The 2013 Georgia Behavioral Risk Factor Surveillance Report 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 Director Madhavi Vajani, MPH Team Lead 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 on 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 404-657-2588 This report was made possible with funding from the Centers for Disease Control and Prevention. Its contents do not necessarily represent the official view of the CDC. Suggested citation Vajani M, Annor F, Benson AB, Sigalo N, Bayakly RA, 2013 Georgia Behavioral Risk Factor Surveillance Report. Georgia Department of Public Health Epidemiology Program. Chronic Disease, Healthy Behaviors and Injury Epidemiology Section. July 2015. 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 U7 Chattahoochee Marion Macon Schley Stewart Webster Sumter Quitman Peach Emanuel Houston Bleckley Laurens Treutlen Candler Bulloch Dooly Pulaski U5-1 Dodge Montgomery Wheeler Toombs Evans Tattnall 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 Bacon U9-2 Wayne McIntosh Early U Baker 8-2 Miller Mitchell Colquitt UBerrien Atkinson Cook 8-1 Seminole Decatur Grady Thomas Brooks Lanier Lowndes Clinch Pierce Brantley Glynn Ware Charlton Camden Echols 3 Table of Contents 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 Arthritis .......................................................................................................................................................20 Risk Behaviors Adequate Physical Activity.........................................................................................................................21 No Leisure-Time Physical Activity ............................................................................................................22 Seatbelt Use ................................................................................................................................................23 Smoking ......................................................................................................................................................24 Smokeless Tobacco.....................................................................................................................................25 Binge Drinking ...........................................................................................................................................26 Heavy Drinking...........................................................................................................................................27 One Drink Per Month..................................................................................................................................28 Use of Equipment ......................................................................................................................................29 Clinical Preventive Practices Adult Immunizations ..................................................................................................................................30 Breast Cancer Screening .............................................................................................................................31 Cervical Cancer Screening..........................................................................................................................32 Colorectal Cancer Screening.......................................................................................................................33 HIV Testing ................................................................................................................................................34 Bibliography ..............................................................................................................................................................35 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 mostly use cellular phones.1 Weighting: Iterative proportional fitting, or raking, methodology was used for the 2013 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.1 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 was considered "statistically significant" (indicating a difference) if there was no overlap in the 95% CI of the percentages being compared. Prevalence estimates exclude those who either answered "don't know/not sure" or refused. Comparing 2013 BRFSS data to previous years: Comparison between 2013 BRFSS data and years prior to 2011 is not recommended due to the significant changes in methodology. Beginning in 2011, methodological changes have improved the accuracy, coverage, validity, and representativeness of the BRFSS.1 Data from 2011, 2012, and subsequent BRFSS can be used in trend analyses. 5 Summary of Results Summary Selected chronic conditions, risk behaviors, and clinical preventive services from the 2013 Georgia BRFSS are shown in the chart below in comparison with median prevalence from 2013 US national BRFSS data, which includes all 50 states, three territories, and Washington, D.C. Selected Chronic Conditions and Risk Factors, US and GA BRFSS, 2013 Ever Told Stroke Diabetes Heart Attack Current Smoking Obesity (BMI >= 30) 2.8 2.8 9.8 10.8 4.4 3.9 19.0 18.8 28.9 30.3 No Flu Shot in Past Year (65+ Years Old) No Health Care Coverage (18-64 Years Old) 0 20.0 27.3 20 40 Percent (%) 62.6 54.6 60 US Georgia 80 100 Stroke In 2013, 2.8% of Georgia adults had ever been diagnosed with stroke. This estimate was similar to the US estimate. Diabetes In 2013, 10.8% of Georgia adults had physician diagnosed diabetes. This estimate is higher than the US median prevalence of 9.8%. Heart Attack In 2013, 3.9% of Georgia adults had ever been told they have had a heart attack. This estimate is lower than the US median of 4.4%. Tobacco Use In 2013, 18.8% of Georgia adults currently smoked cigarettes. This estimate is slightly lower than the US median prevalence of 19.0%. (HP 2020 Objective - Reduce tobacco use by adults to 12%) Obesity In 2013, 30.3% of Georgia adults were obese. This estimate is slightly higher than the US median prevalence of 28.9%. (HP 2020 Objective - Reduce the proportion of adults who are obese to 30.5%) Flu Vaccine in Past Year In 2013, 54.6% of Georgia adults aged 65 years and older received a flu vaccine in the past year. This estimate is lower than the US median estimate of 62.6%. (HP 2020 Objective - Increase the percentage of noninstitutionalized adults aged 65 years and older who are vaccinated annually against seasonal influenza to 90%) No Health Care Coverage In 2013, 27.3% of Georgia adults did not have any form of health insurance coverage, which exceeds the US median estimate of 20.0%. (HP 2020 Objective- Increase the proportion of persons with health insurance to 100%) 6 Demographic Characteristics Demographics In 2013, there were approximately 7,500,000 adults aged 18 years and older residing in the state of Georgia .2 Approximately 8,100 adults participated in the Georgia BRFSS survey statewide. Georgia BRFSS respondents were 51.7% female and 48.3% male. Georgians completing the survey were white non-Hispanic (60.3%), black non-Hispanic (30.8%) and 8.9% Hispanic. Distribution similar to Georgia population. Approximately 25% 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 24.5% had at least a college degree. Percent (%) Distribution of Georgia Residents, by Sex, Georgia, 2013 100 80 60 48.3 51.7 40 20 0 Male Female Demographic Characteristics Sex Male Female Race/Ethnicity White Non-Hispanic Black Non-Hispanic Hispanic Age 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 65+ yr Income Less than $15,000 $15,000-$24,999 $25,000-$34,999 $35,000-$49,999 $50,000-$74,999 $75,000 or More Education Less than High School High School Graduate Some College College Graduate State Total (N=8,100) % 95% CI 48.3 (46.8, 49.8) 51.7 (50.2, 53.2) 60.3 (58.7, 61.8) 30.8 (29.3, 32.4) 8.9 (8.0,10.0) 13.8 (12.6,15.2) 18 (16.8, 19.4) 17.9 (16.7,19.2) 18.7 (17.6,19.9) 15.4 (14.5,16.3) 16.1 (15.3,16.9) 12.8 (11.8,13.9) 19.8 (18.5,21.1) 13.3 (12.1,14.5) 14.7 (13.6,16.0) 14.3 (13.3,15.5) 25.1 (23.8,26.5) 16.8 (15.5,18.2) 29.5 (28.1,30.9) 29.2 (27.8,30.6) 24.5 (23.4,25.6) Percent (%) Distribution of Georgia Residents, by Level of Education, Georgia, 2013 100 80 60 40 29.5 29.2 24.5 16.8 20 0 Less than High School High School Graduate Some College College Graduate Distribution of Georgia Residents, by Age Group, Georgia, 2013 100 80 60 40 20 13.8 18 17.9 18.7 15.4 16.1 0 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 65+ yr Percent (%) Percent (%) Distribution of Georgia Residents, by Annual Household Income, Georiga, 2013 100 80 60 40 25.1 19.8 20 12.8 13.3 14.7 14.3 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 Distribution of Georgia Residents, by Race/Ethnicity, Georiga, 2013 100 80 60.3 60 40 30.8 20 0 White Non-Hispanic Black Non-Hispanic 8.9 Hispanic 7 Percent (%) 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). It is a useful indicator of health for a variety of populations and allows for general comparisons. In 2013, 19.0% of Georgia adults reported that they perceive their health rating as fair or poor. Adults aged 65 years and older (28.7%) were most likely to report fair or poor general health when compared to other age groups. Adults with an annual household income less than $15,000 (40.5%) were significantly more likely to report fair or poor general health when compared to adults with an annual household income greater