2009Georgia Behavioral Risk Factor Surveillance System Report 2 Acknowledgments Georgia Department of Public Health Dr. Brenda Fitzgerald, Commissioner Division of Public Health S. Elizabeth Ford, M.D., Acting Director Health Information, Policy, Strategy, and Accountability Martha N. Okafor, Ph.D., Deputy Director Office of Epidemiology, Dafna Kanny, Ph.D., Senior Director Evaluation and Health Information Epidemiology Section John Horan, M.D., M.P.H., Director Healthy Behaviors Epidemiology Unit Manxia Wu, M.D., M.P.H., Manager Georgia BRFSS Program Leah Bryan, M.P.H., Coordinator Aimee Pragle, M.S., Epidemiologist The Georgia Behavioral Risk Factor Surveillance System is supported in part through the Centers for Disease Control and Prevention Cooperative Agreement U58/CCU422885. Without the cooperation and participation of the Georgia residents who completed the telephone survey, the BRFSS would not be possible. Cover photos courtesy of Georgia Department of Industry, Trade and Tourism. Graphic Design : Jimmy Clanton, Jr. Suggested Citation: Bryan L, Pragle A, 2007 Georgia Behavioral Risk Factor Surveillance System Report. Georgia Department of Human Resources, Division of Public Health, Epidemiology Section, March 2009. Publication number DPH09.350. Table of Contents Introduction.............................................................................................................................................................................................4 Chronic Conditions Diabetes.................................................................................................................................................................................... 6 Asthma...................................................................................................................................................................................... 8 Coronary Heart Disease........................................................................................................................................................... 10 Heart Attack.............................................................................................................................................................................. 12 Stroke....................................................................................................................................................................................... 14 Obesity...................................................................................................................................................................................... 16 Arthritis...................................................................................................................................................................................... 18 Disability................................................................................................................................................................................... 20 Preventive Practices Flu-shot..................................................................................................................................................................................... 22 Pneumonia Vaccination............................................................................................................................................................ 24 Mammography.......................................................................................................................................................................... 26 PAP Test................................................................................................................................................................................... 28 HIV Test.................................................................................................................................................................................... 30 Risk Behaviors Cigarette Smoking.................................................................................................................................................................... 32 Binge Drinking.......................................................................................................................................................................... 34 Physical Inactivity..................................................................................................................................................................... 36 Health Insurance....................................................................................................................................................................... 38 No Access to Medical Care....................................................................................................................................................... 40 No Personal Doctor/Health Care Provider................................................................................................................................ 42 Fair/Poor General Health.......................................................................................................................................................... 44 Frequent Mental Distress.......................................................................................................................................................... 46 Healthy People 2010 Table.................................................................................................................................................................... 48 Data Tables............................................................................................................................................................................................ 50 Methods ................................................................................................................................................................................................ 54 Definitions.............................................................................................................................................................................................. 56 2009 Georgia Behavioral Risk Factor Surveillance System Report 3 4 Introduction The Georgia Behavioral Risk Factor Surveillance System (BRFSS) is a primary source of information on the major health risk behaviors and the use of clinical preventive services among adult Georgians. This report presents BRFSS data for Georgia and for the 18 public health districts overall and by sex, race/ethnicity, age group, annual household income, level of education and health insurance status. For the state, all estimates are based on the 2007 BRFSS survey. For the 18 health districts, survey data from 2000 through 2003 and 2004 through 2007 have been aggregated to increase the sample size and improve the accuracy and precision of the estimates. For each of the risk factors in this report national Healthy People 2010 objectives have been identified. These objectives represent targets to be reached by the year 2010 and support the overarching goals of Healthy People 2010 to increase the quality and years of healthy life and eliminate disparities. If reliable estimates could not be produced for a demographic group, a bar for that group is not shown in the following bar charts. Georgia Public Health Districts District 1-1, Northwest (Rome) District 1-2, North Georgia (Dalton) District 2, North (Gainsville) District 3-1, Cobb/Douglas District 3-2, Fulton District 3-3, Clayton (Marrow) District 3-4, East Metro (Lawrenceville) District 3-5, DeKalb District 4, LaGrange District 5-1, South Central (Dublin) District 5-2, North Central (Macon) District 6, East Central (Augusta) District 7, West Central (Columbus) District 8-1, South (Valdosta) District 8-2, Southwest (Albany) District 9-1, Coastal (Savannah/Brunswick) District 9-2, Southeast (Waycross) District 10, Northeast (Athens) Counties Bartow, Catoosa, Chattooga, Dade, Floyd, Gordon, Haralson, Paulding, Polk, Walker Cherokee, Fannin, Gilmer, Murray, Pickens, Whitfield Banks, Dawson, Forsyth, Franklin, Habersham, Hall, Hart, Lumpkin, Rabun, Stephens, Towns, Union, White Cobb, Douglas Fulton Clayton Gwinnett, Newton, Rockdale DeKalb Butts, Carroll, Coweta, Fayette, Heard, Henry, Lamar, Meriwether, Pike, Spalding, Troup, Upson Bleckley, Dodge, Johnson, Laurens, Montgomery, Pulaski, Telfair, Treutlen, Wheeler, Wilcox Baldwin, Bibb, Crawford, Hancock, Houston, Jasper, Jones, Monroe, Peach, Putnam, Twiggs, Washington, Wilkinson Burke, Columbia, Emanuel, Glascock, Jefferson, Jenkins, Lincoln, McDuffie, Richmond, Screven, Taliaferro, Warren, Wilkes Chattahoochee, Clay, Crisp, Dooly, Harris, Macon, Muscogee, Marion, Quitman, Randolph, Schely, Stewart, Sumter, Talbot, Taylor, Webster Ben Hill, Berrien, Brooks, Cook, Echols, Irwin, Lanier, Lowndes, Tift, Turner Baker, Calhoun, Colquitt, Dougherty, Decatur, Early, Grady, Lee, Miller, Mitchell, Seminole, Terrell, Thomas, Worth Chatham, Effingham, Bryan, Camden, Glynn, Liberty, Long, McIntosh Appling, Atkinson, Bacon, Brantley, Bulloch, Candler, Charlton, Clinch, Coffee, Evans, Jeff Davis, Pierce, Tattnall, Toombs, Ware, Wayne Barrow, Clarke, Elbert, Greene, Jackson, Madison, Morgan, Oconee, Oglethorpe, Walton Georgia County Health Departments JunGee2or0g0ia6 Public Health Districts 2009 Georgia Behavioral Risk Factor Surveillance System Report 5 Chronic Conditions Diabetes Mellitus is a metabolic disease in which the body does not produce or properly use insulin leading to high blood sugar levels. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The three classical symptoms of Diabetes are polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger). About 23 million people in US are affected by Diabetes Mellitus and are the 7th common cause of death in US adults. Complications of diabetes include heart disease, stroke, high blood pressure, blindness, kidney disease, amputations, nerve problems, dental disease, and susceptibility to infections. Obesity and physical inactivity are two of the most important preventable risk factors for developing diabetes. Management of diabetes and reduction of risk for complications involves controlling blood glucose levels through diet and insulin regulation, monitoring blood glucose levels, and regular foot and eye exams by health care professionals. Adults with Diabetes, Georgia 2009: 9.5% U.S. 2009: 8.4% Healthy People 2010 Objective: <2.5% In 2009, approximately 700,000 adult Georgians had diabetes. Diabetes was more common among Black adults than among White adults. Diabetes was 8 times more common among adults aged 65 years and older than among adults aged 18 to 34 years. Diabetes was 4 times more common among adults whose annual household income was less than $15,000 than among adults in households that earned $75,000 or more a year. Diabetes was significantly more common in adults with less than a high school education than among college graduates. Weighted % Weighted % Weighted % Diabetes Percent of adults with Diabetes by Sex in Georgia, 2009 20 15 10.3 10 8.81 5 0 Ma l e Fema l e Percent of adults with Diabetes by Race and Ethnicity in Georgia 2009. 