1 Acknowledgements Georgia Department of Public Health Health Protection Epidemiology Program Chronic Disease, Healthy Behaviors and Injury Epidemiology Section Healthy Behavior Team Brenda Fitzgerald, MD Commissioner, State Health Officer J. Patrick O'Neal, MD Director Cherie L. Drenzek, DVM, MS State Epidemiologist Rana Bayakly, MPH Chief Epidemiologist Francis Annor, MPH The Georgia Department of Public Health is grateful for the support and contribution of: Abt SRBI Inc. Centers for Disease Control and Prevention Residents of Georgia who agreed to participate in the survey For more information about the Georgia Behavioral Risk Factor Surveillance System, please contact: BRFSS Coordinator Chronic Disease, Healthy Behaviors and Injury Epidemiology Section Epidemiology Program Division of Health Protection Georgia Department of Public Health 2 Peachtree Street, 14th Floor Atlanta, GA 30303-3142 GA-BRFSS@dhr.state.ga.us This report was made possible with funding from the Centers for Disease Control and Prevention (Grant # 5U58O000021-03). Its contents do not necessarily represent the official view of the CDC. Suggested citation: Annor FB, Bayakly RA, Vajani M. 2011 Georgia Behavioral Risk Factor Surveillance Report. Georgia Department of Public Health Epidemiology Program. Chronic Disease, Healthy Behaviors and Injury Epidemiology Section. December 2012. Publication number xxxxxxxxxx 2 Georgia Public Health Districts Dade Catoosa Fannin Whitfield Murray Towns Union Rabun Walker Chattooga Gordon UGilmer 1-2 Pickens UWhite Habersham Lumpkin 2 Stephens U1-1 Floyd Bartow Dawson Cherokee Forsyth Hall Banks Franklin Hart Jackson Madison Elbert Polk Cobb U Paulding U U 3-1 Gwinnett 3-4 Barrow Clarke 10 Oglethorpe Haralson UUU Carroll Douglas 3-2 Fulton 3-5 Walton DeKalbRockdale 3-3 Clayton Newton Oconee Morgan Greene Wilkes Taliaferro Lincoln Columbia Fayette Henry McDuffie Coweta Heard U4 Troup Meriwether Warren Spalding Butts Jasper Putnam Hancock Richmond Pike Lamar Monroe Baldwin U Jones 5-2 Glascock U6 Jefferson Washington Burke Upson Harris Talbot Bibb Wilkinson Crawford Twiggs Johnson Jenkins 1-1 Northwest (Rome) 1-2 North Georgia (Dalton) 2 North (Gainesville) 3-1 Cobb-Douglas 3-2 Fulton 3-3 Clayton (Jonesboro) 3-4 East Metro (Lawrenceville) 3-5 DeKalb 4 LaGrange 5-1 South Central (Dublin) 5-2 North Central (Macon) 6 East Central (Augusta) 7 West Central (Columbus) 8-1 South (Valdosta) 8-2 Southwest (Albany) 9-1 Coastal (Savannah) 9-2 Southeast (Waycross) 10 Northeast (Athens) Screven Muscogee Taylor Peach Emanuel U7 Chattahoochee Marion Schley Macon Houston Bleckley Laurens Pulaski U5-1 Treutlen Candler Bulloch Stewart Webster Sumter Dooly Dodge Montgomery Wheeler Toombs Evans Tattnall Quitman Wilcox Crisp Telfair Effingham Bryan Chatham Randolph Terrell Lee Turner Ben Hill Jeff Davis Appling Liberty U Long 9-1 Clay Calhoun Dougherty Worth Irwin Tift Coffee U Bacon 9-2 Wayne McIntosh Early U Baker 8-2 Miller Mitchell Colquitt UBerrien Cook 8-1 Atkinson Seminole Decatur Grady Thomas Brooks Lanier Lowndes Clinch Pierce Brantley Glynn Ware Charlton Camden Echols 3 Table of Contents Acknowledgements .................................................................................................................................... 2 Georgia Public Health Districts.................................................................................................................. 3 BRFSS Methodology ................................................................................................................................. 5 Summary of Results ................................................................................................................................... 6 Demographic Characteristics, State of Georgia ......................................................................................... 7 Health Status Indicators General Health .............................................................................................................................. 8 No Health Care Coverage ............................................................................................................. 9 Limited Health Care Access........................................................................................................ 10 No Annual Doctor's Visit ........................................................................................................... 11 Disability ..................................................................................................................................... 12 Chronic Conditions Asthma ........................................................................................................................................ 13 Diabetes....................................................................................................................................... 14 Heart Attack ................................................................................................................................ 15 Stroke .......................................................................................................................................... 16 Angina ......................................................................................................................................... 17 Obesity ........................................................................................................................................ 18 Overweight.................................................................................................................................. 19 Risk Behaviors Adequate Physical Activity......................................................................................................... 20 No Leisure-Time Physical Activity............................................................................................. 21 Seatbelt Use................................................................................................................................. 22 Smoking ...................................................................................................................................... 23 Smokeless Tobacco..................................................................................................................... 24 Binge Drinking............................................................................................................................ 25 Heavy Drinking ........................................................................................................................... 26 Clinical Preventive Practices Breast Cancer Screening ............................................................................................................. 27 Cervical Cancer Screening .......................................................................................................... 29 Prostate Cancer Screening........................................................................................................... 30 Colorectal Cancer Screening ....................................................................................................... 32 Adult Immunizations................................................................................................................... 33 Bibliography............................................................................................................................................. 34 4 BRFSS Methodology The Georgia Behavioral Risk Factor Surveillance System (BRFSS) is a primary source of information on major chronic conditions, health risk behaviors, and the use of clinical preventive services among adult Georgians. Sampling: Using list-assisted, random digit dialing, Georgia respondents were randomly selected from the non-institutionalized adult population aged 18 years and older from each household. Trained interviewers administered the questionnaire and participation was voluntary and anonymous. The sample excluded institutionalized individuals and households without telephones. Data came from both respondents who had landline telephones as well as those who use only cellular phones. Weighting: The 2011 BRFSS was the first year in which the iterative proportional fitting, or raking, methodology was used for the Georgia BRFSS. Raking is a repetitive post-stratification weighting technique used to match the marginal distributions of the survey sample to known population margins. An advantage of raked weighting technique is that it allows for adjustment of probability selection, telephone source (landline or cellular phone), race, ethnicity, education level, marital status, age by gender, gender by race/ethnicity, age by race/ethnicity, and renter/owner status. The goal is to improve sample representation by reducing respondent under-coverage and non-response biases. Data Analysis: SAS-callable SUDAAN was used for all data analysis to construct estimates and 95% confidence intervals (95% CI). Results were considered not "statistically different" if the 95% CI associated with the weighted percentages overlapped. A result is considered "statistically significant" (indicating a difference) if there were no overlap in the 95% CI of the percentages being compared. Estimates do not include those who either answered "don't know" or refused to answer the question. Comparing 2011 BRFSS data to previous years: Comparison between 2011 BRFSS data and previous years is not recommended due to the significant changes in methodology in 2011 1. Methodological changes implemented in 2011 have improved the accuracy, coverage, validity, and representativeness of the BRFSS. The magnitude of estimates may change as a result and may not reflect true trends in prevalence. Data from 2011 BRFSS should be the new baseline for comparison with future BRFSS data. 5 Summary of Results Summary Selected chronic conditions, risk behaviors, and clinical preventive services from the 2011 Georgia BRFSS are shown in the chart below in comparison with data from the 2011 National BRFSS, which includes all 50 states, three territories, and Washington, D.C. Selected Chronic Conditions and Risk Factors, US and Georgia BRFSS, 2011 Ever Told Stroke Heavy Drinking Ever Told Diabetes Ever Told Asthma Current Smoking Obesity (BMI 30) Flu Shot in Past year (65+ Years Old) No Health Care Coverage (18-64... Adequate Physical Activity 3.4 2.9 6.2 6.6 10.2 9.5 14.1 13.7 21.2 21.1 27.8 27.8 29 21.1 20.7 20.9 55.2 61 0 20 40 60 80 100 Percent (%) GA US Median Stroke: In 2011, 3.4% of Georgia adults have ever been diagnosed with stroke. This estimate is slightly higher than the US median prevalence of 2.9%. Heavy Drinking (5 drinks per occasion for men, 4 drinks per occasion for women in the previous month): In 2011, 6.2% of Georgia adults engaged in heavy drinking. This estimate is similar to the US median prevalence of 6.6%. Diabetes: In 2011, 10.2%of Georgia adults have ever been diagnosed with diabetes. This estimate is slightly higher than the US median prevalence of 9.5%. Asthma: In 2011, 14.1% of Georgia adults have ever been diagnosed with asthma. This estimate is slightly higher than the US median prevalence of 13.7%. Tobacco Use: In 2011, 21.2% of Georgia adults currently smoked cigarettes. This estimate is similar to the US median prevalence of 21.1%. Flu shot in Past Year: In 2011, 55.2% of Georgia adults aged 65 years and older received a flu shot in the past year. This estimate is lower than the US median estimate of 61%. Obesity: In 2011, 27.8% of Georgia adults were obese. This estimate is similar to the US median prevalence of 27.8%. No Health Care Coverage: In 2011, 29% of Georgia adults did not have any form of health coverage, which exceeds the US median estimate of 21.1%. Adequate Physical Activity: In 2011, 20.7% of Georgia adults met both CDC's recommendations for aerobic and muscle-strengthening physical activity. This is similar to the US median prevalence of 20.9%. 