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PubMed1992

The Behavioral Risk Factor Survey and the Stanford Five-City Project Survey: a comparison of cardiovascular risk behavior estimates.

BACKGROUND: Nearly all state health departments collect Behavioral Risk Factor Survey (BRFS) data, and many report using these data in public health planning. Although the BRFS is widely used, little is known about its measurement properties. This study compares the cardiovascular risk behavior estimates of the BRFS with estimates derived from the physiological and interview data of the Stanford Five-City Project Survey (FCPS). METHOD: The BRFS is a random telephone sample of 1588 adults aged 25 to 64; the FCPS is a random household sample of 1512 adults aged 25 to 64. Both samples were drawn from the same four California communities. RESULTS: The surveys produced comparable estimates for measures of current smoking, number of cigarettes smoked per day, rate of ever being told one has high blood pressure, rate of prescription of blood pressure medications, compliance in taking medications, and mean total cholesterol. Significant differences were found for mean body mass index, rates of obesity, and, in particular, rate of controlled hypertension. CONCLUSIONS: These differences indicate that, for some risk variables, the BRFS has limited utility in assessing public health needs and setting public health objectives. A formal validation study is needed to test all the risk behavior estimates measured by this widely used instrument.

Adult↗
PubMedDate not supplied

Outrunning the risks: a behavioral risk profile of runners.

There is a need to assess better the relationship between physical activity and other health behaviors through population-based studies. Using the state-based Behavioral Risk Factor Surveillance System, we examined the behavioral risk factors of smoking, alcohol use, hypertension detection, obesity, seat-belt use, and physical activity in 2,412 runners and 26,538 nonrunners. Our analyses demonstrated marked differences in behavioral risk profiles between runners and nonrunners. Runners, regardless of the amount of running, were more likely to be nonsmokers, be of normal weight, be normotensive, and regularly use seat belts than were nonrunners of similar age and sex. Patterns of alcohol use were not different when comparing male runners with male nonrunners. However, female runners were more likely to drink and drive and to use alcohol on a chronic basis compared to their nonrunning counterparts. The "runner's lifestyle" may convey a certain level of protection from chronic disorders that are associated with these risk factors. However, further prospective studies are needed to examine in more detail the relationship of running to the risks and/or benefits for improved health.

Adolescent↗
PubMed2000

Sex related HIV risk behaviors: differential risks among injection drug users, crack smokers, and injection drug users who smoke crack.

This study was designed to assess differences in sex-related risk behaviors between drug injectors who did not smoke crack cocaine, crack smokers who did not inject drugs, and drug users who both injected drugs and smoked crack. Current drug users (i.e. used within the past 30 days) from 22 cities were recruited and assessed. The sample (n = 26,982) included 28% who injected only, 42% who smoked crack only, and 30% who both injected and smoked crack. Results showed that active drug users were at risk of HIV infection through sexual transmission: in the 30 day period prior to their interview, 28% reported sex with two or more individuals, 23% had an IDU sex partner, and 24% had exchanged sex for drugs or money. In addition, more than 80% did not use a condom during sex. Crack only smokers and crack smoking injectors were more likely than injectors only to report multiple sex partners and exchanging sex. Because of these high risk behaviors, condom use was of particular importance. The number of days of alcohol use and having an IDU sex partner were independently associated with not using a condom. Crack smoking injectors reported the highest average number of days of alcohol consumption and were the most likely to have had an IDU sex partner.

Adult↗
PubMed1997

State-and sex-specific prevalence of selected characteristics--behavioral risk factor surveillance system, 1994 and 1995.

