1. Behavioral Risk Factor Surveillance System
BRFSS
Behavioral Risk Factor Surveillance System
Mountain Area Health Education Center Service Region NC BRFSS Survey Results
This presentation summarizes the 2003 NC BRFSS results for the Mountain Area Health Education Center (AHEC) service region which consists of 16 counties in the western-most region of the state. These AHEC counties include: Buncombe, Cherokee, Clay, Graham, Haywood, Henderson, Jackson, McDowell, Macon, Madison, Mitchell, Polk, Rutherford, Swain, Transylvania, and Yancey counties. The Mountain AHEC region is a subset of the 23 counties that comprise the Western region of the state, which is also featured as a separate geographical strata in this presentation.
State Center for Health Statistics
Division of Public Health
North Carolina Department of Health and Human Services

2. 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, regional, and local level estimates for targeting high-risk groups.
The BRFSS is the largest and longest running telephone health survey in the world.

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

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

5. 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

6. The 2003 North Carolina BRFSS
For the 2003 survey, the North Carolina BRFSS Program conducted interviews in both English and Spanish and interviewed a total of 9,455 adults.
The 2003 sample design included over-sampling of five counties and 12 regions consisting of more than 50 smaller counties to produce county or regional BRFSS estimates. In addition, estimates were produced for three, broad regions of the state: Western, Piedmont, and Eastern.
The 2003 results for each question are available on the BRFSS web site by sex, race, Hispanic origin and language (English, Spanish-only), age group, education level, household income, and county and region. The 2003 data provide estimates on the health of Native Americans and Spanish-speaking only Hispanics, see: /2003/highlights.html
For the 2003 survey, the North Carolina BRFSS Program conducted a total of 9,455 interviews in both English and Spanish. This was the largest number of interviews ever completed by the North Carolina BRFSS. Over 9,000 interviews were needed to ensure a minimum of 400 completed interviews to produce local level estimates for 5 counties, 9 multi-county regions, and 4 (AHEC) health regions. Their combined total of 18 county/regional estimates almost doubles the number produced (10) in 2002.
There are now three consecutive years of NC BRFSS data available on the BRFSS web site, which is maintained by the State Center for Health Statistics in Raleigh. The 2003 results for each survey question are broken out by sex, race, Hispanic origin and language (English, Spanish-only), age group, education level, household income, and county and region. These results, along with previous years’ results, provide public health planners and program providers with a closer look at the health and well-being of North Carolina's minority populations (including American Indians and Spanish-speaking Hispanics), as well as that of the state's general population.

7. 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. All results in this presentation use weighted data. Use of the weighted data allows us to generalize the results of the BRFSS Survey to the North Carolina population of adults, ages 18 and older, with household telephones.
Note: all results are based on weighted data

8. 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 survey using RDD or random digit dialing. Data is analyzed on a calendar year basis. The questionnaire changes each year, beginning in January.
Interviews are conducted using the 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.

9. 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 and sponsored by state programs/agencies.
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 the 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.

10. Survey Topics on the NC 2003 BRFSS
Core Sections
Health status
Health care access
Diabetes
Hypertension
Cholesterol
Weight control
Asthma
Immunization
Tobacco/alcohol
Arthritis/disability
Demographics
Physical Activity
Veteran’s status
HIV/AIDs
Optional Modules
Diabetes
Influenza
Heart Attack & Stroke
Cardiovascular disease
Tobacco indicators
Other tobacco products
Binge drinking
State-added
Arthritis
Disability & aging
Tobacco tax
Diabetes screening
Weight loss products
Violence
Here we see the various topics covered in the Core, Optional Modules, and State-added questions, for the 2003 North Carolina BRFSS Survey. The 2003 questionnaire contained a total of 179 questions. There were 2 new questions in the Core related to falls among persons age 45 and older. The questions asked in the Optional Modules have been asked in previous years, except for two new questions related to binge drinking, i.e., Who purchased the alcohol?, Where was it obtained? There were several new topics/questions introduced in the State-Added Section: these included questions on diabetes screening among the general population, (i.e., those not diagnosed with diabetes) two new questions on care for aging family members, two new questions on exercise and weight loss for those with arthritis, a question on a proposed tobacco tax on cigarettes, several new questions on the use of weight loss products, and a revised set of questions on physical violence, which, for the first time, asked the respondent-victim to identify different persons/groups that she/he may have to talked to about the most recent assault.

11. About this 2003 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.
Survey questions: the BRFSS survey questions are 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.
It’s very important to check the 2003 NC BRFSS questionnaire to learn about the skip patterns for different questions or modules; for example, the question on arthritis and its impact on work related activities is asked only among year olds, including those in that age group who may be retired or out-of-work.
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.

12. About this 2002 BRFSS Presentation (cont.)
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 16 oversampled counties and regions 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 18 over-sampled counties/regions 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.

13. Geographical Analysis Used in this Presentation
In this presentation, we show the results for the featured county or region of interest with those of North Carolina, the state’s urban and rural counties, three regions of the state including the Western, Eastern and Piedmont regions, and the results for the United States, when BRFSS questions appear in Core Section or in standard Modules.
Urban and rural counties are defined as follows:
Urban counties include Buncombe, Cumberland, Davidson, Durham, Forsyth, Gaston, Guilford, Mecklenburg, Onslow and Wake.
All other counties are classified as rural.

14. Geographical Analysis (cont.)
The three regions are defined accordingly:
The Western region includes Alleghany, Ashe, Avery, Buncombe, Burke, Caldwell, Cherokee, Clay, Graham, Haywood, Henderson, Jackson, McDowell, Macon, Madison, Mitchell, Polk, Rutherford, Surry, Swain, Transylvania, Watauga, Wilkes, and Yancey counties.
The Eastern region includes Beaufort, Bertie, Bladen, Brunswick, Camden, Carteret, Chowan, Columbus, Craven, Cumberland, Currituck, Dare, Duplin, Edgecombe, Gates, Greene, Halifax, Harnett, Hertford, Hoke, Hyde, Johnston, Jones, Lenoir, Martin, Nash, New Hanover, Northampton, Onslow, Pamlico, Pasquotank, Pender, Perquimans, Pitt, Robeson, Sampson, Scotland, Tyrrell, Washington, Wayne, and Wilson counties.
The Piedmont region includes Alamance, Alexander, Anson, Cabarrus, Caswell, Catawba, Chatham, Cleveland, Davidson, Davie, Durham, Forsyth, Franklin, Gaston, Granville, Guilford, Iredell, Lee, Lincoln, Mecklenburg, Montgomery, Moore, Mountain AHEC, Person, Randolph, Richmond, Rockingham, Rowan, Stanly, Stokes, Union, Vance, Wake, Warren, and Yadkin counties.

15. Contents of Presentation
i Sample Size & Demographics
Health Status/Healthy Days
Health Care Access
Chronic Diseases
Disability
Care for Aging
Immunization
Physical Activity
Tobacco Use
Tobacco Prevention
Rules About Smoking
Other Tobacco Products
Tobacco Tax
Risk Factors
HIV/AIDS
Obesity
Weight Control
Weight Loss Products
Knowledge of Signs & Symptoms of Heart Attack & Stroke
Cardiovascular Disease
Excess Sun Exposure
Binge Drinking
Falls
Physical Assault
2003 BRFSS Tracked HP2010 Objectives
There are 24 content areas contained in this presentation, beginning with Sample Size and Demographics and ending with the HP2010 Objectives that can be tracked with the 2003 BRFSS Survey. (Each topic above is linked to its introductory slide; these links become available only in slide show mode.)

