Surveillance for Certain Health Behaviors and Conditions Among States and Selected Local Areas - Behavioral Risk Factor Surveillance System, United States, 2015.

Problem: Chronic conditions and disorders (e.g., diabetes, cardiovascular diseases, arthritis, and depression) are leading causes of morbidity and mortality in the United States. Healthy behaviors (e.g., physical activity, avoiding cigarette use, and refraining from binge drinking) and preventive practices (e.g., visiting a doctor for a routine check-up, tracking blood pressure, and monitoring blood cholesterol) might help prevent or successfully manage these chronic conditions. Monitoring chronic diseases, health-risk behaviors, and access to and use of health care are fundamental to the development of effective public health programs and policies at the state and local levels.

Reporting period: January-December 2015.

Description of the system: The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing, state-based, random-digit-dialed landline- and cellular-telephone survey of noninstitutionalized adults aged ≥18 years residing in the United States. BRFSS collects data on health-risk behaviors, chronic diseases and conditions, access to and use of health care, and use of preventive health services related to the leading causes of death and disability. This report presents results for all 50 states, the District of Columbia, the Commonwealth of Puerto Rico (Puerto Rico), and Guam and for 130 metropolitan and micropolitan statistical areas (MMSAs) (N = 441,456 respondents) for 2015.

Results: The age-adjusted prevalence estimates of health-risk behaviors, self-reported chronic health conditions, access to and use of health care, and use of preventive health services varied substantially by state, territory, and MMSA in 2015. Results are summarized for selected BRFSS measures. Each set of proportions refers to the median (range) of age-adjusted prevalence estimates for health-risk behaviors, self-reported chronic diseases or conditions, or use of preventive health care services by geographic jurisdiction, as reported by survey respondents. Adults with good or better health: 84.6% (65.9%-88.8%) for states and territories and 85.2% (66.9%-91.3%) for MMSAs. Adults with ≥14 days of poor physical health in the past 30 days: 10.9% (8.2%-17.2%) for states and territories and 10.9% (6.6%-19.1%) for MMSAs. Adults with ≥14 days of poor mental health in the past 30 days: 11.3% (7.3%-15.8%) for states and territories and 11.4% (5.6%-20.5%) for MMSAs. Adults aged 18-64 years with health care coverage: 86.8% (72.0%-93.8%) for states and territories and 86.8% (63.2%-95.7%) for MMSAs. Adults who received a routine physical checkup during the preceding 12 months: 69.0% (58.1%-79.8%) for states and territories and 69.4% (57.1%-81.1%) for MMSAs. Adults who ever had their blood cholesterol checked: 79.1% (73.3%-86.7%) for states and territories and 79.5% (65.1%-87.3%) for MMSAs. Current cigarette smoking among adults: 17.7% (9.0%-27.2%) for states and territories and 17.3% (4.5%-29.5%) for MMSAs. Binge drinking among adults during the preceding 30 days: 17.2% (11.2%-26.0%) for states and territories and 17.4% (5.5%-24.5%) for MMSAs. Adults who reported no leisure-time physical activity during the preceding month: 25.5% (17.6%-47.1%) for states and territories and 24.5% (16.1%-47.3%) for MMSAs. Adults who reported consuming fruit less than once per day during the preceding month: 40.5% (33.3%-55.5%) for states and territories and 40.3% (30.1%-57.3%) for MMSAs. Adults who reported consuming vegetables less than once per day during the preceding month: 22.4% (16.6%-31.3%) for states and territories and 22.3% (13.6%-32.0%) for MMSAs. Adults who have obesity: 29.5% (19.9%-36.0%) for states and territories and 28.5% (17.8%-41.6%) for MMSAs. Adults aged ≥45 years with diagnosed diabetes: 15.9% (11.2%-26.8%) for states and territories and 15.7% (10.5%-27.6%) for MMSAs. Adults aged ≥18 years with a form of arthritis: 22.7% (17.2%-33.6%) for states and territories and 23.2% (12.3%-33.9%) for MMSAs. Adults having had a depressive disorder: 19.0% (9.6%-27.0%) for states and territories and 19.2% (9.9%-27.2%) for MMSAs. Adults with high blood pressure: 29.1% (24.2%-39.9%) for states and territories and 29.0% (19.7%-41.0%) for MMSAs. Adults with high blood cholesterol: 31.8% (27.1%-37.3%) for states and territories and 31.4% (23.2%-42.0%) for MMSAs. Adults aged ≥45 years who have had coronary heart disease: 10.3% (7.2%-16.8%) for states and territories and 10.1% (4.7%-17.8%) for MMSAs. Adults aged ≥45 years who have had a stroke: 4.9% (2.5%-7.5%) for states and territories and 4.7% (2.1%-8.4%) for MMSAs.

Interpretation: The prevalence of health care access and use, health-risk behaviors, and chronic health conditions varied by state, territory, and MMSA. The data in this report underline the importance of continuing to monitor chronic diseases, health-risk behaviors, and access to and use of health care in order to assist in the planning and evaluation of public health programs and policies at the state, territory, and MMSA level.

Public health action: State and local health departments and agencies and others interested in health and health care can continue to use BRFSS data to identify groups with or at high risk for chronic conditions, unhealthy behaviors, and limited health care access and use. BRFSS data also can be used to help design, implement, monitor, and evaluate health-related programs and policies.