20 15 13.24 10 8.16 5 9.95 5.69 0 Whi te Bl a ck Hi s pa ni c Other Percent of adults with Diabetes by Income in Georgia, 2009 20 18.24 14.37 15 11.93 9.54 10 7.09 4.56 5 0 <$150$0015000-$2499$925000-$3499$935000-$4999$950000-$74999 >$75000 Weighted % Weighted % Weighted % 6 Percent of adults with Diabetes by Age in Georgia, 2009 30 25 20 15 10 5 2.79 0 18-34 3.37 35-44 9.1 45-54 19 55-64 25.41 >65 Percent of adults with Diabetes by Education 20 in Georgia,2009 18 16 13.61 14 11.56 12 9.84 10 8 6.4 6 4 2 0 =10.0 2002- 20062005 2009 1-1 Rome 1-2 Dalton 2-0 Gainesville 3-1 Cobb/Doublas 3-2 Fulton 3-3 Clayton 3-4 Lawrenceville 3-5 DeKalb 4-0 LaGrange 5-1 Dublin 5-2 Macon 6-0 August 7-0 Columbus 8-1 Valdosta 8-2 Albany 9-1 Savannah 9-2 Waycross 10-0 Athens 8.9 9.9 7.3 9.3 7.4 9 7 6.3 4.9 8.6 5.5 9.9 6.3 7.1 4.6 8.5 8.2 10.8 9.8 11.1 10.3 12.6 9.3 11 7.6 11.9 8.3 11.9 10 12.5 9.3 11.6 9.2 10.9 6.9 8.6 *Statistically significant difference exists. Percent (%) Change 11.2 27.4 21.6 -10.0 75.5 80.0 12.7 84.8 31.7 13.3 22.3 18.3 56.6 43.4 25.0 24.7 18.5 24.6 2009 Georgia Behavioral Risk Factor Surveillance System Report 7 Asthma is a chronic inflammatory disease of the lungs that causes breathing problems (wheezing, coughing, chest tightness and shortness of breath) or "asthma attacks" and resulted in more than 50,000 emergency department visits and more than 12,000 hospitalizations in Georgia in 2007. The airways of people with asthma tighten abnormally in response to smoke, pollen, dust, air pollution, infection, irritants, allergens, or exercise, leading to difficulty in breathing. While asthma is not often fatal, loss of productivity, high medical costs, and disability are common outcomes for asthma sufferers. Smoking, genetic factors, allergies and some medications can be risk factors for developing asthma and asthma symptoms. Asthma can be effectively controlled by recognizing and avoiding asthma triggers, appropriate management of medication, monitoring lung function, and giving patients tools and education about managing their own care. Adults with Asthma, Georgia 2009: 6.9% U.S. 2009: 8.8% In 2009, more than 500,000 adults in Georgia had asthma. Asthma was more common among adult women than among adult men. Asthma was 2 times more common among adults with less than a high school education than among college graduates. Asthma was twice more common among adults whose annual household income was less than $15,000 than the more than $75,000 income level. Weighted % Weighted % Weighted % Asthma Percent of adults with Asthma by Sex in Georgia, 2009 10 7.76 8 6.08 6 4 2 0 Ma l e Fema l e Percent of adults with Asthma by 10 Race/Ethnicity in Georgia,2009. 9 8 7.35 7 6.71 6.81 6.07 6 5 4 3 2 1 0 Whi te Black Hispanic Others Percent of adults with Asthma by Income in Georgia 2009. 20 15 10.52 9.5 10 6.55 5 6.34 5.21 5 0 <$150$0015000-$2499$925000-$3499$935000-$4999$950000-$74999 >$75000 Weighted % Weighted % Weighted % 8 Percent of adults with Asthma by Age in Georgia, 2009 10 8.15 8 7.74 7.2 6 5.21 5.45 4 2 0 18-34 35-44 45-54 55-64 >65 Percent of adults with Asthma by Education in 20 18 16 14 12 9.65 10 8 6 4 2 0 Georgia 2009. 8.12 7.1 5.16 =9 1-1 Rome 1-2 Dalton 2-0 Gainesville 3-1 Cobb/Doublas 3-2 Fulton 3-3 Clayton 3-4 Lawrenceville 3-5 DeKalb 4-0 LaGrange 5-1 Dublin 5-2 Macon 6-0 August 7-0 Columbus 8-1 Valdosta 8-2 Albany 9-1 Savannah 9-2 Waycross 10-0 Athens 2002- 20062005 2009 8.6 9.1 7.6 7.4 6.9 5.8 7.9 8.3 7.2 8.7 7.4 8.2 5.4 8.5 8.3 6.4 7.2 8.7 6.2 11.2 8 9.6 7.2 8.5 6.8 6.5 6.3 9.3 8.3 6.8 6.7 7.5 7.9 8.2 7.5 7.2 Percent (%) Change 5.8 -2.6 -15.9 5.1 20.8 10.8 57.4 -22.9 20.8 80.6 20.0 18.1 -4.4 47.6 -18.1 11.9 3.8 -4.0 2009 Georgia Behavioral Risk Factor Surveillance System Report 9 Coronary heart disease is a broad term that refers collectively to the diseases of the coronary arteries (acute coronary syndrome) and the resulting complications such as a heart attack. It is characterized by severe chest pain due to ischemia (lack of blood supply to the heart muscles) due to obstruction of coronary arteries (blood vessels supplying heart). Risk factors include high blood cholesterol levels, smoking, high blood pressure, lack of physical activity and obesity. Adults who have ever been told that they have Coronary Heart Disease, Georgia 2009: 3.5% U.S. 2009: 3.8% In 2009, more than 250,000 adult Georgians have been told by a health professional that they have coronary heart disease. More men than women had coronary heart disease. Significantly more White adults than Black adults had coronary heart disease. Coronary heart disease was significantly more common among adults 65 years or older than among any other age group. Coronary heart disease was significantly more common among adults whose annual household income was less than $15,000 annually than among adults in households that earned $75,000 or more annually. Adults with less than a high school education were significantly more likely to have coronary heart disease than adults with any other education level Weighted % Weighted % Coronary Heart Disease Percent of adults with Angina by Sex in Georgia 2009. 5 4.62 4 3 2.59 2 1 0 Ma l e Fema l e Weighted % Percent of adults with Angina by Income in Georgia, 2009. 10 7.42 8 6.14 6 4.75 3.76 4 2.5 1.42 2 0 <$15000 $15000-$24999 $25000-$34999 $35000-$49999 $50000-$74999 >$75000 Percent of adults with Angina by Age 20 18 16 14 12 10 8 6 4 2 0.29 0 18-34 in Georgia, 2009 12.8 6.37 2.88 1.42 35-44 45-54 55-64 >65 Weighted % Weighted % Weighted % 10 Percent of adults with Angina by Race/Ethnicity in Georgia, 2009. 5 4.09 3.95 4 3.12 3 2.5 2 1 0 Whi te Bl a ck Hi s pa ni c Others Percent of adults with Angina by Education in Georgia, 2009. 7 6.3 6 5 4 3 2 1 0 65 Percent of Adults with Angina, Georgia Health Districts, 2009 Health Districts Percent <2 2.0-<3.0 3.0-<4.0 4.0-<5.0 >=5 1-1 Rome 1-2 Dalton 2-0 Gainesville 3-1 Cobb/Doublas 3-2 Fulton 3-3 Clayton 3-4 Lawrenceville 3-5 DeKalb 4-0 LaGrange 5-1 Dublin 5-2 Macon 6-0 August 7-0 Columbus 8-1 Valdosta 8-2 Albany 9-1 Savannah 9-2 Waycross 10-0 Athens 2002- 20062005 2009 5.3 5.5 7.5 4.3 3.6 5.2 3.8 3.3 3.4 2.5 4 3.6 2.8 2.1 1 2.7 4.2 4.5 5.2 6.2 4.4 5.5 3.6 4 7.1 4.7 5.1 4.9 3.9 2.8 3.8 3.7 3.9 6.5 3.8 4.5 Percent (%) Change 3.8 -42.7 44.4 -13.2 -26.5 -10.0 -25.0 170.0 7.1 19.2 25.0 11.1 -33.8 -3.9 -28.2 -2.6 66.7 18.4 2009 Georgia Behavioral Risk Factor Surveillance System Report 11 Myocardial infarction (MI) or acute myocardial infarction (AMI), commonly known as a heart attack is the interruption of blood supply to a part of the heart, causing heart cells to die. Classical symptoms of acute myocardial infarction include sudden chest pain, breath, nausea, vomiting, palpitations, sweating, and anxiety. Risk factors include high blood cholesterol levels, smoking, high blood pressure, lack of physical activity and obesity. Adults who have ever been told that they have had a Heart Attack, Georgia 2009: 3.7% U.S. 2009: 4.0% In 2009, more than 273,000 Georgia adults had ever been told by a health professional that they have had a heart attack. Heart attack was twice more common among adult men than among adult women. Heart attacks were significantly more common among 65 years and older than among any other age group. Heart attacks were significantly more common among adults whose annual household income was less than $15,000 than among adults whose household income was $75,000 or more. Significantly more adults with less than a high school education had heart attacks than adults with any other level of education. Weighted % Heart Attack Percent of adults with Heart Attack by Sex 10 in Georgia, 2009 Weighted % 8 6 5.3 4 2.36 2 0 Ma l e Fema l e Percent of adults with Heart Attack by 5 Race/Ethnicity in Georgia, 2009 3.88 4 3.75 3.71 3 2.64 2 1 0 Whi te Bl a ck Hi s pa ni c Other Weighted% Percent of adults with Heart Attack by Income 10 7.89 8 in Georgia, 2009 6.68 6.95 6 4 3.14 2.56 2 1.01 0 <$150$0105000-$249$9925000-$3499$935000-$499$9950000-$74999 >$75000 Weighted % 12 Percent of adults with Heart Attack by Sex 10 in Georgia, 2009 Weighted % 8 6 5.3 4 2.36 2 0 Ma l e Fema l e Weighted% Percent of adults with Heart Attack by 10 Education in Georgia, 2009 7.88 8 6 4.78 3.72 4 1.74 2 0 < Hi ghs chool Hi ghs chool Some Col l ege Col l ege Graduate Percent of adults with Heart Attack by Healthcare coverage in Georgia, 2009 5 4 3 2.51 2.25 2 1 0 Health Care Coverage "Yes" Health Care Coverage "No" Percent of Adults PwehrocehnatvAedhualtds awnhoHehaarvteAhttaadcka, HGeeaorrtgAiattHaceka,lth Districts, 2009 Georgia Health Districts, 2000-2007 2000 - 2003 Health Distr2ic0ts04 - 2007 Percent <3.0 3.0-<4.0 4.0-<5.0 5.0-<6.0 >=6 1-1 Rome 1-2 Dalton 2-0 Gainesville 3-1 Cobb/Doublas 3-2 Fulton 3-3 Clayton 3-4 Lawrenceville 3-5 DeKalb 4-0 LaGrange 5-1 Dublin 5-2 Macon 6-0 August 7-0 Columbus 8-1 Valdosta 8-2 Albany 9-1 Savannah 9-2 Waycross 10-0 Athens 2002- 20062005 2009 6.2 5.8 6.4 5 4.3 4.6 2.6 3.9 2.5 2.1 2.5 4.7 2.5 2.4 1.4 2.6 2.9 4.4 4.8 5.2 3.9 5.4 3.8 3 6.7 4.5 4 5.1 4.7 4 4.1 3.7 5.1 5.9 3.1 5.4 Percent (%) Change -6.5 -21.9 7.0 50.0 -16.0 88.0 -4.0 85.7 51.7 8.3 38.5 -21.1 -32.8 27.5 -14.9 -9.8 15.7 74.2 2009 Georgia Behavioral Risk Factor Surveillance System Report 13 Stroke is the rapidly developing loss of brain function(s) due to disturbance in the blood to the brain. A stroke can be the result of a thrombus (blocked artery) or a hemorrhage (ruptured artery) that prevents blood flow to the brain. As a result, the affected area of the brain is unable to function, which might result in an inability to move one or more limbs on one side of the body, inability to understand or formulate speech, or an inability to see one side of the visual field. Risk factors for stroke include old age, hypertension (high blood pressure), previous stroke or transient ischemic attack (TIA), diabetes, high cholesterol, cigarette smoking and atrial fibrillation. High blood pressure is the most important modifiable risk factor of stroke. Adults who have ever been told that they have had a Stroke, Georgia 2009: 2.3% U.S. 2009: 2.4% In 2009, approximately 170,000 Georgia adults had ever been told by a health professional that they have had a stroke. Having had a stroke was significantly more common among adults age 65+ than any other age group. Having had a stroke was 6 times more common among adults whose annual household income was less than $15,000 than among adults in households that earned $75,000 or more a year. Having had a stroke was 4 times more common among adults with less than a high school education than among college graduates. Weighted % Stroke Percent of adults with Stroke by Sex in Georgia, 2009. 