Behavioral Risk Factor Surveillance System

Behavioral Risk Factor Surveillance System
BRFSS Behavioral Risk Factor Surveillance System 2001 Onslow County BRFSS Survey Results Onslow County was a partner in the first North Carolina BRFSS expansion that included ten counties in This presentation summarizes the results from the Onslow County 2001 BRFSS in comparison with other partner counties, state and national data. State Center for Health Statistics Division of Public Health North Carolina Department of Health and Human Services

History of the BRFSS Survey
Developed by the Centers for Disease Control and Prevention (CDC) and state health departments in the early 1980s in response to the need for: on-going assessment of adult health-risk behaviors and health practices; provision of state and regional (and now county) estimates for targeting high-risk groups. It is the largest and longest running telephone health survey in the world. The BRFSS was developed by the Centers for Disease Control and Prevention (CDC) and state health departments in the early 1980s in response to the need for: (1) on-going assessment of adult health-risk behaviors and health practices; and (2) provision of state and regional (and now county) estimates for targeting high-risk groups. It is the largest and longest running telephone health survey in the world. Nationwide, there are now over 200,000 interviews completed annually.

BRFSS in the U.S., 1984 In 1984, 14 states including North Carolina participated in the BRFSS

BRFSS in the U.S., 1990 In 1990, all but six states were part of the BRFSS Surveillance Program.

BRFSS in the U.S., 1994 Guam Puerto Rico Virgin Islands
By 1994, all states, the District of Columbia and three U.S. territories were participating in the BRFSS. Guam Puerto Rico Virgin Islands

The Expansion of the North Carolina 2001 BRFSS
The annual sample size was increased from 2,000+ respondents to 6,000+ respondents. Ten of the largest counties in North Carolina were oversampled to produce county-specific estimates (Buncombe, Cumberland, Durham, Forsyth, Gaston, Guilford, Mecklenburg, New Hanover, Onslow, Wake) The remaining counties were stratified into three regions of the state: Western, Piedmont, and Eastern. (Regional estimates do not include the respective oversampled counties.) The NC 2001 BRFSS contained close to 250 survey questions, nearly twice the number of any previous survey. In 2001, the NC-BRFSS expanded its sample size to collect more county level interviews in order to generate county-specific estimates for health behaviors. The annual sample size was increased from 2,000+ respondents to 6,000+ respondents. Ten of the largest counties in North Carolina were oversampled to produce county-specific estimates (Buncombe, Cumberland, Durham, Forsyth, Gaston, Guilford, Mecklenburg, New Hanover, Onslow, Wake) The remaining NC counties were stratified into three regions of the state: Western, Piedmont, and Eastern. Regional estimates do not include the respective oversampled counties. The NC 2001 BRFSS contained close to 250 survey questions, nearly twice the number of any previous survey. In summary, the 2001 BRFSS was the largest BRFSS Survey to date in North Carolina with respect to sample size and number of questions asked.

This slide shows the oversampled counties (in blue), which include Buncombe, Cumberland, Durham, Forsyth, Gaston, Guilford, Mecklenburg, New Hanover, Onslow, Wake.

Standard BRFSS Data Collection Methods
Ongoing monthly telephone interviews using random digit dialing Computer-assisted telephone interviewing (CATI) Probability sampling of noninstitutionalized adults (18+ years) in households with telephones BRFSS is an ongoing monthly telephone interviews using random digit dialing. Data is analyzed on a calendar year basis. The questionnaire changes each year, beginning in January. Interviews are conducted using Computer Assisted Telephone Interviewing (CATI) system. Data entry is completed during the interview, via CATI. The BRFSS uses a probability sample of non-institutionalized adults (18+ years) in households with telephones.

Weighting the BRFSS Data
BRFSS data are directly weighted for the probability of selection of a telephone number, the number of adults (18+ yrs.) in a household, and the number of phones in a household. Additional weights are developed for non-coverage, i.e. households with no telephones, and for differences between the sample characteristics and the state population characteristics. A final weight is assigned to each respondent so that the weighted proportion and weighted number of respondents by sex, age, and race matches the state population. Weighting the data is an essential part of the BRFSS data processing. BRFSS data are directly weighted for the probability of selection of a telephone number, the number of adults (18+ yrs.) in a household, and the number of phones in a household. Additional weights are developed for non-coverage, i.e. households with no telephones, and for differences between the sample characteristics and the state population characteristics. A final weight is assigned to each respondent so that the weighted proportion and weighted number of respondents by sex, age, and race matches the state population.

The BRFSS Questionnaire
Standard Core Questions Required by CDC and asked every year by all participants. Rotating Core Questions Required by CDC and asked every other year by all participants. Emerging Core Questions Required by CDC and asked every one time by all participants. Optional Modules offered and supported by CDC Included if sponsored by state programs/agencies. State-Added Questions Developed by state programs/agencies that also sponsor them. The BRFSS questionnaire has five types of questions with respect to CDC funding requirements and how often they are asked. Core questions are funded and required by the CDC to be included in the questionnaire. Rotating core questions are usually asked every other year. Emerging core questions are generally asked for one year with respect to an emerging public health issue. Optional Modules are a set of questions related to a topic and offered by CDC for states to use. These modules are included in the BRFSS questionnaire if requested and sponsored by state programs/agencies. Each year different sets of optional modules are offered by CDC. State-added Questions are developed or borrowed from other health surveys or previous years’ BRFSS questions; these questions are usually sponsored by state programs or agencies. The State Center for Health Statistics helps find these questions and occasionally tests and develop them.

Survey Topics on the NC 2001 BRFSS
Core Sections Health status High Blood Pressure Cholesterol Asthma/Diabetes Arthritis Immunization Tobacco/alcohol use Firearms Demographics Prostate/colorectal HIV/AIDs Optional Modules Oral health Tobacco indicators Heart attack/stroke Cardiovascular disease Diabetes care Fruits and vegetables Folic acid State-added Substance abuse Health care coverage Cardiovascular prevention Cancer Osteoporosis Physical activity Disability Family Planning Sexual behavior Sexual assault Here we see the various topics covered in the Core, Optional Modules, and State-added questions, comprising the 2001 North Carolina BRFSS Survey.

About this 2001 BRFSS Slide Presentation
Objectives: (1) promote BRFSS data use and dissemination by North Carolina public health professionals; and (2) by mixing or selecting specific slides, presentations may be tailored or modified to suit the needs of the county/presenter. Talking points: slides include talking points to help with interpretation of the results and offer further explanations. Survey questions: for reference purposes, the BRFSS survey question(s) is quoted verbatim in the talking points. Nationwide data: for core topics, nationwide estimates (means) are provided for comparison. Calculations: only weighted data are presented and all “unknowns/refusals” are excluded from calculations. The primary objective of this presentation is to increase use of BRFSS data and dissemination by North Carolina public health professionals. Secondly, by choosing, mixing and modifying slides, counties may create their own presentation. For example, one can choose only Healthy People 2010 and some BRFSS background slides to include in a HP 2010 presentation. Please check the 2001 NC BRFSS questionnaire to learn about the skip patterns for different questions; for example, colorectal cancer screening questions are asked only of persons age 50 and older. The Diabetes Module is another type of example involving skip patterns: only people with diabetes are asked these questions. Weighted data are used throughout this presentation. Respondents who reported “Don’t know’ or refused to answer the question were excluded in all calculations. In rare cases, “I don’t know” responses were considered.

About this 2001 BRFSS Slide Presentation (continued)
Cautionary Notes: These results need to be viewed as estimates and not the actual or true value of the outcome of interest. With any estimate based on a random sample, there is a margin of error. For the 10 oversampled counties the margin of error is about 5% if the question was asked of all respondents. This means that we can expect the true value to lie somewhere between the sample estimate plus or minus 5 percent. When county results are subset by age or race, for example, the margin of error increases as a function of the resulting smaller sample size. Use caution when comparing the results across counties, as the margin of error may not be the same for all counties. These results need to be viewed as estimates and not the actual or true value of the outcome of interest. With any estimate based on a random sample, there is a margin of error. For the 10 over-sampled counties the margin of error is about 5% if the question was asked of all respondents. This means that we can expect the true value to lie somewhere between the sample estimate plus or minus 5 percent. When county results are subset by age or race, for example, the margin of error increases as a function of the resulting smaller sample size. Use caution when comparing the results across counties, as the margin of error may not be the same for all counties.

Contents of Presentation
Sample size & demographics Health care access Chronic diseases Use of preventive health services Oral health Cardiovascular Health Tobacco Use and Prevention Health Risk Behaviors Physical activity Health status & quality of life Family Planning HIV/AIDS & sexual behavior BRFSS tracked HP2010 objectives Special topics There are 14 content areas contained in this presentation, beginning with Sample Size and Demographics and ending with Special Topics. Also note that all of the results in this presentation are based on weighted data. Note: all results are based on weighted data

I. Sample Size & Demographics

2001 BRFSS Sample Size Each county had at least 400 completed interviews. There was a total of 6,205 completed interviews. In Onslow, a total of 436 interviews were completed.

