Source: Massachusetts BRFSSPrepared by: Health Survey Program
Using the BRFSS to Track Healthy People 2010 Objectives
Highlights from the 2004 Massachusetts Behavioral Risk Factor Surveillance System
Health Survey Program
Center for Health Information, Statistics, Research, and Evaluation
Center for Community Health
Massachusetts Department of Public Health
March 2006
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Source: Massachusetts BRFSSPrepared by: Health Survey Program
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
• 2004 Sample Size: 8,203
2
Source: Massachusetts BRFSSPrepared by: Health Survey Program
BRFSS
TOBACCO
CANCER CONTROL
DRUG &ALCOHOL
DISABILITYDIABETES
OBESITY/ OVERWEIGHT
ORAL HEALTH
HEALTH CARE ACCESS
WOMEN’S HEALTHQUALITY OF LIFE
50 OTHER TOPICS
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Source: Massachusetts BRFSSPrepared by: Health Survey Program
HP2010 Objectives Tracked by BRFSS
• Risk Factors– Smoking– Binge drinking
• Use of Preventive Services– Immunization– Cancer screening
• Health Care– Personal health care
provider
• Conditions– Diabetes– Obesity
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Source: Massachusetts BRFSSPrepared by: Health Survey Program
Massachusetts and HP2010
MA % US% HP2010 %
Current Smoker 18.5 20.8 12.0
Quit Attempt 59.5 75.0
Binge Drinking 17.0 15.9 6.0
Obesity 18.4 23.2 15.0
Diabetes 5.6 7.0 2.5
Flu Shot (65+) 70.7 68.3 90.0
Pneumonia Vaccination (65+) 65.3 64.6 90.0
Blood Stool Test (50+) 33.8 26.5 50.0
Pap Smear 85.7 82.1 90.0
Personal Health Care Provider 87.3 81.3 85.0
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Source: Massachusetts BRFSSPrepared by: Health Survey Program
Selected Topics
• Tobacco
• Alcohol
• Obesity
• Diabetes
6
Source: Massachusetts BRFSSPrepared by: Health Survey Program
Tobacco Use
• All respondents were asked if they had smoked 100 cigarettes in their lifetime.
• A current smoker was defined as someone who smoked at least 100 cigarettes in their lifetime and currently smoked either some days or everyday.
7
Source: Massachusetts BRFSSPrepared by: Health Survey Program
Trend in the percentage of adults who are current smokers, MA vs. US, 1990-2004
2321
24
19
0
10
20
30
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
Year
Pe
rce
nta
ge
of c
urr
en
t sm
oke
rs
US
MA
8
Source: Massachusetts BRFSSPrepared by: Health Survey Program
Percentage of current smokers, by age, MA 2004
24.7
21.2 20.4 19.618.3
10.2
5.9
0
10
20
30
40
18-24 25-34 35-44 45-54 55-64 65-74 75+
Age
Pe
rce
nta
ge
of
curr
en
t sm
oke
rs
MA 18.5%
9
Source: Massachusetts BRFSSPrepared by: Health Survey Program
Percentage of current smokers who quit for 1 day or more in the past year, by age, MA 2004
79.4
59.0 57.3
48.941.5
49.6
60.3
0
20
40
60
80
100
18-24 25-34 35-44 45-54 55-64 65-74 75+
Age
Pe
rce
nta
ge
of q
uit
atte
mp
ts
10
Source: Massachusetts BRFSSPrepared by: Health Survey Program
Percentage of current smokers, by education, MA 2004
26.5 27.4
22.4
10.2
0
10
20
30
40
< High School High School College 1-3 years College 4+ years
Education
Pe
rce
nta
ge
of
curr
en
t sm
oke
rs
MA 18.5%
11
Source: Massachusetts BRFSSPrepared by: Health Survey Program
Program Implications
• Compliance of 92% with the Smoke Free Workplace Law• Focus on populations that experience higher tobacco
prevalence– Medicaid, uninsured, high-school education or less– Southeast, Central, and Western regions
• Develop intensive community interventions in areas with high smoking prevalence
• Youth pilot projects to promote tobacco free schools and reduce youth smoking
• Partner with health care providers to ensure smokers receive cessation services
12
Source: Massachusetts BRFSSPrepared by: Health Survey Program
Alcohol Use
• All respondents were asked about their consumption of alcohol in the past month
• A drink of alcohol was defined as one can or bottle of beer, one glass of wine, one can or bottle of wine cooler, one cocktail, or one shot of liquor
• Binge drinking was defined as consumption of five or more drinks on any one occasion in the past month
13
Source: Massachusetts BRFSSPrepared by: Health Survey Program
Trend in the percentage of adults who binge drink, MA vs. US, 2004
15 15
1917
0
5
10
15
20
25
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
