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Maryland BRFSS State of the State Report
2011 Survey Results on Maryland
Healthy Behaviors and Lifestyles
February 2013
Maryland Department of Health & Mental Hygiene
Vital Statistics Administration
www.marylandbrfss.org
Maryland BRFSS State of the State Report, February 2013
is a publication of the Maryland Department of Health and Mental Hygiene.
Produced by the Vital Statistics Administration Isabelle Horon, Dr.P.H., Director
Helio Lopez, MS, BRFSS Principal Investigator and Project Coordinator
PHONE: (410) 767-5159
FAX: (410)333-7106
E-MAIL: [email protected]
Martin O’Malley
Governor
Anthony G. Brown
Lt. Governor
Joshua M. Sharfstein, M.D.
Secretary
Department of Health and Mental Hygiene
i
STATE OF MARYLAND
DHMH
Maryland Department of Health and Mental Hygiene 201 W. Preston Street • Baltimore, Maryland 21201
Martin O’Malley, Governor – Anthony G. Brown, Lt. Governor – Joshua M. Sharfstein, M.D., Secretary
FOREWORD
The Maryland Department of Health and Mental Hygiene is pleased to announce the
release of selected findings from the 2011 Behavioral Risk Factor Surveillance System (BRFSS).
The purpose of this report is twofold. The primary purpose is to present the findings derived
from BRFSS. The secondary purpose is to provide the reader with “how to” information about
using the BRFSS website itself.
The BRFSS is an ongoing telephone surveillance program designed to collect data on the
behaviors and conditions that place Marylanders at risk for chronic diseases, injuries, and
preventable infectious diseases. The BRFSS is supported through financial and technical
assistance provided by the Centers for Disease Control and Prevention (CDC) and through the
Maryland Department of Health and Mental Hygiene (DHMH).
The data collected through the BRFSS provide valuable support and services to many
statewide and local programs. The BRFSS is an important data component in targeting areas of
need, developing programs, and measuring the effectiveness of initiatives. Additional
information is available through the Maryland BRFSS website, www.marylandbrfss.org, or by
contacting Helio Lopez, BRFSS Coordinator, at 410-767-5159.
We appreciate the efforts of the many individuals both within the Administration and from the
general public that made this publication available. This evaluation would not be possible
without the willingness of the over 10,100 anonymous Maryland households that participate in
surveys each year.
Isabelle Horon, Dr.P.H.
Director, Vital Statistics Administration
ii
TABLE OF CONTENTS
TABLE OF CONTENTS .................................................................................................................................. iii
EXECUTIVE SUMMARY ............................................................................................................................... iv
INTRODUCTION .............................................................................................................................................. 3
METHODOLOGY ............................................................................................................................................. 4
HEALTH STATUS............................................................................................................................................. 5
GENERAL HEALTH ...................................................................................................................................... 6
HEALTHCARE ACCESS............................................................................................................................... 7
DISABILITY ................................................................................................................................................... 8
CHRONIC DISEASES ...................................................................................................................................... .9
ARTHRITIS .................................................................................................................................................. 10
ASTHMA ...................................................................................................................................................... 11
CANCER SURVIVORS ............................................................................................................................... 12
CHOLESTEROL ........................................................................................................................................... 13
COPD ............................................................................................................................................................ 14
DIABETES .................................................................................................................................................... 15
HEART ATTACK ......................................................................................................................................... 16
HIGH BLOOD PRESSURE .......................................................................................................................... 17
KIDNEY DISEASE ...................................................................................................................................... 18
OVERWEIGHT/OBESITY ........................................................................................................................... 19
STROKE ........................................................................................................................................................ 20
HEALTH CARE RISK FACTORS ................................................................................................................ 21
ANXIETY/DEPRESSION ............................................................................................................................ 22
COGNITIVE IMPAIRMENT ....................................................................................................................... 23
IMMUNIZATION-CHILD ........................................................................................................................... 24
IMMUNIZATION-ADULT .......................................................................................................................... 25
ORAL HEALTH ........................................................................................................................................... 26
VISUAL HEALTH ........................................................................................................................................ 27
HEALTH BEHAVIOR RISK FACTORS ...................................................................................................... 28
ALCOHOL CONSUMPTION ...................................................................................................................... 29
PHYSICAL ACTIVITY ................................................................................................................................ 30
TOBACCO USE............................................................................................................................................ 31
DEMOGRAPHIC CHARACTERISTICS: GENDER DIFFERENCES ..................................................... 32
MARYLAND VERSUS UNITED STATES: RISK FACTORS ................................................................... 33
MARYLAND VERSUS UNITED STATES: DEMOGRAPHIC CHARACTERISTICS .......................... 35
iii
APPENDIX ....................................................................................................................................................... 36
HOW TO USE THE BRFSS ......................................................................................................................... 37
FREQUENTLY ASKED QUESTIONS ........................................................................................................ 40
LINKS FOR FURTHER INFORMATION ................................................................................................... 41
iv
EXECUTIVE SUMMARY The ‘Maryland BRFSS – State of the State’ report provides a snapshot of the health behaviors that place
Maryland adults at risk for chronic diseases, injuries, and preventable infectious diseases. The report is
based on information collected on residents aged 18 years or older from over 10,100 Maryland
households throughout 2011. For most indicators, health status for Maryland residents was the same or
better than that of the nation as a whole. Specific state/national comparisons can be found on pages 33-
35.
HEALTH STATUS:
General Health Status: Over 14% of Maryland adults reported their general health as fair or poor.
Health Care Access: About 13% of Maryland adults reported not having any health care coverage.
Disability: A total of 21% of Maryland adults reported limited activity due to physical, mental, or
emotional problems.
CHRONIC DISEASE:
Arthritis: Over 23% of Maryland adults were told by a doctor tht they have arthritis.
Asthma: Nearly most 14% of adult Marylanders were told by a health professional that they had asthma.
Cancer: Over 11% of Maryland adults were told by a doctor that they had cancer.
Cholesterol: Over 35% of Marylanders were told by a health professional that they have high cholesterol.
Chronic Obstructive Pulmonary Disease (COPD): Almost 6% of the Maryland adult population
reported they had COPD.
Diabetes: Nearly 10% of Maryland adults were told by a doctor that they had diabetes, excluding
gestational diabetes.
Heart attack: Over 4% of Marylanders have reported having had a least one heart attack.
High Blood Pressure: A total of 32% of Maryland adults were told by a health professional that they had
high blood pressure.
Kidney Disease: Nearly 2% of the Maryland adult population reported they had kidney disease.
Overweight/Obese: Currently nearly 2.6 million, or 64.4% of Maryland adults, are overweight or obese.
Stroke: Nearly 3% of Marylanders have reported ever having had a stroke.
HEALTH CARE RISK FACTORS:
Anxiety/Depression: Approximately 14% of Maryland adults reported they had been diagnosed with
depression.
Cognitive Impairment: Nearly 8% of Maryland adults reported that in the last 30 days they had
experienced confusion or memory loss that is happening more often or it is getting worse.
Immunization: A total of 59% of Maryland adults and 42% of children did not have a flu shot in the
past 12 months.
Oral Health: A quarter of Maryland adults reported that it has been more than a year since they last had
their teeth professionally cleaned.
Visual Impairment: An estimated 18% Marylanders aged 18 years and over reported being told by a
doctor they have vision impairment in one or both eyes, even when wearing glasses.
HEALTH BEHAVIOR RISK FACTORS:
Alcohol Consumption: Eighteen percent of Maryland adults reported binge drinking in the past month.
Men were more likely to be binge drinkers than women (23% versus 13.4%).
Physical Activity: Over 26% of Maryland adults had not participated in any physical activity or exercise
in the past month.
Tobacco Use: Over 19% of Maryland adults are current smokers.
3
INTRODUCTION
What is the BRFSS?