BRFSS 2001 Sample Demographic Characteristics
With respect to gender, Onslow County has a noticeably higher proportion of males, compared to their proportion statewide. With respect to age, Onslow has a noticeably younger population of adults than the state; for example, the percentage of 18 to 44 year olds in Onslow is about 23% higher than the state percentage. *weighted percentages

BRFSS 2001 Sample Demographic Characteristics (Continued)
In terms of education, the distributions are fairly similar for both Onslow and the state. With respect to household income, Onslow has a noticeably higher proportion of households in the $20,000 to $34,999 range. Furthermore, the proportion of employed adults in Onslow is somewhat higher than the statewide employment rate, while the proportion of retired adults in Onslow is somewhat lower than the state retirement rate. *weighted percentages

II. Health Care Access Health insurance coverage
Cost of seeing a doctor Usual source of care Personal provider Place of care

Health Insurance Coverage*
Q: “Do you have any kind of health care coverage, including health insurance, prepaid plans such as HMOs, or government plans such as Medicare?” Statewide, about 83% of North Carolina adults, less than age 65, have some type of health insurance coverage, which is 17 percentage points below the Healthy People 2010 target of 100%. Of all the oversampled counties, about 80% is the lowest health insurance coverage rate, and about 90% is the highest coverage rate. Presenter Note: for all slides, such as this one, which show the 10 counties together, the order of the counties is based on their stratum order and not on their alphabetical order. HP 2010 Target: 100% *Adults < 65 yrs old XIII. HP 2010 Objectives

Health Insurance Coverage by Race & Sex North Carolina, 1991-2001
Since the beginning of the nineties, African Americans have had consistently lower rates of health insurance coverage than whites. This gap, however, does appear to be closing in 2001. Males also tend to have somewhat less insurance coverage than females. II Health Care Access

Health Insurance Coverage by Sex, Race, & Age: Onslow County & NC (adults <65 yrs. old)
Q: “Do you have any kind of health care coverage, including health insurance, prepaid plans such as HMOs, or government plans such as Medicare? “ Health insurance coverage for males, whites, and 18 to 44 year olds is somewhat lower than the comparable state rates. Health insurance coverage among African Americans in Onslow County far exceeded that of whites in Onslow, and it also exceeded that of African Americans from any of the other oversampled counties. II. Health Care Access

Could not See a Doctor Due to Cost in Past Year
Q: “Was there a time during the past 12 months when you needed to see a doctor, but could not because of the cost?” For Gaston, Buncombe, Cumberland, and New Hanover counties, the rates exceeded the state rate. The lowest rates (or occurrence of not being able to see a doctor because of cost) were found among Wake, Guilford, Forsyth, and Onslow counties. II. Health Care Access

Has a Usual Source of Medical care*
Q: “Is there one particular clinic, health center, doctor's office, or other place that you usually go to if you are sick or need advice about your health?” Having a usual source of medical care ranges from a low of 71.7% in New Hanover County to a high of 86.4% in Forsyth County. No counties are close to the HP2010 target of 96%. HP 2010 Target: 96% *includes clinic, health center, doctor’s office II. Health Care Access

Has Personal Health Care Provider(s)*
Q: “Do you have one person you think of as your personal doctor or health care provider? (These results include those who reported having one or more persons they regard as their personal doctor or doctors.) The results show a fair amount of variability across counties in the proportion of those who report having a personal health care provider, ranging from a low of 67.4% in Cumberland to a high of 90% in Forsyth. *one or more persons regarded as a personal doctor II. Health Care Access

III. Chronic Diseases Arthritis Asthma Cancer Diabetes Disability
High cholesterol High Blood Pressure For each of these chronic diseases, we show the disease prevalence for the 10 BRFSS counties, the state and, where applicable, the US. When the results pertain to an optional module, such as Diabetes, the disease prevalence for the U.S. includes only those states that elected to use the module.

Arthritis We begin with Arthritis.

Doctor-Diagnosed Arthritis
Q: “Have you ever been told by a doctor that you have arthritis?” Statewide, about 23% of adults (ages 18+) have a doctor-diagnosed Arthritis condition. The lowest rate or doctor-diagnosed Arthritis was found in Wake county (recall the age structure of Wake County); the highest rate was found in Gaston County. III. Chronic Diseases: Arthritis

Arthritis* Prevalence by Sex, Race, & Age: Onslow County & NC
The prevalence of doctor-diagnosed arthritis by gender and race is generally lower in Gaston County than that found statewide. Among 18 to 44 year olds in Onslow County, the prevalence of arthritis is somewhat lower than the state prevalence, while among 45+ year olds in Onslow, the prevalence is somewhat higher. * doctor-diagnosed III. Chronic Diseases: Arthritis

Chronic Joint Symptoms (CJS)
Chronic joint symptoms is derived from 2 BRFSS survey questions: Q1: “During the past 12 months, have you had pain, aching, stiffness or swelling in or around a joint?” AND Q2: “Were these symptoms present on most days for at least one month?” For the state as a whole, about one in five adults have chronic joint symptoms. Across the 10 counties, the rates of chronic joint symptoms vary from a low of 14.8% in Mecklenburg County to a high of 24.5% in Buncombe County. III. Chronic Diseases: Arthritis

Total Arthritis (CJS and/or Doctor Diagnosed)
Total arthritis is defined as having either a doctor-diagnosed arthritis condition and/or chronic joint symptoms. For some counties the rates are significantly higher than other counties. For example, in Buncombe and Gaston counties, the burden of arthritis is substantially higher than that found in Wake and Mecklenburg counties. III. Chronic Diseases: Arthritis

Currently Treated by a Doctor for Arthritis
Q: “Are you currently being treated by a doctor for arthritis?” Statewide, about half of adults with arthritis are being treated by a doctor. Wake, Guilford, Cumberland and New Hanover counties had treatment rates noticeably above 50 percent. For the remaining counties, the treatment rates were close to or somewhat below the state rate of 51.1%. Compared to the U.S., proportionately more arthritis patients are being treated in North Carolina. III. Chronic Diseases: Arthritis

Arthritis and Quality of Life: North Carolina
Chart category definitions: Fair/poor: “Would you say that in general your health is: excellent, very good, good, fair or poor?” Poor mental health days (8+ days/month), poor physical health days (8+ days/month), and limited activity days (8+ days/month) are derived from the CDC Healthy Days questions For example: “Now thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good? “ People with arthritis were about 4 times more likely to report that their general is fair or poor than people without arthritis. Similarly, people with arthritis have significantly more poor physical health and limited activity days than people without arthritis.

Arthritis, Obesity and Physical Activity: North Carolina
Persons with arthritis are about 1.8 times more likely to be obese, and also less likely to engage in leisure activities than people without arthritis.

Asthma

Ever Diagnosed with Asthma
Q: “Did a doctor ever tell you that you had Asthma?” About 10% of adults in North Carolina have ever been diagnosed with Asthma. III. Chronic Diseases: Asthma

Asthma (ever had) Prevalence by Sex, Race, & Age: Onslow County & NC
Among females, the prevalence of ever having asthma is noticeably higher in Onslow County than is evident statewide; while among males in Onslow, the prevalence of asthma is noticeably lower than the state prevalence. It’s also apparent that the rate of ever having asthma among African Americans in Onslow is about half the comparable state rate. III. Chronic Diseases: Asthma

Currently Has Asthma III. Chronic Diseases: Asthma
Q: “Do you still have Asthma?” For the state as a whole, a little more than 60% of those who were ever diagnosed with asthma still have asthma. This trend also appears to hold true at the county level. NC current asthma prevalence is slightly lower than the US. III. Chronic Diseases: Asthma

Cancer

Ever Diagnosed with Cancer (Age 40+)
Q: “Have you ever been told by a doctor, nurse, or other health professional that you had cancer?” An estimated 11.3% of North Carolinians have ever been told that they have cancer. The rate of ever being diagnosed with cancer varies from a low of 5.8% in Wake to high of 15.6% in Durham. III. Chronic Diseases: Cancer

Cancer Prevalence (Age 40+) : North Carolina
Cancer (Age 40+) derived from 3 questions: Q1: “Have you ever been told by a doctor, nurse, or other health professional that you had cancer?” Q2: “What type of cancer was/is it? Breast; Colorectal; Skin Cancer; Other” Q3: “Have you ever been told by a doctor, nurse, or other health professional that you had prostate cancer?” (asked of males only, age 40+) For the state as a whole, self-reported breast and ‘other types’ of cancer were the most prevalent, followed by prostate and skin cancer. III. Chronic Diseases: Cancer

Cancer (any type) Prevalence by Sex, Race, & Age: Onslow County & NC
The prevalence of any type of cancer if slightly higher among Onslow County males and somewhat lower among Onslow females, compared to their statewide counterparts. Among African Americans in Onslow, the prevalence of cancer is less than half the statewide prevalence. However, given that there were only 37 African Americans in the Onslow sample of age 40 and older, these results showed be viewed with caution. As one would expect, a very large discrepancy in the prevalence of cancer exists between 40 to 59 year olds and those 60 and older. III. Chronic Diseases: Cancer

Family History of Prostate Cancer*
Q: “Has your father, brother, son, or grandfather ever been told by a doctor, nurse, or health professional that he had prostate cancer?” Overall, about 14% of men with prostate cancer reportedly have a history of the disease among male members of their family. By county, the family history of the disease varies from a low of 6.3% in Buncombe County to a high of 13.2% in Wake County. A family history of prostate cancer is somewhat higher in North Carolina than the U.S. * Asked of male respondents age 40+ III. Chronic Diseases: Cancer

Diabetes

Diabetes III. Chronic Diseases: Diabetes
Q: “Have you ever been told by a doctor that you have diabetes?” An estimated 6.9% of North Carolinians have diabetes. Among the 10 counties, the rate of diabetes varies from a low 4.6% for Wake County to a high of 7.9% for Gaston County. III. Chronic Diseases: Diabetes

Prevalence of Diabetes by Race & Sex North Carolina, 1990-2001
The trend for diabetes shows that the prevalence of the disease is consistently higher for African Americans than whites. The results also suggest that from 1990 to 1994, the prevalence of diabetes declined for both races and then began to increase from 1995 to 2001. By sex the results suggest that, over time, females have a somewhat higher risk of diabetes than males. III. Chronic Diseases: Diabetes

Diabetes Indicators: North Carolina & U.S.
These diabetes indicators were derived from the following questions: Are you now taking insulin? Are you now taking diabetes pills? About how often do you check your blood for glucose or sugar? Include times when checked by a family member or friend, but do not include times when checked by a health professional. About how often do you check your feet for any sores or irritations? Include times when checked by a family member or friend, but do not include times when checked by a health professional. When was the last time you had an eye exam in which the pupils were dilated? This would have made you temporarily sensitive to bright light. Has a doctor ever told you that diabetes has affected your eyes or that you had retinopathy? How old were you when you were told you have diabetes? A test for hemoglobin "A one C" measures the average level of blood sugar over the past three months. About how many times in the past 12 months has a doctor, nurse, or other health professional checked you for hemoglobin "A one C"? About how many times in the past 12 months has a health professional checked your feet for any sores or irritations? Have you ever taken a course or class in how to manage your diabetes yourself? In North Carolina, about 3 in 10 diabetics are taking insulin, while slightly more than 6 in 10 are taking diabetes pills. Slightly more than half of adults with diabetes are checking their blood glucose every day and almost three-quarters are checking their feet for sores every day. About 75% of all diabetics reported having a dilated eye exam in the past year, which meets the Healthy People 2010 objective. One in four diabetics in North Carolina report being told by a doctor that they have retinopathy, that their eyes have been affected by diabetes. Almost half of diabetes onset has occurred before age 50. A little more than one-third of diabetics report having a glycosylated hemoglobin measurement 3 to 4 times in the past year, and more than half of adults with diabetes have taken a diabetes self-management course. About 74% of diabetics reported having at least one annual foot examination, which is very close to the Healthy People 2010 target of 75%. Slightly more than half of persons with diabetes have ever taken a self-management course. The rates for diabetes indicators in North Carolina are comparable to the national rates.

