BRFSS A Rport from th Bhavioral Risk Factor Survillanc Systm Halth Risks Among North Carolina Adults: 2005 Dpartmnt of Halth and Human Srvics Octobr 2006
Halth Risks Among North Carolina Adults: 2005 A Rport from th Bhavioral Risk Factor Survillanc Systm Dpartmnt of Halth and Human Srvics 1908 Mail Srvic Cntr Raligh, NC 27699-1908 www.schs.stat.nc.us/schs/ Octobr 2006
STATE OF NORTH CAROLINA Michal F. Easly, Govrnor DEPARTMENT OF HEALTH AND HUMAN SERVICES Carmn Hookr Odom, Scrtary DIVISION OF PUBLIC HEALTH Lah Dvlin, D.D.S, M.P.H. Stat Halth Dirctor STATE CENTER FOR HEALTH STATISTICS Paul Buschr, Ph.D., Dirctor Contributing Authors Harry Hrrick, M.S.P.H., M.S.W. Brand Robrts, B.A., B.S. Rviwrs Paul Buschr, Ph.D. Kathln Jons-Vssy, M.S. Robrt Woldman, M.A. Spcial Thanks to: BRFSS Survy Lab Suprvisors: Nan Staggrs, Angla Grn, Hnritta Frman, Mary Ann Pittman, Maruja Jordan, and Jacki Stward All th BRFSS Intrviwrs Jan Stafford, Layout Michll Lown, Maps 1,000 copis of this public documnt wr printd at a total cost of $3,775.05 or $3.78 pr copy, fundd by a grant from th Cntrs for Disas Control and Prvntion.
Tabl of Contnts Introduction... 1 Sampling... 2 Qustionnair... 3 Data Wighting... 3 Analysis and Intrprtation... 5 Prsntation of th Rsults... 6 Strngths and Limitations of th Survy Data... 7 Rsults Gnral Halth Status... 8 Halth Car Accss... 12 Physical Activity... 16 High Blood Prssur... 20 Blood Cholstrol... 24 Asthma... 28 Arthritis... 32 Immunization... 36 Smoking... 40 Othr Tobacco Indicators... 44 Environmntal Tobacco Exposur Houshold... 48 Environmntal Tobacco Exposur Work... 52 Alcohol Consumption... 56 Disability... 60 Ostoporosis... 64 HIV/AIDS... 68 Diabts Prvalnc... 72 Diabts Scrning... 76 Colorctal Cancr Scrning... 80 Prostat Cancr Scrning... 84 Nutrition... 88 Wight Control... 92 Rcognition of Hart Attack and Strok Symptoms... 96 Cardiovascular Disas... 100 Emotional Support and Lif Satisfaction... 104 Car Giving... 108 Appndics Appndix A North Carolina Rgional AHECs... 115 Appndix B North Carolina BRFSS Rgions... 116 Appndix C Wight Control National Map... 117 Appndix D Rcognition of Hart Attack and Strok Symptoms National Map... 118 iii
Tabl of Contnts (Quick Rfrnc Topics in Alphabtical Ordr) Alcohol Consumption... 56 Arthritis... 32 Asthma... 28 Blood Cholstrol... 24 Cardiovascular Disas... 100 Car Giving... 108 Colorctal Cancr Scrning... 80 Diabts Prvalnc... 72 Diabts Scrning... 76 Disability... 60 Emotional Support and Lif Satisfaction... 104 Gnral Halth Status... 8 Halth Car Accss... 12 Hart Attack and Strok Symptoms, Rcognition of... 96 High Blood Prssur... 20 HIV/AIDS... 68 Immunization... 36 Nutrition... 88 Ostoporosis... 64 Physical Activity... 16 Prostat Cancr Scrning... 84 Tobacco Environmntal Tobacco Exposur Houshold... 48 Environmntal Tobacco Exposur Work... 52 Othr Tobacco Indicators... 44 Smoking... 40 Wight Control... 92 iv
A Rport from th Bhavioral Risk Factor Survillanc Systm Introduction Th Bhavioral Risk Factor Survillanc Systm (BRFSS) is a random tlphon survy of adults. It is dsignd to collct information about halth status, halth bhaviors, and us of halth srvics that rlat to th lading causs of illnss and dath in North Carolina and th Unitd Stats. Th North Carolina Division of Public Halth has participatd in th BRFSS sinc 1987. Th BRFSS is a cooprativ agrmnt with th Cntrs for Disas Control and Prvntion (CDC) in which all 50 stats, th District of Columbia, and thr Unitd Stats trritoris now participat. This rport rprsnts th third issu in a sris of comprhnsiv BRFSS rports that hav focusd on th halth risks of North Carolina adults, ags 18 and oldr. Th first two rports prsntd th rsults from th 1999 survy and th 2001 survy. In this rport, w prsnt th rsults from th 2005 North Carolina BRFSS survy. Sinc th last rport was producd, th numbr of compltd intrviws has jumpd from 6,205 in 2001 to 17,261 compltd intrviws in 2005 approaching a thr-fold incras. Much of this xpansion first bgan in 2003 whn 9,455 intrviws wr compltd and thn sharply incrasd again in 2004, whn 15,053 intrviws wr compltd (and sampld from 37 diffrnt gographical strata in th stat). In 2005, th North Carolina BRFSS bcam th scond largst BRFSS survy in th nation, only surpassd by th Washington stat BRFSS (N=23,302). Th aim of North Carolina s sampl xpansion was to provid rliabl halth risk assssmnts for all singl county populations of 100,000 or mor adults, or all multi-county groups with populations of 100,000 or mor adults, thus providing som dgr of local lvl stimats across th ntir stat. In addition, its purpos was to nsur that minority groups such as Amrican Indians and Spanishspaking Hispanics would hav sufficint sampl mmbrs to adquatly rprsnt th halth risks of thir rspctiv populations. Th North Carolina BRFSS program is on of a handful of stat BRFSS programs that conducts all intrviws in-hous, or in-agncy. This affords us bttr control of th data and gratr flxibility in handling midstram changs to th qustionnair. Currntly, th North Carolina BRFSS survy lab mploys about 45 parttim intrviwrs, thr of whom ar flunt in Spanish. Intrviws ar conductd svn days pr wk at varying morning, aftrnoon, and vning tim intrvals. To produc th annual sampl of 17,261 rspondnts in 2005, a grat dal of tim and ffort was involvd. For xampl, in th January 2005 BRFSS study thr was a total of 1,479 loggd-on hours on CATI (a computr-assistd tlphon intrviwing systm which houss th qustionnair and survy rsponss), rsulting in 30,701 sparat dialings for th month. Of thos total dialings, 1,318 intrviws wr compltd in January which yildd about 23 dialings pr compltd intrviw. This 2005 rport covrs th following topics (also covrd in th 2001 rport): gnral halth status, halth car accss, physical activity, high blood prssur, blood cholstrol, asthma, arthritis, immunization, smoking, othr smoking indicators, nvironmntal tobacco xposur, alcohol consumption, disability, ostoporosis, HIV/AIDS, diabts, colorctal cancr scrning, prostat cancr scrning, nutrition, wight control, hart attack/strok symptoms, and cardiovascular disas. Nw topics in this rport (not covrd in prvious rports) includ: diabts scrning, motional support and lif satisfaction, and car giving. N. C. Dpartmnt of Halth and Human Srvics 1
