Abstract P193: Life’s Simple 7 Risk Factors and Cardiovascular Disease Among Gender Minority Populations in the 2019 BRFSS
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Gender minority (GM) populations encompass individuals who identify with a gender different from their sex assigned at birth. This includes transgender adults, which make up 0.6% of the U.S. population. Despite cardiovascular disease being the leading cause of morbidity and mortality worldwide, there is little research on the cardiovascular health of GM populations. GM adults may be at higher risk for myocardial infarction, coronary heart disease, and stroke compared to their cisgender peers due to minority stress and the impact of stigma on health. The Behavioral Risk Factor Surveillance System (BRFSS) is a federal survey administered by state health departments and the CDC. The BRFSS has offered an optional standardized Sexual Orientation and Gender Identity (SOGI) module with measures to identify transgender respondents since 2014 and 30 states included the module in 2019. Life’s Simple 7 criteria are used in preventive medicine and public health to describe ideal cardiovascular health. The seven associated risk factors are smoking, obesity, physical inactivity, poor dietary habits, high cholesterol, high blood pressure, and high blood glucose. The 2019 BRFSS included core modules related to each of the risk factors and therefore provides a unique opportunity to investigate the cardiovascular health of GM respondents. BRFSS data (N = 177,322) were used to determine prevalence rates of cardiovascular risk factors and disease among GM compared to cisgender adults. R was used to conduct weighted estimates and regressions comparing behavioral and clinical cardiometabolic risk factors and events by gender identity (cisgender male, cisgender female, transgender male-to-female, transgender female-to-male, and transgender gender nonconforming). On average, GM respondents were younger, more racially/ethnically diverse, less likely to have graduated college, less likely to be straight, and reported lower annual household incomes than cisgender males or females. After adjusting for age, race/ethnicity, education, income, and sexual orientation, gender nonconforming transgender adults were less likely than both cisgender males (adjusted odds ratio = 1.17, 95% confidence interval: (1.02, 1.34)) and cisgender females (1.15 (1.00, 1.32)) to report exercise in the last 30 days. Gender nonconforming transgender adults were less likely to report a diagnosis of diabetes than cisgender males (0.97 (0.94, 1.00)). No significant differences between gender minority and majority adults were detected for cardiovascular events after adjusting for demographic variables and Life’s Simple 7 risk factors. This may be due to the age difference between the cisgender and GM groups, since older adults have higher risk of cardiovascular disease. Analyses may have been underpowered due to small GM sample sizes, emphasizing the importance of all states including the optional standardized SOGI module.In the United States, the Affordable Care Act and marriage equality may have eased sexual orientation-based differences in access to healthcare coverage, but limited research has investigated sexual orientation-based differences in healthcare satisfaction. The purpose of this study was to examine whether satisfaction with healthcare varied by sexual orientation in a large population-based sample of adults.Data are from the 2014 Behavioral Risk Factor Surveillance System, including items about sexual orientation and healthcare (n = 113,317). Healthcare coverage included employer-based insurance; individually purchased insurance; Medicare; Medicaid; or TRICARE, VA, or military care. Respondents indicated whether they were "very satisfied, somewhat satisfied, or not at all satisfied" with healthcare.After adjusting for several sociodemographic covariates, lesbian, gay, and bisexual status was associated with lower satisfaction with healthcare with individually purchased insurance (adjusted odds ratio = 1.49, 95% confidence interval = 1.24-1.80).Efforts are needed to examine and reduce sexual orientation differences in satisfaction with healthcare.
