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Surveillance of Certain Health Behaviors and Conditions Among States and Selected Local Areas --- Behavioral Risk Factor Surveillance System, United States, 2009

Chaoyang Li, MD, PhD

Lina S. Balluz, ScD

Catherine A. Okoro, MS

Tara W. Strine, PhD

Jin-Mann S. Lin, PhD

Machell Town, MS

William Garvin

Wilmon Murphy

William Bartoli

Balarami Valluru, MS

Division of Behavioral Surveillance, Public Health Surveillance Program Office, Office of Surveillance, Epidemiology, and Laboratory Services



Corresponding author: Lina Balluz, ScD, Division of Behavioral Surveillance, Public Health Surveillance Programs Office, Office of Surveillance, Epidemiology, and Laboratory Sciences, CDC. 1600 Clifton Road, N.E., MS E-97, Atlanta, GA 30333. Telephone: 404-498-0496; Fax: 404-498-0585; E-mail: lballuz@cdc.gov.


Abstract

Problem: Chronic diseases and conditions (e.g., heart disease, cancer, stroke, and diabetes) are the leading causes of death in the United States. Controlling health risk behaviors and conditions (e.g., smoking, physical inactivity, poor diet, excessive drinking, and obesity) and using preventive health-care services (e.g., physical examination, vaccination, screening for high blood pressure and high cholesterol, consumption of fruits and vegetables, and participation in regular leisure-time physical activity) can reduce morbidity and mortality from chronic diseases.

Reporting Period: January 2009--December 2009.

Description of the System: The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing state-based random-digit--dialed telephone survey of noninstitutionalized adults aged ≥18 years residing in the United States. BRFSS collects data on health risk behaviors and conditions, chronic diseases and conditions, access to health care, and use of preventative health services and practices related to the leading causes of death and disabilities in the United States. This report presents results for 2009 for all 50 states, the District of Columbia, the Commonwealth of Puerto Rico, Guam, the U.S. Virgin Islands, 180 metropolitan and micropolitan statistical areas (MMSAs), and 283 selected counties.

Results: In 2009, the estimated prevalence of general health status, use of preventive health-care services, health risk behaviors and conditions, chronic diseases, and health impairments and disabilities varied substantially by state and territory, MMSA, and county. The following is a summary of results listed by BRFSS question topics. Each set of proportions refers to the range of estimated prevalence for the disease, condition, or behavior, as reported by the survey respondent. Adults who reported having fair or poor health: 10.1%--30.9% for states and territories, 7.9%--25.8% for MMSAs, and 4.5%--26.1% for counties. Adults with health-care coverage: 71.4%--94.7% for states and territories, 52.7%--96.3% for MMSAs, and 52.7%--97.6% for counties. Annual routine physical checkup among adults aged ≥18 years: 55.8%--79.3% for states and territories, 51.8%--80.7% for MMSAs, and 49.2%--83.5% for counties. Annual influenza vaccination among adults aged ≥65 years: 26.8%--76.8% for states and territories, 55.4%--81.4% for MMSAs, and 50.5%--83.5% for counties. Pneumococcal vaccination among adults aged ≥65 years: 19.1%--73.9% for states and territories, 52.9%--81.3% for MMSAs, and 41.9%--82.0% for counties. Adults who had their cholesterol checked within the preceding 5 years: 67.5%--85.3% for states and territories, 58.2%--88.8% for MMSAs, and 58.2%--92.4% for counties. Adults who consumed at least five servings of fruits and vegetables per day: 14.6%--31.5% for states and territories, 12.6%--33.0% for MMSAs, and 13.4%--34.9% for counties. Adults who engaged in moderate or vigorous physical activity: 28.0%--60.7% for states and territories, 34.6%--64.9% for MMSAs, and 33.6%--67.3% for counties. Adults who engaged in only vigorous physical activity: 13.7%--40.1% for states and territories, 13.8%--43.3% for MMSAs, and 14.2%--50.0% for counties. Current cigarette smoking among adults: 6.4%--25.6% for states and territories, 5.7%--29.0% for MMSAs, and 5.6%--29.8% for counties. Binge drinking among adults: 6.8%--23.9% for states and territories, 3.5%--23.2% for MMSAs, and 3.4%--26.3% for counties. Heavy drinking among adults: 1.9%--8.1% for states and territories, 1.0%--11.1% for MMSAs, and 0.9%--11.1% for counties. Adults who reported no leisure-time physical activity: 15.8%--45.6% for states and territories, 13.3%--40.2% for MMSAs, and 10.5%--40.2% for counties. Adults aged ≥18 years who were overweight: 31.6%--38.7% for states and territories, 28.7%--44.1% for MMSAs, and 25.6%--46.7% for counties. Adults aged ≥20 years who were obese: 19.7%--36.0% for states and territories, 15.4%--43.6% for MMSAs, and 13.8%--45.7% for counties. Adults aged ≥18 years who did not get enough rest or sleep: 34.3%--52.6% for states and territories, 28.2%--54.8% for MMSAs, and 24.5%--55.6% for counties. Adults who had received a high blood pressure diagnosis: 22.1%--38.5% for states and territories, 18.8%--43.9% for MMSAs, and 17.2%--43.6% for counties. Adults who had a high blood cholesterol diagnosis: 24.9%--42.2% for states and territories, 27.5%--47.8% for MMSAs, and 26.7%--51.4% for counties. Adults who had received a diagnosis of coronary heart disease: 2.5%--10.3% for states and territories, 2.6%--11.6% for MMSAs, and 1.6%--12.3% for counties. Adults who had received a stroke diagnosis: 1.4%--3.9% for states and territories, 0.8%--5.9% for MMSAs, and 0.8%--6.6% for counties. Adults who had received a diabetes diagnosis: 5.8%--12.9% for states and territories, 2.8%--15.4% for MMSAs, and 2.8%--14.7% for counties. Adults who had received a cancer diagnosis: 3.0%--12.6% for states and territories, 5.8%--15.1% for MMSAs, and 3.9%--16.2% for counties. Adults who had asthma: 4.4%--11.1% for states and territories, and 3.2%--15.3% for MMSAs, and 3.2%--15.7% for counties. Adults who had arthritis: 10.7%--35.6% for states and territories, 16.2%--36.0% for MMSAs, and 12.6%--39.4% for counties. Adults with activity limitation associated with physical, mental, or emotional problems: 10.2%--27.1% for states and territories, 13.1%--33.7% for MMSAs, and 10.4%--36.1% for counties. Adults who required special equipment because of health problems: 3.6%--10.2% for states and territories, 3.4%--11.5% for MMSAs, and 1.7%--13.0% for counties.

Interpretation: The findings in this report indicate substantial variations in self-rated general health status, health-care coverage, use of preventive health-care services, health risk behaviors and health conditions, cardiovascular conditions, other chronic diseases, and health impairments and disabilities among U.S. adults at the state and territory, MMSA, and county levels. The findings show that Healthy People 2010 objectives had not been met in many areas by 2009, which underscores the continued need for surveillance of general health status, use of preventive health-care services, health risk behaviors and conditions, chronic diseases, and health impairment and disability.

Public Health Action: Data on health risk behaviors, chronic health conditions, preventive care practices, and chronic diseases are used to develop health promotion activities, intervention programs, and health policies at the state, city, and county levels.. The overarching goals of Healthy People 2010 are to increase quality and years of healthy life and to eliminate health disparities. Local and state health departments and federal agencies should continue to use BRFSS data to identify populations at high risk for certain health risk behaviors and conditions, cardiovascular conditions, and other chronic diseases and to evaluate the use of preventive health-care services. In addition, BRFSS data can be used to direct, implement, monitor, and evaluate public health programs and policies that can lead to a reduction in morbidity and mortality.

Introduction

Chronic diseases and conditions (e.g., heart disease, cancer, stroke, and diabetes) are the leading causes of morbidity and mortality in the United States (1,2). Engaging in healthy behaviors (e.g., reducing smoking, being more physically active, and eating a healthy and nutritious diet) and using preventive health-care services (e.g., screening for blood pressure, blood cholesterol, and cancer; and receiving recommended vaccinations) can reduce morbidity and premature mortality from chronic disease (3). The estimated prevalence of health behavior risk factors, chronic diseases and conditions, and use of preventive care services varies substantially across the United States (4,5).

Ongoing surveillance is essential to identify populations at the highest risk and to design and implement appropriate public health programs and policies.

Healthy People 2010 (HP 2010) set national objectives to prevent or delay diseases, decrease morbidity and mortality, and improve health-related quality of life for all U.S. residents (6). HP 2010 includes specific objectives that were to be achieved by 2010 for various modifiable risk factors and preventive health-care services. These objectives can be used to monitor and develop health promotion and disease prevention programs at the state and local levels. This report contains comparisons between 2009 BRFSS data and certain HP 2010 objectives.

Methods

The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing random-digit--dialed state-based telephone survey of noninstitutionalized adults aged ≥18 years that has been conducted since 1984 by state and territorial health departments with assistance from CDC. BRFSS is the largest continuously conducted telephone survey in the world with >400,000 adult interviews completed each year. BRFSS uses a multistage sampling design based on random-digit--dialing methods to select a representative sample from the noninstitutionalized adult population aged ≥18 years in each state and territory. Details on methodology, random sampling procedures, design, and reliability and validity of measures used in BRFSS have been described previously (2,7).

Since 2007, BRFSS has been conducted in all 50 states, the District of Columbia, the Commonwealth of Puerto Rico, Guam, and the U.S. Virgin Islands. BRFSS is the main source of data for states on health risk behaviors, chronic health conditions, and preventive health services primarily related to chronic disease and injury in the United States. BRFSS data are used to set health goals and to monitor progress and success of public health programs and policies at the national and state levels. Since 2002, the large sample size in BRFSS has facilitated calculation of prevalence estimates for selected metropolitan and micropolitan statistical areas (MMSAs), metropolitan divisions, and certain counties. This report provides comparable prevalence estimates for selected risk behaviors, preventive health-care services, and chronic conditions by states and territories, MMSAs, and counties.

Questionnaire

The standard BRFSS questionnaire consists of three parts: 1) core questions, 2) optional supplemental modules, which are sets of questions on specific topics; and 3) state-added questions. All 54 jurisdictions ask the same core questions. Optional modules and jurisdiction-added questions are included at the jurisdiction's discretion to address specific health-care concerns. The core questions address demographics, general health status, number of healthy days, health-related quality of life, health-care access, exercise or leisure-time physical activity, prevalence of cardiovascular diseases, high blood pressure, cholesterol awareness, diabetes, cancer, arthritis, asthma, disabilities, immunization including flu and pneumonia vaccination among older adults, tobacco/cigarette use, alcohol consumption, fruit and vegetable consumption, moderate and vigorous physical activity, sleep habits, caregiver status, being tested for human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), and emotional support and life satisfaction.

In 2009, the following optional modules were included in BRFSS: prediabetes (35 states), diabetes (38 states), visual impairment (three states), inadequate sleep (six states), cardiovascular health (14 states), actions to control high blood pressure (19 states), heart attack and stroke (19 states), women's health (four states), prostate cancer screening (two states), colorectal cancer screening (two states), cancer survivorship (four states), adult asthma history (two states), arthritis management (eight states), tetanus diphtheria (five states), adult human papilloma virus (two states), shingles vaccination (five states), general preparedness (one state), reaction to race (two states), mental illness and stigma (eight states), carbon monoxide detectors and gas-powered generators (one state), social context (eight states), adverse childhood experience (two states), random child selection (35 states), childhood asthma prevalence (31 states), childhood immunization (nine states), child human papilloma virus vaccination (five states), and tetanus diphtheria vaccination (adolescents) (five states). Details about the contents for the modules can be found in the 2009 BRFSS questionnaire.

To address the most significant and common public health issues closely related to the HP 2010 objectives and sustain consistency with previous reports, this report focuses on 1) health status indicators (self-rated fair or poor health and health-care coverage), 2) preventive health-care practices (recent routine physical checkup, influenza and pneumococcal vaccinations for persons aged ≥65 years, blood cholesterol checking in the preceding 5 years, consumption of at least five servings of vegetables and fruits per day, and participation in moderate or vigorous leisure-time physical activity), 3) health risk behaviors and health conditions (current cigarette smoking, binge and heavy drinking, no leisure-time physical activity participation, overweight, obesity, and insufficient rest or sleep), 4) cardiovascular conditions (high blood pressure, high cholesterol, coronary heart disease including heart attack, angina, and stroke), 5) other chronic diseases (diabetes, cancer, current asthma, and arthritis), and 6) health impairments and disabilities (activity limitation because of physical, mental, or emotional health problems, and use of special equipment [e.g., a cane, wheelchair, special bed, or special telephone] because of health problems). The 2009 and all other BRFSS questionnaires are available at http://www.cdc.gov/brfss/questionnaires/pdf-ques/2009brfss.pdf.

Data Collection, Processing, and Cooperation Rate

Trained interviewers administer the BRFSS questionnaire using a computer-assisted telephone interviewing system. Data are collected monthly by each state and territory. After the monthly interviewing cycle concludes, data are submitted to CDC for editing, processing, weighting, reliability checks, and analysis. According to the guidelines of the Council of American Survey and Research Organizations (CASRO), the 2009 BRFSS cooperation rate (defined as the proportion of all respondents interviewed of all eligible units in which a respondent was selected and actually contacted) ranged from 55.0% in California to 88.0% in Kentucky (median: 75.0%), and the 2009 BRFSS response rate ranged from 37.9% in Oregon to 66.9% in Nebraska (median: 52.5%) (8).

Data Weighting and Statistical Analysis

At the end of the survey year, CDC edits and aggregates the monthly data files to create a yearly sample for each state and territory. Each sample is weighted to the respondent's probability of selection and the age- and sex-specific population or the age-, sex-, and race/ethnicity-specific population by using the 2009 postcensus projections for each state. MMSA- and county-level weights are produced beginning with the design weights for a given geographic area. These sampling weights are used to calculate BRFSS prevalence estimates at the state, territory, MMSA, and county levels. MMSAs used in this report were defined by the Office of Management and Budget in December 2008. Respondents were assigned to a particular MMSA on the basis of their American National Standards Institute (ANSI) county code. Aggregated data from states were used to produce nationwide prevalence estimates. Detailed weighting and analytic methodologies have been documented previously (2,8).

SAS and SUDAAN (release 9.0.1; Research Triangle Institute, Research Triangle Park, North Carolina) were used in the analyses to account for the complex sampling design and to calculate prevalence estimates, standard errors, and 95% confidence intervals (CIs) (9,10). Statistics were not reported if the unweighted sample size for the denominator was <50 or the CI half width was >10. MMSAs were included only if they had ≥500 respondents and ≥19 respondents in all the final weighting classes and counties. Within each MMSA or county, weighting classes were based on age and sex cross-classification totals or age, sex, and race cross-classification totals. Responses coded as "do not know" or "refused" were excluded from the analyses.

Results

This report presents results for 2009 from the 54 states and territories, 180 MMSAs, and 283 counties participating in BRFSS that had adequate sample sizes to produce stable prevalence estimates. In 2009, a total of 432,607 interviews were completed and ranged from 1,266 in Guam to20,294 in Washington (median: 6,736). In each section below, "estimated overall prevalence" refers to the state/territorial level; MMSA and county levels are specified separately. This report presents prevalence of general health status, access to health care, use of preventive health-care services, health risk behaviors and health conditions, cardiovascular conditions, other selected chronic diseases, and health impairments and disabilities.

Health Status Indicators

Health Status

Respondents were asked to rate their general health as excellent, very good, good, fair, or poor. Respondents were classified into two groups: those who rated their health as being fair or poor and those who rated it as good, very good, or excellent. In 2009, among adults aged ≥18 years, the estimated overall prevalence of self-rated fair or poor health ranged from 10.1% in Minnesota to 30.9% in Puerto Rico (median: 14.6%) (Table 1). Among selected MMSAs, the estimated prevalence of self-rated fair or poor health among respondents ranged from 7.9% in Fort Collins--Loveland, Colorado to 25.8% in Charleston, West Virginia (median: 14.1%) (Table 2). Among selected counties, the estimated prevalence of self-rated fair or poor health among respondents ranged from 4.5% in Douglas County, Colorado, to 26.1% in Fayette County, Pennsylvania (median: 13.6%) (Table 3).

Health-Care Coverage

Health-care coverage was defined as having any kind of health-care coverage, including health insurance, prepaid plans (e.g., health maintenance organizations), or government plans (e.g., Medicare or Medicaid). In 2009, among adults aged ≥18 years, the estimated overall prevalence of adults who had health-care coverage ranged from 71.4% in the U.S. Virgin Islands to 94.7% in Massachusetts (median: 85.3%) (Table 4). Among selected MMSAs, the estimated prevalence ranged from 52.7% in McAllen--Edinburg--Mission, Texas, to 96.3% in Cambridge--Newton--Framingham, Massachusetts (median: 86.3%) (Table 5). Among selected counties, the estimated prevalence ranged from 52.7% in Hidalgo County, Texas to 97.6% in Norfolk County, Massachusetts (median: 87.5%) (Table 6).

Preventive Practices

Recent Routine Physical Checkup

A routine physical checkup is defined as a general physical examination, not an examination for a specific injury, illness, or condition. Respondents were classified as having a recent routine physical checkup if they reported visiting a doctor for a routine physical checkup during the preceding 12 months. In 2009, the estimated prevalence of adults aged ≥18 years who had a recent routine physical checkup ranged from 55.8% in Oklahoma to 79.3% in Delaware (median: 68.3%) (Table 7). Among selected MMSAs, the estimated proportion ranged from 51.8% in Provo--Orem, Utah, to 80.7% in Seaford, Delaware (median: 68.2%) (Table 8). Among selected counties, the estimated proportion ranged from 49.2% in Madison County, Nebraska to 83.5% in Union County, New Jersey (median: 69.1%) (Table 9).

Influenza Vaccination

In 2009, the estimated overall prevalence of influenza vaccination during the preceding 12 months among adults aged ≥65 years ranged from 26.8% in Puerto Rico to 76.8% in Minnesota (median: 69.8%) (Table 10). Among selected MMSAs, the estimated prevalence ranged from 55.4% in Idaho Falls, Idaho, to 81.4% in Durham, North Carolina (median: 70.3%) (Table 11). Among selected counties, the estimated prevalence ranged from 50.5% in Hudson County, New Jersey, to 83.5% in Monroe County, New York (median: 71.3%) (Table 12).

Pneumococcal Vaccination

In 2009, the estimated overall prevalence of pneumococcal vaccination among adults aged ≥65 years ranged from 19.1% in Guam to 73.9% in Colorado (median: 68.1%) (Table 13). Among selected MMSAs, the estimated prevalence ranged from 52.9% in Idaho Falls, Idaho, to 81.3% in Casper, Wyoming (median: 69.5%) (Table 14). Among selected counties, the estimated prevalence ranged from 41.9% in Hudson County, New Jersey, to 82.0% in Stone County, Mississippi (median: 69.9%) (Table 15).

Blood Cholesterol Checked During Preceding 5 Years

In 2009, the estimated overall prevalence among adults aged ≥18 years of having blood cholesterol checked during the preceding 5 years ranged from 67.5% in Utah to 85.3% in the District of Columbia (median: 77.0%) (Table 16). Among selected MMSAs, the estimated prevalence ranged from 58.2% in McAllen--Edinburg--Mission, Texas, to 88.8% in Miami--Fort Lauderdale--Pompano Beach, Florida (median: 78.2%) (Table 17). Among selected counties, the estimated prevalence ranged from 58.2% in Hidalgo County, Texas, to 92.4% in Westchester County, New York (median: 79.0%) (Table 18).

Nutrition

In 2009, the estimated overall prevalence among adults aged ≥18 years of consuming at least five servings of fruits or vegetables per day ranged from 14.6% in Oklahoma to 31.5% in the District of Columbia (median: 23.5%) (Table 19). Among selected MMSAs, the estimated prevalence ranged from 12.6% in Sioux Falls, South Dakota, to 33.0% in Concord, New Hampshire (median: 23.8%) (Table 20). Among selected counties, the estimated prevalence ranged from 13.4% in Minnehaha County, South Dakota, to 34.9% in Travis County, Texas (median: 24.0%) (Table 21).

Physical Activity

Moderate or vigorous physical activity was defined as participating in moderate exercise (e.g., brisk walking, bicycling, vacuuming, gardening, or anything else that causes a small increase in breathing and heart rate on at least 5 days per week for at least 30 minutes each day) or vigorous exercise (e.g., running, aerobics, heavy yard work, or anything else that causes a large increase in breathing and heart rate on ≥3 days per week for at least 20 minutes each day) other than the respondent's regular work in a usual week. In 2009, the estimated overall prevalence of moderate or vigorous physical activity among adults aged ≥18 years ranged from 28.0% in Puerto Rico to 60.7% in Alaska (median: 50.7%) (Table 22). Among selected MMSAs, the estimated prevalence ranged from 34.6% in Charleston, West Virginia, to 64.9% in Barre, Vermont (median: 50.7%) (Table 23). Among selected counties, the estimated prevalence ranged from 33.6% in Harrison County, Mississippi, to 67.3% in Summit County, Utah (median: 50.9%) (Table 24).

In 2009, the estimated overall prevalence of vigorous physical activity among adults aged ≥18 years ranged from 13.7% in Puerto Rico to 40.1% in Alaska (median: 29.3%) (Table 25). Among selected MMSAs, the estimated prevalence ranged from 13.8% in Charleston, West Virginia, to 43.3% in Bozeman, Montana (median: 29.7%) (Table 26). Among selected counties, the estimated prevalence of vigorous physical activity ranged from 14.2% in Sullivan County, Tennessee, to 50.0% in Summit County, Utah (median: 29.5%) (Table 27).