For qustions about this rport or for mor information about BRFSS in North Carolina, contact Bob Woldman, M.A., BRFSS Coordinator,, 2422 Mail Srvic Cntr, Raligh N.C. 27699-2422, (919) 855-4485, bob.woldman@ncmail.nt. An lctronic vrsion of this rport is availabl on th wb sit: http:// www.schs.stat.nc.us/schs/pubs. For mor information about th BRFSS, visit th CDC s BRFSS wb sit: http://www.cdc.gov/brfss. Th CDC s BRFSS At-A-Glanc publication is availabl at http://www.cdc.gov/nccdphp/publications/aag/ brfss.htm. Sampling Houshold tlphon sampl fram Bginning in 2003, th CDC (Cntrs for Disas Control and Prvntion) protocol for slcting houshold tlphon numbrs discontinud th inclusion of 0 blocks in th sampling fram; 0 blocks ar computr gnratd listings of 100 conscutiv phon numbrs that contain no publishd houshold tlphon numbrs. Now, only 1+ blocks ar sampld; ths ar also computr gnratd listings of 100 conscutiv phon numbrs, but thy contain at last on publishd houshold tlphon numbr. Ths 1+ blocks ar thn assignd to two strata: 1) high dnsity or listd numbrs and 2) low dnsity or unlistd numbrs. Th sampling ratio for ths two strata is 1.5:1, in which th high dnsity stratum (listd) is sampld at th rat of 1.5 tims that of th low dnsity stratum (unlistd). This approach has srvd to lowr cost and improv intrviwr fficincy. At th prsnt tim, only housholds with landlin tlphons ar includd in th BRFSS sampling fram. Howvr, bcaus of th incrasing numbr of wirlss-only housholds (cllular, mobil) in th Unitd Stats, and thir potntial impact on biasing halth stimats if not includd (s, Tlphon Covrag and Halth Survy Estimats: Evaluating th Nd for Concrn About Wirlss Substitution, Am J Public Halth. 2006;96:926 931), pilot studis ar now undrway at th CDC and in Washington stat to tst diffrnt approachs to scrning and intrviwing cll phon usrs for inclusion in th BRFSS survy. North Carolina gographic sampl fram In ordr to provid local-lvl stimats for th ntir stat, 37 diffrnt gographical strata wr formd. Ths 37 strata wr usd in th 2004 and 2005 survy dsigns. Svral diffrnt approachs wr usd to form ths 37 gographical units. First, 12 nw larg-population countis wr addd to th xisting group of 10 (stat s largst) countis ovr-sampld in th 2001 survy. Ths nw singl-county strata, introducd in 2004, ar Alamanc, Cabarrus, Catawba, Davidson, Irdll, Johnston, Orang, Pitt, Randolph, Robson, Rowan, and Union. Th original 10 countis ar Buncomb, Cumbrland, Durham, Forsyth, Gaston, Guilford, Mcklnburg, Nw Hanovr, Onslow, and Wak. Scond, th rmaining 78 countis wr groupd into 13 clustrs or multi-county groups. Population siz and gographical contiguity wr two primary factors usd in dtrmining how to form ths multi-county strata. In som cass, countis that shar halth information wr groupd togthr,.g., th mountain countis that ar srvd by th Mountain AHEC (Ara Halth Education Cntr) rgional cntr. Othr countis ar groupd togthr using clustr analysis (SAS Proc Clustr*). In this instanc, social and conomic information *SAS/STAT Usr s Guid, Vrsion 8. SAS Institut Inc., Cary N.C., 1999. N. C. Dpartmnt of Halth and Human Srvics 2
from th North Carolina Halth Statistics Pockt Guid, 2001*, wr usd to join countis togthr that had similar charactristics, such as th prcnt of th county s population nrolld in Mdicaid. For ths multicounty groups th aim was to achiv a high dgr of commonality or homognity btwn countis, rgarding social and conomic conditions. In th nd, ths 13 multi-county strata containd as fw as thr countis in th Pidmont rgion (Chatham, L, and Moor), or as many 15 countis in th Mountain AHEC rgion (Chrok, Clay, Graham, Haywood, Hndrson, Jackson, Macon, Madison, McDowll, Mitchll, Polk, Ruthrford, Swain, Transylvania, and Yancy). Third, two strata wr formd from cnsus tracts in (1) Graham, Jackson, and Swain countis in th mountains, and (2) Hok and Scotland countis in th southast, that containd a high proportion of Amrican Indian housholds. Thus, th 37 strata wr drivd: 22 individual countis, 13 multi-county groups, and 2 cnsus tract clustrs. Qustionnair Th 2005 BRFSS qustionnair containd about 200 qustions. Th Cor Componnt of th qustionnair, a CDC-dsignatd st of standard qustions askd by all stats, containd 82 qustions. Th Optional CDC Moduls sction, which ar CDC-dsignd sts of qustions on spcific topics (.g., cardiovascular disas, oral halth), containd 50 qustions. And th final sction of th qustionnair, known as th Stat-Addd sction, containd 69 qustions. Th Stat-Addd sction occurs at th nd of th qustionnair and is rsrvd for stats to ask qustions that ar spcific to th public halth prioritis or nds of thos stats. Most rspondnts wr askd fwr than half of th 200 qustions that wr includd in th 2005 qustionnair. Prsons who ar young, thos with no halth problms such as asthma, or non-smokrs or nondrinkrs ar groups likly to rciv th fwst numbr of qustions sinc many qustions will b skippd. For this halthy group th avrag tim to complt an intrviw is about 10 minuts; for th unhalthy group,.g., oldr adults with diabts, th intrviw may tak as long as 20 to 25 minuts to complt. In 2005, th North Carolina BRFSS collaboratd with rsarchrs from th Univrsity of North Carolina at Chapl Hill on th topic of halth car accss: 12 qustions wr addd to th survy for this purpos. A scond collaborativ vntur occurrd with rsarchrs from th Univrsity of Florida Halth Scincs Cntr at Gainsvill, Florida, on th topic of car giving for prsons with a long trm illnss or disability: 11 qustions wr addd to th survy for this study. Th dtaild North Carolina BRFSS qustionnairs can b accssd at: http://www.schs.stat.nc.us/schs/ brfss/qustions.html. Data Wighting Th final BRFSS sampl data ar wightd to adjust for unqual probabilitis of slction du to th disproportionat sampling mthod and du to popl living in housholds with diffrnt numbrs of tlphons and diffrnt numbrs of adults. Th final sampl data ar also wightd to account for unqual non-rspons rats among diffrnt dmographic groups. For xampl, if whit fmals ags 65 and oldr wr 8 prcnt of th sampl rspondnts, but this group was 6 prcnt of th total population of th stat, thn a factor of 0.75 would b ntrd into th last wighting procss for ths rspondnts to account for this discrpancy. On might xpct this group to b mor likly to b at hom and mor likly to hav a tlphon than som othr dmographic groups, and thrfor mor likly to complt an intrviw. Thus th wighting procdur maks th BRFSS data mor rprsntativ of th total population of adults in th stat. All of th prcntags shown in th main tabls of this rport wr calculatd using th wightd data. *S wb sit (http://www.schs.stat.nc.us/schs/data/pocktguid/2001). N. C. Dpartmnt of Halth and Human Srvics 3