than or equal to $15,000. Adults without health insurance (25.7%) were significantly more likely to report fair or poor general health when compared to adults with health insurance (14.1%) Percent (%) Percent of Adults who reported Fair/Poor General Health, by Annual Household Income Level, Georgia, 2013 50 40.5 40 30.4 30 20.2 20 13 9.5 10 6.1 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 Percent (%) Percent of Adults who reported Fair/Poor General Health, by Age Group, Georiga, 2013 50 40 28.7 30 24.6 21.6 20 9.9 17.3 11.8 10 0 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 65+ yr The HP 2020 target for self-reporting of fair or poor physical health is 20.2%. General Health Fair/Poor a Demographic Characteristics % 95% CI State Totals 19.0 (17.9, 20.2) Sex Male 17.5 (15.7, 19.3) Female 20.5 (19.0, 22.1) Race/Ethnicity White Non-Hispanic 16.4 (15.2, 17.7) Black Non-Hispanic 21.4 (19.0, 23.9) Hispanic 30.4 (25.1, 36.3) Age 18-24 yr 9.9 (6.9, 14.0) 25-34 yr 11.8 (9.5, 14.7) 35-44 yr 17.3 (14.4, 20.6) 45-54 yr 21.6 (18.9, 24.6) 55-64 yr 24.6 (22.0, 27.4) 65+ yr 28.7 (26.3, 31.1) Income Less than $15,000 40.5 (36.2, 45.0) $15,000-$24,999 30.4 (27.0, 34.1) $25,000-$34,999 20.2 (16.8, 24.0) $35,000-$49,999 13.0 (10.2, 16.4) $50,000-$74,999 9.5 (7.4, 12.1) $75,000 or More 6.1 (4.7, 7.8) Education Less than High School 37.8 (33.7, 42.2) High School Graduate 21.5 (19.4, 23.7) Some College 16.4 (14.4, 18.7) College Graduate 6.3 (5.4, 7.4) Health Insurance Coverage Has Health Insurance 14.1 (12.8, 15.6) No Health Insurance 25.7 (22.7, 28.8) 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, 2013 <16% 16 to 20% 20 to 24% >=24% Percent (%) Percent of Adults who reported Fair/Poor General Health, by Health Insurance Status, Georgia, 2013 50 40 30 25.7 20 14.1 10 0 Has Health Coverage No Health Coverage 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.3 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 both by lack of health insurance and by insufficient coverage. In 2013, 72.3% of Georgia adults aged 18-64 years reported that they have health care coverage. Hispanics (60.2%) were significantly more likely not to have health coverage than white non-Hispanics (18.7%) and black non-Hispanics (31.9%). Adults aged 55-64 years (15.3%) were significantly less likely not to have health coverage when compared to other age groups. More than half of adults aged 18-64 years with an annual household income less than $15,000 (53.5%) did not have any form of health care coverage. Adults with less than a high school education (52.5%) were significantly more likely not to have health coverage when compared to high school graduates (33.2%), those with some college (23.2%), and college graduates (9.4%). Percent (%) Percent of Adults aged 18-64 years with No Health Care Coverage, by Race/Ethnicity, Georiga, 2013 100 80 60.2 60 40 31.9 18.7 20 0 White Non-Hispanic Black Non-Hispanic Hispanic Percent (%) Percent of Adults aged 18-64 years with No Health Care Coverage, by Annual Household Income, Georiga, 2013 100 80 60 53.5 49.5 40 35.0 18.8 20 9.0 5.3 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 The HP 2020 target for health care coverage among adults is 100%. No Health Care Coverage a Demographic Characteristics % 95% CI State Totals 27.3 (25.7, 29.0) Sex Male 29.1 (26.5, 31.7) Female 25.7 (23.7, 27.7) Race/Ethnicity White Non-Hispanic 18.7 (17.0, 20.5) Black Non-Hispanic 31.9 (28.6, 35.3) Hispanic 60.2 (54.0, 66.0) Age 18-24 yr 30.5 (25.8, 35.6) 25-34 yr 37.4 (33.3, 41.6) 35-44 yr 28.2 (24.9, 31.8) 45-54 yr 24.4 (21.4, 27.6) 55-64 yr 15.3 (13.2, 17.7) Income Less than $15,000 53.5 (48.4, 58.6) $15,000-$24,999 49.5 (45.1, 53.8) $25,000-$34,999 35.0 (29.5, 41.0) $35,000-$49,999 18.8 (15.1, 23.3) $50,000-$74,999 9.0 (6.4, 12.5) $75,000 or More 5.3 (3.6, 7.7) Education Less than High School 52.5 (47.0, 58.0) High School Graduate 33.2 (30.1, 36.5) Some College 23.2 (20.6, 26.0) College Graduate 9.4 (7.9, 11.2) a The proportion 18-64 years old who have no health care coverage. Percent of Adults aged 18-64 years with Health Care Coverage, by Health District, Georgia, 2013 <60% 60 to 70% 70 to 80% >=80% Percent (%) Percent of Adults aged 18-64 years with No Health Care Coverage, by Educaiton Level, Georiga, 2013 100 80 60 52.5 40 33.2 23.2 20 9.4 0 Less than High High School Some College College Graduate School Graduate 9 Health Status Indicators Limited Health Care Access Limited health care coverage is indicated 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 increases in access to primary care have been shown to significantly improve health-related outcomes. In 2013, 28.2% of Georgia adults did not have a personal doctor or a heath care provider. Males (33.8%) were significantly more likely not to have a personal doctor when compared to females (22.9%). Hispanics (55.3%) were significantly more likely not to have a personal doctor when compared to black nonHispanics (30.5%) and white non-Hispanics (21.8%). Adults without health insurance (61.3%) were significantly more likely not to have a personal doctor when compared to adults with health insurance (18%). In 2013, 19.8% of Georgia adults could not visit a doctor due to costs within the past 12 months. Hispanics (31.8%) and black non-Hispanics (24.5%) had higher rates of forgoing medical care due to cost when compared to white non-Hispanics (16.2%). Adults with less than a high school education (32.9%) were significantly more likely to forgo medical care due to cost when compared with adults with higher education levels. Adults without health insurance (47.2%) were significantly more likely to forgo medical care due to cost when compared to adults with health insurance (13.3%). Percent (%) Percent of Adults who have Limited Health Care Access, by Race/Ethnicity, Georiga, 2013 100 No Personal Doctor No Doctor's Visits 80 60 55.3 40 30.5 31.8 21.8 24.5 16.2 20 0 White Non-Hispanic Black Non-Hispanic Hispanic The HP 2020 target for those without usual primary care provider among adults is 16.1%. No Personal Health Care Provider a No Health Care Due to Cost b Demographic Characteristics % 95% CI % 95% CI State Totals 28.2 (26.8, 29.7) 19.8 (18.6, 21.0) Sex Male 33.8 (31.5, 36.3) 16.1 (14.3, 18.0) Female 22.9 (21.2, 24.7) 23.2 (21.6, 24.9) Race/Ethnicity White Non-Hispanic 21.8 (20.2, 23.5) 16.2 (14.8, 17.7) Black Non-Hispanic 30.5 (27.5, 33.6) 24.5 (22.0, 27.3) Hispanic 55.3 (49.2, 61.1) 31.8 (26.5, 37.5) Age 18-24 yr 49.0 (43.7, 54.2) 17.1 (13.9, 20.8) 25-34 yr 48.5 (44.3, 52.7) 25.4 (22.0, 29.1) 35-44 yr 30.6 (27.2, 34.3) 24.4 (21.2, 27.8) 45-54 yr 22.5 (19.7, 25.6) 24.9 (22.1, 27.9) 55-64 yr 13.2 (11.2, 15.5) 19.0 (16.6, 21.6) 65+ yr 6.6 (5.3, 8.3) 5.5 (4.3, 7.0) Income Less than $15,000 41.9 (37.5, 46.4) 42.8 (38.5, 47.3) $15,000-$24,999 39.1 (35.3, 43.0) 33.3 (29.8, 37.0) $25,000-$34,999 31.8 (27.2, 36.7) 21.2 (17.7, 25.2) $35,000-$49,999 25.7 (21.9, 29.9) 15.8 (12.8, 19.3) $50,000-$74,999 15.9 (13.2, 19.1) 11.1 (8.5, 14.3) $75,000 or More 15.7 (13.2, 18.7) 6.3 (4.6, 8.5) Education Less than High School 44.9 (40.3, 49.6) 32.9 (28.8, 37.4) High School Graduate 28.9 (26.2, 31.7) 19.7 (17.6, 22.1) Some College 25.4 (22.9, 28.1) 19.9 (17.8, 22.1) College Graduate 18.8 (16.9, 20.8) 10.2 (8.8, 11.8) Health Insurance Coverage Has Health Insurance 18.0 (16.6, 19.5) 13.3 (12.0, 14.7) No Health Insurance 61.3 (57.8, 64.6) 47.2 (43.6, 50.8) 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. Percent (%) Percent of Adults who have Limited Health Care Access, by Age Group, Georiga, 2013 100 No Doctor's Visit No Personal Doctor 80 60 49.0 40 32.3 20 48.5 42.2 30.830.6 29.4 22.5 18.2 13.2 0 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 8.6 6.6 65+ yr Percent (%) Percent of Adults who have Limited Health Care Access, by Health Insurance Status, Georgia, 2013 100 No Doctor's Visits No Personal Doctor 80 61.3 60 54.3 40 22.2 18 20 0 Has Health Coverage No Health Coverage 10 Health Status Indicators No Annual Doctor's Visit Annual doctor's visit serves as a preventive measure that can reduce risk factors for common chronic diseases. By having a visit every year, certain problems can be detected earlier when treatment might be more effective. In 2013, 27.1% of Georgia adults reported that they have not visited a doctor for a routine checkup within the past 12 months. Males (31.0%) were significantly more likely than females (23.6%) not to visit a doctor in the past year. Hispanics (43.2%) were significantly more likely not to visit a doctor in the past year when compared to white nonHispanics (27.1%) and black non-Hispanics (21.9%). Adults aged 65 years and older (8.6%) were significantly least likely to have not visited a doctor in the past year. Adults with an income of $15,000 - $24,999 (36.4%) were the most likely to have not visited a doctor in the past year. More than half of adults who do not have health coverage (54.3%) did not visit a doctor in the past year. Percent (%) Percent of Adults who had No Doctor's Visit Last Year, by Race/Ethnicity, Georiga, 2013 100 80 60 40 27.1 20 0 White Non-Hispanic 21.9 Black Non-Hispanic 45.2 Hispanic Percent (%) Percent of Adults who had No Doctor's Visit Last Year, by Age Group, Georiga, 2013 100 80 60 42.2 40 32.3 30.8 29.4 18.2 20 0 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 8.6 65+ yr No Doctor's Visit a Demographic Characteristics % 95% CI State Totals 27.1 (25.7, 28.6) Sex Male 