Availability of State-Based Obesity Surveillance Data on High School Students with Disabilities in the United States
2
Citation
47
Reference
10
Related Paper
Citation Trend
Keywords:
Public health surveillance
This paper provides a reviewof the present of public health surveillance— the ongoing systematic collection,analysis,interpretation,and dissemination of health data for the planning,implementation,and evaluation of public health action. Public health surveillance has been established the application conditions and the use of six major categories,and made specific provision in the implementation of surveillance,and classification of the current public health surveillance is mainly expounded in detail. Public health surveillance is still in the stage of development,its theories and methods still need to further improve and perfect,only in this way can we further enhance public health surveillance.
Public health surveillance
Health Surveillance
Cite
Citations (0)
An essential component of a public health surveillance system is its ability to detect priority diseases which fall within the mandate of public health officials at all levels. Early detection, reporting and response to public health events help to reduce the burden of mortality and morbidity on communities. Analysis of reliable surveillance data provides relevant information which can enable implementation of timely and appropriate public health interventions. To ensure that a resilient system is in place, the World Health Organization (WHO) has provided guidelines for detection, reporting and response to public health events in the Integrated Disease Surveillance and Response (IDSR) strategy. This case study provides training on detection, reporting and analysis of priority diseases for routine public health surveillance in Liberia and highlights potential errors and challenges which can hinder effective surveillance. Table-top exercises and group discussion lead participants through a simulated verification and analyses of summary case reports in the role of the District Surveillance Officer. This case study is intended for public health training in a classroom setting and can be accomplished within 2 hours 30 minutes. The target audience include residents in Frontline Epidemiology Training Programs (FETP-Frontline), Field Epidemiology and Laboratory Training Programs (FELTPs), and others who are interested in this topic.
Public health surveillance
Disease Surveillance
Mandate
Officer
Population Health
Public Health Informatics
Cite
Citations (4)
The purpose of evaluating public health surveillance systems is to ensure that problems of public health importance are being monitored efficiently and effectively. CDC's Guidelines for Evaluating Surveillance Systems are being updated to address the need for a) the integration of surveillance and health information systems, b) the establishment of data standards, c) the electronic exchange of health data, and d) changes in the objectives of public health surveillance to facilitate the response of public health to emerging health threats (e.g., new diseases). This report provides updated guidelines for evaluating surveillance systems based on CDC's Framework for Program Evaluation in Public Health, research and discussion of concerns related to public health surveillance systems, and comments received from the public health community. The guidelines in this report describe many tasks and related activities that can be applied to public health surveillance systems.
Public health surveillance
Public Health Informatics
Health Surveillance
Community Health
Health Information Exchange
Cite
Citations (1,086)
High-risk behaviors and lack of preventive care are associated with higher rates of morbidity and mortality in the United States. Without continued monitoring of these factors, state health departments would have difficulty tracking and evaluating progress toward Healthy People 2010 and their own state objectives. Monitoring chronic disease-related behaviors is also key to developing targeted education and intervention programs at the national, state, and local levels to improve the health of the public.Data collected in 2001 are compared with data from 1991 and 2000, and progress toward Healthy People 2010 targets is assessed.The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing, state-based, telephone survey of persons aged > or =18 years. State health departments collect the data in collaboration with CDC. In 2001, participants in data collection included all 50 states, the District of Columbia, Guam, the U.S. Virgin Islands, and the Commonwealth of Puerto Rico. BRFSS data are used to track the prevalence of chronic disease-related characteristics and monitor progress toward national health objectives related to 1) decreasing high-risk behaviors, 2) increasing awareness of medical conditions, and 3) increasing use of preventive health services. For