16. i. Sample Size & Demographics

17. 2003 NC BRFSS Sample Size
There was a total of 9,455 interviews completed statewide. Almost all counties or county-clusters had at least 400 completed interviews. For the Mountain Area Health Education Center (AHEC) service region , a total of 1308 interviews were completed in 2003.

18. 2003 NC BRFSS Sample Demographic Characteristics
Compared to the state, the Mountain AHEC region has a significantly higher percentage of whites and significantly smaller percentage of African Americans. Regarding age, the Mountain AHEC region appears to have a slightly older population than the state.
*weighted percentages

19. 2002 NC BRFSS Sample Demographic Characteristics (cont.)
The distributions for education and employment are fairly similar between the Mountain AHEC region and the state. However, the proportion of household incomes of less than $50,000 is noticeably higher in the Mountain AHEC region.
*weighted percentages

20. I. Health Status/Healthy Days
Perceived Fair/Poor Health
Poor Physical Health Days
Poor Mental Health Days
Restricted Activity Days
I. Health Status/Healthy Days

21. Perceived Fair or Poor Health
Q: Would you say that in general your health is: Excellent, Very Good, Good, Fair or Poor?
In 2003, about 19% of North Carolina adults perceived their health to be fair or poor; the highest rate of 24.0% appeared in Western NC, followed by the Mountain AHEC region.
I. Health Status/Healthy Days

22. Fair or Poor Health by Sex, Race, Age, Education & Income: Mountain AHEC & NC%
Compared to the state, the prevalence of self-reported fair or poor health was higher among most Mountain AHEC demographic groups.
I. Health Status/Healthy Days

23. Poor Physical Health Days (8+ days out of past 30 days)
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?
Both the Mountain AHEC region and Western NC had the highest rates of poor physical health days (8 or more days out of the past 30 days). The Piedmont counties and urban counties had the lowest rates.
I. Health Status/Healthy Days

24. Poor Mental Health Days (8+ days out of past 30 days)
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?
With regard to poor mental health, rural counties and the Western region had the highest rate of self-reported poor mental health.
I. Health Status/Healthy Days

25. Restricted Activity Days (8+ days past 30 days)*
Q: During the past 30 days, for about how many days did poor physical or mental health keep you from doing your usual activities, such as self-care, work, or recreation?
* Respondents who reported no mental and physical health problems in the past month were not asked this question, but were included in the “no days” calculations for this variable.
Rates for this indicator were highest in Western NC and the Mountain AHEC region.
I. Health Status/Healthy Days

26. II. Health Care Access No Health Insurance Coverage No Personal Doctor
Cost Prevented Access
II. Health Care Access

27. No Health Insurance Coverage (ages 18 to 64)
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 20% of North Carolina adults, ages 18 to 64, have no health insurance – slightly higher than the U.S. rate.
Across the state, no health insurance for 18 to 64 year olds ranged from a high of 26.1% in the Western region to a low of
17.5% in urban counties.
II. Health Care Access

28. No Health Insurance Coverage by Sex, Race, Age (18-64 yrs
No Health Insurance Coverage by Sex, Race, Age (18-64 yrs.), Education & Income: Mountain AHEC & NC %
Compared to the state, the percentage of 18 to 64 year olds in Mountain AHEC with no health insurance was higher for most demographic groups, particularly for ‘other’ minorities where the difference between the state and region exceeded 20 percentage points.
II. Health Care Access

29. No Health Insurance Coverage (all ages)
Q: Do you have any kind of health care coverage, including health insurance, prepaid plans such as HMOs, or government plans such as Medicare?
About 1 in 5 adults living in the Mountain AHEC region had no health in 2003.
II. Health Care Access

30. Does Not Have a Personal Doctor*
Q: Do you have one person you think of as your personal doctor or health care provider?
*Those who reported having more than one personal doctor are included in the NO category.
In comparison to other regions of the state, adult residents from the Mountain AHEC region do not appear to have an excess risk of not having a personal doctor.
II. Health Care Access

31. Time When Needed To See Doctor But Could Not Because of Cost
Q: Was there a time during the last 12 months when you needed to see a doctor, but could not because of the cost?
The effect of cost on preventing access to medical care was most evident in the Western region.
II. Health Care Access

32. III. Chronic Diseases Arthritis Asthma Diabetes High Blood Pressure
High Cholesterol
III. Chronic Diseases

33. Arthritis
III. Chronic Diseases

34. Ever Told by a Doctor You Have Some Form of Arthritis
Q: Have you ever been told by a doctor or other health professional that you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?
Mountain AHEC contains the highest rate of doctor-diagnosed arthritis.
III. Chronic Diseases

35. The Prevalence of Arthritis by Sex, Race, Age, Education & Income: Mountain AHEC & NC%
Among females and those over the age of 45, more than 40% of adults from the Mtn. AHEC region have arthritis.
III. Chronic Diseases

36. Joint Pain in Past 30 Days III. Chronic Diseases
Q: DURING THE PAST 30 DAYS, have you had any symptoms of pain, aching, or stiffness in or around a joint?
Statewide, about 44% of adults have had symptoms of joint pain in the past 30 days, with the highest prevalence (49.4%) reported in the Mtn. AHEC region.
III. Chronic Diseases

37. Joint Symptoms Began More than Three Months Ago*
Q: Did your joint symptoms first begin more than 3 months ago?
*This question was asked of respondents who reported having pain, aching, stiffness or swelling in or around a joint.
For most adults with joint pain—over 80%--the symptoms began more than 3 months ago.
III. Chronic Diseases

38. Ever Seen a Health Professional for Joint Symptoms*
Q: Have you ever seen a doctor or other health professional for these joint symptoms?
*This question was asked of respondents who reported having pain, aching, stiffness or swelling in or around a joint.
A little more than 70% of NC adults with joint pain have ever seen a health professional for their joint pain; the Mountain AHEC region had the highest rate.
III. Chronic Diseases

39. Now Limited Because of Joint Symptoms or Arthritis
Q: Are you now limited in any way in any of your usual activities because of arthritis or joint symptoms?*
*This question was asked of respondents who reported joint symptoms beginning at least 3 months ago, or being told by a doctor that they have arthritis.
Statewide, almost a third of those with arthritis or joint symptoms reported that they were now limited in their usual activities.
III. Chronic Diseases

40. Joint Symptoms or Arthritis Now Affects Work-related Activities
Q: In this next question we are referring to work for pay. Do arthritis or joint symptoms now affect whether you work, the type of work you do or the amount of work you do?*
*This question was asked of respondents (18-64 yrs.) who reported joint symptoms beginning 3 months ago, or being told by a doctor that they have arthritis
About one-third of those in Mountain AHEC region reported that their joint symptoms have affected their work activities, which exceeds the state rate.
III. Chronic Diseases

41. Doctor Suggested Losing Weight to Help with Arthritis or Joint Symptoms
Q: Has a doctor or other health professional EVER suggested losing weight to help your arthritis or joint symptoms ?*
*Asked only of respondents with chronic joint symptoms or doctor-diagnosed arthritis
Statewide, about 18% of those with arthritis reported that a doctor or health professional had suggested that they lose weight to help with their joint symptoms.
III. Chronic Diseases

42. Doctor Suggested Physical Activity to Help with Arthritis or Joint Symptoms
Q: Has a doctor or other health professional EVER suggested physical activity or exercise to help your arthritis or joint symptoms?*
*Asked only of respondents with chronic joint symptoms or doctor-diagnosed arthritis
Statewide, a little more than 40% of those with arthritis indicated that a doctor or health professional had suggested physical activity to help with their symptoms.
III. Chronic Diseases

43. Asthma
III. Chronic Diseases

44. Ever Diagnosed with Asthma
Q: Did a doctor ever tell you that you had asthma?
Statewide, about 11% of adults have ever been diagnosed with asthma; in the Mountain AHEC region, the rate climbed to 13.3%.
III. Chronic Diseases