31.0 (28.8, 33.4) Female 23.6 (21.9, 25.3) Race/Ethnicity White Non-Hispanic 27.1 (25.4, 28.9) Black Non-Hispanic 21.9 (19.4, 24.6) Hispanic 43.2 (37.1, 49.5) Age 18-24 yr 32.3 (27.7, 37.3) 25-34 yr 42.2 (38.0, 46.4) 35-44 yr 30.8 (27.4, 34.5) 45-54 yr 29.4 (26.3, 32.7) 55-64 yr 18.2 (16.0, 20.7) 65+ yr 8.6 (7.2, 10.2) Income Less than $15,000 34.7 (30.5, 39.2) $15,000-$24,999 36.4 (32.7, 40.3) $25,000-$34,999 29.9 (25.3, 34.9) $35,000-$49,999 22.5 (19.0, 26.3) $50,000-$74,999 22.4 (19.1, 26.0) $75,000 or More 22.8 (20.0, 25.9) Education Less than High School 34.0 (29.6, 38.8) High School Graduate 27.6 (25.0, 30.3) Some College 26.2 (23.7, 28.9) College Graduate 23.2 (21.2, 25.4) Health Insurance Coverage Has Health Insurance 22.2 (20.6, 24.0) No Health Insurance 54.3 (50.5, 58.0) a The proportion of adults who reported that they did not have a personal doctor. Percent of Adults who reported having No Annual Doctor's Visit, by Health District, Georgia, 2013 Percent (%) Percent of Adults who had No Doctor's Visit Last Year, by Health Coverage Status, Georgia, 2013 100 80 60 54.3 40 22.2 20 0 Has Health Coverage No Health Coverage 11 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 2013, 18.7% of Georgia adults reported being disabled in any way. Hispanics (5.0%) were significantly less likely to be disabled when compared to white non-Hispanics (21.4%) and bla1ck11n1o1n-Hispanics (17.6%). Adults aged 55-64 (29.8%) were the most likely to be disabled when compared to adults in other age groups. Adults with an annual household income less than $15,000 (36.2%) were the most likely to be disabled when compared to adults in other income levels. Adults with less than a high school education (24.8%) had a significantly higher prevalence of disability when compared to adults with some college (18.3%) and college graduates (13.3%). Percent (%) Percent of Adults who reported being Disabled, by Race/Ethnicity, Georiga, 2013 100 80 60 40 21.4 20 0 White Non-Hispanic 17.6 Black Non-Hispanic 5.0 Hispanic Disability a Demographic Characteristics % 95% CI State Totals 18.7 (17.6, 19.8) Sex Male 17.7 (16.1, 19.5) Female 19.6 (18.2, 21.1) Race/Ethnicity White Non-Hispanic 21.4 (20.0, 23.0) Black Non-Hispanic 17.6 (15.5, 19.8) Hispanic 5.0 (3.3, 7.4) Age 18-24 yr 9.1 (6.5, 12.6) 25-34 yr 9.3 (7.2, 12.0) 35-44 yr 14.5 (12.0, 17.4) 45-54 yr 22.0 (19.4, 24.8) 55-64 yr 29.8 (27.1, 32.7) 65+ yr 27.7 (25.3, 30.2) Income Less than $15,000 36.2 (32.2, 40.3) $15,000-$24,999 24.1 (21.1, 27.5) $25,000-$34,999 19.7 (16.4, 23.5) $35,000-$49,999 13.0 (10.6, 15.8) $50,000-$74,999 13.0 (10.6, 15.8) $75,000 or More 10.5 (8.8, 12.5) Education Less than High School 24.8 (21.2, 28.6) High School Graduate 20.1 (18.1, 22.2) Some College 18.3 (16.4, 20.5) College Graduate 13.3 (11.8, 14.8) Health Insurance Coverage Has Health Insurance 16.8 (15.4, 18.2) No Health Insurance 17.9 (15.5, 20.6) 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, 100 byAnnual Household Income, Georgia, 2013 80 60 40 36.2 24.1 19.7 20 13 13 10.5 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 Percent of Adults who reported being Disabled, by Health District, Georgia, 2013 Percent (%) Percent (%) Percent of Adults who reported being Disabled, 100 by Education Level, Georgia, 2013 80 60 40 24.8 20.1 18.3 20 13.3 0 Less than High School High School Graduate Some College College Graduate 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 2013, 14.0% of Georgia adults reported ever having asthma and 8.4% currently have asthma. Adult females were significantly more likely than males to have ever had asthma (16.6% vs. 11.3%) and to currently have asthma (11.3% vs. 5.2%). White non-Hispanics (7.9%) and black non-Hispanics (10.5%) were more likely to currently have asthma when compared to Hispanics (5.9%). Adults with a household income of less than $15,000 were significantly the most likely to ever had asthma (24.7%) and to currently have asthma (18.0%). Percent (%) Percent of Adults who have had Asthma, by Gender, Georgia, 2013 50 Lifetime Asthma 40 Current Asthma 30 20 11.3 10 5.2 16.6 11.3 0 Male Female Percent (%) Percent of Adults who have had Asthma, by Race/Ethnicity, Georiga, 2013 50 40 30 20 15.9 10 7.9 16.5 10.5 Lifetime Asthma Current Asthma 10.2 5.9 0 White Non-Hispanic Black Non-Hispanic Hispanic Lifetime Asthma a Current Asthma b Demographic Characteristics % 95% CI % 95% CI State Totals 14.0 (13.0, 15.1) 8.4 (7.6, 9.2) Sex Male 11.3 (9.8, 13.0) 5.2 (4.3, 6.4) Female 16.6 (15.2, 18.0) 11.3 (10.1, 12.5) Race/Ethnicity White Non-Hispanic 13.9 (12.6, 15.2) 7.9 (6.9, 8.9) Black Non-Hispanic 16.5 (14.4, 18.9) 10.5 (8.8, 12.4) Hispanic 10.2 (7.3, 14.2) 5.9 (3.8, 8.9) Age 18-24 yr 21.5 (17.5, 26.2) 13.0 (10.0, 16.8) 25-34 yr 14.5 (11.8, 17.7) 6.7 (5.1, 8.8) 35-44 yr 13.0 (10.8, 15.5) 7.9 (6.2, 10.0) 45-54 yr 12.1 (10.3, 14.2) 7.3 (5.9, 9.0) 55-64 yr 14.1 (12.1, 16.4) 9.0 (7.4, 10.9) 65+ yr 10.7 (9.2, 12.5) 7.7 (6.4, 9.2) Income Less than $15,000 24.7 (21.1, 28.8) 18.0 (14.8, 21.6) $15,000-$24,999 15.2 (12.8, 18.0) 8.9 (7.1, 11.1) $25,000-$34,999 12.7 (9.9, 16.2) 8.8 (6.3, 12.0) $35,000-$49,999 10.8 (8.4, 13.7) 6.0 (4.4, 8.1) $50,000-$74,999 9.3 (7.3, 11.7) 5.7 (4.1, 7.8) $75,000 or More 11.8 (9.9, 13.9) 5.4 (4.3, 6.8) Education Less than High School 17.9 (14.5, 21.9) 11.0 (8.7, 13.9) High School Graduate 13.2 (11.5, 15.2) 8.2 (6.9, 9.8) Some College 14.1 (12.3, 16.1) 8.3 (6.9, 9.8) College Graduate 12.4 (10.9, 14.1) 7.0 (5.8, 8.3) Health Insurance Coverage Has Health Insurance 14.4 (13.1, 15.8) 8.3 (7.3, 9.4) No Health Insurance 15.6 (13.1, 18.6) 9.3 (7.4, 11.6) 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, 2013 Percent (%) Percent of Adults who have had Asthma, by Annual Household Income, Georgia, 2013 50 40 30 24.7 Lifetime Asthma Current Asthma 20 18 15.2 8.9 12.7 8.8 10.8 9.3 11.8 10 6 5.7 5.4 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 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 the sixth in Georgia, increasing the risk for heart disease, stroke, high blood pressure, blindness, kidney disease, amputations, nerve problems, dental disease, and infections.7 In 2013, 10.8% of Georgia adults reported ever being diagnosed with diabetes by a health care professional. Black non-Hispanics (13.7%) were significantly more likely to have ever been diagnosed with diabetes than Hispanics (7.2%). The prevalence of diabetes was highest among adults aged 65 years and older (23.0%). Adults with a household income of less than $15,000 (15.7%) were the most likely to ever have diabetes compared with adults from other income levels. Adults with less than a high school education (14.3%) were significantly more likely to ever have diabetes when compared to college graduates (7.6%). Percent (%) Percent of Adults Diagnosed with Diabetes, by Race/Ethnicity, Georiga, 2013 30 25 20 15 9.9 10 5 0 White Non-Hispanic 13.7 Black Non-Hispanic 7.2 Hispanic Percent (%) Percent of Adults Diagnosed with Diabetes, by Age Group, Georiga, 2013 30 25 20.1 20 15 12.2 10 5.5 5 2.4 2.1 0 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 23.0 65+ yr Diabetes a Demographic Characteristics % 95% CI State Totals 10.8 (10.0, 11.7) Sex Male 9.8 (8.6, 11.2) Female 11.7 (10.7, 12.8) Race/Ethnicity White Non-Hispanic 9.9 (9.0, 10.9) Black Non-Hispanic 13.7 (11.9, 15.7) Hispanic 7.2 (4.9, 10.6) Age 18-24 yr 2.4 (1.1, 5.3) 25-34 yr 2.1 (1.3, 3.5) 35-44 yr 5.5 (4.1, 7.2) 45-54 yr 12.2 (10.2, 14.6) 55-64 yr 20.1 (17.6, 22.8) 65+ yr 23.0 (20.8, 25.3) Income Less than $15,000 15.7 (13.1, 18.7) $15,000-$24,999 11.8 (9.9, 14.0) $25,000-$34,999 13.0 (10.2, 16.4) $35,000-$49,999 8.9 (6.8, 11.4) $50,000-$74,999 9.1 (7.2, 11.5) $75,000 or More 8.0 (6.4, 10.0) Education Less than High School 14.3 (11.9, 17.0) High School Graduate 11.8 (10.3, 13.5) Some College 10.5 (8.9, 12.2) College Graduate 7.6 (6.6, 8.8) Health Insurance Coverage Has Health Insurance 9.0 (8.0, 10.1) No Health Insurance 7.0 (5.6, 8.8) a The proportion of adults who have physician-diagnosed diabetes. Adults with prediabetes or diabetes only during pregnancy are not considered to have diagnosis of diabetes. Percent of Adults Diagnosed with Diabetes, by Health District, Georgia, 2013 Percent (%) Percent of Adults Diagnosed with Diabetes, by Education Level, Georgia, 2013 30 25 20 14.3 15 11.8 10.5 10 7.6 5 0 Less than High School High School Graduate Some College College Graduate 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 2013, 3.9% of Georgia adults had ever been told that they have had a heart attack. Adult males (4.6%) were more likely to have had a heart attack when compared to females (3.3%). Adults aged 65 years or older (12.0%) were significantly more likely to have had a heart attack when compared to other age groups. Adults with a household income of less than $15,000 (7.5%) were significantly the most likely to have had a heart attack. Percent (%) Percent of Adults who have had a Heart Attack, by Race/Ethnicity, Georiga, 2013 15 10 4.4 5 3.6 0 White Non-Hispanic Black Non-Hispanic 1.9 Hispanic Percent (%) Percent of Adults who have had a Heart Attack, by Age Group, Georiga, 2013 15 12.0 10 7.2 5 0.1 0 18-24 yr 0.2 25-34 yr 1.3 35-44 yr 3.0 45-54 yr 55-64 yr 65+ yr Heart Attack a Demographic Characteristics % 95% CI State Totals 3.9 (3.5, 4.4) Sex Male 4.6 (3.9, 5.5) Female 3.3 (2.7, 3.9) Race/Ethnicity White Non-Hispanic 4.4 (3.8, 5.1) Black Non-Hispanic 3.6 (2.8, 4.7) Hispanic 