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Truancy
Sexual identity
Heterosexism
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ABSTRACT Few population-based surveys in the United States include sexual orientation as a demographic variable. As a result, estimating the proportion of the U.S. population that is gay, lesbian, or bisexual (GLB) is a substantial challenge. Prior estimates vary widely, from 1–21%. In 2001, questions on sexual orientation and sexual behavior were added to the Massachusetts Behavioral Risk Factor Surveillance System (MA BRFSS) and have been asked continually since that time. The purpose of this study was to determine the prevalence of adults in Massachusetts identifying as GLB and providing a demographic description of this group. The study also examined the correlation of reported sexual behavior and sexual identity within this group. Overall, 1.9% of Massachusetts adults identified as gay or lesbian and 1.0% of Massachusetts adults identified as bisexual. Of those identifying as gay or lesbian, 95.4% reported sexual behavior concordant with this identification, and 99.4% of respondents identifying as heterosexual reported behavior concordant with heterosexual sexual orientation. Among those reporting a GLB sexual orientation, men were more likely than women to identify as gay, and women were more likely than men to identify as bisexual. Younger adults (18–25 years old) were more likely than people in other age groups to identify as bisexual. Respondents with 4 or more years of education were more likely to identify as gay or lesbian than those in all other education categories. The addition of sexual orientation to population-based surveys will allow for research on the health of GLB adults and provide critical information for those charged with the creation of public policy regarding sexual orientation.
Sexual identity
Heterosexuality
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OBJECTIVES: This study examined whether there are systematic differences between the Behavioral Risk Factor Surveillance System (BRFSS) and the Current Population Survey (CPS) for state cigarette smoking prevalence estimates. METHODS: BRFSS telephone survey estimates were compared with estimates from the US Census CPS tobacco-use supplements (the CPS sample frame includes persons in households without telephones). Weighted overall and sex- and race-specific BRFSS and CPS state estimates of adults smoking were analyzed for 1985, 1989, and 1992/1993. RESULTS: Overall estimates of smoking prevalence from the BRFSS were slightly lower than estimates from CPS (median difference: -2.0 percentage points in 1985, -0.7 in 1989, and -1.9 in 1992/1993; P < .05 for all comparisons), but there was variation among states. Differences between BRFSS and CPS estimates were larger among men than among women and larger among Blacks than among Hispanics or Whites; for most states, these differences were not significant. CONCLUSIONS: The BRFSS generally provides state estimates of smoking prevalence similar to those obtained from CPS, and these are appropriate for ongoing state surveillance of smoking prevalence.
Current Population Survey
Behavioral risk
Telephone survey
Smoking prevalence
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In this brief, the authors use an example of a Behavioral Risk Factor Surveillance System (BRFSS)-based disability study conducted in Massachusetts to describe how the BRFSS can be used for disability research. The study implemented a follow-up survey to the Massachusetts BRFSS and gathered data on the employment-related health insurance needs of individuals with disabilities.
Behavioral risk
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the behavioral risk factor surveillance system brfss is a state based system of health surveys that collects information on health risk behaviors preventive health practices and health care access primarily related to chronic disease and injury for many states the brfss is the only available source of timely accurate data on health related behaviors
Behavioral risk
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In 1988, 36 states (including the District of Columbia) participated in the Behavioral Risk Factor Surveillance System (BRFSS). This report provides state-specific estimates of the prevalence of certain health-risk behaviors and of the delivery of clinical preventive services as measured by the BRFSS during 1988. Because estimates vary considerably from state to state, national estimates are not always suitable for states to use in planning local programs. Therefore, the BRFSS will continue to provide state-specific data about health behaviors and the use of preventive health services. These data can be used to monitor trends in health behaviors that affect the burden of chronic diseases in the United States and to assess progress toward the year 2000 objectives for the nation.
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OBJECTIVES: The purpose of this study was to document and describe Behavioral Risk Factor Surveillance System (BRFSS) data use patterns, benefits, and barriers from 1993 to 1997. METHODS: Data use information was gathered via a Medline database search and a telephone survey of BRFSS program directors (n = 54). RESULTS: The database search uncovered 109 BRFSS-based reports. Program directors indicated that BRFSS data frequently were used to support health policies regarding diabetes, physical activity, and smoking. Frequent data use barriers included insufficient special population data, insufficient city- or county-specific data, and insufficient staff. CONCLUSIONS: Use of BRFSS data, which aid several state health activities, increased from 1993 to 1997.
Telephone survey
Public health surveillance
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