Disability

North Carolina’s Definition of Disability
A positive response to one or more of the following screener questions: Are you limited in any activities because of physical, mental, or emotional problems? Do you now have any health problem that requires you to use special equipment, such as a cane or wheelchair, a special bed, or a special telephone? A disability can be physical, mental, emotional, or communication related. Do you consider yourself to have a disability? Because of any impairment or health problem, do you have any trouble learning, remembering, or concentrating? History of BRFSS Disability Questions: Screener question #1 was first introduced into the BRFSS Survey in 1995 by the Centers for Disease Control and Prevention (CDC). In 1998, the remaining screener questions were added to the survey. In 2001, screener questions #1 and #2 were included in the Core Section of the BRFSS Survey for the first time; screener questions #3 and #4 were part of North Carolina’s Disability Module. North Carolina is one of 15 grant states in partnership with the CDC’s Disability and Health Branch. The NC Disability Module has been supported by North Carolina’s Office on Disability and Health since (Contact: Marcia Roth ) North Carolina’s definition of disability: A person is considered to have a disability if he or she responds affirmatively to at least one of the four screener questions. The use of four screener questions reflects the fact that people often have different interpretations of what constitutes a disability.

Activity Limitation b/c Physical or Emotional Problems
Statewide, about 15% of adults reported having an activity limitation due to physical, mental, or emotional problems. The county rates vary from a low of 9.7% in Wake County to a high of 16.6% in Gaston County. III. Chronic Diseases: Disability

Health Problem that Requires Use of Special Equipment
Persons with disabilities requiring the use of special equipment, such as a wheelchair or cane, constitute an estimated 6% of the adult population in the state. III. Chronic Diseases: Disability

Self-Perceived Disability
About 14% of the adult population in North Carolina describe their limitation as a “disability.” By county, the rate of self-perceived disability ranges from a low 9.3% in Onslow County to a high of 15.7% in Buncombe County. III. Chronic Diseases: Disability

Trouble Learning and Remembering
Ten percent of North Carolina adults report having trouble learning, remembering, or concentrating as a result of a health problem. Across all counties, except Wake and Onslow, the estimates are fairly close to the state estimate. III. Chronic Diseases: Disability

Prevalence of Disability - Any Type
An estimated 25% of North Carolina adults have some type of disability, based on a positive response to one or more of the four screener questions in the BRFSS Survey. This estimate, however, does not include adults with disabilities living in institutional care settings, such as nursing homes. Inclusion of these individuals would lead to a higher prevalence of disability. The highest prevalence of disability was found in Forsyth, Buncombe, and Gaston counties. The lowest prevalence of disability was found in Wake County, which was also significantly below the statewide prevalence of disability. III. Chronic Diseases: Disability

Disability Prevalence by Sex, Race & Age: Onslow County & NC
Except for older adults (age 45+), the prevalence of disability by sex, race, and age, among Onslow County adults, is somewhat lower than the respective statewide disability estimates. III. Chronic Diseases: Disability

Health, Employment, & Health Care Access among Adults with Disabilities (18-64 yrs.): Onslow & NC
In Onslow County, about 70% of adults with a disability under age 65 report being in good health, which is about 15% higher than the state rate. The rate of employment (employed for wages or self-employed) among Onslow residents with disabilities is somewhat higher the state rate. Health care access among Onslow adults with some type of disability follows statewide trends. Presenter note: Excellent-good health includes three categories of self-reported health: 1) excellent, 2) very good, or 3) good. To provide a context for these results on health status and disability, an estimated 95% of persons statewide with no disability who report being in excellent to good health. III. Chronic Diseases: Disability

High cholesterol

High Cholesterol III. Chronic Diseases: High Cholesterol
Q: “Have you ever been told by a doctor, nurse, or other health professional that your blood cholesterol is high?” Overall, about 29% of North Carolinians report that they have high cholesterol. At the county level, the largest disparity is found between Durham and Gaston counties, where the rates of high cholesterol differ by 13 percentage points. For the remaining counties, the rates are fairly similar. III. Chronic Diseases: High Cholesterol

Prevalence of High Blood Cholesterol by Sex, Race, and Age: Onslow County & NC
Onslow County females, in particular, have significantly lower rates of high cholesterol than their statewide counterparts; while among Onslow County males, the prevalence of high blood cholesterol is slightly higher than their statewide counterparts. With respect to race and age, the prevalence of high blood cholesterol in Gaston County is somewhat lower than the comparable state rates. III. Chronic Diseases: high blood cholesterol

Prevalence of High Cholesterol by Race & Sex North Carolina, 1990-2001*
For whites, the trend suggests that the prevalence of high blood cholesterol has been increasing somewhat since 1995. For African Americans, the prevalence of high cholesterol tends to fluctuate over time between 20 and 30 percent. For females, the rate of high cholesterol was higher than that of males for all years except 1999. * Data not available for 1994, 1996, 1998, 2000. III. Chronic Diseases: High Cholesterol

Cholesterol Checked Past Year among Adults with High Blood Cholesterol
Close to 85% of North Carolina adults with high cholesterol reported that they had their blood cholesterol checked in the past year. The highest rate of 88.3% was found in Guilford County, while the lowest rate of 75% was found in Wake County. III. Chronic Diseases: High Cholesterol

High Blood Pressure

High Blood Pressure HP 2010 Target (reduce to 16%)
Q: “Have you ever been told by a doctor, nurse, or other health professional that you have high blood pressure?” An estimated 26% of North Carolina adults have been told by a health professional that their blood pressure is high. This statewide estimate is about 10 percentage points higher than the Healthy People 2010 target of 16 percent. Low rates of high blood pressure were evident in Wake and Mecklenburg counties; very high rates were evident in Forsyth and Gaston counties. HP 2010 Target (reduce to 16%) III. Chronic Diseases: High Blood Pressure

Prevalence of High Blood Pressure by Race & Sex North Carolina, 1991-2000
Since 1991, the prevalence of high blood pressure has been increasing steadily for African Americans; for whites, the rate of high blood pressure has been increasing steadily since 1993. Since 1992, the results also show that the rate of high blood pressure among African Americans and has been increasing more rapidly than it has among whites. With respect to gender, the trends suggest that, since 1993, the risk of high blood pressure has been somewhat higher among females than males * Data not available for 1994, 1996, 1998, 2000. III. Chronic Diseases: High Blood Pressure

Currently Taking Medicine for High Blood Pressure
Q: “Are you currently taking medicine for your high blood pressure?” About three-quarters of North Carolina adults with High Blood Pressure are currently taking medicine for their high blood pressure. Across the 10 counties, the use of hypertensive medicines ranged from a low of 66.6% in Gaston County to a high of 78.5% in New Hanover County. III. Chronic Diseases: High Blood Pressure

Prevalence of High Blood Pressure by Sex, Race, and Age: Onslow County & NC
Females and whites in Onslow County reportedly have lower rates of high blood pressure than their statewide counterparts. Among African Americans and 45+ year olds, the reported rates of high blood pressure are somewhat higher in Onslow than in the state. III. Chronic Diseases: high blood pressure

IV. Preventive Health Care
Prostate Cancer screening Colorectal Cancer screening Cholesterol screening Immunizations

Ever Had a PSA (Prostate-Specific Antigen) Test (male respondents age 40+)
Q: “A Prostate-Specific Antigen test, also called a PSA test, is a blood test used to check men for prostate Cancer. Have you ever had a PSA test?” These results pertain only to males age 40 and older. The rate of ever having a PSA test, among males, ranges from a low of 52.4% in Buncombe County to a high of 78.4% in Durham, constituting a range of 26 percentage points. IV. Preventive Health Care

Ever Had a Digital Rectal Exam (male respondents age 40+)
Q: “A digital rectal exam is an exam in which a doctor, nurse, or other health professional places a gloved finger into the rectum to feel the size, shape, and hardness of the prostate gland. Have you ever had a digital rectal exam?” Similar to the county results of ever having a PSA test, the rate of ever having a digital rectal exam, ranges from a low of 64.3% in Buncombe County to a high of 88.0% in Durham, representing a range of about 24 percentage points. IV. Preventive Health Care

Ever Had a Blood Stool Test (all respondents age 50+)
Q: “A blood stool test is a test that may use a special kit at home to determine whether the stool contains blood. Have you Ever Had this test using a home kit?” Forsyth County stands out as having the highest rate of self-reported blood stool tests. The rate of ever having blood stool test is also significantly higher in North Carolina than in the U.S. IV. Preventive Health Care