The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing surveillance
program designed to collect data on the behaviors and conditions that place Marylanders at risk
for chronic diseases, injuries, and preventable infectious diseases. Researchers, private
organizations, health care providers, and public health professionals use BRFSS data to design,
implement, and evaluate prevention efforts. Through the BRFSS, organizations characterize
health behaviors, ascertain the prevalence of risk factors, and identify demographic groups with
increased needs. The BRFSS data can be analyzed by a variety of demographic variables,
including age, education, income, marital status, and racial or ethnic background. The ability to
assess information within particular populations enables the health care community to maximize
the effectiveness of scarce resources.
The BRFSS is an important tool in public health. Uses include:
Tracking progress activities – providing baseline data for planning interventions and
measuring progress toward goals and objectives (e.g., smoking, seatbelt use).
Supporting initiatives – monitoring legislature (e.g., seatbelt use, cigarette taxes).
Targeting services – identifying relationships (e.g., between smoking and education).
Documenting geographic variations – (e.g., smoking by county or region).
Preparing funding applications – (e.g., diabetes prevention, asthma).
Producing reports – (e.g., providing current information to the legislature, academic
institutions and the public about trends, improvement areas, policy implications).
Developing surveys – serving as a model to create other surveys (e.g., Maryland Cancer
Survey, Maryland Adult Tobacco Survey).
Why Does Maryland Conduct the BRFSS?
Personal health-risk behaviors contribute to premature morbidity and mortality and
increased health care costs imposed on the State. Health agencies need to determine the rate at
which individuals are participating in risky behaviors in order to prevent these events from
occurring. BRFSS provides data to help health agencies plan and implement programs designed
to promote healthy behaviors and reduce risky behaviors.
How Does Maryland Conduct the BRFSS?
During 2011, individuals representing over 10,100 randomly selected households
participated in the Maryland BRFSS telephone survey. Interviews were conducted and
supervised by trained telephone research interviewers at Abt SRBI Inc., a survey research
company with an office in Maryland. These data were then weighted by the Centers for Disease
Control and Prevention (CDC) to be representative of the demographic distribution of Maryland
residents.
Who Participated in the Maryland BRFSS?
The 2011 BRFSS interviewed 10,117 Maryland residents, 18 years of age or older,
reporting on their households. Of those reporting, 3,791 (47.7%) were male and 6,326 (52.3%)
were female; 7,226 (57.2%) were white, 2,027 (27.5%) were African American, 293 (5.1%) were
‘other races’, 128 (2.1%) were multiracial, 292 (6.8%) were Hispanics, and 141 (1.3%) did not
report their race or ethnicity. The initial sample of 10,117 residents was used to “weight” the
survey data to obtain estimates that were representative of all Maryland residents.
4
METHODOLOGY
Data were collected following the procedures established by the Centers for Disease
Control and Prevention (CDC). Since January 2010, Maryland BRFSS have been collected by
Abt SRBI using Quancept CATI software to collect and manage the Maryland BRFSS sample.
Quancept is an SPSS product which permits reasonably easy programming of fairly complex
question patterns. Quancept CATI software is used to: 1) program the CDC core questionnaire
and Maryland’s optional modules; 2) administer and manage the sample; 3) collect and maintain
the data; 4) monitor interviewers; and 5) produce quality control reports.
Abt SRBI has extensive experience in research and data collection and is staffed by 116
BRFSS-trained interviewers who are located in the Ft. Myers facility where most Maryland
BRFSS interviews are initiated. The facility includes 15 bilingual interviewers (Spanish-English)
and 15 bilingual supervisors. Abt SRBI provides training to their staff on a continuous basis.
The response rate for 2011 was 54.7 percent. This is about above the average for BRFSS
surveys around the country. Estimated time per completed interview averaged 18 minutes during
2011. This figure includes the actual time used to conduct the interview, not other interview
tasks such as tracking of appointments, validations, follow-up training or consultation, in-person
problem solving, and monthly backup of data. The goal in Maryland is to limit the actual time
per completed interview to no more than 20 minutes.
There were substantial changes to the weighting methodology utilized by CDC in the
2011 survey. Prior to 2011, BRFSS only surveyed households with a landline telephone.
However, CDC determined that cellular phone-only households should be included in the survey
to account for the increasing proportion of cellular phone-only households. CDC also added
additional variables to improve the ability to weight the sample to make survey data as
representative as possible of the state population. Prior to 2011, BRFSS data was weighted by
age, race, and gender using a technique called post-stratification. Beginning in 2011, BRFSS
data are weighted using age, race, gender, education, home ownership, marital status, and phone
source (landline and cellular) using a technique called “raking.” The use of additional variables
and use of the raking technique make the sample more representative of the overall population,
which result in more accurate estimates. Due to these extensive changes in methodology, 2011
data should not be compared to data collected in previous years. Examples of the impact of these
changes can be seen by comparing 2010 and 2011 figures for binge drinking and tobacco use.
The percentage of individuals who were binge drinkers appeared to increase from 15% to 18%,
while the percentage of smokers appeared to increase from 15% to 19% between the two years.
However, these changes are attributable to changes in weighting methodology, not to dramatic
changes in risk behavior. More information on the methodological changes is available at:
http://www.cdc.gov/surveillancepractice/reports/brfss/brfss.html.
5
HEALTH STATUS
6
Question: Would you say that your general health is ‘Excellent’, ‘Very good’,
‘Good’, ‘Fair’, or ‘Poor’?
At risk: Adults who answered ‘Fair’ or ‘Poor’ are considered at risk.
Who is at risk in Maryland?
14.2% of Maryland residents rated their general health as fair or poor.
There was no statistically significant difference between men (13.6%) and women
(14.7%) in general health.
Black residents reported poor to fair general health (17.4%) more frequently than
white residents (12.2%); this difference was statistically significant.
Older persons, persons with lower relative income, and those with less education
reported fair to poor general health than other groups; these differences were
statistically significant.
35.4% of residents with less than a high school education reported being in fair to
poor general health.
21.1% of those without healthcare coverage reported fair to poor general health,
compared to 13.1% of those with healthcare coverage.
32.7% of those who were diagnosed with a depressive disorder reported fair to
poor general health, compared with only 11.2% of persons without a depressive
disorder.
Percent of Maryland Adults who reported their General Health as
Fair or Poor, by Age*, Education*, and Income*, 2011
GENERAL HEALTH
Percent of Maryland Adults who reported their General Health as Fair or
Poor, by Gender and Race*, 2011
13.614.7
0
5
10
15
20
Male Female
Pe
rce
nt
Gender
12.2
17.4
0
5
10
15
20
White Black
Pe
rce
nt
Race
8.3 11.2
17.2
24.0
35.4
17.1
11.4
6.1
37.138.6
15.5
9.24.9
0
10
20
30
40
50
Pe
rce
nt
*Denotes a statistically significant difference among the values.
7
Question: Do you have any kind of health care coverage, including health
insurance, prepaid plans such as HMOs, or government plans such
as Medicare?
At risk: Adults who answered ‘No’ are considered at risk.
Who is at risk in Maryland?
An estimated 13.0% of Maryland adults do not have healthcare coverage.
Men are less likely to have healthcare coverage as a group (16.0%) than women
(10.3%); this difference is statistically significant.
Black residents were significantly more likely not to have healthcare coverage
(15.9%) than white residents (8.7%).
Individuals with no healthcare coverage tended to be younger, have less
education, or be from lower-income households.
27.7% of Marylanders who did not complete high school reported that they did
not have healthcare coverage, and 33.3% of those earning under $15,000 a year
reported that they did not have healthcare coverage.
15.3% of those with no coverage reported not having seen a doctor for a routine
check-up in over 5 years compared to 3.2% that have coverage.
Almost half of those with no coverage reported that they needed to see a doctor
in the past year, but could not afford to do so (50.1%).