Year
Pe
rce
nta
ge
of b
ing
e d
rin
kin
g
US
MA
14
Source: Massachusetts BRFSSPrepared by: Health Survey Program
Percentage of adults who binge drink, by age, MA 2004
33.7
27.0
17.4
9.0
4.7
0.7
15.3
0
10
20
30
40
18-24 25-34 35-44 45-54 55-64 65-74 75+
Age
Pe
rce
nta
ge
of b
ing
e d
rin
kin
g
MA 17.0%
15
Source: Massachusetts BRFSSPrepared by: Health Survey Program
Percentage of adults who binge drink, by race/ethnicity, MA 2004
15.315.3
17.5
9.5
0
10
20
30
White-NH Black-NH Hispanic Asian-NH
Race/Ethnicity
Pe
rce
nta
ge
of
bin
ge
dri
nki
ng
MA 17.0%
16
Source: Massachusetts BRFSSPrepared by: Health Survey Program
Percentage of adults who binge drink, by region, MA 2004
17.819.3
21.0
14.8
15.8
14.9
0
5
10
15
20
25
W estern Central North East Metro W est South East Boston
Region
Per
cent
age
of b
inge
drin
king
MA 17.0%
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Source: Massachusetts BRFSSPrepared by: Health Survey Program
Program Implications
• Implementation of the Strategic Plan for Substance Use including broader intergovernmental collaboration.
• Provide a broad spectrum of regional and community-based prevention programs and a treatment services across the continuum
• Partner with state institutions of higher education to focus on college age drinking and associated problems
• Targeted specific prevention and treatment strategies to combat high use rates such as media effort focused on Oxycontin and other prescription drugs.
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Source: Massachusetts BRFSSPrepared by: Health Survey Program
Obesity
• All respondents were asked to report their height and weight to calculate their Body Mass Index (BMI)
• Respondents were categorized based on their BMI using the Healthy People 2010 standards: – BMI 18.0 - 24.9 normal
– BMI 25.0 - 29.9 overweight
– BMI 30.0 + obese
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Source: Massachusetts BRFSSPrepared by: Health Survey Program
Overweight Obesity 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
6’2” 195 234
Overweight and Obese by Height
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Source: Massachusetts BRFSSPrepared by: Health Survey Program
Trend in the percentage of adults who are obese, MA vs. US, 1990-2004
12
23
10
18
0
5
10
15
20
25
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
Year
Pe
rce
nta
ge
of o
be
sity
US
MA
21
Source: Massachusetts BRFSSPrepared by: Health Survey Program
Percentage of adults who are obese, by age, MA 2004
11.7
18.0
22.7
26.1
20.4
14.315.1
0
10
20
30
40
18-24 25-34 35-44 45-54 55-64 65-74 75+
Age
Pe
rce
nta
ge
of a
du
lts o
be
se
MA 18.4%
22
Source: Massachusetts BRFSSPrepared by: Health Survey Program
Percentage of adults who are obese, by sex and race/ethnicity, 2004
19.6
27.9
24.7 24.7
17.416.8
0
10
20
30
40
Females Males Females Males Females Males
Pe
rce
nta
ge
of
ob
esi
ty
White-NH Black-NH Hispanic
MA 18.4%
23
Source: Massachusetts BRFSSPrepared by: Health Survey Program
Percentage of adults who are obese, by education, MA 2004
28.7
23.5
18.4
13.9
0
10
20
30
40
50
< High School High School College 1-3 years College 4+ years
Education
Pe
rce
nta
ge
of o
be
sity
MA 18.4%
24
Source: Massachusetts BRFSSPrepared by: Health Survey Program
Percentage of adults who are obese, by level of physical activity, MA 2004
26.0
16.5
0
10
20
30
40
Exercise No Exercise
Any leisure time activity
Per
cent
age
of o
besi
ty
MA 18.4%
25
Source: Massachusetts BRFSSPrepared by: Health Survey Program
Percentage of adults who are obese, by region, MA 2004
Western 18.5% Central
25.4%
South East20.1%
Metro West13.7%
North East20.1%
Boston 13.6%
Massachusetts: 18.4%
Region's Crude Rate
Significantly Better than State Rate
No Different from State Rate
Significantly Worse than State Rate
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Source: Massachusetts BRFSSPrepared by: Health Survey Program
Program Implications• Facilitate coordinated efforts to address overweight and
obesity through the MA Partnership for Healthy Weight
• Implement evidenced-based/evidence-informed interventions at multiple levels and across the lifespan – Healthy Choices a joint program with BCBS a statewide program
involving 51,000 youth in 113 middle schools.