Th following tabl prsnts for th 2005 survy th unwightd numbr of rspondnts, th unwightd prcnt of rspondnts, and th wightd prcnt of rspondnts by slctd dmographic charactristics. Distribution of th 2005 North Carolina Survy Sampl by Slctd Charactristics Unwightd Unwightd Wightd Numbr Prcnt Prcnt Total 17,261 100 100 Sx Mals 6,183 35.8 48.5 Fmals 11,078 64.2 51.5 Ag 18-24 819 4.7 13.1 25-34 2,403 13.9 18.8 35-44 3,139 18.5 19.9 45-54 3,333 19.3 18.0 55-64 3,153 18.3 13.5 65+ 4,266 24.7 16.3 Unknown/Rfusd 89 0.5 0.4 Rac Whit 13,021 75.4 72.5 African Amrican 3,039 17.6 17.7 Asian 116 0.7 0.9 Amrican Indian 296 1.7 1.3 Othr Minoritis 729 4.2 7.2 Unknown/Rfusd 60 0.3 0.3 Hispanic Origin Ys Spanish spaking 613 3.5 2.0 Ys English spaking 268 1.5 6.9 No 16,365 94.8 91.0 Unknown/Rfusd 15 0.09 0.07 Education Lss than H.S. 2,735 15.8 17.3 H.S. or G.E.D. 5,207 30.2 29.5 Som Post-H.S. 4,203 24.3 24.4 Collg Graduat 5,078 29.4 28.7 Unknown/Rfusd 38 0.2 0.2 Houshold Incom Lss than $15,000 2,084 12.1 9.8 $15,000 24,999 3,095 17.9 18.8 $25,000 34,999 2,120 12.3 12.3 $35,000 49,999 2,348 13.6 13.3 $50,000 + 5,039 29.2 31.4 Unknown/Rfusd 2,575 14.9 14.9 N. C. Dpartmnt of Halth and Human Srvics 4
For th BRFSS and almost all othr survys of its typ, th highst prcntag of unknowns or rfusals ar most oftn associatd with incom-rlatd qustions. In 2005, about half of th rspondnts (n=1,195) in th Unknown/Rfusd catgory did not know thir total houshold incom and th othr half (n=1,380) simply rfusd to answr th qustion. Whn combind, this group rprsntd about 15 prcnt of all thos who rspondd to th incom qustion (s Tabl on pag 4). Though a larg prcntag, this is a noticabl improvmnt ovr th corrsponding rat of 19 prcnt rportd in th 2001 rport (s Halth Risks Among North Carolina Adults: 2001 availabl on th Stat Cntr s wb sit at http://www.schs.stat.nc.us/schs/pdf/ BRFSS2001.pdf). Analysis and Intrprtation Th dmographic charactristics shown in th main tabls of this rport ar gnrally th charactristics of th prson rsponding to th survy. Howvr, incom rflcts th rportd annual incom of th houshold from all houshold mmbrs and sourcs. Unlss othrwis spcifid, rspondnts who answrd that thy did not know or who rfusd to answr wr not includd in th calculation of th prcntags. Thrfor, th sampl sizs usd to calculat th stimats in this rport vary. Th main data tabls in this rport show th 95 prcnt confidnc intrval associatd with ach prcntag (labld C.I. ). All survy rsults, no mattr how larg or small th sampl, ar subjct to som dgr of sampling rror. Th 95 prcnt confidnc intrval shows th rang within which w would xpct th tru valu for th ntir population to fall 95 prcnt of th tim. For smallr sampl sizs (for xampl, for a particular gographic stratum), th confidnc intrvals will b widr. Th confidnc intrvals shown in this rport may not b xactly th sam as thos that CDC calculats for th sam masurs. W us a mthod that may rsult in non-symmtrical confidnc intrvals, which is mor appropriat whn th prvalnc is clos to 0 or 100 prcnt. Givn th complx natur of th BRFSS sampl (i.., it is not a simpl random sampl), th SUDAAN softwar was usd to calculat th confidnc intrvals for th stimats. This softwar taks th complx sampling dsign into account whn computing th rrors of th stimats. In gnral, any prcntag with a numrator of lss than 50 will hav a rlativly larg dgr of sampling rror and should b considrd cautiously. Tsts of th statistical significanc of a diffrnc btwn two prcntags (for xampl, btwn th prcntags for two ag groups) can b prformd aftr calculating th standard rror of th diffrnc. Th data usr should contact BRFSS staff of th for assistanc with this calculation. Though not xactly tchnically corrct, a rough approximation of th statistical significanc of a diffrnc btwn two prcntags can b drivd by comparing th confidnc intrvals shown in th data tabls of this rport. If th confidnc intrvals of th two prcntags bing compard do not ovrlap, thn it is likly that th diffrnc btwn th two prcntags is statistically significant at th 95 prcnt confidnc lvl. Statd anothr way, on can b 95 prcnt crtain that a diffrnc that larg would not b obsrvd just du to random variation in th two prcntags. Undrstanding how rats may vary from on group to anothr rquirs an undrstanding of how risk may b affctd by ag, ducation or socioconomic status, or othr conditions, and th amplifid ffct that such factors may hav in combination. For xampl, th prcntag of prsons ags 65+ is much highr in th lowr ducation groups as compard to thos with highr ducation. Thrfor, to som xtnt th rsults for th lowr ducation groups ar affctd by th ag of ths populations. For xampl, chronic disas rats ar N. C. Dpartmnt of Halth and Human Srvics 5
much highr among prsons of lowr ducation. This is du to th ffcts of both ag and socioconomic status. Nationwid data for CDC cor and optional moduls wr usd to gnrat Unitd Stats maps. A clustring program was usd to crat fiv groups for th national maps for qustions with full participation and four groups for national maps showing data for lss than all of th stats, i.., thos stats who chos to includ th CDC optional modul in thir 2005 survy. Prsntation of th Rsults Thr ar two sts of data tabls in this rport, dmographic and gographic, for ach topic prsntd. For th dmographic tabls, th lft-hand column shows th dmographic groups, including, at th bottom of th tabl, th slctd risk masur of whthr or not th rspondnt has halth insuranc. Lack of halth insuranc will likly rmain a ky political and public halth issu through th nd of this dcad. Th scond column in th dmographic tabls shows th total numbr of rspondnts who answrd th qustion. With a fw xcptions whr a man valu is shown, column thr (N) shows th numbr who answrd Ys to th risk bing masurd. Columns four and fiv show th wightd prcntag of Ys rsponss and th 95 prcnt confidnc intrval for this wightd prcntag. (Not that th wightd prcntag cannot b calculatd dirctly from th unwightd numrator and dnominator that ar shown in th tabl.) Th gographic tabls ar arrangd in th sam mannr as th dmographic tabls, but w show only th total numbr of rspondnts from ach gographic stratum thr ar no dmographic brakouts. Th county nam(s) for ach stratum ar numratd, xcpt in four cass. Two multi-county groups in th northast rgion of th stat ar dfind in th rport