5 4 3 1.95 2 1 0 Ma l e 2.63 Fema l e Weighted % Percent of adults with Stroke by Race/Ethnicity in Georgia, 2009 5 4 3 2.49 2.77 2.28 2 1.24 1 0 Whi te Bl a ck Hi s pa ni c Other Percent of adults with Stroke by Income in 10 9 Georgia, 2009 Weighted % 8 6.74 7 6 5 3.67 4 2.92 3 2 1.46 0.97 1.02 1 0 <$1500$015000-$2499$925000-$3499$935000-$4999$950000-$74999 >$75000 Weighted % Weighted% 14 Percent of adults with Stroke by Age in Georgia,2009 10 8 7.09 6 4.41 4 2.64 2 0.27 0.44 0 18-34 35-44 45-54 55-64 >65 Percent of adults by Stroke by Education in Georgia, 2009 5 4.59 4 3 2.57 2.42 2 1.32 1 0 =5 1-1 Rome 1-2 Dalton 2-0 Gainesville 3-1 Cobb/Doublas 3-2 Fulton 3-3 Clayton 3-4 Lawrenceville 3-5 DeKalb 4-0 LaGrange 5-1 Dublin 5-2 Macon 6-0 August 7-0 Columbus 8-1 Valdosta 8-2 Albany 9-1 Savannah 9-2 Waycross 10-0 Athens 2002- 20062005 2009 6.2 5.8 6.4 5 4.3 4.6 2.6 3.9 2.5 2.1 2.5 4.7 2.5 2.4 1.4 2.6 2.9 4.4 4.8 5.2 3.9 5.4 3.8 3 6.7 4.5 4 5.1 4.7 4 4.1 3.7 5.1 5.9 3.1 5.4 Percent (%) Change -6.5 -21.9 7.0 50.0 -16.0 88.0 -4.0 85.7 51.7 8.3 38.5 -21.1 -32.8 27.5 -14.9 -9.8 15.7 74.2 2009 Georgia Behavioral Risk Factor Surveillance System Report 15 The prevalence of obesity (BMI30) continues to be a health concern for adults in Georgia. Obesity increases the risk for Type II diabetes, coronary heart disease, stroke, gall bladder disease, osteoarthritis, sleep apnea, respiratory problems, and some types of cancer. Obesity is also associated with high blood cholesterol and high blood pressure. The risk of these conditions can be reduced by weight loss. Recommendations for weight loss and weight maintenance include reducing calories and increasing physical activity. Obesity is defined as body mass index (BMI1) of 30.0 or more. Overweight is defined as BMI greater or equal to 25 and less than 30. BMI= weight in kg/(height in meters)2 Obese Adults, Georgia 2009: 27.7% U.S. 2009: 27.2% Healthy People 2010 Objective: <15% In 2009, more than 1.9 million adult Georgians, more than one in four, were obese. Significantly more Black adults were obese than White adults. Obesity was significantly more common among adults whose annual income was less than $15,000 than among adults whose annual income was equal or greater than $35,000. Obesity was twice more common among adults with less than a high school education than among college graduates. Weighted % Weighted % Obesity Percent of adults who are Obese by Sex in Georgia, 2009 50 40 28.4 30 27 20 10 0 Ma l e Fema l e Percent of adults who are Obese by Race/Ethnicity in Georgia, 2009 50 42.4 40 34.9 30 24.6 20 12.1 10 0 Whi te Bl a ck Hi s pa ni c Other Weighted % Percent of adults who are Obese by Income in Georgia, 2009 50 38.5 40 30 33.9 34.8 25.8 28.9 20.6 20 10 0 <$15000 $15000-$24999 $25000-$34999 $35000-$49999 $50000-$74999 >$75000 Weighted % Weighted % Weighted % 16 Percent of adults who are Obese by Age in Georgia, 2009 50 40 30.2 31.2 30.3 30 26.4 24.8 18.6 20 10 0 18-24 25-34 35-44 45-54 55-64 >65 Percent of adults who are Obese by Education in Georgia, 2009 50 38 40 30 20 32.8 29.1 19.7 10 0 < Hi ghs chool Hi ghs chool Some Col l ege Col l ege Graduate Percent of adults who are Obese by Health Care Coverage in Georgia, 2009 35 30 26.9 25 20 15 10 5 0 Health Care Coverage "Yes" 33.2 Health Care Coverage "No" Percent of Adults with a Obesity Health Districts Percent <22.0 22.0-<25.0 25.0-<30.0 30.0-<35.0 >=35.0 2009 Georgia Behavioral Risk Factor Surveillance System Report 17 Arthritis is a form of joint disorder that involves inflammation of one or more joints. There are over 100 different forms of arthritis; the most common form being osteoarthritis (degenerative joint disease) is a result of trauma to the joint, infection of the joint, or age. Other arthritis forms are rheumatoid arthritis, psoriatic arthritis, and related diseases. The major complaint by individuals who have arthritis is joint pain. Pain is often a constant and may be localized to the joint affected. The pain from arthritis occurs due to inflammation that occurs around the joint, damage to the joint from disease, daily wear and tear of joint, muscle strains caused by forceful movements against stiff, painful joints and fatigue. Adults who have ever been told that they have had Arthritis. Georgia 2009: 23.7% U.S. 2009: 25.9% In 2009, more than 1.6 million adult Georgians had some or the other form of Arthritis. Seen more in females than men. Significantly more White adults than Black adults had Arthritis. Arthritis was significantly more common among adults whose annual income was less than $15,000 than among adults whose annual income was equal or greater than $35,000. Arthritis was twice more common among adults with less than a high school education than among college graduates. Weighted % Weighted % Weighted % Arthritis Percent of adults with Arthritis by Sex, Georgia 2009. 75 60 45 27.2 30 19.8 15 0 Ma l e Fema l e Percent of adults with Arthritis by Race/Ethnicity, Georgia,2009 50 40 30 26.2 20.8 20 17.5 16.7 10 0 Whi te Bl a ck Hi s pa ni c Other Percent of adults with Arthritis by Income, 50 Georgia, 2009 40 37.1 29.3 30 25.9 23.4 20 18.2 17.3 10 0 <$15000 $15000-$24999 $25000-$34999 $35000-$49999 $50000-$74999 >$75000 Weighted % Weighted % Weighted % 18 Percent of adults with Arthritis by 100 Age, Georgia, 2009. 80 60 54.7 43.1 40 25.4 20 15.2 5.7 0 18-34 35-44 45-54 55-64 >65 Percent of adults with Arthritis by Education, Georgia, 2009 50 40 32.7 27.9 30 23.6 20 17.4 10 0 $75000 Weighted% 20 Percent of adults with Disability by Age in Georgia, 2009 40 37.73 35 30 28.25 25 19.39 20 15 12.83 10 4.99 6.38 5 0 18-24 25-34 35-44 45-54 55-64 >65 Percent of adults with Disability by Education in Georgia, 2009 50 40 30 27.93 20 10 19.26 18.14 12.59 0 < Highschool Highschool Some College Col l ege Graduate Percent of adults with Disability by Healthcare 25 Coverage in Georgia, 2009 20 15 14.08 14.98 10 5 0 Health Care Coverage "Yes" Health Care Coverage "No" Weighted% Percent of Adults with a Disability 2009 Georgia Behavioral Risk Factor Surveillance System Report 21 Preventive Practices Infection with the influenza virus is often resolved within two weeks, but can lead to serious or life-threatening disease in some people, especially the elderly or people with chronic health problems. Influenza vaccination, or a flu shot, can reduce much of the morbidity and mortality associated with the flu. The Centers for Disease Control and Prevention Advisory Committee on Immunization Practices recommends that the following groups should receive influenza vaccinations during the influenza season: 1) Children aged 6 months up to their 19th birthday; 2) Pregnant women; 3) People of any age with certain chronic medical conditions; 4) People who live in nursing homes and other long-term care facilities; 5) People who live with or care for those at high risk for complications of flu, this includes - healthcare workers, household contacts of persons at high risk for complications from the flu, and household contacts and out of home caregivers of children less than 6 months of age. Adults, aged 65+ years, who had a Flu shot in the Last Year, Georgia 2009: 66.6% U.S. 2009: 69.8% Healthy People 2010 Objective: > 90% In 2009, more than 650,000 adult Georgians, aged 65+ years, had an influenza vaccination. Significantly more White adults aged 65+ received a flu shot than Black adults. More adults aged 65+ who were college graduates received a flu shot than adults with a less than high school education. Weighted % Flu-shot Percent of adults 65 years and above who had Flu Shot by Sex, Georgia,2009 100 80 69.02 60 64.97 40 20 0 Ma l e Fema l e Percent of adults 65 years and above who had Flu Shot by Education, Georgia,2009 100 80 67.41 68.7 72.89 60 54.41 40 20 0 < Highschool Highschool Some College Col l ege Graduate Weighted % Weighted % 22 Percent of adults 65 years and above who had 100 Flu Shot by Race/Ethnicity, Georgia,2009 80 72 60 40 52.63 55.46 41.29 20 0 Whi te Bl a ck Hi s pa ni c Other Percent of adults 65 years and above who had Flu Shot by Income, Georgia,2009 100 80 57.14 60 65.61 65.39 66.46 71.47 76.15 40 20 0 <$15000$15000-$24999$25000-$34999$35000-$49999$50000-$74999 >$75000 Adults, aged 65+ years, who had a Flu shot in the Last Year Health Districts Percent <57.0 57.0-<60.0 60.0-<65.0 65.0-<70.0 >=70 1-1 Rome 1-2 Dalton 2-0 Gainesville 3-1 Cobb/Doublas 3-2 Fulton 3-3 Clayton 3-4 Lawrenceville 3-5 DeKalb 4-0 LaGrange 5-1 Dublin 5-2 Macon 6-0 August 7-0 Columbus 8-1 Valdosta 8-2 Albany 9-1 Savannah 9-2 Waycross 10-0 Athens 2002- 20062005 2009 60.5 66.3 59.7 66.9 66.3 68.6 67.5 74.8 66.3 63.2 58.4 50.1 67.4 65.1 72.5 68.7 56.8 63.5 58.9 63.4 59.8 65.4 62.8 70.7 56.4 65.3 69.5 67.7 62.3 63.4 64.5 65.1 59.3 58.4 66 64.2 Percent (%) Change 9.6 12.1 3.5 10.8 -4.7 -14.2 -3.4 -5.2 11.8 7.6 9.4 12.6 15.8 -2.6 1.8 0.9 -1.5 -2.7 2009 Georgia Behavioral Risk Factor Surveillance System Report 23 Pneumococcal bacteria can cause meningitis, pneumonia, and infections in the blood (septicemia). Adults older than 65 and people with chronic health problems like diabetes, heart disease, and kidney failure are at especially high risk for infection. Penicillin was once an effective treatment for pneumococcal disease, but drug resistant strains of the bacteria have increased the importance of preventing infections through immunization. The vaccine can be given at any time of the year. Usually one dose is all that is needed. However revaccination is recommended if the first dose was received prior to age 65 and if at least 5 years have elapsed since the previous dose. Adults, aged 65+ years, who have ever had a Pneumonia Vaccination, Georgia 2009: 63.4% U.S. 2009: 68.1% Healthy People 2010 Objective: > 90% In 2009, more than 600,000 adult Georgians, aged 65+ years, have ever had a pneumonia vaccination. More females received pneumonia vaccination than males Significantly more White adults aged 65+ received