Preventing Chronic Disease: July 2010: 10_0010 / Measuring Health Behaviors in Populations

Volume 7: No. 4, July 2010

SPECIAL TOPIC
Measuring Health Behaviors in Populations

Ali H. Mokdad, PhD; Patrick L. Remington, MD, MPH
Suggested citation for this article: Mokdad AH, Remington PL. Measuring health behaviors in populations. Prev Chronic Dis 2010;7(4). http://www.cdc.gov/pcd/issues/2010/jul/10_0010.htm. Accessed [date].

PEER REVIEWED

Abstract
Health behaviors are a leading cause of illness and death in the United States. Efforts to improve public health require information on the prevalence of health behaviors in populations — not only to target programs to areas of most need but also to evaluate the effectiveness of intervention efforts. Telephone surveys, such as the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System, are a good way to assess health behaviors in populations. These data provide estimates at the national and state level but often require multiple years of data to provide reliable estimates at the local level. With changes in telephone use (eg, rapid decline in the ownership of landlines), innovative methods to collect data on health behaviors, such as in health care settings or through Internet-based surveys, need to be developed.


Introduction
Efforts to improve community health at the national, state, and local level require detailed and accurate information about the prevalence of health behaviors (1-3). If existing data collection systems are to remain viable, current approaches to measuring population health behaviors must be adapted. Potential solutions address the challenges of nonresponse, coverage, data quality, sample size, and costs.

McGinnis and Foege summarized the role of health behaviors as a leading cause of death and labeled them the “actual causes of death” (4). Later updated by Mokdad (5), these studies concluded that approximately half of all deaths in the United States could be attributed to factors such as smoking, physical inactivity, poor diet, and alcohol use (Table 1). Public health campaigns were established that educated the public about the need for healthy lifestyles and supported health-promoting programs and policies. These changes contributed to major declines in heart disease, stroke, and injury deaths (6).

Telephone surveys emerged as a feasible method to assess the prevalence of many health risk behaviors among populations (7). In 1984, the Centers for Disease Control and Prevention (CDC) implemented the first state-based surveillance system for health behaviors, the Behavioral Risk Factor Surveillance System (BRFSS) (8). BRFSS collects information on health risk behaviors associated with the leading causes of illness and death (9).

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Preventing Chronic Disease: July 2010: 10_0010