Health Risk Behaviors and Conditions

Current Cigarette Smoking

Respondents were categorized as current smokers if they reported having smoked at least 100 cigarettes during their lifetime and indicated that they smoked every day or occasionally at the time of the survey. In 2009, the estimated overall prevalence of current smokers among adults aged ≥18 years ranged from 6.4% in the U.S. Virgin Islands to 25.6% in both Kentucky and West Virginia (median: 17.9%) (Table 28). Among selected MMSAs, the estimated prevalence ranged from 5.7% in Provo--Orem, Utah, to 29.0% in Myrtle Beach--North Myrtle Beach--Conway, South Carolina (median: 17.4%) (Table 29). Among selected counties, the estimated prevalence ranged from 5.6% in Utah County, Utah, to 29.8% in Vanderburgh County, Indiana (median: 16.9%) (Table 30).

Binge Drinking

Binge drinking was defined as adult men having five or more drinks and adult women having four or more drinks on at least one occasion during the last 30 days. In 2009, the estimated overall prevalence of binge drinking among adults aged ≥18 years ranged from 6.8% in Tennessee to 23.9% in Wisconsin (median: 15.5%) (Table 31). Among selected MMSAs, the estimated prevalence of binge drinking ranged from 3.5% in Provo--Orem, Utah, to 23.2% in Butte--Silver Bow, Montana (median: 15.5%) (Table 32). Among selected counties, the estimated prevalence ranged from 3.4% in Utah County Utah, to 26.3% in Macomb County, Michigan (median: 15.5%) (Table 33).

Heavy Drinking

Heavy drinking was defined as adult men having more than two drinks and adult women having more than one drink per day during the last 30 days. In 2009, the estimated overall prevalence of heavy drinking among adults aged ≥18 years ranged from 1.9% in Tennessee to 8.1% in Vermont (median: 5.1%) (Table 34). Among selected MMSAs, the estimated prevalence of heavy drinking ranged from 1.0% in Provo--Orem, Utah, to 11.1% in Kapaa, Hawaii (median: 5.1%) (Table 35). Among selected counties, the estimated prevalence ranged from 0.9% in Utah County, Utah, to 11.1% in Kauai County, Hawaii (median: 5.1%) (Table 36).

No Leisure-Time Physical Activity

No leisure-time physical activity was defined by the respondent's indication of no participation in exercise (e.g., running, calisthenics, golf, gardening, or walking for exercise) other than their regular job during the preceding month. In 2009, the estimated overall prevalence of no leisure-time physical activity among adults aged ≥18 years ranged from 15.8% in Minnesota to 45.6% in Puerto Rico (median: 24.2%) (Table 37). Among selected MMSAs, the estimated prevalence ranged from 13.3% in Provo--Orem, Utah, to 40.2% in McAllen--Edinburg--Mission, Texas (median: 23.4%) (Table 38). Among selected counties, the estimated prevalence ranged from 10.5% in Douglas County, Colorado, to 40.2% in Hidalgo County, Texas (median: 22.6%) (Table 39).

Overweight

Self-reported weight and height were used to calculate body mass index (BMI) (weight [kg]/height [m2]). Respondents were categorized as being overweight if their BMI was ≥25.0 kg/m2 but <30.0 kg/m2. In 2009, the estimated overall prevalence of overweight among adults aged ≥18 years ranged from 31.6% in the District of Columbia to 38.7% in Iowa (median: 36.2%) (Table 40). Among selected MMSAs, the estimated prevalence ranged from 28.7% in both Chattanooga, Tennessee--Georgia and Lake Charles, Louisiana, to 44.1% in Hilton Head Island--Beaufort, South Carolina (median: 36.7%) (Table 41). Among selected counties, the estimated prevalence ranged from 25.6% in Orange County, North Carolina, to 46.7% in Henderson County, North Carolina (median: 36.7%) (Table 42).

Obesity

Respondents were categorized as being obese if their BMI was ≥30.0 kg/m2. Obesity analyses were restricted to adults aged ≥20 years to permit comparison with the HP 2010 objective (objective no. 19.2) (6). In 2009, the estimated overall prevalence of obesity among adults aged ≥20 years ranged from 19.7% in Colorado to 36.0% in Mississippi (median: 28.0%) (Table 43). Among selected MMSAs, the estimated prevalence ranged from 15.4% in Bozeman, Montana, to 43.6% in Houma--Bayou Cane--Thibodaux, Louisiana (median: 27.9%) (Table 44). Among selected counties, the estimated prevalence ranged from 13.8% in Douglas County, Colorado, to 45.7% in Terrebonne Parish, Louisiana (median: 27.3%) (Table 45).

Insufficient Rest or Sleep

Insufficient rest or sleep was defined by the respondent's indication of not getting enough rest or sleep for at least 14 days during the preceding month. In 2009, the estimated overall prevalence of insufficient rest or sleep among adults aged ≥18 years ranged from 34.3% in Virgin Islands to 52.6% in West Virginia (median: 39.3%) (Table 46). Among selected MMSAs, the estimated prevalence ranged from 28.2% in Dallas--Plano--Irving, Texas, to 54.8% in Huntington--Ashland, West Virginia--Kentucky--Ohio (median: 39.5%) (Table 47). Among selected counties, the estimated prevalence ranged from 24.5% in Douglas County, Washington, to 55.6% in Cumberland County, North Carolina (median: 39.3%) (Table 48).

Cardiovascular Conditions

High Blood Pressure

Prevalence of high blood pressure was assessed by asking respondents aged ≥20 years if they had ever been told by a doctor, nurse, or other health professional that they had high blood pressure. Adults who reported having prehypertension or borderline high blood pressure and women who reported having high blood pressure during pregnancy were not considered hypertensive for these analyses. In 2009, the estimated overall prevalence of high blood pressure ranged from 22.1% in Minnesota to 38.5% in Mississippi (median: 29.6%) (Table 49). Among selected MMSAs, the estimated prevalence ranged from 18.8% in Greeley, Colorado to 43.9% in Alexandria, Louisiana (median: 29.4%) (Table 50). Among selected counties, the estimated prevalence ranged from 17.2% in Riley County, Kansas, to 43.6% in Rapides Parish, Louisiana (median: 29.1%) (Table 51).

High Blood Cholesterol

Respondents aged ≥20 years were categorized as having high blood cholesterol if they ever had their blood cholesterol checked and were told by a doctor, nurse, or other health-care professional that their blood cholesterol was high. In 2009, the estimated overall prevalence of high blood cholesterol ranged from 24.9% in Guam to 42.2% in South Carolina (median: 38.1%) (Table 52). Among selected MMSAs, the estimated prevalence of high blood cholesterol ranged from 27.5% in Gallup, New Mexico, to 47.8% in Gulfport--Biloxi, Mississippi (median: 38.2%) (Table 53). Among selected counties, the estimated prevalence ranged from 26.7% in Hampshire County, Massachusetts, to 51.4% in Hancock County, Mississippi (median: 37.7%) (Table 54).

Coronary Heart Disease

Respondents aged ≥18 years were categorized as having coronary heart disease if they reported having ever been told by a doctor, nurse, or other health professional that they had coronary heart disease, angina, or a heart attack. In 2009, the estimated overall prevalence of coronary heart disease ranged from 2.5% in the U.S. Virgin Islands to 10.3% in West Virginia (median: 5.9%) (Table 55). Among selected MMSAs, the estimated prevalence ranged from 2.6% in Provo--Orem, Utah, to 11.6% in Huntington--Ashland, West Virginia--Kentucky--Ohio (median: 6.3%) (Table 56). Among selected counties, the estimated prevalence ranged from 1.6% in Summit County, Utah, to 12.3% in Westmoreland County, Pennsylvania (median: 5.5%) (Table 57).

Stroke

Respondents aged ≥18 years were categorized as having a history of stroke if they reported having ever been told by a doctor, nurse, or other health professional that they had a stroke. In 2009, among adults aged ≥18 years, the estimated overall prevalence of stroke ranged from 1.4% in Colorado to 3.9% in both Alabama and Oklahoma (median: 2.4%) (Table 58). Among selected MMSAs, the estimated prevalence of stroke ranged from 0.8% in Heber, Utah, to 5.9% in Gulfport--Biloxi, Mississippi (median: 2.3%) (Table 59). Among selected counties, the estimated prevalence ranged from 0.8% in both Adams County, Colorado, and Wasatch County, Utah, to 6.6% in Harrison County, Mississippi (median: 2.3%) (Table 60).

Chronic Illness and Disabilities

Diabetes

The prevalence of diagnosed diabetes was assessed by asking respondents if they had ever been told by a doctor that they had diabetes. Those who answered in the affirmative were considered to have diabetes. Specific types of diabetes (e.g., Type 1 or Type 2) were not assessed. Adults reporting gestational, borderline, or prediabetes were not considered to have diabetes for these analyses. In 2009, the estimated overall prevalence of diagnosed diabetes among adults aged ≥18 years ranged from 5.8% in Alaska to 12.9% in Puerto Rico (median: 8.4%) (Table 61). Among selected MMSAs, the estimated prevalence ranged from 2.8% in Bozeman, Montana, to 15.4% in Kingsport--Bristol--Bristol, Tennessee--Virginia (median: 8.2%) (Table 62). Among selected counties, the estimated prevalence ranged from 2.8% in Gallatin County, Montana, to 14.7% in Sullivan County, Tennessee (median: 8.3%) (Table 63).

Cancer

The prevalence of cancer was assessed by asking respondents if they had ever been told by a doctor, nurse, or other health professional that they had cancer. Those who answered in the affirmative were considered to have had cancer. Specific sites and types of cancer also were assessed but are not reported in this summary because of limited space. In 2009, the estimated overall prevalence of cancer among adults aged ≥18 years ranged from 3.0% in Guam to 12.6% in Oregon (median: 9.9%) (Table 64). Among selected MMSAs, the estimated prevalence ranged from 5.8% in Gallup, New Mexico, to 15.1% in Asheville, North Carolina (median: 9.7%) (Table 65). Among selected counties, the estimated prevalence ranged from 3.9% in Clayton County, Georgia, to 16.2% in Buncombe County, North Carolina (median: 9.6%) (Table 66).

Current Asthma

Respondents aged ≥18 years were categorized as currently having asthma if they reported having ever been told by a doctor, nurse, or other health-care professional that they had asthma and still had it during the survey. In 2009, the estimated overall prevalence of current asthma ranged from 4.4% in the U.S. Virgin Islands to 11.1% in Oregon (median: 8.8%) (Table 67). Among selected MMSAs, the estimated prevalence ranged from 3.2% in McAllen--Edinburg--Mission, Texas, to 15.3% in Rochester, New York (median: 8.5%) (Table 68). Among selected counties, the estimated prevalence ranged from 3.2% in Hidalgo County, Texas, to 15.7% in Monroe County, New York (median: 8.2%) (Table 69).

Arthritis

Respondents aged ≥18 years were categorized as having arthritis if they reported having ever been told by a doctor that they had some form of arthritis. Arthritis diagnoses included rheumatism and polymyalgia rheumatica; osteoarthritis (not osteoporosis); tendonitis, bursitis, bunion, and tennis elbow; carpal tunnel syndrome and tarsal tunnel syndrome; joint infection and Reiter's syndrome; ankylosing spondylitis; spondylosis; rotator cuff syndrome; connective tissue disease; scleroderma; and polymyositis, Raynaud's syndrome, or vasculitis (giant cell arteritis, Henoch-Schonlein purpura, Wegener's granulomatosis, and polyarteritis nodosa). In 2009, the estimated overall prevalence of arthritis ranged from 10.7% in Guam to 35.6% in Kentucky (median: 25.9%) (Table 70). Among selected MMSAs, the estimated prevalence of arthritis ranged from 16.2% in Gallup, New Mexico; Lawrence, Kansas; and Provo--Orem, Utah, to 36.0% in Butte--Silver Bow, Montana (median: 25.8%) (Table 71). Among selected counties, the estimated prevalence ranged from 12.6% in Cobb County, Georgia, to 39.4% in Harrison County, Mississippi (median: 25.5%) (Table 72).

Activity Limitation

Respondents aged ≥18 years were categorized as having activity limitation if they reported any limitation of activities because of physical, mental, or emotional problems. In 2009, the estimated overall prevalence of limitations in activities because of physical, mental, or emotional problems ranged from 10.2% in the U.S. Virgin Islands to 27.1% in West Virginia (median: 18.7%) (Table 73). Among selected MMSAs, the estimated prevalence ranged from 13.1% in Santa Ana--Anaheim--Irvine, California, to 33.7% in Gulfport--Biloxi, Mississippi (median: 18.6%) (Table 74). Among selected counties, the estimated prevalence ranged from 10.4% in Sarpy County, Nebraska, to 36.1% in Harrison County, Mississippi (median: 18.5%) (Table 75).

Special Equipment Requirement

Respondents aged ≥18 years were categorized as using special equipment because of a health problem if they used a cane, wheelchair, special bed, or special telephone occasionally or in certain circumstances. In 2009, the estimated overall prevalence who persons who reported requiring special equipment because of a health problem ranged from 3.6% in the U.S. Virgin Islands to 10.2% in both Alabama and West Virginia (median: 7.0%) (Table 76). Among selected MMSAs, the estimated prevalence ranged from 3.4% in Heber, Utah, to 11.5% in both Gulfport--Biloxi, Mississippi and Huntington--Ashland, West Virginia--Kentucky--Ohio (median: 6.9%) (Table 77). Among selected counties, the estimated prevalence ranged from 1.7% in Summit County, Utah to 13.0% in both Baltimore City, Maryland, and George County, Mississippi (median: 6.7%) (Table 78).

Comparisons between the selected HP 2010 objectives and estimated prevalence ranges by states/territories, MMSAs, and counties in 2009 BRFSS have been provided (Table 79).The results indicated that certain HP 2010 goals have not been achieved in some states, territories, and local areas.

Discussion

The findings in this report indicate that substantial variations exist in the estimated prevalence of health status, health-care coverage, use of preventative health practices and services, health risk behaviors and conditions, cardiovascular conditions, other chronic diseases, and health impairments and disabilities among U.S. adults at the state and territory, MMSA, and county levels. These variations might reflect differences in the demographic factors of respondents, including age, race, and sex distribution of the population; socioeconomic conditions including education level attained, income level and employment status; state laws and local ordinances; availability and access to health-care services; use of preventive health-care services; and patterns of reimbursement for preventive health-care services.

HP 2010 established targets for certain health indicators and health behaviors to be attained by 2010 (6). The findings provided in this report indicate that as of 2009, certain HP 2010 goals had not been attained. For example, in 2009, no state and territory, MMSA, or county achieved the HP 2010 objectives for health-care coverage, vaccination against influenza, high blood pressure, or high blood cholesterol.

Health Status Indicators

Health Status

Self-rated general health status encompasses physical health, mental health, and functional capacity of persons (11) and is a proxy indicator for perceived burden of acute and chronic health conditions (12). Substantial variations in fair or poor health at the state and local level suggest differences in the underlying burden of chronic diseases, health-care coverage, and health behaviors among states and territories, MMSAs, and counties.

Health-Care Coverage

The HP 2010 objective for health-care coverage is 100% (6). Lack of health-care coverage might have an adverse impact on health because it is associated with access to and use of preventive health-care services that include blood pressure, cholesterol, and cancer screenings (e.g., mammography, and Pap test) (13). In 2009, no state and territory, MMSA, or county achieved the HP 2010 objective of 100% health-care coverage.

Preventive Practices

The risks for complications, hospitalizations, and deaths from influenza and pneumonia are highest among persons aged ≥65 years (14,15). Influenza and pneumonia vaccination among older adults (aged ≥65 years) is a key public health strategy in the United States (16). The HP 2010 target for adults aged ≥65 years who had annual influenza vaccination is 90% (objective no. 14.29a), and the HP 2010 target for adults aged ≥65 years who had annual vaccination against pneumococcal disease is 90% (objective no. 14.29b) (6). In 2009, no state and territory or county met the HP 2010 target of 90% (6). The reasons for inadequate coverage include lack of knowledge, misconceptions about vaccines and vaccine-associated illness, and lack of recommendations by physicians (17,18). The strategies offered by the Task Force on Community Preventive Services to improve immunization among adults can be employed at the state and local levels (19).

Health Risk Behaviors and Conditions

Consumption of Fruits and Vegetables

Consuming adequate fruits and vegetables can help maintain healthy weight and reduce the risk for cardiovascular conditions and certain cancers (20,21). The 2005 Dietary Guidelines for Americans (20) recommended that U.S. residents consume five to 13 servings of fruits and vegetables per day. BRFSS uses five servings as a measure of fruit or vegetable daily consumption. In 2009, the prevalence of daily consumption of five or more servings of fruit or vegetables ranged from 14.6% to 31.5% across states and territories, indicating a need to increase public awareness of the overall benefits of consuming fruits and vegetables. In addition, sustained and effective public health efforts are needed to promote the importance of eating more fruits and vegetables (22).

Physical Activity

HP 2010 goals are to increase prevalence of moderate physical activity to 50% (objective no. 22.2) and vigorous physical activity to 30% (objective no. 22.3) (6). Despite the proven benefit of physical activity (23), prevalence of moderate and vigorous physical activity is still low. In 2009, approximately half of states and territories, MMSAs, and counties had not met the HP 2010 goal for moderate or vigorous physical activity. Recommended strategies to increase physical activity include communitywide campaigns, signage to encourage stair use near elevators and escalators, individually adapted health-behavior change programs, school physical education, social support interventions in community settings, and the creation of or enhanced access to places for physical activity combined with informational outreach activities (24). According to the 2008 Physical Activity Guidelines for Americans, in addition to conducting muscle strengthening activities on ≥2 days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms), adults should do at least 2 hours and 30 minutes of moderate aerobic exercise (i.e., brisk walking) every week or 1 hour and 15 minutes of vigorous aerobic exercise (i.e., jogging or running) every week (25).

Cigarette Smoking

Cigarette smoking remains the most preventable cause of morbidity, disability, and mortality in the United States (26). Smoking causes many types of cancer, cardiovascular, and pulmonary diseases (27). Health consequences of breathing secondhand smoke include pediatric respiratory problems, cardiovascular disease, and lung cancer in adults (28). Only three states and territories, 15 MMSAs, and 36 counties met the HP 2010 target for smoking (12%) (6). In addition to recent legislation (i.e., Family Smoking Prevention and Tobacco Control Act [Public Law 111-31]) at the national level, these results indicate a need for continued implementation of comprehensive tobacco-control programs at the state and local levels. Such programs have been described previously (29).

Binge Drinking

Excessive alcohol consumption is a leading preventable cause of death in the United States (30,31). Binge and heavy drinking can lead to risky sexual activity, unintentional injuries and accidents, falls, violence, and suicide (32,33). The HP 2010 target is to reduce binge drinking to 13.4% (objective no. 26.11) (6). Only 17 states and territories, 50 MMSAs, and 75 counties met the national target for binge drinking. Compared with other adverse health behaviors (e.g., smoking), binge drinking has not been subjected to intense prevention efforts (34). The differences in binge drinking among states, MMSAs, and counties might reflect cultural factors and differences in state and local laws that affect the price, availability, and marketing of alcoholic beverages (35,36). Population-based prevention efforts to reduce binge drinking should be initiated and strengthened (37).

No Leisure-Time Physical Activity

The HP 2010 objective is to reduce the proportion of adults who engage in no leisure-time physical activity to 20% (objective no. 22-1) (6). In 2009, only eight states, 46 MMSAs, and 93 counties met the national target for no leisure-time physical activity. Continued efforts are needed to promote leisure-time physical activity in the general population and in population subgroups. Science-based recommendations have been published for several populations, including children and adolescents aged 6--17 years, adults aged 18--64 years, adults aged ≥65 years, and persons with disabilities (25). A toolkit has been developed to assist organizations in promoting physical activity in their communities (25).

Overweight and Obesity

The prevalence of overweight and obesity continues to be a critical public health problem (4,5,38,39). The HP 2010 target is to reduce the proportion of adults aged ≥20 years who are obese to <15% (objective no. 19-2). In 2009, the estimated prevalence of overweight among states and territories ranged from 31.6%--38.7%, and the prevalence of obesity among adults aged ≥20 years ranged from 19.7% to 36.0% across states and territories. No state or territory, no MMSA, and only four counties (i.e., Douglas County, Colorado [13.8%]; San Francisco County, California [14.0%]; New York County, New York [14.0%]; and Summit County, Utah [14.8%]) met the HP 2010 target for obesity. However, the estimated prevalence of obesity for counties during 2009 (13.8%--45.7%) did not increase substantially from 2008 (12.9%--39.9%) (4) and 2007 (13.8%--37.6%) (5). These results are similar to those of the National Health and Nutrition Examination Survey (38,39), suggesting that the increasing trend in obesity prevalence might have slowed. Nevertheless, because prevalence of overweight and obesity continues to be high, extensive public health programs that target healthy life styles remain necessary to control overweight and obesity at the state and local levels (40).

Insufficient Rest or Sleep

A recent study indicated that, compared with persons reporting no days of insufficient rest or sleep, those reporting 14--29 days and those reporting ≥30 days of insufficient rest or sleep had approximately 33% and 67% increased likelihood of having any cardiovascular diseases (including coronary heart disease and stroke), 15% and 31% increased likelihood of having diabetes, and 36% and 51% increased likelihood of having obesity, respectively (41). In 2009, nearly one third to half of adults across states and territories or MMSAs, and one fourth to half of adults across counties reported insufficient rest or sleep for ≥14 days during the preceding month, suggesting a potential health issue among U.S. adults. Future studies might be needed to access the predictors or correlations of insufficient rest or sleep. Furthermore, because health risk behaviors and conditions tend to cluster together (42) and are associated with impairment of health-related quality of life and self-rated health (42,43), greater efforts might be needed to develop and implement interventions that address multiple health risk factors and conditions.