Percent of Maryland Adults with no Health Insurance by Age*,
Education*, and Income*, 2011
Percent of Maryland Adults with no Health Insurance
by Gender* and Race*, 2011
16.0
10.3
0
5
10
15
20
Male Female
Perc
en
t
Gender
8.7
15.9
0
5
10
15
20
White Black
Perc
en
t
Race
HEALTHCARE ACCESS
22.6
11.311.2
2.1
27.7
16.512.3
4.8
33.330.9
15.2
6.03.1
0
10
20
30
40
50
Pe
rce
nt
*Denotes a statistically significant difference among the values.
*Denotes a statistically significant difference among the values.
8
DISABILITY
Question:
At risk:
Who is at risk in Maryland?
An estimated 21.0% of Maryland adults reported having limited activities due
to physical, mental, or emotional problems.
Men are less likely to report limited activities due to physical, mental, or
emotional problems (18.9%) than women (23.0%). Black residents were less
likely to report limited activities due to physical, mental, or emotional problems
(17.3%) than white residents (24.2%). These differences are statistically
significant.
Individuals who reported limited activities due to physical, mental, or
emotional problems tended to be older, have less education, or be from lower-
income households.
Over 228,000, or about 26.1% of Maryland adults who reported having limited
activities due to physical, mental, or emotional problems, require special
equipment due to their health problems.
Percent of Maryland Adults who reported Limited
Activity due to Physical, Mental, or Emotional
Problems by Gender* and
Race*, 2011
18.9
23.0
0
5
10
15
20
25
30
Male Female
Perc
en
t
Gender
24.2
17.3
0
5
10
15
20
25
30
White Black
Perc
en
t
Race
Percent of Maryland Adults who reported Limited Activity due to
Physical, Mental, or Emotional Problems by Age*, Education*,
and Income*, 2011
12.3
18.6
27.5
29.8 28.4
23.121.8
16.3
34.4
27.8
20.5
21.917.3
0
10
20
30
40
50
Pe
rce
nt
Are you limited in any way in any activities because of physical,
mental, or emotional problems?
Adults who answered ‘Yes’ are considered at risk.
*Denotes a statistically significant difference among the values.
9
CHRONIC DISEASES
10
Question: Have you ever been told by a doctor that you have some form of
arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?
At risk: Adults who answered ‘Yes’ are considered at risk.
Who is at risk in Maryland?
Nearly a quarter (23.3%) of Maryland adults have been told by a doctor that
they had arthritis.
A significantly higher percentage of women reported having been diagnosed
with arthritis (26.7%) than men (19.5%).
A significant higher percentage of white Marylanders reported having arthritis
(26.3%) than black Marylanders (21.0%).
A significantly higher prevalence of arthritis was found among older
respondents, individuals with low levels of education, and those with lower
incomes.
Approximately 30% of residents with arthritis reported fair to poor health.
Nearly half (45.3%) of individuals with arthritis reported limited activities
because of joint symptoms.
42.7% of those with arthritis reported that arthritis interfered with normal social
activities.
Percent of Maryland Adults who have Arthritis, by Age*,
Education*, and Income*, 2011
Percent of Maryland Adults who have Arthritis, by
Gender* and Race*, 2011
19.5
26.7
0
5
10
15
20
25
30
Male Female
Perc
en
t
Gender
26.3
21.0
0
5
10
15
20
25
30
35
White Black
Perc
en
tRace
ARTHRITIS
5.4
15.9
33.6
50.8
32.728.2
22.1
16.6
30.530.126.9
22.4
17.0
0
10
20
30
40
50
60
Pe
rcen
t
*Denotes a statistically significant difference among the values.
11
Question: Have you ever been told by a doctor, nurse, or other health
professional that you had asthma?
At risk: Adults who answered ‘Yes’ are considered at risk.
Who is at risk in Maryland?
13.8% of Marylanders, or an estimated 610,254 Maryland adults, were told by a
health professional that they had asthma.
A higher percentage of women reported having asthma (14.4%) than men
(13.2%)but this difference was not statistically significant.
There was a significant difference between the percentage of white residents
(12.7%) and the percentage of black residents who had asthma (14.9%).
Higher prevalence rates of asthma were found among younger respondents,
individuals without a high school education and those with a lower income
levels.
18.9% of current smokers reported having been diagnosed with asthma versus
12.7% nonsmokers, a statistically significant difference.
12.6% of Marylander children under the age of 18 were told by a health
professional that they had asthma. This information was obtain from their
parents, who participated in the survey.
Percent of Maryland Adults who have Asthma, by Age*,
Education*, and Income*, 2011
Percent of Maryland Adults who have Asthma, by Gender
and Race*, 2011
13.2 14.4
0
5
10
15
20
25
Male Female
Perc
en
t
Gender
12.714.9
0
5
10
15
20
25
White Black
Perc
en
tRace
ASTHMA
18.3
12.811.811.3
18.8
13.614.4
11.5
18.319.1
13.315.4
10.8
0
5
10
15
20
25
Pe
rce
nt
*Denotes a statistically significant difference among the values.
12
CANCER SURVIVORS
Question: Have you ever been told by a doctor, nurse, or other health
professional that you had cancer?
At risk: Adults who answered ‘Yes’ are considered to be cancer survivors.
Percent of Maryland Adults who are Cancer Survivors,
by Gender* and Race*, 2011
10.512.4
0
5
10
15
20
25
Male Female
Perc
en
t
Gender
15.3
6.7
0
5
10
15
20
25
White Black
Perc
en
t
Race
Who is at risk in Maryland?
11.5% of Maryland adults had been told by a health professional that they had
cancer.
There was a significant difference between the percentage of men and women
diagnosed with cancer (10.5% versus 12.4%).
A significantly higher percentage of white residents (15.3%) reported being
diagnosed with cancer than black residents (6.7%).
Nearly a third of individuals ages 65 and older reported having been diagnosed
with cancer.
6.2% of cancer survivors reported that they did not have any health insurance,
and 10.5% reported that their health insurance did not cover some portion of
their cancer treatment.
Of those reporting having had cancer, the most commonly reported cancers
were melanoma and other skin cancer (30.5%), breast cancer (17.7%), prostate
cancer (10.2%) and cervical cancer (9.9%).
Percent of Maryland Adults who are Cancer Survivors, by Age*,
Education*, and Income*, 2011
2.6
5.9
14.3
31.5
14.713.0
10.7 9.9
13.613.810.6 9.9 10.0
0
5
10
15
20
25
30
35
Pe
rcen
t
*Denotes a statistically significant difference among the values.
13
CHOLESTEROL
Question: Have you ever been told by a doctor, nurse, or other health
professional that your blood cholesterol is high?
At risk: Adults who answered ‘Yes’ are considered at risk.
Percent of Maryland Adults who have High Cholesterol,
by Gender* and Race*, 2011
36.6 34.3
0
10
20
30
40
50
Male Female
Perc
en
t
Gender
38.132.6
0
10
20
30
40
50
White Black
Perc
en
t
Race
Who is at risk in Maryland?
35.4% of Maryland adults reported being told by a health professional that they
had high cholesterol.
There was a significant difference in the prevalence of high cholesterol between
male (36.6%) and female residents (34.3%).
There was a significant difference in the prevalence of high cholesterol between
white (38.1%) and black residents (32.6%).
High cholesterol was most prevalent among older, less well-educated, and
lower income residents.
The percentage of individuals reporting high cholesterol was significantly
higher among those who did not participate in any physical activity or exercise
during the last 30 days compared to those who did (44.8% versus 32.6%).
Of those who were told by a health professional that they have high cholesterol,
75.6% were overweight or obese.