1.9 (1.0, 3.6) Age 18-24 yr 0.1 (0.0, 1.0) 25-34 yr 0.2 (0.1, 0.8) 35-44 yr 1.3 (0.8, 2.3) 45-54 yr 3.0 (2.1, 4.1) 55-64 yr 7.2 (5.7, 9.1) 65+ yr 12.0 (10.2, 14.0) Income Less than $15,000 7.5 (5.8, 9.6) $15,000-$24,999 4.3 (3.3, 5.5) $25,000-$34,999 3.8 (2.5, 5.7) $35,000-$49,999 3.5 (2.5, 4.8) $50,000-$74,999 3.6 (2.2, 5.7) $75,000 or More 1.7 (1.2, 2.5) Education Less than High School 5.2 (3.9, 6.9) High School Graduate 5.0 (4.1, 6.2) Some College 3.6 (2.8, 4.5) College Graduate 2.1 (1.6, 2.8) Health Insurance Coverage Has Health Insurance 2.5 (2.1, 3.1) No Health Insurance 1.9 (1.3, 2.7) a The proportion of adults who had ever been told by a health professional that they had a heart attack of myocardial infarction. Percent of Adults who have had a Heart Attack, by Health District, Georgia, 2013 Percent (%) Percent of Adults who have had a Heart Attack, by Annual Household Income, Georgia, 2013 15 10 7.5 5 4.3 3.8 3.5 3.6 1.7 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 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 fourth leading cause of death in the United States and the fifth in Georgia, and can cause significant disability, such as paralysis, speech difficulties, and emotional problems.9 In 2013, 2.8% of Georgia adults reported ever being told by a health professional that they had a stroke. Hispanics (0.7%) were significantly least likely to have ever had a stroke when compared to black non-Hispanics (3.1%) and white non-Hispanics (3.2%). Adults of age 65 years or older (8.1%) were significantly most likely to have ever had a stroke. Adults with household income less than $15,000 (7.0%) were most likely to have ever had a stroke. Adults with less than a high school education (4.9%) were most likely to have ever had a stroke when compared to high school graduates (3.4%), those with some college (2.6%), and college graduates (1.1%). Percent of Adults who have ever had Stroke, by Race/Ethnicity, Georiga, 2013 15 Percent (%) 10 5 3.2 3.1 0 White Non-Hispanic Black Non-Hispanic 0.7 Hispanic Percent of Adults who ever had Stroke, by Age Group, Georiga, 2013 15 Stroke a Demographic Characteristics % 95% CI State Totals 2.8 (2.5, 3.3) Sex Male 2.3 (1.8, 2.8) Female 3.4 (2.8, 4.0) Race/Ethnicity White Non-Hispanic 3.2 (2.7, 3.8) Black Non-Hispanic 3.1 (2.4, 4.0) Hispanic 0.7 (0.2, 2.1) Age 18-24 yr 0.1 (0.0, 0.6) 25-34 yr 0.7 (0.3, 1.5) 35-44 yr 1.5 (0.8, 2.9) 45-54 yr 2.8 (2.0, 4.0) 55-64 yr 3.9 (3.0, 5.1) 65+ yr 8.1 (6.8, 9.6) Income Less than $15,000 7.0 (5.2, 9.4) $15,000-$24,999 4.1 (3.1, 5.5) $25,000-$34,999 2.4 (1.6, 3.6) $35,000-$49,999 1.6 (1.1, 2.5) $50,000-$74,999 1.9 (1.1, 3.1) $75,000 or More 1.1 (0.7, 1.7) Education Less than High School 4.9 (3.6, 6.6) High School Graduate 3.4 (2.7, 4.3) Some College 2.6 (2.0, 3.3) College Graduate 1.1 (0.8, 1.5) Health Insurance Coverage Has Health Insurance 1.8 (1.4, 2.2) No Health Insurance 1.9 (1.2, 3.1) aThe 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, 2013 10 8.1 Percent (%) 5 3.9 2.8 1.5 0.1 0.7 0 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 65+ yr Percent (%) Percent of Adults who have ever had Stroke, by Level of Education, Georgia, 2013 15 10 4.9 5 3.4 0 Less than High School High School Graduate 2.6 1.1 Some College College Graduate 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 2013, 3.7% of Georgia adults reported ever being told by a health professional that they have angina or coronary heart disease. Adult males (4.4%) were more likely to have had angina when compared to adult females (3.1%). Hispanics (1.5%) were least likely to have had angina when compared to black non-Hispanics (3.1%) and white non-Hispanics (4.4%). Adults aged 65 years and older were most likely to have had angina (10.3%) when compared to other age groups. Percent (%) Percent of Adults who have ever had Angina, by Race/Ethnicity, Georiga, 2013 15 10 5 4.4 3.1 0 White Non-Hispanic Black Non-Hispanic 1.5 Hispanic Percent of Adults who ever had Angina, by Age Group, Georiga, 2013 15 10 7.0 5 4.0 1.1 0.2 0.1 0 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 10.3 65+ yr Percent (%) Angina a Demographic Characteristics % 95% CI State Totals 3.7 (3.3, 4.2) Sex Male 4.4 (3.7, 5.3) Female 3.1 (2.6, 3.7) Race/Ethnicity White Non-Hispanic 4.4 (3.8, 5.1) Black Non-Hispanic 3.1 (2.4, 4.1) Hispanic 1.5 (0.6, 3.8) Age 18-24 yr 0.2 (0.0, 1.2) 25-34 yr 0.1 (0.0, 0.8) 35-44 yr 1.1 (0.6, 2.3) 45-54 yr 4.0 (2.9, 5.4) 55-64 yr 7.0 (5.6, 8.8) 65+ yr 10.3 (8.8, 12.1) Income Less than $15,000 6.4 (4.8, 8.4) $15,000-$24,999 3.8 (2.8, 5.0) $25,000-$34,999 4.3 (2.8, 6.5) $35,000-$49,999 3.7 (2.7, 5.1) $50,000-$74,999 2.5 (1.5, 4.3) $75,000 or More 2.6 (1.9, 3.4) Education Less than High School 4.4 (3.2, 6.0) High School Graduate 4.2 (3.3, 5.2) Some College 3.6 (2.9, 4.6) College Graduate 2.9 (2.3, 3.7) Health Insurance Coverage Has Health Insurance 2.9 (2.4, 3.6) No Health Insurance 1.3 (0.8, 2.0) 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, 2013 Percent (%) Percent of Adults who have ever had Angina, by Health Insurance Status, Georgia, 2013 15 10 5 2.9 0 Has Health Coverage 1.3 No Health Coverage 17 Chronic Conditions Obesity 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 2013, 30.2% of Georgia adults were obese. Adult females (31.4%) were more likely to be obese than males (29.0%). Black non-Hispanics (38.0%) were significantly more likely to be obese when compared to white non-Hispanics (27.2%). Adults with an age of 18-24 years (21.1%) were least likely to be obese when compared to adults of age 25 or older. Adults who are college graduates (24.3%) were significantly least likely to be obese when compared to any other education category. Percent (%) Percent of Adults who were Obese, by Gender, Georgia, 2013 100 80 60 40 29 31.4 20 0 Male Female Percent of Adults who were Obese, by Race/Ethnicity, Georiga, 2013 100 80 60 38.0 40 27.2 29.2 20 0 White Non-Hispanic Black Non-Hispanic Hispanic Percent (%) The HP 2020 target for obesity among adults is 30.5%. Obese a Demographic Characteristics % 95% CI State Totals 30.2 (28.8, 31.7) Sex Male 29.0 (26.9, 31.2) Female 31.4 (29.7, 33.3) Race/Ethnicity White Non-Hispanic 27.2 (25.6, 28.9) Black Non-Hispanic 38.0 (35.0, 41.1) Hispanic 29.2 (23.7, 35.4) Age 18-24 yr 21.1 (17.0, 25.9) 25-34 yr 27.3 (23.8, 31.3) 35-44 yr 34.2 (30.6, 38.0) 45-54 yr 34.6 (31.4, 38.0) 55-64 yr 36.1 (33.1, 39.1) 65+ yr 26.5 (24.1, 29.0) Income Less than $15,000 35.8 (31.6, 40.2) $15,000-$24,999 33.2 (29.8, 36.8) $25,000-$34,999 32.1 (27.8, 36.7) $35,000-$49,999 31.6 (27.6, 35.8) $50,000-$74,999 32.8 (28.9, 36.9) $75,000 or More 24.7 (22.1, 27.6) Education Less than High School 34.9 (30.5, 39.5) High School Graduate 32.1 (29.5, 34.8) Some College 30.9 (28.3, 33.6) College Graduate 24.3 (22.3, 26.4) Health Insurance Coverage Has Health Insurance 30.5 (28.7, 32.4) No Health Insurance 32.3 (28.9, 35.9) 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, 2013 Percent (%) Percent of Adults who were Obese, by Education Level, Georgia, 2013 100 80 60 40 34.9 32.1 30.9 24.3 20 0 Less than High School High School Graduate Some College College Graduate 18 Chronic Conditions Overweight Overweight is defined as having a body mass index (BMI) between 25.0 and 29.9 kg/m2. Being overweight increases poor health outcomes such as coronary heart disease, type 2 diabetes, high blood pressure, stroke, liver and gallbladder disease, and cancer.12 In 2013, 35.3% of Georgia adults were overweight. Adult males (40.9%) were significantly more likely to be overweight than females (29.7%). Hispanics (32.7%) were least likely to be overweight when compared to white non-Hispanics (36.0%) and black nonHispanics (35.7%). Adults of 18-24 years (21.8%) were significantly least likely to be overweight when compared to adults of age 25 or older. Adults with an annual income of $50,000-$74,999 (39.3%) were most likely to be overweight when compared to adults from any other annual household income category. Percent (%) Percent of Adults who were Overweight, by Gender, Georgia, 2013 100 80 60 40.9 40 29.7 20 0 Male Female Percent of Adults who were Overweight, by Annual Household Income, Georgia, 2013 100 The HP 2020 target for adults who are at a healthy weight is 33.9%. Overweight a Demographic Characteristics % 95% CI State Totals 35.3 (33.8, 36.8) Sex Male 40.9 (38.6, 43.4) Female 29.7 (28.0, 31.5) Race/Ethnicity White Non-Hispanic 36.0 (34.2, 37.8) Black Non-Hispanic 35.7 (32.7, 38.9) Hispanic 32.7 (26.9, 39.2) Age 18-24 yr 21.8 (17.7, 26.6) 25-34 yr 35.2 (31.0, 39.5) 35-44 yr 36.3 (32.6, 40.2) 45-54 yr 38.7 (35.4, 42.0) 55-64 yr 36.8 (33.9, 39.8) 65+ yr 40.2 (37.5, 42.9) Income Less than $15,000 33.2 (29.0, 37.6) $15,000-$24,999 33.4 (29.7, 37.3) $25,000-$34,999 31.6 (27.4, 36.2) $35,000-$49,999 37.0 (32.7, 41.6) $50,000-$74,999 39.3 (35.3, 43.4) $75,000 or More 38.4 (35.4, 41.5) Education Less than High School 36.6 (32.0, 41.5) High School Graduate 34.4 (31.7, 37.2) Some College 33.3 (30.6, 36.1) College Graduate 37.9 (35.6, 40.3) Health Insurance Coverage Has Health Insurance 34.3 (32.4, 36.3) No Health Insurance 34.3 (30.8, 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 (%) 80 60 40 33.2 33.4 31.6 37 39.3 38.4 Percent of Adults who were Overweight, by Public Health District, Georgia, 2013 20 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 Percent (%) Percent of Adults who were Overweight, by Age Group, Georiga, 