Cardiovascular Conditions

Heart Disease and Stroke

Heart disease and stroke are the first and third leading causes of death, respectively, in the United States (1). No substantial change occurred in the prevalence of coronary heart disease in 2009 (2.5%--10.3%) compared with that reported in 2007 (2.8%--10.7%) (5). Meanwhile, the prevalence of stroke in 2009 (1.4%--3.9%) was similar to that in 2007 (1.1%--3.7%) (5). High blood pressure and high blood cholesterol are important modifiable risk factors for cardiovascular disease (44). High blood pressure and high cholesterol are relatively easy to monitor and should be maintained at an optimal level (45,46). In 2009, according to the HP 2010 objectives, no state or territory, MMSA, or county met the target for reducing the proportion of adults with high blood pressure (14%; objective no. 12.9) or the target for reducing the proportion of adults with high blood cholesterol (17%; objective no. 12.14). These findings indicate a need for more public health efforts to reduce high blood pressure and high blood cholesterol. Approaches to prevent or control high blood pressure include engaging in moderate physical activity; maintaining normal body weight; limiting consumption of alcohol; reducing intake of sodium; maintaining adequate intake of potassium; and consuming a diet rich in fruits, vegetables, and low-fat dairy products (47). Strategies suggested by the National High Blood Pressure Education Program (46) and the National Cholesterol Education Program (45) can be applied at the state and local levels to help reduce high blood pressure and high blood cholesterol.

Chronic Diseases

Diabetes

Approximately 25.6 million (11.3%) adults aged ≥20 years were estimated to have diabetes in 2010 (48). The estimated prevalence of diabetes among persons aged ≥18 years ranged from 5.8% to 12.9% among states and territories. Persons with diabetes are more likely to have cardiovascular disease, high blood pressure, high cholesterol, complications during pregnancy, and mental disorders (48--50). These diseases and conditions can be prevented by controlling blood glucose through healthy eating, physical activity, medication, and receipt of proper preventive health-care services (48). Moreover, clustering of multiple healthy lifestyle habits might improve health-related quality of life among persons with diabetes (51).

Cancer

Cancer is the second leading causes of death in the United States (52). Because of early detection and medical advances in clinical treatment, persons are living many years after receiving a cancer diagnosis. Approximately 11.7 million Americans were living with cancer in 2007 (53). In 2009, approximately 9.9% of U.S. adults had cancer (range: 3.0%--12.6%). Since cancer survivors core questions were included in the BRFSS for the first time in 2009, these prevalence estimates can be used as baseline rates for monitoring prevalence trends in future surveys.

Asthma

Asthma, a chronic inflammatory disorder of airways, is a major cause of morbidity related to the limitation of activities, increased hospital admissions and emergency department visits, and loss of workdays in the United States (54,55). The majority of asthma symptoms can be prevented with appropriate medication, medical care, and self-management. Guidelines to control asthma are provided by the National Asthma Education and Prevention Program (55). During 2001--2003, approximately 20 million persons in the United States had asthma annually (54). In 2009, the estimated median current asthma prevalence among persons aged ≥18 years was 8.8%, which is similar to the prevalence estimates in 2008 (8.8%) (4) and 2007 (8.3%) (5).

Arthritis

In 2009, arthritis continued to be the most common cause of disabilities in the United States with approximately 25% of U.S. adults affected (56). Strategies to reduce the burden of arthritis among persons include being more physically active, controlling weight, and learning self-management techniques (e.g., those developed by the Arthritis Foundation Self-Help Program or the Chronic Disease Self-Management Program) (56).

Disabilities

Activity Limitations and Use of Assistive Technology

Limitation in activities because of physical, mental, or emotional problems or disabilities severely affect quality of life (57). In 2009, approximately 18.7% of U.S. adults in states and territories had activity limitations (range: 10.2%--27.1%), which is similar to the prevalence estimates in 2008 (20.4%; range: 9.8%--29.5%) (4) and 2007 (18.8%; range: 10.3%--25.9%) (5). Persons with disabilities are less likely to use preventive health services and to participate in healthy behaviors (e.g., physical activity and nonsmoking) and are more likely to have higher rates of chronic conditions (e.g., depression, diabetes, obesity, and hypertension) compared with persons without disabilities (58). Moreover, disability is closely related to excessive medical expenditures and loss of productivity. The estimated disability-related costs are approximately $300 billion annually in the United States (59). Rates of severe disability have been declining among older populations; however, during the preceding 2 decades, the prevalence of disability has been rising among young and working-age populations, particularly among those with obesity and comorbidities (60).

In 2009, the estimated prevalence of special equipment usage (e.g., a cane, wheelchair, special bed or special telephone) because of any health problem was 7.0% (range: 3.6%--10.2%). For persons with disabilities, access to assistive technology can assist with functioning, independence, maintaining physical and mental health, and participation in community life (e.g., work, school, social functions) (61,62). As the population ages and the prevalence of disabilities increases, it is essential to continue disability surveillance in the United States, to increase the quality of years lived among those with disabilities, and to increase access to needed assistive devices and technologies.

Limitations

The findings in this report are subject to at least five limitations. First, BRFSS is a household telephone survey that excludes persons in institutions, nursing homes, long-term-care facilities, and correctional institutions; therefore, results might not be generalizable to these populations. Second, increases in the number of cell-phone--only households and telephone number portability might lead to decreases in the response rate in BRFSS land-line based surveys (63). In 2009, BRFSS began collecting data on use of multimode communications modalities (e.g., cell-phone--only households only, and both cell phone and landline households). However, these data are not available for all states and territories and are not included in this report. Third, BRFSS is conducted in several languages other than English (i.e., Spanish, Chinese [Mandarin], and Portuguese) but does not provide data on persons who speak other languages. Fourth, estimates for some health status indicators could not be obtained for all MMSAs and counties, and consequently these MMSAs and counties were not ranked on these health status indicators. Finally, BRFSS data are self-reported and are subject to recall bias and social desirability effects.

Despite these limitations, BRFSS is a cost-effective, timely, and flexible survey that provides reliable and valid estimates of health risk behaviors and conditions, use of preventive health-care services, cardiovascular conditions, other chronic diseases, and health impairments and disabilities at the national, state, and local levels (64,65). BRFSS data have been demonstrated to provide reliable and valid estimates when compared with national household surveys (7,66) and often are the only timely sources of data available to states and communities to assess local health conditions and to accurately track progress of health promotion programs and strategies.

Conclusion

Because many of the Healthy People 2010 objectives were not achieved in some states, territories, and local areas, continuing to monitor the trends and geographic disparities in health risk behaviors and health conditions, use of preventive health services, chronic diseases, and health impairment and disabilities at state and local levels is warranted. BRFSS data can be used to identify states and local areas that may need additional resources, support, and/or to refocus their efforts on population groups most in need. In addition, the BRFSS survey facilitates effective program evaluation, and can be used to evaluate and improve public health interventions and demonstrate accountability to stakeholders. Moreover, results from BRFSS are used to identify emerging health problems, to support health-related legislative efforts, to develop and evaluate public health policies and programs, and to monitor progress toward achieving HP 2010 and HP 2020 objectives.

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2009 Behavioral Risk Factor Surveillance System State/Territory Project Coordinators

Alabama: Jesse Pevear III, MSPH; Alaska: Rebecca Wells, MS; Arizona: Brian Bender Judy Bass; Arkansas: LaTonya Bynum; California: Arti Parikh-Patel; Colorado: Kieu Vu; Connecticut, Diane Aye, PhD; Delaware: Fred Breukelman; District of Columbia: Tracy Garner; Florida: Melissa Murray, MS; Georgia: Leah Bryan MPH, Suprana Bagchi; Guam: William Brandshagen, Gil Suguitan; Hawaii: Florentina Reyes-Salvail, MS; Idaho: Teresa Abbott; Illinois: Bruce Steiner, MS; Indiana: Linda Stemnock; Iowa: Donald Shepherd, PhD; Kansas: Farooq Ghouri, MBBS, Ghazala Perveen; Kentucky: Tracey Sparks Sarojini Kanotra; Louisiana: Todd Griffin, MSPH; Maine: Kip Neale; Maryland: Helio Lopez, MS; Massachusetts: Helen Hawk; Michigan: Chris Fussman; Minnesota: Nagi Salem, PhD; Mississippi: Ron McAnally; Missouri: Janet Wilson, MEd; Montana: Joanne Oreskovich; Nebraska: Larry Andelt, PhD; Nevada: Alicia Hansen, MS; New Hampshire: Susan Knight, MSPH; New Jersey: Kenneth O'Dowd, PhD; New Mexico: Vivian Heye; New York: Colleen Baker; North Carolina: Harry Herrick, MSPH, James Cassell; North Dakota: Melissa Parsons; Ohio: Patricia Coss; Oklahoma: Derek Pate, MPH; Oregon: Renee Boyd; Pennsylvania: Robert Dewar, MPA, Alden Small; Puerto Rico: Ruby Serrano-Rodriguez, DrPH; Rhode Island: Jana Hesser, PhD, Donald Perry; South Carolina: Ryan Lewis; South Dakota: Mark Gildemaster; Tennessee: David Ridings; Texas: Michelle Cook, MPH; Utah: Jennifer Wrathall, MPH; Vermont: Rodney McCormick, PhD; Virgin Islands: Sharon Williams, MS; Virginia: Susan Spain; Washington: Katrina Wynkoop Simmons, PhD; West Virginia: Fred King; Wisconsin: Anne Ziege, PhD; Wyoming: Menlo Futa, MA.

2009 Behavioral Risk Factor Surveillance System Staff

Haci, Akcin, MSc; Lina Balluz, ScD; Bill Bartoli; Annie Bragg; Julie Brown; Pranesh Chowdhury, MD; Gloria Colclough; Satvinder (Pearly) Dhingra, MPH; Laurie Elam-Evans, PhD; Amy Fan, MD, PhD; Earl S Ford, MD; Suzianne Garner, MPA; William Garvin; Sonya Geathers, MEd; David Gilbertz, MSc; Tod Hebenton, MLLS; Jody Hill; Liegi (Rick) Hu; Shaohua (Sean) Hu, MD, DrPH; Elizabeth Hughes, DrPH; Greta Kilmer, MS; Kenneth Laliberte, MPA; Chaoyang Li, PhD, MD; Yan Li, MD, Wilmon Murphy; Catherine (Katie) Okoro, MS; William Pearson, PhD; Carol Pierannunzi, PhD; Mohamed Qayad, MD; Xiaoting Qin, PhD; James Ribble; Henry Roberts, PhD; Sonya Robinson; Ajay Sharma; Tara Strine, PhD; Machell Town, MS; James Tsai, MD; Balarami Valluru; Justin Vigeant; Judith Wellen, MHS; Xiaojun (John) Wen, MD; Guixiang Zhao, MD, PhD; Yuna Zhong, MD, Division of Adult Community Health, National Center for Chronic Disease Prevention and Health Promotion, CDC.


TABLE 1. Estimated proportion of adults aged ≥18 years who reported fair or poor health,* by state/territory --- Behavioral Risk Factor Surveillance System, United States, 2009

State/Territory

Sample size

%

SE

(95% CI)

Alabama

6,767

21.6

0.7

(20.2--23.0)

Alaska

2,415

11.3

0.9

(9.5--13.1)

Arizona

5,316

14.5

0.8

(12.9--16.1)

Arkansas

3,994

19.7

0.9

(18.0--21.4)

California

17,384

19.6

0.4

(18.7--20.5)

Colorado

11,897

12.0

0.4

(11.2--12.8)

Connecticut

6,382

10.3

0.5

(9.3--11.3)

Delaware

4,352

12.9

0.7

(11.5--14.3)

District of Columbia

3,798

10.9

0.6

(9.7--12.1)

Florida

11,983

16.5

0.6

(15.2--17.8)

Georgia

5,865

15.4

0.7

(14.0--16.8)

Hawaii

6,676

13.8

0.6

(12.6--15.0)

Idaho

5,382

15.2

0.6

(14.0--16.4)

Illinois

5,845

15.2

0.6

(14.0--16.4)

Indiana

9,263

16.4

0.5

(15.4--17.4)

Iowa

6,005

11.4

0.5

(10.5--12.3)

Kansas

18,869

12.3

0.3

(11.7--12.9)

Kentucky

9,649

22.8

0.7

(21.4--24.2)

Louisiana

8,869

20.8

0.6

(19.7--21.9)

Maine

8,061

13.4

0.4

(12.5--14.3)

Maryland

8,384

12.9

0.5

(11.8--14.0)

Massachusetts

16,699

12.0

0.4

(11.3--12.7)

Michigan

9,228

14.8

0.5

(13.9--15.7)

Minnesota

5,603

10.1

0.5

(9.1--11.1)

Mississippi

11,159

21.4

0.5

(20.4--22.4)

Missouri

5,047

16.1

0.7

(14.6--17.6)

Montana

7,603

14.5

0.6

(13.3--15.7)

Nebraska

15,957

13.1

0.5

(12.1--14.1)

Nevada

3,833

15.9

1.0

(13.9--17.9)

New Hampshire

5,803

12.1

0.6

(10.9--13.3)

New Jersey

12,333

14.6

0.5

(13.6--15.6)

New Mexico

8,824

17.1

0.6

(16.0--18.2)

New York

6,904

14.8

0.6

(13.6--16.0)

North Carolina

13,246

18.1

0.6

(16.8--19.4)

North Dakota

4,756

11.6

0.5

(10.6--12.6)

Ohio

9,522

15.9

0.5

(14.9--16.9)

Oklahoma

7,816

19.6

0.6

(18.5--20.7)

Oregon

4,289

13.1

0.7

(11.8--14.4)

Pennsylvania

9,149

14.8

0.5

(13.8--15.8)

Rhode Island

5,999

12.7

0.5

(11.6--13.8)

South Carolina

9,775

16.3

0.6

(15.2--17.4)

South Dakota

6,812

12.2

0.5

(11.1--13.3)

Tennessee

5,566

21.3

0.8

(19.8--22.8)

Texas

11,558

16.0

0.6

(14.9--17.1)

Utah

10,122

10.8

0.4

(10.0--11.6)

Vermont

6,657

10.9

0.5

(10.0--11.8)

Virginia

5,157

14.2

0.9

(12.5--15.9)

Washington

20,227

13.6

0.3

(13.0--14.2)

West Virginia

4,811

23.7

0.7

(22.3--25.1)

Wisconsin

4,548

11.9

0.7

(10.6--13.2)

Wyoming

6,040

12.4

0.5

(11.4--13.4)

Guam

1,265

19.9

1.4

(17.2--22.6)

Puerto Rico

4,226

30.9

0.9

(29.2--32.6)

Virgin Islands

2,488

14.4

0.9

(12.7--16.1)

Median

14.6

Range

10.1--30.9

Abbreviations: SE = standard error; CI = confidence interval.

* Respondents were asked to rate their general health as poor, fair, good, very good, or excellent. Respondents were classified into two groups: those who reported having fair or poor health and those who reported having good, very good, or excellent health.


TABLE 2. Estimated proportion of adults aged ≥18 years who reported fair or poor health,* by metropolitan and micropolitan statistical area (MMSA) --- Behavioral Risk Factor Surveillance System, United States, 2009

MMSA

Sample size

%

SE

(95% CI)

Akron, Ohio

763

18.1

2.0

(14.2--22.0)

Albuquerque, New Mexico

2,608

14.1

0.9

(12.4--15.8)

Alexandria, Louisiana

527

22.0

2.2

(17.7--26.3)

Allentown--Bethlehem--Easton, Pennsylvania--New Jersey

859

13.3

1.8

(9.7--16.9)

Anchorage, Alaska

511

9.1

1.4

(6.4--11.8)

Asheville, North Carolina

846

12.6

1.2

(10.2--15.0)

Atlanta--Sandy Springs--Marietta, Georgia

2,326

12.7

1.2

(10.3--15.1)

Atlantic City--Hammonton, New Jersey

927

16.9

1.6

(13.7--20.1)

Augusta--Richmond County, Georgia--South Carolina

876

18.1

1.9

(14.4--21.8)

Augusta--Waterville, Maine

655

14.2

1.7

(10.9--17.5)

Austin--Round Rock, Texas

1,612

11.2

1.2

(8.9--13.5)

Baltimore--Towson, Maryland

3,042

13.3

0.8

(11.7--14.9)

Bangor, Maine

732

13.6

1.4

(10.9--16.3)

Barre, Vermont

691

9.1

1.2

(6.7--11.5)

Baton Rouge, Louisiana

1,207

17.8

1.4

(15.0--20.6)

Bethesda--Frederick--Gaithersburg, Maryland

1,573

10.2

1.2

(7.9--12.5)

Billings, Montana

623

14.2

1.6

(11.0--17.4)

Birmingham--Hoover, Alabama

1,161

18.0

1.5

(15.1--20.9)

Bismarck, North Dakota

741

10.8

1.5

(7.8--13.8)

Boise City--Nampa, Idaho

1,282

14.1

1.2

(11.7--16.5)

Boston--Quincy, Massachusetts

3,400

12.0

0.8

(10.5--13.5)

Bozeman, Montana

588

9.6

2.4

(4.8--14.4)

Bremerton--Silverdale, Washington

933

10.8

1.1

(8.7--12.9)

Bridgeport--Stamford--Norwalk, Connecticut

1,898

9.0

0.9

(7.2--10.8)

Buffalo--Niagara Falls, New York

551

11.7

1.6

(8.6--14.8)

Burlington--South Burlington, Vermont

1,929

9.4

0.8

(7.8--11.0)

Butte--Silver Bow, Montana

577

19.0

2.1

(14.8--23.2)

Cambridge--Newton--Framingham, Massachusetts

3,080

8.6

0.7

(7.3--9.9)

Camden, New Jersey

1,683

12.2

1.0

(10.3--14.1)

Canton--Massillon, Ohio

704

19.0

2.0

(15.0--23.0)

Casper, Wyoming

773

12.7

1.4

(10.0--15.4)

Cedar Rapids, Iowa

595

9.9

1.4

(7.1--12.7)

Charleston, West Virginia

855

25.8

1.7

(22.4--29.2)

Charleston--North Charleston--Summerville, South Carolina

1,186

11.8

1.4

(9.1--14.5)

Charlotte--Gastonia--Concord, North Carolina--South Carolina

1,869

15.6

1.2

(13.2--18.0)

Chattanooga, Tennessee--Georgia

594

25.2

2.9

(19.5--30.9)

Cheyenne, Wyoming

940

14.2

1.4

(11.5--16.9)

Chicago--Naperville--Joliet, Illinois--Indiana--Wisconsin

4,604

14.7

0.8

(13.2--16.2)

Cincinnati--Middletown, Ohio--Kentucky--Indiana

1,700

15.4

1.3

(12.9--17.9)

Cleveland--Elyria--Mentor, Ohio

1,072

14.4

1.3

(11.8--17.0)

Colorado Springs, Colorado

1,182

8.9

1.0

(7.0--10.8)

Columbia, South Carolina

1,190

15.5

1.6

(12.3--18.7)

Columbus, Ohio

1,367

12.0

1.0

(10.0--14.0)

Concord, New Hampshire

614

9.6

1.4

(6.8--12.4)

Dallas--Plano--Irving, Texas

590

11.9

1.9

(8.2--15.6)

Davenport--Moline--Rock Island, Iowa--Illinois

520

13.8

2.5

(9.0--18.6)

Dayton, Ohio

795

15.7

1.7

(12.4--19.0)

Denver--Aurora, Colorado

4,855

10.7

0.6

(9.6--11.8)

Des Moines--West Des Moines, Iowa

1,054

10.2

1.0

(8.2--12.2)

Detroit--Livonia--Dearborn, Michigan

2,068

17.2

1.1

(15.0--19.4)

Dover, Delaware

1,434

16.2

1.2

(13.9--18.5)

Durham, North Carolina

887

15.5

2.4

(10.8--20.2)

Edison--New Brunswick, New Jersey

2,257

12.6

0.8

(11.0--14.2)

El Paso, Texas

910

21.7

1.6

(18.6--24.8)

Evansville, Indiana--Kentucky

582

23.0

2.6

(17.9--28.1)

Fargo, North Dakota--Minnesota

809

8.6

1.4

(6.0--11.2)

Farmington, New Mexico

898

15.5

1.5

(12.6--18.4)

Fayetteville, North Carolina

542

18.7

2.0

(14.8--22.6)

Fayetteville--Springdale--Rogers, Arkansas--Missouri

668

18.1

2.4

(13.5--22.7)

Fort Collins--Loveland, Colorado

585

7.9

1.2

(5.5--10.3)

Fort Wayne, Indiana

600

13.0

1.5

(10.1--15.9)

Fort Worth--Arlington, Texas

598

13.5

1.6

(10.4--16.6)

Gallup, New Mexico

573

17.0

2.0

(13.2--20.8)


TABLE 2. (Continued) Estimated proportion of adults aged ≥18 years who reported fair or poor health,* by metropolitan and micropolitan statistical area (MMSA) --- Behavioral Risk Factor Surveillance System, United States, 2009

MMSA

Sample size

%

SE

(95% CI)

Grand Island, Nebraska

824

12.3

1.3

(9.8--14.8)

Grand Rapids--Wyoming, Michigan

645

14.1

1.7

(10.8--17.4)

