Public Health Officials Gather in St. Louis to Improve Survey of Americans' Health Status

Public health scientists from the Centers for Disease Control and Prevention (CDC) and each of the state health departments will gather in St. Louis, Missouri February 10-13 to update a system of state-based surveys that profile the current health status of the nation.

The Behavior Risk Factor Surveillance System (BRFSS), the largest continuously conducted telephone health survey in the world, has become the primary source of information for most states on what their adult population is doing, or not doing, to maintain good health and safety. The 2004 survey will emphasize identifying priority health issues and monitoring states’ progress in achieving the nation’s health objectives.

“Health journals and web sites are filled with articles about the things that make us sick and the new treatments that will make us well, but public health is largely committed to preventing illness in the first place,” said Dr. Julie L. Gerberding, director of CDC.

Scientists know that often health behaviors greatly influence health status. Smoking, poor nutritional habits, physical inactivity, alcohol abuse, and poor use of health screening all play key roles in contributing to our ill health. Such behaviors are also strongly linked to the leading causes of death in the United States–heart disease, stroke, cancer, diabetes and unintentional injuries.

“If public health agencies are to get a jump on our nation’s leading causes of death, we need solid data about the types of risky behaviors people engage in, how often and how long, and whether there’s been improvement over time. BRFSS will help provide this important information,” Gerberding said.

Through a series of monthly telephone interviews, state health departments survey their adult residents about a wide range of important health issues, such as diabetes and heart disease awareness, tobacco use, diet and physical activity, quality of life, mental health, health care screening and coverage, and even terrorism. The data is then analyzed according to race, ethnicity, gender, education, income, geographic location and other variables.

“It was data from BRFSS, that alerted us to two major epidemics–obesity and diabetes–that are seriously threatening our nation’s health and stretching our health care system to its limits,” said Ali Mokdad., PhD, BRFSS director. “States have also used BRFSS data to set up programs to help their citizens cope with such national emergencies as the Oklahoma City bombing and the September 11th terrorist attacks,” Mokdad said.

In addition to collaborating on state-of-the-art methodologies and technical innovations in data collection, scientists attending this week’s meeting will also be reviewing the past 20 years of the BRFSS.

The BRFSS is a cross-sectional telephone survey conducted by state health departments with assistance from CDC. States use the survey data to track critical health problems and to develop and evaluate public health programs.

The survey was first conducted in 1984 with just 15 states participating and is now conducted in all 50 states, three territories and the District of Columbia. The questionnaire has also grown in scope as the demand for high quality data has expanded throughout the years. The survey was originally designed with a set of core questions that are asked every year, but its design allows for states to add questions to reflect localized health issues.

Data comparisons show that, while Americans are making vast improvements in curbing some risky behaviors, some things have changed very little over the years. For instance, tobacco use decreased drastically in the years following World War II, but rates of current smoking have leveled off at about 23 percent over the last decade. On the other hand, women are taking advantage of breast cancer screening in ever increasing numbers. In 1990, 35.3 percent of women aged 40 years and older had never had a mammogram. By 2000, that number was reduced to 18 percent.

BRFSS data are particularly valuable to individual states in developing prevention programs and monitoring their results. For instance, Missouri has used the BRFSS to determine levels of health care availability in the state and monitor progress of the “Managing for Results Program” (http://www.mri.state.mo.us/). “BRFSS not only allowed Missouri to monitor risk behaviors, but enabled us to develop the capacity to carry out the surveys as well as analyze and interpret the data regarding the overall health of Missourians,” said, Dr. Eduardo Simoes, Missouri state epidemiologist.

The 20th annual BRFSS meeting is being held at the Sheraton St. Louis City Center Hotel and Suites, 400 South 14th St. For more information call 770-388-5131. For state-based data on health behaviors visit the BRFSS Web site: http://www.cdc.gov/brfss/.

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