Medical Expenditure Panel Survey Agency for Healthcare 

Research and Quality

STATISTICAL BRIEF #165 

March 2007 

Personal Health Behaviors for Heart 

Disease Prevention among the U.S. 

Adult Civilian Noninstitutionalized 

Population, 2004 

Highlights 

 Overall, over 93 percent of 

adults are engaging in at 

least one of three recommended behaviors to prevent 

heart disease: not smoking, 

exercising regularly, and 

maintaining a healthy weight. 

 More than half (56.6 percent) 

of the U.S. adult population 

said that they engage in moderate to vigorous physical 

activity three times a week.

 More than three-fourths (78.8 

percent) of the U.S. adult 

population reported that they 

currently do not smoke. 

 A little over one-third (38.6 

percent) of the U.S. adult 

population reported maintaining a healthy weight by 

keeping their BMI under 25 

and thus are not considered 

overweight, or obese, according to the recommended 

guidelines.

 A higher percentage of men 

engaged in moderate to 

vigorous physical activity at 

least three times a week than

women (60.3 percent versus 

53.1 percent).

 Among those who were ever

told by a doctor that they had 

heart disease, more than 18 

percent (18.3) continued to 

smoke.

Anita Soni, PhD 

Introduction 

Heart disease is the leading cause of death for both men and 

women in the United States. Researchers have identified several 

risk factors that predispose individuals to developing heart disease. 

These factors include gender, heredity, age, physical inactivity, 

smoking, obesity and overweight, high blood pressure, high 

cholesterol, and diabetes. 

The American Heart Association guidelines recommend several 

prevention measures that can help prevent or delay the onset of 

heart disease. By following these guidelines, one can reduce the 

possibility of having heart disease. Some of these measures, like 

checking blood cholesterol and blood pressure, are part of having a 

routine medical checkup. Other measures—such as not smoking, 

engaging in physical exercise regularly, and maintaining healthy 

weight (body mass index [BMI] = <25)—are self-initiated measures

a person can take to reduce the risk of heart disease. 

This Statistical Brief looks at how the U.S. adult civilian 

noninstitutionalized population is incorporating these three selfinitiated measures of heart disease prevention into their lives. The 

smoking estimates are derived from the self-administered 

questionnaire used in the Household Component of the Medical 

Expenditure Panel Survey (MEPS-HC). Other estimates are derived 

from the core MEPS-HC questionnaire. All differences discussed in

the text are statistically significant at the 0.05 level or better. 

Findings 

About 12.0 percent (25.8 million) of the U.S. adult population were

told by a doctor that they had heart disease (see Definitions). 

More than half (56.6 percent) of the U.S. adult population said that they engage in moderate to vigorous 

physical activity three times a week (figure 1). Adults who were never told by a doctor that they had heart 

disease engaged in regular physical exercise more than those who were told by a doctor that they had 

indicators of heart disease (57.9 percent versus 46.3 percent). 
Over one-third (38.6 percent) of the U.S. adult population was found to have maintained a healthy weight 

(see Definitions), and not considered overweight, or obese. Among those who were ever told by a doctor 

that they had heart disease, 33.9 percent had a healthy weight as compared with 39.3 percent of those 

who were never told that they had heart disease. 

More than three-fourths (78.8 percent) of the U.S. adult population do not currently smoke. Among those 

who were ever told by a doctor that they had indictors of heart disease, more than 18 percent (18.3) 

continued to smoke. 

Overall, over 93 percent of adults are engaging in at least one of three recommended behaviors for 

preventing heart disease: not smoking, exercising regularly, and maintaining a healthy weight (figure 2). 

The majority of adults engage in one or two of the recommended preventive measures (75.5 percent). 

Only 18.0 percent engage in all three behaviors, and 6.5 percent are not taking any of the three 

recommended measures. 

The likelihood of adhering to the recommended behaviors to reduce the risk of developing heart disease 

varied according to a number of demographic characteristics. 

Age 

Engaging in moderate to vigorous regular physical activity at least three times a week was found to be 

strongly related to age. Younger ages (18 to 44) were more likely to engage in regular exercise more than 

those who were older (45 to 64 and 65 and older) (59.9 percent versus 55.3 percent and 48.5 percent, 

respectively) (figure 3). 

Similarly, age was correlated with maintaining a healthy weight. A higher percentage of those between 

the ages of 18 and 44 had a healthy weight as compared with those who were in the older age groups 45 

to 64 and 65 and older (43.7 percent versus 31.4 percent and 37.3 percent, respectively). 