Greeley, Colorado

506

16.7

2.9

(11.1--22.3)

Greensboro--High Point, North Carolina

826

14.0

1.5

(11.1--16.9)

Greenville--Mauldin--Easley, South Carolina

848

15.1

1.7

(11.7--18.5)

Gulfport--Biloxi, Mississippi

960

24.4

2.8

(18.9--29.9)

Hagerstown--Martinsburg, Maryland--West Virginia

614

20.0

2.1

(15.9--24.1)

Hartford--West Hartford--East Hartford, Connecticut

2,033

10.3

0.9

(8.5--12.1)

Hastings, Nebraska

581

13.2

1.7

(9.8--16.6)

Heber, Utah

523

10.5

2.2

(6.1--14.9)

Hickory--Lenoir--Morganton, North Carolina

791

19.5

1.7

(16.1--22.9)

Hilo, Hawaii

1,491

14.9

1.1

(12.7--17.1)

Hilton Head Island--Beaufort, South Carolina

803

10.4

1.3

(7.8--13.0)

Honolulu, Hawaii

2,999

13.3

0.8

(11.8--14.8)

Houma--Bayou Cane--Thibodaux, Louisiana

536

20.9

2.1

(16.7--25.1)

Houston--Sugar Land--Baytown, Texas

2,157

13.4

1.1

(11.2--15.6)

Huntington--Ashland, West Virginia--Kentucky--Ohio

695

25.7

2.3

(21.3--30.1)

Idaho Falls, Idaho

503

14.9

1.8

(11.3--18.5)

Indianapolis--Carmel, Indiana

2,212

15.2

1.0

(13.2--17.2)

Jackson, Mississippi

1,209

18.8

1.4

(16.0--21.6)

Jacksonville, Florida

1,074

12.8

1.2

(10.4--15.2)

Kahului--Wailuku, Hawaii

1,539

13.8

1.2

(11.5--16.1)

Kalispell, Montana

553

16.8

2.0

(12.8--20.8)

Kansas City, Missouri--Kansas

6,216

11.9

0.7

(10.5--13.3)

Kapaa, Hawaii

647

14.9

1.9

(11.2--18.6)

Kennewick--Pasco--Richland, Washington

661

17.2

2.2

(12.8--21.6)

Kingsport--Bristol--Bristol, Tennessee--Virginia

517

24.0

2.8

(18.6--29.4)

Lake Charles, Louisiana

621

18.6

1.7

(15.2--22.0)

Las Cruces, New Mexico

731

21.2

2.0

(17.3--25.1)

Las Vegas--Paradise, Nevada

1,224

16.2

1.4

(13.5--18.9)

Lawrence, Kansas

601

9.9

1.9

(6.2--13.6)

Lebanon, New Hampshire--Vermont

1,501

11.8

1.0

(9.9--13.7)

Lewiston, Idaho--Washington

543

19.1

2.1

(15.1--23.1)

Lincoln, Nebraska

1,059

11.2

1.5

(8.3--14.1)

Little Rock--North Little Rock--Conway, Arkansas

833

16.0

1.6

(12.9--19.1)

Los Angeles--Long Beach--Glendale, California

2,169

23.2

1.1

(21.0--25.4)

Louisville/Jefferson County, Kentucky--Indiana

2,306

17.2

1.6

(14.1--20.3)

Lubbock, Texas

520

14.2

2.0

(10.3--18.1)

Manchester--Nashua, New Hampshire

1,393

12.1

1.4

(9.4--14.8)

Manhattan, Kansas

601

9.2

1.4

(6.4--12.0)

McAllen--Edinburg--Mission, Texas

534

23.4

2.4

(18.7--28.1)

Memphis, Tennessee--Mississippi--Arkansas

1,532

17.8

1.5

(14.8--20.8)

Miami--Fort Lauderdale--Pompano Beach, Florida

851

15.3

1.8

(11.7--18.9)

Milwaukee--Waukesha--West Allis, Wisconsin

844

11.1

1.4

(8.3--13.9)

Minneapolis--St. Paul--Bloomington, Minnesota--Wisconsin

3,125

8.7

0.6

(7.5--9.9)

Minot, North Dakota

540

12.1

1.4

(9.4--14.8)

Mobile, Alabama

709

20.1

1.8

(16.6--23.6)

Myrtle Beach--North Myrtle Beach--Conway, South Carolina

682

16.9

1.7

(13.5--20.3)

Nashville--Davidson--Murfreesboro--Franklin, Tennessee

845

17.4

1.9

(13.7--21.1)

Nassau--Suffolk, New York

945

11.8

1.2

(9.5--14.1)

Newark--Union, New Jersey--Pennsylvania

3,361

14.6

0.9

(12.8--16.4)

New Haven--Milford, Connecticut

1,621

12.4

1.1

(10.2--14.6)

New Orleans--Metairie--Kenner, Louisiana

1,617

20.4

1.5

(17.6--23.2)

New York--White Plains--Wayne, New York--New Jersey

4,412

15.9

0.8

(14.3--17.5)

Norfolk, Nebraska

626

12.0

1.5

(9.1--14.9)

North Platte, Nebraska

524

18.9

2.2

(14.5--23.3)

Oakland--Fremont--Hayward, California

1,314

15.9

1.4

(13.1--18.7)

Ocean City, New Jersey

509

14.5

2.2

(10.1--18.9)

Ogden--Clearfield, Utah

1,605

10.4

0.9

(8.7--12.1)

Oklahoma City, Oklahoma

2,301

16.1

1.0

(14.2--18.0)

Olympia, Washington

816

12.5

1.3

(10.0--15.0)

Omaha--Council Bluffs, Nebraska--Iowa

2,342

12.5

1.1

(10.4--14.6)

Orlando--Kissimmee, Florida

909

12.3

1.5

(9.4--15.2)


TABLE 2. (Continued) Estimated proportion of adults aged ≥18 years who reported fair or poor health,* by metropolitan and micropolitan statistical area (MMSA) --- Behavioral Risk Factor Surveillance System, United States, 2009

MMSA

Sample size

%

SE

(95% CI)

Pascagoula, Mississippi

707

19.1

2.1

(14.9--23.3)

Peabody, Massachusetts

2,310

14.0

1.2

(11.7--16.3)

Philadelphia, Pennsylvania

1,672

14.2

1.1

(12.1--16.3)

Phoenix--Mesa--Scottsdale, Arizona

1,534

13.2

1.1

(11.0--15.4)

Pittsburgh, Pennsylvania

2,178

15.8

1.1

(13.7--17.9)

Portland--South Portland--Biddeford, Maine

2,655

10.3

0.7

(9.0--11.6)

Portland--Vancouver--Beaverton, Oregon--Washington

3,086

11.4

0.9

(9.7--13.1)

Providence--New Bedford--Fall River, Rhode Island--Massachusetts

8,972

13.7

0.5

(12.7--14.7)

Provo--Orem, Utah

1,141

8.5

1.0

(6.5--10.5)

Raleigh--Cary, North Carolina

1,013

13.0

1.5

(10.0--16.0)

Rapid City, South Dakota

1,002

12.5

1.2

(10.2--14.8)

Reno--Sparks, Nevada

1,282

13.5

1.1

(11.3--15.7)

Richmond, Virginia

803

14.0

2.1

(9.8--18.2)

Riverside--San Bernardino--Ontario, California

2,036

21.9

1.2

(19.5--24.3)

Riverton, Wyoming

502

15.5

2.0

(11.6--19.4)

Rochester, New York

565

14.6

2.3

(10.0--19.2)

Rockingham County--Strafford County, New Hampshire

1,564

11.2

1.0

(9.2--13.2)

Rutland, Vermont

710

11.5

1.5

(8.6--14.4)

Sacramento--Arden--Arcade--Roseville, California

1,271

12.5

1.1

(10.3--14.7)

St. Louis, Missouri--Illinois

1,628

14.0

1.3

(11.5--16.5)

Salt Lake City, Utah

4,311

10.8

0.6

(9.7--11.9)

San Antonio, Texas

819

13.3

1.3

(10.7--15.9)

San Diego--Carlsbad--San Marcos, California

1,707

14.9

1.1

(12.7--17.1)

San Francisco--San Mateo--Redwood City, California

1,038

18.0

1.6

(14.8--21.2)

San Jose--Sunnyvale--Santa Clara, California

912

14.7

1.8

(11.2--18.2)

Santa Ana--Anaheim--Irvine, California

1,521

15.9

1.2

(13.5--18.3)

Santa Fe, New Mexico

772

14.3

1.8

(10.8--17.8)

Scottsbluff, Nebraska

774

17.3

1.7

(14.0--20.6)

Scranton--Wilkes-Barre, Pennsylvania

931

16.7

1.7

(13.4--20.0)

Seaford, Delaware

1,459

15.5

1.3

(13.0--18.0)

Seattle--Bellevue--Everett, Washington

4,860

11.6

0.6

(10.4--12.8)

Shreveport--Bossier City, Louisiana

685

20.6

1.9

(16.9--24.3)

Sioux City, Iowa--Nebraska--South Dakota

1,158

16.0

2.2

(11.7--20.3)

Sioux Falls, South Dakota

854

9.3

1.2

(7.0--11.6)

Spokane, Washington

1,250

15.8

1.5

(12.9--18.7)

Springfield, Massachusetts

2,093

12.9

1.0

(11.0--14.8)

Tacoma, Washington

1,756

14.3

1.2

(12.0--16.6)

Tallahassee, Florida

581

8.0

1.4

(5.3--10.7)

Tampa--St. Petersburg--Clearwater, Florida

864

16.4

1.7

(13.0--19.8)

Toledo, Ohio

823

19.6

2.2

(15.3--23.9)

Topeka, Kansas

1,939

12.1

0.9

(10.3--13.9)

Trenton--Ewing, New Jersey

509

13.5

1.8

(10.0--17.0)

Tucson, Arizona

678

14.6

1.8

(11.1--18.1)

Tulsa, Oklahoma

2,293

19.8

1.1

(17.7--21.9)

Virginia Beach--Norfolk--Newport News, Virginia--North Carolina

1,051

12.8

1.4

(10.1--15.5)

Warren--Troy--Farmington Hills, Michigan

1,810

13.4

1.0

(11.5--15.3)

Washington--Arlington--Alexandria, District of Columbia--Virginia--Maryland--West Virginia

5,994

11.5

1.2

(9.2--13.8)

Wenatchee, Washington

568

14.1

1.8

(10.6--17.6)

Wichita, Kansas

3,905

12.1

0.7

(10.8--13.4)

Wilmington, Delaware--Maryland--New Jersey

1,881

12.6

0.9

(10.8--14.4)

Wilmington, North Carolina

504

10.7

1.7

(7.3--14.1)

Worcester, Massachusetts

2,057

11.4

0.9

(9.6--13.2)

Yakima, Washington

787

20.9

1.7

(17.5--24.3)

Youngstown--Warren--Boardman, Ohio--Pennsylvania

866

16.4

1.9

(12.6--20.2)

Median

14.1

Range

7.9--25.8

Abbreviations: SE = standard error; CI = confidence interval.

* Respondents were asked to rate their general health as poor, fair, good, very good, or excellent. Respondents were classified into two groups: those who reported having fair or poor health and those with good, very good, or excellent health.

Metropolitan division.


TABLE 3. Estimated proportion of adults aged ≥18 years who reported fair or poor health,* by county --- Behavioral Risk Factor Surveillance System, United States, 2009

County

Sample size

%

SE

(95% CI)

Jefferson County, Alabama

604

16.9

1.9

(13.2--20.6)

Mobile County, Alabama

709

20.1

1.8

(16.6--23.6)

Anchorage Municipality, Alaska

373

8.5

1.6

(5.3--11.7)

Maricopa County, Arizona

1,171

12.9

1.2

(10.6--15.2)

Pima County, Arizona

678

14.6

1.8

(11.1--18.1)

Pinal County, Arizona

363

17.4

2.5

(12.6--22.2)

Benton County, Arkansas

334

12.6

2.2

(8.4--16.8)

Pulaski County, Arkansas

548

14.1

1.8

(10.6--17.6)

Washington County, Arkansas

288

19.0

3.3

(12.5--25.5)

Alameda County, California

734

17.2

2.1

(13.1--21.3)

Contra Costa County, California

580

12.2

1.5

(9.2--15.2)

Los Angeles County, California

2,169

23.2

1.1

(21.0--25.4)

Orange County, California

1,521

15.9

1.2

(13.5--18.3)

Riverside County, California

1,090

21.8

1.8

(18.2--25.4)

Sacramento County, California

767

13.6

1.6

(10.5--16.7)

San Bernardino County, California

946

22.4

1.7

(19.0--25.8)

San Diego County, California

1,707

14.9

1.1

(12.7--17.1)

San Francisco County, California

442

21.5

2.4

(16.7--26.3)

San Mateo County, California

391

14.0

2.4

(9.3--18.7)

Santa Clara County, California

888

14.1

1.8

(10.5--17.7)

Adams County, Colorado

866

16.2

1.6

(13.0--19.4)

Arapahoe County, Colorado

893

10.0

1.3

(7.5--12.5)

Denver County, Colorado

909

14.9

1.4

(12.1--17.7)

Douglas County, Colorado

573

4.5

1.0

(2.6--6.4)

El Paso County, Colorado

1,030

8.9

1.0

(6.9--10.9)

Jefferson County, Colorado

1,140

8.3

0.9

(6.5--10.1)

Larimer County, Colorado

585

7.9

1.2

(5.5--10.3)

Weld County, Colorado

506

16.7

2.9

(11.1--22.3)

Fairfield County, Connecticut

1,898

9.0

0.9

(7.2--10.8)

Hartford County, Connecticut

1,471

10.7

1.1

(8.6--12.8)

Middlesex County, Connecticut

267

11.2

2.6

(6.0--16.4)

New Haven County, Connecticut

1,621

12.4

1.1

(10.2--14.6)

Tolland County, Connecticut

295

7.2

1.7

(3.9--10.5)

Kent County, Delaware

1,434

16.2

1.2

(13.9--18.5)

New Castle County, Delaware

1,459

10.7

1.0

(8.7--12.7)

Sussex County, Delaware

1,459

15.5

1.3

(13.0--18.0)

District of Columbia

3,798

12.0

0.6

(10.7--13.3)

Broward County, Florida

270

11.0

2.9

(5.3--16.7)

Duval County, Florida

501

14.0

1.7

(10.6--17.4)

Hillsborough County, Florida

281

18.7

3.0

(12.8--24.6)

Miami--Dade County, Florida

282

18.4

2.6

(13.2--23.6)

Orange County, Florida

299

11.9

2.7

(6.6--17.2)

Osceola County, Florida

287

16.2

2.7

(11.0--21.4)

Palm Beach County, Florida

299

15.1

2.5

(10.3--19.9)

Pinellas County, Florida

274

13.8

2.5

(8.9--18.7)

Clayton County, Georgia

254

19.6

3.8

(12.2--27.0)

Cobb County, Georgia

283

7.4

1.8

(3.8--11.0)

DeKalb County, Georgia

306

10.0

2.3

(5.5--14.5)

Fulton County, Georgia

334

12.2

2.6

(7.0--17.4)

Hawaii County, Hawaii

1,491

14.9

1.1

(12.7--17.1)

Honolulu County, Hawaii

2,999

13.3

0.8

(11.8--14.8)

Kauai County, Hawaii

647

14.9

1.9

(11.2--18.6)

Maui County, Hawaii

1,539

13.8

1.2

(11.5--16.1)

Ada County, Idaho

678

11.0

1.4

(8.2--13.8)

Bonneville County, Idaho

388

13.5

2.0

(9.7--17.3)

Canyon County, Idaho

461

19.7

2.5

(14.7--24.7)

Nez Perce County, Idaho

303

16.2

2.4

(11.6--20.8)

Cook County, Illinois

1,895

16.7

1.2

(14.4--19.0)

DuPage County, Illinois

394

10.6

1.8

(7.1--14.1)

Lake County, Illinois

302

11.3

2.2

(7.0--15.6)

Will County, Illinois

300

8.6

1.8

(5.1--12.1)

Allen County, Indiana

503

12.9

1.6

(9.7--16.1)

Lake County, Indiana

983

18.4

2.1

(14.3--22.5)


TABLE 3. (Continued) Estimated proportion of adults aged ≥18 years who reported fair or poor health,* by county --- Behavioral Risk Factor Surveillance System, United States, 2009

County

Sample size

%

SE

(95% CI)

Marion County, Indiana

1,509

17.8

1.4

(15.0--20.6)

Vanderburgh County, Indiana

257

24.1

3.7

(16.9--31.3)

Linn County, Iowa

519

9.2

1.6

(6.1--12.3)

Polk County, Iowa

805

9.5

1.1

(7.3--11.7)

Scott County, Iowa

370

10.3

1.7

(7.0--13.6)

Butler County, Kansas

443

11.3

1.8

(7.8--14.8)

Douglas County, Kansas

601

9.9

1.9

(6.2--13.6)

Johnson County, Kansas

3,222

6.6

0.5

(5.6--7.6)

Leavenworth County, Kansas

465

12.6

1.9

(8.8--16.4)

Riley County, Kansas

284

5.5

1.4

(2.8--8.2)

Sedgwick County, Kansas

3,024

12.2

0.8

(10.7--13.7)

Shawnee County, Kansas

1,407

12.3

1.1

(10.1--14.5)

Wyandotte County, Kansas

1,079

20.2

1.6

(17.0--23.4)

Jefferson County, Kentucky

1,799

19.1

2.3

(14.5--23.7)

Caddo Parish, Louisiana

438

18.7

2.2

(14.5--22.9)

Calcasieu Parish, Louisiana

604

18.3

1.7

(14.9--21.7)

East Baton Rouge Parish, Louisiana

719

15.7

1.6

(12.6--18.8)

Jefferson Parish, Louisiana

561

20.7

2.4

(16.1--25.3)

Orleans Parish, Louisiana

381

18.3

2.5

(13.4--23.2)

Rapides Parish, Louisiana

457

22.4

2.4

(17.7--27.1)

St. Tammany Parish, Louisiana

427

16.4

2.1

(12.4--20.4)

Terrebonne Parish, Louisiana

299

22.7

2.9

(17.1--28.3)

Cumberland County, Maine

1,344

10.0

0.9

(8.2--11.8)

Kennebec County, Maine

655

14.2

1.7

(10.9--17.5)

Penobscot County, Maine

732

13.6

1.4

(10.9--16.3)

Sagadahoc County, Maine

343

10.4

1.8

(6.8--14.0)

York County, Maine

968

10.8

1.1

(8.6--13.0)

Anne Arundel County, Maryland

550

9.9

1.3

(7.4--12.4)

Baltimore County, Maryland

967

12.9

1.2

(10.5--15.3)

Cecil County, Maryland

244

17.0

2.7

(11.6--22.4)

Charles County, Maryland

311

9.0

1.8

(5.4--12.6)

Frederick County, Maryland

535

7.4

1.2

(5.1--9.7)

Harford County, Maryland

251

12.6

3.1

(6.5--18.7)

Howard County, Maryland

332

4.7

1.2

(2.4--7.0)

Montgomery County, Maryland

1,038

10.5

1.3

(7.9--13.1)

Prince George´s County, Maryland

625

10.3

1.4

(7.6--13.0)

Queen Anne´s County, Maryland

257

10.8

2.1

(6.8--14.8)

Washington County, Maryland

355

19.5

3.0

(13.7--25.3)

Baltimore City, Maryland

501

21.3

2.3

(16.8--25.8)

Bristol County, Massachusetts

2,973

16.3

1.2

(14.0--18.6)

Essex County, Massachusetts

2,310

13.5

1.3

(11.0--16.0)

Hampden County, Massachusetts

1,612

14.9

1.2

(12.5--17.3)

Hampshire County, Massachusetts

294

9.5

2.0

(5.6--13.4)

Middlesex County, Massachusetts

3,080

8.3

0.7

(7.0--9.6)

Norfolk County, Massachusetts

944

9.2

1.1

(7.1--11.3)

Plymouth County, Massachusetts

664

11.1

1.5

(8.2--14.0)

Suffolk County, Massachusetts

1,792

15.7

1.4

(12.9--18.5)

Worcester County, Massachusetts

2,057

11.4

0.9

(9.6--13.2)

Kent County, Michigan

466

13.6

1.9

(9.8--17.4)

Macomb County, Michigan

529

14.8

1.9

(11.0--18.6)

Oakland County, Michigan

945

11.6

1.2

(9.2--14.0)

Wayne County, Michigan

2,068

17.2

1.1

(15.0--19.4)

Anoka County, Minnesota

293

11.6

2.0

(7.6--15.6)

Dakota County, Minnesota

381

6.3

1.2

(3.9--8.7)

Hennepin County, Minnesota

1,138

9.9

1.2

(7.5--12.3)

Ramsey County, Minnesota

531

9.8

1.5

(6.9--12.7)

DeSoto County, Mississippi

630

16.7

2.1

(12.6--20.8)

George County, Mississippi

377

25.5

2.9

(19.8--31.2)

Hancock County, Mississippi

340

20.3

2.6

(15.2--25.4)

Harrison County, Mississippi

291

25.6

3.5

(18.7--32.5)

Hinds County, Mississippi

507

18.2

2.1

(14.0--22.4)

Jackson County, Mississippi

330

18.1

2.5

(13.2--23.0)

Rankin County, Mississippi

332

17.4

2.4

(12.6--22.2)


TABLE 3. (Continued) Estimated proportion of adults aged ≥18 years who reported fair or poor health,* by county --- Behavioral Risk Factor Surveillance System, United States, 2009

