Surveillance of certain health behaviors and conditions among states and selected local areas--Behavioral Risk Factor Surveillance System (BRFSS), United States, 2006.

PROBLEM Behavioral risk factors such as smoking, poor diet, physical inactivity, and excessive drinking are linked to the leading causes of death in the United States. Controlling these behavioral risk factors and using preventive health services (e.g., influenza vaccinations and cholesterol screenings) can reduce morbidity and mortality in the U.S. population substantially. Continuous monitoring both of health behaviors and of the use of preventive services is essential for developing health promotion activities, intervention programs, and health policies at the state, city, and county level. REPORTING PERIOD COVERED January--December 2006. DESCRIPTION OF THE SYSTEM The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing, state-based, random-digit--dialed telephone survey of the noninstitutionalized U.S. population aged >/=18 years. BRFSS collects data on health-risk behaviors and use of preventive health services related to the leading causes of death and disability in the United States. This report presents results for 2006 for all 50 states, DC, Puerto Rico, the U.S. Virgin Islands, 145 selected metropolitan and micropolitan statistical areas (MMSAs), and 234 corresponding counties. RESULTS Prevalence estimates of risk behaviors, chronic conditions, and the use of preventive services varied substantially by state and territory, MMSA, and county. In 2006, the estimated prevalence of fair or poor health ranged from 11% to 33% for states and territories, from 8% to 24% for MMSAs, and from 5% to 24% for counties. The estimated prevalence of health-care coverage ranged from 61% to 96% for states and territories, MMSAs, and counties. The estimated prevalence of teeth extraction among adults aged >/=65 years was lowest in Hawaii (10%) and highest in Kentucky (39%) and West Virginia (41%). The estimated prevalence of activity limitation as a result of physical, mental, or emotional problems ranged from 10% to 28% for states and territories, from 13% to 36% for MMSAs, and from 11% to 29% for counties. The estimated prevalence of adults who had a recent routine checkup ranged from 45% to 81% for states and territories, MMSAs, and counties. The estimated prevalence of annual influenza vaccination among adults aged >/=65 years was lowest in Puerto Rico (33%) and highest in Colorado (76%). The estimated prevalence of pneumococcal vaccination among older adults ranged from 30% to 75% for states and territories, from 52% to 80% for MMSAs, and from 42% to 82% for counties. The estimated prevalence of sigmoidoscopy/colonoscopy among adults aged >/=50 years ranged from 38% to 84% for states and territories, MMSAs, and counties. The estimated prevalence among adults aged >/=50 years who had a blood stool test during the preceding 2 years was lowest in Puerto Rico (5%) and highest in DC and Maine (33%). The estimated prevalence among women having a Papanicolaou (Pap) test during the preceding 3 years ranged from 72% to 89% for states and territories, from 75% to 94% for MMSAs, and from 75% to 95% in counties. The estimated prevalence among women aged >/=40 years having a mammogram during the preceding 2 years ranged from 60% to 89% for states and territories, MMSAs, and counties. The estimated prevalence among men aged >/=40 years who had a prostate-specific antigen (PSA) test during the preceding 2 years was lowest in Hawaii (40%) and highest in Puerto Rico (66%). The estimated prevalence of cigarette smoking ranged from 9% to 29% for states and territories and from 6% to 31% for MMSAs and counties. The estimated prevalence of binge drinking was lowest in Kentucky and Tennessee (9%) and highest in Wisconsin (24%). The estimated prevalence of leisure-time physical inactivity ranged from 11% to 41% for states and territories, MMSAs, and counties. Seat belt use was lowest in North and South Dakota (58%) and highest in California, Hawaii, and Washington (92%). The estimated prevalence among adults who were overweight ranged from 32% to 40% for states and territories, from 31% to 45% for MMSAs, and from 24% to 49% for counties. The estimated prevalence of obesity ranged from 10% to 46% for states and territories, MMSAs, and counties. The estimated current asthma prevalence ranged from 3% to 14% for states and territories, MMSAs, and counties. The estimated prevalence of diabetes ranged from 2% to 13% for states and territories, MMSAs, and counties. The estimated prevalence of coronary heart disease among adults aged >/=45 years ranged from 5% to 20% for states and territories. The estimated prevalence of a history of stroke history among adults aged >/=45 years ranged from 2% to 10% for states and territories, MMSAs, and counties. INTERPRETATION This report indicates that substantial variations in health-risk behaviors, chronic diseases and conditions, and the use of preventive health services exist among adults from state to state and within states and underscores the continued need for prevention and health promotion activities at the local, state, and federal levels. PUBLIC HEALTH ACTION Healthy People 2010 objectives have been established to monitor health behaviors and the use of preventive health services. Local and state health departments and federal agencies use BRFSS data to measure progress toward achieving national and local health objectives. Continued surveillance is needed to design, implement, and evaluate public health policies and programs that can lead to a reduction in morbidity and mortality from the effects of health-risk behaviors and subsequent chronic conditions.