Percent of Maryland Adults who have High Cholesterol, by Age*,
Education*, and Income*, 2011
13.3
28.8
44.9
54.7
44.1
36.834.632.2
42.5
36.740.1
36.131.3
0
10
20
30
40
50
60
Pe
rce
nt
*Denotes a statistically significant difference among the values.
14
Question: Have you ever been told by a doctor or other health professional
that you have chronic lung disease, such as emphysema, chronic
bronchitis or COPD?
At risk: Adults who answered ‘Yes’ are considered at risk.
Who is at risk in Maryland?
5.9% of Marylanders, or an estimated 261,345 Maryland adults, were told by a
health professional that they had COPD.
A higher percentage of women reported having COPD (6.9%) than men (4.8%).
A significantly higher percentage of white residents (6.9%) reported having
COPD than black residents (4.8%).
A higher prevalence of COPD was found among older respondents, individuals
with lower levels of education and or those with a lower income.
A higher percent of persons (54.1%) diagnosed with COPD reported limited
activities than those without COPD (18.9%) .
Individuals with COPD were more likely to be smokers (43.2%) than
individuals without COPD (17.5%).
Percent of Maryland Adults who have COPD, by Age*,
Education*, and Income*, 2011
Percent of Maryland Adults who have COPD, by
Gender* and Race*, 2011
4.8
6.9
0
5
10
Male Female
Perc
en
t
Gender
6.9
4.8
0
5
10
White Black
Perc
en
t
Race
CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)
3.5 3.7
7.3
11.9
14.8
7.3
4.6
2.6
10.6
14.6
6.3
4.3
2.4
0
5
10
15
20
Pe
rce
nt
*Denotes a statistically significant difference among the values.
15
DIABETES
Question: Have you ever been told by a doctor that you have diabetes
(excluding gestational diabetes)?
At risk: Adults who answered ‘Yes’ are considered to be at risk.
Percent of Maryland Adults who have Diabetes, by
Gender and Race*, 2011
9.6 9.6
0
5
10
15
20
Male Female
Perc
en
t
Gender
8.5
12.8
0
5
10
15
20
White Black
Perc
en
t
Race
Who is at risk in Maryland?
9.6% o Maryland adults were told by a doctor that they had diabetes. This
figure does not include those with undiagnosed diabetes, pre-diabetes, or
women who were diagnosed with gestational diabetes during pregnancy.
There was no difference between the percentage of men and women with
diabetes.
Black residents were significantly more likely to report having diabetes (12.8%)
than white residents (8.5%).
Older adults, individuals with less education, and individuals with low levels of
income were significantly more likely to be diagnosed with diabetes.
Of those diagnosed with diabetes, 34.8% reported having vision impairment in
one or both eyes, compared with 16.1% of those who did not report having
diabetes.
35.4% of those who had been diagnosed with diabetes reported having their
activities limited due to physical, mental, or emotional problems, compared
with 19.5% of those without diabetes.
Percent of Maryland Adults who have Diabetes, by Age*,
Education*, and Income*, 2011
1.8
5.8
13.8
22.4
15.8
11.7
8.56.4
14.014.511.9
8.16.3
0
5
10
15
20
25
30
Pe
rcen
t
*Denotes a statistically significant difference among the values.
16
Question: Has a doctor, nurse, or other health professional ever told you that
you have had a heart attack, also called a myocardial infarction?
At risk: Adults who answered ‘Yes’ are considered at risk.
Who is at risk in Maryland? An estimated 183,027 Marylanders (4.2%) reported being told that they had a
heart attack.
Men were significantly more likely to report a heart attack (5.3%) than women
(3.1%).
There was a significant difference in heart attacks between white (4.4%) and
black (3.7%) respondents with a history of a heart attack.
The percentage o individuals reporting having had a heart attack was highest
among older residents, those with less than a high school education, and less
affluent residents.
Among those who had a heart attack, 58.3% engaged in any leisure time
physical activity such as walking, running, gardening, golf or other moderate
activity in the past month, compared with 74.6% of those who had not had a
heart attack.
66.4% of those who had a heart attack also had high cholesterol, compared with
33.7% of those who had not had a heart attack.
Percent of Maryland Adults who have had a Heart Attack, by
Age*, Education*, and Income*, 2011
Percent of Maryland Adults who have had a Heart
Attack, by Gender* and Race*, 2011
5.3
3.1
0
5
10
Male Female
Perc
en
t
Gender
4.43.7
0
5
10
White Black
Perc
en
t
Race
HEART ATTACK A
0.62.2
5.4
11.9
9.2
5.3
3.0 2.3
8.9 8.5
4.63.2
2.3
0
5
10
15
20
Pe
rcen
t
* Denotes a statistically significant difference among the values.
17
Question: Has a doctor, nurse, or other health professional ever told you that
you have high blood pressure?
At risk: Adults who answered ‘Yes’ are considered at risk.
Who is at risk in Maryland?
32.0% of Marylanders reported being told that they had high blood pressure.
This figure excludes women who were told that they had high blood pressure
while pregnant.
The prevalence of high blood pressure was similar for men (31.8%) and women
(32.2%).
There was a significant difference in prevalence of high blood pressure among
white (31.9%) and black residents (37.5%).
High blood pressure was more prevalent among older, less educated, and less
affluent residents.
41.7% of individuals who were told by a health professional that they have high
blood pressure were obese (BMI greater than 29.99).
Among those who were told by a health professional that they had high blood
pressure, 68.1% report exercising, 74.1% report changing their eating habits,
and 74.9% report cutting down on salt (this does not count the 4.3% who
reported not using salt) to help lower or control their blood pressure.
Percent of Maryland Adults who have been told that they have
High Blood Pressure, by Age*, Education*, and Income*, 2011
Percent of Maryland Adults who have been told that they have High Blood
Pressure, by Gender and
Race*, 2011
31.8 32.2
0
5
10
15
20
25
30
35
Male Female
Perc
en
t
Gender
31.937.5
05
10152025303540
White Black
Perc
en
t
Race
HIGH BLOOD PRESSURE A
10.9
24.5
43.4
63.3
40.436.8
30.726.0
39.836.736.4
32.227.0
0
10
20
30
40
50
60
70
Pe
rce
nt
*Denotes a statistically significant difference among the values.
18
Question: Ever told you have kidney disease? Do not include kidney stones,
bladder infection or incontinence.
At risk: Adults who answered ‘Yes’ are considered at risk.
Who is at risk in Maryland?
Nearly 2% of Marylanders reported being told that they had kidney disease.
This value excludes from the total those with kidney stones, bladder infections
or incontinence.
There was no significant difference in the prevalence of kidney disease among
men (1.5%) and women (2.2%).
There was no significant difference in kidney disease prevalence between white
(1.7%) and black residents (2.0%).
Kidney disease was significantly more prevalent among older, less educated,
and less affluent residents.
42.9% of individuals who were told by a health professional that they had
kidney disease reported limited activity due to physical, mental or emotional
problems, compared by with 20.4% of those without kidney disease.
Maryland adults with kidney disease were more likely to have diabetes 26.9%
than those without kidney disease 9.2%.
Percent of Maryland Adults who have been told that they have
Kidney Disease, by Age*, Education*, and Income*, 2011
Percent of Maryland Adults who have been told that
they have Kidney Disease, by Gender and Race, 2011
1.52.2
0
2
4
6
Male Female
Perc
en
t
Gender
1.7 2.0
0
2
4
6
White Black
Perc
en
t
Race
KIDNEY DISEASE A
1.0 1.1
2.3
4.0
2.82.3
1.71.3
4.8
3.4
2.2
1.31.0
0
2
4
6
Pe
rcen
t
*Denotes a statistically significant difference among the values.
19
Question: Body Mass Index (BMI) was calculated based on data collected from:
1) How much do you weigh without shoes?
2) How tall are you without shoes? At risk: Adults with BMI scores greater than 24.99 are considered
overweight and respondents with BMI scores greater than 29.99 are
considered obese.