County

Sample size

%

SE

(95% CI)

Stone County, Mississippi

329

21.7

3.1

(15.6--27.8)

Jackson County, Missouri

491

14.2

1.9

(10.6--17.8)

St. Louis County, Missouri

483

10.9

1.7

(7.6--14.2)

St. Louis city, Missouri

490

19.2

2.3

(14.7--23.7)

Flathead County, Montana

553

16.8

2.0

(12.8--20.8)

Gallatin County, Montana

588

9.6

2.4

(4.8--14.4)

Silver Bow County, Montana

577

19.0

2.1

(14.8--23.2)

Yellowstone County, Montana

573

14.4

1.7

(11.1--17.7)

Adams County, Nebraska

446

13.5

2.0

(9.6--17.4)

Dakota County, Nebraska

712

17.6

1.7

(14.3--20.9)

Douglas County, Nebraska

935

13.8

1.5

(10.9--16.7)

Hall County, Nebraska

592

12.5

1.5

(9.5--15.5)

Lancaster County, Nebraska

783

11.3

1.7

(8.1--14.5)

Lincoln County, Nebraska

494

19.3

2.3

(14.7--23.9)

Madison County, Nebraska

415

11.7

1.9

(8.1--15.3)

Sarpy County, Nebraska

585

8.2

1.7

(4.8--11.6)

Scotts Bluff County, Nebraska

758

17.1

1.7

(13.8--20.4)

Seward County, Nebraska

276

12.6

2.2

(8.3--16.9)

Clark County, Nevada

1,224

16.2

1.4

(13.5--18.9)

Washoe County, Nevada

1,253

13.3

1.1

(11.1--15.5)

Grafton County, New Hampshire

496

11.4

1.6

(8.3--14.5)

Hillsborough County, New Hampshire

1,393

12.1

1.4

(9.4--14.8)

Merrimack County, New Hampshire

614

9.6

1.4

(6.8--12.4)

Rockingham County, New Hampshire

963

10.1

1.2

(7.8--12.4)

Strafford County, New Hampshire

601

13.3

1.9

(9.6--17.0)

Atlantic County, New Jersey

927

16.9

1.7

(13.7--20.1)

Bergen County, New Jersey

633

11.0

1.6

(7.9--14.1)

Burlington County, New Jersey

554

10.6

1.4

(7.9--13.3)

Camden County, New Jersey

619

13.2

1.9

(9.6--16.8)

Cape May County, New Jersey

509

14.5

2.2

(10.1--18.9)

Essex County, New Jersey

1,064

17.8

1.5

(14.8--20.8)

Gloucester County, New Jersey

510

12.1

1.6

(9.0--15.2)

Hudson County, New Jersey

998

21.0

1.6

(17.8--24.2)

Hunterdon County, New Jersey

539

6.6

1.1

(4.5--8.7)

Mercer County, New Jersey

509

13.5

1.8

(10.0--17.0)

Middlesex County, New Jersey

619

13.8

1.6

(10.7--16.9)

Monmouth County, New Jersey

554

10.3

1.5

(7.4--13.2)

Morris County, New Jersey

714

9.2

1.5

(6.3--12.1)

Ocean County, New Jersey

528

14.2

1.7

(10.9--17.5)

Passaic County, New Jersey

498

19.4

2.5

(14.5--24.3)

Somerset County, New Jersey

556

10.9

1.7

(7.6--14.2)

Sussex County, New Jersey

484

13.4

2.2

(9.1--17.7)

Union County, New Jersey

526

16.0

2.1

(11.9--20.1)

Warren County, New Jersey

477

13.2

1.9

(9.4--17.0)

Bernalillo County, New Mexico

1,474

14.0

1.1

(11.8--16.2)

Dona Ana County, New Mexico

731

21.2

2.0

(17.3--25.1)

McKinley County, New Mexico

573

17.0

2.0

(13.2--20.8)

Sandoval County, New Mexico

651

10.3

1.5

(7.3--13.3)

San Juan County, New Mexico

898

15.5

1.5

(12.6--18.4)

Santa Fe County, New Mexico

772

14.3

1.8

(10.8--17.8)

Valencia County, New Mexico

389

20.0

2.4

(15.3--24.7)

Erie County, New York

451

12.7

2.0

(8.8--16.6)

Kings County, New York

448

17.6

2.3

(13.1--22.1)

Monroe County, New York

382

14.8

2.6

(9.6--20.0)

Nassau County, New York

441

9.9

1.5

(6.9--12.9)

New York County, New York

523

12.6

1.7

(9.3--15.9)

Queens County, New York

480

14.5

1.9

(10.7--18.3)

Suffolk County, New York

504

13.0

1.6

(9.8--16.2)

Westchester County, New York

344

10.7

1.9

(6.9--14.5)

Buncombe County, North Carolina

398

12.2

1.8

(8.7--15.7)

Cabarrus County, North Carolina

349

15.8

2.2

(11.4--20.2)

Catawba County, North Carolina

364

16.8

2.2

(12.6--21.0)

Cumberland County, North Carolina

382

18.3

2.2

(14.0--22.6)


TABLE 3. (Continued) Estimated proportion of adults aged ≥18 years who reported fair or poor health,* by county --- Behavioral Risk Factor Surveillance System, United States, 2009

County

Sample size

%

SE

(95% CI)

Durham County, North Carolina

415

13.9

2.6

(8.8--19.0)

Gaston County, North Carolina

350

22.0

2.9

(16.3--27.7)

Guilford County, North Carolina

428

12.8

1.9

(9.1--16.5)

Henderson County, North Carolina

263

13.5

2.2

(9.1--17.9)

Johnston County, North Carolina

371

18.5

2.8

(13.0--24.0)

Mecklenburg County, North Carolina

615

14.3

2.0

(10.4--18.2)

New Hanover County, North Carolina

412

15.1

2.4

(10.4--19.8)

Orange County, North Carolina

366

10.7

2.1

(6.6--14.8)

Randolph County, North Carolina

356

20.7

2.7

(15.5--25.9)

Union County, North Carolina

369

13.4

2.2

(9.1--17.7)

Wake County, North Carolina

602

11.3

1.7

(7.9--14.7)

Burleigh County, North Dakota

565

10.0

1.8

(6.4--13.6)

Cass County, North Dakota

749

9.1

1.3

(6.5--11.7)

Ward County, North Dakota

467

10.8

1.4

(8.1--13.5)

Cuyahoga County, Ohio

678

16.4

1.9

(12.7--20.1)

Franklin County, Ohio

651

11.1

1.3

(8.5--13.7)

Hamilton County, Ohio

681

15.0

1.5

(12.0--18.0)

Lucas County, Ohio

669

19.1

2.1

(14.9--23.3)

Mahoning County, Ohio

667

15.2

1.5

(12.2--18.2)

Montgomery County, Ohio

663

18.5

1.9

(14.8--22.2)

Stark County, Ohio

672

17.1

1.8

(13.6--20.6)

Summit County, Ohio

664

18.6

2.0

(14.7--22.5)

Canadian County, Oklahoma

267

13.6

2.1

(9.5--17.7)

Cleveland County, Oklahoma

423

11.0

1.5

(8.1--13.9)

Oklahoma County, Oklahoma

1,224

17.5

1.4

(14.8--20.2)

Tulsa County, Oklahoma

1,575

18.6

1.2

(16.3--20.9)

Clackamas County, Oregon

433

12.3

2.0

(8.4--16.2)

Multnomah County, Oregon

651

9.9

1.4

(7.2--12.6)

Washington County, Oregon

441

9.8

2.4

(5.1--14.5)

Allegheny County, Pennsylvania

706

13.9

1.5

(11.0--16.8)

Bucks County, Pennsylvania

304

11.2

2.2

(6.8--15.6)

Delaware County, Pennsylvania

260

12.2

2.2

(7.9--16.5)

Fayette County, Pennsylvania

813

26.1

2.5

(21.1--31.1)

Luzerne County, Pennsylvania

774

17.7

1.7

(14.4--21.0)

Montgomery County, Pennsylvania

392

9.9

1.7

(6.6--13.2)

Philadelphia County, Pennsylvania

489

19.4

2.1

(15.2--23.6)

Westmoreland County, Pennsylvania

252

19.0

2.8

(13.4--24.6)

Kent County, Rhode Island

828

13.0

1.3

(10.5--15.5)

Newport County, Rhode Island

454

10.6

1.8

(7.1--14.1)

Providence County, Rhode Island

3,810

14.5

0.7

(13.1--15.9)

Washington County, Rhode Island

677

7.4

1.2

(5.0--9.8)

Aiken County, South Carolina

462

17.6

2.0

(13.7--21.5)

Beaufort County, South Carolina

684

9.7

1.4

(7.0--12.4)

Berkeley County, South Carolina

358

17.7

3.3

(11.3--24.1)

Charleston County, South Carolina

689

8.8

1.6

(5.6--12.0)

Greenville County, South Carolina

534

13.0

1.9

(9.2--16.8)

Horry County, South Carolina

682

16.9

1.7

(13.5--20.3)

Richland County, South Carolina

735

12.6

1.7

(9.2--16.0)

Minnehaha County, South Dakota

608

10.5

1.5

(7.5--13.5)

Pennington County, South Dakota

790

12.4

1.3

(9.9--14.9)

Davidson County, Tennessee

437

14.3

1.9

(10.5--18.1)

Hamilton County, Tennessee

438

17.2

2.4

(12.5--21.9)

Shelby County, Tennessee

375

16.0

2.1

(11.9--20.1)

Sullivan County, Tennessee

363

21.9

2.5

(17.0--26.8)

Bexar County, Texas

676

13.2

1.5

(10.3--16.1)

Dallas County, Texas

311

11.8

2.2

(7.4--16.2)

El Paso County, Texas

910

21.7

1.6

(18.6--24.8)

Fort Bend County, Texas

694

11.1

1.5

(8.1--14.1)

Harris County, Texas

1,148

14.6

1.5

(11.7--17.5)

Hidalgo County, Texas

534

23.4

2.4

(18.7--28.1)

Lubbock County, Texas

504

13.8

2.0

(9.9--17.7)

Tarrant County, Texas

486

12.7

1.7

(9.3--16.1)

Travis County, Texas

929

12.0

1.5

(9.0--15.0)


TABLE 3. (Continued) Estimated proportion of adults aged ≥18 years who reported fair or poor health,* by county --- Behavioral Risk Factor Surveillance System, United States, 2009

County

Sample size

%

SE

(95% CI)

Williamson County, Texas

600

10.5

2.2

(6.1--14.9)

Davis County, Utah

800

9.0

1.2

(6.7--11.3)

Salt Lake County, Utah

3,315

10.9

0.6

(9.7--12.1)

Summit County, Utah

498

5.3

1.1

(3.2--7.4)

Tooele County, Utah

498

12.2

1.7

(8.9--15.5)

Utah County, Utah

1,084

8.6

1.1

(6.5--10.7)

Wasatch County, Utah

523

10.5

2.2

(6.1--14.9)

Weber County, Utah

770

13.0

1.4

(10.3--15.7)

Chittenden County, Vermont

1,404

7.6

0.9

(5.9--9.3)

Franklin County, Vermont

444

15.0

1.9

(11.3--18.7)

Orange County, Vermont

358

10.2

1.8

(6.7--13.7)

Rutland County, Vermont

710

11.5

1.5

(8.6--14.4)

Washington County, Vermont

691

9.1

1.2

(6.7--11.5)

Windsor County, Vermont

647

12.5

1.5

(9.5--15.5)

Benton County, Washington

422

15.9

2.6

(10.8--21.0)

Chelan County, Washington

301

14.5

2.3

(9.9--19.1)

Clark County, Washington

1,134

14.1

1.4

(11.4--16.8)

Douglas County, Washington

267

13.9

2.7

(8.6--19.2)

King County, Washington

3,197

10.3

0.7

(9.0--11.6)

Kitsap County, Washington

933

10.8

1.1

(8.7--12.9)

Pierce County, Washington

1,756

13.4

1.1

(11.3--15.5)

Skamania County, Washington

252

16.4

2.8

(11.0--21.8)

Snohomish County, Washington

1,663

13.7

1.0

(11.7--15.7)

Spokane County, Washington

1,250

15.8

1.5

(12.9--18.7)

Thurston County, Washington

816

12.5

1.3

(10.0--15.0)

Yakima County, Washington

787

20.9

1.7

(17.5--24.3)

Kanawha County, West Virginia

556

25.8

2.3

(21.3--30.3)

Milwaukee County, Wisconsin

626

14.1

1.9

(10.4--17.8)

Fremont County, Wyoming

502

15.5

2.0

(11.6--19.4)

Laramie County, Wyoming

940

14.2

1.4

(11.5--16.9)

Natrona County, Wyoming

773

12.7

1.4

(10.0--15.4)

Median

13.6

Range

4.5--26.1

Abbreviations: SE = standard error; CI = confidence interval.

* Respondents were asked to rate their general health as poor, fair, good, very good, or excellent. Respondents were classified into two groups: those who reported having fair or poor health and those who reported having good, very good, or excellent health.


TABLE 4. Estimated proportion of adults aged ≥18 years who had health-care coverage,* by state/territory --- Behavioral Risk Factor Surveillance System, United States, 2009

State/Territory

Sample size

%

SE

(95% CI)

Alabama

6,771

84.5

0.8

(83.0--86.0)

Alaska

2,409

82.3

1.3

(79.8--84.8)

Arizona

5,461

85.0

1.2

(82.7--87.3)

Arkansas

4,002

80.0

1.1

(77.8--82.2)

California

17,372

83.0

0.5

(82.1--83.9)

Colorado

11,920

83.3

0.6

(82.1--84.5)

Connecticut

6,485

90.6

0.7

(89.3--91.9)

Delaware

4,358

90.4

0.8

(88.8--92.0)

District of Columbia

3,896

94.0

0.6

(92.8--95.2)

Florida

12,021

81.3

0.8

(79.7--82.9)

Georgia

5,878

81.2

1.0

(79.2--83.2)

Hawaii

6,670

92.7

0.6

(91.6--93.8)

Idaho

5,374

81.3

0.8

(79.7--82.9)

Illinois

5,839

86.4

0.8

(84.9--87.9)

Indiana

9,262

82.9

0.7

(81.5--84.3)

Iowa

6,006

90.1

0.6

(88.9--91.3)

Kansas

18,878

88.2

0.4

(87.4--89.0)

Kentucky

9,632

84.4

0.8

(82.9--85.9)

Louisiana

8,872

80.5

0.7

(79.1--81.9)

Maine

8,059

88.6

0.6

(87.5--89.7)

Maryland

8,569

88.5

0.7

(87.2--89.8)

Massachusetts

16,683

94.7

0.4

(93.9--95.5)

Michigan

9,230

86.4

0.6

(85.2--87.6)

Minnesota

5,603

92.0

0.7

(90.6--93.4)

Mississippi

11,174

80.0

0.7

(78.6--81.4)

Missouri

5,049

86.4

0.9

(84.7--88.1)

Montana

7,593

82.5

0.8

(80.9--84.1)

Nebraska

15,952

87.3

0.7

(85.9--88.7)

Nevada

3,833

80.5

1.4

(77.8--83.2)

New Hampshire

5,975

88.9

0.7

(87.6--90.2)

New Jersey

12,370

87.2

0.6

(86.0--88.4)

New Mexico

8,820

80.6

0.8

(79.1--82.1)

New York

6,907

88.0

0.7

(86.6--89.4)

North Carolina

13,249

81.9

0.7

(80.4--83.4)

North Dakota

4,753

89.3

0.8

(87.7--90.9)

Ohio

9,752

87.9

0.6

(86.7--89.1)

Oklahoma

7,827

80.2

0.7

(78.8--81.6)

Oregon

4,280

82.1

1.0

(80.1--84.1)

Pennsylvania

9,150

89.0

0.6

(87.9--90.1)

Rhode Island

6,272

88.0

0.7

(86.6--89.4)

South Carolina

9,817

83.7

0.7

(82.3--85.1)

South Dakota

6,817

89.0

0.6

(87.7--90.3)

Tennessee

5,567

84.3

0.9

(82.6--86.0)

Texas

11,569

74.8

0.8

(73.2--76.4)

Utah

10,129

85.0

0.6

(83.8--86.2)

Vermont

6,644

90.2

0.6

(89.0--91.4)

Virginia

5,171

88.1

1.0

(86.1--90.1)

Washington

20,238

85.6

0.4

(84.7--86.5)

West Virginia

4,806

82.5

0.8

(80.9--84.1)

Wisconsin

4,543

89.7

0.8

(88.1--91.3)

Wyoming

6,037

83.6

0.8

(82.0--85.2)

Guam

1,264

79.7

1.6

(76.6--82.8)

Puerto Rico

4,240

91.6

0.6

(90.3--92.9)

Virgin Islands

2,494

71.4

1.2

(69.0--73.8)

Median

85.3

Range

71.4--94.7

Abbreviations: SE = standard error; CI = confidence interval.

* Includes health insurance, prepaid plans (e.g., health maintenance organizations), or government plans (e.g., Medicare or Medicaid).


TABLE 5. Estimated proportion of adults aged ≥18 years who had health-care coverage,* by metropolitan and micropolitan statistical area (MMSA) --- Behavioral Risk Factor Surveillance System, United States, 2009

MMSA

Sample size

%

SE

(95% CI)

Akron, Ohio

780

86.7

1.9

(82.9--90.5)

Albuquerque, New Mexico

2,609

84.6

1.3

(82.1--87.1)

Alexandria, Louisiana

527

81.6

2.3

(77.0--86.2)

Allentown--Bethlehem--Easton, Pennsylvania--New Jersey

864

90.5

1.8

(87.0--94.0)

Anchorage, Alaska

508

85.1

2.1

(81.0--89.2)

Asheville, North Carolina

845

82.2

1.9

(78.5--85.9)

Atlanta--Sandy Springs--Marietta, Georgia

2,331

82.3

1.6

(79.1--85.5)

Atlantic City--Hammonton, New Jersey

930

84.2

2.1

(80.0--88.4)

Augusta--Richmond County, Georgia--South Carolina

873

83.8

2.3

(79.2--88.4)

Augusta--Waterville, Maine

653

88.2

2.3

(83.8--92.6)

Austin--Round Rock, Texas

1,611

83.4

1.8

(79.8--87.0)

Baltimore--Towson, Maryland

3,108

89.4

0.9

(87.6--91.2)

Bangor, Maine

738

84.6

2.3

(80.1--89.1)

Barre, Vermont

689

91.5

1.8

(87.9--95.1)

Baton Rouge, Louisiana

1,207

81.6

1.8

(78.0--85.2)

Bethesda--Frederick--Gaithersburg, Maryland

1,621

90.7

1.3

(88.2--93.2)

Billings, Montana

624

82.3

2.6

(77.3--87.3)

Birmingham--Hoover, Alabama

1,161

87.2

1.5

(84.2--90.2)

Bismarck, North Dakota

742

90.9

1.8

(87.3--94.5)

Boise City--Nampa, Idaho

1,280

82.9

1.5

(80.0--85.8)

Boston--Quincy, Massachusetts

3,404

94.5

0.8

(93.0--96.0)

Bozeman, Montana

587

82.9

2.8

(77.3--88.5)

Bremerton--Silverdale, Washington

934

90.8

1.4

(88.0--93.6)

Bridgeport--Stamford--Norwalk, Connecticut

1,928

90.7

1.4

(88.1--93.3)

Buffalo--Niagara Falls, New York

552

91.1

1.9

(87.4--94.8)

Burlington--South Burlington, Vermont

1,929

92.0

1.1

(89.8--94.2)

Butte--Silver Bow, Montana

577

87.5

2.0

(83.5--91.5)

Cambridge--Newton--Framingham, Massachusetts

3,080

96.3

0.6

(95.1--97.5)

Camden, New Jersey

1,687

91.4

1.1

(89.3--93.5)

Canton--Massillon, Ohio

717

87.3

2.0

(83.4--91.2)

Casper, Wyoming

772

86.0

1.9

(82.2--89.8)

Cedar Rapids, Iowa

596

90.9

2.0

(87.0--94.8)

Charleston, West Virginia

856

85.7

1.7

(82.5--88.9)

Charleston--North Charleston--Summerville, South Carolina

1,187

89.5

2.0

(85.6--93.4)

Charlotte--Gastonia--Concord, North Carolina--South Carolina

1,871

85.0

1.3

(82.4--87.6)

Chattanooga, Tennessee--Georgia

594

85.5

2.4

(80.7--90.3)

Cheyenne, Wyoming

941

86.7

1.8

(83.1--90.3)

Chicago--Naperville--Joliet, Illinois--Indiana--Wisconsin

4,606

85.8

0.9

(84.0--87.6)

Cincinnati--Middletown, Ohio--Kentucky--Indiana

1,729

91.7

1.1

(89.6--93.8)

Cleveland--Elyria--Mentor, Ohio

1,096

90.4

1.4

(87.6--93.2)

Colorado Springs, Colorado

1,178

86.9

1.5

(84.0--89.8)

Columbia, South Carolina

1,195

82.8

2.3

(78.2--87.4)

Columbus, Ohio

1,392

87.9

1.5

(84.9--90.9)

Concord, New Hampshire

631

88.6

2.0

(84.7--92.5)

Dallas--Plano--Irving, Texas

589

78.4

2.6

(73.3--83.5)

Davenport--Moline--Rock Island, Iowa--Illinois

520

87.1

3.0

(81.2--93.0)

Dayton, Ohio

819

89.7

1.4

(86.9--92.5)

Denver--Aurora, Colorado

4,870

86.2

0.8

(84.7--87.7)