certain national objectives, BRFSS is the only source of data.BRFSS data indicate changes in certain high-risk behaviors from 1991 to 2001. Among the findings are substantial increases in the prevalence of obesity among adults aged > or =20 years. Among states, prevalence of persons classified as obese in 2001 ranged from 15.5% in Colorado to 27.1% in Mississippi. From 1991 to 2001, the median prevalence for all participating states and territories increased from 12.9% to 21.6%. In 1991, no state had an obesity prevalence of > or =20%; in 2001, 37 states had a prevalence of > or =20%. Percentage increases in prevalence of obesity, from 1991 to 2001, ranged from 24.9% in the District of Columbia to 140.2% in New Mexico. In 2001, substantial variations also existed among states and territories regarding prevalence of other high-risk behaviors and awareness of medical conditions. Ranges included, for no leisure-time physical activity, 16.5% (Utah) to 49.2% (Puerto Rico); cigarette smoking, 9.6% (Virgin Islands) to 31.2% (Guam); binge drinking, 6.8% (Tennessee) to 25.7% (Wisconsin); heavy drinking, 2.5% (Tennessee) to 8.7% (Wisconsin); persons ever told they had diabetes, 4% (Alaska) to 9.8% (Puerto Rico); persons ever told they had high blood pressure, 20% (New Mexico) to 32.5% (West Virginia); and persons ever told they had high blood cholesterol, 24.8% (New Mexico) to 37.7% (West Virginia). Substantial variations also existed among states regarding prevalence of using preventive health services. Ranges included, for persons aged > or =50 years ever screened for colorectal cancer by use of sigmoidoscopy or colonoscopy, 30.5% (Virgin Islands) to 62% (Minnesota); persons aged > or =65 years who received an influenza vaccination in the past year, 36.8% (Puerto Rico) to 79% (Hawaii); persons aged > or =65 years who ever received a pneumococcal vaccination, 24.1% (Puerto Rico) to 70.9% (Oregon). In 2001, 13 states, Guam, and the U.S. Virgin Islands used the women's health module. Ranges included, for women aged > or =18 years who had a Papanicolaou (Pap) smear test in the past 3 years, 79.8% (Virgin Islands) to 89.6% (Wisconsin); women aged > or =40 years who ever had a mammogram, 71.9% (Virgin Islands) to 93% (Rhode Island); and women aged > or =40 years who had a mammogram in the past 2 years, 57.2% (Virgin Islands) to 85.1% (Rhode Island). BRFSS data in 2001 also indicated variations by sex, race or ethnicity, and age group. Greater percentages of men than women reported cigarette smoking, binge drinking, heavy drinking, and were classified as overweight; greater percentages of women reported no leisure-time physical activity. Among racial or ethnic groups, greater percentages of black non-Hispanics than other groups reported being told by a health professional they had high blood pressure and diabetes, and were classified as obese; greater percentages of white non-Hispanics than other groups reported being told they had high cholesterol. Among age groups, greater percentages of persons aged 18-24 years than those in older groups reported smoking cigarettes, binge drinking and heavy drinking; greater percentages of persons in older age groups than younger age groups reported being told they had diabetes, high blood pressure, and high blood cholesterol. Also, comparison of 2001 BRFSS data with 12 targets from Healthy People 2010 indicates that, in 2001, no state had met the targets for obesity, cigarette smoking, binge drinking, receiving a fecal occult blood test within the past 2 years, receiving annual influenza vaccinations, receiving pneumococcal vaccinations, and receiving Pap tests. Certain states had already met targets for no leisure-time activity, receiving a sigmoidoscopy or colonoscopy, having blood cholesterol checked within the past 5 years, and receiving a mammogram within the past 2 years.BRFSS data in this report indicate that despite certain improvements, persons in a high proportion of U.S. states and territories continue to engage in high-risk behaviors and do not report making sufficient use of preventive health practices. Substantial variations (i.e., by state, sex, age group, and race/ethnicity) in prevalence of behaviors, awareness of medical conditions, and use of preventive services indicate a continued need to monitor these factors at state and local levels and assess progress toward reducing morbidity and mortality.BRFSS data can be used to guide public health actions at local, state, and national levels. For certain states, BRFSS is the only reliable source of chronic-disease-related, risk-behavioral data. BRFSS data enable states to design, implement, evaluate, and monitor health-promotion strategies, targeting specific high-risk behaviors among populations experiencing high burdens of disease. BRFSS data continue to be key sources for assessing progress toward both national Healthy People 2010 objectives and state health objectives.