45. Ever Diagnosed with Asthma by Sex, Race, Age, Education & Income: Mountain AHEC & NC%
Accept for minorities, the rate of ever being diagnosed with asthma was higher among Mountain AHEC adults.
III. Chronic Diseases

46. Currently has Asthma* III. Chronic Diseases
Q: Do you still have asthma?
*Adults without asthma are included in the denominator to estimate current asthma prevalence.
For North Carolina, the population rate of those who currently have asthma dropped about 3 percentage points from the population rate of those who have ever been diagnosed with asthma.
III. Chronic Diseases

47. Diabetes
III. Chronic Diseases

48. Diabetes Prevalence III. Chronic Diseases
Q: Have you ever been told by a doctor that you have diabetes?
Statewide, an estimated 8.1% of adults have doctor-diagnosed diabetes.
III. Chronic Diseases

49. The Prevalence of Diabetes by Sex, Race, Age, Education & Income: Mountain AHEC & NC%
Most notably, the prevalence of diabetes among ‘other’ minorities in the Mtn. AHEC region was 14.0% compared to 9.8% for the state.
III. Chronic Diseases

50. Ever Had a Blood Test for Diabetes
Q: Have you ever had a blood test for high sugar or diabetes?*
*Asked of all respondents that answered NO to diabetes Core question: Have you ever been told by a doctor that you have diabetes?
An estimated 61.9% of adults in the state have ever had a blood test for diabetes.
III. Chronic Diseases

51. Had a Blood Test for Diabetes in the Past Three Years
Q: Have you ever had a blood test for high sugar or diabetes?*
*Asked of all respondents that have ever had a blood sugar test?
The majority—over 86%--of those who’ve ever had a blood test for diabetes have had the test in the past 3 years.
III. Chronic Diseases

52. Diabetes Management Indicators – NC & US%
An estimated 24.3% of those with doctor-diagnosed diabetes are taking insulin; a much larger proportion, over 70% are taking diabetes pills.
About 60% of diabetics reportedly check their blood glucose at least once a day; about 70% check their feet for sores or irritations at least once a day, and about 50% have had an eye exam, in which the pupil is dilated, in the past year.
III. Chronic Diseases

53. Diabetes Risk Indicators – NC & US%
About 8% of diabetics have early onset of the disease, before age 30; across the Nation this rate is closer to 12%.
For NC, about 10% of diabetics have never had their hemoglobin checked for 'A one C‘ by a health professional. About 44% have never taken a self-management class and 11 percent reported, that at least on one occasion in the past year, there was a time when they were without medicines and testing supplies because of cost.
State Quest. Only
III. Chronic Diseases

54. High Blood Pressure
III. Chronic Diseases

55. Ever Told by Health Professional that You Have High Blood Pressure
Q: Have you ever been told by a doctor, nurse, or other health professional that you have high blood pressure?
In 2003, the estimated prevalence of doctor-diagnosed high blood pressure in the state was about 29%; in 2001 (the latest year for the Hypertension Module), the statewide prevalence was 27.2%.
III. Chronic Diseases

56. The Prevalence of High Blood Pressure by Sex, Race, Age, Education & Income: Mountain AHEC & NC%
The prevalence of high blood pressure among Mountain AHEC demographic groups was generally lower or close to that of their statewide counterparts.
III. Chronic Diseases

57. Currently Taking Medicine for High Blood Pressure
Q: Are you currently taking medicine for your high blood pressure?*
*This question is asked only if the respondent reported being diagnosed with high blood pressure.
About three-quarters of NC adults with high blood pressure are taking medicine for their high blood pressure; in the Mtn. AHEC region the rate was 81.5%.
III. Chronic Diseases

58. High Cholesterol
III. Chronic Diseases

59. Told by a Doctor that Your Blood Cholesterol is High
Q: Have you ever been told by a doctor, nurse or other health professional that your blood cholesterol is high?*
*This question is asked only if the respondent reported having blood cholesterol checked.
About one-third of NC adults reportedly have high cholesterol.
III. Chronic Diseases

60. The Prevalence of High Cholesterol by Sex, Race, Age, Education & Income: Mountain AHEC & NC%
For the most part, the prevalence of high cholesterol was slightly lower for in Mountain AHEC demographic groups compared to their statewide counterparts.
III. Chronic Diseases

61. Have Had Blood Cholesterol Checked
Q: Blood cholesterol is a fatty substance found in the blood. Have you ever had your blood cholesterol checked?
About 78% of NC and U.S. adults have ever had their blood cholesterol checked – fairly stable rate across all geographic strata.
III. Chronic Diseases

62. IV. Disability Some type of disability Disability Measures:
Self-perceived
Need for special equipment
Activity limitation
Learning/memory problem
IV. Disability

63. Has Some Type of Disability
Some type of disability consists of a positive response to one or more of the four disability screener questions, or four disability measures: activity limitation, need for special equipment, self-perceived disability, or trouble learning/remembering.
Based on the current definition of disability, about 29% of NC adults in 2003 had some type of disability.
Across geographic strata, the disability rates varied from a low of 24.2% in urban counties to high of 35% in the Mtn. AHEC region.
IV. Disability

64. The Prevalence of Disability (some type) by Sex, Race, Age, Education & Income: Mountain AHEC & NC%
For most demographic groups, the prevalence of disability in Mountain AHEC tended to be higher than that of the state.
IV. Disability

65. Measure: Self-perceived* Disability
Q. A disability can be physical, mental, emotional, or communication related. Do you consider yourself to have a disability?*
*This includes possible responses of: “yes, mild disability,” “yes, moderate disability,” or “yes, severe disability.”
The rate of self-perceived disability (using the term ‘disability’ to describe one’s limitation) was almost twice as high in the Mtn. AHEC and Western regions compared to the Piedmont or Urban counties.
IV. Disability

66. Measure: Health Problem Requires Use of Special Equipment
Q. Do you now have any health problem that requires you to use special equipment, such as a cane, a wheelchair, a special bed, or a special telephone?
IV. Disability

67. Measure: Activity Limitation Because of Physical, Mental, or Emotional Problems
Q. Are you limited in any way in any activities because of physical, mental, or emotional problems?
The report of having an activity limitation was significantly higher in the Mtn. AHEC and Western regions, compared to the state.
IV. Disability

68. Measure: Trouble Learning and Remembering
Q. Because of any impairment or health problem, do you have any trouble learning, remembering, or concentrating?
For the state, about 12% of the adult population has some type of learning problem.
IV. Disability

69. V. Care for Aging Assistance provided to aging family member/friend
Memory loss of aging care recipient
V. Care for Aging

70. Provided Care/Assistance to a Family Member w/Long Term Illness
Q. People may provide regular care or assistance to an older adult who has a long-term illness or disability. During the past month, did you provide any such care or assistance to a family member or friend who is 60 years of age or older?
During 2003, we can estimate that in any given month, about one-quarter of adults in NC provided care or assistance to an older (age 60+) family member or friend who had a long term illness. The highest rates for this indicator were observed in the Mountain AHEC region, the Western region and in rural counties.
V. Care for Aging

71. Demographics of Care-giver for Mountain AHEC & NC%
For each demographic group, the results in this slide sum to 100%. For the most part, the demographics of care-givers reflects their distribution or proportion in the general population.
V. Care for Aging

72. Person Who Received Care Had a Problem with Memory Loss*
Q. Did that person have a problem with memory loss or confusion or a disorder like Alzheimer's Disease?*
*This questions was asked only of care-givers.
Among the geographic strata, the Mountain AHEC region had the lowest percentage for this indicator.
V. Care for Aging