as, Northast N.C. I and Northast N.C. II. Northast N.C. I countis ar: Brti, Gats, Halifax, Hrtford, Northampton, and Warrn. Northast N.C. II countis ar: Baufort, Camdn, Chowan, Edgcomb, Martin, Pasquotank, Prquimans, Tyrrll, and Washington. For a multi-county group in th northwst rfrrd to as, Appalachian, Avry, Wilks, Appalachian srvs as a district rfrnc for Allghany, Ash, and Watauga countis. Th MAHEC stratum includs all of th countis in th Mountain AHEC rgion, xcpt Buncomb County. Along with singl-county and multi-county strata, th gographic tabls also fatur thr statwid rgions: th Wstrn rgion, th Pidmont rgion, and th Eastrn rgion. Ths ar standard classifications of county/ rgions that hav bn usd prviously in BRFSS rports and on our wb sit (s Appndix B). Bsids ths rgional dsignations, th rport also faturs th countis srvd by th stat s nin AHEC (Ara Halth Education Cntr) rgional cntrs. Thy ar: Mountain AHEC, Charlott AHEC, Northwst AHEC, Grnsboro AHEC, Wak AHEC, Southrn Rgional AHEC, Ara L AHEC, Eastrn AHEC, and Coastal AHEC. (S Appndix A for a stat map showing th rgional boundaris and countis srvd.) In addition to th data tabls, w show trnds from th North Carolina BRFSS dating back to th 2000 survy, our baslin masur. Two sts of trnds ar prsntd graphically, on for rac and Hispanic thnicity and on for ag. Data from th two strata with a high proportion of Amrican Indians ar not shown sparatly du to small numbrs, though ths data hlp incras th sampl siz for th Amrican Indian racial group. For th ag trnds, 18 to 24 yar olds wr combind with 25 to 34 yar olds in ordr to limit th total numbr of ag groups to fiv (having mor than fiv trnd lins in a singl chart maks it difficult to dciphr individual trnds). For rac trnds, four groups wr constructd: 1) non-hispanic (NHP) whits; 2) NHP African Amricans; 3) NHP othr minoritis (prdominantly Amrican Indian); and Hispanics (both English and N. C. Dpartmnt of Halth and Human Srvics 6
Spanish spakrs). Along with ths four rac/thnic groups, w also show th North Carolina statwid trnd. Trnds for Hispanics wr rstrictd to th 2001 survy and forward, sinc th 2000 sampl was too small to provid maningful comparisons. Also, th BRFSS survy was first conductd in Spanish in 2002 and th inclusion of Spanish-spaking Hispanics has a markd ffct on som of th indicators.* Thr or mor yars of North Carolina BRFSS data wr rquird to show trnds. Som of th BRFSS qustions ar not askd vry yar. Strngths and Limitations of th Survy Data Thr ar som significant advantags of th tlphon survy mthodology, including bttr quality control ovr data collction mad possibl by a computr-assistd-tlphon-intrviwing systm (CATI), rlativly low cost, and spd of data collction. Th BRFSS mthodology has bn usd and valuatd by th CDC and participating stats sinc 1984. Th survy qustions, qustionnair dsign, data collction procdurs, intrviwing tchniqus, and diting procdurs hav bn carfully dvlopd to improv data quality and lssn th potntial for bias. Th data collction is ongoing and ach yar nw annual rsults bcom availabl. On limitation of a tlphon survy is th lack of covrag of prsons who liv in housholds without a tlphon. Housholds without a tlphon ar, on avrag, of lowr incom. Thrfor, for many of th halth risks shown in this rport, th rsults ar likly to undrstat th tru lvl of risk in th total population of adults in North Carolina. Sinc approximatly 95 prcnt of housholds in North Carolina do hav on or mor tlphons, th dgr of undrstatmnt is probably not larg. A scond limitation is du to th fact that th data is slf-rportd by th rspondnts. W xpct that rspondnts tnd to undrrport halth risk bhaviors, spcially thos that ar illgal or socially unaccptabl. Th survy rsults prsntd hr ar purly dscriptiv. It is not possibl to infr causs of th obsrvd diffrncs from th information prsntd hr. For xampl, thr ar larg diffrncs btwn whits and African Amricans on som of th masurs. It should not b infrrd that th diffrncs ar du to rac alon. Social and conomic factors associatd with rac oftn account for a larg part of th diffrncs obsrvd btwn racial groups. Rcnt studis also indicat that racism may b a contributing factor to halth disparitis. Th rsults prsntd hr for a singl yar of data must b approachd with caution du to small numbrs in som of th dmographic sub-catgoris or gographic strata. Th confidnc intrvals ar providd as a mans of intrprting th accuracy of ths stimats. *S SCHS Studis No. 143 Spanish-Spaking Hispanics in North Carolina: Halth Status, Accss to Halth Car, and Quality of Lif Rsults from th 2002 and 2003 N.C. BRFSS Survys at http://www.schs.stat.nc.us/schs/pdf/schs143.pdf N. C. Dpartmnt of Halth and Human Srvics 7
Gnral Halth Status Prcivd fair or poor ovrall halth Ovr 40 prcnt of thos from th lowst incom housholds rportd bing in fair/poor halth, compard to lss than 7 prcnt from th highst incom housholds. Almost 33 prcnt of Spanish-spaking Hispanics rportd bing in fair/poor halth, compard to about 19 prcnt of English-spaking Hispanics. Avrag (man) numbr of days during prvious 30 days whn physical halth was not good Spanish-spaking Hispanics rportd far fwr poor physical halth days (1.8 days) than thir English-spaking countrparts (3.7 days); this is in sharp contrast to th prvious findings on prcivd halth. Avrag (man) numbr of days during prvious 30 days whn mntal halth was not good By rac, th highst risk of poor mntal halth days was vidnt among Amrican Indians. Avrag (man) numbr of days during prvious 30 days whn poor physical or mntal halth prvntd usual activitis Among all dmographic groups, th gratst disparity in th rport of poor physical/mntal halth days prvnting usual activitis was associatd with houshold incom. North Carolina Trnds Th gap in rats of prcivd fair/poor halth, btwn non-hispanic whits and African Amricans, has rmaind fairly constant sinc th start of th dcad (Figur 1a). By ag, th six-yar trnds in prcivd fair/poor halth show a slight dclin for th oldst ag group and a slight incras for th youngst ag group, 18-34 yar olds (Figur 1b). Figur Fair or 1a. Poor Fair Halth or Poor by Halth Rac/Ethnicity: by Rac/Ethnicity: NC BRFSS N.C. 2000-2005 BRFSS 2000-2005 40 35 P r c n t 30 25 20 15 10 5 0 2000 2001 2002 2003 2004 2005 *2002: initiatd Initiatd Spanish intrviws s NC Total NHP Whit NHP Black NHP Othr Hispanic NHP: non-hispanic N. C. Dpartmnt of Halth and Human Srvics 8