6 Demographic Characteristics Demographics In 2011, there were approximately 7,300,000 adults aged 18 years and older residing in the state of Georgia 2. Approximately 9,960 adults participated in the 2011 Georgia BRFSS survey statewide. Among Georgia adult residents, 51% were female and 48% were male. The majority of the population of Georgia was nonHispanic white (59.6%). More than half the population of Georgia in 2011 was under the age of 45 years. Approximately 24.2% of Georgia residents had an annual household income of $75,000 or more. About 83% of the population had at least a high school diploma and 25% had at least a college diploma. Distribution of Georgia Residents, by Sex, Georgia, 2011 100 80 60 48.6 51.4 40 20 0 Male Female Demographic Characteristics Sex Male Female Race/Ethnicity White Non-Hispanic Black Non-Hispanic Hispanic Age 18-24 years 25-34 years 35-44 years 45-54 years 55-64 years 65+ years Annual 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 Education Less than High School High School Graduate Some College College Graduate Georgia Total (N=9,960) % 95% CI 48.6 (47.1, 50.1) 51.4 (49.9, 53.0) 59.6 (58.0, 61.1) 28.0 (26.6, 29.5) 7.9 (6.9, 9.0) 13.5 (12.1, 15.0) 19.0 (17.6, 20.4) 19.6 (18.4, 20.8) 18.8 (17.8, 19.9) 14.4 (13.7, 15.2) 14.8 (14.1, 15.5) 14.3 (13.1, 15.5) 21.7 (20.3, 23.2) 12.9 (11.9, 14.1) 13.2 (12.1, 14.2) 13.7 (12.7, 14.8) 24.2 (23.0, 25.5) 17.1 (15.8, 18.5) 30.1 (28.7, 31.6) 28.2 (26.8, 29.6) 24.6 (23.5, 25.7) Percent (%) Percent (%) Distribution of Georgia Residents, by Race/Ethnicity, Georgia, 2011 100 80 59.6 60 40 28.0 20 0 White Non-Hispanic Black Non-Hispanic 7.9 Hispanic Percent (%) Distribution of Georgia Residents, by Annual Household Income Level, Georgia, 2011 100 80 60 40 21.7 24.2 20 14.3 12.9 13.2 13.7 0 Less than $15,000 $15,000$24,999 $25,000$34,999 $35,000$49,999 $50,000- $75,000 or $74,999 More Percent (%) Distribution of Georgia Residents by Age Group, Georgia, 2011 100 80 60 40 20 13.5 19.0 19.6 18.8 14.4 14.8 0 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 65+ yr Percent (%) Distribtion of Georgia Residents by Level of Education, Georgia, 2011 100 80 60 40 30.1 28.2 24.6 17.1 20 0 Less than High School High School Graduate Some College College Graduate 7 Health Status Indicators General Health Self-assessed health status is a measure of how individuals perceive their health rating (excellent, very good, good, fair, or poor) and is a useful indicator which allows for general comparisons between varieties of health conditions. Poor perceived health may be linked to various adverse psychosocial states such as social isolation, negative life events, depression and job stress 3. In 2011, 18.9% of Georgia adults reported that they perceive their health rating as fair or poor. Adults aged 65 years and older (33%) were significantly more likely to report fair or poor general health compared to adults in other age groups. Adults with an annual household income less than $15,000 (40.2%) were significantly more likely to report fair or poor general health than adults with an annual household income more than $15,000. Adults without health care coverage (24.2%) were significantly more likely to report fair or poor general health than adults with health care coverage (13.3%). Percent (%) Percent of Adults who Reported Fair/Poor General Health, by Age Group, Georgia, 2011 50 40 33 30 27.1 22.1 20 12.6 13 10 7.4 0 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 65+ yr Percent (%) Percent of Adults who Reported Fair/Poor General Health, by Annual Household Income, Georgia, 2011 50 40.2 40 28.2 30 19.4 20 13.8 8.2 10 5.2 0 Less than $15,0$0105,000- $24,9$9295,000- $34,9$9395,000- $49,9$9590,000- $74,9$9795,000 or More Percent (%) Percent of Adults who Reported Fair/Poor General Health, by Health Care Coverage, Georgia, 2011 50 40 30 24.2 20 13.3 10 0 Has Health Coverage No Health Coverage Perceived Fair/Poor General Health a Demographic Characteristics % 95% CI State Totals 18.9 (17.8, 20.1) Sex Male 18.7 (16.9, 20.6) Female 19.1 (17.8, 20.5) Race/Ethnicity White Non-Hispanic 17.5 (16.2, 18.8) Black Non-Hispanic 20.4 (18.1, 22.9) Hispanic 24 (18.5, 30.5) Age 18-24 years 7.4 (4.7, 11.3) 25-34 years 12.6 (9.7, 16.2) 35-44 years 13 (10.6, 15.8) 45-54 years 22.1 (19.7, 24.7) 55-64 years 27.1 (24.8, 29.6) 65+ years 33 (30.8, 35.2) Annual Income Less than $15,000 40.2 (35.7, 44.8) $15,000-$24,999 28.2 (25.1, 31.5) $25,000-$34,999 19.4 (16.0, 23.3) $35,000-$49,999 13.8 (11.3, 16.7) $50,000-$74,999 8.2 (6.5, 10.3) $75,000 or More 5.2 (4.1, 6.5) Education Less than High School 39.8 (35.7, 44.1) High School Graduate 22 (19.8, 24.2) Some College 14.6 (12.9, 16.5) College Graduate 5.8 (4.9, 6.7) Health Care Coverage Has Health Coverage 13.3 (12.1, 14.6) No Health Coverage 24.2 (21.1, 27.6) a The proportion of adults who reported that their health, in general, was fair or poor. Percent of Adults who Reported Fair/Poor General Health, by Health District, Georgia, 2011 2 1-2 1-1 3-4 3-1 10 3-2 3-5 3-3 4 5-2 Percent Poor/Fair General Health <15% 15-<20% 20-<25% >=25% 6 7 5-1 9-1 9-2 8-2 8-1 8 Health Status Indicators No Health Care Coverage Individuals without health care coverage have decreased access to health care services and usually delay getting needed medical attention. Insurance coverage is an important factor in determining whether people will have access to services like screenings, treatment, and health education 4. Access to health care can be limited by both lack of health insurance and by insufficient coverage. In 2011, 29% of Georgia adults aged 18-64 years reported that they did not have health care coverage. Hispanics (60%) were significantly more likely not to have health care coverage than non-Hispanic whites (22.1%) and non-Hispanic blacks (34.9%). Adults aged 18-24 years (41.7%) were more likely not to have health care coverage than other age groups. Adults with an annual household income less than $15,000 (53%) were less likely not to have any form of health care coverage compared to adults in other income levels. Adults with less than a high school education (61.1%) were significantly more likely not to have health coverage than high school graduates (32.7%), those with some college (25.9%), and college graduates (8.1%). Percent (%) Percent of Adults aged 18-64 years with No Health Care Coverage, by Race/Ethnicity, Georgia, 2011 100 80 60.0 60 40 34.9 22.1 20 0 White Non-Hispanic Black Non-Hispanic Hispanic No Health Care Coverage 18-64 Years Age a Demographic Characteristics % 95% CI State Totals 29 (27.3, 30.7) Sex Male 31.3 (28.6, 34.2) Female 26.6 (24.6, 28.8) Race/Ethnicity White Non-Hispanic 22.1 (20.1, 24.1) Black Non-Hispanic 34.9 (31.4, 38.6) Hispanic 60 (52.8, 66.7) Age 18-24 years 41.7 (35.7, 48.0) 25-34 years 34.9 (30.7, 39.3) 35-44 years 31.1 (27.6, 34.8) 45-54 years 21.9 (19.4, 24.6) 55-64 years 15.9 (14.0, 17.9) Annual Income Less than $15,000 53 (47.5, 58.5) $15,000-$24,999 50.2 (45.7, 54.6) $25,000-$34,999 33 (27.8, 38.6) $35,000-$49,999 17.9 (14.2, 22.3) $50,000-$74,999 9.3 (6.3, 13.4) $75,000 or More 5 (3.7, 6.7) Education Less than High School 61.1 (55.8, 66.1) High School Graduate 32.7 (29.5, 36.0) Some College 25.9 (23.0, 29.1) College Graduate 8.1 (6.6, 9.8) a The proportion of adults aged 18-64 years old who have no health care coverage, including health insurance, prepaid plans such as HMOs, or government plans such as Medicare or Indian Health Service. Percent (%) Percent of Adults aged 18-64 years with No Health Care Coverage, by Annual Household Income, Georgia, 2011 100 80 60 53 50.2 40 33 17.9 20 9.3 5 0 Less than $15,0$0105,000- $24,9$9295,000- $34,9$9395,000- $49,9$9590,000- $74,99$975,000 or More Percent of Adults aged 18-64 years with No Health Care Coverage, by Level of Education, Georgia, 2011 100 80 61.1 60 40 32.7 25.9 20 8.1 0 Less than High SchoHoilgh School Graduate Some College College Graduate Percent of Adults aged 18-64 years with No Health Care Coverage, by Health District, Georgia, 2011 2 1-2 1-1 3-4 3-1 10 3-2 3-5 3-3 4 5-2 Percent No Health Insurance <25% 25-<30% 30-<35% >=35% 6 7 5-1 9-1 9-2 8-2 8-1 9 Percent (%) Health Status Indicators Limited Health Care Access Limited health care access is defined as: (1) not having a personal doctor or health care provider; and, (2) having a time in the past year when one needed to see a doctor but could not due to cost. These indicators are very important to health care due to the fact that increase in access to primary care have been shown to significantly improve health-related outcomes. In 2011, 26.9% of Georgia adults did not have a personal doctor or a heath care provider. Hispanics (55.4%) were significantly more likely not to have a personal doctor when compared to non-Hispanics blacks (31.3%) and non-Hispanics whites (20.9%). Adults aged 18-24 yrs. (48.2%) were the most likely not to have a personal doctor. The proportion of Georgia adults with a personal doctor decreases as annual household income decreases. Adults without health care coverage (63.3%) were significantly more likely not to have a personal doctor than adults with health care coverage (17%). In 2011, 21.8% of Georgia adults could not visit a doctor due to costs within the past 12 months. Hispanics (32.1%) had the highest rates of forgoing medical care due to costs. Adults with less than a high school education (37.9%) were four times more likely to forgo medical care due to cost than college graduates (9.4%). The proportion of adults who forgo medical care due to costs increases as annual household income decreases. Adults without health care coverage (51.1%) were significantly more likely to forgo medical care due to cost than adults with health care coverage (13.7%). Percent (%) Percent (%) Percent of Adults who have Limited Health Care Access, by Race/Ethnicity, Georgia, 2011 100 No Doctor's Visit 80 No Personal Doctor 60 55.4 40 17.6 20.9 20 28 31.3 32.1 0 White Non-Hispanic Black Non-Hispanic Hispanic Percent of Adults who have Limited Health Care Access, by Age Group, Georgia, 2011 100 No Doctor's Visits 80 No Personal Doctor 60 48 40 22 20 42 29 31 25 25 19 19 14 76 0 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 65+ yr Percent of Adults who have Limited Health Care Access, by Health Care Coverage, Georgia, 2011 100 No Doctor's Visits No Personal Doctor 80 63.3 60 51.1 40 20 13.7 17 0 Has Health Coverage No Health Coverage No Personal Health Care Provider a No Health Care Due to Cost b Demographic Characteristics % 95% CI % 95% CI State Totals 26.9 (25.5, 28.5) 21.8 (20.4, 23.2) Sex Male 34.1 (31.6, 36.6) 19.4 (17.3, 21.7) Female 20.2 (18.6, 21.9) 24 (22.4, 25.8) Race/Ethnicity White Non-Hispanic 20.9 (19.3, 22.6) 17.6 (16.2, 19.2) Black Non-Hispanic 31.3 (28.1, 34.6) 28 (25.1, 31.2) Hispanic 55.4 (48.5, 62.1) 32.1 (25.9, 39.1) Age 18-24 years 48.2 (42.2, 54.4) 22.2 (17.6, 27.7) 25-34 years 41.8 (37.6, 46.1) 29.4 (25.4, 33.7) 35-44 years 31.3 (27.9, 34.9) 24.9 (21.8, 28.4) 45-54 years 18.5 (16.3, 21.1) 24.6 (22.2, 27.3) 55-64 years 13.8 (12.0, 15.9) 19.1 (17.0, 21.4) 65+ years 6.4 (5.2, 7.8) 6.7 (5.5, 8.2) Annual Income Less than $15,000 37.4 (32.6, 42.5) 45.7 (40.8, 50.5) $15,000-$24,999 37.7 (33.9, 41.7) 35.1 (31.5, 39.0) $25,000-$34,999 26.8 (22.6, 31.5) 24.4 (20.5, 28.9) $35,000-$49,999 19.2 (15.6, 23.5) 16.9 (13.8, 20.5) $50,000-$74,999 20.3 (16.7, 24.4) 8.7 (6.5, 11.6) $75,000 or More 13.6 (11.5, 15.9) 4.8 (3.6, 6.4) Education Less than High School 42 (37.5, 46.7) 37.9 (33.5, 42.4) High School Graduate 27.6 (24.9, 30.5) 23.5 (21.0, 26.1) Some College 24.9 (22.3, 27.8) 21.1 (18.7, 23.6) College Graduate 17.3 (15.2, 19.5) 9.4 (8.1, 10.9) Health Care Coverage Has Health Coverage 17 (15.5, 18.6) 13.7 (12.4, 15.1) No Health Coverage 63.3 (59.7, 66.8) 51.1 (47.3, 55.0) a The proportion of adults who reported that they did not have anyone that they thought of as their personal doctor or health care provider. b The proportion of adults who reported that they could not see a doctor when needed due to cost within the past 12 months. 