Who is at risk in Maryland?
Nearly 2.7 million, or about 64.4% of Maryland adults, were classified as
overweight or obese.
Men were more likely to be overweight or obese (71.2%) than women (57.8%),
and black residents were more likely to be overweight or obese (73.2%) than
white residents (62.2%); these differences are statistically significant.
Adults between ages 35 and 64 years were more likely to be overweight or
obese than younger or older adults.
Adults with no college education and with a household income of less than
$75,000 were significantly more likely to be overweight or obese than other
groups of adults.
Individuals who were obese were significantly more likely to have been
diagnosed with diabetes (19.6%) than normal weight individuals (4.3%). This
excludes women with gestational diabetes.
Percent of Maryland Adults who are Overweight/Obese, by Age*,
Education*, and Income*, 2011
Percent of Maryland Adults who are Overweight or
Obese, by Gender* and
Race*, 2011
71.2
57.8
01020304050607080
Male Female
Perc
en
t
Gender
62.2
73.2
01020304050607080
White Black
Perc
en
t
Race
OVERWEIGHT/OBESITY
54.7
68.770.862.9
66.467.865.160.3 62.363.3
67.871.6
63.3
0
10
20
30
40
50
60
70
80
90
100
Pe
rcen
t
*Denotes a statistically significant difference among the values.
20
Question: Has a doctor, nurse, or other health professional ever told you that
have had a stroke?
At risk: Adults who answered ‘Yes’ are considered at risk.
Who is at risk in Maryland? 2.6%, or 114,517 Maryland adults, reported having had a stroke.
No statistically significant gender or racial differences were found for the
prevalence of stroke.
The occurrence of a stroke was more common among older, less educated, and
less affluent residents.
Among those who had a stroke, 55.4% engaged in any leisure time physical
activity such as walking, running, gardening, golf or other moderate activity in
the past month as compared to 74.4% of those who did not have a stroke.
61.7% of individuals who had a stroke had high cholesterol, compared with
34.6% of those who did not have a stroke.
Percent of Maryland Adults who have had a Stroke, by Age*,
Education*, and Income*, 2011
Percent of Maryland Adults who have had a Stroke, by
Gender and Race, 2011
2.5 2.7
0
1
2
3
4
Male Female
Perc
en
t
Gender
2.5
3.2
0
1
2
3
4
White Black
Perc
en
t
Race
STROKE A
*Denotes a statistically significant difference among the values.
0.51.2
3.3
7.3
5.3
2.92.3
1.3
6.2
5.1
3.8
1.60.9
0
2
4
6
8
10
Pe
rce
nt
21
HEALTH CARE RISK FACTORS
22
Question: Has a doctor or other healthcare provider ever told you that you had
a depressive disorder?
At risk: Adults who answered ‘Yes’ are considered at risk.
Who is at risk in Maryland?
About 13.6% of Maryland adults reported being diagnosed with depression.
Women were significantly more likely to report being diagnosed with depression
(17.0%) than men (9.8%).
Black Marylanders were significantly less likely to report ever being diagnosed
with depression (9.1%) than white Marylanders (16.7%).
A diagnosis of depression was least common among individuals ages 65 and over.
Depression was most common among residents with less than high school
education (19.9%), and lowest among college graduates (11.2%).
26.6% of individuals living in households with an income of $15,000 per year had
a depressive disorder, nearly three times the rate of depression (9.7%) among
individuals living in households with an annual income greater than $75,000.
Percent of Maryland Adults who have a Depressive
Disorder, by Gender* and
Race*, 2011
9.8
17.0
0
5
10
15
20
Male Female
Perc
en
t
Gender
16.7
9.1
0
5
10
15
20
White Black
Pe
rce
nt
Race
ANXIETY/DEPRESSION
12.514.4
17.0
9.2
19.9
13.413.911.2
26.6
21.2
12.613.1
9.7
0
5
10
15
20
25
30
35
40
Pe
rce
nt
* Denotes a statistically significant difference among the values.
Percent of Maryland Adults who have a Depressive Disorder, by
Age*, Education*, and Income*, 2011
23
Question: In the past 30 days, have you experienced confusion or memory
loss that is happening more often or is getting worse?
At risk: Adults who said yes 'Yes' are considered at risk.
Who is at risk in Maryland?
7.8 % of Marylanders reported that they had experienced confusion or memory
loss in the past 30 days.
Women were more likely than men to report that they had experienced confusion
or memory loss in the past 30 days (9.1% versus 6.3%).
Black Marylanders were less likely to report that they had experienced confusion
or memory loss in the past 30 days (7.4%) than white Marylanders (8.2%) but the
difference was not significant.
The percentage of Maryland residents experiencing confusion or memory loss
rose with increasing age, from 5.5% in the age group 18-34 years to 9.8% in the
age group of 65+ years.
Maryland adults with less than a college education were more than twice as likely
to report confusion or memory loss (12.8%) as college graduates (5.9%).
17.4 of Marylanders reported that confusion and memory loss interfered with
their work and social activities.
Percent of Maryland Adults who had
experienced confusion or memory loss in the past 30 days by Gender* and Race,
2011
6.3
9.1
0
5
10
15
20
Male Female
Pe
rce
nt
Gender
8.2 7.4
0
5
10
15
20
White Black
Pe
rce
nt
Race
COGNITIVE IMPAIRMENT
5.5
7.69.3 9.8
12.8
7.28.5
5.9
9.5
15.9
8.0
4.9 5.6
0
5
10
15
20
Pe
rce
nt
* Denotes a statistically significant difference among the values.
Percent of Maryland Adults who had experienced confusion or
memory loss in the past 30 days, by Age*, Education*, and Income*, 2011
24
CHILDHOOD IMMUNIZATIONS A
Question:
At risk:
In the past twelve months, has the child had a seasonal flu
vaccination?
Children who did not receive a seasonal flu vaccination in the past
twelve months are considered at risk.
Who is at risk in Maryland?
An estimated 42.4% of Maryland children did not have a seasonal flu
vaccination flu shot in the past twelve months as reported by a household adult.
The percentage of male children who did not have a flu vaccination in the past
year was greater than the percentage of female children (41.6% versus 43.1%),
although the difference was not significant.
The percentage of black children who did not have a seasonal flu shot in the
past year was significantly greater than that of white children (47.5% versus
41.0%).
Children aged < 2 years and 12 to <18 and those children from households
earning under $15,000 and $25,000 to $49,999 were significantly more likely to
not have had a seasonal flu vaccination flu shot.
Children in households with high school and some college education were more
likely to not have received a seasonal flu vaccination shot.
Children in households without health insurance coverage were significantly
more likely not to receive a seasonal flu vaccination than those with health
insurance coverage (45.1% versus 42.1%) [Graph not shown].
Percent of Maryland Children who did not have a Seasonal flu vaccination in the Past Year, by Gender
and Race*, 2011
41.6 43.1
0
10
20
30
40
50
60
70
Male Female
Perc
en
t
Gender
41.047.5
0
10
20
30
40
50
60
70
White Black
Perc
en
t
Race
38.933.3 33.7
58.4
28.1
50.247.0
38.2
47.3
40.444.5 42.6 41.2
0
10
20
30
40
50
60
70
Pe
rcen
t
* Denotes a statistically significant difference among the values.
Percent of Maryland Children who did not have a Seasonal Flu
Vaccination in the Past Year, by Age*, Household Education*, and
Income*, 2011
25
IMMUNIZATION
In the past twelve months, have you had a flu shot?
Question:
At risk: Adults who did not receive a flu shot in the past twelve months
are considered at risk.
Who is at risk in Maryland?
An estimated 59.0% of Maryland adults reported that they did not have a flu
shot in the past twelve months.