Behavioral risk
Public health surveillance
Disease Surveillance
Cite
Citations (154)
Public health surveillance
Disease Surveillance
Population Health
Relevance
Cite
Citations (0)
BROWNSON, R. C., D. A. JONES, M. PRATT, C. BLANTON, and G. W. HEATH. Measuring physical activity with the behavioral risk factor surveillance system. Med. Sci. Sports Exerc., Vol. 32, No. 11, pp. 1913–1918, 2000. Purpose and Methods Because regular physical activity reduces the risk of premature death and disability, accurate methods of population-based measurement are important for public health surveillance efforts such as those based on the Behavioral Risk Factor Surveillance System (BRFSS). The present study: 1) briefly reviews and compares currently available methods to measure physical activity using BRFSS data, 2) describes physical activity patterns in the United States using these state-aggregated measures, and 3) provides suggestions on future directions for practitioners and researchers. Using a random-digit dialing, telephone survey, we collected data for noninstitutionalized adults aged 18 yr and older. We analyzed BRFSS data for 1996 from 50 states and the District of Columbia and Puerto Rico (N = 124,085). Based on recent literature and public health priorities, we developed eight different physical activity indices (one vigorous and seven moderate). These varied in their threshold for duration, kcal expenditure, and in frequency and intensity of activity. Results Using different algorithms, the population prevalence of moderate physical activity ranged from about 20% to 38%. Only 20% of adults met the Healthy People 2000 definition for regular, sustained activity (≥30 min of moderate activity per day for at least 5 d·wk−1). Conclusions Considerable progress is needed if the United States is to reach the current public health goal for regular physical activity. Standardized approaches to analyzing and collecting physical activity data are essential for public health surveillance, policy making, and communication to the public.
Telephone survey
Public health surveillance
Random digit dialing
Cite
Citations (105)
The Behavioral Risk Factor Surveillance System (BRFSS) is a state-based system of health surveys. Information regarding health risk behaviors, clinical preventive health practices, and health-care access, primarily related to chronic disease and injury is obtained from a representative sample of adults in each state. Approximately 200,000 adult interviews are completed each year in all 50 states, the District of Columbia, Puerto Rico, the Virgin Islands, and Guam. The challenge for BRFSS is how to effectively manage an increasingly complex surveillance system that serves the needs of numerous programs while facing changing telecommunication technology and the greater demand for more local-level data. To determine options and recommendations for how best to meet BRFSS future challenges, CDCs Behavioral Surveillance Branch conducted a 2-day strategy workshop, attended by survey-research specialists. The workshop featured presentations on the current system; emerging technologic challenges; telephone-surveying techniques; program perspectives of CDC, partner organizations, and states; and recommendations for change. This report summarizes the recommendations resulting from that workshop.
Behavioral risk
Public health surveillance
Telephone survey
Cite
Citations (309)
ObjectiveTo assess the equivalence of hypertension prevalence estimates between longitudinal electronic health record (EHR) data from a community-based health information exchange (HIE) and the Behavioral Risk Factor Surveillance System (BRFSS).IntroductionHypertension (HTN) is a highly prevalent chronic condition and strongly associated with morbidity and mortality. HTN is amenable to prevention and control through public and population health programs and policies. Therefore, public and population health programs require accurate, stable estimates of disease prevalence, and estimating HTN prevalence at the community-level is acutely important for timely detection, intervention, and effective evaluation. Current surveillance methods for HTN rely upon community-based surveys, such as the BRFSS. While BRFSS is the standard at the state- and national-level, they are expensive to collect, released once per year, and their confidence intervals are too wide for precise estimates at the local level. More timely, frequently updated, and locally precise prevalence estimates could greatly improve the timeliness and precision of public health interventions. The current study evaluated EHR data from a large, mature HIE as an alternative to community-based surveys for timely, accurate, and precise HTN prevalence estimation.MethodsTwo years (2014-2015) of EHR data were obtained from the Indiana Network for Patient Care for two major health systems in Marion County, Indiana, representing approximately 75% of the total county population (n=530,244). These data were linked and evaluated for prevalent HTN. Six HTN phenotypes were defined using structured data variables including clinical diagnoses (ICD9/10 codes), blood pressure (BP) measurements (HTN = ≥140mmhg systolic or ≥90mmHg diastolic), and dispensed HTN medications (Table 