10 Percent (%) Health Status Indicators No Annual Doctor's Visit An annual doctor's visit serves as a preventive measure that can reduce risk factors for common chronic diseases. By having a doctor's visit every year, certain problems can be detected earlier when treatment might be more effective. In 2011, 27.6% of Georgia adults reported that they have not visited a doctor for a routine checkup within the past 12 months. Males (32.5%) were significantly more likely than females (23.1%) not to visit a doctor in the past year. Hispanics (40%) were more likely not to visit a doctor in the past year when compared to non-Hispanic whites (28.6%) and non-Hispanic blacks (22.8%). Adults aged 65 years and older (9.8%) were significantly less likely to have not visited a doctor in the past year. Adults with an annual household income of less than $15,000 (34.9%) were the most likely to have not visited a doctor in the past year. More than half of adults without health care coverage (55.3%) did not visit a doctor in the past year. Percent (%) Percent of Adults who had No Doctor's Visit Last Year, by Race/Ethnicity, Georgia, 2011 100 80 60 40.0 40 28.6 22.8 20 0 White Non-Hispanic Black Non-Hispanic Hispanic No Doctor's Visit a Demographic Characteristics % 95% CI State Totals 27.6 (26.2, 29.1) Sex Male 32.5 (30.1, 35.0) Female 23.1 (21.5, 24.8) Race/Ethnicity White Non-Hispanic 28.6 (26.9, 30.4) Black Non-Hispanic 22.8 (20.0, 25.9) Hispanic 40 (32.9, 47.5) Age 18-24 years 38.9 (33.0, 45.1) 25-34 years 36.2 (32.1, 40.5) 35-44 years 34.3 (30.9, 37.8) 45-54 years 25.9 (23.3, 28.6) 55-64 years 18.8 (16.9, 21.0) 65+ years 9.8 (8.6, 11.2) Annual Income Less than $15,000 34.9 (30.3, 39.8) $15,000-$24,999 33.7 (30.0, 37.6) $25,000-$34,999 26.4 (22.3, 31.0) $35,000-$49,999 23.8 (20.0, 28.0) $50,000-$74,999 26.1 (22.4, 30.3) $75,000 or More 21.9 (19.5, 24.6) Education Less than High School 33 (28.6, 37.7) High School Graduate 27.5 (24.9, 30.3) Some College 27.7 (25.1, 30.5) College Graduate 24.1 (21.9, 26.4) Health Care Coverage Has Health Coverage 21 (19.5, 22.6) No Health Coverage 55.3 (51.3, 59.2) a The proportion of adults who reported that they did not visited a doctor for a routine checkup within the past 12 months. Percent (%) Percent of Adults who had No Doctor's Visit Last Year, by Age Group, Georgia, 2011 100 80 60 38.9 40 36.2 34.3 25.9 18.8 20 9.8 0 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 65+ yr Percent of Adults who had No Doctor's Visit Last Year, by Health Care Coverage, Georgia, 2011 100 80 60 55.3 40 21.0 20 0 Has Health Coverage No Health Coverage Percent of Adults who had No Doctor's Visit Last Year, by Health District, Georgia, 2011 2 1-2 1-1 3-4 3-1 10 3-2 3-5 3-3 Percent No Annual Doctor's Visit <24% 24-<27% 27-<30% >=30% 4 6 5-2 7 5-1 9-1 9-2 8-2 8-1 11 Percent (%) Health Status Indicators Disability Disability refers to limitations in activities due to physical, mental, or emotional problems or having health problems that require the use of special equipment. People with disabilities may lack access to health services and medical care 5. In 2011, 23.4% of Georgia adults reported being disabled in any way. Hispanics (9.1%) were significantly less likely to be disabled when compared to other race/ethnicity groups. Adults aged 55-64 years (36.2%) and 65 years or older (36.2%) were significantly more likely to be disabled than adults in other age groups. Adults with an annual household income less than $15,000 (36.5%) were significantly more likely to be disabled compared to adults in other income levels. Adults with less than a high school education (30.3%) had a significantly higher prevalence of disability than adults with some college (22.3%) and college graduates (17.8%). Percent (%) Percent of Adults who reported being Disabled, by Race/Ethnicity, Georgia, 2011 100 80 60 40 25.7 21.8 20 9.1 0 White Non-Hispanic Black Non-Hispanic Hispanic Percent (%) Percent of Adults who reported being Disabled, by Annual Household Income, Georgia, 2011 100 80 60 36.5 40 28.4 23.7 20.9 18.1 15.6 20 0 Less than $15,000 $15,000$24,999 $25,000$34,999 $35,000$49,999 $50,000- $75,000 or $74,999 More Percent of Adults who reported being Disabled, by Level of Education, Georgia, 2011 100 80 60 40 30.3 25.4 22.3 17.8 20 0 Less than High SchoHoilgh School Graduate Some College College Graduate Percent (%) Disability a Demographic Characteristics % 95% CI State Totals 23.4 (22.2, 24.7) Sex Male 21.2 (19.3, 23.1) Female 25.6 (24.0, 27.1) Race/Ethnicity White Non-Hispanic 25.7 (24.2, 27.2) Black Non-Hispanic 21.8 (19.4, 24.4) Hispanic 9.1 (6.3, 13.0) Age 18-24 years 12 (8.5, 16.7) 25-34 years 11.8 (9.2, 15.0) 35-44 years 18.8 (16.1, 21.8) 45-54 years 27.7 (25.0, 30.5) 55-64 years 36.2 (33.7, 38.9) 65+ years 36.4 (34.2, 38.7) Annual Income Less than $15,000 36.5 (32.2, 41.1) $15,000-$24,999 28.4 (25.3, 31.8) $25,000-$34,999 23.7 (20.1, 27.7) $35,000-$49,999 20.9 (17.8, 24.3) $50,000-$74,999 18.1 (15.4, 21.0) $75,000 or More 15.6 (13.7, 17.8) Education Less than High School 30.3 (26.6, 34.3) High School Graduate 25.4 (23.1, 27.9) Some College 22.3 (20.2, 24.6) College Graduate 17.8 (16.2, 19.6) Health Care Coverage Has Health Coverage 22 (20.5, 23.5) No Health Coverage 19.1 (16.4, 22.2) a The proportion of adults who reported being limited in any activities due to physical, mental, or emotional problems. Percent of Adults who reported being Disabled, by Health District, Georgia, 2011 2 1-2 1-1 3-4 3-1 10 3-2 3-5 3-3 4 5-2 Percent Disabled <22% 22-<24% 24-<26% >=26% 6 7 5-1 9-1 9-2 8-2 8-1 12 Chronic Conditions Asthma Asthma is a lifelong disease that causes wheezing, breathlessness, chest tightness, and coughing 6. Most people with asthma can control their symptoms and prevent asthma attacks by avoiding asthma triggers and correctly using prescribed medicines. In 2011, 14.1% of Georgia adults reported ever having asthma and 9.6% currently have asthma. Adult females were significantly more likely than males to have ever had asthma (15.7% vs. 12.3%) and to currently have asthma (11.6% vs. 7.5%). Non-Hispanic whites (9.8%) and non-Hispanic blacks (10.9%) were more likely to currently have asthma compared to Hispanics (3.5%). Adults with a household income of less than $15,000 were the most likely to have ever had asthma (20.5%) and to currently have asthma (16%). Adults with less than a high school education were most likely to have ever had asthma (17.5%) and to currently have asthma (13.4%). Percent (%) Percent of Adults who have had Asthma, by Gender, Georgia, 2011 50 Lifetime Asthma 40 Current Asthma 30 20 12.3 10 7.5 15.7 11.6 0 Male Female Percent (%) Percent of Adults who have had Asthma, by Race/Ethnicity, Georgia, 2011 50 Lifetime Asthma 40 Current Asthma 30 20 14.9 9.8 10 0 White Non-Hispanic 14.3 10.9 Black Non-Hispanic 6.3 3.5 Hispanic Percent (%) Percent of Adults who have had Asthma, by Annual Household Income, Georgia, 2011 50 Lifetime Asthma 40 Current Asthma 30 20.5 20 16 10 17.3 12 12.1 8.6 12.5 8.8 12.1 7.7 10.8 6.5 0 Less than $15,000 $15,000$24,999 $25,000$34,999 $35,000$49,999 $50,000$74,999 $75,000 or More Lifetime Asthma a Current Asthma b Demographic Characteristics % 95% CI % 95% CI State Totals 14.1 (13.0, 15.2) 9.6 (8.7, 10.5) Sex Male 12.3 (10.7, 14.2) 7.5 (6.2, 8.9) Female 15.7 (14.3, 17.2) 11.6 (10.4, 12.9) Race/Ethnicity White Non-Hispanic 14.9 (13.6, 16.3) 9.8 (8.8, 11.0) Black Non-Hispanic 14.3 (12.1, 16.8) 10.9 (9.0, 13.2) Hispanic 6.3 (3.9, 10.1) 3.5 (2.0, 6.1) Age 18-24 years 18.7 (14.5, 23.9) 10 (7.0, 14.1) 25-34 years 15.7 (12.8, 19.1) 10.6 (8.1, 13.7) 35-44 years 12.7 (10.5, 15.3) 9.3 (7.4, 11.6) 45-54 years 12.7 (10.9, 14.7) 9.3 (7.7, 11.1) 55-64 years 13.7 (11.9, 15.6) 9.1 (7.7, 10.7) 65+ years 11.9 (10.5, 13.5) 9.3 (8.0, 10.7) Annual Income Less than $15,000 20.5 (16.9, 24.7) 16 (12.9, 19.7) $15,000-$24,999 17.3 (14.5, 20.5) 12 (9.6, 14.8) $25,000-$34,999 12.1 (9.4, 15.3) 8.6 (6.3, 11.5) $35,000-$49,999 12.5 (9.7, 16.0) 8.8 (6.3, 12.1) $50,000-$74,999 12.1 (9.7, 15.1) 7.7 (5.8, 10.2) $75,000 or More 10.8 (9.1, 12.8) 6.5 (5.3, 8.0) Education Less than High School 17.5 (14.5, 21.0) 13.4 (10.7, 16.5) High School Graduate 14.4 (12.3, 16.7) 9.8 (8.2, 11.7) Some College 14 (12.0, 16.3) 9 (7.4, 11.0) College Graduate 11.5 (10.1, 13.1) 7.4 (6.3, 8.7) Health Care Coverage Has Health Coverage 14.7 (13.3, 16.2) 9.7 (8.6, 11.0) No Health Coverage 13.4 (11.0, 16.2) 9.5 (7.5, 12.1) a The proportion of adults who reported that they were ever told by a doctor, nurse, or other health care professional that they had asthma. b The proportion of adults who reported that they still had asthma. Percent of Adults who currently have Asthma, by Health District, Georgia, 2011 2 1-2 1-1 3-4 3-1 10 3-2 3-5 3-3 4 5-2 Percent Asthma <6% 6-<8% 8-<10% >=10% 6 7 5-1 9-1 9-2 8-2 8-1 13 Chronic Conditions Diabetes Diabetes is a chronic disease where the body is unable to process glucose, causing blood glucose levels to be higher than normal. Diabetes is the seventh leading cause of death in the United States and increases the risk for heart disease, stroke, high blood pressure, blindness, kidney disease, amputations, nerve problems, dental disease, and infections 7. In 2011, 10.2% of Georgia adults reported ever being diagnosed with diabetes by a health care professional. Non-Hispanic blacks (11.8%) were more likely to have ever been diagnosed with diabetes than Hispanics (6.3%). The prevalence of diabetes was significantly higher among adults aged 65 years and older (25.9%). Adults with an annual household income of less than $15,000 (18%) were more likely to ever have diabetes than adults with an income of $75,000 or more (4.9%). Adults with less than a high school education (16.4%) were significantly more likely to ever have diabetes compared to high school graduates (11.4%), some college education (8.9%), and college graduates (5.8%). Percent (%) Percent of Adults Diagnosed with Diabetes, by Race/Ethnicity, Georgia, 2011 30 25 20 15 11.8 10.1 10 6.3 5 0 White Non-Hispanic Black Non-Hispanic Hispanic Percent (%) Percent of Adults Diagnosed with Diabetes, by Age Group, Georgia, 2011 30 25.9 25 19.6 20 15 10 5 1 0 9.9 5.2 2.3 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 65+ yr Diabetes a Demographic Characteristics % 95% CI State Totals 10.2 (9.5, 10.9) Sex Male 9.8 (8.8, 11.0) Female 10.5 (9.6, 11.5) Race/Ethnicity White Non-Hispanic 10.1 (9.3, 11.0) Black Non-Hispanic 11.8 (10.2, 13.5) Hispanic 