Fair or Figur Poor 1b. Halth Fair by or Ag: Poor NC Halth BRFSS by Ag: 2000-2005 N.C. BRFSS 2000-2005 P r c n t 45 40 35 30 25 20 15 10 5 0 2000 2001 2002 2003 2004 2005 18-34 yrs 35-44 yrs 45-54 yrs 55-64 yrs 65+ yrs Tabl 1a. Halth Status of N.C. Adults, 2005 Days Poor Physical or Poor Physical Halth Poor Mntal Halth Mntal Halth Prvntd Fair or Poor Gnral Halth Days/Month Days/Month Usual Activitis* Total Total Total Total Rsp. N % 95% C.I. Rsp. Man 95% C.I. Rsp. Man 95% C.I. Rsp. Man 95% C.I. TOTAL 17223 3700 18.6 17.8-19.3 16914 3.5 3.3-3.6 16999 3.1 3.0-3.3 17108 2.0 1.9-2.1 GENDER Mal 6169 1316 17.6 16.5-18.9 6094 3.0 2.7-3.2 6094 2.4 2.2-2.6 6140 1.7 1.5-1.8 Fmal 11054 2384 19.4 18.5-20.4 10820 3.9 3.7-4.1 10905 3.8 3.6-4.0 10968 2.3 2.1-2.4 RACE Whit 12997 2541 16.3 15.5-17.1 12782 3.5 3.3-3.7 12824 3.3 3.1-3.5 12912 2.0 1.8-2.1 African Amrican 3026 823 24.1 22.2-26.2 2944 3.8 3.4-4.1 2985 3.3 2.9-3.6 3006 2.4 2.1-2.7 Asian 116 8 5.9 2.7-12.3 114 1.5 0.7-2.2 113 1.4 0.5-2.3 114 1.2 0.5-1.9 Amrican Indian 295 94 29.8 23.7-36.8 292 5.5 4.1-6.9 293 4.7 3.3-6.0 290 3.5 2.3-4.6 Othr Minoritis 729 215 27.1 23.1-31.6 726 2.1 1.5-2.7 725 1.3 0.9-1.6 726 1.2 0.8-1.6 HISPANIC English Spaking 268 56 18.5 13.2-25.5 266 3.7 2.6-4.7 262 2.6 1.6-3.5 264 2.7 1.7-3.7 Spanish Spaking 613 224 32.8 28.2-37.8 613 1.8 1.2-2.3 613 0.8 0.5-1.1 613 0.8 0.5-1.2 Non-Hispanic 16327 3413 17.4 16.7-18.2 16020 3.6 3.4-3.7 16110 3.3 3.2-3.5 16216 2.1 1.9-2.2 AGE 18-24 819 91 11.3 8.8-14.3 811 1.9 1.5-2.2 810 3.5 2.9-4.1 816 1.2 0.8-1.6 25-34 2402 262 11.1 9.6-12.9 2383 2.0 1.8-2.3 2378 3.1 2.8-3.5 2397 1.2 1.0-1.4 35-44 3193 398 12.0 10.7-13.4 3172 2.7 2.4-2.9 3176 3.4 3.1-3.7 3189 1.6 1.4-1.8 45-54 3328 660 19.5 17.9-21.3 3291 4.1 3.7-4.5 3295 3.6 3.3-4.0 3309 2.5 2.2-2.8 55-64 3146 829 25.9 24.0-27.8 3095 4.8 4.4-5.2 3089 3.1 2.8-3.4 3118 2.9 2.6-3.2 65+ 4246 1444 34.0 32.3-35.7 4079 5.7 5.3-6.1 4165 2.1 1.8-2.3 4193 2.7 2.4-3.0 EDUCATION Lss Than H.S. 2722 1255 38.4 35.8-41.1 2598 5.4 4.9-5.9 2650 3.7 3.2-4.1 2674 3.3 2.9-3.7 H.S. or G.E.D. 5195 1260 21.1 19.7-22.6 5090 3.7 3.5-4.0 5116 3.4 3.1-3.7 5162 2.1 1.9-2.3 Som Post-H.S. 4198 712 13.5 12.3-14.8 4151 3.3 3.1-3.6 4156 3.5 3.2-3.8 4178 2.0 1.7-2.2 Collg Graduat 5071 459 8.2 7.3-9.1 5038 2.1 1.9-2.3 5040 2.2 2.0-2.4 5059 1.2 1.1-1.3 HOUSEHOLD INCOME Lss than $15,000 2075 1001 42.5 39.6-45.5 1994 7.2 6.6-7.7 2021 5.7 5.1-6.3 2031 4.7 4.2-5.2 $15,000-24,999 3086 912 26.9 24.8-29.1 3024 4.2 3.8-4.5 3038 3.4 3.0-3.7 3066 2.4 2.1-2.7 $25,000-34,999 2117 433 18.8 16.8-21.1 2088 3.3 2.9-3.7 2101 3.4 2.9-3.8 2109 1.9 1.5-2.3 $35,000-49,999 2344 314 12.2 10.8-13.9 2321 3.0 2.7-3.4 2329 2.9 2.5-3.3 2341 1.6 1.3-1.8 $50,000+ 5038 342 6.5 5.7-7.4 5023 1.9 1.7-2.1 5010 2.2 2.0-2.4 5029 1.0 0.8-1.1 HEALTH INSURANCE Ys 14717 2988 17.0 16.3-17.8 14448 3.5 3.3-3.6 14519 3.0 2.9-3.2 14615 2.0 1.8-2.1 No 2472 707 25.3 23.1-27.7 2437 3.4 3.0-3.7 2448 3.7 3.3-4.1 2460 2.1 1.8-2.5 *Rspondnts who rportd no mntal or physical halth problms in th past month wr not askd this qustion; howvr, thy ar includd in th dnominator. N. C. Dpartmnt of Halth and Human Srvics 9
Gnral Halth Status (cont.) Gographical Variation Prcivd fair or poor ovrall halth Across individual countis, Robson had th highst rat (26.0%) for this indicator. Among multi-county groups, th highst rat of prcivd fair/poor halth was obsrvd in th Northast N.C. I rgion (31.8%) of th stat, which consists of Brti, Gats, Halifax, Hrtford, Northampton, and Warrn countis. Nationally, th rats of prcivd fair/poor halth rang from a low of 11.1 prcnt in Nw Hampshir to 34.1 prcnt in Purto Rico; North Carolina had th 11 th highst rat (18.6%) among stats (Figur 1c). Avrag (man) numbr of days during prvious 30 days whn physical halth was not good Th avrag numbr of poor physical halth days was highst in Gaston County (5.0 days). Thr was a gnral trnd for rspondnts from both astrn and wstrn countis to rport highr numbrs of poor physical halth days than thos from th cntral or Pidmont countis. Avrag (man) numbr of days during prvious 30 days whn mntal halth was not good Th highst risk of poor mntal halth days tndd to occur in th astrn rgion of th stat, particularly among th multicounty group of Bladn, Brunswick, Columbus and Pndr (4.5 man days). Avrag (man) numbr of days during prvious 30 days whn poor physical or mntal halth prvntd usual activitis Th man numbr of poor physical/mntal halth days prvnting usual activitis was 2 days for th stat as a whol; th high/low rang for all gographic strata tndd to fall within on day of this avrag. Figur 1c. Prcivd Fair/Poor Halth, Unitd Stats, 2005 Prcivd Fair/Poor Halth Unitd Stats, 2005 District of Columbia (12.5%) Prcnt Alaska Hawaii Virgin Islands Purto Rico Sourc: BRFSS Numbr of Participating Stats: 53 Not to Scal (Including Purto Rico, Virgin Is. & D.C.) 11.1-12.8 12.9-15.5 15.6-19.8 19.9-24.7 24.8-34.1 Unitd Stats 14.9 North Carolina 18.6 N. C. Dpartmnt of Halth and Human Srvics 10
Tabl 1b. Halth Status of N.C. Adults, 2005 Days Poor Physical or Poor Physical Halth Poor Mntal Halth Mntal Halth Prvntd Fair or Poor Gnral Halth Days/Month Days/Month Usual Activitis* Total Total Total Total Rsp. N % 95% C.I. Rsp. Man 95% C.I. Rsp. Man 95% C.I. Rsp. Man 95% C.I. TOTAL 17223 3700 18.6 17.8-19.3 16914 3.5 3.3-3.6 16999 3.1 3.0-3.3 17108 2.0 1.9-2.1 COUNTIES/REGIONS Alamanc 462 106 21.2 16.9-26.2 450 3.9 3.1-4.7 457 3.5 2.6-4.3 458 2.2 1.6-2.8 Buncomb 453 95 17.5 13.5-22.4 441 3.6 2.8-4.5 445 3.0 2.2-3.8 453 2.2 1.6-2.8 Cabarrus 423 83 18.7 14.0-24.6 414 2.7 2.0-3.4 414 3.1 2.3-3.9 419 1.7 1.2-2.2 Catawba 448 100 19.3 15.3-24.1 442 3.4 2.6-4.3 438 2.6 1.8-3.5 444 2.0 1.3-2.7 Cumbrland 455 94 17.3 13.8-21.5 446 3.7 2.8-4.6 452 3.0 2.2-3.8 456 3.1 1.9-4.3 Davidson 458 117 23.6 18.8-29.2 450 4.1 3.1-5.0 455 2.6 1.9-3.4 457 2.1 1.3-2.8 Durham 467 76 15.3 11.3-20.4 458 2.7 2.0-3.5 464 2.3 1.8-2.9 462 1.3 0.9-1.8 Forsyth 456 79 16.5 12.5-21.4 446 3.0 2.3-3.8 455 3.7 2.8-4.7 457 1.6 1.1-2.1 Gaston 447 123 23.6 19.3-28.5 444 5.0 4.0-6.1 440 4.2 3.2-5.2 446 2.8 2.0-3.5 Guilford 470 98 18.6 14.8-23.2 460 3.7 2.8-4.6 467 3.4 2.4-4.3 466 2.2 1.5-2.9 Irdll 407 70 14.5 11.0-19.0 402 3.2 2.4-4.0 402 2.8 2.0-3.6 406 1.7 1.2-2.2 Johnston 389 85 17.7 13.4-23.1 383 3.9 3.0-4.8 386 2.8 2.0-3.6 387 2.1 1.5-2.7 Mcklnburg 880 132 12.8 10.4-15.6 872 2.9 2.3-3.5 875 2.5 2.0-2.9 876 1.6 1.2-2.1 Nw Hanovr 450 57 11.6 8.5-15.6 445 3.1 2.3-3.9 442 3.2 2.4-4.0 445 1.9 1.3-2.4 Onslow 397 