73. VI. Immunization Had flu shot past year Had flu shot in health dept.
Ever had pneumonia shot
VI. Immunization

74. Had Flu Shot in Past Year
Q. During the past 12 months, have you had a flu shot?
Among adults statewide, ages 18 and older, an estimated 33.9% received a flu shot in the past 12 months (in 2002, the statewide rate was 31.4%). Mountain AHEC reported the lowest rate of having a recent flu shot.
VI. Immunization

75. Recent* Flu Shot by Sex, Race, Age, Education & Income: Mountain AHEC & NC%
The rates for having a recent flu shot among Mountain AHEC demographic groups tended to be somewhat higher than the state rates.
*past year
VI. Immunization

76. Had Flu Shot in Health Department
Q. At what kind of place did you get your last flu shot?
Across the nation in 2003, only about 3% of adults had their last flu shot in health departments, while in North Carolina, the rate was closer to 12%, and in the Mtn. AHEC region the rate was almost 19%.
VI. Immunization

77. Ever Had a Pneumonia Shot (all ages)
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.
About 22% of NC adults have ever had a pneumonia shot.
VI. Immunization

78. Ever Had a Pneumonia Shot (age 65+)
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.
When considering those age 65 and older, about two-thirds of the statewide population have ever had a pneumonia shot. The highest rates were observed in urban counties and in the Mtn. AHEC region.
VI. Immunization

79. VII. Physical Activity No leisure time physical activity
Does not meet recommendation
Moderate physical activity
Vigorous physical activity
Work activity
VII. Physical Activity

80. No Leisure Time Physical Activity
No = Respondents reporting no physical activity or exercise.
Yes = Respondents who report any level of physical activity or exercise.
In 2003, 1 in 4 adults in NC and the Nation had no physical activity of exercise in the past month.
VII. Physical Activity

81. No Leisure Time Activity by Sex, Race, Age, Education & Income: Mountain AHEC & NC%
In North Carolina, no leisure time activity was highest among females, minorities, those over age 45, those with less education, and those with the lowest household incomes. Mountain AHEC demographic groups tended to follow the same trends as the state.
VII. Physical Activity

82. Does Not Meet Recommendation for Physical Activity
Does Not Meet Recommendation includes those who engage in some physical activity (but not sufficient) or those who are physically inactive.
For most geographic areas of the state, over 60 percent of adults do not meet recommendations for adequate physical activity. North Carolina’s rate of not meeting physical activity recommendations significantly exceeded that of the U.S.
VII. Physical Activity

83. Engages in Moderate Physical Activity
Q. Now, thinking about the moderate physical activities you do when you are not working 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?
These results suggest that most adults, about three-fourths, engage in some type of moderate physical activity. Again, the nation as a whole outperformed North Carolina on this indicator.
For Mountain AHEC, the rate of participation in moderate activity was noticeably higher than the state.
VII. Physical Activity

84. Adequate Moderate Physical Activity per Week
Adequate = Respondents who report doing moderate physical activity for 30 or more minutes per day, five or more days per week or respondents who report doing vigorous physical activity for 20 or more minutes per day, three or more days per week. Not adequate = Respondents who report no moderate physical activity or less than 30 minutes per day, or less than five days per week and no vigorous physical activity or less than 20 minutes per day, or less than three days per week.
These results suggest that about half of those who engage in some type of moderate physical activity actually meet the recommendations for moderate physical activity.
VII. Physical Activity

85. Engages in Vigorous Physical Activity
Q. Now, thinking about the vigorous physical activities you do when you are not working 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?
A significantly smaller percentage of NC adults engage in vigorous physical activity as compared to the percentage of adults nationwide.
VII. Physical Activity

86. Adequate Vigorous Physical Activity per Week
Adequate = Respondents who report doing vigorous physical activity for 20 or more minutes per day, three or more days per week. Not adequate = Respondents who report no vigorous physical activity or less than 20 minutes per day, or less than three days per week.
Statewide, less than 20% of adults meet the recommendations for adequate vigorous physical activity.
VII. Physical Activity

87. Mostly Sitting or Standing at Work
Q. When you are at work, which of the following best describes what you do? Would you say: *
*This question was asked only of respondents who reported being employed or self-employed.
In urban counties, about 65% of adults mostly sit or stand at work; in rural counties the rate drops to about 56%.
VII. Physical Activity

88. VIII. Tobacco Use Current smoker Smoked 100+ cigarettes
Age first started smoking
VIII. Tobacco Use

89. Current Smoker VIII. Tobacco Use
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 24.8% of NC adults were current smokers in 2003, down somewhat from the rate of 26.2% reported in the 2002 NC BRFSS.
The rate of current smoking was lowest in urban counties and highest in Western NC.
VIII. Tobacco Use

90. Current Smoking by Sex, Race, Age, Education & Income: Mountain AHEC & NC%
The rate of current smoking across most Mountain AHEC demographic groups was higher (particularly among year olds) than the corresponding smoking rates for the state.
VIII. Tobacco Use

91. Smoked at Least 100 Cigarettes in Lifetime
Q. Have you smoked at least 100 cigarettes in your entire life?
Almost half of NC adults have ever smoked at least 100 cigarettes in their lifetime; the highest rate was observed in Mtn. AHEC region, which was significantly above the state rate.
VIII. Tobacco Use

92. First Started Smoking Regularly at Age 14 or Younger
Q. How old were you when you first started smoking cigarettes regularly?
Statewide, about 1 in 10 adults first started smoking regularly at age 14 or younger.
VIII. Tobacco Use

93. IX. Tobacco Prevention Quit smoking Advised to quit
Medical care for smokers
IX. Tobacco Prevention

94. Quit Smoking One Day or Longer in Past Year / Trying to Quit
Q: During the past 12 months, have you stopped smoking for one day or longer because you were trying to quit smoking?
Quick smoking rates—one day or longer in past year—averaged about 53% for all smokers in the state , a decline from the 2002 statewide rate of 58%. In Mountain AHEC, the quit-attempt rate for 2003 was the highest of any region in the state.
IX. Tobacco Prevention

95. Advised by Health Professional to Quit Smoking in Past Year*
Q. In the past 12 months, has a doctor, nurse, or other health professional advised you to quit smoking?
*This question was asked only of respondents who reported smoking regularly within the past year and had received health care of some kind.
Overall, about three-quarters of smokers were advised by a health professional to quit smoking in the past 12 months.
IX. Tobacco Prevention

96. 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?
*Regular smokers include those who smoke daily or occasionally.
Over 60% of smokers received some kind of medical care in the past year.
IX. Tobacco Prevention

97. X. Rules about Smoking Rules about smoking at home
Rules about smoking at work
X. Rules about Smoking

98. Smoking Not Allowed in the Home
Q. Which statement best describes the rules about smoking inside your home?
Smoking is not allowed anywhere inside your home.
2. Smoking is allowed in some places or at some times
3. Smoking is allowed anywhere inside the home or
4. There are no rules about smoking inside the home.
Respondents from urban counties were most likely to report that smoking was not allowed anywhere in the home.
X. Rules about Smoking

99. Smoking Not Allowed at Home by Sex, Race, Age, Education & Income: Mountain AHEC & NC%
Not allowing smoking in the home was about the same for Mtn. AHEC region and the state.
X. Rules about Smoking

100. At Work, Smoking Not Allowed in Work Areas*
* This question was asked only of respondents who reported working indoors most of the time.
Q. Which of the following best describes your place of works' official smoking policy for work areas:?
Not allowed in any work areas
Allowed in some work areas
Allowed in all work areas or
4.No official policy
Across the state, an estimated 88% of adults reported that smoking at work was not allowed in any work areas, up slightly from the 2002 rate of 86%.
X. Rules about Smoking

