1. BRFSS Behavioral Risk Factor Surveillance System 2002 Forsyth County BRFSS Survey Results 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: 1. on-going assessment of adult health-risk behaviors and health practices; 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.

3. BRFSS in the U.S., 1984

4. BRFSS in the U.S., 1990

5. BRFSS in the U.S., 1994 Guam Puerto Rico Virgin Islands

6. The 2002 North Carolina BRFSS The 2002 NC BRFSS Survey consists of 6,748 completed interviews in English and Spanish. County-level estimates were produced for: Buncombe, Forsyth, Guilford, Hend./Transyl., Mecklenburg, Orange, Pitt, Randolph, Roberson, and Wake. The remaining counties were stratified into three regions of the state: Western, Piedmont, and Eastern Region. First in the history of the NC BRFSS Program, the 2002 data provide estimates on the health of Native Americans, Hispanics speaking Spanish-only, and Asian Americans. These results may be viewed at the NC State Center for Health Statistics website: www.schs.state.nc.us/SCHS/healthstats /brfss/2002/highlights.html

7. Eastern North Carolina: 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, Sampson, Scotland, Tyrrell, Washington, Wayne, Wilson Piedmont North Carolina: Alamance, Alexander, Anson, Cabarrus, Caswell, Catawba, Chatham, Cleveland, Davidson, Davie, Durham, Franklin, Granville, Iredell, Lee, Lincoln, Montgomery, Moore, Person, Richmond, Rockingham, Rowan, Stanly, Stokes, Union, Vance, Warren, Yadkin Western North Carolina: Alleghany, Ashe, Avery, Burke, Caldwell, Cherokee, Clay, Graham, Haywood, Jackson, McDowell, Macon, Madison, Mitchell, Polk, Rutherford, Surry, Swain, Watauga, Wilkes, Yancey The 2002 North Carolina Regions

9. 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

10. 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.

11. 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.

12. Survey Topics on the NC 2002 BRFSS Core Sections Health status Health care access Oral health Womens health Family planning Diabetes Immunization Tobacco/alcohol Firearms Demographics Prostate/colorectal HIV/AIDs Optional Modules Healthy days Tobacco indicators Weight control Physical activity Adult/child asthma Arthritis State-added Diabetes counseling Cancer prevalence Disability Routine checkup Sexual/physical assault Reaction to race

13. About this 2002 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.

14. 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 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. –All results are presented on a 100 point scale.

15. Contents of Presentation Sample Size & Demographics Health Status/Healthy Days Health Care Access Chronic Diseases Cancer Screening Immunization Oral Health Tobacco Use and Prevention Risk Factors HIV/AIDS Womens Health Family Planning Physical Activity Weight Control Firearms Reaction to Race 2002 BRFSS Tracked HP2010 Objectives Note: all results are based on weighted data

16. Sample Size & Demographics

17. NC 2002 BRFSS Sample Size

18. NC 2002 BRFSS Sample Demographic Characteristics *weighted percentages

19. NC 2002 BRFSS Sample Demographic Characteristics (cont.) *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 I. Health Status/Healthy Days

22. Perceived Fair/Poor Health by Age, Sex, Race, Education & Income: Forsyth & NC % I. Health Status/Healthy Days

23. Poor Physical Health Days (8+ days out of past 30 days) I. Health Status/Healthy Days

24. Poor Mental Health Days (8+ days out of past 30 days) I. Health Status/Healthy Days

25. Restricted Activity Days (8+ days past 30 days)* I. Health Status/Healthy Days

26. II. Health Care Access Health Care Coverage Personal Doctor Use of Doctors Office Needed Care But Could Not Get It Routine Checkup