1). Phenotypes were validated using a random sample of 600 records, comparing EHR phenotype HTN to HTN as determined through manual chart review by a Registered Nurse. Each phenotype was further evaluated against BRFSS estimates for Marion County, and stratified by sex, race, and age to compare EHR-generated HTN prevalence measures to those known and in current use for chronic disease surveillance. Comparisons were made using the two one-sided statistical test (TOST) of equivalence, wherein the null hypothesis is the BRFSS and EHR prevalence estimates are different by +/-5% and the alternative is estimates differ by less than +/-5%. Rejection of the null resulted in the conclusion of equivalence of the estimates for use in population/public health.ResultsIn general, the performance of the EHR phenotypes was characterized by high specificity (>87%) and low to moderate sensitivity (range 25.4%-95.3%). The false positive rate was lowest among the phenotype defining HTN by both clinical diagnosis and BP measurements (0.3%), and sensitivity was greatest for the phenotype combining all three structured data elements (95.2%). The prevalence of HTN in Marion County, Indiana (2014-2015) for the EHR sample (n=530,244) ranged between 13.7% and 36.2%, compared to 28.4% in the BRFSS sample (Table 1). Only one EHR phenotype (≥1 HTN BP measurement) demonstrated equivalence with BRFSS prevalence at the county level (difference 0.9%, 90% CI for difference -2.3%-4.0%). HTN prevalence by sex, race, age, sex and age, and sex and race (n=120 comparisons) failed to demonstrate equivalence between EHR and BRFSS measures in all but two comparisons, both among females aged 18-39 years. Differences between EHR and BRFSS HTN prevalence at the subgroup level varied but were particularly pronounced among older adults. As suspected, HTN prevalence precision was improved in the EHR sample with the largest subgroup 95% CI width of 0.7% for male African Americans compared to the BRFSS sample 95% CI width of 29.6%.ConclusionsThe applicability of the tested HTN phenotypes will vary based upon which EHR structured data elements are available to public health (i.e., ICD10, vitals, medications). We found that HTN surveillance using a community-based HIE was not a valid replacement for the BRFSS, although the HIE-based estimates could be readily generated and had much narrower confidence intervals.ReferencesMozaffarian D, et al. Heart Disease and Stroke Statistics — 2016 Update. Circulation. 2016; 133: e38-e360.Yoon S, Fryar C, Carroll M. HTN Prevalence and Control Among Adults: United States, 2011–2014. NCHS Data Brief No. 220. 2015; Hyattsville, MD: National Center for Health Statistics, Centers for Disease Control and Prevention, US Dept of Health and Human Services.
Public health surveillance
Disease Surveillance
Health Information Exchange
Community Health
Health records
Cite
Citations (4)
Public health surveillance
Disease Surveillance
Public Health Informatics
Community Health
Cite
Citations (88)
Objectives. Industry and occupation variables are overlooked in many public health surveillance efforts, yet they are useful for describing the burden and distribution of various public health diseases, behaviors, and conditions. This study is the first ever analysis of the Colorado Behavioral Risk Factor Surveillance System (BRFSS) to describe chronic conditions and risk behaviors by occupation. It is intended to provide a new perspective on this existing data source and demonstrate the value of occupation as a core demographic variable for public health research, policy, and practice. Methods. Two standardized employment questions were included in the 2012 Colorado BRFSS survey and administered to eligible survey respondents who were employed, self-employed, or out of work for less than one year. Occupation data were coded using the National Institute for Occupational Safety and Health (NIOSH) Industry and Occupation Computerized Coding System. We analyzed health behaviors and conditions by major occupation groups. We calculated prevalence estimates and 95% confidence intervals (Cls). Results. The prevalence of chronic conditions, health statuses, and risk behaviors (e.g., smoking and seatbelt use) varied significantly by occupation. For example, compared with all workers (93.6%, 95% CI 92.7, 94.5), significantly fewer workers in farming, forestry, fishing and construction, extraction jobs (87.0%, 95% CI 82.0, 92.0) reported always or nearly always wearing a seatbelt while driving. Additionally, significantly more office and administrative support workers (27.5%, 95% CI 22.5, 32.4) compared with all workers (20.6%, 95% CI 19.3, 22.0) were obese. Further observation and research is needed to understand the effects of occupation on health outcomes and behaviors. Conclusion. There are no other Colorado state-level datasets that link health behaviors and chronic conditions with occupation. This study shows that the prevalence of chronic conditions and risk behaviors varies substantially by occupation. Other states conducting the BRFSS may choose to adopt the NIOSH industry and occupation module and add other questions to further investigate health issues by occupation.
Public health surveillance
Cite
Citations (9)