国家和部分选定地区特定健康行为、慢性病及状况、卫生保健服务利用和预防保健服务的监测 - 美国 2012 年行为危险因素监测系统。

Surveillance for Certain Health Behaviors, Chronic Diseases, and Conditions, Access to Health Care, and Use of Preventive Health Services Among States and Selected Local Areas - Behavioral Risk Factor Surveillance System, United States, 2012.

机构信息

Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC.

出版信息

MMWR Surveill Summ. 2016 Apr 29;65(4):1-142. doi: 10.15585/mmwr.ss6504a1.

DOI:10.15585/mmwr.ss6504a1

PMID:27124212

Abstract

PROBLEM

Chronic diseases (e.g., heart diseases, cancer, chronic lower respiratory disease, stroke, diabetes, and arthritis) and unintentional injuries are the leading causes of morbidity and mortality in the United States. Behavioral risk factors (e.g., tobacco use, poor diet, physical inactivity, excessive alcohol consumption, failure to use seat belts, and insufficient sleep) are linked to the leading causes of death. Modifying these behavioral risk factors and using preventive health services (e.g., cancer screenings and influenza and pneumococcal vaccination of adults aged ≥65 years) can substantially reduce morbidity and mortality in the U.S.

POPULATION

Continuous monitoring of these health-risk behaviors, chronic conditions, and use of preventive services are essential to the development of health promotion strategies, intervention programs, and health policies at the state, city, and county level.

REPORTING PERIOD

January-December 2012.

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 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, participating U.S. territories that include the Commonwealth of Puerto Rico (Puerto Rico) and Guam, 187 Metropolitan/Micropolitan Statistical Areas (MMSAs), and 210 counties (n = 475,687 survey respondents) for the year 2012.

RESULTS

In 2012, the estimated prevalence of health-risk behaviors, chronic diseases or conditions, access to health care, and use of preventive health services substantially varied by state and territory, MMSA, and county. The following portion of the abstract lists a summary of results by selected BRFSS measures. Each set of proportions refers to the range of estimated prevalence for health-risk behaviors, chronic diseases or conditions, and use of preventive health care services among geographical units, as reported by survey respondents. Adults with good or better health: 64.0%-88.3% for states and territories, 62.7%-90.5% for MMSAs, and 68.1%-92.4% for counties. Adults aged 18-64 years with health care coverage: 64.2%-93.1% for states and territories, 35.4%- 93.7% for MMSAs, and 35.4%-96.7% for counties. Adults who received a routine physical checkup during the preceding 12 months: 55.7%-80.1% for states and territories, 50.6%-85.0% for MMSAs, and 52.4%-85.0% for counties. An influenza vaccination received during the preceding 12 months among adults aged ≥65 years: 26.3%-70.1% for states and territories, 20.8%-77.8% for MMSAs, and 24.1%-77.6% for counties. Ever received pneumococcal vaccination among adults aged ≥65 years: 22.2%-76.2% for states and territories, 15.3%-83.4% for MMSAs, and 25.8%-85.2% for counties. Adults who had a dental visit in the past year: 53.7%-76.2% for states and territories, and 44.8%-81.7% for MMSAs and counties. Adults aged ≥65 years who have lost all of their natural teeth from tooth decay or gum disease: 7.0%-33.7% for states and territories, 5.8%-39.6% for MMSAs, and 5.8%-37.1% for counties. Adults aged 50-75 years who received a colorectal cancer screening on the basis of the U.S. Preventive Services Task Force recommendation: 40.0%-76.4% for states and territories, 47.1%-80.7% for MMSAs, and 47.0%-81.0% for counties. Women aged 21-65 years who had a Papanicolaou test during the preceding 3 years: 68.5% to 89.6% for states and territories, 70.3% to 92.8% for MMSAs, and 65.7%-94.6% for counties. Women aged 50-74 years who had a mammogram during the preceding 2 years: 66.5%- 89.7% for states and territories, 61.1%-91.5% for MMSAs, and 61.8%-91.6% for counties. Current cigarette smoking among adults: 10.6%-28.3% for states and territories, 5.1%-30.1% for MMSAs, and 5.1%-28.3% for counties. Binge drinking among adults during the preceding month: 10.2%-25.2% for states and territories, 6.2%-28.1% for MMSAs, and 6.2%-29.5% for counties. Heavy drinking among adults during the preceding month: 3.5%-8.5% for states and territories, 2.0%-11.0% for MMSAs, and 1.9%-11.0% for counties. Adults who reported no leisure-time physical activity: 16.3%-42.4% for states and territories, 9.2%-47.3% for MMSAs, and 9.2%-39.0% for counties. Self- reported seat belt use: 62.0%-93.7% for states and territories, 54.1%-97.1% for MMSAs, and 50.1%-97.4% for counties. Adults who were obese: 20.5%-34.7% for states and territories, 14.8%-44.5% for MMSAs and counties. Adults with diagnosed diabetes: 7.0%-16.4% for states and territories, 3.4%-17.4% for MMSAs, and 3.1%-17.4% for counties. Adults who ever had any type of cancer: 3.0%-13.7% for states and territories, 3.8%-19.2% for MMSAs, and 4.5%-19.2% for counties. Adults with current asthma: 5.8%-11.1% for states and territories, 3.1%-15.0% for MMSAs, and 3.1%-15.7% for counties. Adults with some form of arthritis: 15.6%-36.4% for states and territories, 16.8%-45.8% for MMSAs, and 14.8%-35.9% for counties. Adults having had a depressive disorder: 9.0%-23.5% for states and territories, 9.2%-28.3% for MMSAs, and 8.5%-28.4% for counties. Adults aged ≥45 years who have had coronary heart disease: 7.4%-19.0% for states and territories, 6.1%-23.3% for MMSAs, and 6.1%-20.6% for counties. Adults aged ≥45 years who have had a stroke: 3.1%-7.3% for states and territories, 2.1%-9.3% for MMSAs, and 1.5%-9.3% for counties. Adults with limited activities because of physical, mental, or emotional problems: 15.0%-28.6% for states and territories, 12.0%-31.7% for MMSAs, and 11.3%-31.7% for counties. Adults using special equipment because of any health problem: 4.8%-11.6% for states and territories, 4.0%-14.7% for MMSAs, and 2.8%-13.6% for counties.