Ever Had a Colonoscopy Exam (all respondents age 50+)
Q: “Sigmoidoscopy and colonoscopy are exams in which a tube is inserted in the rectum to view the bowel for signs of Cancer or other health problems. Have you Ever Had either of these exams?” Across the state, about 48% of adults age 50 and older have ever had colonoscopy exam. Wake, Mecklenburg, Forsyth, and New Hanover counties had comparatively higher rates than all other counties. IV. Preventive Health Care

Ever Had Blood Cholesterol Checked (all respondents age 18+)
Q: “Blood cholesterol is a fatty substance found in the blood. Have you ever had your blood cholesterol checked?” An estimated 79% of North Carolina adults have ever had their blood cholesterol checked. The rates were fairly similar across all counties except Cumberland and Onslow, which had the lowest rates of 70.2% and 72.5% respectively. IV. Preventive Health Care

Prevalence of Ever Having Blood Cholesterol Checked by Race & Sex, North Carolina 1990-2001*
Since 1990, the prevalence of ever having blood cholesterol checked has generally been increasing by race and sex. Over time, both whites and females are more likely than African Americans or males to report ever having their blood cholesterol checked. * Data not available for 1994, 1998, 2000. IV. Preventive Health Care

Blood Cholesterol Checked in Past 5 Years (all respondents age 18+)
Across the state, about 75% of adults have had their blood cholesterol checked in the past 5 years. Only Guilford, Forsyth, and Gaston counties have met or exceeded the HP 2010 target of 80% of adults having their cholesterol checked in the past 5 years. The remaining counties, except Cumberland and Onslow, are very close to meeting the HP2010 objective. HP 2010 Target: 80% IV. Preventive Health Care

Had Flu Shot in Past 12 Months (all respondents age 18+)
Q: “During the past 12 months, have you had a flu shot?” A little less than one in three adults in North Carolina reported having a flu shot in the past year. Forsyth, Cumberland, and Durham counties exceeded the state rate by about 5 percentage points. IV. Preventive Health Care

Prevalence of Having an Annual Flu Shot by Race & Sex, North Carolina, 1993-2001*
From 1993 to 2000, the rate of having an annual flu shot increased from 21% to 34% among whites. For African Americans, the prevalence declined slightly between 1993 and 1995, and has since been gradually increasing - though less noticeably than it has been for whites. Beginning in 1999, females were somewhat more likely than males to have an annual flu shot. * Data not available for 1994, 1996, 1998. IV. Preventive Health Care

Ever Had a Pneumonia Shot (all respondents age 18+)
Q: “Have you Ever Had a pneumonia shot? This shot is usually given only once or twice in a person’s lifetime and is different from the flu shot. It is also called the pneumococcal vaccine.” Statewide, about 2 in 10 adults have ever had a pneumonia shot. About 1 in 4 adults in Forsyth and Cumberland counties have Ever Had a pneumonia shot, the highest of any oversampled county. IV. Preventive Health Care

Prevalence of Ever Having a Pneumonia Vaccination by Race & Sex, North Carolina 1993-2001*
From 1993 to 2001, the rate of ever having a pneumonia vaccination has doubled, from 10% to about 20%, for both race and sex groups. * Data not available for 1994, 1996, 1998. IV. Preventive Health Care

V. Oral Health Dental insurance Dental visits Dental cleaning
Tooth loss

Dental Insurance Coverage
Q: “Do you have any kind of insurance coverage that pays for some or all of your routine dental care, including dental insurance, prepaid plans such as HMOs, or government plans such as Medicaid?” A little more than half of adults in North Carolina have some type dental insurance coverage. The highest rate of dental insurance coverage was observed in Mecklenburg County, followed by Onslow, Forsyth, Wake, and Guilford. V. Oral health

Dental Insurance Coverage by Sex, Race, & Age: Onslow County & NC
Across all demographic groups, the rate of dental insurance coverage was higher in Onslow County, as compared to the state. In particular, the rate of dental insurance coverage among African Americans in Onslow County is about 25% higher than the statewide coverage rate. V. Oral health

Visited Dentist Past Year for Any Reason
Q: “How long has it been since you last visited a dentist or a dental clinic for any reason?” Almost 70% of adults in North Carolina visited a dentist for any reason in the past year. By county, the rates range from a low of 66.8% in Gaston to high of 80% in Wake County. V. Oral health

Teeth Cleaned Past Year
Q: “How long has it been since you had your teeth cleaned by a dentist or dental hygienist?” The results for having teeth cleaned in past year closely parallel those in previous slide, pertaining to visiting a dentist in the past year for any reason. V. Oral health

All Permanent Teeth Extracted
Q: “How many of your permanent teeth have been removed because of tooth decay or gum disease? Do not include teeth lost for other reasons, such as injury or orthodontics.” Response: All An estimated 9.1% of adults in the state have had all their permanent teeth extracted. The rates vary considerably by county, ranging from a low of 2.7% in Wake to high of 13.1% in Gaston County. V. Oral health

VI. Cardiovascular Health
History of heart disease, High Blood Pressure, high cholesterol Disease prevention Knowledge of symptoms of heart attack, stroke

History of Cardiovascular Disease*
History of cardiovascular disease defined by 3 questions: “Has a doctor, nurse, or other health professional ever told you that you had any of the following? Q1:A heart attack, also called a myocardial infarction Q2: Angina or coronary heart disease Q3:A stroke” Overall, slightly less than 9% of adults report having some type of cardiovascular disease. For most counties, the rate of cardiovascular disease ranged between 5% and 8%; a low rate of 3.7% was observed in Wake, while a high rate of 10% was observed in Gaston. *doctor-diagnosed heart attack, stroke, and/or angina VI. Cardiovascular Health

Ever Been Told* Blood Pressure is High
HP 2010 Target (reduce to 16%) Q: “Have you ever been told by a doctor, nurse, or other health professional that you have high blood pressure?” High blood pressure is a known risk factor for cardiovascular disease; close to 30% of adults in North Carolina have high blood pressure. By county, the rates of high blood pressure are fairly similar for all but Wake and Mecklenburg, which have relatively low rates. * by health professional VI. Cardiovascular Health

Ever Told* Blood Cholesterol is High
Q: “Have you ever been told by a doctor, nurse, or other health professional that your blood cholesterol is high?” High blood cholesterol is also a known risk factor for cardiovascular disease. Except for Durham which has a low rate and Gaston which has a high rate, the rate of high blood cholesterol is similar across counties. * by health professional VI. Cardiovascular Health

Eating Less Fat Foods to Lower Risk of Heart Disease
Q: “To lower your risk of developing heart disease or stroke, are you.... a. Eating fewer high fat or high cholesterol foods?” Slightly more than two-thirds of adults are reportedly eating fewer high fat foods in order to lower their risk of cardiovascular disease. In Durham, almost 80% of adults are reportedly eating fewer high fat foods. VI. Cardiovascular Health

More Active to Lower Risk of Heart Disease
Q: “To lower your risk of developing heart disease or stroke, are you....More physically active?” Statewide, about 68% of adults reported being more physically active to lower their risk of heart disease. In Buncombe and Durham counties, the reported rates of being more physically active exceed 75%. VI. Cardiovascular Health

Told by Health Professional to Eat Less Fat Foods
Q: “Within the past 12 months, has a doctor, nurse, or other health professional told you to...Eat fewer high fat or high cholesterol foods?” Statewide, about 30% of adults report that they’ve been told by a health professional to eat fewer high fat foods. VI. Cardiovascular Health

Told by Health Professional to Eat more Fruits & Veggies
Q: “Within the past 12 months, has a doctor, nurse, or other health professional told you to…Eat more fruits and vegetables?” About 35% of adults report that they’ve been told by a health professional to eat more fruits and vegetables. VI. Cardiovascular Health

Told by Health Professional to be More Active
Q: “Within the past 12 months, has a doctor, nurse, or other health professional told you to... c. Be more physically active?” In the past year, about 36% of North Carolinians have told by a health professional to be more active. VI. Cardiovascular Health

Take Aspirin Daily or Every Other Day*
Q: “Do you take aspirin daily or every other day?” This question was asked of adults age 35 and older. The results show that about 1 in 3 North Carolina adults are taking aspirin on a daily or every other day basis. * Adults age 35+ VI. Cardiovascular Health

Percent Who Recognized Signs & Symptoms of a Heart Attack: Onslow & North Carolina
Q: “Which of the following do you think is a symptom of a heart attack. For each, tell me yes, no, or you’re not sure. Do you think pain or discomfort in the arms or shoulder are symptoms of a heart attack? Do you think shortness of breath is a symptom of a heart attack?” Do you think feeling weak, lightheaded, or faint are symptoms of a heart attack? Do you think chest pain or discomfort are symptoms of a heart attack? These questions were asked of all respondents, and designed to assess respondent knowledge of possible symptoms of a heart attack; all are potential symptoms of a heart attack. The results show that most respondents understand that chest pains, shortness of breath, and arm or shoulder pain are possible symptoms of a heart attack. Comparatively few respondents recognize that trouble seeing in one or both eyes could be a symptom of a heart attack. VI. Cardiovascular Health

Percent Who Recognized Signs & Symptoms of a Stroke: Onslow & North Carolina
Q: “Which of the following do you think is a symptom of a stroke. For each, tell me yes, no, or you’re not sure. Do you think severe headache with no known cause is a symptom of a stroke?” Do you think sudden numbness or weakness of face, arm, or leg, especially on one side, are symptoms of a stroke? Do you think sudden trouble seeing in one or both eyes is a symptom of a stroke? Do you think sudden trouble walking, dizziness, or loss of balance are symptoms of a stroke? These questions were asked of all respondents, and were designed to assess respondent knowledge of the possible symptoms of a stroke; all are potential symptoms of a stroke. In general, there was less certainty among respondents about the possible symptoms of a stroke than a heart attack. Most respondents understand that sudden numbness of the face, arm, or leg, or sudden trouble walking, are possible symptoms of a stroke. Less than half of respondents, however, recognized that sudden chest pain could be a symptom of a stroke. Responses among Onslow County adults tended to mirror those across the state. VI. Cardiovascular Health: knowledge stroke of symptoms