PROBLEM/CONDITION: High-risk behaviors (e.g., cigarette smoking, excessive alcohol consumption, and physical inactivity) and lack of preventive health care (e.g., screening for cancer) are associated with chronic disease- and injury-related morbidity and mortality. States use the Behavioral Risk Factor Surveillance System (BRFSS) to collect data about these modifiable health behaviors and to monitor trends and changes in the prevalence of behavioral risk factors in state populations. BRFSS data also are used to monitor progress toward the year 2000 national health objectives. REPORTING PERIOD: 1994 and 1995. DESCRIPTION OF SYSTEM: The BRFSS is a state-based telephone survey of the civilian, noninstitutionalized, adult (persons > or =18 years of age) population. In 1994, 49 states and the District of Columbia participated in the BRFSS; in 1995, 50 states participated. RESULTS: As in previous years, there were state-specific variations in the prevalences of high-risk behaviors, awareness of certain medical conditions, use of preventive health services, and health-care coverage. Selected findings for 1995 were that 22.4% of adults reported being current cigarette smokers (range: 13.2%-27.8%); the percentage of adults who reported driving after drinking too much alcohol ranged from 0.6% to 5.2% (median: 2.3%); and among adults aged > or =65 years, 36.8% (range: 11.4%-46.6%) reported ever having had a pneumococcal vaccination and 59.2% (range: 44.2%-70.0%) reported having had an influenza vaccination within the past 1 year. INTERPRETATION: State-specific variations in prevalence may reflect differences in population composition, socioeconomic factors, state laws enacted to discourage high-risk behaviors, levels of effort to screen for certain diseases and physiological conditions, and other factors. ACTION TAKEN: States continue to use the BRFSS to monitor risk factors associated with chronic disease- and injury-related morbidity and mortality and to develop public health programs and policies to address these problems. BRFSS data continue to be important in assessing progress toward national year 2000 and state health objectives.

Adult↗
PubMed2000

Behavioral risk reduction in a declining HIV epidemic: injection drug users in New York City, 1990-1997.

OBJECTIVES: This study assessed trends in HIV risk behaviors among injection drug users in New York City from 1990 to 1997. METHODS: Injection drug users were recruited continuously from a large drug detoxification treatment program (N = 2588) and a research storefront located in a high-drug-use area (N = 2701). Informed consent was obtained, and a trained interviewer administered a structured interview covering sociodemographics, drug use history, HIV risk behavior, and participation in syringe exchange. RESULTS: Trends were assessed for 5 risk behaviors in the 6-month period before the interview. The 3 injection risk behaviors declined significantly over time at each site (all P < .01). When data were pooled across sites, all 5 risk behaviors declined significantly over time (all P < .01). Participation in syringe exchange programs and in HIV counseling and testing increased greatly from 1990 to 1997. CONCLUSIONS: The continuing risk reduction among injection drug users indicates a "declining phase" in the large HIV epidemic in New York City. HIV prevention programs appear to be making an important contribution to the declining phase.

Adult↗
PubMed1999

Assessment of health risk behaviors. A tool to inform consumers, providers, health care organizations, and purchasers.

INTRODUCTION: Tobacco use, diet and physical activity patterns, and alcohol use are the leading causes of death in the United States. To make major improvements in the health status of the population, behavioral risk factors for disease must be addressed. METHODS: We propose a brief survey of behavioral risk factors for enrollees of health care organizations, employer groups, or other adult populations that can be used to profile the health risk behaviors of a population, assess performance of prevention and risk reduction programs, or make comparisons with other populations. The survey contains questions about tobacco, diet, physical activity, alcohol, firearms, motor vehicle safety, sexual behavior, and drugs. RESULTS: Recommendations for survey items, implementation, and calculation of performance measures are given. CONCLUSIONS: Widespread adoption of this type of survey would be a major step forward in acknowledging the impact that behavior has on health and in furthering individual and organizational accountability for improving health risk behaviors.

Adult↗
PubMedDate not supplied

The feasibility of behavioral risk reduction in primary medical care.

This prospective study evaluated changes in patients' health-risk behavior one year after preventive intervention by primary care physicians. The trial used a quasiexperimental design with 2,218 adults (1,409 study subjects and 809 controls) at five multispecialty, group practice sites in three regions of the United States. Pre- and postintervention surveys showed that the treated study patients with behavioral risks were more likely to report positive changes than were controls in regard to beginning regular exercise (P = .02), using auto seat belts, (P less than .001), losing weight (P = .05), decreasing alcohol intake (P = .01), and to performance of monthly breast self-examination by women (P less than .001). The smoking cessation rate was greater among the treated study group compared with the controls, although the change was not significantly different. Greater behavioral risk changes also occurred among the total study group (treated and untreated) in comparison with the control group. An additive index of these behavioral risks showed greater reduction among the treated and the total group of study patients compared with controls. These initial results suggest that clinical preventive services, which include risk factor education and counseling by primary care physicians, can improve short-term health-related behavior of patients.

Adolescent↗
PubMed1997

Youth Risk Behavior Surveillance: National College Health Risk Behavior Survey--United States, 1995.

