Source: Massachusetts BRFSS Prepared by: Health Survey Program Using the BRFSS to Track Healthy People 2010 Objectives Highlights from the 2004 Massachusetts.

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

1


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


BRFSS

TOBACCO

CANCER CONTROL

DRUG &ALCOHOL

DISABILITYDIABETES

OBESITY/ OVERWEIGHT

ORAL HEALTH

HEALTH CARE ACCESS

WOMEN’S HEALTHQUALITY OF LIFE

50 OTHER TOPICS

3


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

4


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

5


Selected Topics

• Tobacco

• Alcohol

• Obesity

• Diabetes

6


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


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


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


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


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


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


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


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


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


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


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%

17



• 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.

18


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

19


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

20


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


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


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


Percentage of adults who are obese, by education, MA 2004

28.7

23.5

18.4

13.9

0

10

20

30

40

50


Education

Pe

rce

nta

ge

of o

be

sity

MA 18.4%

24


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


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

26


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.

27


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


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


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


Percentage of adults with diabetes, by education, MA 2004

13.0

7.3

5.6

3.4

0

5

10

15

20


Education

Pe

rce

nta

ge

with

dia

be

tes

MA 5.6%

31


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


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



• 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.

34


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

35


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.

36


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/

37

http://www.mass.gov/dph/bhsre/cdsp/brfss/brfss.htm

http://masschip.state.ma.us/



Source: Massachusetts BRFSS Prepared by: Health Survey Program Using the BRFSS to Track Healthy People 2010 Objectives Highlights from the 2004 Massachusetts.

Documents

health survey program

health survey program

health information

states massachusetts

health care providers

brfss risk factors

hp2010 ma

current smoker18