81 15.0 11.7-19.1 389 3.3 2.6-4.0 393 3.7 2.8-4.6 392 1.6 1.1-2.1 Orang 419 38 10.5 6.4-16.9 419 2.2 1.6-2.8 417 2.4 1.8-3.1 420 1.5 1.0-2.0 Pitt 443 88 18.3 14.4-23.0 441 3.4 2.5-4.3 434 2.7 1.9-3.5 441 1.8 1.1-2.5 Randolph 457 106 19.9 16.1-24.3 448 3.7 2.8-4.6 448 3.0 2.2-3.7 452 2.3 1.6-3.1 Robson 446 136 26.0 21.5-31.0 431 4.6 3.7-5.6 444 4.3 3.3-5.3 440 2.9 2.1-3.6 Rowan 475 122 20.5 16.7-25.0 467 3.7 2.8-4.5 470 4.0 2.8-5.2 469 2.3 1.5-3.1 Union 382 72 16.8 12.9-21.5 377 3.3 2.4-4.1 379 2.7 1.9-3.5 381 1.4 0.8-2.1 Wak 860 112 11.5 9.3-14.2 851 2.1 1.7-2.5 849 2.1 1.7-2.5 857 1.1 0.8-1.4 Cartrt,Currituck, Cravn,Dar,Hyd, Pamlico 471 96 16.3 12.8-20.6 464 3.4 2.6-4.1 462 3.9 2.7-5.1 468 1.9 1.3-2.5 Northast N.C. I 516 179 31.8 27.0-37.0 496 4.6 3.7-5.4 509 3.2 2.5-4.0 512 2.5 1.8-3.1 Northast N.C. II 510 139 26.8 22.2-32.1 500 4.0 3.2-4.8 504 3.3 2.5-4.1 506 2.4 1.8-3.1 Franklin,Nash,Wilson 422 98 19.0 15.0-23.7 416 3.0 2.2-3.7 416 3.2 2.2-4.2 419 1.8 1.2-2.3 Duplin,Grn, Harntt,Jons, Lnoir, Sampson, Wayn 526 141 23.2 19.3-27.7 517 3.8 3.0-4.6 518 3.2 2.4-4.0 521 2.2 1.6-2.8 Bladn,Brunswick, Columbus,Pndr 429 102 23.1 18.7-28.2 423 4.4 3.3-5.5 420 4.5 3.4-5.6 422 3.1 2.1-4.1 Caswll,Granvill, Prson,Vanc 478 92 18.0 14.0-22.8 472 3.6 2.8-4.4 472 3.1 2.3-3.8 475 2.0 1.3-2.6 Chatham,L,Moor 525 99 18.2 14.6-22.5 519 3.4 2.5-4.2 520 3.0 2.1-3.8 521 1.9 1.3-2.4 Anson,Hok, Montgomry,Richmond, Scotland,Stanly 651 150 19.3 16.0-23.0 630 3.7 3.0-4.3 635 3.5 2.7-4.2 644 2.2 1.6-2.7 Davi,Rockingham, Stoks,Surry,Yadkin 468 113 19.3 15.5-23.7 453 3.2 2.5-3.9 460 4.0 2.9-5.0 462 1.9 1.4-2.5 Appalachian,Avry, Wilks 408 104 24.0 19.2-29.6 403 4.5 3.6-5.5 404 3.6 2.4-4.7 409 2.2 1.6-2.8 Alxandr,Burk, Caldwll,Clvland, Lincoln 509 136 21.5 17.7-26.0 493 4.5 3.6-5.5 501 3.3 2.5-4.0 505 2.5 1.8-3.2 MAHEC (xcluding Buncomb County) 766 181 22.1 18.4-26.4 752 3.7 3.0-4.4 752 3.4 2.7-4.0 760 2.2 1.6-2.7 REGIONS Eastrn 5553 1308 20.7 19.4-22.0 5449 3.8 3.5-4.1 5477 3.5 3.2-3.7 5505 2.3 2.1-2.5 Pidmont 9671 1913 16.8 15.9-17.8 9513 3.2 3.0-3.4 9554 2.9 2.8-3.1 9611 1.8 1.6-1.9 Wstrn 1999 479 21.0 18.8-23.4 1952 3.9 3.4-4.3 1968 3.3 2.9-3.8 1992 2.2 1.9-2.5 AHEC REGIONS Mountain 1195 266 20.2 17.3-23.5 1169 3.6 3.1-4.2 1173 3.2 2.7-3.7 1189 2.1 1.7-2.6 Northwst 3279 752 20.0 18.3-21.8 3215 3.7 3.4-4.1 3240 3.4 3.0-3.7 3265 2.0 1.8-2.3 Charlott 2548 510 16.5 14.8-18.3 2511 3.4 3.0-3.7 2514 2.9 2.6-3.2 2533 1.8 1.5-2.1 Grnsboro 2223 441 18.3 16.3-20.6 2186 3.4 3.0-3.9 2202 3.4 2.9-3.9 2208 2.1 1.8-2.5 Southrn Rgional 1789 439 21.2 18.9-23.7 1748 3.9 3.4-4.4 1766 3.5 3.0-4.0 1775 2.7 2.2-3.2 Coastal 877 154 18.6 15.5-22.1 866 3.9 3.2-4.6 861 3.4 2.8-4.0 867 2.2 1.7-2.7 Wak 2423 419 14.0 12.4-15.9 2382 2.6 2.3-2.9 2396 2.4 2.1-2.6 2406 1.4 1.2-1.6 Ara L 699 202 24.5 20.8-28.7 684 3.7 3.1-4.4 690 3.6 2.8-4.5 696 2.3 1.8-2.8 Eastrn 2190 517 20.6 18.6-22.8 2153 3.7 3.3-4.0 2157 3.4 2.9-3.9 2169 2.1 1.8-2.3 *Rspondnts who rportd no mntal or physical halth problms in th past month wr not askd this qustion; howvr, thy ar includd in th dnominator. N. C. Dpartmnt of Halth and Human Srvics 11
Halth Car Accss No halth insuranc covrag Clos to 1 in 5 North Carolina adults (19.1%), or an stimatd 1.2 million adults, had no halth insuranc covrag in 2005. Ovr 40 prcnt of thos with lss than a high school ducation had no halth insuranc covrag. Compard to fmals (16.6%), mals (21.8%) wr significantly mor likly not to hav halth insuranc. Dos not hav a prsonal doctor About 82 prcnt of Spanish-spaking Hispanics rportd not having a prsonal doctor, narly twic th rat of most othr high-risk dmographic groups, such as young adults. As rportd in th 2001 rport (S footnot*; rfrrd to hraftr as th 2001 rport or 2001. ), 24.2 prcnt of thos with th lowst ducation had no prsonal doctor, but in 2005, th rat for this group jumpd to 40.8 prcnt. Could not s a doctor in past yar du to cost Among th rac groups, Amrican Indians rportd th highst rat (27.5%) of not bing abl to s a doctor in th past yar bcaus of cost. Cost was a prohibitiv factor for 41.3 prcnt of thos with no halth insuranc, compard to 9.5 prcnt of thos with halth insuranc a diffrnc of almost 32 prcntag points. North Carolina Trnds Lack of halth insuranc for all North Carolina adults has incrasd from about 13 prcnt in 2000 to about 19 prcnt in 2005. Much of this incras is du to th xcptionally high rats of uninsuranc among Spanish-spaking Hispanics (Figur 2a). Th first yar that th BRFSS survy was conductd in Spanish was 2002, so th 2000 and 2001 data do not includ Spanish-spaking Hispanics. Sinc 2000, th rat of no halth insuranc covrag has incrasd dramatically for 18-34 yar olds, and appars to b on ris for 35 to 44 yar olds, as wll (Figur 2b). No Halth Figur Insuranc 2a. No Halth Covrag Insuranc by Rac/Ethnicity: Covrag by Rac/Ethnicity: NC BRFSS 2000- N.C. BRFSS 2005 2000-2005 70 P r c n t 60 50 40 30 20 10 NC Total NHP Whit NHP Black NHP Othr Hispanic NHP: non-hispanic 0 2000 2001 2002 2003 2004 2005 *2002: 2002: initiatd Initiatd Spanish intrviws s Halthy Popl 2010 Objctivs: 1) Incras th prcntag with halth insuranc to 100% (N.C.: 1999=89.7%; 2000=88.9%; 2001=85.8%; 2005=80.9%). 2) Incras th proportion of prsons with a usual primary car providr to 85% (N.C.: 2001=80.7%; 2005=77.2%). *Halth Risks Among North Carolina Adults: 2001, A Rport from th Bhavioral Risk Factor Survillanc Systm, DHHS, Stat Cntr for Halth Statistics, August 2003 N. C. Dpartmnt of Halth and Human Srvics 12