101. Worksites Prohibit Smoking in Both Public and Work Areas*
*Data in this table were derived from the two worksite questions from the Tobacco Indicators Module.
Statewide, 77.5% of worksites prohibit smoking in both public areas, such as lobbies, and work areas; the current rate is up considerably from the rate of 70.4% reported in 2002.
X. Rules about Smoking

102. XI. Other Tobacco Products
Ever used smokeless tobacco
Ever smoked a cigar
Current smokeless tobacco user
XI. Other Tobacco Products

103. Ever Use Smokeless Tobacco
Q. Have you ever used or tried any smokeless tobacco products such as chewing tobacco or snuff?
Respondents from rural counties, the Western region, and the Mtn. AHEC region were most likely to report ever using some type of smokeless tobacco product. (The rate for Mtn. AHEC was significantly higher than the state rate.)
XI. Other Tobacco Products

104. Ever Used Smokeless Tobacco by Sex, Race, Age, Education & Income: Mountain AHEC & NC%
As one would expect, males were far more likely than females to report ever using smokeless tobacco. In general, ever using smokeless tobacco among Mountain AHEC demographic groups was noticeably higher than the state, particularly for Mtn. AHEC males.
XI. Other Tobacco Products

105. Ever Smoked a Cigar XI. Other Tobacco Products
Q. Have you ever smoked a cigar, even one or two puffs?
An estimated 36% of adults in the state have ever smoked a cigar – well below the national rate. But in the Western region and the Mtn. AHEC region, the rates were close to the national rate.
XI. Other Tobacco Products

106. Current Smokeless Tobacco User
*Data in this chart were derived from the smokeless tobacco use questions 1 and 2.
About 4% of adults across the state are current smokeless tobacco users; in Mtn. AHEC region, the rate jumps to 6%.
XI. Other Tobacco Products

107. XII. Tobacco Tax Support for tobacco tax
Amount of tax by smoking status
XII. Tobacco Tax

108. Support for Tobacco Tax (any amount)
Q. In some states, the tax is as little as three cents a pack or as high as one dollar and fifty cents. The national average is currently $ How much additional tax on a pack of cigarettes would you be willing to support if all the money raised was used to fund smoking prevention programs for our youth and/or help balance the budget?
Support For Tobacco Tax = any amount of additional tax on a pack of cigarettes.
The majority of adults (over 70%) in NC support some kind of tax on cigarettes if the money was used for the prevention of youth-smoking and/or help balance the state budget.
XII. Tobacco Tax

109. Support for Tobacco Tax (any amount) by Sex, Race, Age, Education & Income: Mountain AHEC & NC%
The support for a tobacco tax across Mountain AHEC demographic groups tends to follow the state demographics.
XII. Tobacco Tax

110. Support for Amount of Tax on Pack of Cigarettes by Smoking Status*%
Q. In some states, the tax is as little as three cents a pack or as high as one dollar and fifty cents. The national average is currently $ How much additional tax on a pack of cigarettes would you be willing to support if all the money raised was used to fund smoking prevention programs for our youth and/or help balance the budget?
*Smokers include everyday and occasional smokers.
There’s a noticeable difference between smokers and non-smokers with regard to the specific amount of tax on a pack of cigarettes: smokers tend to favor a tax of 49 cents or less, while non-smokers tend to favor a higher tax of one dollar or more. Also, almost a third of smokers are opposed to a tax of any amount, while only 20 of non-smokers are opposed to a tax.
XII. Tobacco Tax

111. XIII. Risk Factors Overweight/obese Binge/heavy drinking Smoking
Physical inactivity
No leisure time
XIII. Risk Factors

112. Obese XIII. Risk Factors
Body mass index is computed as weight in kilograms divided by height in meters squared:(kg/ m2). BMI is an intermediate variable used in defining overweight and obesity.
Obese=BMI greater than 30.0.
The statewide rate for obesity in 2003 was 24 percent.
XIII. Risk Factors

113. Overweight or Obese XIII. Risk Factors
Body mass index is computed as weight in kilograms divided by height in meters squared:(kg/ m2). BMI is an intermediate variable used in defining overweight and obesity.
Not Overweight/Obese=BMI less than 25.0, and
Overweight/Obese= BMI greater than 25.0.
When being overweight is included with obesity, the risk more than doubles for adults in the state.
XIII. Risk Factors

114. Binge Drinking* XIII. Risk Factors
*Binge Drinking = Respondents who report they did drink in the past 30 days and had five or more drinks on one or more occasions in the past month.
Over 10% of Mtn. AHEC adults engaged in binge drinking in 2003, the highest rate of any region in the state.
XIII. Risk Factors

115. Heavy Drinking* XIII. Risk Factors
*Heavy Drinking = Respondents reported having MORE than 2 drinks/day for MALES and MORE than 1 drink/day for FEMALES.
The highest rate of heavy drinking was found in urban counties.
XIII. Risk Factors

116. Current Smoker XIII. Risk Factors
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.
Western NC, followed by rural counties and the Mtn. AHEC region had the highest rates of smoking.
XIII. Risk Factors

117. Physically Inactive* XIII. Risk Factors
Physically Inactive = Respondents reporting no moderate or vigorous physical activity.
About 1 in 5 NC adults are physically inactive, substantially higher than the U.S. rate.
XIII. Risk Factors

118. No Leisure Time Activity*
No leisure time activity = Respondents reporting no physical activity or exercise.
The percentage of adults in the Mountain AHEC region who reported no leisure time activity was slightly below the state as a whole.
XIII. Risk Factors

119. Less than 5 Daily Servings of Fruits/Vegetables*
*Data in this table were derived from the fruits and vegetables questions.
The Mtn. AHEC region had the lowest risk for this indicator – significantly lower than the state.
XIII. Risk Factors

120. Cholesterol Never Checked or Checked > 5 Years Ago*
*Data in this table were derived from the cholesterol awareness questions 1 and 2.
Mountain AHEC had the highest risk of not having cholesterol checked or checked more than 5 years ago.
XIII. Risk Factors

121. XIV. HIV/AIDS Ever Tested for HIV Knowledge of AIDS Treatment
STD Prevention
Sexual risk/intravenous drug use
XIV. HIV/AIDS

122. Ever 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.
*This question was asked only of respondents who reported being less than age 65 and who believed medical treatments were available for HIV.
About 47 percent of NC adults under age 65 have ever been tested for AIDS; about the same percentage as that reported in the 2002 NC BRFSS of 46%.
The HIV/AIDS testing rate for the Mountain AHEC region was significantly below that of the state.
XIV. HIV/AIDS

123. Ever Tested for AIDS by Sex, Race, Age, Education & Income: Mountain AHEC & NC%
Across the board, HIV testing rates were lower among Mountain AHEC demographic groups than that found among their statewide peers.
XIV. HIV/AIDS

124. A Pregnant Woman w/HIV Can Get Treatment to Reduce Chances that Baby Will Acquire Virus*
* This question was asked only of respondents who reported being less than age 65.
Q. I'm going to read two statements about HIV, the virus that causes AIDS. After I read each one, please tell me whether you think it is true or false, or if you don't know. A pregnant woman with HIV can get treatment to help reduce the chances that she w ill pass the virus on to her baby.
Chart features respondents who believed this statement was true, which is the correct response.
More than half of NC adults recognize this statement to be true.
XIV. HIV/AIDS

