Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.
MMWR Surveill Summ. 2010 Dec 10;59(10):1-221.
Chronic diseases (e.g., diabetes, cancer, heart disease, and stroke) are the leading causes of morbidity and mortality in the United States. Data on health risk behaviors that increase the risk for chronic diseases and use of preventive practices are essential for the development, implementation, and evaluation of health promotion programs, policies, and intervention strategies to decrease or prevent the leading causes of morbidity and mortality. Surveillance data from states and territories, selected metropolitan and micropolitan areas, and counties are vital components of these various prevention and intervention strategies.
January-December 2008 DESCRIPTION OF THE SYSTEM: The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing, state-based, random-digit--dialed telephone survey of noninstitutionalized adults residing in the United States. BRFSS collects data on health risk behaviors, preventive health services and practices, and access to health care related to the leading causes of death and disability in the United States. This report presents results for 2008 for all 50 states, the District of Columbia, Puerto Rico, Guam, the U.S. Virgin Islands, 177 metropolitan and micropolitan statistical areas (MMSAs), and 266 counties.
In 2008, the estimated prevalence of high-risk behaviors, chronic diseases and conditions, screening practices, and use of preventive health-care services varied substantially by state and territory, MMSA, and county. The following is a summary of results listed by BRFSS question topic. Each set of proportions refers to the range of estimated prevalence for the disease, condition, or behavior as reported by the survey respondent. Adults reporting good or better health: 68% to 89% for states and territories and 69% to 93% for selected MMSAs and counties. Health care insurance coverage: 72% to 96% for states and territories, 61% to 97% for MMSAs, and 61% to 98% for counties. Teeth extractions among persons aged ≥65 years: 10% to 38% for states and territories, 5% to 36% for MMSAs, and 4% to 34% for counties. Adults who had a checkup during the preceding 12 months: 56% to 81% for states and territories, 51% to 85% for MMSAs, and 51% to 89% for counties. Influenza vaccination among persons aged ≥65 years: 31% to 78% for states and territories, 52% to 82% for MMSAs, and 51% to 86% for counties. Pneumococcal vaccination among persons aged ≥65 years: 28% to 73% for states and territories, 46% to 82% for MMSAs, and 41% to 83% for counties. Adults aged ≥50 years who had a sigmoidoscopy/colonoscopy: 38% to 74% for states and territories, 45% to 78% for selected MMSAs, and 45% to 80% for counties. Adults aged ≥50 years who had a blood stool test during the preceding 2 years: 8% to 29% for states and territories, 7% to 51% for MMSAs, and 7% to 40% for counties. Among women aged ≥18 years who had a Papanicolaou test during the preceding 3 years: 67% to 89% for states and territories, 66% to 93% for selected MMSAs, and 66% to 96% for counties. Women aged ≥40 years who had a mammogram during the preceding 2 years: 64% to 85% for states and territories, and 61% to 88% for MMSAs and counties. Men aged ≥40 years who had a Prostate-Specific Antigen (PSA) test during the preceding 2 years: 34% to 66% for states and territories, 39% to 70% for MMSAs, and 37% to 71% for counties. Current cigarette smoking among adults aged ≥18 years: 6% to 27% for states and territories, 5% to 31% for MMSAs, and 5% to 30% for counties. Adults who reported binge drinking during the preceding month: 8% to 23% for states and territories, 3% to 25% for selected MMSAs, and 3% to 26% for counties. Heavy drinking among adults during the preceding month: 3% to 8% for states and territories, <1% to 10% for MMSAs, and 1% to 11% for counties. Adults who reported no leisure-time physical activity: 18% to 47% for states and territories, 12% to 40% for MMSAs, and 10% to 40% for selected counties. Adults who were overweight (BMI ≥25.0 and <30.0): 33% to 40% for states and territories, 31% to 46% for selected MMSAs, and 28% to 50% for counties. Adults aged ≥20 years who were obese (BMI ≥30.0): 20% to 34% for states and territories, 15% to 40% for MMSAs, and 13% to 40% for counties. Asthma among adults: 5% to 11% for states and territories, 4% to 13% for MMSAs, and 4% to 15% for counties. Diabetes among adults: 6% to 12% for states and territories, 3% to 17% for selected MMSAs, and 3% to 14% for counties. Adults aged ≥18 years who had limited activity because of physical, mental, or emotional problems: 10% to 30% for states and territories, 13% to 33% for MMSAs, and 12% to 31% for counties. Adults who required use of special equipment: 4% to 11% for states and territories, 3% to 12% for MMSAs, and 2% to 13% for counties. Angina and coronary heart disease among adults aged ≥45 years: 5% to 19% for states and territories, 6% to 22% for MMSAs, and 4% to 22% for counties. Adults aged ≥45 years with a history of stroke: 3% to 7% for states and territories, 2% to 11% for selected MMSAs, and 1% to 12% for counties.
The findings in this report indicate substantial variation in health-risk behaviors, chronic diseases and conditions, and use of preventive health-care services among U.S. adults at the state and territory, MMSA, and county level. The findings underscore the continued need for surveillance of health-risk behaviors, chronic diseases and conditions, and the use of preventive health services.
Healthy People 2010 objectives have been established to monitor health behaviors and the use of preventive health services. Local and state health departments and federal agencies use BRFSS data to identify populations at high risk for certain health behaviors, chronic diseases and conditions, and to evaluate the use of preventive services. In addition, BRFSS data are used to direct, implement, monitor, and evaluate public health programs and policies that can lead to a reduction in morbidity and mortality from adverse effects of health-risk behaviors and subsequent chronic conditions.