6.3 (4.2, 9.4) Age 18-24 years 1 (0.3, 2.9) 25-34 years 2.3 (1.3, 4.1) 35-44 years 5.2 (3.9, 7.0) 45-54 years 9.9 (8.3, 11.7) 55-64 years 19.6 (17.6, 21.9) 65+ years 25.9 (23.9, 27.9) Annual Income Less than $15,000 18 (15.1, 21.4) $15,000-$24,999 12.3 (10.6, 14.2) $25,000-$34,999 12.5 (10.1, 15.2) $35,000-$49,999 8.6 (7.0, 10.6) $50,000-$74,999 6.5 (5.2, 8.1) $75,000 or More 4.9 (4.0, 5.8) Education Less than High School 16.4 (14.0, 19.2) High School Graduate 11.4 (10.0, 13.0) Some College 8.9 (7.8, 10.1) College Graduate 5.8 (5.1, 6.7) Health Care Coverage Has Health Coverage 8.1 (7.3, 9.1) No Health Coverage 5.6 (4.5, 7.0) a The proportion of adults who have physician-diagnosed diabetes. Adults with prediabetes or diabetes only during pregnancy are not considered to have a diagnosis of diabetes. Percent of Adults Diagnosed with Diabetes, by Health District, Georgia, 2011 2 1-2 1-1 3-4 3-1 10 3-2 3-5 3-3 Percent Diabetes <9% 9-<11% 11-<13% >=13% Percent (%) Percent of Adults Diagnosed with Diabetes, by Level of Education, Georgia, 2011 30 25 20 16.4 15 11.4 8.9 10 5.8 5 0 Less than High SchoHoilgh School Graduate Some College College Graduate 4 7 8-2 6 5-2 5-1 9-1 9-2 8-1 14 Chronic Conditions Heart Attack Heart attack, also called myocardial infarction, occurs when blood flow to a section of the heart muscle becomes blocked. Risk factors for heart attack include high blood cholesterol levels, high blood pressure, smoking, lack of physical activity, and obesity 8. In 2011, 4.4% of Georgia adults reported being told by a health professional that they have had a heart attack. Adult males (5.2%) were significantly more likely to have had a heart attack when compared to females (3.6%). White non-Hispanics (5.2%) were significantly more likely to have had a heart attack than black non-Hispanics (3.1%) and Hispanics (2.0%). Adults aged 65 years or older (13.8%) were significantly more likely to have had a heart attack when compared to other age groups. Adults with an annual household income of less than $15,000 (7.9%) were most likely to have had a heart attack. Percent of Adults who have had a Heart Attack, by Race/Ethnicity, Georgia, 2011 15 Percent (%) 10 5.2 5 3.1 0 White Non-Hispanic Black Non-Hispanic 2 Hispanic Percent (%) Percent of Adults who have had a Heart Attack, by Age Group, Georgia, 2011 15 13.8 10 7.6 5 4 0.8 0.6 1.3 0 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 65+ yr Percent of Adults who have had a Heart Attack, by Annual Household Income, Georgia, 2011 15 Percent (%) 10 7.9 6.9 5 4.2 2.7 3.1 1.7 0 Less than $15,000 $15,000 $24,999 $25,000 $34,999 $35,000 $49,999 $50,000 - $75,000 or $74,999 More Please Note: The percentage of adults who have had a heart attack in this document include only those who survived the condition. Heart Attack a Demographic Characteristics % 95% CI State Totals 4.4 (3.9, 4.9) Sex Male 5.2 (4.4, 6.0) Female 3.6 (3.1, 4.2) Race/Ethnicity White Non-Hispanic 5.2 (4.6, 5.9) Black Non-Hispanic 3.1 (2.3, 4.0) Hispanic 2 (1.1, 3.8) Age 18-24 years 0.8 (0.2, 2.4) 25-34 years 0.6 (0.2, 2.1) 35-44 years 1.3 (0.6, 2.5) 45-54 years 4 (3.0, 5.4) 55-64 years 7.6 (6.3, 9.2) 65+ years 13.8 (12.2, 15.6) Annual Income Less than $15,000 7.9 (6.2, 10.1) $15,000-$24,999 6.9 (5.5, 8.5) $25,000-$34,999 4.2 (3.1, 5.7) $35,000-$49,999 2.7 (2.0, 3.7) $50,000-$74,999 3.1 (2.2, 4.3) $75,000 or More 1.7 (1.2, 2.4) Education Less than High School 9.4 (7.5, 11.7) High School Graduate 4.1 (3.4, 4.9) Some College 3.1 (2.6, 3.9) College Graduate 2.5 (2.0, 3.1) Health Care Coverage Has Health Coverage 2.7 (2.3, 3.3) No Health Coverage 2.7 (1.9, 4.0) a The proportion of adults who had ever been told by a health professional that they had a heart attack or myocardial infarction. Percent of Adults who have had a Heart Attack, by Health District, Georgia, 2011 2 1-2 1-1 3-4 3-1 10 3-2 3-5 3-3 4 5-2 Percent Heart Attack <3.5% 3.5-<5% 5-<6.5% >=6.5% 6 7 5-1 9-1 9-2 8-2 8-1 15 Chronic Conditions Stroke Stroke is the result of a blocked artery or a ruptured artery that prevents blood flow to the brain. Stroke is the leading cause of death in the United States and can cause significant disability, such as paralysis, speech difficulties, and emotional problems 9. In 2011, 3.4% of Georgia adults reported ever being told by a health professional that they survived a stroke. Non-Hispanic whites (3.9%) were more likely to have ever had a stroke when compared to non-Hispanic blacks (2.8%) and Hispanics (1.4%). A significantly higher proportion of Georgia adults aged 65 years and older (8.4%) have ever had a stroke. Adults with an annual household income less than $15,000 (6.6%) were most likely to have ever had a stroke. Adults with less than a high school education (6.8%) were significantly more likely to have ever had a stroke compared to high school graduates (3.6%), those with some college (3.0%), and college graduates (1.4%). Percent (%) Percent of Adults who have ever had a Stroke, by Race/Ethnicity, Georgia, 2011 15 10 5 3.9 2.8 0 White Non-Hispanic Black Non-Hispanic 1.4 Hispanic Percent (%) Percent of Adults who have ever had Stroke, by Age Group, Georgia, 2011 15 10 8.4 5.4 5 3.1 1.2 1.7 1.7 0 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 65+ yr Percent of Adults who have ever had Stroke, by Level of Education, Georgia, 2011 15 Percent (%) 10 6.8 5 0 Less than High School 3.6 High School Graduate 3 1.4 Some College College Graduate Please Note: The percentage of adults who have had a stroke in this document include only those who survived the condition. Stroke a Demographic Characteristics % 95% CI State Totals 3.4 (3.0, 3.9) Sex Male 3.5 (2.8, 4.5) Female 3.3 (2.9, 3.9) Race/Ethnicity White Non-Hispanic 3.9 (3.2, 4.6) Black Non-Hispanic 2.8 (2.1, 3.7) Hispanic 1.4 (0.6, 3.0) Age 18-24 years 1.2 (0.4, 3.2) 25-34 years 1.7 (0.7, 4.0) 35-44 years 1.7 (1.0, 2.9) 45-54 years 3.1 (2.2, 4.3) 55-64 years 5.4 (4.3, 6.8) 65+ years 8.4 (7.3, 9.8) Annual Income Less than $15,000 6.6 (4.9, 8.7) $15,000-$24,999 5.8 (4.4, 7.5) $25,000-$34,999 3.7 (2.1, 6.6) $35,000-$49,999 1.6 (1.1, 2.4) $50,000-$74,999 1.5 (1.0, 2.3) $75,000 or More 1.1 (0.7, 1.7) Education Less than High School 6.8 (5.2, 9.0) High School Graduate 3.6 (2.8, 4.7) Some College 3 (2.4, 3.8) College Graduate 1.4 (1.0, 1.8) Health Care Coverage Has Health Coverage 2.6 (2.1, 3.3) No Health Coverage 2.4 (1.5, 3.8) a The proportion of adults who have ever been told by a health professional that they had a stroke. Percent of Adults who have ever had a Stroke, by Health District, Georgia, 2011 2 1-2 1-1 3-4 3-1 10 3-2 3-5 3-3 4 5-2 Percent Stroke <3% 3-<4% 4-<5% >=5% 6 7 5-1 9-1 9-2 8-2 8-1 16 Chronic Conditions Angina Angina is chest pain or discomfort that occurs when the heart muscle is not getting enough blood. Angina may feel like pressure or a squeezing pain in the chest. The pain may also occur in the shoulders, arms, neck, jaw, or back, and it may feel like indigestion 10. In 2011, 4.4% of Georgia adults reported ever being told by a health professional that they have angina or coronary heart disease. Adult males (5.0%) were significantly more likely to have had angina than adult females (3.7%). White non-Hispanics (5.1%) were significantly more likely to have had angina compared to black non-Hispanics (3.3%) and Hispanics (1.4%). Adults aged 65 years and older were most likely to have had angina (14.1%). Adults with health care coverage (3.1%) were significantly more likely to have had angina than those without health care coverage (1.8%). Percent of Adults who have ever had Angina, by Race/Ethnicity, Georgia, 2011 15 Percent (%) 10 5.1 5 3.3 0 White Non-Hispanic Black Non-Hispanic 1.4 Hispanic Percent (%) Percent of Adults who have ever had Angina, by Age Group, Georgia, 2011 15 14.1 10 8.6 5 4.2 0.6 0.3 0.7 0 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 65+ yr Percent of Adults who have ever had Angina, by Health Care Coverage, Georgia, 2011 15 10 5 3.1 0 Has Health Coverage 1.8 No Health Coverage Percent (%) Angina a Demographic Characteristics % 95% CI State Totals 4.4 (3.9, 4.8) Sex Male 5 (4.3, 5.8) Female 3.7 (3.2, 4.3) Race/Ethnicity White Non-Hispanic 5.1 (4.6, 5.8) Black Non-Hispanic 3.3 (2.6, 4.2) Hispanic 1.4 (0.7, 3.0) Age 18-24 years 0.6 (0.1, 2.2) 25-34 years 0.3 (0.1, 1.4) 35-44 years 0.7 (0.3, 1.6) 45-54 years 4.2 (3.2, 5.5) 55-64 years 8.6 (7.1, 10.3) 65+ years 14.1 (12.5, 15.8) Annual Income Less than $15,000 6.4 (4.9, 8.3) $15,000-$24,999 6.9 (5.5, 8.5) $25,000-$34,999 4.4 (3.3, 5.9) $35,000-$49,999 3.5 (2.6, 4.6) $50,000-$74,999 3 (2.2, 4.1) $75,000 or More 2.3 (1.8, 3.0) Education Less than High School 7.6 (5.9, 9.6) High School Graduate 4.3 (3.6, 5.1) Some College 3.7 (3.1, 4.5) College Graduate 2.9 (2.3, 3.5) Health Care Coverage Has Health Coverage 3.1 (2.6, 3.7) No Health Coverage 1.8 (1.2, 2.6) a The proportion of adults who had ever been told by a health professional that they had angina or coronary heart disease. Percent of Adults who have ever had Angina, by Health District, Georgia, 2011 2 1-2 1-1 3-4 3-1 10 3-2 3-5 3-3 4 5-2 Percent Angina <3% 3-<4% 4-<5% >=5% 6 7 5-1 9-1 9-2 8-2 8-1 17 Chronic Conditions Obesity In adults, obesity is defined as having a body mass index (BMI) greater than or equal to 30.0 kg/m2. Obesity increases the risk of developing high blood pressure, diabetes, coronary heart disease, stroke, high cholesterol, gallbladder disease and some types of cancers 11. In 2011, 27.8% of Georgia adults were obese. Adult females (29.2%) were significantly more likely to be obese than males (26.4%). Non-Hispanic blacks (36.4%) were significantly more likely to be obese compared to non-Hispanic whites (24.8%) and Hispanics (26.4%). Adults with an annual household income of less than $15,000 (34.3%) were most likely to be obese compared to those with an annual household income of $15,000 or more. Adults with less than a high school education (34.0%) were significantly more likely to be obese compared to adults with some college (28.3%) and college graduates (21.3%). Percent (%) Percent of Adults who were Obese, by Gender, Georgia, 2011 100 80 60 40 26.4 29.2 20 0 Male Female Percent of Adults who were Obese, by Race/Ethnicity, Georgia, 2011 100 80 60 36.4 40 24.8 26.4 20 0 White Non-Hispanic Black Non-Hispanic Hispanic Percent (%) Percent of Adults who were Obese, by Level of Education, Georgia, 2011 100 80 60 40 34 20 29.3 28.3 21.3 0 Less than High School High School Graduate Some College College Graduate Obese a Demographic Characteristics % 95% CI State Totals 27.8 (26.5, 29.2) Sex Male 26.4 (24.3, 28.5) Female 29.2 (27.5, 31.0) Race/Ethnicity White Non-Hispanic 24.8 (23.3, 26.4) Black Non-Hispanic 36.4 (33.4, 39.6) Hispanic 26.4 (20.5, 33.2) Age 18-24 years 15.2 (11.4, 20.1) 25-34 years 25.8 (22.2, 29.8) 35-44 years 29.7 (26.5, 33.1) 45-54 years 33.6 (30.9, 36.5) 55-64 years 34.4 (31.9, 37.0) 65+ years 25.4 (23.4, 27.4) Annual Income Less than $15,000 34.3 (30.1, 38.8) $15,000-$24,999 32.3 (28.8, 35.9) $25,000-$34,999 28.9 (24.8, 33.3) $35,000-$49,999 27.1 (23.5, 31.0) $50,000-$74,999 31.1 (27.5, 34.9) $75,000 or More 21.3 (19.0, 23.7) Education Less than High School 34 (30.0, 38.4) High School Graduate 29.3 (26.8, 31.9) Some College 28.3 (25.8, 30.9) College Graduate 21.3 (19.4, 23.3) Health Care Coverage Has Health Coverage 28.4 (26.8, 30.2) No Health Coverage 28.1 (24.8, 31.7) a The proportion of adults whose BMI was greater than or equal to 30.0 kg/m2. Note: Body mass index, BMI, is defined as weight (kg) divided by height (m) squared. Percent of Adults who were Obese, by Health District, Georgia, 2011 2 1-2 1-1 3-4 3-1 10 3-2 3-5 3-3 4 5-2 Percent Obese <25% 25-<30% 30-<35% >=35% 6 7 5-1 9-1 9-2 8-2 8-1 Percent (%) 18 Chronic Conditions Overweight In adults, overweight is defined as having a body mass index (BMI) between 25.0 and 29.9 kg/m2. Being overweight increases the risk of poor health outcomes such as coronary heart disease, type II diabetes, high blood pressure, stroke, liver and gallbladder disease 12. In 2011, 34.9% of Georgia adults were overweight. Adult males (41.2%) were significantly more likely to be overweight than females (28.8%). Hispanics (39.2%) were more likely to be overweight compared to white non-Hispanics (34.7%) and black nonHispanics (35.3%). Adults with an annual household income of $75,000 or more (40.8%) were most likely to be overweight compared to adults with an annual household income less than $75,000. Adults who were college graduates (38.0%) were significantly more likely to be overweight compared to adults with less than a high school education (30.6%). Percent (%) Percent of Adults who were Overweight, by Gender, Georgia, 2011 100 80 60 41.2 40 28.8 20 0 Male Female Percent (%) Percent of Adults who were Overweight, by Annual Household Income, Georgia, 2011 100 80 60 40 29.4 32 34.9 35.8 38.8 40.8 20 0 Less than $15,000 $15,000$24,999 $25,000$34,999 $35,000$49,999 $50,000- $75,000 or $74,999 More Percent (%) Percent of Adults who were Overweight, by Level of Education, Georgia, 2011 100 80 60 40 30.6 32.9 37 38 20 0 Less than High School High School Graduate Some College College Graduate Overweight a Demographic Characteristics % 95% CI State Totals 34.9 (33.5, 36.4) Sex Male 41.2 (38.8, 43.6) Female 28.8 (27.1, 30.5) Race/Ethnicity White Non-Hispanic 34.7 (33.0, 36.4) Black Non-Hispanic 35.3 (32.2, 38.5) Hispanic 39.2 (32.0, 46.8) Age 18-24 years 22.6 (17.9, 28.1) 25-34 years 34.4 (30.4, 38.6) 35-44 years 38 (34.5, 41.6) 45-54 years 37 (34.1, 40.0) 55-64 years 37.2 (34.6, 39.8) 65+ years 37.8 (35.6, 40.1) Annual Income Less than $15,000 29.4 (25.1, 34.1) $15,000-$24,999 32 (28.5, 35.7) $25,000-$34,999 34.9 (30.7, 39.4) $35,000-$49,999 35.8 (31.8, 40.0) $50,000-$74,999 38.8 (34.9, 42.8) $75,000 or More 40.8 (37.9, 43.8) Education Less than High School 30.6 (26.6, 34.9) High School Graduate 32.9 (30.3, 35.6) Some College 37 (34.2, 39.9) College Graduate 38 (35.7, 40.4) Health Care Coverage Has Health Coverage 34.6 (32.9, 36.5) No Health Coverage 34.2 (30.5, 38.1) a The proportion of adults whose BMI was between 25.0 and 29.9 kg/m2 . Note: Body mass index, BMI, is defined as weight (kg) divided by height (m) squared. Percent of Adults who were Overweight, by Health District, Georgia, 2011 2 1-2 1-1 3-4 3-1 10 3-2 3-5 3-3 Percent Overweight <32% 32-<36% 36-<40% >=40% 4 6 5-2 7 5-1 9-1 9-2 8-2 8-1 19 Risk Behaviors Adequate Physical Activity Adequate physical activity can lower the risk of chronic disease or falls and fractures, helps maintain healthy body weight, and enhances quality of life. The U.S. Department of Health and Human Services recommends that adults aged 18-64 years participate in either moderate physical activities for at least 150 minutes per week, vigorous physical activities for at least 75 minutes per week, or equivalent combination of both and participate in muscle strengthening activities on two or more days per week 13. In 2011, 20.7% of Georgia adults currently meet both the aerobic and muscle strengthening components of the physical activity recommendations. Adult males (24.9%) were significantly more likely than females (16.8%) to engage in adequate physical activity. Black non-Hispanic adults (25.8%) were significantly more likely to engage in adequate physical activity compared to white non-Hispanic (19.3%) and Hispanic (11.3%) adults. The proportion of adults who engaged in adequate physical activity decreased as age increased. Adults with an annual household income of $75,000 or more (26.4%) were more likely to engage in adequate physical activity compared to adults in other household income levels. Adults with a less than high school education (11.4%) were significantly less likely to engage in adequate physical activity compared to adults with some college (22.6%) and college graduates (29.0%). Adults with health care coverage (23.2%) were more likely to engage in adequate physical activity compared to adults without health care coverage (18.4%). Percent (%) Percent of Adults who Engaged in Adequate Physical Activity, by Gender, Georgia, 2011 50 40 30 24.9 20 16.8 10 0 Male Female Percent (%) Percent of Adults who Engaged in Adequate Physical Activity, by Annual Household Income, Georgia, 2011 50 40 30 24.4 26.4 18.8 20.6 20.7 20 13.6 10 0 Less than $15,000 - $25,000 - $35,000 - $50,000 - $75,000 or $15,000 $24,999 $34,999 $49,999 $74,999 More Meeting Recommendation a Demographic Characteristics % 95% CI State Totals 20.7 (19.4, 22.1) Sex Male 24.9 (22.7, 27.3) Female 16.8 (15.3, 18.3) Race/Ethnicity White Non-Hispanic 19.2 (17.8, 20.8) Black Non-Hispanic 25.8 (22.7, 29.1) Hispanic 11.3 (7.8, 16.2) Age 18-24 years 29.6 (24.1, 35.7) 25-34 years 25.7 (22.1, 29.8) 35-44 years 20.8 (18.0, 24.0) 45-54 years 18.7 (16.4, 21.1) 55-64 years 16.1 (14.3, 18.2) 65+ years 13.2 (11.6, 14.8) Annual Income Less than $15,000 13.6 (10.2, 18.0) $15,000-$24,999 18.8 (15.7, 22.4) $25,000-$34,999 20.6 (16.5, 25.4) $35,000-$49,999 24.4 (20.3, 29.0) $50,000-$74,999 20.7 (17.5, 24.3) $75,000 or More 26.4 (23.9, 29.2) Education Less than High School 11.4 (8.4, 15.3) High School Graduate 17.2 (14.8, 19.8) Some College 22.6 (20.0, 25.5) College Graduate 29 (26.8, 31.4) Health Care Coverage Has Health Coverage 23.2 (21.5, 25.0) No Health Coverage 18.4 (15.4, 21.9) a The proportion of adults who currently meet both the aerobic and muscle strengthening components of the physical activity recommendations Percent of Adults who Engaged in Adequate Physical Activity, by Health District, Georgia, 2011 2 1-2 1-1 3-4 3-1 10 3-2 3-5 3-3 Percent Adequate Physical Activity <15% 15-<20% 20-<25% >=25% 4 6 5-2 7 5-1 9-1 9-2 8-2 8-1 20 Risk Behaviors No Leisure Time Physical Activity Leisure time physical activity helps improve overall health and fitness, and reduces risk for many chronic diseases such as diabetes, cardiovascular disease, and osteoporosis. Regular physical activity also helps to maintain body weight, reduces symptoms of anxiety and depression, and enhances quality of life 14. Physical inactivity is defined as not participating in physical activities or exercises such as running, calisthenics, gold, gardening, or walking for exercise during leisure time within the past month. In 2011, 26.7% of Georgia adults were physically inactive during their leisure time within the past month. Adult females (29.7%) were significantly more likely than males (23.6%) to be physically inactive. Adults with an income of less than $15,000 (37.3%) were significantly most likely to be physically inactive. Adults with a less than high school education (40.6%) were significantly more likely to be physically inactive compared to college graduates (15%). Adults with health care coverage (22.8%) were less likely to be physically inactive compared to adults without health care coverage (31.1%). Percent (%) Percent of Adults who reported No-Leisure Time Activity, by Gender, Georgia, 2011 100 80 60 40 29.7 23.6 20 0 Male Female Percent (%) Percent of Adults who reported No Leisure-Time Activity, by Annual Household Income, Georgia, 2011 100 80 60 37.3 40 31.4 30.2 24.5 23 15.9 20 0 Less than $15,0$0105,000 - $24,$92959,000 - $34,$93959,000 - $49,$95909,000 - $74,9$9795,000 or More Percent (%) Percent of Adults who reported No Leisure-Time Activity, by Health Care Coverage, Georgia, 2011 100 80 60 40 31.1 22.8 20 0 Has Health Coverage No Health Coverage No Leisure Time Physical Activity a Demographic Characteristics % 95% CI State Totals 26.7 (25.4, 28.1) Sex Male 23.6 (21.6, 25.8) Female 29.7 (27.9, 31.4) Race/Ethnicity White Non-Hispanic 25.5 (24.0, 27.1) Black Non-Hispanic 28.2 (25.3, 31.2) Hispanic 31.2 (24.9, 38.4) Age 18-24 years 19.2 (14.8, 24.6) 25-34 years 22.5 (18.9, 26.4) 35-44 years 26.2 (23.0, 29.6) 45-54 years 28 (25.4, 30.9) 55-64 years 28.6 (26.2, 31.1) 65+ years 36.4 (34.2, 38.7) Annual Income Less than $15,000 37.3 (32.7, 42.1) $15,000-$24,999 31.4 (28.0, 35.0) $25,000-$34,999 30.2 (26.1, 34.6) $35,000-$49,999 24.5 (21.4, 28.0) $50,000-$74,999 23 (19.5, 26.8) $75,000 or More 15.9 (13.8, 18.2) Education Less than High School 40.6 (36.2, 45.1) High School Graduate 31.8 (29.1, 34.5) Some College 23 (20.8, 25.4) College Graduate 15 (13.4, 16.7) Health Care Coverage Has Health Coverage 22.8 (21.2, 24.4) No Health Coverage 31.1 (27.6, 34.9) a The proportion of adults who reported not participating in any leisure-time physical activities or exercises during the past month. Percent of Adults who reported No Leisure-Time Activity, by Health District, Georgia, 2011 2 1-2 1-1 3-4 3-1 10 3-2 3-5 3-3 4 5-2 Percent No Leisure-Time Physical Activity <65% 65-<70% 70-<75% >=75% 6 7 5-1 9-1 9-2 8-2 8-1 21 Risk Behaviors Seatbelt Use Seatbelt use reduces serious injuries and deaths in motor vehicle crashes by 50% 15. In 2009, about 12,000 more injuries would have been prevented and about 450 more lives saved if all states had primary enforcement seat belt laws 15. Georgia's seat belt law states that while the passenger vehicle is being operated on a public road, street or highway, each occupant in the front seat of a passenger vehicle should be restrained by a safety seat belt approved under federal motor vehicle safety standard 208 16. In 2011, 88.4% of Georgia adults reported always using a seatbelt when they are driving or riding in a car. Females (93%) were significantly more likely to always use a seatbelt than males (83.5%). Hispanics (94%) were significantly more likely to always use a seatbelt compared to non-Hispanic whites (88.5%) and non-Hispanic blacks (86.2%). Adults aged 18-24 years (78.7%) were significantly least likely to always use a seatbelt. Adults who are college graduates (91%) were more likely to always use a seatbelt compared to adults with less than a high school education (86.8%). Percent (%) Percent of Adults who Always Use a Seatbelt, by Gender, Georgia, 2011 100 83.5 80 60 40 20 0 Male 93 Female Percent (%) Percent of Adults who Always Use a Seatbelt by Race/Ethnicity, Georgia, 2011 100 88.5 86.2 94.0 80 60 40 20 0 White Non-Hispanic Black Non-Hispanic Hispanic Percent (%) Percent of Adults who Aways Use a Seatbelt, by Age Group Georgia, 2011 100 88.3 87.2 91.6 91.3 78.7 80 60 40 20 0 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 91.7 65+ yr Always use a Seatbelt a Demographic Characteristics % 95% CI State Totals 88.4 (87.2, 89.4) Sex Male 83.5 (81.4, 85.4) Female 93 (91.8, 94.0) Race/Ethnicity White Non-Hispanic 88.5 (87.1, 89.7) Black Non-Hispanic 86.2 (83.4, 88.7) Hispanic 94 (89.1, 96.8) Age 18-24 years 78.7 (73.0, 83.4) 25-34 years 88.3 (85.2, 90.8) 35-44 years 87.2 (84.3, 89.7) 45-54 years 91.6 (89.6, 93.2) 55-64 years 91.3 (89.7, 92.6) 65+ years 91.7 (90.3, 92.9) Annual Income Less than $15,000 86.7 (82.7, 89.9) $15,000-$24,999 87.9 (84.9, 90.3) $25,000-$34,999 87.8 (83.9, 90.8) $35,000-$49,999 90.1 (87.2, 92.4) $50,000-$74,999 88.2 (84.9, 90.9) $75,000 or More 91.3 (89.3, 93.0) Education Less than High School 86.8 (82.7, 90.0) High School Graduate 87.5 (85.3, 89.5) Some College 