VII. Tobacco Use and Prevention
Smoking status Smokeless tobacco use Quit smoking Medical care for smokers Cigar smoking Prevention

Smoked at Least 100 Cigarettes in Lifetime
Q: “Have you smoked at least 100 cigarettes in your entire life?” Almost half of North Carolina adults have ever smoked at least 100 cigarettes in their lifetime. By county, these ever-smoked rates are highest among Onslow and Buncombe and lowest among Durham and Mecklenburg. VII. Tobacco Use and Prevention

First Smoked at Age 16 or Younger
Q: “How old were you the first time you smoked a cigarette, even one or two puffs?” The majority of those who first smoked, even on or two puffs, were in their mid-teens, or at age 16 or younger. Across most counties, the rates of first smoking at or below age 16 are fairly similar except for Durham, which had a high rate of 79.2%, and Onslow, which had a comparatively low rate of 60.1%. VII. Tobacco Use and Prevention

First Started Smoking Regularly: North Carolina
Q: “How old were you when you first started smoking cigarettes regularly?” Only 3.9% of adults who smoked cigarettes in their lifetime did not become regular smokers. More than 1 in 3 adults who smoked 100+ cigarettes in their lifetime became regular smokers before the age of 17. VII. Tobacco Use and Prevention

Current smokers* (age 18+)
Current smoking is defined by 2 questions: Q1: “Have you smoked at least 100 cigarettes in your entire life?” Q2: “Do you now smoke cigarettes every day, some days, or not at all? Definition of current smoker: smoked at least 100 cigarettes in lifetime and now smokes everyday or some days. An estimated 25.7% of NC adults are current smokers, most being everyday smokers. Across counties, the rate of current smoking varies from a low of 18.2% in Durham to a high of 34.3% in Onslow. *includes everyday and occasional smokers VII. Tobacco Use and Prevention

Prevalence of Smoking by Race & Sex, North Carolina, 1990-2001
Since 1991, the prevalence of smoking among whites has remained fairly constant, at about 25%. Among African Americans, the prevalence of smoking has been more variable, ranging from 20% to 30%. In 2000 and 2001, the prevalence of smoking among African Americans appears to be declining. The prevalence of smoking has also remained fairly constant among males and females, with close to 30% of males continuing to smoke and about 22% of females continuing to smoke. VII. Tobacco Use and Prevention

Current Smoker by Sex, Race, & Education: Onslow County & NC
Compared to the state, the prevalence of smoking is higher across all sex, race, and education groups in Onslow County. In particular, the rate of smoking among Onslow males, whites, and those with a post high-school education is substantially higher than evident among their statewide counterparts. VII. Tobacco Use and Prevention

Smoking Status (all respondents): Onslow, North Carolina, & US
Smoking status derived from 2 questions: Q1: Have you smoked at least 100 cigarettes in your entire life? Q2: Do you now smoke cigarettes every day, some days, or not at all? Definitions: Smoke every day: smoked 100 cigarettes and now smokes everyday Smoke some days: smoked 100 cigarettes and now smokes some days Former smoker: smoked 100 cigarettes and does not smoke now Never smoked: did not smoke 100 cigarettes in entire life Compared to the state and the U.S., the percentage of Onslow respondents who have never smoked is very low. Also, the overall high rate of smoking in Onslow County can be attributed, in part, to the high proportion of occasional or non-daily smokers. VII. Tobacco Use and Prevention

Quit Smoking One Day or Longer
Q: “During the past 12 months, have you stopped smoking for one day or longer because you were trying to quit smoking?” These results pertain to smokers who attempted to quit for at least one day in the past year. About 56% of current smokers across the state attempted to quit smoking for at least one day in the past year. Quit-smoking rates across counties are fairly similar, except for Forsyth which had a particularly low rate of 41.3%. VII. Tobacco Use and Prevention

Prevalence of Quit-Smoking Attempts by Race & Sex, North Carolina, 1990-2001
Since the beginning of nineties, the rate of quit-smoking attempts has generally been higher among African Americans, compared to whites. By 2001, nearly 70% of African American smokers reported a quit-smoking attempt, compared to a little more than 50% of white smokers. With respect to gender, the rates of quit-smoking attempts for males and females are somewhat similar. However, in 2001 the rate of quit-smoking attempts among females rises by about 10 percentage points, from 51% to 61%. VII. Tobacco Use and Prevention

Regular Smokers* Who Received Medical Care in Past Year
Q: “In the past 12 months, have you seen a doctor, nurse, or other health professional to get any kind of care for yourself?” About two-thirds (65.7%) of regular smokers across the state reported getting some type of medical care in the past year. Across counties, the percentage of smokers receiving recent medical care ranged form a high of 87.6% in Forsyth County to a low of 52.5% in Wake County. Cautionary note: given the small cell sizes for Mecklenburg (n=49), Guilford (n=44), and Durham (n=42) counties, these results should be viewed with caution. *smoked regularly within the past year VII. Tobacco Use and Prevention

Ever Used Smokeless Tobacco Products
Q: “Have you ever used or tried any smokeless tobacco products such as chewing tobacco or snuff?” Considerable variation exists across counties in the prevalence of ever using smokeless tobacco products. Almost one-third of Onslow County adults have ever used smokeless tobacco products, compared to less than one-tenth of Durham County adults. VII. Tobacco Use and Prevention

Smokeless Tobacco User
Current smokeless tobacco user derived from 2 questions: Q1: “Have you ever used or tried any smokeless tobacco products such as chewing tobacco or snuff? Q2: Do you currently use chewing tobacco or snuff every day, some days, or not at all? Current smokeless tobacco users represent about 5% of the state’s adult population. By county, the rates vary from a low of less than 1% in Durham to a high of almost 8 percent in Onslow. VII. Tobacco Use and Prevention

Ever Smoked a Cigar VII. Tobacco Use and Prevention
Q: “Have you ever smoked a cigar, even one or two puffs?” Statewide, almost 40% of adults have ever smoked a cigar. In Forsyth and Wake counties, the percentage of those who have ever smoked a cigar is closer to 50%. VII. Tobacco Use and Prevention

Smoking Not Allowed Anywhere in the Home
Q: “Which statement best describes the rules about smoking inside your home? Response: Smoking is not allowed anywhere inside your home” More than 60% of North Carolinians report that smoking is not allowed anywhere in their home. In Wake County, more than three-quarters of adults report that smoking is not allowed in their home; this compares to a little more 55% in Forsyth County. VII. Tobacco Use and Prevention

Smoking Not Allowed in the Workplace, Both Common Areas and Work Areas*
These results combine 2 questions: Q1: “Which of the following best describes your place of works’ official smoking policy for indoor public or common areas, such as lobbies, rest rooms, and lunch rooms? Response: Not allowed in any public areas Q2: “Which of the following best describes your place of works’ official smoking policy for work areas? Response: Not allowed in any work areas” Statewide, about 75% of adults who work indoors report that smoking is not allowed in either common areas, such as lobbies, or in work areas. Across counties, at least 70% of respondents report such non-smoking policies at their workplace. *asked of respondents who reported working indoors VII. Tobacco Use and Prevention

VIII. Health Risk Behaviors
Overweight Cholesterol not checked Smoking Binge/heavy drinking Physical inactivity

Overweight VIII. Health Risk Behaviors
Overweight is defined from respondents self-reported weight and height Overweight is determined by first computing the respondent’s Body Mass Index (BMI), as weight in kilograms divided by height in meters squared:(kg/m2); a BMI of 25.0 to 29.9 is considered overweight. Based on self-reported weight and height, almost 36% of North Carolina adults are overweight. The rates of being overweight are fairly similar across all 10 counties. VIII. Health Risk Behaviors

Prevalence of Overweight by Race & Sex, North Carolina, 1990-2001
Most apparent, the trends indicate that males have the highest risk of being overweight; since the beginning of the nineties, at least 40% of males were reportedly overweight and, by 1997, that percentage increased to 45% and has remained at that level. A little more than 25% of females are reportedly overweight, and this rate seems to be fairly constant since the middle of nineties. With respect to race, the rate of being overweight appears to be increasing slightly overtime for whites; while for African Americans, beginning in the late nineties, the rate appears to be decreasing somewhat. VIII. Health Risk Behaviors

Obesity VIII. Health Risk Behaviors
As is the case with the overweight indicator, obesity is determined from the respondent’s Body Mass Index (BMI), as weight in kilograms divided by height in meters squared:(kg/m2); a BMI greater than 29.9 is considered obese. The results indicate that a little more than 20% of North Carolina adults are obese. County estimates are fairly close to the statewide estimate of 20%. VIII. Health Risk Behaviors

Prevalence of Obesity by Race & Sex, North Carolina, 1990-2001
The trend lines suggest a steady increase in the rate of obesity for both race and sex groups. In particular, the risk of obesity among African Americans is not only increasing but also noticeably higher than that of whites, or males and females – without regard for race. The increase over time in the prevalence of obesity among males and females appears to be fairly similar. VIII. Health Risk Behaviors

Cholesterol Never Checked
Q: “Blood cholesterol is a fatty substance found in the blood. Have you Ever Had your blood cholesterol checked?” Across the state, about 21% of North Carolinians report that they have ever had their blood cholesterol checked. Forsyth County has the lowest rate of those never having their cholesterol checked; Cumberland County has the highest rate. VIII. Health Risk Behaviors