125. There Are Medical Treatments to Help Those w/HIV to Live Longer*
* This question was asked only of respondents who reported being less than age 65.
Q. I'm going to read two statements about HIV, the virus that causes AIDS. After I read each one, please tell me whether you think it is true or false, or if you don't know. There are medical treatments available that are intended to help a person who is infected with HIV to live longer.
Chart features “true” responses.
In 2003, about 87% of NC adults believe this statement to be true.
XIV. HIV/AIDS

126. In Past Year, Counseled About Condom Use to Prevent 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?
*This question was asked only of respondents who reported being less than age 65.
Among those less than age 65, about 11 percent of NC adults were counseled in the past year about condom use and prevention of STDs.
XIV. HIV/AIDS

127. At Risk for HIV/AIDS: Sexual Risk or Intravenous Drug Use*
I'm going to read you a list. When I'm done, please tell me if any of the situations apply to you. You don't need to tell me which one. You have used intravenous drugs in the past year. You have been treated for a sexually transmitted or venereal disease in the past year. You have given or received money or drugs in exchange for sex in the past year. You had anal sex without a condom in the past year. Do any of these situations apply to you?
*This question was asked only of respondents who reported being less than age 65.
For the state, the Mtn. AHEC region had the highest risk for HIV/AIDS.
XIV. HIV/AIDS

128. XV. Obesity Special Section Obesity by Race & Education
Obesity by Chronic Disease Status
Obesity by Health Risk Factors
Obesity by Limited Access to Health Care
XV. Obesity-Special Sect.

129. Obese XV. Obesity-Special Sect.
Body mass index is computed as weight in kilograms divided by height in meters squared:(kg/ m2). BMI is an intermediate variable used in defining overweight and obesity.
Obese=BMI greater than 30.0.
About one-fourth of adults in the state are obese.
XV. Obesity-Special Sect.

130. Prevalence of Obesity by Sex, Race, Age, Education & Income: Mountain AHEC & NC%
By demographics, the prevalence of obesity in the Mountain AHEC region tended to follow that of the state.
XV. Obesity-Special Sect.

131. Obesity by Race/Ethnicity & Education%
By race and ethnicity, African Americans and Native Americans have similarly high rates of obesity, while whites and Hispanics have relatively low rates of obesity.
With respect to education, the rate of obesity tends to decrease with increasing levels of education.
XV. Obesity-Special Sect.

132. Obesity by Chronic Disease Status%
The difference in obesity between diabetics and non-diabetics is striking: nearly half of all diabetics are obese, while the rate among non-diabetics falls back to about 22%, close to the state rate. The rate of obesity is also high among with those high blood pressure and high cholesterol, compared to those without these conditions.
XV. Obesity-Special Sect.

133. Obesity by Health Risk Factors%
Obesity is also related to health risk conditions. As one would expect, the prevalence of obesity is substantially higher among those trying to lose weight, compared to those not in need of losing weight. Obesity also tends to be higher among those with no recent exercise, or those in fair or poor health %
XV. Obesity-Special Sect.

134. Obesity by Limited Access to Health Care%
The strongest association between obesity and limited access to health care lies with the effect of cost preventing access.
XV. Obesity-Special Sect.

135. XVI. Weight Control Ever tried to lose weight
Now trying to lose weight
Using physical activity to lose wt.
Eating fewer calories to lose wt.
Advised to lose weight
XVI. Weight Control

136. Ever Tried to Lose Weight
Q. For some people, this is a sensitive topic and you do not have to answer any question that you do not want to. However, we would appreciate you answering them to the best of your ability. Have you ever tried to lose weight?
About 62% of adults statewide have ever tried to lose weight. Little variation was observed across strata.
XVI. Weight Control

137. Ever Tried to Lose Weight by Sex, Race, Age, Education & Income: Mountain AHEC & NC%
As one might expect, females are far more likely than males to have ever tried to lose weight. Weight loss efforts also appear to be more prevalent among higher educated adults and those from higher income households.
There was little difference between the state and Mountain AHEC demographic groups.
XVI. Weight Control

138. Now Trying to Lose Weight
Q. Are you now trying to lose weight?
For the state, an estimated 38.6 percent of the adult population were trying to lose weight in 2003.
XVI. Weight Control

139. Now Trying to Maintain Current Weight
Q. Are you now trying to maintain your current weight, that is to keep from gaining weight?
About 59 percent of the NC adult population are now trying to maintain their current weight.
XVI. Weight Control

140. Using Physical Activity to Lose Weight or Keep from Gaining Weight*
Q. Are you using physical activity or exercise to lose weight or keep from gaining weight?
*Asked only of those who are trying to lose weight or keep from gaining weight.
Among those trying to lose weight or keep from gaining weight, about 65% are using physical activity to help.
XVI. Weight Control

141. Eating Fewer Calories & Less Fat to Lose Weight or Keep from Gaining Weight*
Q. Are you eating either fewer calories or less fat to lose weight or keep from gaining weight?
*Asked only of those who are trying to lose weight or keep from gaining weight.
A smaller proportion of NC adults, about 37%, are eating fewer calories and less fat to lose weight.
XVI. Weight Control

142. Advised by Health Professional to Lose Weight
Q. In the past 12 months, has a doctor, nurse, or other health professional given you advice about your weight?
This question was asked of all respondents. Advise in this instance refers to advise about losing weight only.
The results indicate that only about 14% of NC adults in the past year were advised by a health professional to lose weight
XVI. Weight Control

143. XVII. Weight Loss Products
Taken over-the-counter weight loss pills
Taken wt. loss pills prescribed by a doctor
Taken weight loss pills that contain ephedra
XVII. Weight Loss Products

144. In Past Two Years, Taken Over-the-Counter (OTC) Weight Loss Pills*
Q. In the past 2 years, that is in the past 24 months, have you taken any over-the-counter weight loss products to control your weight? This includes dietary supplements and natural or herbal weight loss products. Would you say...?
*Responses include: “Yes, you are currently/ taking them” or “Yes, you've taken/ them in past 2 years”
An estimated 8.9% of adults in NC are either currently taking over the counter weight loss pills or have taken such pills in the past two years. The highest rate of was observed in Mountain AHEC.
XVII. Weight Loss Products

145. Taken OTC Weight Loss Pills (past 2 yrs
Taken OTC Weight Loss Pills (past 2 yrs.) by Sex, Race, Age, Education & Income: Mountain AHEC & NC %
These results indicate that females are at least twice as likely as males to have taken over-the-counter weight loss pills. Young adults (18 to 44 yrs.) are also at least twice as likely as older adults (45+ yrs) to have taken weight loss pills. However, there seems to be little variation with regard to high & low income groups and those with less or more education.
XVII. Weight Loss Products

146. In Past Two Years, Taken Weight Loss Pills Prescribed by a Doctor*
Q. In the past 2 years, that is in the past 24 months, have you taken any weight loss pills prescribed by a doctor to control your weight? Do not include water pills or thyroid medications. Would you say ...?
*Responses include: “Yes, you are currently/ taking them” or “Yes, you've taken/ them in past 2 years”
The use of doctor prescribed weight loss pills is less than half the use of over-the-counter weight loss products. For the state, an estimated 2.3% of adults have taken weight loss pills prescribed by a doctor.
XVII. Weight Loss Products

147. Taking Over-the-counter Weight Loss Pills that Contain Ephedra*
*These results pertain only to those respondents who reported taking over-the-counter weight control products .
Among those who’ve taken over-the-counter weight loss pills, about half of adults in NC have taken over-the-counter weight loss pills that contain the controversial drug, Ephedra.
NOTE: Very small sample sizes limit the reliability of these results.
XVII. Weight Loss Products

148. XVIII. Knowledge of Signs & Symptoms of Heart Attack and Stroke
Knew all symptoms/heart attack
Knew all symptoms/stroke
Call 911 as first response
XVIII. Heart Attack & Stroke