– ACCENT a joint program with Office of Elderly Affairs, and Councils on Aging which provides motivational training for elders on nutrition, physical activity, injury prevention, etc. at 9 COA sites
• Partnering with providers and community agencies and a CHC to reduce obesity among people with developmental disabilities in one community.
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Source: Massachusetts BRFSSPrepared by: Health Survey Program
Diabetes
• All respondents were asked if they had ever been told by a doctor that they had diabetes (Type 1 or Type 2)
• Women who had reported that they had diabetes only during pregnancy (gestational diabetes) were excluded
28
Source: Massachusetts BRFSSPrepared by: Health Survey Program
Trend in the percentage of adults with diabetes, MA vs. US, 2004
7
4 6
4
0
2
4
6
8
10
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
Year
Per
cent
age
with
dia
bete
s
US
MA
29
Source: Massachusetts BRFSSPrepared by: Health Survey Program
Percentage of adults with diabetes, by sex and race/ethnicity, MA 2004
4.8
6.1
7.37.9
8.4
7.1
0
2
4
6
8
10
Females Males Females Males Females Males
Pe
rce
nta
ge
with
dia
be
tes
White-NH Black-NH Hispanic
MA 5.6%
30
Source: Massachusetts BRFSSPrepared by: Health Survey Program
Percentage of adults with diabetes, by education, MA 2004
13.0
7.3
5.6
3.4
0
5
10
15
20
< High School High School College 1-3 years College 4+ years
Education
Pe
rce
nta
ge
with
dia
be
tes
MA 5.6%
31
Source: Massachusetts BRFSSPrepared by: Health Survey Program
Percentage of adults with diabetes, by level of physical activity, MA 2004
4.1
11.5
0
5
10
15
Exercise No Exercise
Any leisure time activity
Per
cent
age
with
dia
bete
s
MA 5.6%
32
Source: Massachusetts BRFSSPrepared by: Health Survey Program
Percentage of adults with diabetes, by obesity/overweight status, MA 2004
1.8
5.6
14.4
0
5
10
15
20
Normal Overweight Obese
BMI weight category
Pe
rce
nta
ge
with
dia
be
tes
MA 5.6%
33
Source: Massachusetts BRFSSPrepared by: Health Survey Program
Program Implications
• Partner with key stakeholders to implement the Massachusetts Health Disparities Collaborative in 17 community health centers to reduce disparities in care.
• Coordinate the development and dissemination of the Massachusetts Guidelines for Adult Diabetes Care to promote quality diabetes care to health care providers.– http://www.mass.gov/dph/diabetes/guidelin.pdf
• Facilitate networking and community mobilization for diabetes prevention and control through the Diabetes Coalition of Massachusetts.
• Participate (as one of five states nationally) in the design and pilot of a Diabetes Primary Prevention Initiative to address rising rates of obesity and diabetes.
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Source: Massachusetts BRFSSPrepared by: Health Survey Program
Massachusetts and HP2010
MA % US HP2010 %
Current Smoker 18.5 20.8 12.0
Quit Attempt 59.5 75.0
Binge Drinking 17.0 15.9 6.0
Obesity 18.4 23.2 15.0
Diabetes 5.6 7.0 2.5
Flu Shot (65+) 70.7 68.3 90.0
Pneumonia Vaccination (65+) 65.3 64.6 90.0
Blood Stool Test (50+) 33.8 26.5 50.0
Pap Smear 85.7 82.1 90.0
Personal Health Care Provider 87.3 81.3 85.0
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Source: Massachusetts BRFSSPrepared by: Health Survey Program
Summary
• Overall, Massachusetts is doing better than the US, but has a way to go to meet HP2010 goals.
• Need to maintain vigilance to reduce race/ethnicity, education, geographic, and gender disparities for these goals.
• BRFSS offers historical trends in health risk and behaviors and it provides insight and direction for program developing and targeting of services.
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Source: Massachusetts BRFSSPrepared by: Health Survey Program
Accessing BRFSS data
• BRFSS Annual Report: A Profile of Health Among Massachusetts Adults, 2004
• Health Survey Program– http://www.mass.gov/dph/bhsre/cdsp/brfss/brfss.htm
• MassCHIP– http://masschip.state.ma.us/
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