P r c n t 35 30 25 20 15 10 5 0 Figur 2b. No Halth Insuranc by by Ag: Ag: N.C. BRFSS 2000-2005 NC BRFSS 2000-2005 2000 2001 2002 2003 2004 2005 18-34 yrs 35-44 yrs 45-54 yrs 55-64 yrs 65+ yrs Tabl 2a. Halth Car Accss of N.C. Adults, 2005 No Currnt Halth Insuranc Dos Not Hav a Prsonal Doctor Could Not S a Doctor Du to Cost Total Total Total Rsp. N % 95% C.I. Rsp. N % 95% C.I. Rsp. N % 95% C.I. TOTAL 17226 2476 19.1 18.2-20.1 17227 2811 22.8 21.8-23.8 17239 2534 15.6 14.8-16.4 GENDER Mal 6160 975 21.8 20.3-23.5 6165 1372 29.3 27.6-31.0 6173 711 13.3 12.1-14.6 Fmal 11066 1501 16.6 15.6-17.6 11062 1439 16.6 15.6-17.7 11066 1823 17.8 16.8-18.7 RACE Whit 12999 1369 13.7 12.8-14.7 13000 1730 18.0 17.0-19.0 13007 1614 13.3 12.5-14.1 African Amrican 3030 608 23.7 21.5-26.1 3029 521 22.5 20.2-25.0 3034 635 20.3 18.4-22.4 Asian 115 16 15.3 8.6-25.9 114 32 30.6 21.1-42.1 116 17 14.3 8.4-23.3 Amrican Indian 296 75 26 20.2-32.9 296 56 23.5 17.6-30.7 295 71 27.5 21.2-34.9 Othr Minoritis 728 402 61.4 56.5-66.2 729 458 69.6 64.8-74.1 728 184 24.7 20.2-29.8 HISPANIC English Spaking 268 64 28.9 21.9-37.0 267 83 38.9 31.4-46.9 267 63 21.0 15.5-27.8 Spanish Spaking 612 460 76.7 71.9-80.8 613 485 81.7 77.4-85.3 613 169 25.0 20.7-29.9 Non-Hispanic 16331 1950 14.5 13.7-15.4 16332 2241 17.9 17.0-18.8 16344 2301 14.8 14.0-15.6 AGE 18-24 808 256 35.2 30.9-39.8 812 321 43.0 38.6-47.5 818 145 17.8 14.6-21.5 25-34 2401 622 29.3 26.9-31.8 2399 813 37.6 35.1-40.1 2399 479 20.0 18.0-22.2 35-44 3194 566 19.7 17.9-21.7 3197 648 24.3 22.3-26.4 3193 586 18.3 16.6-20.1 45-54 3329 518 15.9 14.4-17.6 3328 493 16.4 14.8-18.1 3332 576 16.5 15.1-18.1 55-64 3146 415 13.6 12.2-15.2 3148 304 9.9 8.6-11.3 3150 481 14.0 12.6-15.5 65+ 4262 94 2.5 1.9-3.2 4255 223 5.9 5.0-6.9 4259 259 6.0 5.1-6.9 EDUCATION Lss Than H.S. 2725 768 41.0 38.0-44.0 2729 710 40.8 37.8-43.8 2732 634 25.5 23.0-28.1 H.S. or G.E.D. 5194 887 22.9 21.2-24.8 5193 874 23.5 21.7-25.3 5199 841 17.8 16.2-19.4 Som Post-H.S. 4197 517 14.2 12.7-15.9 4195 565 18.0 16.3-19.8 4196 628 15.1 13.7-16.6 Collg Graduat 5072 300 6.2 5.4-7.2 5074 658 15.3 14.0-16.7 5074 426 7.9 7.0-8.8 HOUSEHOLD INCOME Lss than $15,000 2082 564 35.9 32.8-39.1 2081 427 31.4 28.3-34.7 2082 594 28.9 26.3-31.7 $15,000-24,999 3091 852 38.7 36.0-41.5 3090 757 37.1 34.4-39.9 3088 750 27.2 24.9-29.7 $25,000-34,999 2119 341 22.5 19.6-25.7 2116 380 25.1 22.2-28.2 2118 370 20.1 17.5-23.0 $35,000-49,999 2344 196 10.2 8.6-12.1 2345 328 18.5 16.1-21.1 2347 256 12.1 10.4-13.9 $50,000+ 5034 163 4.3 3.4-5.3 5036 545 13.6 12.2-15.0 5038 240 4.8 4.1-5.6 HEALTH INSURANCE Ys N/A N/A N/A N/A 14728 1580 14.5 13.6-15.4 14732 1417 9.5 8.9-10.1 No N/A N/A N/A N/A 2468 1226 58.1 55.3-60.8 2473 1108 41.3 38.5-44.1 N. C. Dpartmnt of Halth and Human Srvics 13
Halth Car Accss (cont.) Gographical Variation No halth insuranc covrag Among individual countis, no halth insuranc covrag rangd from a high of 26.1 prcnt in Durham to a low of 12.7 prcnt in Onslow. By stat rgions, th rat of no halth insuranc was highst in th Wstrn rgion. By AHEC rgions, lack of insuranc was highst in th Mountain countis. (S Appndix A for county listing). Nationally, North Carolina had th 11 th highst rat (19.1%) of no halth insuranc, whil Minnsota and Purto Rico had th lowst rat (7.0%). Th U.S. mdian rat was 14.5 prcnt (Figur 2c). Dos not hav a prsonal doctor Among individual countis, th adult populations of Cumbrland (29.7%), Durham (29.8%), Orang (27.9%), and Robson (28.4%) wr most likly not to hav a prsonal doctor. Among multi-county strata, th coastal countis of Cartrt, Currituck, Cravn, Dar, Hyd, and Pamlico had th highst rat of not having a prsonal doctor (27.2%). Among AHEC rgions, th Southrn Rgion (Bladn, Cumbrland, Harntt, Hok, Moor, Richmond, Robson, Sampson, and Scotland) had th highst rat (27.2%). Could not s a doctor in past yar du to cost Th highst prcntag of thos that could not afford to s a doctor bcaus of cost wr found in th countis of Alamanc (19.0%), Gaston (19.2%), and Robson (20.8%). Among multi-county strata, th Northast N.C. I countis of Brti, Gats, Halifax, Hrtford, Northampton, and Warrn had th highst risk for this indicator (22.0%). Similarly, among statwid rgions, th Eastrn rgion (17.1%) had th highst rat of any rgion, significantly highr than th Pidmont rgion (14.5%). Figur 2c. No Halth Insuranc, Unitd Stats, 2005 No Halth Insuranc Unitd Stats, 2005 District of Columbia (9.7%) Prcnt Alaska Hawaii Virgin Islands Purto Rico Sourc: BRFSS Numbr of Participating Stats: 53 Not to Scal (Including Purto Rico, Virgin Is. & D.C.) 7.0-9.0 9.1-13.2 13.3-17.2 17.3-22.6 22.7-30.1 Unitd Stats 16.4 14.5 North Carolina 19.1 N. C. Dpartmnt of Halth and Human Srvics 14
Tabl 2b. Halth Car Accss of N.C. Adults, 2005 No Currnt Halth Insuranc Dos Not Hav a Prsonal Doctor Could Not S a Doctor Du to Cost Total Total Total Rsp. N % 95% C.I. Rsp. N % 95% C.I. Rsp. N % 95% C.I. TOTAL 17226 2476 19.1 18.2-20.1 17227 2811 22.8 21.8-23.8 17239 2534 15.6 14.8-16.4 COUNTIES/REGIONS Alamanc 460 79 23.4 18.0-29.9 463 86 26.2 20.6-32.7 461 82 19.0 14.5-24.5 Buncomb 452 71 20.7 15.8-26.6 453 75 23.8 18.7-29.8 453 63 15.9 11.7-21.1 Cabarrus 422 56 16.0 11.5-21.9 423 58 20.1 15.0-26.3 423 62 14.2 10.2-19.5 Catawba 445 68 20.5 15.9-26.1 447 75 23.1 18.0-29.1 445 66 15.9 12.2-20.5 Cumbrland 455 64 16.9 12.4-22.7 456 105 29.7 24.2-35.8 456 59 12.5 8.8-17.5 Davidson 458 73 23.0 17.5-29.7 458 62 23.3 17.5-30.3 459 60 14.4 10.4-19.5 Durham 467 81 26.1 20.4-32.8 467 93 29.8 24.0-36.3 466 59 14.0 10.1-19.1 Forsyth 456 42 13.2 9.4-18.2 457 60 19.7 14.6-25.9 457 53 13.1 9.4-17.9 Gaston 449 58 19.7 13.6-27.6 449 43 12.8 9.2-17.5 449 68 19.2 14.0-25.9 Guilford 469 57 18.6 13.7-24.8 471 68 19.2 14.5-25.1 470 58 13.7 10.2-18.3 Irdll 404 48 13.7 9.6-19.1 406 69 20.7 15.9-26.4 407 55 12.4 9.2-16.7 Johnston 389 50 18.3 12.9-25.4 387 66 23.3 17.6-30.2 389 48 11.8 8.0-17.0 Mcklnburg 880 110 17.9 14.4-22.1 880 144 23.2 19.3-27.7 882 105 13.0 10.5-16.2 Nw Hanovr 450 48 13.3 9.5-18.2 449 70 23.7 18.5-29.9 450 49 12.2 8.8-16.7 Onslow 395 43 12.7 8.5-18.5 394 83 25.0 19.7-31.3 397 53 14.6 9.3-22.2 Orang 420 39 14.8 9.9-21.7 420 77 27.9 21.6-35.3 421 39 12.1 7.7-18.4 Pitt 443 66 16.7 12.6-21.8 443 78 23.2 17.6-29.8 443 66 14.0 10.6-18.2 Randolph 458 61 17.9 13.4-23.4 456 63 19.4 14.8-25.0 458 65 13.8 10.5-18.1 Robson 448 90 24.8 19.9-30.6 448 91 28.4 23.0-34.6 447 97 20.8 16.6-25.8 Rowan 475 63 16.4 12.0-22.0 474 82 21.5 16.5-27.5 473 74 14.6 11.4-18.5 Union 382 47 14.8 10.7-20.2 382 70 24.7 19.4-30.7 381 63 17.2 13.1-22.4 Wak 861 100 14.5 11.4-18.4 859 171 25.8 21.8-30.3 859 108 12.9 10.2-16.2 Cartrt,Currituck,Cravn, Dar,Hyd,Pamlico 470 85 21.7 16.8-27.7 472 86 27.2 21.5-33.6 472 77 19.0 14.2-24.9 Northast N.C. I 519 82 19.4 15.0-24.8 518 70 18.1 14.0-23.1 518 96 22.0 17.0-28.0 Northast N.C. II 510 70 17.1 13.1-22.1 510 90 23.7 18.9-29.3 511 81 17.9 13.8-22.9 Franklin,Nash,Wilson 424 55 17.0 12.1-23.3 424 57 20.9 15.3-27.9 425 62 14.4 10.6-19.2 Duplin,Grn,Harntt,Jons, Lnoir,Sampson,Wayn 524 87 22.7 17.4-29.1 528 91 23.2 18.4-28.8 526 98 20.4 15.6-26.3 Bladn,Brunswick,Columbus, Pndr 429 69 19.5 15.2-24.7 430 67 20.9 16.4-26.3 430 73 18.4 14.3-23.4 Caswll,Granvill,Prson, Vanc 479 71 19.8 15.1-25.5 479 64 18.6 14.1-24.3 479 88 18.1 14.2-22.8 Chatham,L,Moor 526 73 21.2 16.5-26.8 525 82 22.7 17.9-28.4 526 50 12.2 