149. Knew All Heart Attack Symptoms
Data in this chart were derived from six heart attack symptom questions (five of which are the correct ones).
About 10% of respondents could identify all the correct heart attack symptoms.
XVIII. Heart Attack & Stroke

150. Knew All Stroke Symptoms
Data in this chart were derived from all five stroke symptom questions.
About 17% of NC adults could identify all 5 stroke symptoms correctly.
XVIII. Heart Attack & Stroke

151. Percent Who Recognized Individual Symptoms
Percent Who Recognized Individual Symptoms* of a Heart Attack: Mountain AHEC & NC
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 jaw, neck, or back are symptoms of a heart attack?
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 sudden trouble seeing in one or both eyes 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?
*Trouble seeing in one or both eyes is not a symptom of a heart attack.
The majority of respondents recognize that shoulder pain, chest pain or shortness of breath could be a symptom of a heart attack. There’s less certainty about the heart attack symptoms of feeling lightheaded or having pain in the jaw, neck or back.
XVIII. Heart Attack & Stroke

152. Percent Who Recognized Individual Symptoms
Percent Who Recognized Individual Symptoms* of a Stroke: Mountain AHEC & NC
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 sudden confusion or trouble speaking are symptoms of a stroke?
Do you think severe headache with no known cause is a symptom of a stroke?
Do you think sudden chest pain or discomfort are symptoms 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?
*Sudden chest pain is not a symptom of a stroke.
Regarding stroke, the majority of respondents recognize that sudden dizziness, sudden numbness of face, arm or leg, or sudden trouble speaking could be a symptom of a stroke. There’s less certainty about stroke symptoms related to sudden severe headaches or sudden trouble seeing in one or both eyes.
XVIII. Heart Attack & Stroke

153. Call 911 as First Response, if Someone Was Having a Heart Attack or Stroke*
Q. If you thought someone was having a heart attack or a stroke, what is the first thing you would do?
*The correct response is featured here.
All Response categories:
Take them to the hospital
Tell them to call doctor
Call 911
Call a family member
Do something else
Call 911 is the correct response.
Most adults, over 85% across all geographic strata, would call 911 as their first response if someone was having a heart attack or stroke.
XVIII. Heart Attack & Stroke

154. XIX. Cardiovascular Disease
History of any cardiovascular disease (CVD)
Diet changes to lower risk of CVD
Physical activity changes to lower risk of CVD
Aspirin use to lower risk of CVD
XIX. Cardiovascular Disease

155. History of Any Cardiovascular Diseases*
*Includes heart attack or coronary heart disease or stroke.
The history of CVD was highest in the Mountain AHEC region and Western NC.
XIX. Cardiovascular Disease

156. History of Cardiovascular Disease by Sex, Race, Age, Education & Income: Buncombe & NC%
The history of CVD (cardiovascular disease) among Mountain AHEC demographic groups tends to exceed that of the state.
XIX. Cardiovascular Disease

157. History of Heart Attack
Q. Has a doctor, nurse, or other health professional ever told you that you had any of the following: A heart attack, also called a myocardial infarction?
A reported history of a heart attack was highest in the Western region, followed by the Mtn. AHEC region.
XIX. Cardiovascular Disease

158. History of Angina or Coronary Heart Disease
Q. Has a doctor, nurse, or other health professional ever told you that you had any of the following: Angina or coronary heart disease?
The Mtn. AHEC region and all western counties continue to have the high rates of history of angina or coronary heart disease.
XIX. Cardiovascular Disease

159. History of Stroke XIX. Cardiovascular Disease
Q. Has a doctor, nurse, or other health professional ever told you that you had any of the following: A stroke?
Reported stroke history in the Mountain AHEC region is similar to the state.
XIX. Cardiovascular Disease

160. Eating Fewer High Fat or Cholesterol Foods to Lower Risk of Cardiovascular Disease
Q. To lower your risk of developing heart disease or stroke, are you... Eating fewer high fat or high cholesterol foods?
About 71% of NC adults report that they are eating fewer high fat or cholesterol foods to lower their risk of CVD, exceeding the national rate by about 5 percentage points.
XIX. Cardiovascular Disease

161. Eating More Fruits/Vegetables to Lower Risk of Cardiovascular Disease
Q. To lower your risk of developing heart disease or stroke, are you... Eating fewer high fat or high cholesterol foods?
A slightly higher percentage – about 74% - are reporting that they’re eating more fruits and vegetables to lower their risk of CVD; the Mtn. AHEC region was the best performer on this indicator.
XIX. Cardiovascular Disease

162. Being More Physically Active to Lower Risk of Cardiovascular Disease
Q. To lower your risk of developing heart disease or stroke, are you... More physically active?
70% reported being more physical activity to reduce the risk of CVD.
XIX. Cardiovascular Disease

163. Past 12 months, Health Professional Suggested Eating More Fruits/Vegetables
Q. Within the past 12 months, has a doctor, nurse, or other health professional told you to... Eat more fruits and vegetables?
(The following 2 questions are the same as the previous questions, only in this case, we’re interested in whether a doctor or health professional may have also suggested these same strategies to lower the risks of CVD.)
About 30% of all respondents reported that a health professional suggested they eat more fruit and vegetables.
XIX. Cardiovascular Disease

164. Past 12 months, Health Professional Suggested Being More Physically Active
Q. Within the past 12 months, has a doctor, nurse, or other health professional told you to... Be more physically active?
Close to the same percentage indicate that a health professional has suggested they be more physically active.
XIX. Cardiovascular Disease

165. Take Aspirin Daily or Every Other Day*
Do you take aspirin daily or every other day?
*This question was asked only of respondents who were age 35 and older.
More than one-third of adults take aspirin on a regular basis, either daily or every other day.
XIX. Cardiovascular Disease

166. Take Aspirin Daily or Every Other Day
Take Aspirin Daily or Every Other Day* by Sex, Race, Age, Education & Income: Mountain AHEC & NC %
* Applies only to respondents age 35 and older.
These results indicate that males are more likely than females and those over the age of 44 are more likely than younger adults to take aspirin regularly.
XIX. Cardiovascular Disease

167. Take Aspirin to Relieve Pain*
Q. Why do you take aspirin... To relieve pain?
*This question was asked only of respondents who take aspirin regularly and are at least 35 years of age.
Among regular aspirin-takers, about 24% take aspirin to relieve pain.
XIX. Cardiovascular Disease

168. Take Aspirin to Reduce the Chance of a Heart Attack*
Q. Why do you take aspirin... To reduce the chance of a heart attack?
*This question was asked only of respondents who take aspirin regularly.
In North Carolina, among regular aspirin-takers a much higher percentage, about 87%, take aspirin to reduce the chance of a heart attack, with the highest rate found in rural counties.
XIX. Cardiovascular Disease

169. Take Aspirin to Reduce the Chance of a Stroke*
Q. Why do you take aspirin... To reduce the chance of a stroke?
*This question was asked only of respondents who take aspirin regularly.
Among regular aspirin-takers, 81% take aspirin to reduce the chance of a stroke. There was little variation across geographic strata.
XIX. Cardiovascular Disease

170. XX. Excess Sun Exposure Had sunburn
Had four or more sunburns in past year
XX. Excess Sun Exposure

171. Had Sunburn in Past 12 Months
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?
About 1 in 5 NC residents have had a sunburn in the past 12 months.
XX. Excess Sun Exposure

172. Had Sunburn in Past Year by Sex, Race, Age, Education & Income: Mountain AHEC & NC%
As one would expect, having a sunburn is significantly more likely to occur among younger persons (18-44 yrs) than older persons (45+).
XX Excess Sun Exposure