2013 100 80 60 40 35.2 36.3 38.7 36.8 21.8 20 0 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 40.2 65+ yr 19 Chronic Conditions Arthritis Arthritis refers to rheumatic conditions that cause pain in and around joints and connective tissues. This pain can develop over time or can occur suddenly. Arthritis pain can be relieved by engaging in frequent physical activity.33 In 2013, 24.1% of Georgia adults had arthritis. Adult females (27.6%) were significantly more likely to have arthritis than males (20.4%). Hispanics (7.4%) were significantly least likely to have arthritis when compared to white non-Hispanics (28.7%) and black non-Hispanics (22.1%). Adults aged 65 years and older (51.0%) were significantly more likely to have arthritis when compared to other age groups. Adults with an annual income of less than $15,000 (37.9%) were significantly most likely to have arthritis when compared to adults from any other annual household income category. Percent (%) Percent of Adults who had Arthritis, by Gender, Georgia, 2013 100 80 60 40 27.6 20.4 20 0 Male Female Percent (%) Percent of Adults who had Arthritis, by Age Group, Georiga, 2013 100 80 60 42.7 40 28.5 20 4.1 14.3 4.9 0 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 51.0 65+ yr Demographic Characteristics State Totals Sex Male Female Race/Ethnicity White Non-Hispanic Black Non-Hispanic Hispanic Age 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 65+ yr Income Less than $15,000 $15,000-$24,999 $25,000-$34,999 $35,000-$49,999 $50,000-$74,999 $75,000 or More Education Less than High School High School Graduate Some College College Graduate Health Insurance Coverage Has Health Insurance No Health Insurance Arthritis % 95% CI 24.1 (23.0, 25.3) 20.4 (18.7, 22.3) 27.6 (26.1, 29.1) 28.7 (27.1, 30.3) 22.1 (19.9, 24.5) 7.4 (5.1, 10.5) 4.1 (2.3, 7.3) 4.9 (3.3, 7.1) 14.3 (11.9, 17.1) 28.5 (25.6, 31.7) 42.7 (39.8, 45.8) 51.0 (48.3, 53.7) 37.9 (33.7, 42.3) 25.6 (22.7, 28.6) 23.8 (20.4, 27.7) 19.8 (16.8, 23.2) 22.9 (19.9, 26.1) 19.9 (17.5, 22.5) 31.1 (27.4, 35.0) 26.5 (24.3, 28.8) 22.8 (20.7, 25.1) 18.3 (16.7, 20.0) 27.0 (25.6, 28.4) 15.0 (12.9, 17.4) Percent of Adults who had Arthritis, by Health District, Georgia, 2013 Percent (%) Percent of Adults who had Arthritis, by Annual Household Income, Georiga, 2013 100 80 60 37.9 40 25.6 23.8 19.8 22.9 19.9 20 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 20 Risk Behaviors Adequate Physical Activity Adequate physical activity can lower the risk of chronic disease, falls and fractures, helps maintain healthy body weight, and enhance quality of life. The U.S. Department of Health and Human Services recommend that adults aged 18-64 years participate in moderate physical activity for at least 150 minutes per week, vigorous physical activities for at least 75 minutes per week, or an equivalent combination of both and also participate in muscle strengthening activities on two or more days per week.13 In 2013, 20.9% of Georgia adults currently meet both the aerobic and muscle strengthening components of the physical activity recommendations. Adult males (25.4%) were significantly more likely than females (16.8%) to engage in adequate physical activity. Hispanic (12.9%) adults were significantly less likely to engage in adequate physical activity when compared to white non-Hispanic (21.5%) and black non-Hispanic adults (21.7%). The proportion of adults who engaged in adequate physical activity decreases as age increases. Adults with a household income of $75,000 or more (26.3%) were more likely to engage in adequate physical activity when compared to adults in other household income levels. Adults with a less than high school education (12.5%) were significantly less likely to engage in adequate physical activity when compared to adults with some college (22.3%) and college graduates (27.4%). The HP 2020 target for combined aerobic and muscle strengthening components among adults is 20.1%. The current prevalence among Georgia adults meets this goal. Percent of Adults who Engaged in Adequate Physical Activity, by Gender, Georgia, 2013 50 40 Adequate Physical Activity Demographic Characteristics % 95% CI State Totals 20.9 (19.5, 22.4) Sex Male 25.4 (23.0, 27.8) Female 16.8 (15.3, 18.3) Race/Ethnicity White Non-Hispanic 21.5 (19.9, 23.3) Black Non-Hispanic 21.7 (18.7, 25.1) Hispanic 12.9 (9.4, 17.5) Age 18-24 yr 33.0 (27.8, 38.7) 25-34 yr 25.3 (21.4, 29.7) 35-44 yr 18.5 (15.7, 21.7) 45-54 yr 20.4 (17.6, 23.6) 55-64 yr 15.1 (13.0, 17.5) 65+ yr 14.9 (12.9, 17.0) Income Less than $15,000 14.2 (11.2, 17.8) $15,000-$24,999 17.0 (14.2, 20.2) $25,000-$34,999 16.3 (12.5, 20.9) $35,000-$49,999 22.4 (18.4, 26.9) $50,000-$74,999 22.4 (19.0, 26.3) $75,000 or More 26.3 (23.5, 29.3) Education Less than High School 12.5 (8.9, 17.3) High School Graduate 18.7 (16.2, 21.5) Some College 22.3 (19.7, 25.1) College Graduate 27.4 (25.2, 29.7) Health Insurance Coverage Has Health Insurance 23.3 (21.5, 25.2) No Health Insurance 18.6 (15.4, 22.3) 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, 2013 Percent (%) 30 25.4 20 16.8 10 <16% 16 to 20% 20 to 24% >=24% 0 Male Female Percent (%) Percent of Adults who Engaged in Adequate Physical Activity, by Annual Household Income, Georiga, 2013 50 40 30 26.3 22.4 22.4 20 14.2 17.0 16.3 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 21 Risk Behaviors No Leisure-Time Physical Activity Leisure-time physical activity helps improve overall health and fitness, and reduces your risk for many chronic diseases such as cardiovascular disease, diabetes, colon and breast cancers, and osteoporosis. Regular physical activity also helps to maintain body weight, healthy bones, muscles, and joints, reduce symptoms of anxiety and depression, and enhances quality of life.14 In 2013, 27.2% of Georgia adults were physically inactive during leisure time within the past month. Adult females (31.1%) were significantly more likely than males (23.0%) to be physically inactive. Adults with an income of $75,000 or more (14.6%) were significantly least likely to be physically inactive. Adults with a less than high school education (42.2%) were significantly more likely to be physically inactive when compared to high school graduates (32.1%), adults with some college (24.2%), and college graduates (15.2%). Adults with health insurance (23.0%) were significantly less likely to be physically inactive when compared to adults without health insurance (34.4%). Percent (%) Percent of Adults who reported No Leisure -Time Activity, by Gender, Georiga, 2013 100 80 60 40 31.1 23.0 20 0 Male Female Percent of Adults who reported No Leisure -Time Activity, by Income Level, Georiga, 2013 100 80 The HP 2020 target for adults who engage in no leisure-time physical activity is 32.6%. The current prevalence among Georgia adults meets this goal. No Leisure-Time Physical Activity a Demographic Characteristics % 95% CI State Totals 27.2 (25.8, 28.7) Sex Male 23.0 (21.0, 25.2) Female 31.1 (29.3, 33.0) Race/Ethnicity White Non-Hispanic 25.2 (23.6, 26.8) Black Non-Hispanic 30.9 (28.0, 34.0) Hispanic 30.3 (24.8, 36.6) Age 18-24 yr 19.4 (15.3, 24.3) 25-34 yr 35-44 yr 22.9 (19.4, 26.9) 26.4 (23.0, 30.0) 45-54 yr 30.4 (27.2, 33.8) 55-64 yr 29.1 (26.3, 32.0) 65+ yr 34.4 (31.8, 37.2) Income Less than $15,000 38.2 (33.9, 42.6) $15,000-$24,999 36.5 (32.8, 40.4) $25,000-$34,999 31.4 (26.8, 36.4) $35,000-$49,999 25.9 (22.2, 30.0) $50,000-$74,999 21.7 (18.5, 25.3) $75,000 or More 14.6 (12.4, 17.2) Education Less than High School 42.2 (37.4, 47.0) High School Graduate 32.1 (29.4, 34.9) Some College 24.2 (21.9, 26.8) College Graduate 15.2 (13.6, 16.9) Health Insurance Coverage Has Health Insurance 23.0 (21.3, 24.7) No Health Insurance 34.4 (30.7, 38.2) 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, 2013 Percent (%) 60 38.2 40 36.5 31.4 25.9 21.7 20 14.6 0 Less Than $15,000 - $25,000 - $35,000 - $50,000 - $75,000 or $15,000 $14,999 $34,999 $49,999 $74,999 More Percent No Leisure-Time Physical Activity <<2645%% 2645-t>==4705%% Percent (%) Percent of Adults who reported No Leisure -Time Activity, by Health Insurance Status, Georiga, 2013 100 80 60 40 34.4 23.0 20 0 Has Health Coverage No Health Coverage 22 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 seat safety belt approved under federal motor vehicle safety standard 208.16 In 2013, 94.2% of Georgia adults reported always or almost always using a seatbelt when they are driving or riding in a car. Females (96.5%) were significantly more likely to always or almost always use a seatbelt when compared to males (91.7%). Adults aged 25-34 years (92%) were least likely to always or almost always use a seatbelt when compared to all other age groups. Adults identified as college graduates (97.6%) were significantly more likely to always or almost always use a seatbelt when compared to adults with lower levels of education. Adults with health coverage (95.4%) were significantly more likely to always use a seatbelt when compared to those without health coverage (90.3%). The HP 2020 target for seatbelt use is 92.4%. Percent (%) Percent of Adults who Always Use a Seatbelt, by Gender, Georgia, 2013 100 91.7 96.5 80 60 40 20 0 Male Female Percent (%) Percent of Adults who Always Use a Seatbelt, by Age Group Georgia, 2013 100 92.9 92 94.6 94.1 96.2 95.7 80 60 40 20 0 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 65+ yr Always/Almost Always use a Seatbelt a Demographic