87.8 (85.4, 89.8) College Graduate 91 (89.4, 92.4) Health Care Coverage Has Health Coverage 88.9 (87.5, 90.2) No Health Coverage 85 (81.7, 87.8) a The proportion of adults who always use a seatbelt while driving or riding in a car. Percent of Adults who always use Seatbelt, by Health District, Georgia, 2011 2 1-2 1-1 3-4 3-1 10 3-2 3-5 3-3 4 5-2 Percent Seat Belt Use <85% 85-<88% 88-<91% >=91% 6 7 5-1 9-1 9-2 8-2 8-1 22 Risk Behaviors Smoking Cigarette smoking is one of the leading causes of preventable deaths in the United States17. Smoking is associated with deaths related to cancer, respiratory diseases, and cardiovascular diseases 18. About 10.1% of deaths among Georgia adults are linked to smoking 18. In 2011, 21.2% of Georgia adults were current cigarette smokers and 22.1% were former smokers. Adult males (24.3%) were significantly more likely to currently smoke cigarettes than females (18.2%). Non-Hispanic whites (24.2%) were significantly most likely to be current smokers. Adults with less than a high school education (35.8%) were significantly more likely to currently smoke cigarettes compared to high school graduates (24.2%), those with some college (20.7%), and college graduates (8.2%). Adults with health insurance (17.7%) were significantly less likely to currently smoke compared to adults without health insurance (36.4%). Percent (%) Percent of Adults who Smoke Cigarettes, by Gender, Georgia, 2011 50 40 30 24.3 18.2 20 10 0 Male Female Percent (%) Percent of Adults who Smoke Cigarettes, by Race/Ethnicity, Georgia, 2011 50 40 30 24.2 20 17.5 12.6 10 0 White Non-Hispanic Black Non-Hispanic Hispanic Percent (%) Percent of Adults who Smoke Cigarettes, by Level of Education, Georgia, 2011 50 40 35.8 30 24.2 20.7 20 8.2 10 0 Less than High School High School Graduate Some College College Graduate Current Smoker a Former Smoker b Demographic Characteristics % 95% CI % 95% CI State Totals 21.2 (19.9, 22.6) 22.1 (21.0, 23.3) Sex Male 24.3 (22.2, 26.6) 25.5 (23.6, 27.5) Female 18.2 (16.8, 19.8) 18.9 (17.6, 20.3) Race/Ethnicity White Non-Hispanic 24.2 (22.6, 26.0) 25.8 (24.3, 27.3) Black Non-Hispanic 17.5 (15.0, 20.2) 16.9 (14.7, 19.3) Hispanic 12.6 (8.6, 18.1) 17.6 (13.0, 23.4) Age 18-24 years 25 (20.1, 30.6) 6.5 (4.2, 9.9) 25-34 years 24.4 (20.9, 28.3) 19.9 (16.6, 23.6) 35-44 years 22.7 (19.6, 26.1) 14.8 (12.5, 17.6) 45-54 years 24.1 (21.6, 26.8) 23.2 (20.8, 25.9) 55-64 years 18.8 (16.8, 21.0) 32.1 (29.6, 34.6) 65+ years 10.8 (9.4, 12.4) 38 (35.8, 40.2) Annual Income Less than $15,000 35.1 (30.5, 40.0) 18.8 (15.5, 22.5) $15,000-$24,999 29.1 (25.7, 32.6) 20.3 (17.5, 23.4) $25,000-$34,999 25.7 (21.8, 30.1) 23.9 (20.3, 27.8) $35,000-$49,999 19.2 (16.0, 22.8) 23.9 (20.6, 27.5) $50,000-$74,999 14.8 (11.9, 18.2) 24.6 (21.4, 28.2) $75,000 or More 8.2 (6.6, 10.0) 23.4 (21.1, 25.8) Education Less than High School 35.8 (31.5, 40.4) 20.7 (17.6, 24.2) High School Graduate 24.2 (21.8, 26.7) 22.9 (20.7, 25.3) Some College 20.7 (18.4, 23.1) 23.5 (21.2, 25.8) College Graduate 8.2 (7.0, 9.6) 20.7 (18.9, 22.5) Health Care Coverage Has Health Coverage 17.7 (16.3, 19.2) 21.4 (20.0, 23.0) No Health Coverage 36.4 (32.7, 40.2) 14.7 (12.3, 17.4) a The proportion of adults who reported that they had smoked at least 100 cigarettes (5 packs) in their life and they currently smoke cigarettes, either every day or on some days. b The proportion of adults who reported that they had smoked at least 100 cigarettes (5 packs) in their life but do not currently smoke. Percent of Adults who currently Smoke Cigarettes, by Health District, Georgia, 2011 2 1-2 1-1 3-4 3-1 10 3-2 3-5 3-3 Percent Smokers <15% 15-<20% 20-<25% >25% 4 6 5-2 7 5-1 9-1 9-2 8-2 8-1 23 Risk Behaviors Smokeless Tobacco Smokeless tobacco is known to cause cancer of the oral cavity and pancreas, and should not be considered a safe substitute for smoking cigarettes 19. The main types of smokeless tobacco sold in the United States are chewing tobacco, snuff, and snus. In 2011, 4.4% of Georgia adults reported using smokeless tobacco. Adult males (7.5%) were significantly more likely to use smokeless tobacco compared to females (1.5%). Non-Hispanic whites (5.1%) were more likely to use smokeless tobacco when compared to non-Hispanic blacks (3.8%) and Hispanics (0.5%). A higher proportion of adults with an annual household income of less than $15,000 (5.5%) use smokeless tobacco. Adults with less than high school education (8.0%) were significantly more likely to use smokeless tobacco compared to college graduates (2.4%). Percent (%) Percent of Adults who used Smokeless Tobacco, by Gender, Georgia, 2011 15 10 7.5 5 0 Male 1.5 Female Percent (%) Percent of Adults who use Smokeless Tobacco, by Race/Ethnicity, Georgia, 2011 15 10 5.1 5 3.8 0 White Non-Hispanic Black Non-Hispanic 0.5 Hispanic Percent (%) Percent of Adults who used Smokeless Tobacco, by Level of Education, Georgia, 2011 15 10 8 5.2 5 0 Less than High School High School Graduate 2.9 2.4 Some College College Graduate Smokeless Tobacco Use a Demographic Characteristics % 95% CI State Totals 4.4 (3.8, 5.1) Sex Male 7.5 (6.3, 8.9) Female 1.5 (1.1, 2.0) Race/Ethnicity White Non-Hispanic 5.1 (4.3, 6.2) Black Non-Hispanic 3.8 (2.6, 5.3) Hispanic 0.5 (0.2, 1.6) Age 18-24 years 5.8 (3.5, 9.4) 25-34 years 4.3 (2.7, 6.6) 35-44 years 4.6 (3.3, 6.3) 45-54 years 4.4 (3.1, 6.0) 55-64 years 3.6 (2.7, 4.8) 65+ years 4 (3.1, 5.2) Annual Income Less than $15,000 5.5 (3.6, 8.2) $15,000-$24,999 5.2 (3.6, 7.4) $25,000-$34,999 4.5 (3.0, 6.7) $35,000-$49,999 3 (1.8, 5.1) $50,000-$74,999 3.3 (2.2, 4.9) $75,000 or More 3.2 (2.2, 4.6) Education Less than High School 8 (5.9, 10.6) High School Graduate 5.2 (4.0, 6.8) Some College 2.9 (2.0, 4.3) College Graduate 2.4 (1.8, 3.3) Health Care Coverage Has Health Coverage 4.4 (3.6, 5.4) No Health Coverage 4.6 (3.2, 6.6) a The proportion of adults who reported that they currently use chewing tobacco, snuff or snus, either every day or on some days. Percent of Adults who used Smokeless Tobacco, by Health District, Georgia, 2011 2 1-2 1-1 3-4 3-1 10 3-2 3-5 3-3 4 5-2 Percent Use Smokeless Tobacco <3% 3-<5% 5-<7% >=7% 6 7 5-1 9-1 9-2 8-2 8-1 24 Risk Behaviors Binge Drinking Binge drinking is linked to unintentional injuries (falls, car crashes), intentional injuries (sexual assault, domestic violence), alcohol poisoning, liver disease, and neurological damage 20. Binge drinking is defined as consuming five or more drinks per occasion for men or four or more drinks per occasion for women in the previous month. In 2011, 16.6% of Georgia adults engaged in binge drinking. Adult males (22.5%) were significantly more likely than females (11.1%) to engage in binge drinking. More young adults aged 18-24 years (28.8%) and 25-34 years (25.3%) reported binge drinking. Adults with an annual household income of $75,000 or more (19.2%) were the most likely to engage in binge drinking. Adults without health care coverage (23.2%) were more likely to engage in binge drinking compared to adults with health care coverage (17.4%). Percent (%) Percent of Adults who Engaged in Binge Drinking, by Gender, Georgia, 2011 40 30 22.5 20 11.1 10 0 Male Female Percent (%) Percent of Adults who Engaged in Binge Drinking, by Age Group, Georgia, 2011 40 28.8 30 25.3 19.3 20 13.5 9 10 2.8 0 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 65+ yr Percent (%) Percent of Adults who Engaged in Binge Drinking, by Health Care Coverage, Georgia, 2011 40 30 23.2 20 17.4 10 0 Has Health Coverage No Health Coverage Binge Drinking a Demographic Characteristics % 95% CI State Totals 16.6 (15.3, 18.0) Sex Male 22.5 (20.3, 24.9) Female 11.1 (9.7, 12.5) Race/Ethnicity White Non-Hispanic 17.5 (15.9, 19.2) Black Non-Hispanic 13.3 (10.9, 16.2) Hispanic 21.4 (15.7, 28.5) Age 18-24 years 28.8 (23.4, 34.9) 25-34 years 25.3 (21.5, 29.6) 35-44 years 19.3 (16.5, 22.4) 45-54 years 13.5 (11.4, 15.9) 55-64 years 9 (7.5, 10.8) 65+ years 2.8 (2.2, 3.7) Annual Income Less than $15,000 19 (14.7, 24.1) $15,000-$24,999 17.4 (14.2, 21.0) $25,000-$34,999 13 (9.8, 17.0) $35,000-$49,999 13.5 (10.3, 17.6) $50,000-$74,999 15 (12.1, 18.4) $75,000 or More 19.2 (16.7, 22.0) Education Less than High School 17.8 (14.0, 22.5) High School Graduate 15.7 (13.3, 18.4) Some College 17 (14.6, 19.6) College Graduate 16.6 (14.6, 18.7) Health Care Coverage Has Health Coverage 17.4 (15.8, 19.1) No Health Coverage 23.2 (19.8, 27.0) a The proportion of adults who reported drinking 5 or more drinks for men or 4 or more drinks for women per occasion at least once in the previous month. Percent of Adults who Engaged in Binge Drinking, by Health District, Georgia, 2011 2 1-2 1-1 3-4 3-1 10 3-2 3-5 3-3 4 5-2 Percent Binge Drinking <12% 12-<15% 15-<18% >=18% 6 7 5-1 9-1 9-2 8-2 8-1 25 Risk Behaviors Heavy Drinking Heavy drinking is defined as consuming more than two drinks per day for males and more than one drink per day for females. Excessive alcohol use is the third leading lifestyle-related cause of death in the United States and has been associated with cirrhosis of the liver, high blood pressure, stroke, and can increase the risk for motor vehicle accidents, injuries, violence, and suicide 21. In 2011, 6.2% of Georgia adults engaged in heavy drinking. Adult males (7.4%) were significantly more likely than females (5.1%) to engage in heavy drinking. Non-Hispanic whites (7.7%) were significantly more likely to engage in heavy drinking compared to non-Hispanic blacks (3.1%). Adults aged 65 years and older (3%) were significantly less likely to engage in heavy drinking compared to any other age groups. Heavy drinking is more prevalent among adults with a high annual household income of $50,000-$74,000 (7.7%) and $75,000 or more (7.4%). Percent (%) Percent of Adults who Engaged in Heavy Drinking, by Gender, Georgia, 2011 30 20 10 7.4 0 Male 5.1 Female Percent (%) Percent of Adults who Engaged in Heavy Drinking, by Race/Ethnicity, Georgia 2011 30 21.4 20 17.5 13.3 10 0 White Non-Hispanic Black Non-Hispanic Hispanic Percent (%) Percent of Adults who Engaged in Heavy Drinking, by Age Group, Georgia, 2011 30 20 9 10 7.8 6.8 5.5 5.3 3 0 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 65+ yr Heavy Drinking a Demographic Characteristics % 95% CI State Totals 6.2 (5.4, 7.1) Sex Male 7.4 (6.1, 9.1) Female 5.1 (4.3, 6.0) Race/Ethnicity White Non-Hispanic 7.7 (6.6, 8.9) Black Non-Hispanic 3.1 (2.1, 4.6) Hispanic 5.3 (2.5, 10.6) Age 18-24 years 9 (6.0, 13.4) 25-34 years 7.8 (5.6, 10.7) 35-44 years 6.8 (5.0, 9.1) 45-54 years 5.5 (4.2, 7.1) 55-64 years 5.3 (4.3, 6.5) 65+ years 3 (2.4, 3.8) Annual Income Less than $15,000 6.4 (3.9, 10.2) $15,000-$24,999 5.9 (4.3, 8.2) $25,000-$34,999 3.8 (2.4, 6.0) $35,000-$49,999 6.4 (4.7, 8.7) $50,000-$74,999 7.7 (5.4, 10.8) $75,000 or More 7.4 (5.7, 9.5) Education Less than High School 5.6 (3.5, 8.9) High School Graduate 6.7 (5.2, 8.7) Some College 5.5 (4.2, 7.0) College Graduate 6.9 (5.7, 8.3) Health Care Coverage Has Health Coverage 6.2 (5.3, 7.3) No Health Coverage 8.1 (6.0, 10.7) a The proportion of adults who reported drinking 2 or more drinks for males or 1 or more drinks for women per day. Percent of Adults who Engaged in Heavy Drinking, by Health District, Georgia, 2011 2 1-2 1-1 3-4 3-1 10 3-2 3-5 3-3 4 5-2 Percent Heavy Drinking <4% 4-<6% 6-<8% >=8% 6 7 5-1 9-1 9-2 8-2 8-1 26 Clinical Preventive Practices Breast Cancer Screening Breast cancer screening means checking a woman's breast for cancer before there are signs or symptoms of the diseases. Mammograms help screen for breast