INTERPRETATION

This report underscores the need for continuous surveillance of health-risk behaviors, chronic diseases or conditions, health care access, and use of preventive care services at state and local levels. It will help to identify high-risk populations and to evaluate public health intervention programs and policies designed to reduce morbidity and mortality from chronic disease and injury.

PUBLIC HEALTH ACTION

State and local health departments and agencies can continue to use BRFSS data to identify populations at high risk for unhealthy behaviors and chronic diseases or conditions, lack of health care access, and inadequate use of preventive care services. Additionally, states can use the data to design, implement, monitor, and evaluate public health programs and policies at state and local levels.

摘要

问题

慢性病（如心脏病、癌症、慢性下呼吸道疾病、中风、糖尿病和关节炎）和意外伤害是导致美国发病率和死亡率的主要原因。行为风险因素（如吸烟、不良饮食、缺乏身体活动、过量饮酒、不系安全带和睡眠不足）与主要死亡原因有关。改变这些行为风险因素并使用预防保健服务（如癌症筛查以及 65 岁及以上成年人的流感和肺炎球菌疫苗接种）可以显著降低美国的发病率和死亡率。

人群

连续监测这些健康风险行为、慢性病和使用预防服务对于制定州、市和县级的健康促进战略、干预计划和卫生政策至关重要。

报告期

2012 年 1 月至 12 月。

描述

行为风险因素监测系统（BRFSS）是一项持续进行的、基于州的、随机数字拨号的陆地电话和移动电话调查，调查对象为年龄在 18 岁及以上、居住在美国的非机构化成年人。BRFSS 收集与主要死亡和残疾原因有关的健康风险行为、慢性病和状况、获得保健服务以及使用预防保健服务的数据。本报告介绍了所有 50 个州、哥伦比亚特区、参加的美国领土（包括波多黎各和关岛）、187 个大都市区/大都市统计区（MMSA）和 210 个县（n=475687 名调查受访者）在 2012 年的调查结果。

