Leads from the MMWR. Sex-, age-, and region-specific prevalence of sedentary lifestyle in selected states in 1985--the Behavioral Risk Factor Surveillance System.
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Alcohol use during pregnancy can cause fetal alcohol syndrome and other congenital anomalies. Substantial prenatal alcohol use can occur before a woman knows she is pregnant, and teratogenic risk increases if she continues to drink during pregnancy. Characterization of alcohol consumption patterns among women of childbearing age (i.e., age 18-44 years) can help identify the magnitude of this problem, the subpopulations at greatest risk, and the geographic areas in which increased prevention efforts are needed. This report presents state-specific data on the prevalence of frequent alcohol consumption among women of childbearing age.
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In this article, the American Cancer Society (ACS) provides estimates on the number of new cancer cases and deaths, and compiles health statistics on the US Hispanic population. The compiled statistics include cancer incidence, mortality, and behaviors relevant to cancer using the most recent data on incidence from the National Cancer Institute's (NCI) Surveillance, Epidemiolgy, and End Results (SEER) Program, mortality data from the National Center for Health Statistics, and behavioral information from the Behavior Risk Factor Surveillance System (Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System [BRFSS], Youth Risk Behavior Surveillance System [YRBSS], and National Health Interview Survey [NHIS].) An estimated 67,400 new cases of cancer and 22,100 cancer deaths will occur among Hispanics in 2003. Hispanics have lower incidence and death rates from all cancers combined and from the four most common cancers (breast, prostate, lung and bronchus, and colon and rectum) than non-Hispanic whites. However, Hispanics have higher incidence and mortality rates from cancers of the stomach, liver, uterine cervix, and gallbladder, reflecting in part greater exposure to specific infectious agents and lower rates of screening for cervical cancer, as well as dietary patterns and possible genetic factors. Strategies for reducing cancer risk among Hispanics include further development of effective interventions to increase screening and physical activity, reductions in tobacco use and obesity, and the development and application of effective vaccines.
Although the percentage of overall AIDS diagnoses remains low among Asian and Pacific Islanders (APIs) in the United States compared with other racial/ethnic groups, research on API risk behaviors and health status suggest that the low number of AIDS cases may not provide a full picture of the epidemic and issues faced by this understudied and underserved population. Data from national HIV/AIDS surveillance systems and the Behavioral Risk Factor Surveillance System (BRFSS) were examined to delineate the magnitude and course of the HIV/AIDS epidemic among APIs in the United States. Same-sex sexual activity is the main HIV risk for API men, whereas heterosexual contact is for API women. APIs are significantly less likely to report being tested for HIV despite the fact that a similar proportion of APIs and other racial/ethnic groups reported having HIV risk in the past 12 months. Given the enormous diversity among APIs in the United States it is important to collect detailed demographic information to improve race/ethnicity and HIV risk classification, conduct better behavioral and disease monitoring for informing prevention planning, and addressing cultural, linguistic, economic and legal barriers to HIV prevention among APIs.
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.
OBJECTIVE: To assess the fat-related dietary behaviors of adult Puerto Ricans with and without diagnosed diabetes, living in New York City. DESIGN: A random-digit-dialing telephone survey was conducted following Behavioral Risk Factor Surveillance System procedures. Dietary behavior was assessed using a brief Fat-Related Diet Habits Questionnaire, in which higher scores indicated higher fat intake. SUBJECTS/SETTING: A total of 1,304 adult Puerto Ricans living in New York City were interviewed. Diabetes status was assessed using standard Behavioral Risk Factor Surveillance System questions. STATISTICAL ANALYSES PERFORMED: Weighted analyses using SUDAAN software for complex surveys were done, and t tests were used to assess differences in mean fat-related dietary score by sociodemographic and health characteristics. Age-adjusted least-squared means were used to compare scores between those with and without diabetes. Linear regression was used to model characteristics associated with fat-related dietary score. RESULTS: Fat-related dietary score was lower among those with diabetes and varied by population and health characteristics. Age-adjusted scores were significantly lower for those with diabetes who were younger, less educated, obese, or physically active. In the regression model, family history, weight, and exercise interacted with diabetes status. Those with diabetes were significantly more likely to modify meat consumption practices (eg, remove skin or trim fat) to reduce fat compared with those without diabetes. CONCLUSIONS: New York City Puerto Ricans with diabetes are somewhat more likely to engage in behaviors to reduce fat compared with those without diabetes. Targeted, culturally sensitive nutrition education and counseling emphasizing lower-fat food choices and other fat-reducing behaviors can help reduce risk and control diabetes. Education messages should be tailored to the individual's diabetes status and other health and sociodemographic characteristics.