PROBLEM/CONDITION: Colleges and universities are important settings for delivering health promotion education and services to many young adults. However, before this national college-based survey was conducted in 1995, the prevalences of health-risk behaviors among college students nationwide had not been well characterized. REPORTING PERIOD: January through June 1995. DESCRIPTION OF THE SYSTEM: The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults: behaviors that contribute to unintentional and intentional injuries, tobacco use, alcohol and other drug use, sexual behaviors, unhealthy dietary behaviors, and physical inactivity. The YRBSS includes a) national, state, and local school-based surveys of high school students conducted biennially since 1991, b) a household-based survey conducted in 1992 among a national sample of youth aged 12-21 years, whether enrolled in school, and c) the national college-based survey conducted in 1995. This report summarizes results from the national college-based survey-the National College Health Risk Behavior Survey (NCHRBS)-and describes priority health-risk behaviors among college students nationwide and health promotion programs on college campuses. RESULTS AND INTERPRETATION: Data from the 1995 survey indicated that many college students throughout the United States engage in behaviors that place them at risk for serious health problems. Almost one third (29.0%) of college students were current cigarette smokers. One third (34.5%) of college students reported episodic heavy drinking during the 30 days preceding the survey, 27.4% reported drinking alcohol and driving during the 30 days preceding the survey, and 30.5% of students who had gone boating or swimming during the 12 months preceding the survey had drunk alcohol while boating or swimming. One in five (20.4%) female college students had been forced to have sexual intercourse during her lifetime. Only 29.6% of students who had had sexual intercourse during the 3 months preceding the survey had used a condom at last sexual intercourse, and 34.5% had used birth control pills. Approximately one in five (20.5%) college students was overweight. Survey results indicated that three fourths (73.7%) of students had failed to eat five or more servings of fruits and vegetables on the day preceding the survey, 21.8% had eaten three or more high-fat foods on the day preceding the survey, and few students had engaged in vigorous (37.6%) or moderate (19.5%) physical activity at recommended levels. ACTIONS TAKEN: The NCHRBS data will be used to measure progress toward achieving 28 national health objectives related to the health-risk behaviors of college students and two national health objectives related to the availability and characteristics of health promotion programs for college students. These data also will be used nationwide by college health and education officials to improve health policies and programs designed to reduce risks associated with the leading causes of mortality and morbidity among college students.

Adolescent↗
PubMed1997

Using the Youth Risk Behavior Survey to compare risk behaviors of Texas High School and college students.

This study used the Youth Risk Behavior Survey (YRBS) to assess selected health behaviors of Texas high school and college students. The YRBS was administered during 1993 in paper and pencil form to 6,015 high school students representing 329 classrooms from 78 school districts. A total of 1,408 college students representing 23 college and universities were surveyed by telephone in 1993 using a modified version of YRBS. Texas college students reported a higher percentage who had experienced sexual intercourse (82% versus 55.4%), but Texas high school students reported a younger age of first sexual intercourse. High school students also initiated alcohol consumption at a younger age, although college students were more likely to binge drink (33.5% versus 31%). Regular cigarette use also was higher among college students (25.4% versus 19.3%), but was initiated at a younger age by high school students. Study results indicate that health education programs must begin much earlier than during the high school years. Due to early initiation of negative health behaviors, emphasis must be placed on abstinence and risk-reduction techniques for both populations.

Adolescent↗
PubMed1996

State- and sex-specific prevalence of selected characteristics--Behavioral Risk Factor Surveillance System, 1992 and 1993.

PROBLEM/CONDITION: Much chronic disease and injury morbidity and mortality is associated with high-risk behaviors (e.g., cigarette smoking, excessive alcohol consumption, and physical inactivity) and with lack of preventive health care (e.g., screening for cancer). States use the Behavioral Risk Factor Surveillance System (BRFSS) to collect data about these modifiable health behaviors and to monitor trends and significant changes in their populations over time. REPORTING PERIOD: 1992 and 1993. DESCRIPTION OF SYSTEM: The BRFSS is a state-based telephone survey of the civilian, noninstitutionalized, adult (persons > or = 18 years of age) population. In 1992, 48 states and the District of Columbia participated in the BRFSS; in 1993, 49 states and the District of Columbia participated. Several questions were added to the BRFSS in 1993. RESULTS: As in previous years, state-specific variations occurred in the prevalence of high-risk behaviors, awareness of certain medical conditions, use of preventive health services, and health-care coverage. In 1993, 4.0% (range: 1.4% - 6.4%) of adults reported riding with a driver who had had too much alcohol to drink. The percentage of persons > or = 50 years of age who had ever had a proctoscopic examination ranged from 25.6% to 51.5% (median: 36.8%). Among adults > or = 65 years of age, 27.4% (range: 18.5 % - 40.0%) had ever had a pneumococcal vaccination, and 49.9% (range: 28.7% - 66.2%) had had an influenza vaccination within the past 1 year. INTERPRETATION: The variations in prevalence across states likely reflect socioeconomic differences, differences in state laws enacted to discourage risky behaviors, different levels of effort to screen for certain types of cancer or risk factors for other diseases, and other factors. ACTION TAKEN: States will continue to use the BRFSS to collect data about health behaviors. Analysis of these data will enable states to monitor factors that may affect the rate of chronic disease and injury mortality and morbidity and to develop public health policies to address these problems.