a pneumonia vaccination than Black adults aged 65+. . Weighted % Weighted % Pneumonia Vaccination Percent of adults 65 years and above who had Pneumonia Shot by Sex, Georgia,2009 100 80 66.3 59.32 60 40 20 0 Ma l e Fema l e Percent of adults 65 years and above who had Pneumonia Shot by Education, Georgia,2009 100 80 57.1 60 61.96 68.41 65.84 40 20 0 < Hi ghs chool Hi ghs chool Some Col l ege Col l ege Graduate Weighted % 24 Percent of adults 65 years and above who had Pneumonia Shot by Race/Ethnicity, 100 Georgia,2009 Weighted % 80 68.21 60 49.95 54.87 44.9 40 20 0 Whi te Black Hispanic Other Percent of adults 65 years and above who had Pneumonia Shot by Sex, Georgia,2009 100 80 60 54.09 65.33 58.99 65.44 63.95 65.05 40 20 0 <$150$0105000-$249$9925000-$349$9395000-$499$9950000-$74999 >$75000 Adults, aged 65+ years, who have ever had a Pneumonia Vaccination Health Districts Percent <58.0 58.0-<60.0 60.0-<65.0 65.0-<70.0 >=70.0 1-1 Rome 1-2 Dalton 2-0 Gainesville 3-1 Cobb/Doublas 3-2 Fulton 3-3 Clayton 3-4 Lawrenceville 3-5 DeKalb 4-0 LaGrange 5-1 Dublin 5-2 Macon 6-0 August 7-0 Columbus 8-1 Valdosta 8-2 Albany 9-1 Savannah 9-2 Waycross 10-0 Athens 2002- 20062005 2009 62.2 67.5 65.8 65 58.3 66.5 68.1 68.9 59 63.5 62 59.8 66.8 66.6 71.9 68.3 50.3 63.9 59.8 58.2 58.8 60.9 62.5 66.7 45.2 59.9 63.5 62.8 55.8 59 59.7 64.6 55.6 57.2 63.4 61.3 Percent (%) Change 8.5 -1.2 14.1 1.2 7.6 -3.5 -0.3 -5.0 27.0 -2.7 3.6 6.7 32.5 -1.1 5.7 8.2 2.9 -3.3 2009 Georgia Behavioral Risk Factor Surveillance System Report 25 Breast cancer is the leading cause of cancer incidence among women in Georgia and the second leading cause of cancer death. The number of deaths can be reduced if the disease is diagnosed early. Factors associated with breast cancer are personal or family history of breast cancer, biopsy-confirmed atypical hyperplasia, early onset of the menstrual cycle coupled with late onset of menopause, use of oral contraceptives or post-menopausal estrogens, never having children or first child born after age 30 and consuming 2 or more drinks of alcohol daily. The American Cancer Society recommends that women ages 40 and older receive annual breast cancer screening, including a clinical breast exam and a mammogram. Women, aged 40+ years, who have had a Mammogram in the Last Two Years, Georgia 2009: 76.0% U.S. 2008: 76.5% Healthy People 2010 Objective: > 70% In 2009, more than 155,000 women of Georgia women, aged 40+ years, have had a mammogram in the last two years. More women who had some college education or college graduates had mammograms than women with less than a high school education. Significantly more women with health insurance had mammograms than women without health insurance. Weighted % Mammography Percent of Adult Women above 40 years who Had Mammogram by Age, Georgia,2009 100 80 66.15 78.79 81.65 60 40 20 0 40-44 45-64 65+ Percent of Adult Women above 40 years who Had Mammogram by Education, Georgia,2009 Weighted % 100 80 64.99 60 73.96 79.27 40 20 0 < Hi ghs chool Hi ghs chool Some Col l ege 82.79 Col l ege Graduate Weighted % Percent of Adult Women above 40 years who Had Mammogram by Health Coverage,Georgia,2009 100 80.6 80 60 51.53 40 20 0 Health Care Coverage Health Care Coverage "Yes " "No" Weighted % 26 Percent of Adult Women above 40 years who Had Mammogram by Race, Georgia,2009 100 78.6 80 77.84 74.62 59.59 60 40 20 0 Whi te Black Hispanic Other Weighted % Percent of Adult Women above 40 years who Had Mammogram by Income , Georgia,2009 100 80 64.67 69.78 73.47 77.46 83.86 85.85 60 40 20 0 <$15$01050000-$249$9295000-$349$9395000-$499$9590000-$74999 >$75000 Women, aged 40+ years, who have had a Mammogram in the Last Two Years,Georgia 2009 Health Districts Percent <72.0 72.0-<75.0 75.0-<78.0 78.0-<81.0 >=81.0 1-1 Rome 1-2 Dalton 2-0 Gainesville 3-1 Cobb/Doublas 3-2 Fulton 3-3 Clayton 3-4 Lawrenceville 3-5 DeKalb 4-0 LaGrange 5-1 Dublin 5-2 Macon 6-0 August 7-0 Columbus 8-1 Valdosta 8-2 Albany 9-1 Savannah 9-2 Waycross 10-0 Athens 2002- 20062005 2009 73.4 71.8 73.2 74 74.2 74.2 73.9 76.2 79.8 83.9 71.3 77.5 73.6 79 80.8 81.6 77.2 75 71.5 74.6 78.2 80.3 77.6 80.9 76.4 83.7 68.9 75 76 80.9 80.7 79.5 66.1 71.1 75 78.6 *Statistically significant difference exists. Percent(%) Change -2.2 1.1 0.0 3.1 5.1 8.7 7.3 1.0 -2.8 4.3 2.7 4.3 9.6 8.9 6.4 -1.5 7.6 4.8 2009 Georgia Behavioral Risk Factor Surveillance System Report 27 The risk of developing cervical cancer is closely linked with sexual practices and sexually transmitted human Papillomavirus infection. Becoming sexually active at a young age, having multiple sex partners, and smoking cigarettes are all risk factors for cervical cancer. The American Cancer Society recommends that all women begin cervical cancer screening within 3 years after becoming sexually active, but no later than age 21. Screening should be done every year with the regular Pap test, or every 2 years using the newer liquid-based Pap test. At age 30, women who have had 3 normal Pap tests in a row may get screened every two to three years. Women who have had a Pap test within Three Years, Georgia 2009: 86.2% U.S. 2008: 82.0% Healthy People 2010 Objective: > 90% In 2009, an estimated 2.1 million Georgia women have had a pap test in the last three years. More women whose annual household income is $75,000 or more have had a pap test in the past 2 years than women at any other income level. More women who were college graduates had a pap test than women with any other level of education. Significantly more women with health insurance had a pap test than women without health insurance. Weighted % Pap Test Percent of Adult women who had PAP Test by Age, Georgia,2009 100 80 71.22 90.18 92.09 89.15 85.06 72.25 60 40 20 0 18-24 25-34 35-44 45-54 55-64 >65 Weighted % Percent of Adult women who had PAP Test by Education, Georgia,2009 100 75.42 80 78.44 60 40 20 0 < Highschool Highschool 85.69 Some Col l ege 94.02 Col l ege Graduate Weighted % Percent of Adult women who had PAP Test by Health Coverage, Georgia,2009 100 91.52 80 75.15 60 40 20 0 Health Care Coverage "Yes" Health Care Coverage "No" Weighted % Weighted % 28 Percent of Adult women who had PAP Test by Race/Ethnicity, Georgia,2009 100 85.94 80 60 40 20 0 Whi te 87.88 85.02 83.24 Black Hispanic Other Percent of Adult women who had PAP Test by Age, Georgia,2009 100 82.42 80 60 80.65 85.84 87.26 90.05 92.47 40 20 0 <$1500$015000-$24999$25000-$34999$35000-$49999$50000-$74999 >$75000 Women who have had a Pap test within Three Years, Georgia 2009 Health Districts Percent <82.0 82.0-<84.0 84.0-<86.0 86.0-<88.0 >=88.0 1-1 Rome 1-2 Dalton 2-0 Gainesville 3-1 Cobb/Doublas 3-2 Fulton 3-3 Clayton 3-4 Lawrenceville 3-5 DeKalb 4-0 LaGrange 5-1 Dublin 5-2 Macon 6-0 August 7-0 Columbus 8-1 Valdosta 8-2 Albany 9-1 Savannah 9-2 Waycross 10-0 Athens 2002- 20062005 2009 84.6 80.5 87.9 86.6 85.5 87.8 89.8 88.8 89.5 87.9 90.4 88.5 89.2 88.6 91.4 90.7 86.5 87.6 86.5 81.4 89.8 92 90.9 86 89 87.4 88.5 84.2 86.6 80.9 92.2 84.7 82.1 78.6 89.2 90.8 Percent (%) Change -4.8 -1.5 2.7 -1.1 -1.8 -2.1 -0.7 -0.8 1.3 -5.9 2.4 -5.4 -1.8 -4.9 -6.6 -8.1 -4.3 1.8 2009 Georgia Behavioral Risk Factor Surveillance System Report 29 Human Immunodeficiency Virus (HIV) is the virus that causes Acquired Immune Deficiency Syndrome (AIDS). HIV is mainly transmitted through sexual contact and through intravenous drug use. People who become infected with the virus can be asymptomatic for long periods of time during which they can infect sexual and drug injection partners. Following infection with HIV, people develop AIDS, a disease that affects the immune system and leaves patients vulnerable to a wide variety of potentially fatal opportunistic infections. Testing for HIV infection is crucial to determine HIV status. When individuals are aware of their HIV status they have knowledge of their health status and opportunities for counseling from health care professionals. Knowledge of HIV status provides the opportunity to reduce risk behaviors so that those infected can stop HIV transmission, begin treatment, and, in the case of pregnant women, reduce the risk of transmission to an unborn baby. The Centers for Disease Control and Prevention recommends HIV testing as part of routine medical care for persons aged 13 64 years Adults, aged 18-64 years, tested for HIV Georgia 2009: 51.0% In 2009, more than 2.9 million Georgia adults, aged 1864 years, have ever been tested for HIV. HIV testing occurred significantly more among Black adults than among White adults. HIV testing was more common among adults aged 2534 years than among adults of any other age group. Weighted % Weighted % HIV Test Percent of adults 18-64 years who had HIV 100 Test by Sex, Georgia,2009 80 60 49.01 40 52.95 20 0 Ma l e Fema l e Percent of adults 18-64 years who had HIV 100 Test by Race/Ethnicity, Georgia,2009 80 60 42.17 40 69.22 47.77 53.09 20 0 Whi te Black Hispanic Other Percent of adults 18-64 years who had HIV Test by Income, Georgia,2009 100 W 80 eig 60 ht 40 ed % 20 53.12 56.79 52.34 58.19 50.28 47.85 0 <$1500$015000-$2499$925000-$3499$935000-$4999$950000-$74999 >$75000 Weighted % 30 Weighted % Percent of adults 18-64 years who had HIV Test by Age, Georgia,2009 100 80 60 51.41 40 20 65.11 59.75 42.21 25.94 0 18-24 25-34 35-44 45-54 55-64 Percent of adults 18-64 years who had HIV 100 Test by Education, Georgia,2009 80 60 50.49 48.08 53.6 51.57 40 20 0 < Highschool Highschool Some College Col l ege Graduate Weighted % Percent of adults 18-64 years who had HIV Test by Health Coverage, Georgia,2009 100 80 60 49.83 55.93 40 20 0 Health Care Coverage Health Care Coverage "No" "Yes" Adults, aged 18-64 years, tested for HIV Georgia 2009 Health Districts Percent <45.0 45.0-<50.0 50.0-<55.0 55.0-<60.0 >=60.0 1-1 Rome 1-2 Dalton 2-0 Gainesville 3-1 Cobb/Doublas 3-2 Fulton 3-3 Clayton 3-4 Lawrenceville 3-5 DeKalb 4-0 LaGrange 5-1 Dublin 5-2 Macon 6-0 August 7-0 Columbus 8-1 Valdosta 8-2 Albany 9-1 Savannah 9-2 Waycross 10-0 Athens 2002- 20062005 2009 45.1 40 47.5 37 40.9 33.7 52.1 47 61.9 52.4 60.7 62.6 47.7 48.5 60.5 58 47.9 44.3 46 39 50.7 42.7 55.1 44.4 56.9 50.1 51.7 47.8 51.3 49 56.9 51.1 48.4 43.3 53 39.6 Percent (%) Change -11.3 -22.1 -17.6 -9.8 -15.3 3.1 1.7 -4.1 -7.5 -15.2 -15.8 -19.4 -12.0 -7.5 -4.5 -10.2 -10.5 -25.3 2009 Georgia Behavioral Risk Factor Surveillance System Report 31 Risk Behaviors Cigarette smoking is a leading cause of preventable death in the United States. Smoking is associated with illness and death related to heart disease, stroke, chronic obstructive pulmonary disease, low birth weight, sudden infant death syndrome, and fire. For those who smoke, quitting is always beneficial. At