cancer by detecting for tumors or lumps using X-rays imaging. Women between 50-75 years old should get mammograms once every 2 years 22. Breast cancer screening before age 50 should be done on an individual basis 22. In 2011, 83.2% of Georgian women aged 40-64 years and 78.3% of Georgian women aged 50 years and older have had a mammogram in the past two years. Non-Hispanic white women were less likely to have had a mammogram in the past two years. Women with a higher annual household income were more likely to have had a mammogram in the past two years. Women with less than a high school education were significantly less likely to have had a mammogram in the past two years than women who are college graduates. Women with health care coverage were significantly more likely to have had a mammogram in the past two years when compared to women without health care coverage. Among women aged 40-64 years, those with an annual household income of less than $15,000 (73.6%) were significantly less likely to have had a mammogram in the past two years compared to those with an annual household income $75,000 and above (88.3%). Among women aged 50 years and older, non-Hispanic blacks (85.5%) were more likely to have had a mammogram in the past two years compared to nonHispanic whites (76%) and Hispanics (78.5%). Mammogram 40-64 in Past 2 Years a Mammogram 50+ in Past 2 Years b Demographic Characteristics % 95% CI % 95% CI State Totals 84.2 (80.8, 87.1) 78.3 (75.1, 81.2) Race/Ethnicity White Non-Hispanic 82.1 (77.6, 85.9) 76.0 (72.2, 79.5) Black Non-Hispanic 87.3 (80.7, 91.9) 85.5 (78.3, 90.5) Hispanic 92.0 (74.3, 97.9) 78.5 (49.9, 93.0) Age 40-44 years 87.4 (77.0, 93.5) 45-49 years 83.2 (75.0, 89.0) 50-54 years 80.9 (71.9, 87.5) 76.6 (67.5, 83.8) 55-59 years 85.3 (78.6, 90.2) 81.2 (74.4, 86.6) 60-64 years 85.5 (79.2, 90.1) 83.0 (76.5, 88.1) 65+ years 75.8 (71.0, 80.0) Annual Income Less than $15,000 73.6 (61.2, 83.1) 65.3 (54.5, 74.7) $15,000-$24,999 77.2 (64.6, 86.2) 73.2 (64.2, 80.6) $25,000-$34,999 85.9 (74.6, 92.6) 77.7 (69.0, 84.6) $35,000-$49,999 92.2 (85.3, 96.0) 85.4 (77.8, 90.8) $50,000-$74,999 91.5 (84.5, 95.5) 92.7 (86.9, 96.1) $75,000 or More 88.3 (81.0, 93.1) 87.0 (80.1, 91.7) Education Less than High School 75.6 (61.8, 85.5) 66.6 (56.5, 75.3) High School Graduate 85.2 (78.7, 90.0) 78.8 (73.1, 83.5) Some College 81.7 (74.8, 87.1) 80.8 (75.1, 85.4) College Graduate 91.2 (87.4, 93.9) 86.7 (82.5, 90.0) Health Care Coverage Has Health Coverage 89.3 (86.2, 91.8) 87.0 (83.4, 89.9) No Health Coverage 62.6 (51.4, 51.4) 50.7 (36.7, 64.6) a The proportion of women aged 40-64 years who had a mammogram within the past 2 years. b The proportion of women aged 50+ years who had a mammogram within the past 2 years. Percent (%) Percent of Females who have had a Mammogram in the Past 2 Years, by Level of Education, Georgia, 2011 40-64 Years Old 50+ Years Old 100 80 75.6 66.6 60 85.2 78.8 81.7 80.8 91.2 86.7 40 20 0 Less than High SchoHoigl h School Graduate Some College College Graduate Percent of Females who have had a Mammogram in the Past 2 Years, by Health Care Coverage, Georgia, 2011 100 89.3 87 80 60 40 20 0 Has Health Coverage 40-64 Years Old 50+ Years Old 62.6 50.7 No Health Coverage Percent of Females aged 50+ years who have had a Mammogram in the Past 2 years, by Health District, Georgia, 2011 01-1 01-2 02-0 03-1 03-4 03-2 03-5 03-3 10-0 04-0 05-2 Percent Mammogram, Females 50+ years <75% 75-<80% 80-<85% >=85% 06-0 07-0 08-2 05-1 08-1 09-2 09-1 27 Percent (%) Clinical Preventive Practices Breast Cancer Screening cont. The American Cancer Society recommends that for early breast cancer detection in women without breast symptoms, women aged 40 years and older should have a mammogram every year 23. Mammograms should be continued regardless of age, as long as there are no serious, chronic health problems such as congestive heart failure, end-stage renal disease, and chronic obstructive pulmonary disease 23. Women with serious health problems or short life expectancies should discuss breast cancer screening with their doctor. In 2011, 70.4% of Georgian women aged 40 years and older have had a mammogram in the past year. Among women aged 40 years and older, non-Hispanic blacks (75.9%) were more likely to have had a mammogram in the past year compared to non-Hispanic whites (68.9%) and Hispanics (63.4%). Women aged 65 years and older (70%) were the most likely to have had a mammogram in the past year. Among women aged 40 years and older, those with an annual household income of less than $15,000 (61.6%) were less likely to have had a mammogram in the past year compared to those with an annual household income of $15,000 or more. Women with less than a high school education (61.1%) were significantly less likely to have had a mammogram within the past year compared to women who are college graduates (76.3%). Among women aged 40 years and older, those without health care coverage (47.4%) were significantly less likely to have had a mammogram in the past year compared to those with health care coverage (75%). Mammogram 40+ in Past Year a Demographic Characteristics % 95% CI State Totals 70.4 (67.2, 73.4) Race/Ethnicity White Non-Hispanic 68.9 (65.1, 72.4) Black Non-Hispanic 75.9 (69.0, 81.6) Hispanic 63.4 (37.9,83.2) Age 40-49 years 71.4 (42.5, 89.4) 50-64 years 69.3 (61.8, 75.9) 65+ years 70 (65.2,74.3) Annual Income Less than $15,000 61.6 (51.5, 70.7) $15,000-$24,999 68.3 (60.3, 75.3) $25,000-$34,999 72 (62.7, 79.8) $35,000-$49,999 74.1 (65.6, 81.1) $50,000-$74,999 77.2 (68.0, 84.3) $75,000 or More 73.8 (66.1, 80.3) Education Less than High School 61.1 (50.8, 70.5) High School Graduate 70.8 (65.3, 75.8) Some College 69.6 (63.1, 75.4) College Graduate 76.3 (71.1, 80.9) Health Care Coverage Has Health Coverage 75 (70.7, 78.9) No Health Coverage 47.4 (36.8, 58.4) a The proportion of women aged 40+ years who had a mammogram within the past year. Percent (%) Percent of Females aged 40+ years who have had a Mammogram in the Past Year, by Race/Ethnicity, Georgia, 2011 100 75.9 80 68.9 63.4 60 40 20 0 White Non-Hispanic Black Non-Hispanic Hispanic Percent (%) Percent of Females aged 40+ years who have had a Mammogram in the Past Year, by Age Group, Georgia, 2011 100 80 71.4 69.3 70.0 60 40 20 0 40-49 yr 50-64 yr 65+ yr Percent (%) Percent of Females aged 40+ years who have had a Mammogram in the Past Year, by Health Care Coverage, Georgia, 2011 100 80 75 60 47.4 40 20 0 Has Health Coverage No Health Coverage Percent (%) Percent of Females aged 40+ years who have had a Mammogram in the Past Year, by Level of Education, Georgia, 2011 100 76.3 80 70.8 69.6 61.1 60 40 20 0 Less than High SchoHoilgh School Graduate Some College College Graduate 28 Clinical Preventive Practices Cervical Cancer Screening Cervical cancer screening is one of the most effective ways to prevent cervical cancer. Current recommendations for cervical cancer screening states that Pap testing should begin at 21 years of age. Women aged 21-65 years should have a Pap test every 3 years and women aged 30-65 years can have Pap test every 3 years or Pap and HPV co-testing every 5 years 24. Women aged 65 years or older with adequate screening history or women who had a total hysterectomy should not be screened 24. In 2011, 83.5% of Georgia women aged 21-65 years reported having a Pap test within the past 3 years. Hispanics (75.2%) were less likely to have had a Pap test in the past 3 years than other race/ethnicity groups. Woman with a lower annual household income were less likely to have had a Pap test in the past 3 years. Women with less than high school education (77%) were less likely to have had a Pap test in the past 3 years compared to college graduates (89.1%). Woman with health care coverage (88.8%) were significantly more likely to have had a Pap test in the past 3 years than women without health care coverage (66.3%). Percent (%) Percent of Females aged 21-65 years who have had a Pap Test in the Past 3 Years, by Race/Ethnicity, Georgia, 2011 100 83.1 87 75.2 80 60 40 20 0 White Non-Hispanic Black Non-Hispanic Hispanic Pap Test in Past 3 Years a Demographic Characteristics % 95% CI State Totals 83.5 (79.1, 87.1) Race/Ethnicity White Non-Hispanic 83.1 (77.6, 87.5) Black Non-Hispanic 87 (77.5, 92.8) Hispanic 75.2 (50.2, 90.1) Age 21-24 years 73.3 (24.6, 95.9) 25-34 years 84.2 (74.4, 90.8) 35-44 years 83.3 (73.9, 89.7) 45-54 years 87.1 (80.0, 91.9) 55-65 years 80 (73.5, 85.3) Annual Income Less than $15,000 80.6 (68.6, 88.7) $15,000-$24,999 80.6 (67.0, 89.5) $25,000-$34,999 68.3 (47.8, 83.5) $35,000-$49,999 88.3 (77.8, 94.2) $50,000-$74,999 94 (87.6, 97.2) $75,000 or More 92.6 (86.2, 96.2) Education Less than High School 77 (62.5, 87.1) High School Graduate 85.4 (78.6, 90.3) Some College 79.3 (68.9, 86.9) College Graduate 89.1 (82.7, 93.3) Health Care Coverage Has Health Coverage 88.8 (84.4, 92.1) No Health Coverage 66.6 (55.5, 76.2) a The proportion of adult females aged 21-65 years who have had a Pap test within the past three years. Percent (%) Percent of Females aged 21-65 years who have had a Pap Test in the Past 3 Years, by Level of Education, Georgia, 2011 100 77 80 85.4 79.3 60 40 20 0 Less than High SchoHoilgh School Graduate Some College 89.1 College Graduate Percent of Females aged 21-65 years who have had a Pap Test in the Past 3 Years, by Health Care Coverage, Georgia, 2011 100 88.8 80 60 40 20 0 Has Health Coverage 66.6 No Health Coverage Percent of Females aged 21-65 years who have had a Pap Test in the Past 3 years, by Health District, Georgia, 2011 2 1-2 1-1 3-4 3-1 10 3-2 3-5 3-3 4 5-2 Percent Pap Test <70% 70-<75% 75-<80% >=80% 6 7 5-1 9-1 9-2 8-2 8-1 29 Percent (%) Clinical Preventive Practices Prostate Cancer Screening Prostate cancer is the most common cancer in American men, second only to lung cancer in the number of related cancer deaths 25. Symptoms can include urination problems, constant pain in the back, hips, or pelvis, and painful ejaculation. Prostate specific antigen test (PSA) measures the level of PSA, a substance produced by the prostate, in the blood, which may be higher in men who have prostate cancer 26. However, other conditions such as an enlarged prostate and prostate infection may also increase PSA levels. In 2011, 50.6% of Georgia males aged 40 years or older reported having a PSA test within the past 2 years. Hispanic males aged 40 years and older (15.8%) were less likely to have had a PSA test in the past 2 years. PSA testing was lowest in men aged 40 years and older with an annual income less than $15,000 (36.9%). A higher proportion of men aged 40 years and older with a college degree (58.2%) reported having a PSA test in the past 2 years compared with those without a college degree. Men aged 40 years and older with health care coverage (47.5%) were significantly more likely to have had a PSA test compared to those without health care coverage (21.2%). Percent (%) Percent of Males aged 40+ years who have had a PSA Test in the Past 2 Years, by Race/Ethnicity, Georgia, 2011 100 80 60 51.1 55.4 40 15.8 20 0 White Non-Hispanic Black Non-Hispanic Hispanic PSA Test in Past 2 Years a Demographic Characteristics % 95% CI State Totals 50.6 (45.8, 55.4) Race/Ethnicity White Non-Hispanic 51.1 (45.9, 56.4) Black Non-Hispanic 55.4 (43.2, 66.9) Hispanic 15.8 (5.9, 36.0) Age 40-44 years 24.4 (14.9, 37.2) 45-54 years 41.8 (33.2, 50.8) 55-64 years 60.3 (52.6, 67.5) 65+ years 78.9 (73.2, 83.7) Annual Income Less than $15,000 36.9 (22.7, 53.8) $15,000-$24,999 