Prevalence of Never Having Cholesterol Checked by Race & Sex, North Carolina, 1990-2001*
These results show an overall decline in the prevalence of never having blood cholesterol checked for both race and sex groups. By 2001, both whites and African Americans experienced about a 50% reduction from the 1990 rates of never having their blood cholesterol checked. Even so, African Americans remain more at risk of not having their cholesterol checked than whites. With respect to gender, the results show that males continue to be at higher risk of never having their cholesterol checked. * Data not available for 1994, 1996, 1998, 2000. VIII. Health Risk Behaviors

Smoking* VIII. Health Risk Behaviors
Smoking defined by 2 questions: Q1: “Have you smoked at least 100 cigarettes in your entire life?” Q2: “Do you now smoke cigarettes every day, some days, or not at all? Definition of current smoker: smoked at least 100 cigarettes in lifetime and now smokes everyday or some days. An estimated 25.7% of NC adults are current smokers, most being everyday smokers. Across counties, the rate of cigarette smoking varies from a low of 18.2% in Durham to a high of 34.3% in Onslow. *includes everyday and occasional smokers VIII. Health Risk Behaviors

Prevalence of Smoking by Race & Sex, North Carolina, 1990-2001
Since 1991, the prevalence of smoking among whites has remained fairly constant, at about 25%. Among African Americans, the prevalence of smoking has been more variable, ranging from 20% to 30%. In 2000 and 2001, the prevalence of smoking among African Americans appears to be declining. The prevalence of smoking has also remained fairly constant among males and females, with close to 30% of males continuing to smoke and about 22% of females continuing to smoke. VIII. Health Risk Behaviors

Binge Drinking VIII. Health Risk Behaviors
Binge drinking is defined as those who reported drinking in the past 30 days AND had five or more drinks on one or more occasions. About 10% of North Carolina adults are reportedly binge drinkers. The rate of binge drinking in Wake, New Hanover, and Onslow counties is about 1 ½ times that of the state rate. VIII. Health Risk Behaviors

Heavy Drinking VIII. Health Risk Behaviors
Heavy drinking for males is defined as 2+ drinks per day; for females 1+ drinks per day. The rate of heavy drinking remains under 5% across the state. The rates of heavy drinking are also fairly similar across all counties, except New Hanover, which reportedly has a heavy drinking rate of 8.9%. In all likelihood, the use of alcohol is under-reported in the BRFSS Survey, which means the true rates of binge or heavy drinking are higher than reported here. VIII. Health Risk Behaviors

Physically Inactive VIII. Health Risk Behaviors
Physically inactive consists of NO moderate or vigorous physical activity: Q1: “Now, thinking about the moderate physical activities you do in a usual week, do you do moderate activities for at least 10 minutes at a time, such as brisk walking, bicycling, vacuuming, gardening, or anything else that causes small increases in breathing or heart rate?” AND Q2: “Now thinking about the vigorous physical activities you do in a usual week, do you do vigorous activities for at least 10 minutes at a time, such as running, aerobics, heavy yard work, or anything else that causes large increases in breathing or heart rate?” The results show that about 17% of NC adults are physically inactive. By county, the rates of physical inactivity vary from a low of 10.8% in Durham to a high of 17.9% in Guilford County. VIII. Health Risk Behaviors

No Leisure Time Physical Activity
No leisure time physical activity consists of NO exercise: Q: “During the past 30 days, other than your regular job, did you participate in any physical activities or exercise such as running, calisthenics, golf, gardening, or walking for exercise?” About 1 in 4 North Carolina adults report no leisure time physical activity. The North Carolina and U.S. rates are the same. VIII. Health Risk Behaviors

IX. Physical Activity & Nutrition
Work activity Leisure time activity Moderate physical activity Vigorous physical activity Physical activity status Daily fruit & vegetable consumption

Mostly Sitting/Standing at Work
Q: “When you are at work, which of the following best describes what you do? Response: Mostly sitting or standing” About 60% of North Carolina adults mostly sit or stand while they’re at work. A fair amount of variation exists across counties: almost 75% of Mecklenburg County adults have sedentary work lives, compared to about 56% of Cumberland County adults. IX. Physical Activity & Nutrition

Engage in Leisure Time Physical Activity
Definition of leisure time physical activity: any type of exercise. An estimated 73.6% of NC adults engage in some type of leisure time physical activity. The rates of leisure time activities are similar across the oversampled counties. IX. Physical Activity & Nutrition

Prevalence of Leisure Time Physical Activity by Race & Sex, North Carolina, 1990-2001*
The prevalence of leisure time physical activity over time ranges from about 40% to 65% for African Americans, and about 60 to 75% for whites. Since the middle of the nineties, the prevalence of leisure activities appears to be increasing for both race and sex groups. Among males, the prevalence of leisure activities, is generally higher than that of females. *Data not available for 1993, 1995, 1997, 1999. IX. Physical Activity & Nutrition

Moderate Physical Activity
Moderate activities are defined as activities that cause small increases in breathing or heart rate such as bicycling or gardening. Criteria for moderate physical activity: 1) respondents who report doing moderate physical activity for 30 or more minutes per day, five or more days per week, or 2) respondents who report doing vigorous physical activity 20 or more minutes per day, three or more days per week. A little more than 40% of NC adults engage in moderate physical activities. Among the 10 counties, the rate of moderate activities ranges from 35% to 55%. IX. Physical Activity & Nutrition

Vigorous Physical Activity
Vigorous activities are defined as activities that cause large increases in breathing or heart rate such as running or heavy yard work. Criteria vigorous physical activity: 1) respondents who report doing vigorous physical activity 20 or more minutes per day, three or more days per week. About 1 in 5 NC adults participate in any kind of vigorous physical activity. County rates are somewhat similar, with Onslow, New Hanover, and Durham leading the county group. IX. Physical Activity & Nutrition

Physical Activity Status: Onslow County, North Carolina, & US
Physical activity status definitions: Meets recommendation includes: 1) respondents who report doing moderate physical activity for 30 or more minutes per day, five or more days per week, or 2) respondents who report doing vigorous physical activity 20 or more minutes per day, three or more days per week. Some physical activity: includes respondents who do some type of physical activity but do not meet recommendations. Physically inactive: includes respondents who report no physical activity or exercise of any kind. The rates associated with physical inactivity are fairly comparable between Onslow, North Carolina, and the US. However, with regard to meeting recommendations for physical activity, adults in Onslow County appear to be well above the state and the U.S. rates. IX. Physical Activity & Nutrition

Daily Fruit & Vegetable Consumption: Onslow County & North Carolina
Category definitions: Less than once or never: respondents reporting they never consume fruits or vegetables or consume less than 1 serving pre day. 1 to less than 3 times: respondents reporting they consume 1 to less than 3 servings of fruits and vegetables per day. 3 to less than 5 times: respondents reporting they consume 3 to less than 5 servings of fruits and vegetables per day. 5 or more times: respondents reporting they consume 5 or more servings of fruits and vegetables per day. The majority of adults in the Onslow County and North Carolina reportedly consume between 3 and 4servings of fruits and vegetables per day. IX. Physical Activity & Nutrition

X. Health Status & Quality of Life
Self-perceived fair/poor health Poor physical health days Poor mental health days Emotional support Satisfaction with life Pain days Worried days Sadness days Sleepless days

Self-perceived Fair or Poor Health
Q: “Would you say that in general your health is: Excellent, Very good, Good, Fair or Poor.” The percentage of those with self-reported fair or poor health varies from a low of 8% in Wake County to a high of 17% in Buncombe County. X. Health Status & Quality of life

Prevalence of Fair/Poor Health by Race & Sex, North Carolina, 1993-2001
For both whites and males, the prevalence of fair or poor health has remained about 15% since 1993. For African Americans, the prevalence of self-reported fair or poor health has fluctuated between 19% and 27% since 1993. The risk of fair or poor health is also slightly higher among females than males. X. Health Status & Quality of life

7+ Days in Past 30 Days of Not Good Physical Health
Q: “Now thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good?” At the time of the interview, about 14% of adults reported that their physical health was not good for at least one week out of the past 30 days. X. Health Status & Quality of life

7+ Days in Past 30 Days of Not Good Mental Health
Q: “Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?” About 12% of NC adults report that their mental health was not good for at least one week out of the past 30 days. X. Health Status & Quality of life

Always/Usually Gets Emotional Support
Q: “How often do you get the social and emotional support you need? Would you say: Always, Usually, Sometimes, Rarely or Never” The vast majority of respondents – over 80% – report that they always or usually get the emotional support they need. County-specific rates are also very similar. X. Health Status & Quality of life

Satisfied with Life X. Health Status & Quality of life
Q: “In general, how satisfied are you with your life? Response: Very satisfied or satisfied” Almost everyone – over 95% – report that they are satisfied or very satisfied with life. X. Health Status & Quality of life

7+ Days in Past 30 Days When Pain Prevented Activities
Q: “During the past 30 days, for about how many days did pain make it hard for you to do your usual activities, such as self-care, work, or recreation?” About 12% of NC adults reported that pain made it difficult to perform usual activities in 7 out of the past 30 days. The rates in Buncombe, New Hanover, and Gaston counties were about double that of Wake, Mecklenburg, and Durham. X. Health Status & Quality of life

7+ Days in Past 30 Days When Worried or Anxious
Q: “During the past 30 days, for about how many days have you felt worried, tense or anxious?” Almost 18% of North Carolinians reported that they felt anxious, tense, or worried in 7 out of the past 30 days. These rates ranged from a low of 14.5% in Durham to high of 23.5% in Gaston. X. Health Status & Quality of life

7+ Days in Past 30 days When Depressed
Q: “During the past 30 days, for about how many days have you felt sad, blue or depressed?” A little more than 1 in 10 North Carolinians reported feeling sad, blue or depressed for at least a week out of the past 30 days. In Gaston County, the rate of self-reported depression was considerably higher than most other counties. X. Health Status & Quality of life

7+ Days in Past 30 Days When Not Enough Sleep
Q: “During the past 30 days, for about how many days have you felt that you did not get when not enough rest or sleep?” A little more than 1 in 3 adults have experienced 7+ days of not enough rest or sleep out of the past 30 days. By county, these rates varied from 32.7% in Guilford to 43.2% in Onslow. X. Health Status & Quality of life

XI. Family Planning* Pregnancy history History of hysterectomy
Birth control Use of health department Access to private gynecologist Ever used family planning clinic * Questions pertain only to female respondents, ages 18 to 44.

