1. Trends in Health Risks and Behaviors Highlights from the 2003 Massachusetts Behavioral Risk Factor Surveillance System Health Survey Program Center for Health Information, Statistics, Research, and Evaluation Massachusetts Department of Public Health December 2004

2. What is the BRFSS? oRandom digit dial telephone survey oAdults ages 18 and older oCollaboration between CDC and States oMassachusetts BRFSS since 1986 oData are weighted: provide population-based estimates of health oSample Size: 7,000 - 8,000 annually Source: Massachusetts BRFSS

3. BRFSS TOBACCO CANCER SCREENING DRUG & ALCOHOL ASTHMA CHOLESTEROL NUTRITION & EXERCISE HEALTH CARE ACCESS INJURY DIABETES 50 OTHER TOPICS WEIGHT Source: Massachusetts BRFSS

4. Topics to be covered oFlu Vaccination oOverweight or Obesity oTobacco Use oBinge Drinking oMammogram oHIV Testing

5. Influenza (flu) Vaccine

6. Trend in the percentage of adults, ages 65+, who have had a flu vaccine in the past year, 1993-2003 Note: Dotted line signifies year in which question was not asked.Source: Massachusetts BRFSS

7. State vaccine purchase and statewide immunization rates

8. Percentage of adults who received a flu or pneumonia vaccine by race/ethnicity, 2001-2003 Source: Massachusetts BRFSS

9. MDPH Program Highlights Immunization Program oEducational outreach Mailing to 10,000 providers about flu vaccination recommendations Presentations and grand rounds to health care providers MDPH influenza web site Partnerships and Coalitions Promotional campaign targeting Latino and African-American communities oStanding Orders Project to vaccinate hospital in-patients oFlu vaccination of health care workers Source: MDPH Immunization Program

10. Obesity

11. Overweight Obese Height BMI* 25.0-29.9 BMI* > 30 5’128 lbs.153 lbs. 5’2’’136164 5’4’’145174 5’6’’155186 5’8’’164197 6’184221 Adult Overweight or Obese by Height *BMI (Body Mass Index): weight in kilograms  height in meters squaredSource: Massachusetts BRFSS

12. Overweight Obese Height BMI* 25.0-29.9 BMI* > 30 5’128 lbs.153 lbs. 5’2’’136164 5’4’’145174 5’6’’155186 5’8’’164197 6’184221 Adult Overweight or Obese by Height Source: Massachusetts BRFSS*BMI (Body Mass Index): weight in kilograms  height in meters squared

13. Trend in the percentage of adults who are overweight or obese, 1990-2003 Source: Massachusetts BRFSS

14. Percentage of adults who are obese, by sex and race/ethnicity, 2003 Rates are age adjusted to the US 2000 standard population.Source: Massachusetts BRFSS

15. MDPH Program Highlights: Massachusetts Overweight Prevention and Control Initiative (MOPCI) oStatewide: partnering with public and private organizations to coordinate overweight prevention and control efforts oCommunities: working with communities to implement walk/bike to school and work initiatives oSchools: working with schools to increase student awareness and participation in healthy eating and physical activity before, during, and after school oWorksites: working with employers to support improved nutrition and increased participation in physical activity for their employees Source: Massachusetts Overweight Prevention and Control Initiative

16. Breast Cancer Screening

17. Trend in the percentage of women, ages 40+, who had a mammogram in past 2 years, 2003 Note: Dotted line signifies year in which question was not asked.Source: Massachusetts BRFSS

18. Trend in the percentage of women, ages 40+, who had a mammogram in past 2 years by insurance status, 2003 * 2000 data only Source: Massachusetts BRFSS

19. Percentage of women, ages 40+, who had a mammogram in the past 2 years, by disability status, 2003 Rates are age adjusted to the US 2000 standard population.Source: Massachusetts BRFSS

20. MDPH Program Highlights: Breast Cancer Screening oIncrease in mammograms among women ages 40+ after program inception. oBetter access to care needed for people with disabilities. oMore outreach needed to Hispanic women. Source: Massachusetts Women’s Health Network