8.7-16.9 Anson,Hok,Montgomry, Richmond,Scotland,Stanly 650 112 23.2 18.8-28.4 648 96 21.3 17.1-26.2 650 106 18.5 14.5-23.2 Davi,Rockingham,Stoks, Surry,Yadkin 470 73 23.0 18.0-28.9 468 59 18.3 13.7-23.9 469 66 15.2 11.4-20.0 Appalachian,Avry,Wilks 408 66 21.7 16.6-27.9 406 51 19.3 14.0-26.0 409 69 17.6 13.6-22.4 Alxandr,Burk,Caldwll, Clvland,Lincoln 511 78 20.2 15.6-25.8 510 62 16.3 12.2-21.5 511 96 18.8 14.9-23.4 MAHEC (xcluding Buncomb County) 768 141 23.3 18.9-28.4 767 147 25.8 21.3-30.9 767 120 16.4 13.2-20.3 REGIONS Eastrn 5555 827 19.0 17.4-20.7 5557 978 24.2 22.5-25.9 5562 878 17.1 15.7-18.7 Pidmont 9668 1309 18.1 16.9-19.4 9669 1506 21.8 20.5-23.1 9673 1338 14.5 13.5-15.5 Wstrn 2003 340 22.9 20.2-25.9 2001 327 23.8 21.0-26.8 2004 318 16.7 14.7-19.0 AHEC REGIONS Mountain 1196 206 22.2 18.7-26.2 1196 219 25.3 21.7-29.2 1196 180 16.3 13.6-19.3 Northwst 3276 456 18.8 16.9-20.9 3276 484 20.6 18.5-22.8 3280 480 15.0 13.4-16.7 Charlott 2549 339 18.5 16.2-21.1 2547 361 20.1 17.8-22.6 2552 367 15.3 13.4-17.4 Grnsboro 2223 302 19.6 16.9-22.5 2225 351 20.8 18.2-23.7 2225 305 15.3 13.2-17.6 Southrn Rgional 1792 294 21.5 18.3-25.1 1794 347 27.2 24.1-30.6 1792 303 17.7 14.9-20.9 Coastal 876 124 17.9 14.9-21.5 877 143 22.4 18.9-26.4 878 119 15.8 12.9-19.2 Wak 2424 334 17.8 15.5-20.3 2421 423 25.0 22.4-27.9 2422 321 13.2 11.4-15.3 Ara L 703 105 18.9 14.7-23.9 700 98 21.1 16.6-26.5 702 126 19.5 15.6-23.9 Eastrn 2187 316 17.8 15.5-20.4 2191 385 23.2 20.6-26.0 2192 333 17.1 14.8-19.6 N. C. Dpartmnt of Halth and Human Srvics 15
Physical Activity No lisur-tim physical activity in th past month Fmals (28.3%) wr significantly mor likly than mals (22.7%) to rport no lisur-tim activitis. Th risk of no lisur-tim activity dos not appar to b associatd with ag, particularly among youngr ag groups. Th highst rats wr found among rspondnts from th lowst lvls of houshold incom and ducation, and among Spanish-spaking Hispanics. Not gtting rcommndd physical activity Thr was littl chang in th 2005 statwid rat (57.9%) of not gtting th rcommndd physical activity and th comparabl rat rportd in 2001 (57.6%). About 80 prcnt of Spanish-spaking Hispanics rport not gtting th rcommndd amount of physical activity outsid of work (i.., modrat physical activity for 30 or mor minuts pr day for 5 or mor days pr wk, or vigorous activity for 20 or mor minuts pr day on 3 or mor days pr wk). No vigorous physical activity in th past month An stimatd 77.8 prcnt of North Carolina adults did not participat in vigorous physical activity. Among th ag group most apt to ngag in vigorous activity, narly two-thirds (64.5%) of 18 to 24 yar olds did not participat in any vigorous activity in th past month.. North Carolina Trnds Th six-yar trnds for no lisur tim activity show a modst dclin for th stat as a whol, and for non-hispanic African Amricans and whits (Figur 3a). By ag, th largst dclin in no lisur activity ovr th priod was vidnt among 55 to 64 yar olds (Figur 3b). Figur No 3a. Lisur No Lisur Activity by Activity Rac/Ethnicity: by Rac/Ethnicity: NC BRFSS 2000-2005 N.C. BRFSS 2000-2005 60 P r c n t 50 40 30 20 10 NC Total NHP Whit NHP Black NHP Othr Hispanic NHP: non-hispanic 0 2000 2001 2002 2003 2004 2005 *2002: initiatd Initiatd Spanish intrviws s Halthy Popl 2010 Objctiv: Rduc th proportion of adults who ngag in no lisur-tim physical activity to 20% (N.C.: 2001=26.4%; 2005=25.6%). N. C. Dpartmnt of Halth and Human Srvics 16
Figur No Figur 2b: Lisur No 3b. Halth Activity No Lisur Insuranc by Ag: Activity Covrag NC BRFSS by Ag: by 2000-2005 Ag: N.C. N.C. BRFSS BRFSS 2000-2005 2000-2005 P r c n t 45 40 35 30 25 20 15 10 5 0 2000 2001 2002 2003 2004 2005 18-34 yrs 35-44 yrs 45-54 yrs 55-64 yrs 65+ yrs Tabl 3a. Physical Activity of N.C. Adults, 2005 No Lisur-Tim Not Gtting Rcommndd No Vigorous Lisur-Tim Physical Activity Physical Activity Physical Activity Total Total Total Rsp. N % 95% C.I. Rsp. N % 95% C.I. Rsp. N % 95% C.I. TOTAL 17247 4687 25.6 24.7-26.5 16491 9935 57.9 56.9-59.0 16843 13740 77.8 76.8-78.7 GENDER Mal 6179 1439 22.7 21.3-24.2 5921 3307 53.9 52.2-55.7 6013 4576 72.4 70.7-74.0 Fmal 11068 3248 28.3 27.2-29.4 10570 6628 61.7 60.5-62.9 10830 9164 82.9 81.9-83.8 RACE Whit 13010 3143 21.7 20.8-22.6 12484 7181 54.4 53.2-55.6 12732 10207 75.8 74.6-76.8 African Amrican 3036 1071 33.6 31.3-36.0 2844 1965 65.5 62.9-68.1 2940 2532 82.5 80.1-84.6 Asian 116 25 16.9 10.7-25.7 113 69 65.1 54.3-74.6 113 93 84.3 74.9-90.6 Amrican Indian 296 105 32.7 26.4-39.8 284 164 54.4 46.8-61.8 287 235 78.6 71.3-84.4 Othr Minoritis 729 327 45.1 40.0-50.2 709 521 75.4 70.6-79.7 714 626 86.0 81.3-89.7 HISPANIC English Spaking 268 76 27.7 21.1-35.4 259 148 59.0 51.2-66.3 264 200 73.8 66.4-80.0 Spanish Spaking 613 334 52.4 46.9-57.8 603 481 81.4 77.1-85.0 605 555 90.1 86.3-92.9 Non-Hispanic 16351 4270 23.5 22.7-24.4 15616 9297 56.1 55.0-57.1 15960 12975 76.9 75.9-77.9 AGE 18-24 818 202 22.6 19.2-26.4 783 390 47.5 43.0-52.1 792 539 64.5 59.9-68.9 25-34 2403 555 22.9 20.7-25.1 2319 1282 55.7 53.2-58.2 2356 1748 72.4 70.1-74.7 35-44 3195 745 22.9 21.1-24.8 3089 1763 56.8 54.7-59.0 3117 2359 74.5 72.6-76.4 45-54 3331 910 27.7 25.8-29.6 3208 1924 60.1 57.9-62.2 3266 2653 80.7 78.9-82.3 55-64 3152 919 27.8 26.0-29.8 3026 1878 60.4 58.3-62.6 3082 2617 84.3 82.7-85.8 65+ 4261 1340 30.4 28.7-32.0 3995 2655 65.9 64.1-67.6 4150 3757 89.8 88.6-90.9 EDUCATION Lss Than H.S. 2732 1260 45.0 42.1-47.8 2560 1863 70.0 67.0-72.8 2649 2442 87.4 84.7-89.7 H.S. or G.E.D. 5202 1676 29.6 27.9-31.3 4953 3134 59.8 57.8-61.8 5069 4328 81.3 79.5-83.0 Som Post-H.S. 4201 992 21.5 19.9-23.2 4026 2362 55.4 53.2-57.5 4113 3353 76.3 74.2-78.2 Collg Graduat 5074 747 13.2 12.1-14.4 4922 2557 51.1 49.4-52.9 4980 3587 69.7 68.1-71.3 HOUSEHOLD INCOME Lss than $15,000 2079 903 43.4 40.4-46.5 1967 1387 68.6 65.5-71.5 2029 1861 88.0 85.3-90.2 $15,000-24,999 3095 1132 36.8 34.3-39.3 2955 1936 65.5 62.9-68.0 3022 2629 84.3 82.2-86.2 $25,000-34,999 2118 603 27.3 24.8-29.9 2036 1196 56.1 52.9-59.2 2087 1698 77.8 74.8-80.6 $35,000-49,999 2347 499 19.9 18.0-22.0 2272 1291 54.8 52.1-57.5 2302 1816 75.6 73.0-78.0 $50,000+ 5037 755 13.9 12.7-15.1 4899 2561 50.9 49.1-52.7 4948 3620 70.2 68.4-71.9 HEALTH INSURANCE Ys 14739 3735 22.7 21.8-23.5 14094 8411 56.9 55.8-58.0 14411 11704 77.3 76.2-78.2 No 2475 947 38.5 35.8-41.3 2367 1514 63.2 60.4-66.0 2400 2017 80.9 78.3-83.3 N. C. Dpartmnt of Halth and Human Srvics 17