Adult↗
PubMed2000

State- and sex-specific prevalence of selected characteristics--Behavioral Risk Factor Surveillance System, 1996 and 1997.

PROBLEM/CONDITION: High-risk behaviors (e.g., physical inactivity, cigarette smoking, and drinking and driving) and lack of preventive health care (e.g., screening for cancer) are associated with morbidity and mortality from chronic disease and injury. The Behavioral Risk Factor Surveillance System (BRFSS) collects state-specific information to determine the prevalence of such behaviors and preventive practices. By using the BRFSS, states can gain a better understanding of the factors that have a major affect on the health of their adult populations. The BRFSS is also used to monitor progress toward national health objectives. REPORTING PERIOD COVERED: 1996 and 1997. DESCRIPTION OF SYSTEM: The BRFSS is a state-based telephone survey of the civilian, noninstitutionalized, adult (i.e., persons aged 18 years) population. In both 1996 and 1997, 50 states, the District of Columbia, and the Commonwealth of Puerto Rico participated in the BRFSS. RESULTS: As in previous years, state- and sex-specific variations occurred in the prevalence of high-risk behaviors, awareness of certain medical conditions, use of preventive health services, and health-care coverage. For example, in 1997, the percentage of adults who reported being current cigarette smokers ranged from 13.8% to 30.7% among states (median: 23.2%), and the percentage of adults who reported driving after drinking too much alcohol ranged from 0.6% to 5.3% (median: 1.9%). Binge drinking varied substantially not only by state (range: 6.3%-23.3%; median: 14.5%) but also by sex (men: 22.3%; women: 6.7%). Similarly, the prevalence of overweight varied considerably by sex: 62.2% of men and 44.5% of women were overweight in 1997. INTERPRETATION: The 1996 and 1997 BRFSS data demonstrate that U.S. adults engage in behaviors that are detrimental to their health. The data also demonstrate that many adults are making efforts to prevent chronic disease and injury. The prevalence of certain behaviors and health practices differs between states and between men and women. The reasons for these differences by state and sex are subjects for further analysis, but only through continued surveillance can the areas that need further study be identified. PUBLIC HEALTH ACTIONS: Data from the BRFSS are useful in developing and guiding public health programs and policies. For many states, the BRFSS is the only source of state-level data on behaviors and practices related to chronic disease and injury; therefore, BRFSS data are vital for effective decision-making at the local level. States will continue to use these data to help prevent premature morbidity and mortality among their adult population and to assess progress toward national health objectives.

Adult↗
PubMed1995

Behavioral risk factors related to chronic diseases in ethnic minorities.

This article reviews the evidence on 5 risk behaviors: cigarette smoking, dietary intake, being overweight, limited exercise, and alcohol consumption among African Americans, Asian/Pacific Islanders, Latinos, and Native Americans. Although there is little basis for believing that these high-risk behaviors are any less significant as contributors to chronic disease risk in any ethnic group, the limited information available, especially for Asian/Pacific Islanders and Native Americans, indicates that there may be significant within- and between-group differences in the prevalence of these behaviors. Therefore, some of the ethnic group differences in morbidity and mortality for chronic diseases are partly attributable to differences in behavioral risk profiles. Limited basic health behavior information on most ethnic minority groups delay the development of effective health promotion interventions.

Adolescent↗
PubMed1997

Sexual risk behavior and risk factors for HIV-1 seroconversion in homosexual men participating in the Tricontinental Seroconverter Study, 1982-1994.

