Core State PCH Indicators: A Preliminary Report of Multi-State Findings Using Data from the BRFSS CDR Lauren B. Zapata, PhD, MSPH Division of Reproductive Health, CDC

Core State PCH Indicators Effort to improve data and surveillance activities to monitor women’s PCH 45 indicators were collaboratively identified by a committee from 7 states CA, DE, FL, MI, NC, TX and UT Published in MCHJ Feb 2011

Core State PCH Indicators DOMAIN # OF INDICATORS TOTALBRFSS General health11 Social determinants of health21 Health care73 Reproductive health/Family Planning80 Substance abuse73 Nutrition/PA53 Mental health31 Social/emotional health41 Chronic conditions53 Infections31 TOTAL4517 (38%)

BRFSS Overview State-based system of telephone health surveys Designed to gather information on  Health risk behaviors, clinical preventive health practices, and health-care access Women & men 18+ years living in households  General population of reproductive age women (18-44) For many states, only source of timely data

BRFSS Overview Data collected monthly in all 50 states, DC & US territories 430,000+ adults were interviewed in 2010 States use data to:  Identify emerging health problems  Establish and monitor health objectives  Develop and evaluate programs and policies

Purpose Present preliminary descriptive data from a multi-state, comprehensive report summarizing the full set of PCH indicators  MMWR Surveillance Summary – Jan 2012  Several data systems: BRFSS, PRAMS, ASEC, NSTD, NVSS

Purpose Present preliminary descriptive data from a multi-state, comprehensive report summarizing the full set of PCH indicators  MMWR Surveillance Summary – Jan 2012  Several data systems: BRFSS, PRAMS, ASEC, NSTD, NVSS

Study Questions What is the prevalence of select PCH indicators? Do they vary by state or by select demographic characteristics?

Methods 2009 BRFSS data from 50 states & DC Non-pregnant women aged years Prevalence of select core state PCH indicators for U.S., by state, and stratified by age and race/ethnicity Analyses conducted using SUDAAN and weighted to provide unbiased national and state estimates

Selected Indicators Access to Health Care Percentage of women who currently have some type of health care coverage Utilization of Health Care Percentage of women who had a routine checkup in the past year Overweight and Obesity Percentage of women who are overweight or obese based on BMI >= 25 kg/m2 DiabetesPercentage of women who have ever been told by a health care provider that they had diabetes, not including gestational diabetes

RESULTS

Access to Health Care Percentage of Women Who Currently Have Some Type of Health Care Coverage Non-Pregnant Women Aged years, BRFSS,

Utilization of Health Care Percentage of women who had a routine checkup in the past year Non-Pregnant Women Aged years, BRFSS,

Overweight & Obesity Percentage of women who are overweight or obese based on BMI >= 25 kg/m2 Non-Pregnant Women Aged years, BRFSS,

Diabetes Percentage of women ever been told by a health care provider that they had diabetes, not including GDM Non-Pregnant Women Aged years, BRFSS,

STRATIFIED RESULTS

Access to Health Care Percentage of Women Who Currently Have Some Type of Health Care Coverage

Utilization of Health Care Percentage of women who had a routine checkup in the past year

Overweight & Obesity Percentage of women who are overweight or obese based on BMI >= 25 kg/m2

Diabetes Percentage of women ever been told by a health care provider that they had diabetes, not including GDM

Conclusions Data provide a brief and preliminary glimpse into a forthcoming CDC surveillance summary Findings document variations by state and demographic characteristics Findings document need for further efforts to improve women’s PCH status

Implications Data on the core state PCH indicators can be used by states to:  Identify needs  Set priorities  Evaluate implementation and impact of PCH- related policies and initiatives States can also use the data to compare their indicators with other states

Contact Information: Lauren Zapata THANK YOU!

Challenges Increased use of cellular telephones Increased use of call-screening devices Decreased # of land-line telephones Availability of the “Do Not Call Registry” Societal concerns about privacy Population diversity

Challenges

Strengths of BRFSS Indicators can be monitored over time Findings are state-representative Data can be combined to generate national estimates Data are timely Allows comparisons between states Availability of online query system

Limitations of BRFSS Data are self-reported Response rates are generally low and declining Online query system does allow 2-level stratification of indicators