every age, smokers who quit live longer than those who continue smoking. Policy changes to prevent the initiation of smoking among youth and to reduce exposure to environmental tobacco smoke are also important for reducing the burden of tobacco-related death and disease in Georgia. Adults who Smoke Cigarettes, Georgia 2009: 17.7% U.S. 2009: 17.9% Healthy People 2010 Objective: <12% In 2009, approximately 1.2 million adult Georgians smoked cigarettes. Smoking cigarettes was more common among men than among women. Smoking cigarettes was 3 times more common among adults whose annual household income was less than $15,000 than among adults whose household income was $75,000 or more. Smoking cigarettes was significantly more common among adults with less than a high school education than among any other level of education. Smoking cigarettes was twice more common among with no health insurance than among adults with health insurance. Cigarette Smoking Percent of adults who Smoke by Sex, 25 Georgia,2009 20 20 15.5 15 10 5 0 Ma l e Fema l e Percent of adults who Smoke by 30 Race/Ethnicity, Georgia,2009 25 19.3 20 18.5 15.1 15 12 10 5 0 Whi te Bl a ck Hi s pa ni c Other Percent of adults who Smoke by Income, Georgia,2009 50 40 32.6 30 25.2 19.2 20 16.1 16.3 11.8 10 0 <$1500$015000-$24999$25000-$34999$35000-$49999$50000-$74999 >$75000 Weighted % Weighted % 32 Percent of adults who Smoke by Sex, 25 Georgia,2009 20 20 15.5 15 10 5 0 Ma l e Fema l e Percent of adults who Smoke by Education, Georgia,2009 50 40 28.8 30 24.3 19.1 20 8 10 0 < Highschool Highschool Some College Col l ege Graduate Percent of adults who Smoke by Health 50 Insurance, Georgia,2009 40 33.9 30 20 15.1 10 0 Has Health Coverage No Health Coverage Adults who Smoke Cigarettes, Georgia 2009 Health Districts Percent <=17 17.0-20.0 20.0-23.0 23.0-26.0 >=26 1-1 Rome 1-2 Dalton 2-0 Gainesville 3-1 Cobb/Doublas 3-2 Fulton 3-3 Clayton 3-4 Lawrenceville 3-5 DeKalb 4-0 LaGrange 5-1 Dublin 5-2 Macon 6-0 August 7-0 Columbus 8-1 Valdosta 8-2 Albany 9-1 Savannah 9-2 Waycross 10-0 Athens 2002- 20062005 2009 28.5 25.4 27 22.6 23 16.5 16.3 16.3 17.1 16.1 24.2 17.1 19.7 16.6 17.5 12.2 21.6 19.9 20.6 22.5 24 23.3 22.4 22.3 23.5 21.2 25.7 24 23.5 20.8 22.4 23.2 25.5 24.6 26.6 17.7 *Statistically significant difference exists. Percent (%) Change -10.9 -16.3 -28.3 0.0 -5.8 -29.3 -15.7 -30.3 -7.9 9.2 -2.9 -0.4 -9.8 -6.6 -11.5 3.6 -3.5 -33.5 2009 Georgia Behavioral Risk Factor Surveillance System Report 33 Binge drinking is defined as five or more drinks for men and four drinks or more for women on an occasion. One drink equals one can or bottle of beer, one glass of wine, one can or bottle of wine cooler, one cocktail or one shot of liquor. Binge drinking can result in acute impairment of judgment and physical skills, and causes a significant fraction of alcohol-related deaths. Binge drinking increases the risk of unintentional injuries (motor vehicle crashes, drowning and falls) and suicide. Chronic conditions such as high blood pressure, pancreatitis and poor diabetic control are also related to binge drinking. Binge drinking has high social and economic impact; it increases the risk of homicide, child abuse, rape and domestic violence and causes loss of productivity. Binge drinking during pregnancy may cause fetal alcohol syndrome. Effective prevention measures against binge drinking can save lives and prevent development of birth defects. Adults who Binge Drink, Georgia 2009: 10.4% U.S. 2009: 15.5% Healthy People 2010 Objective: < 6% In 2009, approximately 730,000 adult Georgians were binge drinkers. Binge drinking was significantly more common among men than among women. Binge drinking was more common among White adults than among Black adults. Binge drinking was more common among adults, aged 44 years of age or younger than among adults aged 45 years of age or older. Binge drinking was nearly twice as common among adults whose annual household income was $75,000 or more than among adults who earned less than $25,000. Binge Drinking Percent of Binge Drinking by Sex, Georgia,2009 20 14.43 15 10 6.85 5 0 Ma l e Fema l e Percent of Binge Drinking by Race/Ethnicity , Georgia,2009 20 15 12.51 10 7.75 7.15 6.51 5 0 Whi te Bl a ck Hi s pa ni c Other Percent of Binge Drinking by Income, 25 Georgia,2009 20 16.85 15 10 7.63 7.43 9.2 9.67 8.06 5 0 <$150$0015000-$2499$925000-$3499$935000-$4999$950000-$74999 >$75000 Weighted % Weighted % 34 Percent of Binge Drinking by Age , 20 Georgia,2009 15 14.37 14.1 11.36 10 9.96 7.11 5 2.38 0 18-24 25-34 35-44 45-54 55-64 >65 Percent of Binge Drinking by Education, Georgia,2009 20 15 9.54 10 11.14 11.17 9.54 5 0 < Highschool Highschool Some Col l ege Col l ege Graduate Percent of Binge Drinking by Health Insurance, 20 Georgia,2009 15 12.52 9.53 10 5 0 Has Health Coverage No Health Coverage Adults who Binge Drink, Georgia 2009 Health Districts Percent <9.0 9.0-<11.0 11.0-<13.0 13.0-<15.0 >=15.0 1-1 Rome 1-2 Dalton 2-0 Gainesville 3-1 Cobb/Doublas 3-2 Fulton 3-3 Clayton 3-4 Lawrenceville 3-5 DeKalb 4-0 LaGrange 5-1 Dublin 5-2 Macon 6-0 August 7-0 Columbus 8-1 Valdosta 8-2 Albany 9-1 Savannah 9-2 Waycross 10-0 Athens 2002- 20062005 2009 10.7 8.7 12.1 13.5 11.1 10.3 14 15.6 13.9 16.1 11.3 7.2 14.6 12.4 13.7 12.8 11.7 15.5 8.2 12.2 9.4 10 11.4 14.1 15.9 14.1 9.9 10.1 10 9.3 12.9 15.3 11.9 14.4 14.5 10.7 Percent (%) Change -18.7 11.6 -7.2 11.4 15.8 -36.3 -15.1 -6.6 32.5 48.8 6.4 23.7 -11.3 2.0 -7.0 18.6 21.0 -26.2 2009 Georgia Behavioral Risk Factor Surveillance System Report 35 Physical activity can reduce the risk of heart disease, stroke, high blood pressure, diabetes, colon cancer and osteoporosis. Regular physical activity also helps maintain healthy body weight, reduces the risk of falls and fractures, helps prevent back pain, reduces symptoms of anxiety and depression, and enhances quality of life. Benefits can be achieved through regular moderate-intensity activities like walking, housework, and gardening as well as through traditional exercise programs. The 2008 Physical Activity Guidelines for Americans recommends at least 150 minutes of moderate-intensity aerobic activity every week (30 minutes a day), and muscle strengthening activities on two or more days. Adults who are physically Inactive during Leisure Time, Georgia 2009: 24.2% U.S. 2009: 24.2% Healthy People 2010 Objective: < 20% In 2009, more than 1.7 million adult Georgians were physically inactive during their leisure time. Physical inactivity during leisure time was more common among women than men. Physical inactivity during leisure time was more common among Black adults than White adults. Physical inactivity was significantly more common in adults 45 years or older compared to adults 1824 years of age. Physical inactivity during leisure time was significantly more common among adults with less than a high school education than among any other level of education. Physical inactivity during leisure time was significantly more common among adults with income less than $15,000 than other income groups. Weighted % Physical Inactivity Percent of adults with No Physical Activity by Sex, Georgia,2009 50 40 30 21.1 20 27.14 10 0 Ma l e Fema l e Weighted % Percent of adults with No Physical Activity by 50 Race/Ethnicity , Georgia,2009 40 34.49 29.2 30 21.07 20 20.96 10 0 Whi te Black Hispanic Other Percent of adults with No Physical Activity by 50 44.21 Income, Georgia,2009 40 37.3 31.23 30 21.97 20 14.44 12.14 10 0 <$1500$015000-$24999$25000-$34999$35000-$49999$50000-$74999 >$75000 36 Percent of adults with No Physical Activity by Age , Georgia,2009 50 Weighted % 40 30 18.61 20 23.07 25.11 27.92 33.92 10 0 18-34 35-44 45-54 55-64 65+ Percent of adults with No Physical Activity by Education, Georgia,2009 50 44.54 40 32.19 30 21.5 20 13.02 10 0 < Highschool Highschool Some College College Graduate Adults who are physically Inactive during Leisure Time, Georgia 2009 Health Districts Percent <20.0 20.0-<24.0 24.0-<28.0 28.0-<32.0 >=32.0 2009 Georgia Behavioral Risk Factor Surveillance System Report 37 Access to preventive services and health care can prevent or improve the outcomes of many diseases. Insurance coverage is a strong factor in determining whether people will have access to services like screenings, treatment, and health recommendations. Access to quality health care can help eliminate disparities in disease and disease outcomes and can improve the quality and length of life for people living in Georgia. Access to health care can be limited both by lack of health insurance and by insufficient coverage. People who cannot afford to see a doctor or a health-care professional for either of these reasons are at risk for adverse health outcomes. Adults with Health Insurance, Georgia 2009: 78.4% U.S. 2009: 85.3% Healthy People 2010 Objective: 100% In 2009, more than 4.8 million of Georgia adults had health insurance. Significantly more White adults than Black adults have health insurance. Significantly more adults whose household annual income was more than $75,000 a year have health insurance than adults in households that earned $35,000 or less. Significantly more adults with college graduation have health insurance than adults with less than high school education. Health Insurance Percent of adults who had Health Insurance in Georgia, 2009 100 83.35 82.86 86.05 80 72.9 58.85 60 Weighted % 40 20 0 18-24 25-34 35-44 45-54 55-64 Percent of adults who had Health Insurance by Education in Georgia, 2009 100 W 80 eig 60 ht ed 40 % 20 46.88 68.35 80.43 93.55 0 < Highschool Some College Hi ghs chool College Graduate Percent of adults who have Health Insurance by Sex in Georgia,2009 100 77.63 79.3 80 60 40 20 0 Ma l e Fema l e 38 Weighted% Percent of adults who had Health Insurance by Race/Ethnicity in Georgia, 2009 100 85.62 80 60 40 20 0 Whi te 71.43 48.44 77.87 Black Hispanic Other Percent of adults who had Health Insurance by Income in Georgia, 2009 Weighted% 100 94.28 96.18 82.21 80 60 55.23 43.89 61.2 40 20 0 <$15$01050000-$24$92959000-$34$93959000-$49$95909000-$74999 >$75000 Adults with Health Insurance, Georgia 2009 Health Districts Percent <13.0 13.0-<15.0 15.0-<18.0 18.0-<21.0 >=21.0 2009 Georgia Behavioral Risk Factor Surveillance System Report *Statistically significant difference exists. 