Trends in sexual behavior associated with incident infection with human immunodeficiency virus (HIV) type 1 are described and a case-control study was conducted to examine risk factors for HIV seroconversion in homosexual men who became infected with HIV between 1982 and 1994 from four geographic sites: Amsterdam, the Netherlands; San Francisco, California; Vancouver, Canada; and Sydney, Australia. Changes in sexual behaviors were evaluated from cohort visits in the preseroconversion, seroconversion, and postseroconversion intervals and were further examined over three time periods: 1982-1984, 1985-1987, and 1988-1994. In a case-control study, sexual behaviors, substance use, and presence of sexually transmitted disease were compared between 345 HIV-positive cases and 345 seronegative controls matched by visit date and site. Receptive anal intercourse was the sexual behavior most highly associated with seroconversion. The odds ratio (OR) per receptive anal intercourse partner increase was 1.05 (95% confidence interval (CI) 1.02-1.09). To more carefully examine risk associated with receptive oral intercourse, analyses were done in a subgroup of men who reported no or one receptive anal intercourse partner. The risk (OR) associated with receptive oral intercourse partner increase was 1.05 (95% CI 1.0-1.11). In multivariate conditional logistic regression analyses, presence of sexually transmitted disease (OR = 3.39, 95% CI 1.95-5.91) and amphetamine use (OR = 2.55, 95% CI 1.26-5.15) were independently associated with seroconversion. Although the prevalence of major risk factors has decreased over time, the associations of these behaviors and HIV infection persist, suggesting that these risk behaviors remain important avenues for public health interventions.

Adult↗
PubMed1994

Behavioral risks for HIV in adolescents.

A psychosocial perspective on adolescent risk behavior is used to highlight aspects of psychological development and social environment that are relevant to sexual activity and substance use. Differences in behavior are also related to factors such as age and gender that have biological, developmental, and demographic implications. Sexual activity and substance use increase during adolescence, and are often interrelated. In the USA in 1992, 69% of 8th graders and 88% of 12th graders had drunk alcohol. In 1990, 54% of high school students had had sexual intercourse. Age of sexual initiation has decreased in recent cohorts, but condom use by adolescents has increased, with 35% of 15-19-year-old women reporting using condoms. Interventions that successfully change adolescent risk behavior take account of the teen's level of development and social context.

Adolescent↗
PubMed2000

Smokers with multiple behavioral risk factors: how are they different?

OBJECTIVE: The first aim of the present investigation was to examine cross-sectional differences between smokers who engage in additional health risk behaviors (i.e., high-fat diets and low physical activity levels) and those who do not that could affect readiness for smoking cessation treatment and treatment prognosis. The second aim was to examine prospective associations between risk factor status and smoking outcomes (i.e., cessation and quit attempts). DESIGN: Data were derived from baseline and 1-year follow-up surveys for the SUCCESS project, a randomized trial of worksite smoking interventions conducted in 24 worksites in Minneapolis/St. Paul, Minnesota. Included in the analyses were 2,149 study participants who reported smoking at baseline. METHODS: Current smokers were categorized into one of three "risk groups": the "1 additional risk factor" group (i.e., either low physical activity level or high dietary fat intake), the "2 additional risk factor" group (i.e., both low physical activity and high dietary fat intake), and the "smoker only" group (i.e., neither low physical activity nor high dietary fat intake). Mixed model regression analyses examined cross-sectional associations between risk group status and baseline demographic variables, smoking dependency, social environments for smoking, and health problems. Prospective associations between baseline risk group status and 1-year follow-up cessation attempts and quits were also examined. RESULTS: At baseline, risk factor status was associated with smoking dependency for both men and women. Women smokers with at least one additional risk factor reported a greater number of cigarettes smoked per day, higher Fagerstrom Nicotine Dependence scores, and lower self-efficacy for refraining from smoking in a variety of situations compared with smokers with no additional risk factors. Men smokers with at least one additional risk factor reported higher Fagerstrom Nicotine Dependence scores compared with smokers with no additional risk factors. Women smokers with at least one additional risk factor were more likely to report being encouraged to quit by co-workers compared with smokers with no other risk factors. No relationship between risk factor status and social pressure to quit was observed among men. Prospective analyses indicated that baseline risk factor status was marginally related to smoking outcome at 1-year follow-up; however, these relationships were attenuated considerably when controlling for smoking dependence. Relationships between risk factor status and smoking outcomes were stronger for men. CONCLUSION: Results indicated that the presence of multiple health risk behaviors was related to more serious problems with smoking. However, the presence of additional risk factors did not strongly affect prognosis for smoking cessation.