Pregnant in the Last Five Years
Q: “Have you been pregnant in the last 5 years?” Slightly less than one-third of 18 to 45 year old NC females have been pregnant in the last 5 years. In Onslow, the 5-year pregnancy rate is over 43%, while in Buncombe, the pregnancy rate is less than 25%. XI. Family Planning

Ever Had a Hysterectomy
Q: “Have you had a hysterectomy? ” About 8% of females ages 18 to 45 have reportedly ever had a hysterectomy. The rates of ever having a hysterectomy also vary considerably across counties: 9.5% of females in Mecklenburg report having had a hysterectomy, compared to 2.9% in Cumberland. XI. Family Planning

Currently Using Some Type of Birth Control
Q: “Are you or your husband/partner using any kind of birth control now? Birth control means having your tubes tied, vasectomy, the pill, condoms, diaphragm, foam, rhythm, Norplant, shots (Depo-provera) or any other way to keep from getting pregnant.” Among females ages 18 to 45 who have not had a hysterectomy or were not pregnant at the time of survey, over 60% of these women report that they or their partner are using some type of birth control. Use of birth control is highest Buncombe County and lowest in Forsyth. XI. Family Planning

Types of Birth Control Used: North Carolina
Q: “What kinds of birth control are you or your using now? Response: pill” Birth control pills are the most common method of birth control followed by getting tubes tied and use of condoms. XI. Family Planning

Use Health Department for Female Health
Q: “Where is your usual source of services for female health concerns, such as family planning, annual exams, breast exams, tests for sexually transmitted diseases, and other female health concerns? Response: health department” Statewide, slightly less than 10% of females ages 18 to 44 report using their county health department for their female health concerns. XI. Family Planning

Use Private Gynecologist for Female Health
Q: “Where is your usual source of services for female health concerns, such as family planning, annual exams, breast exams, tests for sexually transmitted diseases, and other female health concerns? Response: a private gynecologist” Among NC women ages 18 to 45, two-thirds report that they use a private GYN for their female health concerns. In Forsyth and New Hanover counties, use of a private gynecologist exceeds 75%. XI. Family Planning

Ever Used Services of a Family Planning Clinic
Q: “Have you ever used the services at a family planning clinic?” An estimated 36.9% of females ages 18 to 45 report that they have ever used the services of a family planning clinic. For most counties, at least 30% of women have ever used the services of a family planning clinic. XI. Family Planning

XII. HIV/AIDS & Sexual Behavior*
Understanding of HIV treatment Testing for HIV STD Counseling Condom use *Questions asked of respondents less than age 65.

A Pregnant Woman with HIV Can Get Treatment to Reduce HIV Transmission to Fetus: Onslow, North Carolina, & US Q: “A pregnant woman with HIV can get treatment to help reduce the chances that she will pass the virus on to her baby.” Of all 10 oversampled counties, Onslow respondents had the lowest rate of believing that treatment was available to help a pregnant women with HIV reduce transmission of the virus to her fetus. By the same token, Onslow respondents had the highest rate (27.7%) of believing that there was no such treatment available. XII. HIV/AIDS & Sexual Behavior

Medical Treatments Available to Help a Person with HIV to Live Longer: Onslow, North Carolina & US
Q: “There are medical treatments available that are intended to help a person who is infected with HIV to live longer.” About 89% of Onslow County respondents recognize that there are medical treatments available to help a person with HIV to live longer; a little more than 7% were not sure, and about 3% believed no such treatment was available. XII. HIV/AIDS & Sexual Behavior

Believe that Treatments for Persons w/HIV are Effective
Q: “How effective do you think these treatments are for helping persons with HIV to live longer? Would you say: Very effective, Somewhat effective, or Not at all effective.” Overall, about 23% of adults (<64 yrs. old) believe there are very effective treatments for persons with HIV to live longer. In Gaston County, the rate was 20.1%; in Durham, the rate was 34% - the highest of any county. XII. HIV/AIDS & Sexual Behavior

Knowing HIV Status by Getting Tested is Important
Q: “How important do you think it is for people to know their HIV status by getting tested? Response: very important” The vast majority of respondents in all counties and across the state believe that it is very important to know one’s HIV status by getting tested. XII. HIV/AIDS & Sexual Behavior

Ever Been Tested for HIV/AIDS
Q: “As far as you know, have you ever been tested for HIV? Do not count tests you may have had as part of a blood donation.” Across the state, about 49% of adults (<64 yrs. old) have ever been tested for HIV. High rates of HIV testing in Cumberland and Onslow counties are due largely to military induction. XII. HIV/AIDS & Sexual Behavior

Prevalence of Ever Been Tested for HIV by Race & Sex, North Carolina, 1995-2001
From 1995 to 2001, the prevalence of HIV testing among whites has increased from about 33% to 46%; among African Americans, the increase in HIV testing has risen from about 42% in 1995 to 56% in 2001. From 1995 to 1998, HIV testing rates were around 40% for males and females; in 2001, males and females had comparable testing rates of 47.8% and 49.5% respectively. XII. HIV/AIDS & Sexual Behavior

Reason for HIV/AIDS Testing: North Carolina
Q: “What was the main reason you had your test for HIV? Among adults who have had an HIV test, about 30% report that the main reason for their last HIV test was having a routine checkup, followed by just wanting to find out, and because of pregnancy. XII. HIV/AIDS & Sexual Behavior

Tested for HIV/AIDS Just to Find Out HIV Status
Q: “What was the main reason you had your test for HIV? Reason: Just to find out if you were infected” Among adults who have had an HIV test, about 19% report that the main reason for their last HIV test was just to find out about their HIV status. Testing for HIV just to find out status, ranges from a low of 9% in Onslow to a high of 28% in Guilford. XII. HIV/AIDS & Sexual Behavior

Testing Place for HIV/AIDS: North Carolina
Q: “Where did you have the HIV test? Facility: Health department” Among those who’ve had an HIV test, about 48% report that they had their testing done at private doctor clinic followed by health department and hospital. XII. HIV/AIDS & Sexual Behavior

Had HIV Test in Health Department
Q: “Where did you have the HIV test? Facility: Health department” Among those who’ve had an HIV test, about 16% reported having their test in a county health department. Significantly more adults get tested in health departments in NC than the US. About 27% of Buncombe County adults reported having their HIV test in the county health department, compared to about 11% in Cumberland. XII. HIV/AIDS & Sexual Behavior

Health Professional Counseled About Preventing STDs
Q: “In the past 12 months has a doctor, nurse, or other health professional talked to you about preventing sexually transmitted diseases through condom use?” About 17% of adults report that in the last 12 months a health professional has counseled them about the use of condoms to prevent STDs. XII. HIV/AIDS & Sexual Behavior

Condom Was Used Last Time Sexual Intercourse
Q: “Was a condom used the last time you had sexual intercourse?” Statewide, among adults (<65 yrs. old) who’ve had sexual intercourse in the last 12 months, 20% report that a condom was used. XII. HIV/AIDS & Sexual Behavior

Properly Used Condom Effective in Preventing HIV
Q: “Some people use condoms to keep from getting infected with HIV through sexual activity. How effective do you think a properly used condom is for this purpose?” About 50% of North Carolina adults believe that a properly used condom is very effective in preventing HIV infection during sexual activity. XII. HIV/AIDS & Sexual Behavior

XIII. Healthy People 2010 Objectives (tracked by BRFSS data)
Access to quality health services Cancer Heart disease and stroke Immunizations and infectious diseases Nutrition and overweight Oral health Physical activity and fitness Substance abuse Tobacco use

Health Insurance Coverage*
Q: “Do you have any kind of health care coverage, including health insurance, prepaid plans such as HMOs, or government plans such as Medicare?” Statewide, about 83% of North Carolina adults, less than age 65, have some type of health insurance coverage, which is 17 percentage points below the HP 2010 target of 100%. Of all the oversampled counties, about 80% is the lowest health insurance coverage rate. HP 2010 Target: 100% *Adults < 65 yrs old XIII. HP 2010 Objectives

Specific Source of On-going Medical Care*
Q: “Is there one particular clinic, health center, doctor's office, or other place that you usually go to if you are sick or need advice about your health?” About 80% of North Carolina adults report having a specific source of on-going medical care; this rate is within 16 percentage points of the HP 2010 target. For some counties, such as Forsyth and Gaston, the rates exceed 85%; for other counties, such as Cumberland and Onslow, the rates are below 70%. HP 2010 Target: 96% *Adults 18+ yrs old XIII. HP 2010 Objectives

Fecal Occult Blood Test in Past 2 Years*
HP 2010 Target: 50% Indicator derived from 2 questions: Q1: “A blood stool test is a test that may use a special kit at home to determine whether the stool contains blood. Have you Ever Had this test using a home kit?” Q2: “How long has it been since you had your last blood stool test using a home kit?” About 43% of North Carolina adults, ages 50 and older, report having a fecal occult blood test in the past two years. The rates of fecal occult blood testing vary from a high of 60% in Forsyth County to a low 33% in Onslow County. *Adults 50+ years old XIII. HP 2010 Objectives

Ever Received Colonoscopy Exam*
HP 2010 Target: 50% Q: “Sigmoidoscopy and colonoscopy are exams in which a tube is inserted in the rectum to view the bowel for signs of Cancer or other health problems. Have you Ever Had either of these exams?” Almost 48% of North Carolina adults, ages 50 and older, report ever having a colonoscopy exam; this is very close to the HP 2010 target of 50%. In some counties, such as Forsyth and New Hanover, the rates of colonoscopy exams exceed the HP2010 target. *Adults 50+ years old XIII. HP 2010 Objectives