Characteristics % 95% CI State Totals 94.2 (93.3, 95.0) Sex Male 91.7 (90.1, 93.1) Female 96.5 (95.6, 97.2) Race/Ethnicity White Non-Hispanic 94.6 (93.6, 95.4) Black Non-Hispanic 93.0 (90.7, 94.8) Hispanic 94.1 (90.0, 96.6) Age 18-24 yr 92.9 (89.8, 95.1) 25-34 yr 92.0 (89.1, 94.2) 35-44 yr 94.6 (92.2, 96.3) 45-54 yr 94.1 (91.6, 95.9) 55-64 yr 96.2 (94.8, 97.2) 65+ yr 95.7 (94.5, 96.7) Income Less than $15,000 91.3 (88.2, 93.7) $15,000-$24,999 92.8 (90.2, 94.8) $25,000-$34,999 91.0 (86.9, 93.8) $35,000-$49,999 95.3 (93.0, 96.8) $50,000-$74,999 96.0 (94.0, 97.3) $75,000 or More 97.2 (96.1, 98.0) Education Less than High School 90.9 (87.1, 93.6) High School Graduate 92.5 (90.6, 94.0) Some College 95.0 (93.6, 96.1) College Graduate 97.6 (96.8, 98.2) Health Insurance Coverage Has Health Insurance 95.4 (94.6, 96.1) No Health Insurance 90.3 (87.4, 92.6) a The proportion of adults who always or almost always use a seatbelt while driving or riding in a car. Percent of Adults who always use Seatbelt, by Health District, Georgia, 2013 Percent Seat Belt Use <<9805%% 9805-t>==9961%% Percent (%) Percent of Adults who Always Use a Seatbelt, by Level of Education Georgia, 2013 100 90.9 92.5 95 97.6 80 60 40 20 0 Less than High School High School Graduate Some College College Graduate 23 Risk Behaviors Smoking Cigarette smoking is one of the leading causes of preventable deaths in the United States.17 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 2013, 18.8% of Georgia adults were current cigarette smokers and 20.6% were former smokers. Adult males (22.5%) were significantly more likely to currently smoke cigarettes than females (15.4%). Adults with an annual income of less than $15,000 (31.7%) were more likely to currently smoke cigarettes than those with an annual income of $15,000 or greater. Adults with less than a high school education (29.3%) were significantly more likely to currently smoke cigarettes when compared to high school graduates (21.8%), those with some college (19.2%), and college graduates (7.8%). Adults with health insurance (16.9%) were significantly less likely to currently smoke when compared to adults without health insurance (31.6%). The HP 2020 target for current cigarette smokers is 12%. Percent (%) Percent of Adults who Smoke Cigarettes, by Gender, Georgia, 2013 50 40 30 22.5 20 15.4 10 0 Male Female Percent of Adults who Smoke Cigarettes, by Level of Education, Georgia, 2013 50 Current Smoker a Former Smoker b Demographic Characteristics % 95% CI % 95% CI State Totals 18.8 (17.6, 20.1) 20.6 (19.5, 21.8) Sex Male 22.5 (20.5, 24.8) 24.5 (22.6, 26.5) Female 15.4 (14.0, 16.9) 17.0 (15.8, 18.4) Race/Ethnicity White Non-Hispanic 20.6 (19.0, 22.3) 25.5 (23.9, 27.1) Black Non-Hispanic 17.3 (14.9, 20.0) 14.5 (12.6, 16.7) Hispanic 13.3 (9.5, 18.3) 11.8 (8.6, 16.1) Age 18-24 yr 16.5 (13.1, 20.6) 6.1 (4.2, 8.8) 25-34 yr 26.9 (23.1, 31.1) 14.9 (12.2, 18.1) 35-44 yr 19.9 (17.0, 23.1) 15.6 (13.1, 18.5) 45-54 yr 21.6 (18.8, 24.8) 18.8 (16.3, 21.7) 55-64 yr 17.8 (15.5, 20.4) 29.0 (26.3, 31.9) 65+ yr 8.7 (7.2, 10.6) 38.8 (36.2, 41.6) Income Less than $15,000 31.7 (27.7, 36.1) 17.2 (14.2, 20.7) $15,000-$24,999 25.6 (22.2, 29.2) 18.1 (15.7, 20.8) $25,000-$34,999 20.7 (17.1, 24.9) 22.0 (18.3, 26.2) $35,000-$49,999 19.8 (16.5, 23.7) 21.2 (18.2, 24.6) $50,000-$74,999 13.0 (10.5, 15.9) 23.5 (20.2, 27.1) $75,000 or More 10.7 (8.5, 13.4) 22.6 (20.2, 25.2) Education Less than High School 29.3 (25.1, 34.0) 17.1 (14.0, 20.7) High School Graduate 21.8 (19.5, 24.3) 20.7 (18.6, 22.9) Some College 19.2 (17.1, 21.5) 21.8 (19.7, 24.1) College Graduate 7.8 (6.5, 9.4) 21.4 (19.6, 23.3) Health Insurance Coverage Has Health Insurance 16.9 (15.5, 18.5) 18.3 (16.9, 19.8) No Health Insurance 31.6 (28.2, 35.3) 14.3 (12.0, 16.9) 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 (%) 40 29.3 30 21.8 19.2 20 7.8 10 Percent of Adults who currently Smoke Cigarettes, by Health District, Georgia, 2013 0 Less than High School High School Graduate Some College College Graduate Percent (%) Percent of Adults who Smoke Cigarettes, by Household Income, Georgia, 2013 50 40 31.7 30 25.6 20.7 19.8 20 13 10.7 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 24 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 two main types of smokeless tobacco sold in the United States are chewing tobacco and snuff. In 2013, 5.0% of Georgia adults reported using smokeless tobacco. Adult males (8.4%) were significantly more likely to use smokeless tobacco compared to females (1.8%). White non-Hispanics (6.0%) were more likely to use smokeless tobacco when compared to black non-Hispanics (4.0%) and Hispanics (2.1%). A higher proportion of adults with a household income of $25,000 to $34,999 (6.8%) used smokeless tobacco. Adults with less than high school education (8.8%) were significantly more likely to use smokeless tobacco when compared to college graduates (2.5%). Percent of Adults who used Smokeless Tobacco, by Gender, Georgia, 2013 15 Percent (%) 10 8.4 5 0 Male 1.8 Female Percent of Adults who used Smokeless Tobacco, by Race/Ethnicity, Georiga, 2013 15 The HP 2020 target for smokeless tobacco use is 0.3%. Smokeless Tobacco Use a Demographic Characteristics % 95% CI State Totals 5.0 (4.3, 5.8) Sex Male 8.4 (7.1, 9.9) Female 1.8 (1.4, 2.4) Race/Ethnicity White Non-Hispanic 6.0 (5.1, 7.1) Black Non-Hispanic 4.0 (2.8, 5.5) Hispanic 2.1 (0.9, 4.5) Age 18-24 yr 6.6 (4.5, 9.7) 25-34 yr 4.6 (3.2, 6.6) 35-44 yr 5.9 (4.3, 8.2) 45-54 yr 5.6 (4.0, 7.9) 55-64 yr 3.5 (2.4, 5.1) 65+ yr 3.7 (2.8, 4.9) Income Less than $15,000 5.9 (4.1, 8.3) $15,000-$24,999 5.2 (3.8, 7.2) $25,000-$34,999 6.8 (4.3, 10.7) $35,000-$49,999 4.5 (2.9, 6.9) $50,000-$74,999 3.7 (2.4, 5.7) $75,000 or More 4.5 (3.2, 6.3) Education Less than High School 8.8 (6.5, 11.8) High School Graduate 5.5 (4.3, 7.1) Some College 4.3 (3.3, 5.7) College Graduate 2.5 (1.8, 3.5) Health Insurance Coverage Has Health Insurance 5.2 (4.4, 6.2) No Health Insurance 5.4 (3.8, 7.5) a The proportion of adults who reported that they currently use chewing tobacco, snuff or snus, either every day or some days. Percent (%) 10 6.0 5 4.0 2.1 Percent of Adults who used Smokeless Tobacco, by Health District, Georgia, 2013 0 White Non-Hispanic Black Non-Hispanic Hispanic Percent (%) Percent of Adults who used Smokeless Tobacco, by Education Level, Georgia, 2013 15 10 8.8 5.5 5 0 Less than High School High School Graduate 4.3 2.5 Some College College Graduate 25 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 at least once in the previous month. In 2013, 13.1% of Georgia adults engaged in binge drinking. Adult males (17.3%) were significantly more likely than females (9.2%) to engage in binge drinking. More young adults aged 18-24 (18.7%) and 25-34 (19.2%) reported binge drinking than any other age groups. Adults with an annual household income of $75,000 or more (16.4%) were the most likely to engage in binge drinking. The HP 2020 target for binge drinking is 24.4%. The current prevalence among Georgia adults meets this goal. Percent (%) Percent of Adults who Engaged in Binge Drinking, by Gender, Georgia, 2013 40 30 20 17.3 9.2 10 0 Male Female Percent (%) Percent of Adults who Engaged in Binge Drinking, by Age Group, Georiga, 2013 40 30 18.7 19.2 20 16.5 11.9 9.1 10 0 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 3.4 65+ yr Binge Drinking a Demographic Characteristics % 95% CI State Totals 13.1 (12.1, 14.2) Sex Male 17.3 (15.5, 19.2) Female 9.2 (8.2, 10.5) Race/Ethnicity White Non-Hispanic 15.1 (13.7, 16.6) Black Non-Hispanic 9.4 (7.8, 11.2) Hispanic 14.4 (10.3, 19.7) Age 18-24 yr 18.7 (15.1, 22.9) 25-34 yr 19.2 (16.2, 22.6) 35-44 yr 16.5 (13.8, 19.7) 45-54 yr 11.9 (9.9, 14.2) 55-64 yr 9.1 (7.4, 11.1) 65+ yr 3.4 (2.5, 4.6) Income Less than $15,000 11.3 (8.7, 14.5) $15,000-$24,999 11.8 (9.5, 14.6) $25,000-$34,999 12.2 (9.5, 15.6) $35,000-$49,999 14.9 (11.8, 18.6) $50,000-$74,999 15.7 (12.9, 19.0) $75,000 or More 16.4 (14.1, 19.0) Education Less than High School 10.9 (8.0, 14.7) High School Graduate 12.1 (10.3, 14.2) Some College 13.0 (11.2, 15.1) College Graduate 15.9 (14.1, 17.9) Health Insurance Coverage Has Health Insurance 15.3 (13.8, 16.8) No Health Insurance 14.6 (12.2, 17.3) 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, 2013 Percent (%) Percent of Adults who Engaged in Binge Drinking, by Household Income, Georgia, 2013 40 30 20 14.9 15.7 16.4 11.3 11.8 12.2 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 26 Risk Behaviors Heavy Drinking Heavy drin1king 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 2013, 4.7% of Georgia adults engaged in heavy drinking. White non-Hispanics (5.4%) were more likely to be engaged in heavy drinking when compared to black nonHispanics (3.6%) and Hispanics (3.4%). Adults aged 18 to 24 years of age (5.8%) were the most likely to engage in heavy drinking when compared to any other age group. Heavy drinking is more prevalent among adults with an annual household income of $75,000 or more (6.5%). Percent (%) Percent of Adults who Engaged in Heavy Drinking, by Race/Ethnicity, Georiga, 2013 30 20 10 5.4 0 White Non-Hispanic 3.6 Black Non-Hispanic 3.4 Hispanic Percent of Adults who Engaged in Heavy Drinking, by Age Group, Georiga, 2013 30 20 Heavy Drinking a Demographic Characteristics % 95% CI State Totals 4.7 (4.0, 5.3) Sex Male 5.6 (4.6, 6.8) Female 3.8 (3.1, 4.6) Race/Ethnicity White Non-Hispanic 5.4 (4.5, 6.3) Black Non-Hispanic 3.6 (2.6, 