39 Access to preventive services and health care can prevent or improve the outcomes of many diseases. Medical costs involved is an important factor in determining whether people will have access to services like screenings, treatment, and health recommendations. People who cannot afford to see a doctor or a health-care professional due to medical cost involved are at risk for adverse health outcomes. Adults with who did not seek medical care due to medical cost involved. Georgia 2009: 18% In 2009, more than 1.3 million Georgia adults did not seek medical care due to high medical costs. Significantly more seen in women than men. Significantly more in Hispanics than any other races. No medical visits due to costs were significantly seen more common in adults 18-24 years of age. No medical visits due to costs were significantly more common among adults with less than a high school education than among any other level of education. No medical visits due to costs were significantly more common among adults with income less than $15,000 and in adults with no health coverage. Weighted % No Access to Medical Care Percent of adults with No Healthcare Access due to Cost by Sex, Georgia 2009 25 20 16.3 15 10 5 0 Ma l e 19.5 Fema l e Percent of adults with No Healthcare Access due to Cost by Race/Ethnicity, Georgia 2009 50 40 30 20 12.7 10 0 Whi te 40.2 22.6 24.2 Bl a ck Hi s pa ni c Other Weighted % Percent of adults with No Healthcare Access due to Cost by Income, Georgia 2009 50 40 36.8 37.9 28.4 30 20 14.4 10 7.7 6.8 0 <$150$0015000-$2499$925000-$3499$935000-$4999$950000-$74999 >$75000 Weighted % Weighted % Weighted % 40 Percent of adults with No Healthcare Access due to Cost by Age, Georgia 2009 50 40 30 26.2 23.6 20 17.6 18.7 16 10 5.5 0 18-24 25-34 35-44 45-54 55-64 >65 Percent of adults with No Healthcare Access due to Cost by Education, Georgia 2009 50 40 30.1 30 21.8 20 10 0 < Hi ghs chool Hi ghs chool 19.1 Some Col l ege 10.3 Col l ege Graduate Percent of adults with No Healthcare Access due to Cost by Healthcare Coverage, Georgia 100 2009 80 60 54.5 40 20 10.6 0 Has Health Coverage No Health Coverage Adults with who did not seek Medical Care due to Medical Cost Involved Health Districts Percent <12.0 12.0-<15.0 15.0-<18.0 18.0-<21.0 >=21.0 2009 Georgia Behavioral Risk Factor Surveillance System Report 41 No Personal Doctor/Health Care Provider Adults who did not have a personal doctor or a health care provider. Georgia 2009: 21.3% In 2009, more than 1.5 million Georgia adults did not have a personal doctor/Health care provider. Significantly more seen in men than women. Significantly more in Hispanics than any other races. Significantly more seen in adults in age group 18-24 years More common among adults with less than a high school education and among adults with income less than $35,000 than other income groups. Significantly high in the adults with no health care coverage. Weighted % Percent of adults with No Personal Doctor by Sex in Georgia, 2009 50 40 30 27.5 20 15.4 10 0 Ma l e Fema l e Percent of adults with No Personal Doctor by Race in Georgia,2009 50 45.1 40 30 25.5 25.9 20 16.4 10 0 Whi te Bl a ck Hi s pa ni c Other Weighted % Percent of adults with No Personal Doctor by Income in Georgia, 2009 50 40 30.9 32.9 30 25.8 20.6 20 16.8 12 10 0 <$15$01050000-$24$92959000-$34$93959000-$49$95909000-$74999 >$75000 Weighted % Weighted % 42 Percent of adults with No Personal Doctor by Age in Georgia,2009 50 42.8 40 35.9 30 19 20 16.7 10.2 10 5.6 0 18-24 25-34 35-44 45-54 55-64 >65 Weighted % Percent of adults with No Personal Doctor by Education in Georgia,2009 50 39.7 40 30 26.4 21.6 20 11.3 10 0 < Highschool Highschool Some College College Graduate Percent of adults with No Personal 100 Doctor by Health Coverage, Georgia, 2009 80 60.9 60 40 20 13.5 0 Health Care Coverage "Yes" Health Care Coverage "No" No Personal Doctor/Health Care Provider Health Districts Percent <18.0 18.0-<20.0 20.0-<24.0 24.0-<28.0 >=28.0 2009 Georgia Behavioral Risk Factor Surveillance System Report 43 Self-assessed health status is a measure of how an individual perceives his or her health--rating it as excellent, very good, good, fair, or poor. Self-assessed health status has been validated as a useful indicator of health for a variety of populations and allows for broad comparisons across different conditions and populations. Adults with Fair/Poor General Health in Georgia, 2009. Georgia 2009: 15.4% In 2009, more than 1.1 million Georgia adults had Fair/ Poor general health. Significantly more in Hispanics than any other races. Fair/Poor general health were significantly seen more common in adults >65 years of age. Fair/Poor general health was significantly more common among adults with less than a high school education than among any other level of education. Fair/Poor general health was significantly more common among adults with income less than $15,000 than other income groups. Fair/Poor general health was significantly more common among adults with no health coverage than with adults who had health coverage. Weighted% Fair/Poor General Health Percent of adults with Fair/Poor General Health by Sex in Georgia, 2009 20 15.22 15 15.61 10 5 0 Ma l e Fema l e Weighted% Percent of adults with Fair/Poor General 50 Health by Race /Ethnicity in Georgia, 2009 40 30 20 12.77 10 17.85 29.31 14.94 Whi te Bl a ck Hi s pa ni c Other 0 Whi te Black Hispanic Other Weighted % Percent of adults with Fair/Poor General Health by Income in Georgia, 2009 50 40.54 40 30 27.05 20.09 20 9.94 11.44 10 4.45 0 <$15$01050000-$24$92959000-$34$93959000-$49$95909000-$74999 >$75000 Weighted % 44 Percent of adults with Fair/Poor General 50 Health by Age in Georgia, 2009 40 30.73 30 24.14 20 13.87 9.86 9.61 9.78 10 0 18-24 25-34 35-44 45-54 55-64 >65 Weighted% Percent of adults with Fair/Poor General Health by Education in Georgia, 2009 50 39.5 40 30 18.93 20 13.21 10 0 < Highschool Some Hi ghs chool Col l ege 6.33 Col l ege Graduate Weighted% Percent of adults with Fair/Poor General Health by Health Coverage in Georgia, 2009 25 22.14 20 15 10.39 10 5 0 Health Care Coverage "Yes" Health Care Coverage "No" Fair/Poor General Health, Georgia 2009 Health Districts Percent <10.0 10.0-<15.0 15.0-<20.0 >=20.0 2009 Georgia Behavioral Risk Factor Surveillance System Report 45 Mental health is a state of successful mental functioning, resulting in productive activities, fulfilling relationships, and the ability to adapt to change and cope with adversity. Mental health is indispensable to personal well-being, family and interpersonal relationships, and one's contribution to society. Approximately 20 percent of the U.S. population is affected by mental illness during a given year. Adults with Frequent Mental Distress (Mentally Unhealthy more than 14 days) Georgia 2009: 8.6% In 2009, approximately 620,000 adult Georgians had frequent mental distress. Mental distress was more common among women than men. Mental distress was more common among Black adults than among White adults. Mental distress was more common among adults aged 45-64 years than among adults of other age groups. Mental distress was 5 times more common among adults whose annual household income was less than $15,000 than among adults in households that earned $75,000 or more a year. Mental distress was significantly more common in adults with no healthcare coverage than adults who had healthcare coverage. Weighted % Frequent Mental Distress Percent of adults withFrequent Mental Distress by Sex in Georgia, 2009 25 20 15 10 6.72 5 10.51 0 Ma l e Fema l e Percent of adults with Frequent Mental Distress by Race/Ethnicity in Georgia, 2009 25 20 Weighted% 15 10.06 9.72 9.47 10 7.88 5 0 Whi te Black Hispanic Other Weighted% Percent of adults with Frequent Mental Distress by Income in Georgia, 2009 25 20.73 20 14.06 15 9.76 10 7.66 6.68 4.27 5 0 <$150$0105000-$249$9295000-$349$9395000-$499$9590000-$74999 >$75000 Weighted % Weighted% 46 Percent of adults with Frequent Medical Distress by Age in Georgia, 2009 25 20 15 10.87 10.06 10 7.79 8.83 7.28 6.67 5 0 18-24 25-34 35-44 45-54 55-64 >65 Percent of adults with Frequent Mental Distress by Education in Georgia, 2009 25 20 15 12.12 10 11.75 10.13 4.2 5 0 < Hi ghs chool Hi ghs chool Some Col l ege Col l ege Graduate Weighted% Percent of adults with Frequent Mental 20 Distress by Healthcare coverage in Georgia, 2009 16.42 15 10 6.99 5 0 Health Care Coverage "Yes" Health Care Coverage "No" Adults with Frequent Mental Distress (Mentally Unhealthy more than 14 days) Georgia 2009 Health Districts Percent <9.0 9.0-<11.0 11.0-<13.0 13.0-<15.0 >=15.0 2009 Georgia Behavioral Risk Factor Surveillance System Report 47 Healthy People 2010 Table 48 Year 2010 HealthPrOogrbessjteowcartdisvHeealsthy fPoeoprle 2t0h10eObjNectaivets,ion: Summary of BRFSS Data,GeGorgeia,o20r0g2-2i0a07, 2002-2007 Healthy People 2010 1 Objectives 2 Health Outcomes Georgia 2002 Georgia Georgia Georgia Georgia Georgia 2003 2004 2005 2006 2007 Year 2010 Target Obese, BMI 30 (Objective # 19.2) Ages 20 years Diabetes, Clinically Diagnosed (Objective #5.3) Ages >18 years 24% 26% 25% 27% 28% 29% 15% 7% 8% 7% 8% 9% 10% 2.5% Limitation in Activities Due to Arthritis (Objective #2.2) Adults with Doctor-diagnosed Arthritis, Ages >18 yrs (definition for arthritis surveillance before change in 2002) Health-related Behaviors 41% 41% 43% 33% (< 21%) No Leisure Time Physical Activity (Objective # 22.1) Ages >18 years 26% 25% 26% 27% 25% 25% 20% Regular Moderate Physical Activity, 42% 42% 48% 50% 5 or more days/week for 30 or more (> 30%) minutes or Vigorous Physical Activity, 3 or more days per week for 20 minutes or more per day (Objective # 22.2) Ages 18 years Regular, Vigorous Physical Activity, 3 25% 24% 28% 30% or more days per week for 20 or more minutes (Objective #22.3) Ages >18 years Cigarette Smoking (Objective # 23% 23% 20% 22% 20% 19% 12% 27.1a) Ages 18 years Binge Drinking, During Past Month 13% 13% 12% 12% 12% 13% 6% (Objective # 26.11c) Ages 18 years 1 Healthy People 2010 is designed to achieve two overarching goals: 1. Increase quality and years of healthy life, 2. Eliminate health disparities. U.S. Department of Health and Human Services, Healthy People 2010. 2nd edition, Washington DC: U.S. Government Printing Office, November 2000. 