Smoking behavior also varied substantially by age. The elderly (65 and older) were more likely than 

younger adults (18 to 44 and 45 to 64) to be current non-smokers (89.7 percent versus 76.1 percent and 

77.7 percent, respectively). 

Race/ethnicity 

Non-Hispanic whites were more likely to have engaged in moderate to vigorous physical activity at least 

three times a week as compared with Hispanics or non-Hispanic blacks (58.5 percent versus 51.4 percent 

and 52.5 percent, respectively) (figure 4). 

Non-Hispanic whites were more likely to have maintained a healthy weight than either Hispanics or nonHispanic blacks (39.8 percent versus 32.1 percent and 29.7 percent, respectively). 

Hispanics were more likely to be non-smokers (84.2 percent) compared with non-Hispanic whites and 

non-Hispanic blacks (77.8 percent and 76.3 percent, respectively). 

Sex 

Men were more likely to have engaged in moderate to vigorous physical activity at least three times a 

week than women (60.3 percent versus 53.1 percent) (figure 5). 

Women were more likely than men to have maintained a healthy weight (45.1 percent versus 31.7 

percent). 

More than 80 percent (81.7) of women did not currently smoke compared with 75.7 percent of men. 

Education level 

A higher percentage of adults with at least some college education engaged in moderate to vigorous 

physical activity at least three times a week compared with those who had only a high school or less than 

high school education (60.8 percent versus 55.3 percent and 48.3 percent, respectively) (figure 6). 

Higher education was found to be related to maintaining a healthy weight. A higher percentage of adults 

with at least some college had a healthy weight compared with those with up to a high school or less than 

a high school education (41.2 percent versus 36.2 percent and 36.1 percent, respectively). 
Education level was also found to be related to smoking. There was a higher percentage of non-smokers 

among those with a college education compared with those with a high school or less than a high school 

education (85.5 percent versus 73.8 percent and 69.9 percent, respectively). 

Data Source 

The estimates in this Statistical Brief were derived from MEPS 2004 Full Year Data File (HC-089). 

Estimates for BMI, physical activity, and smoking variables were drawn only from the persons with a

response in those questions. 

Definitions 

Heart disease 

The indicator for heart disease was drawn from questions pertaining to various forms of heart disease 

(coronary heart disease, angina, heart attack, stroke, or any other heart-related disease). For each of the 

conditions listed, the following question was asked: “(Have/Has) PERSON ever been told by a doctor or 

other health professional that PERSON had [condition]?” 

Racial and ethnic classifications 

Classification by race and ethnicity is based on information reported for each family member. 

Respondents were asked if each family member’s race was best described as American Indian, Alaska 

Native, Asian or Pacific Islander, black, white, or other. They also were asked if each family member’s 

main national origin or ancestry was Puerto Rican; Cuban; Mexican, Mexicano, Mexican American, or 

Chicano; other Latin American; or other Spanish. All persons whose main national origin or ancestry was 

reported in one of these Hispanic groups, regardless of racial background, were classified as Hispanic. 

Since the Hispanic grouping can include black Hispanic, white Hispanic, Asian and Pacific Islanders 

Hispanic, and other Hispanic, the race categories of black, white, Asian and Pacific Islanders, and other 

do not include Hispanic. MEPS respondents who reported other single or multiple races and were nonHispanic were included in the other category. 

Education level 

Respondents were asked to report the highest grade or schooling year ever completed by each family 

member as of the date of the interview: not a high school graduate (grade less than 12), high school 

graduate/GED/other (grade 12 equivalent), and at least some college. 

Healthy weight 

BMI = less than 25 

Body mass index (BMI) 

Body mass index is a measure of body fat based on height and weight that applies to both adult men and 

women. 

BMI categories 

– Underweight: BMI less than 18.5 

– Normal weight: BMI between 18.5 and 24.9 

– Overweight: BMI between 25.0 and 29.9 

– Obesity: BMI of 30.0 or greater 

– 

Age 

Adult = 18 and older as of the Round 2 or 4 interview date (AGE42X >= 18). 

Smoking 

Questions about smoking are asked annually in the MEPS adult self-administered questionnaire. 

This question asks the following: Do you currently smoke? Yes or No 

About MEPS-HC 

MEPS-HC is a nationally representative longitudinal survey that collects detailed information on health 

care utilization and expenditures, health insurance, and health status, as well as a wide variety of social, 
demographic, and economic characteristics for the civilian noninstitutionalized population. It is cosponsored by the Agency for Healthcare Research and Quality and the National Center for Health Statistics. 