Blood Cholesterol Checked Past 5 Years*
HP 2010 Target: 80% Indicator derived from 2 questions: Q1: “Blood cholesterol is a fatty substance found in the blood. Have you Ever Had your blood cholesterol checked?” Q2: “About how long has it been since you last had your blood cholesterol checked?” Among adults, ages 18 and older, 75% report having had their blood cholesterol checked in the past 5 years; this is within 5 percentage points of HP 2010 target of 80%. Three counties have met or exceeded the HP 2010 target: Guilford, Forsyth, and Gaston. *Adults 18+ years old XIII. HP 2010 Objectives: quality health care services

Annual Flu Vaccine* HP 2010 Target: 80% XIII. HP 2010 Objectives
Q: “During the past 12 months, have you had a flu shot?” Statewide, about 66% of adults, ages 65 and older, report having a flu exam in the past 12 months; this rate falls short of the HP 2010 target by 14 percentage points. Only Wake County was found to exceed the HP 2010 target. HP 2010 Target: 80% *Adults 65+ years old XIII. HP 2010 Objectives

Ever Received Pneumococal Vaccine*
Q: “Have you Ever Had a pneumonia shot? This shot is usually given only once or twice in a person’s lifetime and is different from the flu shot. It is also called the pneumococcal vaccine.” Similar to the previous results (annual flu vaccine), about 66% of adults over age 64 report ever receiving pneumococal vaccine. None of the oversampled counties are close to the HP 2010 target of 90%. HP 2010 Target: 90% *Adults 65+ years old XIII. HP 2010 Objectives

Reduce Obesity HP 2010 Target: reduce to 15% XIII. HP 2010 Objectives
Obesity is derived from the respondents weight and height Obesity is determined by first computing the respondent’s Body Mass Index (BMI), as weight in kilograms divided by height in meters squared:(kg/m2); a BMI greater than 29.9 is considered obese. For NC adults ages 20 and older, the statewide rate of obesity – 23% – exceeds the HP 2010 target by 8 percentage points. In particular, New Hanover and Onslow counties are close to meeting the target of 15%. *Adults 20+ years old XIII. HP 2010 Objectives

Reduce No Leisure Time Physical Activity*
No leisure time physical activity consists of NO exercise or physical activity: Q: “During the past 30 days, other than your regular job, did you participate in any physical activities or exercise such as running, calisthenics, golf, gardening, or walking for exercise?” Across the state, 26% of adults (ages 18+) report no leisure time activities in the past month; this is about 6 percentage points above the target of 20%. HP 2010 Target: reduce to 20% *Adults 18+ years old XIII. HP 2010 Objectives

Vigorous Physical Activity/3 Times Week
Indicator derived from 3 questions: Q1: “Now thinking about the vigorous physical activities you do in a usual week, do you do vigorous activities for at least 10 minutes at a time, such as running, aerobics, heavy yard work, or anything else that causes large increases in breathing or heart rate?” Q2: “How many days per week do you do these vigorous activities for at least 10 minutes at a time?” Q3: “On days when you do vigorous activities for at least 10 minutes at a time, how much total time per day do you spend doing these activities?” Across the state, an estimated 20% of adults participate in vigorous activity for 20 minutes at least 3 times a week; the HP 2010 target calls for 30%. New Hanover, Durham and Onslow counties are very close to meeting this target. HP 2010 Target: 30% *Adults 18+ years old XIII. HP 2010 Objectives

Reduce Binge Drinking*
Indicator derived from 2 questions: Q1: “A drink of alcohol is 1 can or bottle of beer, 1 glass of wine, 1 can or bottle of wine cooler, 1 cocktail, or 1 shot of liquor. During the past 30 days, how often have you had at least one drink of any alcoholic beverage?” Q2: Considering all types of alcoholic beverages, how many times during the past 30 days did you have 5 or more drinks on an occasion? Binge drinking includes respondents who reported drinking in the past 30 days, and had five or more drinks on one or more occasions in the past month. Based on this definition, about 10% of North Carolinians may be classified as binge drinkers, which is in excess of the HP 2010 target of 6 percentage points. However, given that alcohol consumption is generally under-reported, the state and county estimates are most likely below the true rate of binge drinking. HP 2010 Target: reduce to 6% *Adults 18+ years old XIII. HP 2010 Objectives

Reduce Cigarette Smoking
Cigarette smoking defined by 2 questions: Q1: “Have you smoked at least 100 cigarettes in your entire life?” Q2: “Do you now smoke cigarettes every day, some days, or not at all?” The rate of cigarette smoking (everyday & occasional) for the state exceeds the HP 2010 target by about 14 percentage points, or the state smoking rate is about twice as high as the target reduction. The rate of cigarette smoking varies considerably by county, with Onslow and Buncombe exceeding 30%, and Durham and Mecklenburg less than 20%. HP 2010 Target: reduce to 12% *Adults 18+ years old XIII. HP 2010 Objectives

Reduce Cigar Smoking* HP 2010 Target: reduce to 1.2%
Cigar smoking defined by 2 questions: Q1: “Have you ever smoked a cigar, even one or two puffs?” Q2: “Do you now smoke cigars every day, some days, or not at all?” Definition of cigar smoker: ever smoked a cigar and now smokes some days or everyday. Across the state, about 6% of adults are cigar smokers, about 5 times the HP 2010 reduction rate of 1.2%. HP 2010 Target: reduce to 1.2% *Adults 18+ years old XIII. HP 2010 Objectives: quality health care services

XIV. Special Topics Alternative medicine Skin Cancer
Osteoporosis prevention Firearms Sexual/physical assault Birth defect prevention

Ever Used Medicinal Herbs, Such as Ginseng
Q: “Have you ever used any kind of medicinal herbs, such as Ginseng, St. John’s wort, or Echinacea?” About 20% of North Carolina adults have ever used medicinal herbs. Use of medicinal herbs varies from a high of 31% in Wake County to a low of about 15% in Cumberland County. XIV. Special Topics

Tried to Get a Tan Using a Tanning Lamp
Q: “In the past 12 months, have you tried to get a tan using a tanning lamp or tanning machine, whether it was at a tanning salon, at your home, or elsewhere?” About 9% of all respondents report that they have tried to get a tan using a tanning lamp in the past year. In Gaston and Buncombe, the rates are about 14%, compared to less than 4% in Forsyth and Durham. XIV. Special Topics

Tried to Get a Tan from the Sun
Q: “In the past 12 months, have you tried to get a tan from the sun?” Statewide, about 2 in 10 adults reported trying to get a tan from the sun in the past year. In New Hanover County, which borders the coastline, almost 4 in 10 adults have reported trying to get a tan from the sun in the past year. XIV. Special Topics

Always Protect Skin from Sun When Outdoors
Q: “When you’re outdoors during the summer for at least half an hour, how often do you protect your skin from the sun, such as by using sunscreens or sunblock or wearing hats or protective clothing?” Approximately, 1 in 3 adults report that they always try to protect their skin from sunburn when outside for at least half an hour. XIV. Special Topics

Sunburn in the Past Year
Q: “The next question is about sunburns, including any time that even a small part of your skin was red for more than 12 hours. Have you had a sunburn within the past 12 months?” The rate of reported sunburns among NC adults is about 22%; in New Hanover County, this rate jumps to 38%. XIV. Special Topics

Take Vitamin Pills w/Calcium to Reduce Osteoporosis*
Q: “Are you taking any vitamin pills or supplements that contain calcium, to lower your risk of osteoporosis or weak bones?” Across the state, about 53% of females over the age of 44 are reportedly taking vitamin pills with calcium to lower their risk of osteoporosis. *Question asked of female respondents age 45 and older XIV. Special Topics

Firearms Kept in or Around Home
Q: “Are any firearms now kept in or around your home? Include those kept in a garage, outdoor storage area, car, truck, or other motor vehicle.” About 41% of NC adults report that firearms are kept in or around their homes which is significantly higher than the U.S. rate. XIV. Special Topics

Received Treatment for Substance Abuse Problem
Q: “Have you ever received counseling or treatment for a substance abuse problem including alcohol?” About 5% of NC adults reported receiving treatment for substance abuse. Note that the BRFSS does not interview people who are in prisons which may have large number of people who have ever received treatment for substance abuse problem. XIV. Special Topics

Family Member Received Tx for Substance Abuse
Q: “Has any close family member received treatment for a substance abuse problem?” About 14% of adults report that a family member has received treatment for a substance abuse problem. XIV. Special Topics

Ever Sexually Assaulted*
Q: “Has a stranger, partner or someone you knew other than partner ever forced you to have sex or to do sexual things?” The estimated rate of sexual assault, for both males and females across the state, is 6.8%. *Male and female respondents XIV. Special Topics

Ever Physically Assaulted
Q: “Has a stranger, partner or someone you knew other than partner ever pushed, hit, slapped, kicked, or physically hurt you in any other way?” The estimated rate of physical assault, for both males and females across the state, is 17.5%. The reported rate of physical assault in Onslow County is almost double that of the state rate. XIV. Special Topics

Believe Folic Acid Helps Prevent Birth Defects*
Q: “Some health experts recommend that women take 400 micrograms of the B vitamin folic acid, for which one of the following reasons... To make strong bones, to prevent birth defects, to prevent high blood pressure, or some other reason” Among females, ages 18 to 44, approximately 41% believe that taking 400 micrograms of the B vitamin folic acid will help prevent birth defects. In Buncombe County, over 60% of women had the right answer, while in Cumberland County, only 28% of women had the right answer. *Ages included here XIV. Special Topics

Behavioral Risk Factor Surveillance System

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