Des Moines--West Des Moines, Iowa

1,058

89.5

1.4

(86.8--92.2)

Detroit--Livonia--Dearborn, Michigan

2,073

84.6

1.4

(81.9--87.3)

Dover, Delaware

1,435

89.9

1.3

(87.4--92.4)

Durham, North Carolina

890

82.4

2.9

(76.7--88.1)

Edison--New Brunswick, New Jersey

2,262

90.9

1.0

(89.0--92.8)

El Paso, Texas

909

64.0

2.2

(59.8--68.2)

Evansville, Indiana--Kentucky

581

86.9

2.2

(82.6--91.2)

Fargo, North Dakota--Minnesota

810

92.8

1.6

(89.6--96.0)

Farmington, New Mexico

898

74.6

2.4

(69.9--79.3)

Fayetteville, North Carolina

541

86.0

2.0

(82.0--90.0)

Fayetteville--Springdale--Rogers, Arkansas--Missouri

669

81.8

2.4

(77.1--86.5)

Fort Collins--Loveland, Colorado

584

81.0

3.1

(74.9--87.1)

Fort Wayne, Indiana

597

85.3

2.2

(81.0--89.6)

Fort Worth--Arlington, Texas

600

78.2

2.4

(73.4--83.0)

Gallup, New Mexico

571

69.5

2.5

(64.5--74.5)


TABLE 5. (Continued) Estimated proportion of adults aged ≥18 years who had health-care coverage,* by metropolitan and micropolitan statistical area (MMSA) --- Behavioral Risk Factor Surveillance System, United States, 2009

MMSA

Sample size

%

SE

(95% CI)

Grand Island, Nebraska

828

86.3

1.8

(82.7--89.9)

Grand Rapids--Wyoming, Michigan

642

85.8

2.3

(81.3--90.3)

Greeley, Colorado

507

81.2

2.7

(75.9--86.5)

Greensboro--High Point, North Carolina

825

84.0

2.3

(79.4--88.6)

Greenville--Mauldin--Easley, South Carolina

863

82.3

2.6

(77.2--87.4)

Gulfport--Biloxi, Mississippi

959

83.7

2.8

(78.2--89.2)

Hagerstown--Martinsburg, Maryland--West Virginia

617

81.3

2.4

(76.7--85.9)

Hartford--West Hartford--East Hartford, Connecticut

2,062

91.9

1.1

(89.7--94.1)

Hastings, Nebraska

581

88.1

2.3

(83.6--92.6)

Heber, Utah

527

85.4

2.4

(80.7--90.1)

Hickory--Lenoir--Morganton, North Carolina

793

81.4

2.6

(76.2--86.6)

Hilo, Hawaii

1,488

91.8

1.0

(89.8--93.8)

Hilton Head Island--Beaufort, South Carolina

807

86.9

2.4

(82.2--91.6)

Honolulu, Hawaii

2,999

93.1

0.8

(91.6--94.6)

Houma--Bayou Cane--Thibodaux, Louisiana

535

76.3

3.1

(70.3--82.3)

Houston--Sugar Land--Baytown, Texas

2,164

77.6

1.6

(74.4--80.8)

Huntington--Ashland, West Virginia--Kentucky--Ohio

693

83.1

2.3

(78.5--87.7)

Idaho Falls, Idaho

502

82.3

2.4

(77.5--87.1)

Indianapolis--Carmel, Indiana

2,211

83.9

1.4

(81.1--86.7)

Jackson, Mississippi

1,209

81.4

1.8

(77.9--84.9)

Jacksonville, Florida

1,076

84.8

2.0

(80.9--88.7)

Kahului--Wailuku, Hawaii

1,537

91.7

1.1

(89.6--93.8)

Kalispell, Montana

550

77.1

2.8

(71.6--82.6)

Kansas City, Missouri--Kansas

6,217

89.3

0.9

(87.6--91.0)

Kapaa, Hawaii

646

90.7

1.8

(87.2--94.2)

Kennewick--Pasco--Richland, Washington

660

80.7

2.5

(75.8--85.6)

Kingsport--Bristol--Bristol, Tennessee--Virginia

519

87.0

2.7

(81.7--92.3)

Lake Charles, Louisiana

622

76.7

2.6

(71.5--81.9)

Las Cruces, New Mexico

732

73.5

2.7

(68.3--78.7)

Las Vegas--Paradise, Nevada

1,223

79.9

1.9

(76.3--83.5)

Lawrence, Kansas

601

88.0

2.5

(83.1--92.9)

Lebanon, New Hampshire--Vermont

1,517

86.7

1.4

(83.9--89.5)

Lewiston, Idaho--Washington

544

83.8

2.5

(78.9--88.7)

Lincoln, Nebraska

1,056

86.1

2.2

(81.8--90.4)

Little Rock--North Little Rock--Conway, Arkansas

835

87.5

1.8

(83.9--91.1)

Los Angeles--Long Beach--Glendale, California

2,166

80.4

1.2

(78.1--82.7)

Louisville/Jefferson County, Kentucky--Indiana

2,304

88.1

1.7

(84.8--91.4)

Lubbock, Texas

518

80.8

2.8

(75.2--86.4)

Manchester--Nashua, New Hampshire

1,433

90.6

1.3

(88.0--93.2)

Manhattan, Kansas

604

90.5

2.0

(86.5--94.5)

McAllen--Edinburg--Mission, Texas

538

52.7

3.1

(46.7--58.7)

Memphis, Tennessee--Mississippi--Arkansas

1,532

84.0

2.0

(80.0--88.0)

Miami--Fort Lauderdale--Pompano Beach, Florida

848

84.4

2.2

(80.2--88.6)

Milwaukee--Waukesha--West Allis, Wisconsin

845

91.0

1.8

(87.6--94.4)

Minneapolis--St. Paul--Bloomington, Minnesota--Wisconsin

3,124

92.9

0.8

(91.3--94.5)

Minot, North Dakota

537

91.5

1.8

(88.0--95.0)

Mobile, Alabama

709

79.1

2.5

(74.1--84.1)

Myrtle Beach--North Myrtle Beach--Conway, South Carolina

685

78.3

2.8

(72.8--83.8)

Nashville--Davidson--Murfreesboro--Franklin, Tennessee

844

84.7

2.2

(80.5--88.9)

Nassau--Suffolk, New York

945

91.4

1.5

(88.4--94.4)

Newark--Union, New Jersey--Pennsylvania

3,371

85.8

1.2

(83.5--88.1)

New Haven--Milford, Connecticut

1,652

88.7

1.5

(85.8--91.6)

New Orleans--Metairie--Kenner, Louisiana

1,619

83.9

1.6

(80.8--87.0)

New York--White Plains--Wayne, New York--New Jersey

4,423

85.7

0.9

(83.8--87.6)

Norfolk, Nebraska

626

86.5

2.1

(82.4--90.6)

North Platte, Nebraska

525

91.7

1.4

(88.9--94.5)

Oakland--Fremont--Hayward, California

1,311

89.5

1.4

(86.7--92.3)

Ocean City, New Jersey

510

89.5

2.3

(85.0--94.0)

Ogden--Clearfield, Utah

1,607

89.5

1.1

(87.3--91.7)

Oklahoma City, Oklahoma

2,301

79.7

1.3

(77.2--82.2)

Olympia, Washington

816

87.1

1.9

(83.5--90.7)

Omaha--Council Bluffs, Nebraska--Iowa

2,340

87.4

1.4

(84.7--90.1)

Orlando--Kissimmee, Florida

916

79.3

2.5

(74.4--84.2)


TABLE 5. (Continued) Estimated proportion of adults aged ≥18 years who had health-care coverage,* by metropolitan and micropolitan statistical area (MMSA) --- Behavioral Risk Factor Surveillance System, United States, 2009

MMSA

Sample size

%

SE

(95% CI)

Pascagoula, Mississippi

708

79.9

3.2

(73.7--86.1)

Peabody, Massachusetts

2,301

94.5

1.0

(92.5--96.5)

Philadelphia, Pennsylvania

1,672

91.1

1.1

(89.0--93.2)

Phoenix--Mesa--Scottsdale, Arizona

1,580

86.7

1.4

(83.9--89.5)

Pittsburgh, Pennsylvania

2,179

90.5

1.2

(88.2--92.8)

Portland--South Portland--Biddeford, Maine

2,651

91.4

0.9

(89.7--93.1)

Portland--Vancouver--Beaverton, Oregon--Washington

3,084

85.8

1.2

(83.4--88.2)

Providence--New Bedford--Fall River, Rhode Island--Massachusetts

9,238

90.3

0.5

(89.3--91.3)

Provo--Orem, Utah

1,140

82.1

1.9

(78.5--85.7)

Raleigh--Cary, North Carolina

1,012

81.8

2.2

(77.6--86.0)

Rapid City, South Dakota

1,005

84.8

1.6

(81.7--87.9)

Reno--Sparks, Nevada

1,279

84.3

1.5

(81.3--87.3)

Richmond, Virginia

809

90.5

1.9

(86.8--94.2)

Riverside--San Bernardino--Ontario, California

2,036

77.3

1.5

(74.5--80.1)

Riverton, Wyoming

500

79.7

3.1

(73.6--85.8)

Rochester, New York

566

90.0

2.4

(85.3--94.7)

Rockingham County--Strafford County, New Hampshire

1,622

90.1

1.4

(87.4--92.8)

Rutland, Vermont

708

91.4

1.4

(88.7--94.1)

Sacramento--Arden--Arcade--Roseville, California

1,267

88.7

1.5

(85.9--91.5)

St. Louis, Missouri--Illinois

1,626

89.3

1.4

(86.6--92.0)

Salt Lake City, Utah

4,313

85.4

0.9

(83.7--87.1)

San Antonio, Texas

816

81.1

2.2

(76.8--85.4)

San Diego--Carlsbad--San Marcos, California

1,707

83.4

1.4

(80.7--86.1)

San Francisco--San Mateo--Redwood City, California

1,039

88.5

1.4

(85.8--91.2)

San Jose--Sunnyvale--Santa Clara, California

912

91.9

1.5

(89.0--94.8)

Santa Ana--Anaheim--Irvine, California

1,521

85.9

1.3

(83.4--88.4)

Santa Fe, New Mexico

772

81.8

2.3

(77.4--86.2)

Scottsbluff, Nebraska

772

87.2

1.6

(84.0--90.4)

Scranton--Wilkes-Barre, Pennsylvania

929

92.4

1.9

(88.8--96.0)

Seaford, Delaware

1,462

87.6

1.5

(84.6--90.6)

Seattle--Bellevue--Everett, Washington

4,859

88.0

0.8

(86.4--89.6)

Shreveport--Bossier City, Louisiana

685

79.7

2.3

(75.2--84.2)

Sioux City, Iowa--Nebraska--South Dakota

1,157

84.6

2.6

(79.5--89.7)

Sioux Falls, South Dakota

854

92.6

1.4

(89.9--95.3)

Spokane, Washington

1,249

84.6

1.8

(81.0--88.2)

Springfield, Massachusetts

2,089

94.7

1.1

(92.6--96.8)

Tacoma, Washington

1,755

84.0

1.5

(81.0--87.0)

Tallahassee, Florida

580

83.6

3.5

(76.6--90.6)

Tampa--St. Petersburg--Clearwater, Florida

869

82.9

2.3

(78.3--87.5)

Toledo, Ohio

842

85.8

2.4

(81.1--90.5)

Topeka, Kansas

1,937

89.8

1.0

(87.8--91.8)

Trenton--Ewing, New Jersey

510

89.7

1.9

(86.0--93.4)

Tucson, Arizona

688

87.2

2.1

(83.1--91.3)

Tulsa, Oklahoma

2,297

80.1

1.3

(77.5--82.7)

Virginia Beach--Norfolk--Newport News, Virginia--North Carolina

1,054

88.5

1.7

(85.1--91.9)

Warren--Troy--Farmington Hills, Michigan

1,815

89.2

1.1

(87.0--91.4)

Washington--Arlington--Alexandria, District of Columbia--Virginia--Maryland--West Virginia

6,121

91.0

1.2

(88.6--93.4)

Wenatchee, Washington

569

79.0

3.0

(73.2--84.8)

Wichita, Kansas

3,905

89.5

0.7

(88.1--90.9)

Wilmington, Delaware--Maryland--New Jersey

1,889

90.4

1.1

(88.3--92.5)

Wilmington, North Carolina

505

78.8

4.1

(70.8--86.8)

Worcester, Massachusetts

2,059

95.7

0.7

(94.4--97.0)

Yakima, Washington

787

77.5

2.1

(73.3--81.7)

Youngstown--Warren--Boardman, Ohio--Pennsylvania

886

87.8

2.1

(83.8--91.8)

Median

86.3

Range

52.7--96.3

Abbreviations: SE = standard error; CI = confidence interval.

* Includes health insurance, prepaid plans (e.g., health maintenance organizations), or government plans (e.g., Medicare or Medicaid).

Metropolitan division.


TABLE 6. Estimated proportion of adults aged ≥18 years who had health-care coverage,* by county --- Behavioral Risk Factor Surveillance System, United States, 2009

County

Sample size

%

SE

(95% CI)

Jefferson County, Alabama

604

85.0

2.3

(80.6--89.4)

Mobile County, Alabama

709

79.1

2.5

(74.1--84.1)

Anchorage Municipality, Alaska

371

85.6

2.6

(80.5--90.7)

Maricopa County, Arizona

1,203

86.3

1.5

(83.3--89.3)

Pima County, Arizona

688

87.2

2.1

(83.1--91.3)

Pinal County, Arizona

377

89.6

2.1

(85.6--93.6)

Benton County, Arkansas

333

84.1

3.3

(77.6--90.6)

Pulaski County, Arkansas

550

87.3

2.1

(83.1--91.5)

Washington County, Arkansas

290

76.1

4.3

(67.7--84.5)

Alameda County, California

732

88.5

2.0

(84.5--92.5)

Contra Costa County, California

579

92.0

1.6

(88.8--95.2)

Los Angeles County, California

2,166

80.4

1.2

(78.1--82.7)

Orange County, California

1,521

85.9

1.3

(83.4--88.4)

Riverside County, California

1,090

81.1

1.9

(77.3--84.9)

Sacramento County, California

765

88.1

1.9

(84.3--91.9)

San Bernardino County, California

946

74.1

2.1

(70.0--78.2)

San Diego County, California

1,707

83.4

1.4

(80.7--86.1)

San Francisco County, California

443

88.0

2.0

(84.1--91.9)

San Mateo County, California

391

88.8

2.4

(84.1--93.5)

Santa Clara County, California

888

91.8

1.5

(88.9--94.7)

Adams County, Colorado

870

78.8

2.1

(74.8--82.8)

Arapahoe County, Colorado

897

88.5

1.7

(85.3--91.7)

Denver County, Colorado

913

82.8

1.9

(79.1--86.5)

Douglas County, Colorado

574

93.4

1.4

(90.6--96.2)

El Paso County, Colorado

1,026

87.1

1.5

(84.1--90.1)

Jefferson County, Colorado

1,140

88.9

1.5

(86.1--91.7)

Larimer County, Colorado

584

81.0

3.1

(74.9--87.1)

Weld County, Colorado

507

81.2

2.7

(75.9--86.5)

Fairfield County, Connecticut

1,928

90.7

1.4

(88.1--93.3)

Hartford County, Connecticut

1,496

91.7

1.2

(89.3--94.1)

Middlesex County, Connecticut

269

94.3

1.9

(90.7--97.9)

New Haven County, Connecticut

1,652

88.7

1.5

(85.8--91.6)

Tolland County, Connecticut

297

93.8

2.1

(89.6--98.0)

Kent County, Delaware

1,435

89.9

1.3

(87.4--92.4)

New Castle County, Delaware

1,461

91.6

1.1

(89.4--93.8)

Sussex County, Delaware

1,462

87.6

1.5

(84.6--90.6)

District of Columbia

3,896

93.0

0.7

(91.5--94.5)

Broward County, Florida

269

82.4

4.2

(74.2--90.6)

Duval County, Florida

502

85.4

2.6

(80.2--90.6)

Hillsborough County, Florida

283

82.2

3.3

(75.6--88.8)

Miami--Dade County, Florida

280

82.9

4.3

(74.4--91.4)

Orange County, Florida

302

81.6

3.7

(74.4--88.8)

Osceola County, Florida

289

74.1

3.9

(66.4--81.8)

Palm Beach County, Florida

299

89.0

2.6

(84.0--94.0)

Pinellas County, Florida

276

88.1

2.6

(83.0--93.2)

Clayton County, Georgia

254

67.3

4.8

(57.9--76.7)

Cobb County, Georgia

286

90.6

2.3

(86.1--95.1)

DeKalb County, Georgia

305

84.2

3.3

(77.8--90.6)

Fulton County, Georgia

335

87.3

2.6

(82.2--92.4)

Hawaii County, Hawaii

1,488

91.8

1.0

(89.8--93.8)

Honolulu County, Hawaii

2,999

93.1

0.8

(91.6--94.6)

Kauai County, Hawaii

646

90.7

1.8

(87.2--94.2)

Maui County, Hawaii

1,537

91.7

1.1

(89.6--93.8)

Ada County, Idaho

676

87.9

1.7

(84.5--91.3)

Bonneville County, Idaho

388

81.8

2.8

(76.3--87.3)

Canyon County, Idaho

461

75.0

2.9

(69.3--80.7)

Nez Perce County, Idaho

303

83.2

3.3

(76.8--89.6)

Cook County, Illinois

1,892

84.2

1.3

(81.6--86.8)

DuPage County, Illinois

394

91.0

2.1

(86.8--95.2)

Lake County, Illinois

302

91.4

2.4

(86.6--96.2)

Will County, Illinois

300

88.4

3.1

(82.3--94.5)

Allen County, Indiana

500

84.9

2.5

(80.0--89.8)

Lake County, Indiana

987

81.8

2.8

(76.2--87.4)


TABLE 6. (Continued) Estimated proportion of adults aged ≥18 years who had health-care coverage,* by county --- Behavioral Risk Factor Surveillance System, United States, 2009

County

Sample size

%

SE

(95% CI)

Marion County, Indiana

1,509

80.4

1.9

(76.7--84.1)

Vanderburgh County, Indiana

255

85.4

3.3

(78.9--91.9)

Linn County, Iowa

520

91.6

1.9

(87.9--95.3)

Polk County, Iowa

809

88.7

1.6

(85.5--91.9)

Scott County, Iowa

370

93.2

1.9

(89.5--96.9)

Butler County, Kansas

442

94.3

1.5

(91.4--97.2)

Douglas County, Kansas

601

88.0

2.5

(83.1--92.9)

Johnson County, Kansas

3,218

93.6

0.6

(92.3--94.9)

Leavenworth County, Kansas

464

88.2

2.3

(83.6--92.8)

Riley County, Kansas

285

95.1

2.4

(90.5--99.7)

Sedgwick County, Kansas

3,026

88.6

0.8

(87.0--90.2)

Shawnee County, Kansas

1,405

89.9

1.2

(87.5--92.3)

Wyandotte County, Kansas

1,081

78.4

1.9

(74.7--82.1)

Jefferson County, Kentucky

1,797

88.1

2.4

(83.4--92.8)

Caddo Parish, Louisiana

438

77.2

3.1

(71.1--83.3)

Calcasieu Parish, Louisiana

605

76.6

2.7

(71.3--81.9)

East Baton Rouge Parish, Louisiana

719

81.3

2.2

(76.9--85.7)

Jefferson Parish, Louisiana

562

82.8

2.6

(77.8--87.8)

Orleans Parish, Louisiana

381

79.5

3.7

(72.3--86.7)

Rapides Parish, Louisiana

457

84.0

2.3

(79.5--88.5)

St. Tammany Parish, Louisiana

428

90.7

1.9

(86.9--94.5)

Terrebonne Parish, Louisiana

299

73.1

4.2

(64.9--81.3)

Cumberland County, Maine

1,343

91.9

1.2

(89.5--94.3)

Kennebec County, Maine

653

88.2

2.3

(83.8--92.6)

Penobscot County, Maine

738

84.6

2.3

(80.1--89.1)

Sagadahoc County, Maine

343

91.2

1.8

(87.7--94.7)

York County, Maine

965

90.5

1.5

(87.6--93.4)

Anne Arundel County, Maryland

559

92.1

1.6

(88.9--95.3)

Baltimore County, Maryland

986

91.6

1.3

(89.1--94.1)

Cecil County, Maryland

250

92.8

2.3

(88.3--97.3)

Charles County, Maryland

315

93.8

1.6

(90.7--96.9)

Frederick County, Maryland

548

91.1

1.8

(87.6--94.6)

Harford County, Maryland

260

93.8

2.1

(89.8--97.8)

Howard County, Maryland

340

92.5

2.1

(88.5--96.5)

Montgomery County, Maryland

1,073

91.2

1.3

(88.6--93.8)

Prince George´s County, Maryland

640

85.1

2.3

(80.5--89.7)

Queen Anne´s County, Maryland

264

90.8

2.2

(86.4--95.2)

Washington County, Maryland

358

84.9

2.7

(79.6--90.2)

Baltimore City, Maryland

514

81.5

2.7

(76.2--86.8)

Bristol County, Massachusetts

2,966

94.7

0.7

(93.3--96.1)

Essex County, Massachusetts

2,301

95.6

0.9

(93.9--97.3)

Hampden County, Massachusetts

1,609

94.1

1.3

(91.6--96.6)

Hampshire County, Massachusetts

293

97.1

1.1

(95.0--99.2)

Middlesex County, Massachusetts

3,080

96.4

0.6

(95.2--97.6)

Norfolk County, Massachusetts

943

97.6

0.7

(96.2--99.0)