BACKGROUND: Colorectal cancer (CRC) is a leading cause of cancer-related death. Although CRC screening can reduce CRC mortality, it is underutilized. We examined the association between personal and health care characteristics and CRC testing, defined as being current on any test that meets CRC screening guidelines. METHODS: The current investigation relies on questionnaire data from the 1999 Massachusetts Behavioral Risk Factor Surveillance System and a CRC call-back survey of 869 Behavioral Risk Factor Surveillance System participants age 50 and older. Multivariate logistic regression was used to identify predictors of CRC testing. All analyses were stratified by gender. RESULTS: Men were more likely than women to be currently tested for CRC. Physician recommendation for testing was strongly associated with testing among men and women, but among those with a recommendation, men were more likely to be tested than women. Older age, usually having an annual check-up, and HMO membership were associated with CRC testing among men and women. Perceived high risk of CRC was more strongly associated with testing among men, while other cancer screening was more strongly associated with testing among women. CONCLUSIONS: There are important gender differences in the prevalence of CRC testing and in factors associated with testing. Research into understanding gender differences related to compliance with physician recommendations is warranted.
BACKGROUND: Little is known about the health of Chamorros residing in the United States. METHODS: The Chamorro Directory International and CDC's Behavioral Risk Factor Surveillance System were used to assess behavioral risk factors and health needs of San Diego's Chamorro women. RESULTS: Of 128 Chamorro women, 42.2% reported having a total frequency of five or more fruits and vegetables daily, 54.5% reported being current on their colorectal cancer screening, and 9.4% smoke. CONCLUSIONS: While this sample of Chamorro women reported higher rates of healthpromoting practices than nationwide averages, significant health improvement opportunities remain.
This article discusses methods and elements of three major national health survey systems, particularly as they relate to HIV infection and AIDS. The National Health Interview Survey and the Behavioral Risk Factor Surveillance System provide information about health-related knowledge, attitudes, beliefs, and behaviors of adults in the United States. The Youth Risk Behavior Surveillance System measure health-related behaviors of American youth. Questions and survey designs differ among the three surveys, but all three surveys utilize probability sampling. The National Health Interview Survey's AIDS Knowledge and Attitudes Supplement is administered to a subsample of approximately 20,000 people annually. The Behavioral Risk Factor Surveillance System consists of telephone surveys providing data for all 50 states and the District of Columbia, with an average annual sample size of approximately 2,000 per state. The Youth Risk Behavior Surveillance System samples approximately 12,000 youth for its national school-based survey, 2,000 (average) for each of its state and local school-based surveys, 10,000 for its national household-based survey, and 6,000 (projected) for its national college-based survey. This article is meant to assist researchers, students, health educators, public health officials and others in utilizing survey data bases to address policy, program, research, and evaluation needs. All three surveys can help guide prevention efforts by providing information about the general population and by identifying national, local, or state-wide trends. More detailed studies and targeted studies of specific high-risk populations are also needed in light of the complexity of the determinants of HIV risk behavior.