27. Health Insurance Coverage II. Health Care Access

28. Health Insurance Coverage by Age, Sex, Race, Education & Income: Forsyth & NC % II. Health Care Access

29. Has Personal Doctor* II. Health Care Access * Only one personal doctor

30. Usually Go to Doctors Office When Sick or Need Advice II. Health Care Access

31. Time When Needed Medical Care But Could Not Get It II. Health Care Access

32. Had Routine Medical Checkup in Past Year II. Health Care Access

33. III. Chronic Diseases Arthritis Asthma Cancer Diabetes Disability III. Chronic Diseases

34. Arthritis

35. Joint Pain in Past 30 Days III. Chronic Diseases

36. Has Chronic Joint Symptoms (CJS) III. Chronic Diseases

37. Seen a Doctor for Joint Symptoms III. Chronic Diseases

38. Doctor-diagnosed Arthritis III. Chronic Diseases

39. Doctor-diagnosed Arthritis by Age, Sex, Race, Education & Income: Forsyth & NC % III. Chronic Diseases

40. Now Limited b/c of Joint Symptoms III. Chronic Diseases

41. Arthritis/Joint Symptoms Affect Work III. Chronic Diseases

42. Asthma

43. Ever Diagnosed with Asthma III. Chronic Diseases

44. Ever Diagnosed with Asthma by Age, Sex, Race, Education & Income: Forsyth & NC % III. Chronic Diseases

45. Currently has Asthma III. Chronic Diseases

46. Percent Households w/Children* Who Have Ever Been Diagnosed w/Asthma III. Chronic Diseases

47. Percent Households w/Children* Who Still Have Asthma III. Chronic Diseases

48. Cancer

49. Ever Diagnosed with Cancer* III. Chronic Diseases

50. Ever Diagnosed with Cancer* by Age, Sex, Race, Education & Income: Forsyth & NC % III. Chronic Diseases

51. Ever Diagnosed with Prostate Cancer* III. Chronic Diseases

52. Ever Diagnosed with Breast Cancer III. Chronic Diseases

53. Diabetes

54. Diabetes Prevalence III. Chronic Diseases

55. Prevalence of Diabetes by Age, Sex, Race, Education & Income: Forsyth & NC % III. Chronic Diseases

56. Disability

57. Activity Limitation b/c Physical or Emotional Problems III. Chronic Diseases

58. Health Problem Requires Use of Special Equipment III. Chronic Diseases

59. Self- perceived Disability III. Chronic Diseases

60. Trouble Learning and Remembering III. Chronic Diseases

61. Total Disability III. Chronic Diseases

62. Total Disability by Age, Sex, Race, Education & Income: Forsyth & NC % III. Chronic Diseases

63. IV. Cancer Screening Prostate Cancer Screening Colorectal Cancer Screening IV. Cancer Screening

64. Ever Had a PSA (Prostate-Specific Antigen) Test* IV. Cancer Screening Percent

65. Ever Had a Digital Rectal Exam* IV. Cancer Screening

66. Ever Had a Blood Stool Test* IV. Cancer Screening Percent

67. Ever Had a Colonoscopy Exam* IV. Cancer Screening Percent

68. V. Immunization Pneumonia Vaccination Flu Shot V. Immunization

69. Ever Had a Pneumonia Shot V. Immunization Percent

70. Had Flu Shot in Past Year V. Immunization Percent

71. Had Flu Shot by Age, Sex, Race, Education & Income: Forsyth & NC % V. Immunization

72. VI. Oral Health Dental Visits Dental Cleaning Tooth Loss

73. Visited Dental Clinic (for any reason) Past Year VI. Oral Health Percent

74. Visited Dental Clinic Past Year (any reason) by Age, Sex, Race, Education & Income: Forsyth & NC % VI. Oral Health

75. Teeth Cleaned Past Year* VI. Oral Health Percent

76. All Permanent Teeth Extracted VI. Oral Health Percent

77. VII. Tobacco Use & Prevention Smoked 100+ Cigarettes Age First Started Smoking Current Smoker Quit Smoking Medical Care for Smokers Rules About Smoking at Home Rules About Smoking at Work