21. Binge Drinking (5 or more drinks on one occasion)

22. Trend in the percentage of binge drinkers among adults, 1990-2003 Note: Dotted line signifies year in which question was not asked.Source: Massachusetts BRFSS

23. Percentage of binge drinkers among adults, by household income, 2003 Source: Massachusetts BRFSS

24. MDPH Program Highlights: Binge Drinking oMA monitors binge drinking because of the associated high risk behaviors oPercentage of MA adults reporting binge drinking is consistently higher than US average on both the BRFSS and SAHMSA. (Substance Abuse Mental Health Services Administration’s National Survey on Drug Use and Health (NSDUH)). oBoth BRFSS and NSDUH show similar patterns by demographic group. oBureau of Substance Abuse Services funds a broad spectrum of regional and community-based prevention programs and a continuum of substance use treatment services. Source: MDPH Bureau of Substance Abuse and Services

25. Cigarette Smoking

26. Percentage of current smokers among adults, 1986-2003 Source: Massachusetts BRFSS

27. Percentage of current smokers among adults and young adults, 1986-2003 Source: Massachusetts BRFSS

28. Percentage of current smokers among adults, by household income, 1986-2003 Source: Massachusetts BRFSS

29. MDPH Program Highlights: Tobacco Control Program oImplementation of smokefree workplace laws oMonitoring illegal cigarette sales to minors via statewide compliance check program oWorking with health care systems to determine smoking status of patients and refer smokers to quit line oPromoting smokefree homes and smoking cessation services to programs serving young women with children such as Healthy Start, Early Intervention, Head Start and WIC Source: MDPH Tobacco Control Program

30. HIV Testing

31. Percentage of adults, ages 18-64, who report ever being tested for HIV, by risk status, 1993-2003 0 20 40 60 80 100 19931994199519961997199819992000200120022003 % ever tested ever testedever tested and high risk behavior Source: Massachusetts BRFSS

32. MDPH Program Highlights HIV/AIDS Bureau Counseling and Testing Program oThe general population have multiple opportunities for HIV testing, including private health care and life insurance application processes. oPublicly funded HIV testing and counseling programs are required to identify and target high risk populations for testing. oPublic and clinical education programs emphasize the importance of knowing one’s risk and HIV testing as the point of access to HIV care. oHigher relative testing rates among high risk individuals may reflect the impact of educational programming about HIV risk and the benefits of testing, as well as the effectiveness of targeted public test access. oAs the efficiency of the publicly funded HIV counseling and testing system increases, it remains important to maintain access to health care and anti-HIV medications for the 1,000 Massachusetts resident who yearly are newly identified with HIV. Source: MDPH HIV/AIDS Bureau

33. Summary oImportant to examine trends to inform program development oTrends that bear watching: Smoking: rates stable among adults; concerns among young adults Mammogram: concerns among women with disabilities Overweight/Obesity: continued rise for all; race and gender disparities exist Binge Drinking: Massachusetts higher than the US HIV testing: high testing rate among high risk adults

34. Monitoring the Health of Massachusetts: 2003 BRFSS Report oOverall health measures: health status, quality of life oAccess and Utilization: insurance coverage, access to care oRisk factors and preventive behaviors: physical activity, nutrition, hypertension, cholesterol awareness oChronic conditions: diabetes, CVD, asthma, disability oCancer screening oChildhood health: dental sealant, access to care, asthma oOthers: HIV testing, illicit drug use, unwanted sexual contact

35. How to obtain this report? For access to reports and data: Visit the BRFSS website: http://www.state.ma.us/dph/bhsre/cdsp/brfss/brfss.htm MassCHIP: 2003 BRFSS data will be available late in 2005 For more information about BRFSS, please contact: Zi Zhang, Director of Health Survey Program Tel: (617) 624-5623 E-mail: zi.zhang@state.ma.us http://www.state.ma.us/dph/bhsre/cdsp/brfss/brfss.htm