Plymouth County, Massachusetts

665

96.1

1.1

(94.0--98.2)

Suffolk County, Massachusetts

1,796

88.8

2.0

(84.9--92.7)

Worcester County, Massachusetts

2,059

95.7

0.7

(94.4--97.0)

Kent County, Michigan

463

88.7

2.6

(83.6--93.8)

Macomb County, Michigan

531

85.4

2.5

(80.6--90.2)

Oakland County, Michigan

947

92.9

1.2

(90.5--95.3)

Wayne County, Michigan

2,073

84.6

1.4

(81.9--87.3)

Anoka County, Minnesota

293

93.2

2.1

(89.1--97.3)

Dakota County, Minnesota

381

96.3

1.2

(93.9--98.7)

Hennepin County, Minnesota

1,139

94.7

0.9

(93.0--96.4)

Ramsey County, Minnesota

532

92.1

1.7

(88.8--95.4)

DeSoto County, Mississippi

629

84.2

3.3

(77.7--90.7)

George County, Mississippi

377

74.6

3.3

(68.2--81.0)

Hancock County, Mississippi

339

83.3

2.9

(77.6--89.0)

Harrison County, Mississippi

291

87.1

3.0

(81.3--92.9)

Hinds County, Mississippi

506

77.6

2.9

(71.9--83.3)

Jackson County, Mississippi

331

81.9

3.5

(75.1--88.7)

Rankin County, Mississippi

332

88.7

2.7

(83.4--94.0)


TABLE 6. (Continued) Estimated proportion of adults aged ≥18 years who had health-care coverage,* by county --- Behavioral Risk Factor Surveillance System, United States, 2009

County

Sample size

%

SE

(95% CI)

Stone County, Mississippi

329

78.9

3.3

(72.5--85.3)

Jackson County, Missouri

492

90.7

1.6

(87.5--93.9)

St. Louis County, Missouri

482

91.8

1.9

(88.0--95.6)

St. Louis City, Missouri

489

79.6

3.1

(73.5--85.7)

Flathead County, Montana

550

77.1

2.8

(71.6--82.6)

Gallatin County, Montana

587

82.9

2.8

(77.3--88.5)

Silver Bow County, Montana

577

87.5

2.0

(83.5--91.5)

Yellowstone County, Montana

574

81.7

2.6

(76.5--86.9)

Adams County, Nebraska

446

88.6

2.6

(83.4--93.8)

Dakota County, Nebraska

712

77.6

2.2

(73.3--81.9)

Douglas County, Nebraska

934

85.6

1.9

(81.9--89.3)

Hall County, Nebraska

596

85.4

2.2

(81.0--89.8)

Lancaster County, Nebraska

782

86.0

2.4

(81.3--90.7)

Lincoln County, Nebraska

495

91.1

1.5

(88.1--94.1)

Madison County, Nebraska

415

89.4

2.1

(85.2--93.6)

Sarpy County, Nebraska

583

91.3

2.1

(87.1--95.5)

Scotts Bluff County, Nebraska

756

87.5

1.7

(84.2--90.8)

Seward County, Nebraska

274

90.0

2.8

(84.6--95.4)

Clark County, Nevada

1,223

79.9

1.9

(76.3--83.5)

Washoe County, Nevada

1,250

84.5

1.5

(81.5--87.5)

Grafton County, New Hampshire

513

83.7

2.8

(78.1--89.3)

Hillsborough County, New Hampshire

1,433

90.6

1.3

(88.0--93.2)

Merrimack County, New Hampshire

631

88.6

2.0

(84.7--92.5)

Rockingham County, New Hampshire

998

91.3

1.6

(88.2--94.4)

Strafford County, New Hampshire

624

87.2

2.3

(82.7--91.7)

Atlantic County, New Jersey

930

84.2

2.1

(80.0--88.4)

Bergen County, New Jersey

633

87.2

2.3

(82.7--91.7)

Burlington County, New Jersey

552

93.3

1.5

(90.4--96.2)

Camden County, New Jersey

623

90.1

1.9

(86.5--93.7)

Cape May County, New Jersey

510

89.5

2.3

(85.0--94.0)

Essex County, New Jersey

1,066

81.0

1.9

(77.3--84.7)

Gloucester County, New Jersey

512

92.4

1.8

(88.9--95.9)

Hudson County, New Jersey

1,008

80.0

1.9

(76.3--83.7)

Hunterdon County, New Jersey

540

93.1

2.1

(88.9--97.3)

Mercer County, New Jersey

510

89.7

1.9

(86.0--93.4)

Middlesex County, New Jersey

621

92.8

1.5

(89.9--95.7)

Monmouth County, New Jersey

555

93.2

1.2

(90.8--95.6)

Morris County, New Jersey

715

92.2

2.0

(88.3--96.1)

Ocean County, New Jersey

528

89.9

2.1

(85.8--94.0)

Passaic County, New Jersey

499

85.0

2.5

(80.0--90.0)

Somerset County, New Jersey

558

89.8

1.9

(86.1--93.5)

Sussex County, New Jersey

487

91.6

2.2

(87.3--95.9)

Union County, New Jersey

527

86.5

2.2

(82.2--90.8)

Warren County, New Jersey

481

90.5

2.0

(86.6--94.4)

Bernalillo County, New Mexico

1,473

85.4

1.6

(82.2--88.6)

Dona Ana County, New Mexico

732

73.5

2.7

(68.3--78.7)

McKinley County, New Mexico

571

69.5

2.5

(64.5--74.5)

Sandoval County, New Mexico

652

88.0

1.8

(84.5--91.5)

San Juan County, New Mexico

898

74.6

2.4

(69.9--79.3)

Santa Fe County, New Mexico

772

81.8

2.3

(77.4--86.2)

Valencia County, New Mexico

390

77.1

3.2

(70.8--83.4)

Erie County, New York

452

90.3

2.3

(85.8--94.8)

Kings County, New York

450

89.3

2.0

(85.4--93.2)

Monroe County, New York

381

90.5

2.6

(85.5--95.5)

Nassau County, New York

440

93.1

1.7

(89.7--96.5)

New York County, New York

522

88.2

2.2

(84.0--92.4)

Queens County, New York

480

83.8

2.6

(78.7--88.9)

Suffolk County, New York

505

90.4

2.1

(86.2--94.6)

Westchester County, New York

344

86.1

3.1

(80.0--92.2)

Buncombe County, North Carolina

396

84.7

2.4

(80.1--89.3)

Cabarrus County, North Carolina

349

82.4

2.7

(77.2--87.6)

Catawba County, North Carolina

366

81.7

3.7

(74.5--88.9)

Cumberland County, North Carolina

383

87.3

2.3

(82.9--91.7)


TABLE 6. (Continued) Estimated proportion of adults aged ≥18 years who had health-care coverage,* by county --- Behavioral Risk Factor Surveillance System, United States, 2009

County

Sample size

%

SE

(95% CI)

Durham County, North Carolina

416

79.6

3.6

(72.6--86.6)

Gaston County, North Carolina

350

83.1

2.8

(77.6--88.6)

Guilford County, North Carolina

426

85.3

3.5

(78.5--92.1)

Henderson County, North Carolina

263

74.3

4.1

(66.4--82.2)

Johnston County, North Carolina

370

83.3

2.6

(78.2--88.4)

Mecklenburg County, North Carolina

616

84.8

2.2

(80.6--89.0)

New Hanover County, North Carolina

413

84.4

3.2

(78.2--90.6)

Orange County, North Carolina

369

87.8

2.6

(82.7--92.9)

Randolph County, North Carolina

357

78.6

2.9

(72.9--84.3)

Union County, North Carolina

369

87.8

2.5

(83.0--92.6)

Wake County, North Carolina

602

82.1

2.6

(77.0--87.2)

Burleigh County, North Dakota

565

91.9

2.0

(87.9--95.9)

Cass County, North Dakota

750

93.4

1.3

(90.8--96.0)

Ward County, North Dakota

465

91.9

2.0

(88.0--95.8)

Cuyahoga County, Ohio

691

88.7

1.9

(85.0--92.4)

Franklin County, Ohio

663

86.5

2.0

(82.5--90.5)

Hamilton County, Ohio

696

90.2

1.6

(87.0--93.4)

Lucas County, Ohio

685

86.3

2.1

(82.1--90.5)

Mahoning County, Ohio

681

87.4

2.0

(83.5--91.3)

Montgomery County, Ohio

680

86.6

1.8

(83.1--90.1)

Stark County, Ohio

684

87.6

2.0

(83.7--91.5)

Summit County, Ohio

681

88.2

1.8

(84.6--91.8)

Canadian County, Oklahoma

267

84.7

3.0

(78.7--90.7)

Cleveland County, Oklahoma

421

88.5

2.1

(84.4--92.6)

Oklahoma County, Oklahoma

1,223

78.2

1.7

(74.9--81.5)

Tulsa County, Oklahoma

1,579

80.3

1.4

(77.5--83.1)

Clackamas County, Oregon

431

85.3

2.6

(80.3--90.3)

Multnomah County, Oregon

649

85.9

2.1

(81.7--90.1)

Washington County, Oregon

441

84.0

3.2

(77.8--90.2)

Allegheny County, Pennsylvania

705

89.8

1.7

(86.5--93.1)

Bucks County, Pennsylvania

304

94.5

1.5

(91.5--97.5)

Delaware County, Pennsylvania

259

91.5

2.7

(86.1--96.9)

Fayette County, Pennsylvania

814

86.3

2.0

(82.4--90.2)

Luzerne County, Pennsylvania

774

93.2

1.2

(90.9--95.5)

Montgomery County, Pennsylvania

392

93.1

1.7

(89.7--96.5)

Philadelphia County, Pennsylvania

491

89.7

2.0

(85.8--93.6)

Westmoreland County, Pennsylvania

253

93.6

2.1

(89.5--97.7)

Kent County, Rhode Island

858

92.0

1.2

(89.6--94.4)

Newport County, Rhode Island

474

92.6

1.9

(88.8--96.4)

Providence County, Rhode Island

3,994

85.2

1.0

(83.3--87.1)

Washington County, Rhode Island

699

89.3

2.0

(85.4--93.2)

Aiken County, South Carolina

460

86.8

2.5

(82.0--91.6)

Beaufort County, South Carolina

687

87.5

2.6

(82.4--92.6)

Berkeley County, South Carolina

359

93.8

1.9

(90.1--97.5)

Charleston County, South Carolina

689

89.9

2.8

(84.4--95.4)

Greenville County, South Carolina

543

82.7

3.1

(76.6--88.8)

Horry County, South Carolina

685

78.3

2.8

(72.8--83.8)

Richland County, South Carolina

738

78.6

3.6

(71.5--85.7)

Minnehaha County, South Dakota

608

92.0

1.8

(88.4--95.6)

Pennington County, South Dakota

793

85.6

1.8

(82.2--89.0)

Davidson County, Tennessee

436

85.7

3.2

(79.4--92.0)

Hamilton County, Tennessee

437

89.2

2.3

(84.6--93.8)

Shelby County, Tennessee

374

88.3

2.2

(83.9--92.7)

Sullivan County, Tennessee

363

82.8

3.3

(76.4--89.2)

Bexar County, Texas

673

79.6

2.5

(74.6--84.6)

Dallas County, Texas

310

71.0

3.7

(63.7--78.3)

El Paso County, Texas

909

64.0

2.2

(59.8--68.2)

Fort Bend County, Texas

697

81.1

3.0

(75.2--87.0)

Harris County, Texas

1,149

74.9

2.0

(71.0--78.8)

Hidalgo County, Texas

538

52.7

3.1

(46.7--58.7)

Lubbock County, Texas

502

81.3

2.9

(75.7--86.9)

Tarrant County, Texas

487

78.8

2.7

(73.5--84.1)

Travis County, Texas

928

80.6

2.5

(75.7--85.5)


TABLE 6. (Continued) Estimated proportion of adults aged ≥18 years who had health-care coverage,* by county --- Behavioral Risk Factor Surveillance System, United States, 2009

County

Sample size

%

SE

(95% CI)

Williamson County, Texas

599

88.2

2.4

(83.5--92.9)

Davis County, Utah

800

89.7

1.6

(86.6--92.8)

Salt Lake County, Utah

3,317

85.4

0.9

(83.5--87.3)

Summit County, Utah

498

84.0

2.7

(78.7--89.3)

Tooele County, Utah

498

87.1

2.1

(82.9--91.3)

Utah County, Utah

1,083

82.3

1.9

(78.6--86.0)

Wasatch County, Utah

527

85.4

2.4

(80.7--90.1)

Weber County, Utah

773

89.0

1.6

(85.9--92.1)

Chittenden County, Vermont

1,404

92.4

1.3

(89.8--95.0)

Franklin County, Vermont

444

90.8

1.7

(87.5--94.1)

Orange County, Vermont

355

87.9

2.3

(83.4--92.4)

Rutland County, Vermont

708

91.4

1.4

(88.7--94.1)

Washington County, Vermont

689

91.5

1.8

(87.9--95.1)

Windsor County, Vermont

649

90.1

1.6

(86.9--93.3)

Benton County, Washington

419

84.9

2.9

(79.2--90.6)

Chelan County, Washington

300

79.2

3.2

(72.9--85.5)

Clark County, Washington

1,136

87.7

2.0

(83.8--91.6)

Douglas County, Washington

269

NA

NA

NA

King County, Washington

3,199

89.1

0.9

(87.3--90.9)

Kitsap County, Washington

934

90.8

1.4

(88.0--93.6)

Pierce County, Washington

1,755

84.6

1.5

(81.7--87.5)

Skamania County, Washington

252

84.2

2.8

(78.6--89.8)

Snohomish County, Washington

1,660

87.2

1.2

(84.8--89.6)

Spokane County, Washington

1,249

84.6

1.8

(81.0--88.2)

Thurston County, Washington

816

87.1

1.9

(83.5--90.7)

Yakima County, Washington

787

77.5

2.1

(73.3--81.7)

Kanawha County, West Virginia

556

87.1

2.1

(83.0--91.2)

Milwaukee County, Wisconsin

627

87.1

2.8

(81.5--92.7)

Fremont County, Wyoming

500

79.7

3.1

(73.6--85.8)

Laramie County, Wyoming

941

86.7

1.8

(83.1--90.3)

Natrona County, Wyoming

772

86.0

1.9

(82.2--89.8)

Median

87.5

Range

52.7--97.6

Abbreviations: SE = standard error; CI = confidence interval.

* Includes health insurance, prepaid plans (e.g., health maintenance organizations), or government plans (e.g., Medicare or Medicaid).

Not availailable if the unweighted sample size for the denominator was <50 or if the 95% CI half width is >10.


TABLE 7. Estimated proportion of adults aged ≥18 years who visited a doctor for a routine checkup during the preceding 12 months, by state/territory --- Behavioral Risk Factor Surveillance System, United States, 2009

State/Territory

Sample size

%

SE

(95% CI)

Alabama

6,695

74.9

0.9

(73.1--76.7)

Alaska

2,368

62.5

1.6

(59.4--65.6)

Arizona

5,414

65.9

1.4

(63.2--68.6)

Arkansas

3,968

60.8

1.2

(58.4--63.2)

California

17,354

67.3

0.5

(66.2--68.4)

Colorado

11,714

59.4

0.7

(58.0--60.8)

Connecticut

6,439

71.3

0.9

(69.6--73.0)

Delaware

4,333

79.3

1.0

(77.3--81.3)

District of Columbia

3,868

75.0

1.0

(73.1--76.9)

Florida

11,906

74.9

0.8

(73.2--76.6)

Georgia

5,835

74.4

1.0

(72.4--76.4)

Hawaii

6,613

61.9

0.9

(60.1--63.7)

Idaho

5,353

56.7

1.0

(54.7--58.7)

Illinois

5,840

64.4

0.9

(62.6--66.2)

Indiana

9,241

62.6

0.8

(61.0--64.2)

Iowa

5,936

70.1

0.8

(68.4--71.8)

Kansas

18,603

71.2

0.5

(70.2--72.2)

Kentucky

9,557

66.8

0.9

(65.0--68.6)

Louisiana

8,791

76.1

0.7

(74.7--77.5)

Maine

8,042

70.6

0.7

(69.2--72.0)

Maryland

8,507

74.7

0.7

(73.3--76.1)

Massachusetts

16,590

76.3

0.6

(75.0--77.6)

Michigan

9,142

68.9

0.7

(67.5--70.3)

Minnesota

5,585

71.4

1.0

(69.5--73.3)

Mississippi

11,050

66.6

0.7

(65.2--68.0)

Missouri

4,991

63.9

1.1

(61.7--66.1)

Montana

7,556

57.7

0.9

(55.9--59.5)

Nebraska

15,741

59.3

0.9

(57.6--61.0)

Nevada

3,805

64.5

1.5

(61.6--67.4)

New Hampshire

5,933

71.4

0.9

(69.6--73.2)

New Jersey

12,251

77.1

0.7

(75.8--78.4)

New Mexico

8,708

60.6

0.9

(58.9--62.3)

New York

6,893

73.4

0.8

(71.8--75.0)

North Carolina

13,066

70.8

0.8

(69.3--72.3)

North Dakota

4,724

63.3

1.0

(61.3--65.3)

Ohio

9,675

68.6

0.7

(67.1--70.1)

Oklahoma

7,679

55.8

0.8

(54.2--57.4)

Oregon

4,219

59.3

1.1

(57.1--61.5)

Pennsylvania

9,126

70.9

0.7

(69.4--72.4)

Rhode Island

6,267

78.0

0.9

(76.3--79.7)

South Carolina

9,660

68.0

0.9

(66.3--69.7)

South Dakota

6,775

70.3

0.9

(68.4--72.2)

Tennessee

5,517

76.6

1.0

(74.7--78.5)

Texas

11,519

60.5

0.9

(58.8--62.2)

Utah

9,938

57.0

0.8

(55.5--58.5)

Vermont

6,624

64.1

0.8

(62.5--65.7)

Virginia

5,123

72.8

1.2

(70.5--75.1)

Washington

19,942

61.5

0.5

(60.5--62.5)

West Virginia

4,774

75.9

0.9

(74.2--77.6)

Wisconsin

4,533

64.7

1.2

(62.4--67.0)

Wyoming

6,023

57.3

0.9

(55.5--59.1)

Guam

1,254

69.5

1.7

(66.2--72.8)

Puerto Rico

4,193

77.6

0.9

(75.8--79.4)

Virgin Islands

2,487

66.6

1.3

(64.1--69.1)

Median

68.3

Range

55.8--79.3

Abbreviations: SE = standard error; CI = confidence interval.