Adult↗
PubMed1998

Cardiovascular disease risk factors and preventive practices among adults--United States, 1994: a behavioral risk factor atlas. Behavioral Risk Factor Surveillance System State Coordinators.

UNLABELLED: PROBLEM/CONDITIONS: Cardiovascular disease (CVD), including coronary heart disease (CHD) and stroke, is the leading cause of death in the United States, and state rates of CVD vary by state and by region of the country. Several behavioral risk factors (i.e., overweight, physical inactivity, smoking, hypertension, and diabetes mellitus) and preventive practices (i.e., weight loss and smoking cessation) are associated with the development of CVD and also vary geographically. This summary displays and analyzes geographic variation in the prevalences of selected CVD risk factors. REPORTING PERIOD: 1994 (1992 for prevalence of hypertension). DESCRIPTION OF SYSTEM: The Behavioral Risk Factor Surveillance System (BRFSS) is a state-based random-digit-dialing telephone survey of noninstitutionalized adults aged > or =18 years; 50 states and the District of Columbia participated in BRFSS in 1994, and 48 states and the District of Columbia participated in 1992. METHODS: Several different analyses were conducted: a) analysis of state risk factor and preventive practice prevalences by sex and race (i.e., black and white); b) mapping; c) cluster analysis; d) correlations of state prevalence rates by sex and race; and e) regression of state risk factor prevalences on state CHD and stroke mortality rates. RESULTS: Mapping the prevalence of selected CVD risk factors and preventive health practices indicates substantial geographic variation for black and white men and women, as confirmed by cluster analysis. Data for blacks are limited by small sample size, especially in western states. Geographic clustering is found for physical inactivity, smoking, and risk factor combinations. Risk factor prevalences are generally lower in the West and higher in the East. White men and white women are more similar in state risk factor rates than other race-sex pairs; white women and black women ranked second in similarity. State prevalences of physical inactivity and hypertension are strongly associated with state mortality rates of CVD. INTERPRETATION: Geographic patterns of risk factor prevalence suggest the presence (or absence) of sociocultural environments that promote (or inhibit) the given risk factor or preventive behavior. Because the risk factors examined in this summary are associated with CVD, further exploration of the reasons underlying observed geographic patterns might be useful. The BRFSS will continue to provide geographic data about cardiovascular health behaviors with a possible emphasis on more data-based small- area analyses and mapping. This will permit states to more adequately monitor trends that affect the burden of CVD in their regions and the United States. Mapping also facilitates the exploration of patterns of morbidity, health-care use, and mortality, as well as the epidemiology of risk factors. Finally, by identifying those segments of the population with high levels of these risk factors and lower levels of the preventive health practices, public health personnel can better allocate resources and target intervention efforts for the prevention of CVD.

Adult↗
PubMed1993

Behavioral Risk Factor Surveillance System: summary of data for 1991.

PROBLEM/CONDITION: High-risk behaviors, such as smoking cigarettes and driving under the influence of alcohol, contribute heavily to morbidity and mortality from noninfectious disease and injury. Substantial variation exists among states in the prevalences of these behaviors. REPORTING PERIOD: 1991. DESCRIPTION OF SYSTEM: The Behavioral Risk Factor Surveillance System (BRFSS) is a state-based random-digit-dialing telephone survey of noninstitutionalized adults (> or = 18 years of age). In 1991, 47 states and the District of Columbia participated in BRFSS. The system focuses on behaviors that are related to one or more of the 10 leading causes of death. In 1991, BRFSS also began collecting data on self-reported lack of health insurance. RESULTS: As in previous years, BRFSS data for 1991 indicate substantial state-to-state variation in the prevalence of risk factors such as chronic or binge alcohol consumption, sedentary lifestyle, and overweight. In addition to measures reported in previous years, the current report includes state prevalences of high blood cholesterol awareness (range = 13.5%-21.5%; median = 16.9%) and lack of health insurance (range = 7.2%-25.7%; median = 14.5%). INTERPRETATION: Because prevalence estimates vary considerably from state to state, state estimates may be preferable to national ones for use in planning programs. ACTIONS TAKEN: The BRFSS will continue to provide state-specific data about health behaviors to allow states to monitor trends that affect the burden of chronic diseases in the United States.

Adult↗