The percentage of men who did not have a flu shot in the past year was not
significantly greater than the percentage of women who did not have a flu shot
in the past year (62.0% versus 56.3%).
The percentage of black residents who did not have a flu shot in the past year
was significantly greater than that of white residents (63.3% versus 55.3%).
Younger adults and those from households earning less than $15,000 per year
were significantly more likely to not have had a flu shot than older adults.
There was a difference in the likelihood of having a flu shot among the
different levels of educational attainment.
Marylanders without health coverage were significantly more likely not to
receive a flu shot than those with health coverage (84.1% versus 55.3%)
Percent of Maryland Adults who did not have a Flu Shot in the Past Year, by Gender and
Race*, 2011
62.056.3
01020304050607080
Male Female
Pe
rce
nt
Gender
55.363.3
01020304050607080
White Black
Pe
rce
nt
Race
Percent of Maryland Adults who did not have a Flu Shot in the
Past Year, by Age*, Education*, and Income*, 2011
70.664.1
55.0
37.2
60.963.662.8
51.3
66.262.0
65.260.9
53.5
0
10
20
30
40
50
60
70
80
Per
cen
t
*Denotes a statistically significant difference among the values.
26
ORAL HEALTH
Question: How long has it been since you last had your teeth cleaned by a
dentist or dental hygienist?
Who is at risk in Maryland?
A quarter of Marylanders reported that they either never had their teeth cleaned,
or that it had been more than a year since they last had their teeth cleaned by a
dentist or dental hygienist. About 1% reported that they have never had their
teeth cleaned professionally.
Men were significantly more likely than women not to have their teeth cleaned
in the past year (28.2% versus 23.0%).
Black residents were significantly less likely to have had their teeth cleaned in
the past year than white residents (34.7% versus 21.3%).
Individuals with less than high school education were more than three times
more likely to not have had a professional teeth cleaning in the past year
(54.9%) as college graduates (15.7%).
The percentage of individuals who did not have their teeth cleaned ranged from
45.7% among persons earning less than $15,000 per year to 13.4% among those
earning $75,000 or more.
Percent of Maryland Adults who did not have their Teeth
Professionally Cleaned in the Past Year, by Age*, Education*, and
Income*, 2011
Percent of Maryland Adults who did not have their Teeth Professionally Cleaned in the
Past Year, by Gender* and
Race*, 2011
28.2
23.0
05
10152025303540
Male Female
Pe
rce
nt
Gender
21.3
34.7
05
10152025303540
White Black
Perc
en
t
Race
25.623.727.6
24.4
54.9
30.6
22.9
15.7
45.741.3
36.1
23.6
13.4
0
10
20
30
40
50
60
70
Per
cen
t
*Denotes a statistically significant difference among the values.
At risk: Adults who answered ‘more than 1 year’ or ‘never’ are
considered at risk.
27
VISUAL HEALTH
Question:
At risk:
Has a doctor or other health professional ever said you have vision
impairment in one eye or both eyes, even wearing glasses?
Adults who answered ‘Yes’ are considered at risk.
Percent of Maryland Adults who have Vision Impairment in One Eye or Both Eyes, by
Gender and Race*, 2011
17.1 18.3
0
5
10
15
20
25
30
Male Female
Pe
rce
nt
Gender
17.519.2
0
5
10
15
20
25
30
White Black
Perc
en
t
Race
Who is at risk in Maryland?
17.8% of Marylanders adults reported that they have vision impairment in one
eye or both eyes, even when wearing glasses.
Women were more likely than men to have vision impairment (18.3% versus
17.1%), but the difference was not statistically significant.
Black residents were significantly more likely to report they had vision
impairment than white residents (19.2% versus 17.5%).
Nearly 30% of individuals ages 65 years and older reported having vision
impairment, double the figure of 14.5% among young adults.
The percentage of individuals with vision impairment declined as income rose,
from 23.7% among those earning less than $15,000 to 13.2% among those
earning $75,000 or more.
Percent of Maryland Adults who reported Vision Impairment in One
Eye or Both Eyes, by Age*, Education*, and Income*, 2011
14.513.0
18.9
29.5
21.8
17.019.5
15.4
23.722.7
19.117.2
13.2
0
5
10
15
20
25
30
35
40
Per
cen
t
*Denotes a statistically significant difference among the values.
28
HEALTH BEHAVIOR RISK FACTORS
29
Question: Considering all types of alcoholic beverages, how many times
during the past month did you have five or more drinks on one
occasion?
At risk: Men reporting drinking at least five alcoholic beverages and
women reporting at least four alcoholic beverages on one occasion
in the past month are considered at risk.
Who is at risk in Maryland?
18.0% of Maryland adults reported binge drinking (males having at least five
alcoholic beverages and women having at least four alcoholic beverages in one
occasion).
Men reported binge drinking significantly more than women (23.0% vs.
13.4%).
White residents were significantly more likely to report binge drinking (19.8%)
than black residents (13.9%).
30% of young adults under the age of 35 engaged binge drinking; this figure
dropped sharply with increasing age.
Residents with a high school education or less were less likely to binge drink
than those with some college or a college degree.
Individuals with incomes below $15,000 per year were less likely to be binge
drinkers than individuals with higher income.
Binge drinkers were are significantly more likely to be smokers than those who
do not binge drinkers (34.1% vs. 15.8%).
Percent of Maryland Adults who are classified as Binge Drinkers,
by Age*, Education*, and Income*, 2011
Percent of Maryland Adults who are classified as Binge
Drinkers, by Gender* and
Race*, 2011
23.0
13.4
0
5
10
15
20
25
30
Male Female
Pe
rce
nt
Gender
19.8
13.9
0
5
10
15
20
25
30
White BlackP
erc
en
tRace
ALCOHOL CONSUMPTION A
29.5
21.4
10.5
4.8
16.916.819.318.2
14.9
17.918.420.219.8
0
5
10
15
20
25
30
Per
cen
t
* Denotes a statistically significant difference among the values.
30
Question: During the past 30 days, other than your regular job, did you
participate in any physical activity or exercise such as running,
calisthenics, golf, gardening, or walking for exercise?
At risk: Adults who do not participate in any physical activity or exercise
during the last 30 days are considered at risk.
Who is at risk in Maryland?
26.2% of Marylanders did not participate in any physical activities or exercise
during the past month.
Women were more likely to be physically inactive than men (27.8% vs.
24.3%).
Black residents were more likely to be physically inactive than white residents
(28.6% vs. 24.3%).
Physical inactivity rose with increasing age, and fell with increasing education
and income.
Those who have not participated in any physical activity or exercise during the
past thirty days were significantly more likely to report fair or poor health than
those who did participate in physical activity or exercise (24.9% vs. 10.3%).
Percent of Maryland Adults who did not participate in any Physical
Activity During the Past 30 Days, by Age*, Education*, and Income*, 2011
Percent of Maryland Adults who did not participate in
any Physical Activity During the Past 30 Days, by
Gender* and Race*, 2011
24.327.8
0
10
20
30
40
Male Female
Perc
en
t
Gender
24.328.6
0
10
20
30
40
White Black
Perc
en
t
Race
PHYSICAL ACTIVITY A
21.325.2
29.430.9
44.3
31.4
25.4
16.0
38.536.3
30.727.3
16.9
0
10
20
30
40
50
Pe
rce
nt
*Denotes a statistically significant difference among the values.
31
Who is at risk in Maryland?
19.1% of Maryland adults are current smokers (i.e., smoke everyday or some
days).
Men are more likely to be current smokers (21.2%) than women (17.2%); this
difference is statistically significant.
White residents were more likely to be current smokers (19.6%) than black
residents (18.9%), but this difference is not statistically significant.
The percentage of current smokers fell with increasing age, level of education,
and income.
Current smokers were more likely to report fair or poor general health than
nonsmokers (19.9% vs. 12.7%).