78. Smoked at Least 100 Cigarettes in Lifetime VII. Tobacco Use & Prevention Percent

79. First Started Smoking Regularly at Age 14 or Younger VII. Tobacco Use & Prevention Percent

80. Current Smoker VII. Tobacco Use & Prevention Percent

81. Current Smoker by Age, Sex, Race, Education & Income: Forsyth & NC % VII. Tobacco Use & Prevention

82. Quit Smoking One Day or Longer in Past Year VII. Tobacco Use & Prevention Percent

83. Regular Smokers* Who Received Medical Care in Past Year VII. Tobacco Use & Prevention Percent

84. Advised by Health Professional to Quit Smoking in Past Year* VII. Tobacco Use & Prevention Percent

85. Smoking Not Allowed in the Home VII. Tobacco Use & Prevention Percent

86. At Work, Smoking Not Allowed in Work Areas* VII. Tobacco Use & Prevention Percent

87. Worksites Prohibit Smoking in Both Public and Work Areas* VII. Tobacco Use & Prevention Percent

88. VIII. Risk Factors Overweight/obese Smoking Binge/heavy drinking Physical inactivity

89. Obese* VIII. Risk Factors Percent

90. Obesity by Age, Sex, Race, Education & Income: Forsyth & NC % VIII. Risk Factors

91. Overweight or Obese VIII. Risk Factors Percent

92. Binge Drinking* VIII. Risk Factors Percent

93. Heavy Drinking* VIII. Risk Factors Percent

94. Current Smoker VIII. Risk Factors Percent

95. No Leisure Time Physical Activity VIII. Risk Factors Percent

96. Physically Inactive VIII. Risk Factors Percent

97. Physically Inactive by Sex, Race, Education & Income: Forsyth & NC % VIII. Risk Factors

98. Less than Once or Never Consumes Fruits/Vegetables on Daily Basis* VIII. Risk Factors Percent

99. Ever Sexually Assaulted VIII. Risk Factors Percent

100. Ever Physically Assaulted VIII. Risk Factors Percent

101. IX. HIV/AIDS Knowledge of AIDS Treatment Ever Tested for HIV STD Prevention

102. A Pregnant Woman w/HIV Can Get Treatment to Reduce Chances that Baby Will Acquire Virus* IX. HIV/AIDS Percent

103. There Are Medical Treatments to Help Those w/HIV to Live Longer* IX. HIV/AIDS Percent

104. Ever Tested For HIV* IX. HIV/AIDS Percent

105. Ever Tested for AIDS by Age, Sex, Race, Education & Income: Forsyth & NC % IX. HIV/AIDS

106. In Past Year, Counseled About Condom Use to Prevent STDs* IX. HIV/AIDS Percent

107. X. Womens Health Mammogram Clinical Breast Exam Pap Smear Test Hysterectomy

108. Ever Had a Mammogram X. Womens Health Percent

109. Ever Had a Mammogram by Age, Sex, Race, Education & Income: Forsyth & NC % X. Womens Health

110. Had Mammogram in Past 2 Years* X. Womens Health Percent

111. Ever Had a Clinical Breast Exam X. Womens Health Percent

112. Ever Had a Pap Smear Test* X. Womens Health Percent

113. Ever Had a Hysterectomy* X. Womens Health Percent

114. XI. Family Planning Pregnancy Intention Pregnancy Prevention

115. Husband/Wife/Partner Doing Anything to Keep From Getting Pregnant* XI. Family Planning Percent

116. Had Tubes Tied to Keep From Getting Pregnant* XI. Family Planning Percent

117. Want to Get Pregnant (main reason for not using birth control)* XI. Family Planning Percent

118. XII. Physical Activity Mostly Sitting at Work Moderate Physical Activity Vigorous Physical Activity Recommendation for Physical Activity Leisure Time Activity

