. states which creates categories that minimize within-group variation and maximize between-group variation. The Technical Notes provide more information on the data and methods.

DATA SOURCE: Behavioral Risk Factor Surveillance System (BRFSS), CDC/NCCDPHP

Figure II–7. Example Midcourse Map That Does Not Compare States to the National Target