Search

Objectives. We analyzed state-specific uninsurance trends among US adults aged 18 to 64 years. Methods. We used logistic regression models to examine Behavioral Risk Factor Surveillance System data for uninsurance from 1992 to 2001 in 47 states. Results. Overall, uninsurance rates increased in 35 states and remained unchanged in 12 states. Increases were observed among people aged 30 to 49 years (in 34 states) and 50 to 64 years (in 24 states), and increases were also observed among individuals at middle and low income levels (in 39 states and 19 states, respectively), individuals employed for wages (in 33 states), and the self-employed (in 18 states). Conclusions. Among adults aged 18-64, rates of uninsurance increased in most states from 1992 through 2001. Decreased availability of employer-sponsored health insurance, rising health care costs, and state fiscal crises are likely to worsen the growing uninsurance problem.

Health behaviors vary from state to state, according to data collected by the Behavioral Risk Factor Surveillance System between 1991 and 2000. Safety belt use, mammographic screening, and influenza and pneumococcal vaccination of the elderly increased in most states. The results for other health behaviors were mixed, with increases occurring in some states and decreases occurring in others., Context Monitoring trends is essential for evaluating past activities and guiding current preventive health program and policy efforts. Although tracking progress toward national health goals is helpful, use of national estimates is limited because most preventive health care activities, policies, and other efforts occur at the state or community level. There may be important state trends that are obscured by national data. Objective To estimate state-specific trends for 5 health risk factors and 6 clinical preventive services. Design Telephone surveys were conducted from 1991 through 2000 as part of the Behavioral Risk Factor Surveillance System. Setting and Participants Randomly selected adults aged 18 years or older from 49 US states. Annual state sample sizes ranged from 1188 to 7543. Main Outcome Measures Statistically significant changes (P Results There were statistically significant increases in safety belt use for 39 of 47 states and receipt of mammography in the past 2 years for women aged 40 years or older for 43 of 47 states. For persons aged 65 years or older, there were increases in receipt of influenza vaccination for 44 of 49 states and ever receiving pneumococcal vaccination for 48 of 49 states. State trends were mixed for binge alcohol use (increasing in 19 of 47 states and declining in 3), physical inactivity (increasing in 3 of 48 states and declining in 11), and cholesterol screening (increasing in 13 of 47 states and decreasing in 5). Obesity increased in all states and smoking increased in 14 of 47 states (declining only in Minnesota). Cervical cancer screening increased in 8 of 48 states and colorectal cancer screening increased in 13 of 49 states. New York experienced improvements for 8 of 11 measures, while 7 of 11 measures improved in Delaware, Kentucky, and Maryland; in contrast, Alaska experienced improvements for no measu res and at least 4 of 11 measures worsened in Iowa, North Dakota, and South Dakota. Conclusions Most states experienced increases in safety belt use, mammography, and adult vaccinations. Trends for smoking and binge alcohol use are disturbing, and obesity data support previous findings. Trend data are useful for targeting state preventive health efforts.

Objectives. To assess the level of HIV-related risk behavior among the general US adult population, we analyzed data from the first sexual behavior questions available for states to use with the Behavioral Risk Factor Surveillance System. Methods. The Behavioral Risk Factor Surveillance System is a state-specific, population-based, random telephone survey. In 1997, 25 states collected sexual behavior data. Annual prevalence estimates for selected behaviors were calculated and examined by sociodemographic characteristics. The correlation between actual and perceived HIV risk also was determined. Results. Most (77.1%) of the respondents reported just 1 sexual partner in the past year; 26.0% reported using a condom at last intercourse. Males, persons who were younger, and Blacks were more likely to report 2 or more partners but also more likely to report using a condom at last intercourse. Only 4.1% of the respondents reported a risk factor for HIV infection; 7.7% reported that they were at medium or high risk for HIV. Actual and perceived HIV risk were positively associated. Conclusions. Most US adults do not engage in HIV-related risk behavior; those that do are more likely to report protective behavior. (Am J Public Health. 2001;91:1882-1888)

Objectives. Variations among states in household exposure to firearms, loaded firearms, and handguns were examined. Methods. Data from the Behavioral Risk Factor Surveillance System in 22 states were used to estimate the prevalence of adults and children exposed to household firearms. Results. The prevalence of adults living in households with firearms ranged from 12% to 57%; the corresponding ranges were 1% to 23% for loaded firearms and 5% to 36% for handguns. The prevalence of children less than 18 years of age living in households with loaded firearms ranged from 2% to 12%. Conclusions. Important variations among states exist in the prevalence of adults and children living in households with firearms, loaded firearms, and handguns. (Am J Public Health. 1998;88:969-972)

This article explores knowledge, attitudes, and behaviors regarding HIV/AIDS for persons aged 50-64 by using data from the 1996 Behavioral Risk Factor Surveillance System. It examines what percentage have been tested for HIV, where and why they have been tested, knowledge about condom effectiveness, and self-perceived risk. The purpose is twofold: First, it presents an epidemiologic analysis of HIV/AIDS-related attitudes and behaviors of adults aged 50-64; second, it explores whether theoretical models used on other groups fit well with this age group. The authors conclude that the conceptual model is less robust for this group and there is a substantial need for health promotion efforts directed at older adults. Key words: HIV/AIDS, Epidemiology, Disease prevention

Objectives. To describe characteristics of emergency department (ED) encounters for pediatric patients with an acute mental health diagnosis. Methods. Data are from the National Hospital Ambulatory Medical Care Survey, which includes abstracts from the medical records of a national probability sample of visits to EDs. Analysis was limited to records of patients who were younger than 19 years and had a diagnosis of either confirmed or suspected mental disorder or a suicide attempt. Results. There was an estimated annual average of 434 000 ED pediatric mental health visits from 1993 to 1999, an average annual rate of 326.8 visits per 10 000 people. Visit rates varied by patient's region, age, race, and gender. Psychosis was the diagnosis in 10.8% of these patients, and suicide attempt was the diagnosis in 13.6%. ED pediatric mental health visits accounted for 1.6% of all ED visits in this age group. Conclusions. The significant increase in emergency department pediatric mental health (EDPMH) visits from 1993-1999 is greatest among patients who are non-white, teenaged, female, and live in the Northeast or Midwest. This variation in EDPMH visits may reflect variability in the shortage of mental health providers. The lack of increase in the 2 categories of diagnoses mandatorily seen in EDs--psychoses and suicide attempts--suggests that the overall rise in EDPMH visits may have been attributable to nonurgent complaints more appropriately managed by a primary mental health provider. Pediatrics 2002;110(4). URL: http://www.pediatrics.org/cgi/content/ full/110/4/e40; emergency services, psychiatric, emergency medicine, mental disorders diagnosed in childhood, National Hospital Ambulatory Medical Care Survey.

Objectives. This study examined trends in fruit and vegetable consumption among adults in 16 US states. Method. Data from telephone surveys were used to stratify respondents by sociodemographic and health-related characteristics. Results. The proportion of adults who consumed fruits and vegetables at least 5 times daily was 19%, 22%, and 23% in 1990, 1994. and 1996, respectively. While the proportion increased among those with active leisure-time physical activities and normal weight. it remained almost the same among inactive people and dropped among the obese. Conclusions. Progress in fruit and vegetable intake from 1990 to 1994 was encouraging, but it changed little between 1994 and 1996. (Am d Public Health. 2000;90:777-781) [ABSTRACT FROM AUTHOR]