The percentage of people reporting participation in any physical activity or
exercise during the last 30 days was significantly lower for smokers than
nonsmokers (65.3% versus 75.9%).
Percent of Maryland Adults who are Current Smokers (Smoke
Everyday or Some Days), by Age*, Education*, and Income*, 2011
Percent of Maryland Adults who are Current Smokers (Smoke Everyday or Some
Days), by Gender* and Race, 2011
21.2
17.2
0
5
10
15
20
25
Male Female
Perc
en
t
Gender
19.6 18.9
0
5
10
15
20
25
White Black
Perc
en
tRace
23.620.9
18.8
9.2
36.1
26.6
17.7
7.6
34.632.2
24.8
14.412.2
0
10
20
30
40
Pe
rce
nt
* Denotes a statistically significant difference among the values.
Question:
At risk:
If you have smoked at least 100 cigarettes in your entire life, are
you now smoking everyday, some days, or not at all?
Adults who smoke ‘everyday’ or ‘some days’ are considered at risk
TOBACCO USE A
32
Demographic Characteristics by Gender and Race Weighted Maryland BRFSS data indicated that there were more women over
the age of 18 in Maryland than men (52.3% versus 47.7%) in 2011.
Women comprised 52.4 of the white population and 54.4 of the black
population.
There was a statistically significant difference in the percentage of men versus
women in the 65+ year age group. Of the residents in this group, 57.9% were
women and only 42.1% were men.
A greater percentage of residents who graduated from college were women
(51.3%) and men (48.7%).
Of residents who reported earning less than $15,000 per year, were men
(38.3%) and (61.7%) were women.
Distribution of Maryland Adult Men and Women by
Gender and Race, 2011 NEED THIS PAGE??
47.752.3
0
15
30
45
60
Male Female
Perc
en
t
Gender
47.6 45.6
52.4 54.4
0
20
40
60
80
100
White Black
Race and Sex
Female
Male
Distribution of Maryland Adult Men and Women by Demographic Characteristic, by Age, Education, and Income, 2011
0
10
20
30
40
50
60
70
Male Female
DEMOGRAPHIC CHARACTERISTICS: GENDER AND RACE DIFFERENCES FOR MARYLAND
33
14.213.0
21.0
17.0 17.9
24.3
0
5
10
15
20
25
30
Fair/Poor General Health
NoHealth Care Coverage
Disability
Pe
rce
nt
Maryland United States
18.0
26.6
19.118.3
26.2
21.2
0
5
10
15
20
25
30
Binge Drinking Did Not Participate In Any Physical Activity
Current Smoking
Per
cen
t
Maryland United States
Source: National Center for Chronic Disease Prevention & Health Promotion (CDC) ‘Behavioral Risk Factor Surveillance System –
State Prevalence Data Charts’, available from http://apps.nccd.cdc.gov/brfss/index.asp Accessed December, 2012.
MARYLAND VERSUS UNITED STATES: RISK FACTORS
Health Status, 2011
Health Behavior Risk Factors, 2011
Marylanders reported that they were in
better health than the U.S. residents overall.
The percentage of Marylanders reporting
that their health was fair or poor was
14.2%, compared with 17.0% for the total
U.S. population.
Marylanders are more likely to have
healthcare coverage than U.S. residents
overall. Thirteen percent of Marylanders
lacked healthcare coverage compared with
17.9% of U.S. residents.
Fewer adults reported that they had a
disability in Maryland than the U.S. as a
whole (21.0% versus 24.3%).
Compared to U.S. residents as a
whole, Maryland residents were
slightly less to be binge drinkers
and slightly more to participate in
any physical activity or exercise.
However, Marylanders were
substantially less likely to be
current smokers (19.1% versus
21.2%).
34
13.8
35.4
4.2 2.6
13.6
38.4
4.4 2.9
0
5
10
15
20
25
30
35
40
45
50
Asthma High Cholesterol Heart Attack Stroke
Pe
rce
nt
Maryland United States
9.6
64.4
9.5
63.5
0
10
20
30
40
50
60
70
80
Diabetes Overweight/Obesity
Pe
rce
nt
Maryland United States
Source: National Center for Chronic Disease Prevention & Health Promotion (CDC) ‘Behavioral Risk Factor Surveillance System –
State Prevalence Data Charts’, available from http://apps.nccd.cdc.gov/brfss/index.asp Accessed December, 2012.
Chronic Disease Prevalence, 2011
MARYLAND VERSUS UNITED STATES: RISK FACTORS
Rates of asthma, heart attack and
stroke were similar to the U.S.
However, Marylanders were less
likely to report that they had high
cholesterol levels than U.S. residents
as a whole (35.4% versus 38.4%).
The percentage of
residents reporting that
they had diabetes was
similar in Maryland and
the U.S.
The percentage of the
population classified as
overweight/obese
according to BMI scores
was higher in Maryland
than nationwide (64.4%
versus 63.5%).
o
r
e
l
e
s
s
l
i
k
35
12.3
17.3 17.920.1
15.8 16.7
12.9
17.3 17.018.8
15.818.1
0
5
10
15
20
25
30
18-24 Yrs 25-34 Yrs 35-44 Yrs 45-54 Yrs 55-64 Yrs 65+ Yrs
Perce
nt
Maryland United States
12.6
27.1 27.5
32.8
13.0
30.1 30.3
23.8
0
10
20
30
40
50
< HS GRAD HS GRAD Some College or Vocational
College Grad
Pe
rce
nt
Maryland United States
7.0
15.19.1
12.6
56.1
12.418.5
11.715.0
41.7
0
10
20
30
40
50
60
70
<$15,000 $15-24,999 $25-34,999 $35-49,999 >$50,000
Perc
ent
Maryland United States
Educational Characteristics of Adult Population, 2011
MARYLAND VERSUS UNITED STATES: DEMOGRAPHIC CHARACTERISTICS
Age Distribution of Adult Population, 2011
Income Characteristics of Maryland Households, 2011
The age distributions of the
Maryland and U.S
populations were similar,
except with respect to the
65+ age group; the
percentage of individuals in
this age group was smaller in
Maryland than in the nation.
The population of Maryland is well-
educated compared to the nation as a
whole; 32.8% of Maryland residents
were college graduates, compared
with only 23.8 of all U.S. residents.
Overall, Marylanders were wealthier than the U.S. residents as a whole. In 2011, 56.1% of Maryland
households had incomes above $50,000 per year, compared to only 41.7% of the population nationwide.
Source: National Center for Chronic Disease Prevention & Health Promotion (CDC) ‘Behavioral Risk Factor Surveillance
System – State Prevalence Data Charts’, available from http://apps.nccd.cdc.gov/brfss/index.asp Accessed December, 2012.
36
APPENDICES
37
The Maryland BRFSS data are accessible on the web at www.marylandbrfss.org (for
national data, please go to www.cdc.gov/brfss/). Once accessing the Maryland site, users will see
a homepage of survey reports; choose the BRFSS by clicking on the icon. The next page is a
resource page for the BRFSS; it is here that users will find resources such as detailed instructions
on how to use the site, tools, and the questionnaires. To enter the query window, choose the year
of interest in the right hand side column. The search window will look like the image below.
Example of a Query:
Search Window: Question = “How many Marylanders currently smoke everyday?” To begin searching, choose the year of interest, the topic of interest, then any crossing
variables (e.g., gender, race, age, income, county etc.). Finally, click the “Run Tabulate” button
on the bottom of the page.
Output Window: Answer = An estimated 234,722 Men (11.5%) and 210,560 Women (9.4%)
smoke everyday.
Choose topic: “How many people
smoke everyday?
Choose year of report
Click “Run Tabulate”
Choose counties
Choose “crossing” variable, or subtopic
“How many men versus women smoke
everyday?
An estimated 234,722 or 11.5% of
Maryland adult men smoke
everyday.