173. Had Four or More Sunburns in Past 12 Months
Q. Including times when even a small part of your skin was red for more than 12 hours, how many sunburns have you had within the past 12 months?
*Asked only of respondents who reported having a sunburn in past 12 months.
The highest risk of having 4 or more sunburns in the past year occurred in Eastern NC – which seems likely.
XX. Excess Sun Exposure

174. XXI. Binge Drinking Special Section
Binge drinking by demographics
Location of most recent binge drinking
How alcohol was obtained for most recent binge drinking
XXI. Binge Drinking

175. Binge Drinking* XXI. Binge Drinking
*Binge Drinking = Respondents who report that they did drink in the past 30 days and had five or more drinks on one or more occasions in the past month.
The national rate of binge drinking was almost twice the state rate.
XXI. Binge Drinking

176. Binge Drinking by Sex, Race, Age, Education & Income: Mountain AHEC & NC%
Binge drinking among Mountain AHEC minorities and 18 to 44 year olds substantially surpassed their statewide counterparts.
XXI. Binge Drinking

177. Location for Most Recent Binge Drinking Occasion
Q. During this most recent occasion, where were you when you did most of your drinking?*
Categories:
At home
Another person’s home
Restaurant
Bar or club
Other
Binge drinking is most likely to occur at one’s own home or at another person’s home – together these locations account for about two-thirds of where binge drinking occurs.
An estimated 17 percent of binge drinking occurs in bars or night clubs.
XXI. Binge Drinking

178. How Alcohol Was Obtained, During Most Recent Binge Drinking Occasion
Q. During this most recent occasion, how did you get most of the alcohol?*
Response categories:
Someone else bought it
I bought it at store
I bought it at Restaurant/Bar or club
Other
Under most circumstances, about 56% of the time, the individual engaged in binge drinking buys the alcohol from a store. About one-quarter of the time, someone else buys it.
XXI. Binge Drinking

179. XXII. Falls Had fall in last 3 months Injured from last fall

180. Had a Fall in Past Three Months (ages 45+)
Q. The next question asks about a recent fall. By a fall, we mean when a person unintentionally comes to rest on the ground or another lower level. In the past 3 months, have you had a fall?
The highest rates of having a fall in the past 3 months were observed in the Western region and the Mtn. AHEC region.
XXII. Falls

181. Injured in the Fall XXII. Falls Q. Were you injured?
*This question was asked of respondents ages 45 or older who had a fall.
NOTE: Very small sample sizes limit reliability of these results.
Statewide, among those who had a recent fall, an estimated 39 percent were injured in the fall. In the Mountain AHEC region the injured rate jumped to 46%.
XXII. Falls

182. XXIII. Physical Assault
Ever physically assaulted
Person who committed most recent assault
Persons told about most recent assault
XXIII. Physical Assault

183. Ever Physically Assaulted*
Q. Since you've been 18 years old, has anyone (including a relative, current or ex-husband/wife, current or ex- boyfriend/ girlfriend, acquaintance, stranger, etc) ever pushed, hit, slapped, kicked, or physically hurt you in any other way?
About 18% of adults across the state reported ever being physically assaulted; in Mountain AHEC, the rate was slightly higher.
XXIII. Physical Assault

184. Ever Physically Assaulted by Sex, Race, Age, Education & Income: Mountain AHEC & NC%
Females as compared to males and 18 to 44 year olds as compared to older persons were more likely to report ever being physically assaulted.
XXIII. Physical Assault

185. Person Who Committed Most Recent Assault
Q: I’d like you to think about the most recent time this violence occurred. Who was the person who did this to you most recently? [If prompting is required, read all response categories. Check only one response.]
Categories:
01 Current husband/wife
02 Current partner (boyfriend/girlfriend)
03 Ex-husband/wife
04 Ex-partner (boyfriend/girlfriend)
05 Some relative other than a husband/wife
06 Acquaintance
07 Stranger
77 Don’t know/Not Sure
In almost half of all recent physical assaults, the person committing the assault was the victim’s ex-husband/wife or ex-partner;
this is followed by a relative or acquaintance committing the most recent assault.
XXIII. Physical Assault

186. All Persons You Told About Most Recent Assault
Q. Who were all the persons you told about this most recent violence? Categories (check all that apply):
01 No one
02 Friends/family members
03 Police/law enforcement officer
04 Lawyer/attorney/legal aid
05 Health care provider/doctor/nurse/social worker/counselor
06 Someone working in a rape crisis center/sexual assault program
07 Someone working in a domestic violence program
08 Someone else
09 Don’t know/not sure
XXIII. Physical Assault

187. XIV. Healthy People 2010 Objectives (tracked by 2003 BRFSS data)
Access to Health Insurance
Cancer Prevention
Immunizations
Overweight
Physical Activity
Substance Abuse
Tobacco Use
XXIV. HP 2010 Objectives

188. Health Insurance Coverage (ages 18 to 64)
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 80% of North Carolina adults, ages 18 to 64, have health insurance.
HP 2010 Target: 100%
XXIV. HP 2010 Objectives

189. Had Flu Shot in Past Year (age 65+)
HP 2010 Target: 80%
Q. During the past 12 months, have you had a flu shot?
*This indicator pertains to those age 65 and older.
Statewide, about 69% of adults, ages 65 and older, had a flu shot in the past 12 months; this rate falls short of the HP 2010 target by 11 percentage points.
XXIV. HP 2010 Objectives

190. Ever Had a Pneumonia Shot (age 65+)
Q. Have you ever had a pneumonia shot?
*This indicator pertains to those age 65 and older.
About 67% of adults, age 65 and older, have ever had a pneumonia shot.
Urban counties and the Mtn. AHEC region came closest to meeting this indicator.
HP 2010 Target: 90%
XXIV. HP 2010 Objectives

191. Reduce Obesity (age 20+) XXIV. HP 2010 Objectives HP 2010 Target: 15%
Body mass index is computed as weight in kilograms divided by height in meters squared:(kg/ m2). BMI is an intermediate variable used in defining overweight and obesity.
Obese=BMI greater than 30.0.
An estimated 24.5% of NC adults, ages 20 and older, are obese, exceeding the HP2010 target reduction by about 9½ percentage points.
XXIV. HP 2010 Objectives

192. Reduce No Leisure Time Activity*
No leisure time activity = Respondents reporting no physical activity or exercise.
Across the state, 25% of adults (ages 18+) had no leisure time activities in the past month, which was within 5 percentage points of the target. In 2002, 30% of NC adults had no leisure time activity.
HP 2010 Target: 20%
XXIV. HP 2010 Objectives

193. Vigorous Physical Activity/3 Times Week*
HP 2010 Target: 30%
* Respondents who report doing vigorous physical activity for 20 or more minutes per day, three or more days per week.
In 2003, about 19% of NC adults participated in vigorous activity for 20 minutes at least 3 times a week; the HP 2010 target calls for 30%.
XXIV. HP 2010 Objectives

194. Reduce Binge Drinking*
HP 2010 Target: 6%
*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 9% of NC adults may be classified as binge drinkers, which exceeds the HP 2010 target reduction by 3 percentage points.
XXIV. HP 2010 Objectives

195. Reduce Smoking XXIV. HP 2010 Objectives HP 2010 Target: 12%
In 2003, the rate of cigarette smoking (everyday or occasional) for the state exceeded the HP 2010 target reduction by about 13 percentage points, or the state smoking rate is more than twice as high as the target reduction.
Definition of current smoker: smoked at least 100 cigarettes in lifetime and now smokes everyday or some days.
The statewide smoking rate is slightly higher than the national rate and over twice the percentage of the HP 2010 target of 12%.
HP 2010 Target: 12%
XXIV. HP 2010 Objectives