2 In some cases, BRFSS definitions of objectives differ slightly from those in Healthy People 2010. See Healthy People 2010 for the exact definition of the objective. Data were not collected in that year. ( ) Original target prior to 2005 Midcourse Review Met Year 2010 target. Healthy People 2010 Objectives (cont'd) Georgia 2002 Georgia Georgia Georgia Georgia Georgia 2003 2004 2005 2006 2007 Year 2010 Target Screening/Vaccinations Pap Smear, Ever Had (Objective 96% 97% 95% 95% 94% 95% 97% #3.11a) Women without a hysterectomy, Ages >18 years Pap Smear, Within Past Three Years (Objective #3.11b) Women without a hysterectomy, Ages >18 years Mammogram, Within Past Two Years (Objective #3.13) Women, Ages >40 years 87% 88% 76% 76% 85% 75% 87% 75% 87% 79% 86% 76% 90% 70% Fecal Occult Blood Test (FOBT) 30% Within Past Two Years (Objective #3.12a) Ages >50 years Sigmoidoscopy, Ever Had (Objective #3.12b) Ages >50 years Cholesterol Screening, Within Past Five Years (Objective #12.15) Ages >18 years 26% 27% 27% 33% (> 50%) 54% 62% 57% 50% 75% 74% 80% 80% Influenza Vaccination, Within Past Year (Objective # 14.29a) Ages 65 years 59% 67% 64% 61% 65% 68% 90% Pneumococcal Vaccination, Ever 57% 61% 59% 63% 63% 64% 90% Had (Objective # 14.29b) Ages 65 years Access to Health Care Health Insurance (Objective # 84% 84% 83% 83% 84% 83% 100% 1.1) Ages 18 years Specific Source of Ongoing 77% 77% 79% 79% 80% 79% 96% Primary Care (Objective #1.4c) Ages 18 years 1 Healthy People 2010 is designed to achieve two overarching goals: 1. Increase quality and years of healthy life, 2. Eliminate health disparities. U.S. Department of Health and Human Services, Healthy People 2010. 2nd edition, Washington DC:U.S. Government Printing Office, November 2000. 2 In some cases, BRFSS definitions of objectives differ slightly from those in Healthy People 2010. See Healthy People 2010 for the exact definition of the objective. Data were not collected in that year. ( ) Original target prior to 2005 Midcourse Review Met Year 2010 target. Georgia Department of Human Resources, Division of Public Health Publication No. 2009 Georgia Behavioral Risk Factor Surveillance System Report 49 Data Tables 50 Total Sex Male Female Race/Ethnicity WhiteNH BlackNH Hispanic Other Age 18-24 (18-34 Diabetes) 25-34 35-44 (40-44 Mammogram/PSA) 45-54 (50-54 Sigmoidoscopy/Colonoscopy) 55-64 yr (45-64 Mammogram/PSA) 65+ yr Income Less than $15,000 $15,000-$24,999 $25,000-$34,999 $35,000-$49,999 $50,000-$74,999 $75,000 or more Level of Education Less than High School High School Graduate/GED Some College College Graduate Health Insurance Health Insurance No Health Insurance Obesity (BMI 30) N=7,344 n % 95% CI 2,118 28.7 27.2-30.2 n 1,072 Diabetes N=7,700 % 95% CI 10.1 9.3-11.0 Asthma N=7,638 Coronary Heart Disease N=7,610 Heart Attack N=7,658 n% 95% CI n % 95% CI n % 95% CI 675 7.6 6.9-8.4 507 4.1 3.6-4.6 476 4.3 3.8-4.9 762 28.7 26.3-31.2 404 9.8 1,356 28.7 27.0-30.5 668 10.4 8.6-11.3 9.4-11.5 141 4.4 534 10.7 3.5-5.4 215 4.6 9.6-11.9 292 3.5 3.9-5.6 243 5.7 3.0-4.0 233 3.1 4.8-6.7 2.6-3.6 1,443 26.0 24.5-27.5 749 9.3 8.5-10.1 515 35.5 32.0-39.2 239 12.5 10.5-14.9 42 23.3 15.6-33.2 23 8.2 4.8-13.8 87 28.6 21.9-36.5 37 9.0 5.8-13.7 40 12.9 8.6-18.9 34 3.5 2.2-5.4 220 27.3 23.4-31.6 380 32.2 28.9-35.7 62 5.1 3.8-6.9 486 32.4 29.5-35.5 188 11.4 9.6-13.5 501 33.7 30.8-36.7 305 19.1 16.8-21.6 482 23.4 21.2-25.7 476 23.8 21.6-26.2 490 8.2 129 6.9 9 3.2 33 7.7 . 18 5.7 74 8.0 110 7.3 150 8.2 152 8.2 166 7.5 7.3-9.2 413 4.8 5.5-8.6 61 2.8 1.4-7.2 6 1.8 5.1-11.4 17 4.0 4.2-5.4 381 4.8 1.9-4.0 51 3.0 0.7-4.7 13 3.7 2.0-7.8 18 5.6 4.2-5.4 2.1-4.3 1.9-7.1 3.1-9.7 3.3-9.5 6.2-10.3 5.9-9.1 6.8-9.9 6.7-9.9 6.2-8.9 3 0.6 2 0.6 17 1.3 61 3.8 135 7.8 286 13.8 0.2-1.8 0.1-2.6 0.7-2.4 2.8-5.0 6.3-9.6 12.1-15.8 2 0.8 7 1.0 18 1.5 58 4.2 113 7.6 276 14.3 0.2-4.0 0.5-2.2 0.8-2.8 3.1-5.6 5.9-9.8 12.5-16.4 283 41.3 36.0-46.8 180 18.8 15.4-22.7 334 35.6 31.2-40.1 202 17.1 14.1-20.6 239 33.8 28.7-39.4 124 13.2 10.0-17.4 291 29.1 25.1-33.4 132 7.1 5.7-8.8 300 29.0 25.3-32.9 111 8.3 6.5-10.6 426 23.4 20.8-26.1 142 5.5 4.5-6.7 128 15.6 116 10.6 56 7.0 67 5.0 83 5.9 130 6.7 12.2-19.7 102 9.1 8.4-13.3 87 6.6 4.9-10.0 60 4.5 3.7-6.7 60 3.0 4.4-7.7 43 2.7 5.4-8.2 78 2.7 6.9-11.9 4.7-9.2 3.1-6.4 2.2-4.1 1.8-3.9 2.0-3.5 104 12.0 94 8.8 49 3.7 60 3.3 39 2.9 43 1.7 9.0-15.8 6.6-11.5 2.5-5.3 2.4-4.4 1.9-4.4 1.2-2.6 290 35.0 30.1-40.2 220 19.7 16.5-23.4 659 32.2 29.2-35.2 383 12.7 11.0-14.6 557 30.7 27.7-33.9 230 8.8 7.3-10.6 610 23.3 21.1-25.7 238 6.8 5.7-8.0 110 12.7 191 7.0 176 7.8 197 6.6 9.7-16.6 106 8.7 5.9-8.4 151 4.3 6.5-9.5 132 3.8 5.5-7.8 117 2.9 6.5-11.7 3.4-5.4 3.0-4.7 2.3-3.7 120 11.7 152 4.8 107 3.5 96 2.6 9.1-14.8 3.8-6.1 2.7-4.5 2.0-3.5 1,335 29.0 27.2-30.9 490 8.1 289 32.2 27.9-36.9 96 8.1 7.2-9.1 6.0-10.9 402 7.4 98 8.4 6.5-8.4 184 2.6 6.5-10.7 34 2.4 2.1-3.2 158 2.7 1.5-3.8 40 3.4 2.2-3.4 2.3-5.0 N=Number of respondents NA=Estimates are considered unreliable and thus are not available because the 95% CI exceeds the recommended width. Data Tables Total Sex Male Female Race/Ethnicity WhiteNH BlackNH Hispanic Other Age 18-24 (18-34 Diabetes) 25-34 35-44 (40-44 Mammogram/PSA) 45-54 (50-54 Sigmoidoscopy/Colonoscopy) 55-64 yr (45-64 Mammogram/PSA) 65+ yr Income Less than $15,000 $15,000-$24,999 $25,000-$34,999 $35,000-$49,999 $50,000-$74,999 $75,000 or more Level of Education Less than High School High School Graduate/GED Some College College Graduate Health Insurance Health Insurance No Health Insurance Stroke N=7,687 Disability N=7,585 High Blood Pressure N=7,692 High Cholesterol N=6,712 Cigarette Smoking N=7,674 Physical Inactivity N=7,694 n % 95% CI n% 95% CI n % 95% CI n% 95% CI n% 95% CI n% 95% CI 349 3.3 2.8-3.8 2,096 21.8 20.5-23.1 3,095 30.4 29.0-31.8 3,024 37.4 35.8-39.0 1,366 19.4 18.1-20.7 2,168 24.7 23.3-26.2 120 3.3 229 3.3 . 242 2.7 69 4.5 9 3.3 17 2.7 2.5-4.3 697 20.9 2.7-3.9 1,399 22.7 18.8-23.1 1,096 30.2 21.2-24.2 1,999 30.5 27.9-32.6 1,103 38.6 28.9-32.2 1,921 36.3 35.9-41.3 34.5-38.2 527 21.2 839 17.6 19.1-23.6 670 22.0 16.1-19.1 1,498 27.3 19.8-24.4 25.7-29.1 2.3-3.2 1,584 22.2 3.2-6.4 357 21.9 1.5-7.3 38 19.2 1.5-4.6 75 18.2 20.8-23.6 2,268 29.7 19.1-25.0 638 34.9 12.0-29.2 48 17.7 13.3-24.5 86 26.2 28.3-31.2 31.6-38.4 12.2-25.1 19.9-33.7 2,370 474 53 77 40.4 32.9 NA 30.4 38.7-42.1 1,008 19.1 29.4-36.7 249 19.6 NA 28 15.0 22.9-39.1 60 22.9 17.7-20.5 16.7-22.8 9.2-23.5 16.7-30.6 1,513 22.1 484 31.5 51 18.9 75 24.5 20.7-23.5 28.1-35.1 13.0-26.6 18.3-32.0 4 1.9 0.5-6.6 28 9.1 5.8-14.0 16 6.0 3.2-11.0 15 12.2 6.4-22.0 65 23.4 17.4-30.6 43 16.7 11.6-23.5 8 1.2 0.4-3.5 100 14.2 10.9-18.2 100 13.2 10.3-16.7 113 21.3 17.3-25.9 165 22.0 18.4-26.0 161 20.7 16.9-25.0 19 1.5 0.8-2.7 208 15.4 13.0-18.0 240 19.8 17.1-22.8 269 24.7 21.5-28.1 237 18.8 16.2-21.8 280 21.4 18.7-24.4 47 3.2 2.3-4.6 406 26.4 23.7-29.4 550 34.7 31.7-37.7 628 44.5 41.2-47.8 367 23.3 20.7-26.1 410 26.2 23.5-29.1 79 5.5 4.2-7.2 535 31.6 28.9-34.5 842 53.5 50.4-56.5 829 56.0 52.9-59.1 308 18.0 15.8-20.5 494 28.6 26.0-31.4 189 8.6 7.3-10.2 803 38.0 35.5-40.7 1,317 62.5 59.9-65.1 1,148 57.6 54.8-60.3 206 9.9 8.3-11.7 758 35.2 32.7-37.8 90 10.1 79 6.6 36 3.6 42 2.7 24 1.4 24 1.1 7.6-13.4 4.8-9.1 1.8-7.0 1.9-3.8 0.8-2.3 0.6-1.8 433 50.0 406 35.2 207 19.9 243 20.7 191 14.1 273 12.5 44.6-55.5 31.1-39.5 16.3-24.1 17.4-24.5 11.5-17.2 10.6-14.6 446 48.8 527 42.1 337 32.2 418 28.7 360 26.5 535 22.4 43.5-54.2 37.7-46.6 27.4-37.3 25.2-32.5 23.3-30.0 20.2-24.9 364 51.0 435 43.4 299 39.5 426 39.8 402 35.0 648 32.0 44.9-57.1 38.8-48.2 33.6-45.8 35.2-44.6 31.2-39.0 29.3-34.9 219 32.2 274 30.3 159 25.5 202 22.5 163 16.6 185 10.2 27.4-37.4 26.2-34.7 20.8-31.0 18.7-26.9 13.7-19.9 8.4-12.4 405 51.5 437 39.1 226 29.3 261 21.1 229 20.6 250 12.7 46.1-56.9 34.9-43.6 24.3-34.9 17.9-24.6 17.2-24.5 10.6-15.0 91 8.0 6.0-10.5 400 40.7 35.7-46.0 513 46.2 41.2-51.2 412 47.6 42.1-53.3 243 35.1 30.3-40.3 459 44.8 39.8-49.9 115 4.0 3.0-5.3 639 22.8 20.4-25.3 1,004 34.5 31.7-37.3 891 39.7 36.5-42.9 491 25.0 22.4-27.9 765 31.9 29.0-34.9 81 3.1 2.1-4.4 538 23.3 20.8-26.1 755 29.4 26.7-32.2 744 37.4 34.1-40.7 382 23.3 20.4-26.5 522 24.8 22.1-27.8 61 1.6 1.2-2.3 513 15.0 13.2-16.9 814 24.0 21.9-26.2 969 34.1 31.7-36.7 244 8.3 7.0-9.9 413 14.2 12.4-16.3 126 2.2 31 3.4 1.7-2.8 1,033 18.8 2.0-5.8 239 21.3 17.3-20.4 1,465 25.7 17.9-25.2 279 23.9 24.1-27.4 1,628 34.5 20.3-27.9 222 29.3 32.6-36.4 24.4-34.7 808 17.1 330 36.0 15.6-18.7 1,061 20.0 31.5-40.7 319 34.7 18.5-21.6 30.3-39.5 N=Number of respondents NA=Estimates are considered unreliable and thus are not available because the 95% CI exceeds the recommended width. 2009 Georgia Behavioral Risk Factor Surveillance System Report 51 Data Tables 52 Total Sex Male Female Race/Ethnicity WhiteNH BlackNH Hispanic Other Age 18-24 (18-34 Diabetes) 25-34 35-44 (40-44 Mammogram/PSA) 45-54 (50-54 Sigmoidoscopy/Colonoscopy) 55-64 yr (45-64 Mammogram/PSA) 65+ yr Income Less than $15,000 $15,000-$24,999 $25,000-$34,999 $35,000-$49,999 $50,000-$74,999 $75,000 or more Level of Education Less than High School High School Graduate/GED Some College College Graduate Health Insurance Health Insurance No Health Insurance Less than 5 Fruits & Vegetables N=7,545 n % 95% CI 5,629 75.0 73.4-76.4 Binge Drinking N=7,514 n% 95% CI 665 12.5 11.3-13.8 No Health Insurance N=5,493 n % 95% CI 905 19.5 17.9-21.2 Mammorgaphy N=3,608 n% 95% CI 2,822 76.0 74.0-77.9 n 2,491 Pap Test N=2,897 % 95% CI 86.0 84.1-87.8 HIV/AIDS Testing N=5,181 n % 95% CI 2,175 48.5 46.6-50.5 2,083 78.9 76.4-81.2 385 18.2 16.0-20.5 315 21.0 18.3-23.9 760 47.3 44.2-50.5 3,546 71.2 69.4-72.9 280 7.1 6.1-8.2 590 18.0 16.3-19.8 2,822 76.0 74.0-77.9 2,491 86.0 84.1-87.8 1,415 49.7 47.5-51.9 4,213 1,024 130 185 175 616 914 1,144 1,217 1,514 75.2 74.8 NA 71.0 71.9 76.5 74.8 75.2 76.6 72.9 73.7-76.7 71.2-78.1 NA 63.2-77.7 522 13.8 95 9.3 22 NA 21 10.1 64.0-78.6 72.2-80.3 71.5-77.9 72.3-77.8 73.9-79.0 70.4-75.3 46 18.6 135 18.2 180 16.1 150 9.6 103 6.7 46 3.3 12.4-15.2 7.1-12.0 NA 5.7-17.3 12.9-25.9 14.9-21.9 13.5-19.1 7.9-11.5 5.3-8.4 2.0-5.3 527 14.1 275 28.2 40 NA 54 19.8 . 81 35.6 183 26.8 197 16.6 237 14.3 207 12.2 12.6-15.7 24.4-32.2 NA 13.9-27.4 28.1-43.8 22.6-31.5 14.0-19.6 12.4-16.6 10.4-14.3 2,188 471 41 88 75.7 76.4 NA NA . 