OBJECTIVE: To examine the health-related behaviors of women physicians compared with those of other women of high and not high socioeconomic status and with national goals. METHODS: We examined the results of a questionnaire-based survey of a stratified random sample, the Women Physicians' Health Study, and a US telephone survey (Behavioral Risk Factor Surveillance System of the Centers for Disease Control and Prevention, Atlanta, Ga). We analyzed 3 samples of women aged 30 to 70 years: (1) respondents from the Women Physicians' Health Study (n = 4501); (2) respondents from the Behavioral Risk Factor Surveillance System (n = 1316) of the highest socioeconomic status; and (3) all other respondents from the Behavioral Risk Factor Surveillance System (n = 35,361). RESULTS: Women physicians were more likely than other women of high socioeconomic status and even more likely than other women not to smoke. The few physicians (3.7%) who smoked reported consuming fewer cigarettes per day, and physicians who had stopped smoking reported quitting at a younger age than women in the general population. Women physicians were less likely to report abstaining from alcohol, but those who drank reported consuming less alcohol per episode than other women and were less likely to report binging on alcohol than women in the general population. Unlike women in the general population and even other women of high socioeconomic status, women physicians' reported behaviors exceeded national goals for the year 2000 in all examined behaviors and screening habits. CONCLUSIONS: Women physicians report having generally good health habits even when compared with other socioeconomically advantaged women and report exceeding all examined national goals for personal screening practices and other personal health behaviors. Women physicians' behaviors may provide useful standards for other women in the United States.
In public health research and practice, quality of life is increasingly acknowledged as a valid and appropriate indicator of service need and intervention outcomes. Health-related quality of life measures, including objective and subjective assessments of health, are particularly useful for evaluating efforts in the prevention of disabling chronic diseases. Such data can inform health policy, planning, and practice. Mechanisms for routinely monitoring quality of life of populations at the State and local levels are currently lacking, however. This article discusses the rationale for and concepts measured by four quality of life questions developed for the 1993 Behavioral Risk Factor Surveillance System, a State-based telephone surveillance system. To encourage quality of life surveillance by States, the Centers for Disease Control and Prevention's National Center for Chronic Disease Prevention and Health Promotion held two related workshops, one in December 1991 and the other in June 1992. The workshops convened experts in quality of life and functional status measurement and resulted in the formulation of items for the Behavioral Risk Factor Surveillance System on self-perceived health, recent physical and mental health, and recent limitation in usual activities. The criteria, including feasibility and generalizability, considered by the Centers for Disease Control and Prevention and the workshop participants in the selection and development of these items are discussed. A model that conceptualizes the relationship of quality of life domains measured by the four survey items is presented and validated with preliminary data from the 1993 Behavioral Risk Factor Surveillance System. Finally, how States can use these measures to track progress towards the Year 2000 goal of improving quality of life is discussed.
OBJECTIVES: To estimate the prevalence of diabetes and related risk factors among Native Americans. RESEARCH DESIGN AND METHODS: We used 1988-1989 data from the Behavioral Risk Factor Surveillance System to calculate the overall, age-adjusted prevalence of diabetes, obesity, sedentary life-style, hypertension, and smoking among Native Americans. The SESUDAAN software package was used to derive confidence intervals. RESULTS: The prevalence of diabetes was 11.6% among the 768 Native American Behavioral Risk Factor Surveillance System respondents (95% confidence interval 7.8-15.4) and 4.7% among the 121,986 white respondents (95% confidence interval 4.6-4.8). The age-adjusted prevalence of diabetes was 2.5 times higher among Native Americans than among whites. The prevalence of obesity was higher among Native Americans (34.4; 95% confidence interval 31.7-37.1) than among whites (23.9%; confidence interval 23.7-24.1). The prevalences of sedentary lifestyle (58%), hypertension (16%), and smoking (28%) were similar among both populations. CONCLUSIONS: The Behavioral Risk Factor Surveillance System may prove as a useful tool for surveying Native Americans living on and off reservations for inclusion in national estimates of diabetes prevalences.