4.9) Hispanic 3.4 (1.6, 7.2) Age 18-24 yr 5.8 (3.8, 8.9) 25-34 yr 4.2 (3.0, 5.8) 35-44 yr 5.9 (4.4, 8.0) 45-54 yr 5.0 (3.6, 6.9) 55-64 yr 4.3 (3.3, 5.6) 65+ yr 2.9 (2.2, 4.0) Income Less than $15,000 3.3 (2.1, 5.3) $15,000-$24,999 4.7 (3.1, 6.8) $25,000-$34,999 3.5 (2.1, 5.8) $35,000-$49,999 6.2 (4.5, 8.4) $50,000-$74,999 4.8 (3.4, 6.7) $75,000 or More 6.5 (5.0, 8.5) Education Less than High School 3.5 (2.0, 6.2) High School Graduate 4.1 (3.2, 5.3) Some College 5.2 (4.1, 6.7) College Graduate 5.4 (4.4, 6.7) Health Insurance Coverage Has Health Insurance 4.9 (4.1, 5.7) No Health Insurance 5.5 (4.0, 7.6) 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, 2013 Percent (%) 10 5.8 4.2 5.9 5.0 4.3 0 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 2.9 65+ yr Percent (%) Percent of Adults who Engaged in Heavy Drinking, by Income, Georgia 2013 30 20 10 3.3 4.7 3.5 6.2 4.8 6.5 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 27 Risk Behaviors At Least One Drink per Month Those categorized as having at least one drink per month have consumed either a 12-ounce beer, a 5-ounce glass of wine, or a drink with one shot of liquor within the past 30 days. In 2013, 47.8% of Georgia adults consumed at least one alcoholic drink within the past month. Adult males (55.3%) were significantly more likely than females (40.9%) to consume at least one drink within 30 days. White non-Hispanics (50.9%) were significantly more likely than black non-Hispanics (44.2%) and Hispanics (39.6%) to consume at least one drink within 30 days. Adults with college degrees (63.5%) were significantly more likely to consume at least one drink per month when compared to adults of lower education levels. Percent (%) Percent of Adults who Consumed at Least One Drink per Month, by Gender, Georgia, 2013 100 80 60 54.2 40.6 40 20 0 Male Female Percent (%) Percent of Adults who Consumed at Least One Drink, by Race/Ethnicity, Georiga, 2013 100 80 60 51.5 41.5 44.2 40 20 0 White Non-Hispanic Black Non-Hispanic Hispanic Demographic Characteristics State Totals Sex Male Female Race/Ethnicity White Non-Hispanic Black Non-Hispanic Hispanic Age 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 65+ yr Income Less than $15,000 $15,000-$24,999 $25,000-$34,999 $35,000-$49,999 $50,000-$74,999 $75,000 or More Education Less than High School High School Graduate Some College College Graduate Health Insurance Coverage Has Health Insurance No Health Insurance At Least One Drink per Month % 95% CI 47.1 (45.6, 48.7) 54.2 (51.7, 56.7) 40.6 (38.7, 42.5) 51.1 (49.3, 53.0) 41.5 (38.4, 44.7) 44.2 (38.0, 50.6) 47.0 (41.7, 52.4) 56.1 (51.9, 60.2) 51.0 (47.1, 54.8) 49.0 (45.6, 52.4) 44.8 (41.7, 47.9) 33.7 (31.1, 36.4) 29.7 (25.8, 33.9) 40.8 (37.0, 44.7) 42.1 (37.4, 47.0) 49.4 (44.9, 53.9) 56.2 (52.0, 60.3) 65.4 (62.3, 68.3) 28.7 (24.4, 33.4) 40.9 (38.1, 43.9) 49.6 (46.7, 52.5) 63.9 (61.6, 66.2) 52.9 (50.9, 54.9) 42.1 (38.4, 45.9) Percent of Adults who Consumed at Least One Drink per Month, by Health District, Georgia, 2013 Percent (%) Percent of Adults who Consumed at Least One Drink per Month, by Level of Education, Georgia, 2013 100 80 60 40 28.7 20 0 Less than High School 40.9 High School Graduate 63.9 49.6 Some College College Graduate 28 Risk Behaviors Use of Equipment Use of equipment such as a cane, a wheelchair, a special bed, or a special telephone can make everyday tasks easier and improve the overall quality of life for those with health problems or disabilities. In 2013, 7.9% of Georgia adults reported using equipment due to a health problem or disability. Hispanic adults (2.4%) were significantly less likely than Black non-Hispanics (9.3%) or white non-Hispanics (8.3%) to use equipment. Use of equipment increases with age. Adults of age 65 or older (19.4%) are significantly more likely to use equipment than any younger age category. Adults with less than a high school education (12.3%) were more likely to use equipment when compared to adults with higher levels of education. Percent (%) Percent of Adults who use Equipment, by Race/Ethnicity, Georiga, 2013 30 20 10 8.3 9.3 0 White Non-Hispanic Black Non-Hispanic 2.4 Hispanic Percent of Adults who use Equipment, by Age Group, Georiga, 2013 30 20 13.2 10 8.4 4.0 1.2 1.9 0 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 19.4 65+ yr Percent (%) Demographic Characteristics State Totals Sex Male Female Race/Ethnicity White Non-Hispanic Black Non-Hispanic Hispanic Age 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 65+ yr Income Less than $15,000 $15,000-$24,999 $25,000-$34,999 $35,000-$49,999 $50,000-$74,999 $75,000 or More Education Less than High School High School Graduate Some College College Graduate Health Insurance Coverage Has Health Insurance No Health Insurance Use of Equipment % 95% CI 7.9 (7.2, 8.7) 7.0 (6.0, 8.3) 8.8 (7.9, 9.8) 8.3 (7.4, 9.3) 9.3 (7.8, 11.1) 2.4 (1.4, 4.2) 1.2 (0.4, 3.3) 1.9 (0.8, 4.0) 4.0 (2.6, 6.0) 8.4 (6.7, 10.5) 13.2 (11.3, 15.4) 19.4 (17.4, 21.6) 18.7 (15.7, 22.0) 11.5 (9.5, 13.9) 6.6 (5.0, 8.5) 5.3 (3.9, 7.2) 2.8 (2.0, 4.0) 3.8 (2.5, 5.7) 12.3 (10.0, 15.0) 9.6 (8.2, 11.2) 7.5 (6.3, 9.0) 3.6 (3.0, 4.3) 6.1 (5.3, 7.1) 4.9 (3.5, 6.8) Percent of Adults who reported Using Equipment, by Health District, Georgia, 2013 Percent (%) Percent of Adults who use Equipment, by Level of Education, Georgia, 2013 30 20 12.3 9.6 10 0 Less than High School High School Graduate 7.5 3.6 Some College College Graduate 29 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 2013, 54.6% of Georgia adults aged 65 and older had a seasonal flu vaccine within the past year. White non-Hispanics (57.7%) were significantly more likely to receive the seasonal flu vaccine when compared to black non-Hispanics (43.3%). The HP 2020 target for influenza immunization in adults aged 65 years and older is 90% In 2013, 66.4% of Georgia adults aged 65 and older have ever had the pneumonia vaccine. Females (69.2%) were more likely to receive the pneumonia vaccine when compared to males (62.6%). White non-Hispanics (70.6%) were significantly more likely to receive the pneumonia vaccine when compared to black non-Hispanics (53.3%). Adults with an annual household income $25,000-$34,999 (59.1%) were the least likely to receive the pneumonia vaccine. The HP 2020 target for pneumonia immunization in adults aged 65 years and older is 90% Influenza Pneumonia Vaccine a Vaccine b Demographic Characteristics % 95% CI % 95% CI State Totals 54.6 (51.7, 57.4) 66.4 (63.6, 69.2) Sex Male 56.5 (51.8, 61.1) 62.6 (57.8, 67.2) Female 53.1 (49.6, 56.6) 69.2 (65.8, 72.5) Race/Ethnicity White Non-Hispanic 57.7 (54.5, 60.8) 70.6 (67.6, 73.5) Black Non-Hispanic 43.3 (36.6, 50.3) 53.3 (46.1, 60.4) Hispanic NA NA NA NA Income Less than $15,000 43.8 (35.6, 52.3) 64.5 (55.4, 72.7) $15,000-$24,999 50.9 (44.5, 57.3) 59.4 (52.8, 65.7) $25,000-$34,999 52.6 (44.3, 60.7) 59.1 (50.3, 67.5) $35,000-$49,999 57.4 (49.1, 65.4) 72.2 (63.8, 79.4) $50,000-$74,999 54.7 (45.6, 63.5) 67.9 (59.4, 75.3) $75,000 or More 64.8 (57.2, 71.7) 66.8 (58.4, 74.2) Education Less than High School 49.0 (41.9, 56.2) 59.4 (51.8, 66.5) High School Graduate 52.2 (47.2, 57.2) 66.0 (60.9, 70.8) Some College 54.7 (49.0, 60.3) 69.7 (64.2, 74.7) College Graduate 63.2 (58.2, 68.0) 69.5 (64.7, 74.0) a The proportion of adults 65+ years that had a seasonal flu vaccine within the past year. b The proportion of adults 65+ years that have ever had a pneumonia vaccine Percent (%) Percent (%) Percent of Adults aged 65+ years who recieve Vaccinations, by Race/Ethnicity, Georiga, 2013 100 80 57.7 62.6 60 40 Flu Shot In Past Year Pneumonia Shot 69.2 43.3 20 0 White Non-Hispanic Black Non-Hispanic Percent of Adults aged 65+ years who recieve Vaccinations, by Level of Education, Georgia, 2013 100 80 59.4 60 49 40 66 52.2 69.7 54.7 Flu Shot in Past Year Pneumonia Shot 69.5 63.2 20 0 Less than High School High School Graduate Some College College Graduate Percent of Adults aged 65+ years who had the Flu Vaccine, by Health District, Georgia, 2013 Percent of Adults aged 65+ years who had the Pneumonia Vaccine, by Health District, Georgia, 2013 30 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 50-74 years old should get mammograms once every 2 years.22 Breast cancer screening for women 40 to 49 years old should be determined by a doctor.22 In 2013, 81.0% of Georgian women aged 50-74 years and older have had a mammogram in the past two years. Among women 50 to 74 years of age: Black non-Hispanic women (83.9%) were more likely than white non-Hispanic women (80.6%) to have had a mammogram in the past two years. Women with an annual household income of $25,000 to $34,999 (74.1%) were least likely to have had a mammogram in the past two years. Women without a high school diploma (76.6%) were the least likely to have had a mammogram in the past two years when compared to women of other education levels. Women with health care coverage (84.8%) were significantly more likely to have had a mammogram in the past two years when compared to women without health care coverage (56.5%). Percent of Females who have had a Mammogram in the Past 2 Years, by Health Care Coverage, Georiga, 2013 100 85.9 84.8 80 60 40-64 Years Old 50-74 Years Old 59.3 56.5 40 The HP 2020 target for breast cancer screening in adults aged 50 to 74 years old is 81.1%. Mammogram 50-74 in Past 2 Years a Demographic Characteristics % 95% CI State Totals 81.0 (78.7, 83.0) Race/Ethnicity White Non-Hispanic 80.6 (77.9, 83.1) Black Non-Hispanic 83.9 (79.4, 87.6) Hispanic NA NA Age 35-44 years NA NA 45-54 years 80.4 (75.5, 84.4) 55-64 years 80.7 (77.2, 83.8) 65-74 years 81.9 (77.8, 85.4) Annual Income Less than $15,000 75.7 (68.1, 82.0) $15,000-$24,999 77.4 (71.5, 82.4) $25,000-$34,999 74.1 (65.2, 81.5) $35,000-$49,999 79.3 (71.7, 85.3) $50,000-$74,999 86.0 (80.2, 90.3) $75,000 or More 87.8 (83.1, 91.4) Education Less than High School 76.6 (68.9, 82.9) High School Graduate 78.1 (73.4, 82.1) Some College 82.9 (78.8, 86.4) College Graduate 84.6 (81.2, 87.5) Health Insurance Has Health Insurance 84.8 (81.9, 87.3) No Health Insurance 56.5 (47.7, 64.9) a The proportion of women aged 50-74 years who had a mammogram within the past 2 years. Percent of Females aged 50 to 74 years who have had a Mammogram in the Past 2 years, by Health District, Georgia, 2013 Percent (%) 20 0 Has Health Coverage No Health Coverage Percent (%) Percent of Females who have had a Mammogram in the Past 2 Years, by Level of Education, Georiga, 2013 100 80 73.6 76.6 60 40 20 0 Less than High School 80.8 78.1 High School Graduate 82.3 82.9 40-64 Years Old 50-74 Years Old 86.5 84.6 Some College College Graduate 31 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 21-29 years should have a Pap test every 3 years and women aged 30-65 years can have Pap and HPV co-testing every 5 years or just a pap test alone every 3 years. Women aged 65 years or older with adequate screening history or women who had a total hysterectomy should not be screened.24 In 2013, 78.9% of Georgia women aged 21-65 years reported having a Pap test within the past 3 years. White non-Hispanic women (78.8%) were less likely to have had a Pap test in the past 3 years than other race/ethnicity groups. Woman with an annual household income of less than $15,000 (69.9%) were the least likely to have had a Pap test in the past 3 years. Women with less than high school education (61.4%) were less likely to have had a Pap test in the past 3 years compared to college graduates (84.3%). Woman with health care coverage (85.1%) were significantly more likely to have had a Pap test in the past 3 years than women without health care coverage (62.1%). Percent (%) Percent of Females aged 21-65 years who have had a Pap Test in the Past 3 Years, by Race/Ethnicity, Georiga, 2013 100 78.8 82.4 80 69.4 60 40 20 0 White Non-Hispanic Black Non-Hispanic Hispanic The HP 2020 target for cervical cancer screening in adults aged 21 to 65 years old is 93%. Pap Test in Past 3 Years a Demographic Characteristics % 95% CI State Totals 78.9 (76.5, 81.0) Race/Ethnicity White Non-Hispanic 78.8 (75.8, 81.6) Black Non-Hispanic 82.4 (78.4, 85.8) Hispanic 69.4 (59.3, 77.9) Age 21-24 years 74.5 (64.8, 82.3) 25-34 years 80.7 (75.2, 85.1) 35-44 years 81.0 (76.1, 85.1) 45-54 years 77.2 (72.5, 81.3) 55-65 years 78.7 (74.3, 82.6) Annual Income Less than $15,000 69.9 (62.4, 76.5) $15,000-$24,999 72.2 (65.7, 77.8) $25,000-$34,999 72.7 (63.9, 80.0) $35,000-$49,999 83.8 (77.1, 88.7) $50,000-$74,999 88.2 (83.0, 91.9) $75,000 or More 89.1 (85.3, 92.0) Education Less than High School 61.4 (52.1, 69.9) High School Graduate 77.8 (72.9, 82.0) Some College 81.8 (77.9, 85.2) College Graduate 84.3 (81.1, 87.1) Health Insurance Coverage Has Health Insurance 85.1 (82.7, 87.2) No Health Insurance 62.1 (56.2, 67.6) 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, Georiga, 2013 100 80 61.4 60 40 20 0 Less than High School 77.8 High School Graduate 81.8 84.3 Some College College Graduate Percent of Females aged 21-65 years who have had a Pap Test in the Past 3 years, by Health District, Georgia, 2013 Percent (%) Percent of Females aged 21-65 years who have had a Pap Test in the Past 3 Years, by Health Care Coverage, Georiga, 2013 100 85.1 80 62.1 60 40 20 0 Has Health Coverage No Health Coverage 32 Clinical Preventive Practices Colorectal Cancer Screening Colorectal cancer affects both men and women, particularly those aged 50 years and older.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 2013, 64.6% of Georgia adults aged 50 to 75 years met the recommendations for colorectal cancer screening. Hispanics aged 50 to 75 years (35.5%) were least likely to meet recommendations for colorectal cancer screening. Adults aged 65 to 75 years (78.6%) were significantly most likely to meet the recommendations for colorectal cancer screening. Adults aged 50 to 75 years with an annual household income of $50,000-$74,999 (75.9%) were most likely to meet recommendations for colorectal cancer screening, while adults with an annual household income of less than $15,000 were least likely to meet the recommendations (49.1%). Adults aged 50 to 75 years with less than a high school education (45.6%) were significantly less likely to meet colorectal cancer screening recommendations when compared to those who are high school graduates (64.2%), some college (72.7%) and college graduates (75.1%). Adults aged 50 to 75 years without health care coverage (28.3%) were significantly less likely to meet colorectal cancer screening recommendations when compared to those with health care coverage (68.5%). The HP 2020 target for colorectal cancer screening in adults aged 50 to 75 years old is 70.5%. Colorectal Cancer Screening a Demographic Characteristics % 95% CI State Totals 66.4 (64.2, 68.6) Sex Males 64.8 (61.2, 68.3) Females 67.9 (65.2, 70.4) Race/Ethnicity White Non-Hispanic 69.3 (66.8, 71.8) Black Non-Hispanic 64.0 (59.3, 68.4) Hispanic 35.5 (24.2, 48.7) Age 45-54 years 47.6 (42.8, 52.3) 55-64 years 70.7 (67.6, 73.5) 65+ years 78.6 (75.4, 81.5) Annual Income Less than $15,000 49.1 (42.6, 55.5) $15,000-$24,999 53.8 (47.9, 59.6) $25,000-$34,999 58.4 (50.4, 66.0) $35,000-$49,999 75.2 (69.3, 80.3) $50,000-$74,999 75.9 (70.4, 80.6) $75,000 or More 73.9 (69.4, 78.0) Education Less than High School 45.6 (39.0, 52.4) High School Graduate 64.2 (60.2, 68.0) Some College 72.7 (68.7, 76.3) College Graduate 75.1 (71.9, 78.0) Health Insurance Coverage Has Health Insurance 68.5 (65.6, 71.2) No Health Insurance 28.3 (22.6, 34.7) a The proportion of adults aged 50 to 75 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 to 75 years who met Colorectal Cancer Screening Recommendations, by Race/Ethnicity, Georiga, 2013 100 80 69.3 60 40 20 0 White Non-Hispanic 64.0 Black Non-Hispanic 58.7 Hispanic Percent (%) Percent of Adults aged 50 to 75 years who met Colorectal Cancer Screening Recommendations, by Level of Education, Georiga, 2013 100 80 60 45.6 40 20 0 Less than High School 64.2 High School Graduate 72.7 75.1 Some College College Graduate Percent (%) Percent of Adults aged 50 to 75 years who met Colorectal Cancer Screening Recommendations, by Health Care Coverage, Georiga, 2013 100 80 68.5 60 40 20 0 Has Health Coverage 28.3 No Health Coverage Percent (%) Percent of Adults aged 50 to 75 years who met Colorectal Cancer Screening Recommendations, by Annual Household Income, Georiga, 2013 100 75.2 75.9 73.9 80 60 49.1 53.8 58.4 40 20 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 33 Clinical Preventive Practices HIV Testing Human Immunodeficiency Virus (HIV) is a preventable disease that affects both men and women alike. While there is no known cure for HIV, getting tested for HIV can reduce the risk of transmitting the virus to others and improve the health of infected persons with early detection.32 In 2013, 43.7% of Georgia adults reported that they had ever been tested for HIV. White non-Hispanics (36.3%) were least likely to have ever been tested for HIV compared to black non-Hispanics (59.3%) and Hispanics (43.8%). Adults 25 to 34 years old (62.6%) were most likely to have ever been tested for HIV. Adults with less than a high school education (36.2%) were least likely to have ever been tested for HIV. Adults without health care coverage (54.8%) were significantly more likely to have ever been tested for HIV when compared to those with health care coverage (47.1%). Percent (%) Percent of Adults who Ever Tested for HIV, by Healthcare Coverage, Georgia, 2013 80 70 60 47.1 50 40 30 20 10 0 Has Health Coverage 54.8 No Health Coverage Demographic Characteristics State Totals Sex Male Female Race/Ethnicity White Non-Hispanic Black Non-Hispanic Hispanic Age 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 65+ yr Income Less than $15,000 $15,000-$24,999 $25,000-$34,999 $35,000-$49,999 $50,000-$74,999 $75,000 or More Education Less than High School High School Graduate Some College College Graduate Health Insurance Coverage Has Health Insurance No Health Insurance Ever Tested for HIV % 95% CI 43.7 (42.1, 45.3) 43.7 (41.1, 46.3) 43.6 (41.6, 45.6) 36.3 (34.5, 38.2) 59.3 (56.0, 62.6) 43.8 (37.4, 50.4) 39.8 (34.5, 45.3) 62.6 (58.2, 66.9) 61.4 (57.4, 65.3) 44.3 (40.9, 47.9) 33.7 (30.8, 36.8) 16.0 (14.0, 18.2) 49.9 (45.3, 54.5) 46.9 (42.9, 50.9) 46.6 (41.5, 51.8) 47.4 (42.7, 52.1) 43.6 (39.4, 48.0) 41.9 (38.7, 45.1) 36.2 (31.5, 41.3) 39.6 (36.6, 42.7) 48.9 (45.9, 52.0) 47.0 (44.5, 49.5) 47.1 (45.0, 49.2) 54.8 (50.8, 58.8) Percent (%) Percent of Adults who Ever Tested for HIV, by Age Group, Georiga, 2013 80 70 62.6 61.4 60 50 39.8 40 44.3 33.7 30 20 10 0 18-24 yr 25-34 yr 35-44 yr 45-54 yr 55-64 yr 16.0 65+ yr Percent (%) Percent of Adults who Ever Tested for HIV, by Race/Ethnicity, Georiga, 2013 80 70 60 50 40 36.3 30 20 10 0 White Non-Hispanic 59.3 Black Non-Hispanic 43.8 Hispanic 34 Bibliography 1. 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