269 66.6 1,511 78.8 1,042 79.0 73.6-77.7 1,829 87.4 71.6-80.7 498 85.3 NA 51 NA NA 85 NA 85.5-89.1 80.5-89.1 NA NA 1,367 614 58 113 41.1 62.3 NA 53.0 39.0-43.1 58.2-66.3 NA 43.8-62.1 61.0-71.7 76.4-81.1 75.6-82.1 98 NA 405 91.4 565 88.6 543 85.6 435 88.9 422 76.3 NA 87.4-94.1 85.2-91.3 81.5-88.9 84.9-92.0 71.7-80.3 97 36.1 28.7-44.3 495 64.9 60.5-69.1 670 58.4 54.8-61.9 552 38.8 35.6-42.1 361 24.0 21.4-26.7 609 80.6 75.4-84.8 46 9.6 6.7-13.7 182 44.5 37.9-51.3 799 77.5 73.4-81.2 63 9.6 6.8-13.3 260 44.3 39.0-49.7 593 77.1 71.8-81.6 65 11.4 8.2-15.7 122 31.2 25.2-37.8 776 75.0 70.5-79.0 99 11.5 8.7-15.0 100 16.7 12.7-21.5 787 75.9 72.2-79.1 91 13.0 10.0-16.7 71 11.2 7.8-15.9 1,282 70.1 67.1-73.0 258 17.3 14.8-20.0 55 5.0 3.5-7.2 328 71.4 391 68.3 272 69.9 386 80.1 364 79.4 615 81.3 65.2-76.9 61.7-74.3 62.7-76.3 75.1-84.2 74.0-83.9 77.4-84.7 194 75.6 287 75.2 253 88.3 366 89.6 382 88.3 682 91.7 67.1-82.5 67.9-81.4 82.8-92.2 84.5-93.2 83.2-92.0 87.9-94.3 206 53.7 46.9-60.4 280 51.6 46.0-57.1 211 51.5 44.5-58.4 298 49.6 44.1-55.1 366 48.7 44.1-53.4 661 47.4 44.1-50.7 713 83.8 79.6-87.3 51 12.5 1,717 80.7 78.0-83.1 150 10.5 1,401 73.8 70.7-76.7 188 13.2 1,779 69.2 66.6-71.7 276 13.6 8.8-17.6 8.3-13.2 11.0-15.7 11.7-15.7 157 41.3 339 27.0 225 20.3 181 9.3 34.6-48.2 23.6-30.7 17.0-23.9 7.5-11.5 311 65.9 883 74.8 747 76.5 874 79.9 58.8-72.4 168 71.7 71.1-78.3 628 78.5 72.8-79.9 665 88.2 76.6-82.9 1,022 91.7 63.1-78.9 73.6-82.7 85.0-90.8 89.0-93.9 141 41.7 34.8-49.0 509 43.5 39.6-47.5 623 52.8 49.0-56.6 897 50.1 47.1-53.1 3,351 75.1 73.2-76.8 487 13.0 11.6-14.6 700 76.2 71.3-80.5 126 17.9 14.3-22.1 1,586 78.5 189 53.7 76.0-80.9 1,762 90.8 88.8-92.5 1,780 47.7 45.6-49.8 47.0-60.4 280 70.8 64.0-76.8 390 52.2 47.1-57.2 N=Number of respondents NA=Estimates are considered unreliable and thus are not available because the 95% CI exceeds the recommended width. Data Tables Total Sex Male Female Race/Ethnicity WhiteNH BlackNH Hispanic Other Age 18-24 (18-34 Diabetes) 25-34 35-44 (40-44 Mammogram/PSA) 45-54 (50-54 Sigmoidoscopy/Colonoscopy) 55-64 yr (45-64 Mammogram/PSA) 65+ yr Income Less than $15,000 $15,000-$24,999 $25,000-$34,999 $35,000-$49,999 $50,000-$74,999 $75,000 or more Level of Education Less than High School High School Graduate/GED Some College College Graduate Influenza Vaccination N=2,114 n % 95% CI 1,456 67.6 64.9-70.1 Pneumonia Vaccination N=2,046 n% 95% CI 1,331 63.6 60.9-66.3 490 67.7 63.4-71.7 427 61.7 57.2-66.0 966 67.5 64.0-70.7 904 64.9 61.4-68.3 1,249 137 16 22 72.5 51.2 NA NA 69.9-74.8 1,151 43.8-58.5 118 NA 14 NA 20 68.8 45.7 NA NA 66.2-71.3 38.4-53.2 NA NA 1,456 67.6 64.9-70.1 1,331 63.6 60.9-66.3 188 64.4 57.3-70.9 180 58.4 50.3-65.9 241 58.5 50.9-65.6 229 59.5 51.8-66.7 184 68.8 61.6-75.2 164 65.1 57.6-71.9 183 65.8 58.3-72.7 171 60.5 52.8-67.8 147 73.8 65.8-80.5 121 63.1 54.6-70.8 175 78.8 72.3-84.0 147 67.6 60.2-74.2 265 60.5 53.3-67.2 243 57.0 49.8-63.9 447 63.2 58.4-67.7 405 61.6 56.8-66.3 351 70.1 65.0-74.7 323 66.7 61.5-71.5 387 75.8 71.3-79.8 356 68.4 63.3-73.1 N=Number of respondents NA=Estimates are considered unreliable and thus are not available because the 95% CI exceeds the recommended width. 2009 Georgia Behavioral Risk Factor Surveillance System Report 53 Methods 54 Georgia has been conducting the Behavioral Risk Factor Surveillance System (BRFSS) in cooperation with the Centers for Disease Control and Prevention (CDC) since 1984. In 2007, approximately 642 Georgia non-institutional residents age 18 and older were interviewed each month by telephone about health conditions, behaviors, and the use of preventive services. The total sample size was 7,703. The average monthly cooperation rate for 2007 was 73%. The cooperation rate is the proportion of all respondents interviewed of all eligible units in which a respondent was selected and actually contacted. Non-contacts are excluded from the denominator. The 2007 BRFSS used a Disproportionate Stratified Sample (DSS) design. Telephone numbers were classified into two strata based on the presumed density of residential telephone numbers. Telephone numbers in the high-density strata were sampled at a higher rate than numbers in the low-density strata. The sample was further stratified to yield approximately equal numbers of respondents in each of the 18 health districts in Georgia (see page 1). The 2007 BRFSS questionnaire covered a range of topics on health behaviors and conditions. This report contains selected chronic conditions such as obesity, diabetes, asthma, coronary heart disease, heart attack, stroke and disability, high blood pressure, and high cholesterol. The risk behaviors included are cigarette smoking, physical inactivity, consuming less than five servings of fruits and vegetables daily, binge drinking, and having no health insurance. Preventive practices included on the survey are mammography, pap test, HIV/AIDS testing and influenza and pneumonia vaccination. Participation in the survey was random, anonymous, and confidential. Respondents were randomly selected from among the adult members of residential households in Georgia. Trained interviewers administered the questionnaire, and data were entered during the interview via computer using CATI (Computer Assisted Telephone Interviewing) software. Households without telephones and households that use cellular telephones only are not represented in the sampling frame. At the end of the year, data from the monthly surveys were compiled and weighted to represent the age-, race/ethnicity-, and sex-distribution of the adult population in Georgia and to compensate for an individual's probability of selection. Weighting also adjusts for non-response to the extent that non-responders are similar to responders. Estimates for the health districts were weighted to the age-, race-, and sex-specific population of the district. Analysis for this report was performed using statistical software that accounts for the complex survey sample design, and 95% confidence intervals were calculated for all estimates. Significant differences among demographic groups were identified by comparing confidence interval overlap. In addition to the 2007 state-wide estimates for Georgia, this report also contains district estimates. BRFSS data from 2000 to 2003 and 2004 to 2007 were aggregated to increase the sample size and reduce the statistical variability of demographic estimates. This approach facilitates review of BRFSS data over time. Sample & Population Demographic Distribution Table, 2007 Georgia BRFSS Total Sex Male Female Race/Ethnicity White Black Hispanic Other Age 18-24 25-34 35-44 45-54 55-64 65+ Level of Education < HS HS Grad/GED Some College College Grad Income <$15,000 $15,000-$24,999 $25,000-$34,999 $35,000-$49,999 $50,000-$74,999 $75,000+ Health Care Coverage Health Coverage No Health Coverage N Sample % 7,703 Population Weighted % 6,927,458 2,680 34.8 3,388,397 48.9 5,023 65.2 3,539,061 51.1 5,748 75.7 4,166,496 60.7 1,406 18.5 1,870,442 27.3 165 2.2 324,014 4.7 272 3.6 498,782 7.3 253 3.3 536,556 7.8 818 10.7 1,356,467 19.7 1,253 16.4 1,893,413 27.5 1,566 20.5 1,267,117 18.4 1,620 21.2 897,351 13.0 2,121 27.8 925,858 13.5 892 11.6 691,340 10.0 2,183 28.4 1,853,658 26.9 1,951 25.4 1,779,617 25.8 2,650 34.5 2,577,189 37.3 776 11.7 500,260 8.2 1,062 16 874,408 14.3 769 11.6 693,546 11.3 1,033 15.6 917,237 15.0 1,103 16.7 1,051,267 17.2 1,878 28.4 2,074,859 33.9 4,588 83.5 4,775,115 80.5 905 16.5 1,154,627 19.5 2009 Georgia Behavioral Risk Factor Surveillance System Report 55 Definitions 56 Chronic Conditions Obesity: Adults with a body mass index (BMI) equal to or greater than 30.0. BMI is measured as weight in kilograms divided by height in meters squared. Diabetes: Adults who have ever been told by a doctor that they have diabetes. Asthma: Adults who have ever been told by a doctor, nurse, or other health professional that they have asthma and still have asthma. Coronary Heart Disease: Adults who have ever been told by a doctor, nurse or other health professional that they have angina or coronary heart disease. Heart Attack: Adults who have ever been told by a doctor, nurse or other health professional that they have had a heart attack, also called a myocardial infarction. Stroke: Adults who have ever been told by a doctor, nurse or other health professional that they have had a stroke. Disability: Adults who have activity limitation because of physical, mental, or emotional problems or who require the use of special equipment, such as a cane, wheelchair, special bed, or special telephone. High Blood Pressure: Adults who have ever had their blood pressure tested and told by a doctor, nurse or other health professional that they have high blood pressure. High Cholesterol: Adults who have ever had their cholesterol level tested and told by a doctor, nurse or other health professional that they have high cholesterol. Risk Behaviors Cigarette Smoking: Adults who have smoked at least 100 cigarettes in their lifetime and who are current smokers. Physical Inactivity: Adults who did not participate in any physical activities or exercise during leisure time in the past 30 days. Consuming Less Than Five Servings of Fruits and Vegetables Daily: Adults who consume less than five servings of fruit and vegetables daily. Binge Drinking: Men who consume five or more drinks on an occasion and women who consume four or more drinks on an occasion. Preventive Practices Mammography: Adult women, age 40 and older, who had a mammogram within the past two years. Pap Test: Adult women, who have not had a hysterectomy, who had a Pap smear within the past three years. HIV/AIDS Testing: Adults, age 18-64, who have ever been tested for HIV. Influenza Vaccination: Adults, age 65 and older, who have had a flu shot within the past 12 months. Pneumonia Vaccination: Adults, age 65 and older, who have ever had a pneumonia vaccination. Demographics Race/Ethnicity: Race/ethnicity is based on responses to questions about race and Hispanic origin. Hispanics may be of any race; White, Black and Other exclude persons who reported they were Hispanic. Other includes multiracial and all race categories other than Black or White or Hispanic ethnicity. Income: Self-reported annual household income from all sources. Education: Highest grade or year of school completed. No Health Insurance: Adults who have no health insurance. 2009 Georgia Behavioral Risk Factor Surveillance System Report 57 Preventive Practices Pap Test: Adult women, who have not had a hysterectomy, who had a Pap smear within the past three years. Colorectal Cancer Screenings (Sigmoidoscopy/Colonoscopy): Adults aged 50+ who have had a sigmoidoscopy or colonoscopy. Cholesterol Screening: Adults who have ever had blood cholesterol checked within the past five years. HIV/AIDS Testing: Adults, age 18-64, who have ever been tested for HIV. Influenza Vaccination: Adults, age 65 and older, who have had a flu shot within the past 12 months. Pneumonia Vaccination: Adults, age 65 and older, who have ever had a pneumonia vaccination. Disability: Adults who have activity limitation because of physical, mental, or emotional problems or who require the use of special equipment, such as a cane, wheelchair, special bed, or special telephone. Demographics Race/Ethnicity: Race/ethnicity is based on responses to questions about race and Hispanic origin. Hispanics may be of any race; white, black and other exclude persons who reported they were Hispanic. Other includes multiracial and all race categories other than black or white or Hispanic ethnicity. Income: Self-reported annual household income from all sources. Health Insurance: Adults who have no health insurance. Education: Highest grade or year of school completed. 2009 Georgia Behavioral Risk Factor Surveillance System Report 58