Health insurance coverage and use of selected preventive services by working-age women, BRFSS, 2006

Access to healthcare and participation in preventive screening are important to the well-being of women. Using 2006 Behavioral Risk Factor Surveillance System (BRFSS) data, we examined the prevalence of health insurance coverage among working-age women and their use of selected preventive health screening. These data were also used to determine these women's access to services and the extent to which cost was a barrier. Overall, 17.3% of working-age women reported not having health insurance coverage, and lack of coverage varied widely among the states. Those without coverage were significantly more likely to report having neither routine health examinations nor a regular provider, to report cost as a barrier to access, and to be less likely to get screened for breast, cervical, and colorectal cancers during the specified time intervals. Future research and programs need to address the public health issues of unmet healthcare needs and health insurance coverage of U.S. women.

Surveillance of certain health behaviors among states and selected local areas--United States, 2005

PROBLEM

Behavioral risk factors such as smoking, poor diet, physical inactivity, and excessive drinking are linked to the leading causes of death in the United States. Controlling these behavioral risk factors and using preventive health services (e.g., influenza and pneumococcal vaccination of adults aged > or =65 years and hypertension and cholesterol screenings) can substantially reduce the morbidity and mortality in the U.S. population. Continuous monitoring of these behaviors and preventive services are essential for developing health promotion, intervention programs, and health policies at the state, city, and county level.

REPORTING PERIOD COVERED

Data collected in 2005 are presented for states/territories, selected metropolitan and micropolitan statistical areas (MMSAs), metropolitan divisions, and selected counties.

DESCRIPTION OF THE SYSTEM

The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing, state-based, random-digit--dialed telephone survey of the noninstitutionalized U.S. population aged > or =18 years. BRFSS collects information on health risk behaviors and preventive health services related to leading causes of death. All 50 states, the District of Columbia (DC), the Commonwealth of Puerto Rico, and the U.S. Virgin Islands participated in BRFSS during 2005. Within these states and territories, 153 MMSAs and 232 counties that reported data for at least 500 respondents or a minimum sample size of 19 per weighting class were included in the analyses.

RESULTS

Prevalence of health-risk behaviors, awareness of specific medical conditions, and use of preventive services varied substantially by state/territory, MMSA, and county. In 2005, prevalence of health insurance ranged from 60% to 95% for states/territories, MMSAs, and counties. Prevalence of leisure-time physical inactivity ranged from 16% to 49% for states/territories, 14% to 36% for MMSAs, and 12% to 41% for counties. Prevalence of adults who engaged in at least moderate physical activity ranged from 33% to 62%, and prevalence of vigorous physical activity ranged from 15% to 42% for states/territories, MMSAs, and counties. Prevalence of adults who currently smoke cigarettes ranged from 6% to 35% for states/territories, MMSAs, and counties. The prevalence of binge drinking was substantially higher than the prevalence of heavy drinking across all the states/territories, MMSAs, and counties. Prevalence of adults who were overweight ranged from 53% to 67 % for states/territories, 49% to 70% for MMSAs, and 44% to 71% for counties. Prevalence of current asthma ranged from 4% to 14% for states/territories, MMSAs, and counties. Prevalence of diabetes ranged from 4% to 14% for states/territories and MMSAs and from 3% to 14% for counties. Proportion of respondents with high blood pressure ranged from 13% to 39% for states/territories, MMSAs and counties. Prevalence of respondents with high cholesterol ranged from 31% to 41% for states/territories and 26% to 47% for MMSAs and counties. The prevalence estimates for respondents who reported being limited in any way in any activities because of physical, mental, or emotional problems ranged from 10% to 27% for states/territories, 12% to 31% for MMSAs, and 10% to 27% for counties. The percentage of respondents who required use of special equipment ranged from 4% to 10% for the states/territories, 3% to 15% for MMSAs, and 3% to 11% for counties. Prevalence of fair or poor health ranged from 11% to 34% for states/territories and 6% to 26% for MMSAs and counties. The prevalence of adults who checked their cholesterol during the preceding 5 years ranged from 55% to 86% for states/territories, MMSAs, and counties. Prevalence of annual influenza vaccination among adults aged > or =65 years ranged from 32% to 78% for states/territories, 48% to 83% for MMSAs, and 41% to 84% for counties. The estimated prevalence of pneumococcal vaccination among adults aged > or =65 years ranged from 28% to 72% for states/territories, 52% to 82% for MMSAs, and 35% to 83% for counties.

INTERPRETATION

The findings in this report indicate a wide variation in health-risk behaviors, chronic conditions, and use of preventive services among U.S. adults at the state/territory, MMSA, and county level. The findings underscore a need for continuous efforts to evaluate public health intervention programs and policies designed to reduce morbidity and mortality caused by chronic disease and injury.

PUBLIC HEALTH ACTION

The 2005 BRFSS data indicate a need for continued monitoring of health-risk behaviors, specific disease conditions, and use of preventive services to identify high-risk populations and to implement and monitor health-promotion programs and health policies at the state/territory, MMSA, and county level.