An estimated 210,560 or 9.4% of
Maryland adult women smoke
everyday.
Click to generate an excel file or a
graph of the results.
HOW TO USE THE MARYLAND BRFSS
38
The results provide two different frequencies: n= the number of respondents interviewed
(i.e., the number of people who actually responded) and N = the weighted sample frequency (i.e.,
the number estimated if all the persons in the state would have responded). The percent value
that is given is based on the estimate of the Maryland population, and is therefore, an estimation
of the percentage of Maryland residents, not the actual percentage of Marylanders.
If the BRFSS were to be administered to all Marylanders, then no estimation would be
needed, and one could make conclusions based on the population values. For example, if we
were to ask all Marylanders if they had their teeth cleaned and 95% of women responded ‘yes’
versus 90% of the men, then one could draw the conclusion that the proportion of women who
have their teeth cleaned is greater than that of men. However, the BRFSS does not reach every
citizen; therefore, the percentage values given are only estimates of the true population values.
Consequently, one cannot draw conclusions based solely on these values and must also review
confidence intervals, which are included in the BRFSS output. Throughout the report, statistical
tests (the t-test) were conducted to determine if percentages were significantly different. These
differences are indicated on the graphs.
We also provide confidence intervals (CI) to enable users to test for the reliability of the
estimates. The larger the CI, the more error is present in the estimate. Sample size has an inverse
relationship with the size of the CI. Sampling error may be improved by computing estimates
with larger samples. The sample size of the BRFSS is determined to minimize sampling error.
The website includes an aggregated file with data from 1995 to 2010 for the purpose of enabling
accurate estimates despite small numbers of affected individuals for some diseases and
behaviors. Aggregate years can be used from this file to increase sample size as needed.
Lastly, one can generate graphs and maps of the output by clicking on the appropriate
icon immediately below the results. The graph below presents the percent of men and women
who smoke everyday.
Graph Window: An Estimated 11.5% of Men and 9.4% of Women Smoke Everyday
39
Mapping Window: Percent of Population who Smoke Everyday by County
40
FREQUENTLY ASKED QUESTIONS (FAQs)
When I run my query, no numbers appear in the cells. What went wrong? Most likely, nothing went wrong. When the values in the cells are too small (n<50), BRFSS will not
generate an output for those cells because the estimates are considered too unreliable. This often
happens when the user crosses one or more variables with conditions that have a low prevalence
(e.g., asthma by county). This situation might be corrected by aggregating a number of years
together when running your analysis. (This can be done by holding down the control key while
choosing multiple years in the search window).
For any other questions, please contact Helio Lopez, BRFSS Coordinator, at
41
Below are resources providing definitions and descriptions of conditions found in the BRFSS report. These
links direct you to government sources or non-profit institutions that have assembled reliable, non-commercial
information. Most sites provide information about disease symptoms, causes, risk factors, and tips about
prevention. Other sites provide important information about finding good quality health care and making
informed choices about your options.
Health care access and quality: http://mhcc.maryland.gov/
http://www.hrsa.gov/help/default.htm
http://www.ahrq.gov/consumer/
Chronic diseases and conditions: http://fha.maryland.gov/cdp/
http://fha.maryland.gov/cancer/
http://www.nichd.nih.gov/health/topics/
Asthma http://www.nhlbi.nih.gov/health/dci/Diseases/Asthma/Asthma_WhatIs.html
http://www.cdc.gov/asthma/
http://www.noattacks.org/?gclid=CKOktZL5zosCFRQkUAodpFklGw
Cancer http://www.nlm.nih.gov/medlineplus/cancer.html
http://www.cdc.gov/cancer/
http://www.cancer.org/index
Cholesterol http://www.nlm.nih.gov/medlineplus/cholesterol.html
http://www.heart.org/HEARTORG/Conditions/Cholesterol/Cholesterol_UCM_001089_SubHomePage.jsp
Diabetes http://www.nlm.nih.gov/medlineplus/diabetes.html
http://www2.niddk.nih.gov/
http://www.diabetes.org/
Heart Attack http://www.nlm.nih.gov/medlineplus/heartdiseases.html
http://www.americanheart.org/presenter.jhtml?identifier=1200000
http://www.nhlbi.nih.gov/health/public/heart/index.htm
High Blood Pressure http://www.nlm.nih.gov/medlineplus/highbloodpressure.html
http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/High-Blood-
Pressure_UCM_002020_SubHomePage.jsp
Overweight/Obesity http://www.nlm.nih.gov/medlineplus/obesity.html
http://www.cdc.gov/obesity/
http://www.surgeongeneral.gov/obesityprevention/factsheet/index.html
LINKS FOR FURTHER INFORMATION
42
Stroke http://www.nlm.nih.gov/medlineplus/stroke.html
http://www.strokeassociation.org/presenter.jhtml?identifier=1200037
http://www.ninds.nih.gov/disorders/stroke/stroke.htm
Risk factors and prevention:
Anxiety/Depression http://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml
http://www.nimh.nih.gov/health/topics/depression/index.shtml
http://www.nami.org/Template.cfm?Section=By_Illness&Template=/TaggedPage/TaggedPageDisplay.cfm&TPLID=54
&ContentID=23039&lstid=326
Flu Shot http://www.nlm.nih.gov/medlineplus/flu.html
http://www.cdc.gov/flu/protect/children.htm
http://www.mayoclinic.com/health/influenza/AN00651
Oral Health http://www.nlm.nih.gov/medlineplus/toothdisorders.html
http://www.ada.org/3031.aspx?currentTab=1
http://www.nidcr.nih.gov/OralHealth/Topics/OralCancer/OralCancer.htm
Visual Health http://www.cdc.gov/visionhealth/about/index.htm
http://www.nlm.nih.gov/medlineplus/visionimpairmentandblindness.html
http://www.nei.nih.gov/health/
Alcohol Consumption http://www.niaaa.nih.gov/FAQs/General-English/default.htm
http://www.nida.nih.gov/students.html
http://www.nlm.nih.gov/medlineplus/pregnancyandsubstanceabuse.html
Fruit and Vegetable Consumption http://www.nlm.nih.gov/medlineplus/nutrition.html
http://www.cnpp.usda.gov/
http://www.cfsan.fda.gov/~lrd/advice.html
Physical Activity http://www.cdc.gov/nccdphp/dnpa/physical/
http://www.nlm.nih.gov/medlineplus/exerciseandphysicalfitness.html
http://www.fitness.gov/
Sleep http://www.nlm.nih.gov/medlineplus/sleepdisorders.html
http://www.cdc.gov/Features/Sleep/
http://science.education.nih.gov/supplements/nih3/sleep/guide/info-sleep.htm
Tobacco Use http://www.nlm.nih.gov/medlineplus/smoking.html
http://smoking.drugabuse.gov/
http://www.lungusa.org/
43
Choose year of report
Choose counties
Choose topic: “How many people
smoke everyday?
Choose “crossing” variable, or
subtopic “How many men versus
women smoke everyday?
HHaavvee qquueessttiioonnss aabboouutt tthhee ssttaattee ooff MMaarryyllaanndd’’ss hheeaalltthh??
VViissiitt uuss aatt wwwwww..mmaarryyllaannddbbrrffssss..oorrgg YYoouurr aannsswweerrss aarree jjuusstt aa ffeeww cclliicckkss aawwaayy.. HHeerree’’ss hhooww…… Search Window:
Question = “How many Marylanders currently smoke everyday?”
Output Window: Answer = An estimated 234,722 Men (11.5%) and 210,560 Women (9.4%) smoke
everyday
Graph Window Map Window
Click “Run Tabulate”
An estimated 234,722 or 11.5% of
men smoke everyday.
An estimated 210,560 or 9.4% of
women smoke everyday.
Click to generate an excel file of
results, a graph or a map for a
report of the results.