For more information about MEPS, call the MEPS information coordinator at AHRQ (301-427-1656) or 

visit the MEPS Web site at http://www.meps.ahrq.gov/. 

References 

For a detailed description of the MEPS survey design, sample design, and methods used to minimize 

sources of nonsampling error, see the following publications: 

Cohen, J. Design and Methods of the Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 2. AHCPR Pub. No. 97-0027. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Design Strategies and Innovations in the Medical Expenditure Panel Survey. Medical Care,

July 2003: 41(7) Supplement: III-5–III-12. 

For information on heart disease, see the following: 

ABCs of Preventing Heart Disease, Stroke and Heart Attack, American Heart Association, Feb. 2007. 

Available at www.Americanheart.org 

Heart Disease—Facts and Statistics: U.S. Department of Health and Human Services, Centers for 

Disease Control and Prevention: Atlanta, Ga. 2006. Available at http://www.cdc.gov/heart. 

Disease/facts.htm 

Obesity Education initiative: Calculate your BMI (body mass Index). National Heart, Lung and Blood 

Institute, Bethesda, Md. Available at http://www.nhlbisupport.com/bmi/ 

Suggested Citation 

Soni, A. Personal Health Behaviors for Heart Disease Prevention among the U.S. Adult Civilian 

Noninstitutionalized Population, 2004. Statistical Brief #165. March 2007. Agency for Healthcare 

Research and Quality, Rockville, Md. http://www.meps.ahrq.gov/mepsweb/data_files/publications/ 

st165/stat165.pdf 

∗ ∗ ∗

AHRQ welcomes questions and comments from readers of this publication who are interested in 

obtaining more information about access, cost, use, financing, and quality of health care in the United 

States. We also invite you to tell us how you are using this Statistical Brief and other MEPS data and 

tools and to share suggestions on how MEPS products might be enhanced to further meet your needs. 

Please e-mail us at mepspd@ahrq.gov or send a letter to the address below: 

Steven B. Cohen, PhD, Director 

Center for Financing, Access, and Cost Trends 

Agency for Healthcare Research and Quality 

540 Gaither Road 

Rockville, MD 20850 
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey 2004

33.9

39.3

81.7 78.4

56.6

46.3

57.9

38.6

78.8

0

20

40

60

80

100

Total population With indicators of heart

disease

Without indicators of heart

disease

Physical activity 3x/wk BMI <25 Currently not smoking

Percent

Figure 1. Heart disease prevention measures among the U.S.

adult population, by presence of heart disease indicators, 2004

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey 2004

6.5%

18.0%

75.5%

One or two measures All three measures None

Figure 2. Percentage of the U.S. adult population 

with heart disease prevention measures, 2004

Statistical Brief #165: Personal Health Behaviors for Heart Disease Prevention among the U.S. Adult Civilian 

Noninstitutionalized Population, 2004 
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey 2004

31.4

37.3

89.7

48.5

55.3 59.9

43.7

77.7 76.1

0

20

40

60

80

100

18–44 45–64 65+

Physical activity 3x/wk BMI <25 Currently not smoking

Percent

Figure 3. Heart disease prevention measures 

among the U.S. adult population, by age, 2004

 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey 2004

39.8

29.7

54.2

77.8 76.3

83.7

52.5 53.2 58.5

51.4

32.1

84.2

0

20

40

60

80

100

Hispanic or Latino Non-Hispanic white Non-Hispanic black Other

Physical activity 3x/wk BMI <25 Currently not smoking

Percent

Figure 4. Heart prevention measures among the 

U.S. adult population, by race/ethnicity, 2004

Statistical Brief #165: Personal Health Behaviors for Heart Disease Prevention among the U.S. Adult Civilian 

Noninstitutionalized Population, 2004 
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey 2004

31.7

45.1

75.7

81.7

53.1

60.3

56.6

38.6

78.8

0

20

40

60

80

100

Total Male Female

Physical activity 3x/wk BMI <25 Currently not smoking

Percent

Figure 5. Heart disease prevention measures 

among the U.S. adult population, by sex, 2004

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey 2004

36.2

41.2

73.8

85.5

60.8

55.3

48.3

36.1

69.9

0

20

40

60

80

100

Less than high school High school completed At least some college

Physical activity 3x/wk BMI <25 Currently not smoking

Percent

Figure 6. Heart disease prevention measures among 

the U.S. adult population, by education level, 2004

Statistical Brief #165: Personal Health Behaviors for Heart Disease Prevention among the U.S. Adult Civilian 

Noninstitutionalized Population, 2004