慢性病（如糖尿病、癌症、心脏病和中风）是美国发病率和死亡率的主要原因。关于增加慢性病风险的健康风险行为以及使用预防措施的数据对于开发、实施和评估健康促进计划、政策和干预策略以减少或预防发病率和死亡率的主要原因至关重要。来自州和领土、选定的大都市和米都市统计区以及县的监测数据是这些各种预防和干预策略的重要组成部分。
2008 年 1 月至 12 月
行为风险因素监测系统（BRFSS）是一项正在进行的、基于州的、随机拨号电话调查，对象是居住在美国的非机构化成年人。BRFSS 收集与美国主要死亡和残疾原因相关的健康风险行为、预防保健服务和做法以及获得保健的相关数据。本报告介绍了 2008 年所有 50 个州、哥伦比亚特区、波多黎各、关岛、美属维尔京群岛、177 个大都市和米都市统计区（MMSA）以及 266 个县的数据结果。
2008 年，高风险行为、慢性病和疾病状况、筛查做法以及预防保健服务的使用情况因州和领土、大都市和米都市统计区以及县而异。以下是按 BRFSS 问题主题列出的结果摘要。每个比例范围均指所报告的疾病、状况或行为的估计流行率。
州和领土为 68%至 89%，选定的大都市和米都市统计区为 69%至 93%。
州和领土为 72%至 96%，大都市和米都市统计区为 61%至 97%，县为 61%至 98%。
年龄≥65 岁的人拔牙：州和领土为 10%至 38%，大都市和米都市统计区为 5%至 36%，县为 4%至 34%。
在过去 12 个月内进行过体检的成年人：州和领土为 56%至 81%，大都市和米都市统计区为 51%至 85%，县为 51%至 89%。
年龄≥65 岁的人接种流感疫苗：州和领土为 31%至 78%，大都市和米都市统计区为 52%至 82%，县为 51%至 86%。
年龄≥65 岁的人接种肺炎球菌疫苗：州和领土为 28%至 73%，大都市和米都市统计区为 46%至 82%，县为 41%至 83%。
年龄≥50 岁且接受过乙状结肠镜检查/结肠镜检查的成年人：州和领土为 38%至 74%，选定的大都市和米都市统计区为 45%至 78%，县为 45%至 80%。
年龄≥50 岁且在过去 2 年内接受过粪便潜血试验的成年人：州和领土为 8%至 29%，大都市和米都市统计区为 7%至 51%，县为 7%至 40%。
在过去 3 年内接受过巴氏试验的年龄≥18 岁的女性：州和领土为 67%至 89%，选定的大都市和米都市统计区为 66%至 93%，县为 66%至 96%。
年龄≥40 岁且在过去 2 年内接受过乳房 X 光检查的女性：州和领土为 64%至 85%，大都市和米都市统计区为 61%至 88%，县为 61%至 96%。
年龄≥40 岁且在过去 2 年内接受过前列腺特异性抗原（PSA）检测的男性：州和领土为 34%至 66%，大都市和米都市统计区为 39%至 70%，县为 37%至 71%。
年龄≥18 岁且当前吸烟的成年人：州和领土为 6%至 27%，大都市和米都市统计区为 5%至 31%，县为 5%至 30%。
在过去一个月内报告有 binge drinking（狂饮）行为的成年人：州和领土为 8%至 23%，选定的大都市和米都市统计区为 3%至 25%，县为 3%至 26%。
州和领土为 3%至 8%，大都市和米都市统计区为<1%至 10%，县为 1%至 11%。
州和领土为 18%至 47%，大都市和米都市统计区为 12%至 40%，县为 10%至 40%。
体重超重（BMI≥25.0 且<30.0）的成年人：州和领土为 33%至 40%，选定的大都市和米都市统计区为 31%至 46%，县为 28%至 50%。
年龄≥20 岁且肥胖（BMI≥30.0）的成年人：州和领土为 20%至 34%，大都市和米都市统计区为 15%至 40%，县为 13%至 40%。
州和领土为 5%至 11%，大都市和米都市统计区为 4%至 13%，县为 4%至 15%。
州和领土为 6%至 12%，选定的大都市和米都市统计区为 3%至 17%，县为 3%至 14%。
由于身体、精神或情感问题而活动受限的成年人：州和领土为 10%至 30%，大都市和米都市统计区为 13%至 33%，县为 12%至 31%。
州和领土为 4%至 11%，大都市和米都市统计区为 3%至 12%，县为 2%至 13%。
年龄≥45 岁的成年人心绞痛和冠心病：州和领土为 5%至 19%，大都市和米都市统计区为 6%至 22%，县为 4%至 22%。
年龄≥45 岁且有中风史的成年人：州和领土为 3%至 7%，选定的大都市和米都市统计区为 2%至 11%，县为 1%至 12%。
本报告中的调查结果表明，美国成年人在州和领土、大都市和米都市统计区以及县一级的健康风险行为、慢性病和疾病状况以及预防性保健服务的使用情况存在很大差异。这些调查结果强调了需要继续监测健康风险行为、慢性病和疾病状况以及预防性保健服务的使用情况。
《健康人民 2010》目标已经确定，以监测健康行为和预防性卫生服务的使用情况。地方和州卫生部门以及联邦机构使用 BRFSS 数据来确定某些健康行为、慢性病和疾病状况以及使用预防性服务的高风险人群。此外，BRFSS 数据还用于指导、实施、监测和评估可导致不良健康风险行为和随后的慢性疾病的发病率和死亡率降低的公共卫生计划和政策。