119. Mostly Sitting/Standing at Work* XII. Physical Activity Percent

120. Engages in Moderate Physical Activity XII. Physical Activity Percent

121. Engages in Vigorous Physical Activity XII. Physical Activity Percent

122. Meets Recommendation for Vigorous Physical Activity* XII. Physical Activity Percent

123. Meets Recommendation for Physical Activity XII. Physical Activity Percent

124. Leisure Time Physical Activity* XII. Physical Activity Percent

125. Leisure Time Activity by Age, Sex, Race, Education & Income: Forsyth & NC % XII. Physical Activity

126. XIII. Weight Control Now Trying to Lose Weight Diet Changes and Exercise to Lose Weight Received Advice About Weight Overweight Obese

127. Now Trying to Lose Weight XIII. Weight Control Percent

128. Trying to Lose Weight by Age, Sex, Race, Education & Income: Forsyth & NC % XIII. Weight Control

129. Eating Fewer Calories and Less Fat to Lose Weight* XIII. Weight Control Percent

130. Using Physical Activity or Exercise to Lose Weight* XIII. Weight Control Percent

131. Overweight* XIII. Weight Control Percent

132. Obese* XIII. Weight Control Percent

133. Received Advise from Health Professional about Weight in Past Year XIII. Weight Control Percent

134. XIV. Firearms Firearms at Home Loaded Firearms at Home Loaded & Unlocked Firearms at home

135. Firearms at Home XIV. Firearms Percent

136. Firearms at Home by Age, Sex, Race, Education & Income: Forsyth & NC % XIV. Firearms

137. Loaded Firearms at Home XIV. Firearms Percent

138. Percent Unlocked Firearms among Households with Loaded Firearms XIV. Firearms Percent

139. Loaded & Unlocked Firearms at Home XIV. Firearms Percent

140. XV. Reaction to Race Time Spent Thinking About Race Perceived Mistreatment Due to Race Experience of Emotional/Physical Symptoms Due to Racial Mistreatment

141. Think About Your Race Weekly or More Often* XV. Reaction to Race Percent

142. Treated Worse than Other Races at Work in Past Year* XV. Reaction to Race Percent

143. Treated Worse than Other Races at Work by Age, Sex, Race, Education & Income: Forsyth & NC % XV. Reaction to Race

144. Treated Worse than Other Races When Seeking Health Care in Past Year* XV. Reaction to Race Percent

145. Felt Emotionally Upset Due to Unfair Racial Treatment (past 30 days) XV. Reaction to Race Percent

146. Experienced Physical Symptoms Due to Unfair Racial Treatment (past 30 days) XV. Reaction to Race Percent

147. XVI. Healthy People 2010 Objectives (tracked by 2002 BRFSS data) Access to Health Insurance Cancer Prevention Immunizations Overweight Physical Activity Substance Abuse Tobacco Use

148. Health Insurance Coverage* XVI. HP2010 Objectives HP 2010 Target: 100% Percent

149. Had a Blood Stool Test in Past 2 Years* XVI. HP2010 Objectives Percent HP 2010 Target: 50%

150. Ever Had a Colonoscopy Exam* XVI. HP2010 Objectives Percent HP 2010 Target: 50%

151. Had Flu Shot in Past Year* XVI. HP2010 Objectives Percent HP 2010 Target: 80%

152. Ever Had a Pneumonia Shot* XVI. HP2010 Objectives Percent HP 2010 Target: 90%

153. Reduce Obesity* XVI. HP2010 Objectives Percent HP 2010 Target: 15%

154. Reduce No Leisure Time Physical Activity* XVI. HP2010 Objectives Percent HP 2010 Target: 20%

155. Vigorous Physical Activity/3 Times Week* XVI. HP2010 Objectives Percent HP 2010 Target: 30%

156. Reduce Binge Drinking* XVI. HP2010 Objectives Percent HP 2010 Target: 6%

157. Reduce Smoking XVI. HP2010 Objectives Percent HP 2010 Target: 12%