48.2 (35.8, 60.8) $25,000-$34,999 41.5 (28.1, 56.3) $35,000-$49,999 53.9 (40.9, 66.3) $50,000-$74,999 49 (37.4, 60.7) $75,000 or More 59.3 (51.4, 66.8) Education Less than High School 40.5 (27.8, 54.6) High School Graduate 46.8 (38.6, 55.2) Some College 51.2 (41.2, 61.1) College Graduate 58.2 (50.6, 65.4) Health Care Coverage Has Health Coverage 47.5 (41.7, 53.5) No Health Coverage 21.2 (11.1, 36.8) a The proportion of adult males over 40 years of age who have had a Prostate-Specific Antigen (PSA) test within the past 2 years. Percent (%) Percent of Males aged 40+ years who have had a PSA Test in the Past 2 Years, by Level of Education, Georgia, 2011 100 80 58.2 60 46.8 51.2 40.5 40 20 0 Less than High SchoHoilgh School Graduate Some College College Graduate Percent of Males aged 40+ years who have had a PSA Test in the Past 2 Years, by Health Care Coverage, Georgia, 2011 100 80 60 47.5 40 21.2 20 0 Has Health Coverage No Health Coverage Percent of Males aged 40+ years who have had a PSA Test in the Past 2 Years, by Health District, Georgia, 2011 2 1-2 1-1 3-4 3-1 10 3-2 3-5 3-3 4 5-2 Percent PSA Test <40% 40-<50% 50-<60% >=60% 6 7 5-1 9-1 9-2 8-2 8-1 30 Percent (%) Clinical Preventive Practices Prostate Cancer Screening cont. The American Cancer Society recommends that for early detection of prostate cancer, men aged 50 years should begin talking to their doctor about whether testing is a right choice for them 27. Men at high risk of developing prostate cancer, including African Americans or those with a history of prostate cancer, should talk to their doctor at age 45 years 27. Men who want to be screened should be tested with the prostate-specific antigen (PSA) blood test. The digital rectal exam (DRE) may also be done as a part of screening. The time between future screenings will depend on the results of the PSA blood test 27. In 2011, 60.5% of Georgia males aged 45 years or older reported having a PSA test within the past 2 years. Among males aged 45 years and older, Hispanics (31.8%) were less likely to have had a PSA test in the past two years compared to non-Hispanic whites (60.8%) and nonHispanic blacks (63.7%). Males 65 years and older (79.3%) were significantly most likely to have had a PSA test in the past two years. Among males aged 45 years and older, PSA testing within the past two years was lowest in those with an annual household income less than $15,000 (48.7%). A higher proportion of men aged 45 years and older with a college degree (65.4%) had a PSA test in the past two years compared to those with less than high school education (56.1%), high school graduates (54.6%), and those with some college (63.7%). Males aged 45 years and older with health care coverage (55.8%) were significantly more likely to have had a PSA test in the past two years compared to those without health care coverage (24.7%). PSA Test in Past 2 Years a Demographic Characteristics % 95% CI State Totals 60.5 (55.6, 65.1) Race/Ethnicity White Non-Hispanic 60.8 (55.2, 66.1) Black Non-Hispanic 63.7 (50.9, 74.8) Hispanic 31.8 (14.3, 56.7) Age 45-49 years 1.81 (0.2, 13.4) 50-64 years 48.3 (36.4, 60.5) 65+ years 79.3 (73.6, 84.1) Annual Income Less than $15,000 48.7 (31.8, 65.9) $15,000-$24,999 57.6 (45.5, 68.8) $25,000-$34,999 55.5 (40.4, 69.7) $35,000-$49,999 58.5 (45.5, 70.4) $50,000-$74,999 66.2 (52.0, 77.9) $75,000 or More 66 (57.8, 73.2) Education Less than High School 56.1 (40.4, 70.7) High School Graduate 54.6 (46.0, 63.0) Some College 63.7 (53.6, 72.8) College Graduate 65.4 (57.9, 72.2) Health Care Coverage Has Health Coverage 55.8 (49.3, 62.1) No Health Coverage 24.7 (13.1, 41.7) a The proportion of adult males aged 45 and above who have had a Prostate-Specific Antigen (PSA) test within the past 2 years. Percent (%) Percent of Males aged 45+ years who have had a PSA Test in the Past 2 Years, by Race/Ethnicity, Georgia 2011 100 80 60.8 63.7 60 40 20 0 White Non-Hispanic Black Non-Hispanic 31.8 Hispanic Percent (%) Percent of Males aged 45+ years who have had a PSA Test in the Past 2 Years, by Level of Education, Georgia, 2011 100 80 63.7 56.1 60 54.6 40 20 0 Less than High SchoHoilgh School Graduate Some College 65.4 College Graduate Percent (%) Percent of Males aged 45+ years who have had a PSA Test in the Past 2 Years, byAnnual Household Income, Geogia, 2011 100 80 66.2 66 57.6 55.5 58.5 60 48.7 40 20 0 Less than $15,0$0105,000- $24,9$9295,000- $34,9$9395,000- $49,9$9590,000- $74,9$9795,000 or More Percent (%) Percent of Males aged 45+ years who have had a PSA Test in the Past 2 Years , by Health Care Coverage, Georgia, 2011 100 80 55.8 60 40 20 0 Has Health Coverage 24.7 No Health Coverage 31 Clinical Preventive Practices Colorectal Cancer Screening Colorectal cancer is the second leading cause of cancer-related deaths and third most common cancer in the United States 28. Screening can find precancerous polyps (abnormal growths in the colon or rectum) so they can be removed before turning cancerous. The U.S. Preventive Services Task Force recommends colorectal cancer screening for men and women aged 5075 years using high-sensitivity fecal occult blood testing (FOBT) every year, sigmoidoscopy every five years, or colonoscopy every ten years 29. In 2011, 60.7% of Georgia adults aged 50 years and older met the recommendations for colorectal cancer screening. Hispanics aged 50 years or older (51.1%) were least likely to meet recommendations for colorectal cancer screening. Adults aged 65 years or older (68.4%) were most likely to meet the recommendations for colorectal cancer screening. Adults aged 50 years or older with a high annual household income were more likely to meet recommendations for colorectal cancer screening. Adults aged 50 years or older with less than a high school education (44.0%) were significantly less likely to meet colorectal cancer screening recommendations when compared to those who are high school graduates (60.7%), some college (63.1%) and college graduates (70.2%). Adults aged 50 years or older without health care coverage (33.2%) were significantly less likely to meet colorectal cancer screening recommendations when compared to those with health care coverage (62.8%). Among adults aged 50 years or older, 63.8% have had a sigmoidoscopy or colonoscopy and 19.6% have had a blood stool test in the past two years. Colorectal Cancer Screening a Demographic Characteristics % 95% CI State Totals 60.7 (57.3, 63.9) Sex Males 58.4 (52.9, 63.6) Females 62.7 (58.5, 66.7) Race/Ethnicity White Non-Hispanic 61.7 (58.0, 65.3) Black Non-Hispanic 60.5 (52.5, 68.0) Hispanic 51.1 (27.2, 74.6) Age 50-54 years 44.3 (37.1, 51.8) 55-64 years 66.6 (62.1, 70.9) 65+ years 68.4 (63.2, 73.3) Annual Income Less than $15,000 44.9 (34.9, 55.4) $15,000-$24,999 50.1 (41.8, 58.4) $25,000-$34,999 60.4 (50.3, 69.7) $35,000-$49,999 69.7 (60.9, 77.2) $50,000-$74,999 71.5 (63.4, 78.5) $75,000 or More 70 (63.4, 75.9) Education Less than High School 44 (34.6, 53.8) High School Graduate 60.7 (54.9, 66.3) Some College 63.1 (56.6, 69.2) College Graduate 70.2 (65.0, 74.9) Health Care Coverage Has Health Coverage 62.8 (58.4, 67.0) No Health Coverage 33.2 (23.4, 44.7) a The proportion of adults aged 50+ years who have had a blood stool test ever year, sigmoidoscopy every five years, or colonoscopy every ten years. Percent (%) Percent of Adults aged 50+ years who met Colorectal Cancer Screening Recommendations, by Age Group, Georgia, 2011 100 80 60 44.3 40 20 0 50-54 yr 66.6 55-64 yr 68.4 65+ yr Percent (%) Percent of Adults aged 50+ years who met Colorectal Cancer Screening Recommendations, by Health Care Coverage, Georgia, 2011 100 80 62.8 60 40 20 0 Has Health Coverage 33.2 No Health Coverage Percent (%) Percent of Adults aged 50+ years who met Colorectal Cancer Screening Recommendations, by Annual Household Income, Georgia, 2011 100 80 69.7 71.5 70 60.4 60 44.9 50.1 40 20 0 Less than $15,000 $15,000$24,999 $25,000$34,999 $35,000$49,999 $50,000- $75,000 or $74,999 More Percent (%) Percent of Adults aged 50+ years who met Colorectal Cancer Screening Recommendations, by Level of Education, Georgia, 2011 100 80 60 44 40 60.7 63.1 20 0 Less than High SchoHoilgh School Graduate Some College 70.2 College Graduate 32 Clinical Preventive Practices Adult Immunizations Adult immunizations against influenza and pneumococcal disease are important preventative measures against morbidity and mortality for adults aged 65 years and older since they are at high risk of developing complications from the diseases 30. From 1976 to 2007, there was an estimated annual average of 5,546 (87.9%) influenza-associated deaths among adults 65 years and older 31. In 2011, 55.2% of Georgia adults aged 65 and older had a seasonal flu shot within the past year. Non-Hispanic whites (59.2%) were significantly more likely to receive the seasonal flu shot compared to nonHispanic blacks (43.7%). Adults with a less than high school education (48.8%) were significantly less likely to receive the seasonal flu shot compared to those with some college (59.4%) and college graduates (61.0%). In 2011, 66.5% of Georgia adults aged 65 and older have ever had the pneumonia vaccine. Non-Hispanic whites (71.9%) were significantly more likely to receive the pneumonia shot compared to nonHispanic blacks (43.7%), Hispanics (41.3%). Adults with an annual household income less than $15,000 (61.4%) were the least likely to receive the pneumonia shot. Influenza Shot a Pneumonia Shot b Demographic Characteristics % 95% CI % 95% CI State Totals 55.2 (52.9, 57.5) 66.5 (64.2, 68.8) Sex Male 54.3 (50.4, 58.2) 65.6 (61.6, 69.5) Female 55.9 (53.0, 58.6) 67.1 (64.3, 69.8) Race/Ethnicity White Non-Hispanic 59.2 (56.8, 61.7) 71.9 (69.5, 74.1) Black Non-Hispanic 43.7 (37.6, 50.1) 54.4 (47.8, 60.7) Hispanic 47.2 (28.2, 67.1) 41.3 (23.3, 61.9) Annual Income Less than $15,000 43.3 (36.8, 50.1) 61.4 (54.0, 68.3) $15,000-$24,999 55.1 (49.8, 60.2) 71.5 (66.5, 76.0) $25,000-$34,999 51 (44.8, 57.2) 64.4 (58.1, 70.2) $35,000-$49,999 57.5 (50.8, 63.9) 66.2 (59.2, 72.5) $50,000-$74,999 67.9 (61.0, 74.0) 68.1 (60.9, 74.5) $75,000 or More 66.7 (60.1, 72.6) 70.6 (63.9, 76.6) Education Less than High School 48.8 (43.3, 54.3) 65.4 (59.8, 70.7) High School Graduate 54 (50.1, 57.8) 64.7 (60.8, 68.3) Some College 59.4 (54.6, 63.9) 69.3 (64.5, 73.6) College Graduate 61 (56.7, 65.1) 68.6 (64.4, 72.5) a The proportion of adults 65+ years that had a seasonal flu shot within the past year. b The proportion of adults 65+ years that have ever had a pneumonia shot. Percent (%) Percent (%) Percent of Adults aged 65+ years who recieved Vaccinations, by Race/Ethnicity, Georgia, 2011 100 80 71.9 59.2 60 40 54.4 43.7 Flu Shot in Past Year Pneumonia Vaccine 47.2 41.3 20 0 White Non-Hispanic Black Non-Hispanic Hispanic Percent of Adults aged 65+ years who recieved Vaccinations, by Level of Education, Georgia, 2011 100 80 65.4 60 48.8 40 64.7 54 69.3 59.4 Flu Shot in Past Year Pneumonia Shot 68.6 61 20 0 Less than High SchoHoilgh School Graduate Some College College Graduate Percent of Adults aged 65+ years who received the Flu Shot, by Health District, Georgia, 2011 2 1-2 1-1 3-4 3-1 10 3-2 3-5 3-3 4 5-2 Percent Influenza Shot <50% 50-<55% 55-<60% >=60% 6 7 5-1 9-1 9-2 8-2 8-1 Percent of Adults aged 65+ years who received the Pneumonia Shot, by Health District, Georgia, 2011 2 1-2 1-1 3-4 3-1 10 3-2 3-5 3-3 4 5-2 Percent Pneumonia Shot <60% 60-<65% 65-<70% >70% 6 7 5-1 9-1 9-2 8-2 8-1 33 Bibliography 1. 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