结果

2012 年，在州和领土、大都市/大都市统计区以及县一级，健康风险行为、慢性病或状况、获得保健服务以及使用预防保健服务的流行率存在显著差异。以下摘要部分列出了 BRFSS 各项措施的部分结果。每一组比例均指调查受访者报告的健康风险行为、慢性病或状况以及使用预防保健服务的估计流行率，范围为地理单位。成年人健康状况良好或更好：州和领土为 64.0%-88.3%，大都市/大都市统计区为 62.7%-90.5%，县为 68.1%-92.4%。18-64 岁的成年人有医疗保险：州和领土为 64.2%-93.1%，大都市/大都市统计区为 35.4%-93.7%，县为 35.4%-96.7%。在过去 12 个月内接受过常规体检的成年人：州和领土为 55.7%-80.1%，大都市/大都市统计区为 50.6%-85.0%，县为 52.4%-85.0%。在过去 12 个月内，年龄在 65 岁及以上的成年人接种过流感疫苗：州和领土为 26.3%-70.1%，大都市/大都市统计区为 20.8%-77.8%，县为 24.1%-77.6%。在过去 12 个月内，年龄在 65 岁及以上的成年人接种过肺炎球菌疫苗：州和领土为 22.2%-76.2%，大都市/大都市统计区为 15.3%-83.4%，县为 25.8%-85.2%。在过去一年中接受过牙科治疗的成年人：州和领土为 53.7%-76.2%，大都市/大都市统计区为 44.8%-81.7%。年龄在 65 岁及以上、因龋齿或牙周病导致所有天然牙齿脱落的成年人：州和领土为 7.0%-33.7%，大都市/大都市统计区为 5.8%-39.6%，县为 5.8%-37.1%。年龄在 50-75 岁之间、根据美国预防服务工作组建议接受结直肠癌筛查的成年人：州和领土为 40.0%-76.4%，大都市/大都市统计区为 47.1%-80.7%，县为 47.0%-81.0%。21-65 岁的女性在过去 3 年内接受过巴氏涂片检查：州和领土为 68.5%-89.6%，大都市/大都市统计区为 70.3%-92.8%，县为 65.7%-94.6%。50-74 岁的女性在过去 2 年内接受过乳房 X 光检查：州和领土为 66.5%-89.7%，大都市/大都市统计区为 61.1%-91.5%，县为 61.8%-91.6%。目前吸烟的成年人：州和领土为 10.6%-28.3%，大都市/大都市统计区为 5.1%-30.1%，县为 5.1%-28.3%。成年人过去一个月内的 binge 饮酒：州和领土为 10.2%-25.2%，大都市/大都市统计区为 6.2%-28.1%，县为 6.2%-29.5%。成年人过去一个月内的重度饮酒：州和领土为 3.5%-8.5%，大都市/大都市统计区为 2.0%-11.0%，县为 1.9%-11.0%。报告称没有闲暇时间进行体育活动的成年人：州和领土为 16.3%-42.4%，大都市/大都市统计区为 9.2%-47.3%，县为 9.2%-39.0%。自我报告的安全带使用率：州和领土为 62.0%-93.7%，大都市/大都市统计区为 54.1%-97.1%，县为 50.1%-97.4%。成年人肥胖：州和领土为 20.5%-34.7%，大都市/大都市统计区和县为 14.8%-44.5%。患有糖尿病的成年人：州和领土为 7.0%-16.4%，大都市/大都市统计区和县为 3.4%-17.4%，大都市/大都市统计区和县为 3.1%-17.4%。曾经患有任何类型癌症的成年人：州和领土为 3.0%-13.7%，大都市/大都市统计区为 3.8%-19.2%，县为 4.5%-19.2%。成年人有哮喘：州和领土为 5.8%-11.1%，大都市/大都市统计区为 3.1%-15.0%，县为 3.1%-15.7%。成年人有关节炎：州和领土为 15.6%-36.4%，大都市/大都市统计区为 16.8%-45.8%，县为 14.8%-35.9%。成年人患有某种形式的关节炎：州和领土为 15.6%-36.4%，大都市/大都市统计区为 16.8%-45.8%，县为 14.8%-35.9%。成年人患有抑郁症：州和领土为 9.0%-23.5%，大都市/大都市统计区为 9.2%-28.3%，县为 8.5%-28.4%。年龄在 45 岁及以上、患有冠心病的成年人：州和领土为 7.4%-19.0%，大都市/大都市统计区为 6.1%-23.3%，县为 6.1%-20.6%。年龄在 45 岁及以上、患有中风的成年人：州和领土为 3.1%-7.3%，大都市/大都市统计区为 2.1%-9.3%，县为 1.5%-9.3%。因身体、精神或情绪问题而活动受限的成年人：州和领土为 15.0%-28.6%，大都市/大都市统计区为 12.0%-31.7%，县为 11.3%-31.7%。因任何健康问题而使用特殊设备的成年人：州和领土为 4.8%-11.6%，大都市/大都市统计区为 4.0%-14.7%，县为 2.8%-13.6%。