TABLE 8. Estimated proportion of adults aged ≥18 years who visited a doctor for a routine checkup during the preceding 12 months, by metropolitan and micropolitan statistical area (MMSA) --- Behavioral Risk Factor Surveillance System, United States, 2009

MMSA

Sample size

%

SE

(95% CI)

Akron, Ohio

771

67.2

2.6

(62.1--72.3)

Albuquerque, New Mexico

2,585

61.7

1.5

(58.8--64.6)

Alexandria, Louisiana

522

74.9

2.7

(69.5--80.3)

Allentown--Bethlehem--Easton, Pennsylvania--New Jersey

856

74.4

2.5

(69.6--79.2)

Anchorage, Alaska

504

65.3

2.6

(60.2--70.4)

Asheville, North Carolina

835

70.8

2.1

(66.6--75.0)

Atlanta--Sandy Springs--Marietta, Georgia

2,316

74.1

1.6

(71.0--77.2)

Atlantic City--Hammonton, New Jersey

920

78.1

2.1

(74.0--82.2)

Augusta--Richmond County, Georgia--South Carolina

859

75.2

2.4

(70.5--79.9)

Augusta--Waterville, Maine

653

70.0

2.7

(64.7--75.3)

Austin--Round Rock, Texas

1,605

64.5

2.5

(59.6--69.4)

Baltimore--Towson, Maryland

3,087

74.1

1.1

(71.9--76.3)

Bangor, Maine

732

69.9

2.5

(64.9--74.9)

Barre, Vermont

686

65.7

2.5

(60.8--70.6)

Baton Rouge, Louisiana

1,199

77.1

1.8

(73.6--80.6)

Bethesda--Frederick--Gaithersburg, Maryland*

1,611

72.3

1.6

(69.2--75.4)

Billings, Montana

622

55.3

2.7

(50.0--60.6)

Birmingham--Hoover, Alabama

1,151

74.5

1.9

(70.7--78.3)

Bismarck, North Dakota

733

63.4

2.5

(58.6--68.2)

Boise City--Nampa, Idaho

1,275

56.5

1.9

(52.8--60.2)

Boston--Quincy, Massachusetts*

3,384

77.7

1.3

(75.2--80.2)

Bozeman, Montana

586

56.7

3.2

(50.5--62.9)

Bremerton--Silverdale, Washington

926

64.8

2.1

(60.6--69.0)

Bridgeport--Stamford--Norwalk, Connecticut

1,921

68.2

1.8

(64.7--71.7)

Buffalo--Niagara Falls, New York

551

76.5

2.6

(71.4--81.6)

Burlington--South Burlington, Vermont

1,922

60.9

1.6

(57.7--64.1)

Butte--Silver Bow, Montana

571

61.4

3.0

(55.4--67.4)

Cambridge--Newton--Framingham, Massachusetts*

3,062

74.0

1.4

(71.2--76.8)

Camden, New Jersey*

1,665

78.7

1.4

(76.0--81.4)

Canton--Massillon, Ohio

710

69.0

2.5

(64.2--73.8)

Casper, Wyoming

772

56.9

2.4

(52.2--61.6)

Cedar Rapids, Iowa

586

72.9

2.5

(68.0--77.8)

Charleston, West Virginia

852

77.2

1.9

(73.4--81.0)

Charleston--North Charleston--Summerville, South Carolina

1,170

70.0

2.6

(64.8--75.2)

Charlotte--Gastonia--Concord, North Carolina--South Carolina

1,837

66.6

1.8

(63.1--70.1)

Chattanooga, Tennessee--Georgia

589

72.7

3.2

(66.5--78.9)

Cheyenne, Wyoming

937

59.6

2.3

(55.1--64.1)

Chicago--Naperville--Joliet, Illinois--Indiana--Wisconsin

4,600

64.2

1.1

(62.0--66.4)

Cincinnati--Middletown, Ohio--Kentucky--Indiana

1,718

69.1

1.8

(65.5--72.7)

Cleveland--Elyria--Mentor, Ohio

1,092

71.2

1.8

(67.6--74.8)

Colorado Springs, Colorado

1,147

62.6

2.0

(58.8--66.4)

Columbia, South Carolina

1,180

68.8

2.5

(63.9--73.7)

Columbus, Ohio

1,383

66.8

1.9

(63.1--70.5)

Concord, New Hampshire

626

69.6

2.6

(64.5--74.7)

Dallas--Plano--Irving, Texas*

586

61.6

3.5

(54.7--68.5)

Davenport--Moline--Rock Island, Iowa--Illinois

515

64.3

3.5

(57.4--71.2)

Dayton, Ohio

809

70.1

2.3

(65.6--74.6)

Denver--Aurora, Colorado

4,801

60.5

1.0

(58.5--62.5)

Des Moines--West Des Moines, Iowa

1,048

71.8

1.8

(68.2--75.4)

Detroit--Livonia--Dearborn, Michigan*

2,053

70.5

1.7

(67.1--73.9)

Dover, Delaware

1,427

79.9

1.5

(77.0--82.8)

Durham, North Carolina

879

72.5

3.4

(65.8--79.2)

Edison--New Brunswick, New Jersey*

2,237

77.1

1.2

(74.7--79.5)

El Paso, Texas

909

54.7

2.2

(50.3--59.1)

Evansville, Indiana--Kentucky

583

71.2

2.8

(65.7--76.7)

Fargo, North Dakota--Minnesota

805

66.5

3.4

(59.8--73.2)

Farmington, New Mexico

885

58.3

2.4

(53.5--63.1)

Fayetteville, North Carolina

536

78.9

2.4

(74.1--83.7)

Fayetteville--Springdale--Rogers, Arkansas--Missouri

661

55.2

3.2

(48.9--61.5)

Fort Collins--Loveland, Colorado

576

53.2

3.2

(47.0--59.4)

Fort Wayne, Indiana

598

57.6

2.6

(52.5--62.7)

Fort Worth--Arlington, Texas*

598

62.0

2.7

(56.7--67.3)

Gallup, New Mexico

556

60.8

2.6

(55.6--66.0)


TABLE 8. (Continued) Estimated proportion of adults aged ≥18 years who visited a doctor for a routine checkup during the preceding 12 months, by metropolitan and micropolitan statistical area (MMSA) --- Behavioral Risk Factor Surveillance System, United States, 2009

MMSA

Sample size

%

SE

(95% CI)

Grand Island, Nebraska

816

57.2

2.4

(52.6--61.8)

Grand Rapids--Wyoming, Michigan

636

70.7

2.6

(65.7--75.7)

Greeley, Colorado

496

55.4

3.3

(48.9--61.9)

Greensboro--High Point, North Carolina

810

72.9

2.5

(67.9--77.9)

Greenville--Mauldin--Easley, South Carolina

850

63.9

2.9

(58.2--69.6)

Gulfport--Biloxi, Mississippi

953

65.1

3.4

(58.5--71.7)

Hagerstown--Martinsburg, Maryland--West Virginia

614

70.5

2.6

(65.4--75.6)

Hartford--West Hartford--East Hartford, Connecticut

2,048

73.6

1.5

(70.6--76.6)

Hastings, Nebraska

573

58.0

2.9

(52.3--63.7)

Heber, Utah

521

56.6

3.4

(50.0--63.2)

Hickory--Lenoir--Morganton, North Carolina

779

70.1

2.7

(64.8--75.4)

Hilo, Hawaii

1,475

59.1

1.6

(55.9--62.3)

Hilton Head Island--Beaufort, South Carolina

798

70.5

2.8

(65.1--75.9)

Honolulu, Hawaii

2,972

63.2

1.2

(60.9--65.5)

Houma--Bayou Cane--Thibodaux, Louisiana

530

75.1

2.9

(69.5--80.7)

Houston--Sugar Land--Baytown, Texas

2,154

58.4

1.7

(55.0--61.8)

Huntington--Ashland, West Virginia--Kentucky--Ohio

692

73.7

2.6

(68.7--78.7)

Idaho Falls, Idaho

502

55.1

3.0

(49.3--60.9)

Indianapolis--Carmel, Indiana

2,208

62.8

1.7

(59.5--66.1)

Jackson, Mississippi

1,194

70.1

1.9

(66.4--73.8)

Jacksonville, Florida

1,068

73.7

2.3

(69.1--78.3)

Kahului--Wailuku, Hawaii

1,523

57.9

1.8

(54.3--61.5)

Kalispell, Montana

547

54.5

2.9

(48.8--60.2)

Kansas City, Missouri--Kansas

6,157

68.0

1.3

(65.5--70.5)

Kapaa, Hawaii

643

58.1

2.7

(52.7--63.5)

Kennewick--Pasco--Richland, Washington

650

65.1

2.6

(59.9--70.3)

Kingsport--Bristol--Bristol, Tennessee--Virginia

514

78.9

3.3

(72.5--85.3)

Lake Charles, Louisiana

618

74.6

2.6

(69.5--79.7)

Las Cruces, New Mexico

722

59.7

2.8

(54.2--65.2)

Las Vegas--Paradise, Nevada

1,214

64.4

2.0

(60.5--68.3)

Lawrence, Kansas

593

62.9

3.4

(56.2--69.6)

Lebanon, New Hampshire--Vermont

1,514

68.8

1.6

(65.6--72.0)

Lewiston, Idaho--Washington

540

56.9

3.0

(51.1--62.7)

Lincoln, Nebraska

1,045

55.9

2.6

(50.8--61.0)

Little Rock--North Little Rock--Conway, Arkansas

829

64.3

2.5

(59.3--69.3)

Los Angeles--Long Beach--Glendale, California*

2,161

69.8

1.4

(67.1--72.5)

Louisville/Jefferson County, Kentucky--Indiana

2,296

64.4

2.3

(59.9--68.9)

Lubbock, Texas

521

67.2

3.2

(61.0--73.4)

Manchester--Nashua, New Hampshire

1,427

72.0

2.1

(67.9--76.1)

Manhattan, Kansas

591

67.8

3.1

(61.6--74.0)

McAllen--Edinburg--Mission, Texas

536

53.0

3.1

(47.0--59.0)

Memphis, Tennessee--Mississippi--Arkansas

1,525

75.1

2.2

(70.8--79.4)

Miami--Fort Lauderdale--Pompano Beach, Florida

846

79.1

2.4

(74.5--83.7)

Milwaukee--Waukesha--West Allis, Wisconsin

843

68.0

2.8

(62.6--73.4)

Minneapolis--St. Paul--Bloomington, Minnesota--Wisconsin

3,115

69.9

1.3

(67.3--72.5)

Minot, North Dakota

533

68.7

2.6

(63.7--73.7)

Mobile, Alabama

704

71.2

2.8

(65.7--76.7)

Myrtle Beach--North Myrtle Beach--Conway, South Carolina

670

58.6

2.9

(52.9--64.3)

Nashville--Davidson--Murfreesboro--Franklin, Tennessee

834

75.3

2.4

(70.6--80.0)

Nassau--Suffolk, New York*

947

72.0

1.9

(68.2--75.8)

Newark--Union, New Jersey--Pennsylvania*

3,329

77.6

1.2

(75.3--79.9)

New Haven--Milford, Connecticut

1,635

71.8

1.9

(68.1--75.5)

New Orleans--Metairie--Kenner, Louisiana

1,603

76.5

1.7

(73.2--79.8)

New York--White Plains--Wayne, New York--New Jersey*

4,408

76.0

1.0

(74.0--78.0)

Norfolk, Nebraska

623

51.9

2.7

(46.6--57.2)

North Platte, Nebraska

515

61.2

3.2

(54.9--67.5)

Oakland--Fremont--Hayward, California*

1,312

68.3

1.9

(64.6--72.0)

Ocean City, New Jersey

510

75.4

2.9

(69.7--81.1)

Ogden--Clearfield, Utah

1,565

61.6

1.6

(58.4--64.8)

Oklahoma City, Oklahoma

2,252

54.4

1.4

(51.6--57.2)

Olympia, Washington

803

61.0

2.2

(56.6--65.4)

Omaha--Council Bluffs, Nebraska--Iowa

2,324

63.7

1.6

(60.5--66.9)

Orlando--Kissimmee, Florida

906

73.5

2.5

(68.7--78.3)


TABLE 8. (Continued) Estimated proportion of adults aged ≥18 years who visited a doctor for a routine checkup during the preceding 12 months, by metropolitan and micropolitan statistical area (MMSA) --- Behavioral Risk Factor Surveillance System, United States, 2009

MMSA

Sample size

%

SE

(95% CI)

Pascagoula, Mississippi

700

62.4

3.2

(56.0--68.8)

Peabody, Massachusetts*

2,298

77.5

1.7

(74.2--80.8)

Philadelphia, Pennsylvania*

1,667

70.8

1.5

(67.8--73.8)

Phoenix--Mesa--Scottsdale, Arizona

1,564

64.5

1.9

(60.8--68.2)

Pittsburgh, Pennsylvania

2,176

72.0

1.7

(68.8--75.2)

Portland--South Portland--Biddeford, Maine

2,648

71.4

1.2

(69.0--73.8)

Portland--Vancouver--Beaverton, Oregon--Washington

3,031

60.7

1.4

(57.9--63.5)

Providence--New Bedford--Fall River, Rhode Island--Massachusetts

9,216

78.7

0.8

(77.0--80.4)

Provo--Orem, Utah

1,113

51.8

2.2

(47.5--56.1)

Raleigh--Cary, North Carolina

1,003

68.2

2.2

(63.9--72.5)

Rapid City, South Dakota

999

68.2

1.9

(64.4--72.0)

Reno--Sparks, Nevada

1,274

65.2

1.9

(61.4--69.0)

Richmond, Virginia

805

72.9

2.6

(67.8--78.0)

Riverside--San Bernardino--Ontario, California

2,036

65.1

1.5

(62.1--68.1)

Riverton, Wyoming

500

55.0

3.1

(49.0--61.0)

Rochester, New York

566

67.9

2.7

(62.7--73.1)

Rockingham County--Strafford County, New Hampshire*

1,610

73.8

1.7

(70.5--77.1)

Rutland, Vermont

704

64.6

2.3

(60.0--69.2)

Sacramento--Arden--Arcade--Roseville, California

1,271

64.8

2.0

(61.0--68.6)

St. Louis, Missouri--Illinois

1,621

65.5

1.9

(61.7--69.3)

Salt Lake City, Utah

4,252

58.1

1.1

(56.0--60.2)

San Antonio, Texas

814

62.5

2.5

(57.6--67.4)

San Diego--Carlsbad--San Marcos, California

1,703

67.4

1.6

(64.2--70.6)

San Francisco--San Mateo--Redwood City, California*

1,037

67.0

2.1

(63.0--71.0)

San Jose--Sunnyvale--Santa Clara, California

908

66.9

2.2

(62.6--71.2)

Santa Ana--Anaheim--Irvine, California*

1,515

67.7

1.6

(64.5--70.9)

Santa Fe, New Mexico

766

62.0

2.6

(56.9--67.1)

Scottsbluff, Nebraska

764

56.2

2.4

(51.4--61.0)

Scranton--Wilkes-Barre, Pennsylvania

931

73.8

2.5

(68.8--78.8)

Seaford, Delaware

1,457

80.7

1.6

(77.5--83.9)

Seattle--Bellevue--Everett, Washington*

4,792

61.9

1.0

(59.9--63.9)

Shreveport--Bossier City, Louisiana

680

73.2

2.6

(68.0--78.4)

Sioux City, Iowa--Nebraska--South Dakota

1,144

66.3

3.0

(60.3--72.3)

Sioux Falls, South Dakota

846

74.7

2.3

(70.1--79.3)

Spokane, Washington

1,237

57.8

2.1

(53.8--61.8)

Springfield, Massachusetts

2,074

76.0

1.6

(72.8--79.2)

Tacoma, Washington*

1,731

64.5

1.6

(61.3--67.7)

Tallahassee, Florida

574

76.9

4.2

(68.7--85.1)

Tampa--St. Petersburg--Clearwater, Florida

856

73.6

2.6

(68.6--78.6)

Toledo, Ohio

828

68.1

2.8

(62.6--73.6)

Topeka, Kansas

1,919

74.7

1.4

(72.0--77.4)

Trenton--Ewing, New Jersey

507

75.5

2.6

(70.4--80.6)

Tucson, Arizona

683

70.5

2.7

(65.2--75.8)

Tulsa, Oklahoma

2,266

54.2

1.5

(51.3--57.1)

Virginia Beach--Norfolk--Newport News, Virginia--North Carolina

1,048

76.6

2.1

(72.5--80.7)

Warren--Troy--Farmington Hills, Michigan*

1,796

68.3

1.5

(65.3--71.3)

Washington--Arlington--Alexandria, District of Columbia--Virginia--Maryland--West Virginia*

6,066

76.2

1.6

(73.2--79.2)

Wenatchee, Washington

557

61.4

3.0

(55.6--67.2)

Wichita, Kansas

3,834

72.2

1.0

(70.2--74.2)

Wilmington, Delaware--Maryland--New Jersey*

1,873

77.6

1.3

(75.0--80.2)

Wilmington, North Carolina

502

72.3

3.8

(64.8--79.8)

Worcester, Massachusetts

2,044

75.0

1.8

(71.5--78.5)

Yakima, Washington

777

65.3

2.3

(60.8--69.8)

Youngstown--Warren--Boardman, Ohio--Pennsylvania

887

73.6

2.4

(68.9--78.3)

Median

68.2

Range

51.8--80.7

Abbreviations: SE = standard error; CI = confidence interval.

* Metropolitan division.


TABLE 9. Estimated proportion of adults aged ≥18 years who visited a doctor for a routine checkup during the preceding 12 months, by county --- Behavioral Risk Factor Surveillance System, United States, 2009

County

Sample size

%

SE

(95% CI)

Jefferson County, Alabama

600

73.6

2.6

(68.6--78.6)

Mobile County, Alabama

704

71.2

2.8

(65.7--76.7)

Anchorage Municipality, Alaska

367

65.5

3.2

(59.3--71.7)

Maricopa County, Arizona

1,192

64.0

2.0

(60.0--68.0)

Pima County, Arizona

683

70.5

2.7

(65.2--75.8)

Pinal County, Arizona

372

68.6

4.0

(60.7--76.5)

Benton County, Arkansas

328

63.0

4.0

(55.2--70.8)

Pulaski County, Arkansas

548

64.2

3.2

(58.0--70.4)

Washington County, Arkansas

287

49.9

4.6

(41.0--58.8)

Alameda County, California

733

69.4

2.6

(64.4--74.4)

Contra Costa County, California

579

66.7

2.6

(61.6--71.8)

Los Angeles County, California

2,161

69.8

1.4

(67.1--72.5)

Orange County, California

1,515

67.7

1.6

(64.5--70.9)

Riverside County, California

1,091

66.8

2.1

(62.6--71.0)

Sacramento County, California

767

67.4

2.3

(62.8--72.0)

San Bernardino County, California

945

64.0

2.1

(59.8--68.2)

San Diego County, California

1,703

67.4

1.6

(64.2--70.6)

San Francisco County, California

442

65.1

2.9

(59.4--70.8)

San Mateo County, California

390

68.6

3.6

(61.5--75.7)

Santa Clara County, California

885

66.6

2.2

(62.2--71.0)

Adams County, Colorado

856

56.1

2.2

(51.7--60.5)

Arapahoe County, Colorado

887

61.3

2.3

(56.8--65.8)

Denver County, Colorado

895

57.9

2.4

(53.2--62.6)

Douglas County, Colorado

572

65.1

2.6

(60.1--70.1)

El Paso County, Colorado

1,000

62.6

2.0

(58.6--66.6)

Jefferson County, Colorado

1,120

62.0

2.0

(58.0--66.0)

Larimer County, Colorado

576

53.2

3.2

(47.0--59.4)

Weld County, Colorado

496

55.4

3.3

(48.9--61.9)

Fairfield County, Connecticut

1,921

68.2

1.8

(64.7--71.7)

Hartford County, Connecticut

1,486

73.9

1.7

(70.6--77.2)

Middlesex County, Connecticut

266

72.0

3.5

(65.2--78.8)

New Haven County, Connecticut

1,635

71.8

1.9

(68.1--75.5)

Tolland County, Connecticut

296

70.8

3.5

(63.9--77.7)

Kent County, Delaware

1,427

79.9

1.5

(77.0--82.8)

New Castle County, Delaware

1,449

78.7

1.5

(75.7--81.7)

Sussex County, Delaware

1,457

80.7

1.6

(77.5--83.9)

District of Columbia

3,868

76.7

1.0

(74.8--78.6)

Broward County, Florida

269

73.7

4.4

(65.1--82.3)

Duval County, Florida

502

74.9

2.8

(69.4--80.4)

Hillsborough County, Florida

280

75.2

3.5

(68.3--82.1)

Miami--Dade County, Florida

279

82.0

4.4

(73.3--90.7)

Orange County, Florida

298

73.8

3.9

(66.2--81.4)

Osceola County, Florida

285

65.5

4.1

(57.5--73.5)

Palm Beach County, Florida

298

78.8

3.7

(71.6--86.0)

Pinellas County, Florida

272

78.7

3.2

(72.4--85.0)

Clayton County, Georgia

255

66.5

4.7

(57.2--75.8)

Cobb County, Georgia

283

67.7

4.0

(59.8--75.6)

DeKalb County, Georgia

306

74.9

3.7

(67.6--82.2)

Fulton County, Georgia

331

77.4

3.4

(70.8--84.0)

Hawaii County, Hawaii

1,475

59.1

1.6

(55.9--62.3)

Honolulu County, Hawaii

2,972

63.2

1.2

(60.9--65.5)

Kauai County, Hawaii

643

58.1

2.7

(52.7--63.5)

Maui County, Hawaii

1,523

57.9

1.8

(54.3--61.5)

Ada County, Idaho

673

60.5

2.5

(55.7--65.3)

Bonneville County, Idaho

388

54.2

3.4

(47.5--60.9)

Canyon County, Idaho

459

52.1

3.3

(45.7--58.5)

Nez Perce County, Idaho

302

55.1

3.9

(47.4--62.8)

Cook County, Illinois

1,895

63.2

1.6

(60.1--66.3)

DuPage County, Illinois

394

65.3

3.1

(59.2--71.4)

Lake County, Illinois

301

73.9

3.1

(67.9--79.9)

Will County, Illinois

300

59.9

3.8

(52.5--67.3)

Allen County, Indiana

501

57.4

2.9

(51.7--63.1)

Lake County, Indiana

981

66.7

2.8

(61.2--72.2)


TABLE 9. (Continued) Estimated proportion of adults aged ≥18 years who visited a doctor for a routine checkup wduring the preceding 12 months, by county --- Behavioral Risk Factor Surveillance System, United States, 2009

County

Sample size

%

SE

(95% CI)

Marion County, Indiana

1,504

64.6

2.1

(60.5--68.7)

Vanderburgh County, Indiana

256

71.4

4.0

(63.5--79.3)

Linn County, Iowa

511

72.8

2.6

(67.7--77.9)

Polk County, Iowa

802

72.0

2.1

(67.9--76.1)

Scott County, Iowa

365

70.3

3.2

(64.0--76.6)

Butler County, Kansas

433

69.3

3.0

(63.5--75.1)

Douglas County, Kansas

593

62.9

3.4

(56.2--69.6)

Johnson County, Kansas

3,201

73.6

1.1

(71.5--75.7)

Leavenworth County, Kansas

458

72.1

3.2

(65.9--78.3)

Riley County, Kansas

281

NA*

NA

NA

Sedgwick County, Kansas

2,971

72.6

1.1

(70.4--74.8)

Shawnee County, Kansas

1,389

73.7

1.7

(70.4--77.0)

Wyandotte County, Kansas

1,062

72.8

2.0

(68.9--76.7)

Jefferson County, Kentucky

1,792

66.8

3.3

(60.4--73.2)

Caddo Parish, Louisiana

435

70.3

3.3

(63.8--76.8)

Calcasieu Parish, Louisiana

601

74.5

2.6

(69.4--79.6)

East Baton Rouge Parish, Louisiana

715

78.1

2.2

(73.9--82.3)

Jefferson Parish, Louisiana

554

76.9

2.7

(71.7--82.1)

Orleans Parish, Louisiana

380

77.6

3.7

(70.3--84.9)

Rapides Parish, Louisiana

455

76.9

2.8

(71.4--82.4)

St. Tammany Parish, Louisiana

422

73.2

3.1

(67.2--79.2)

Terrebonne Parish, Louisiana

295

76.3

3.8

(68.8--83.8)

Cumberland County, Maine

1,344

72.0

1.7

(68.6--75.4)

Kennebec County, Maine

653

70.0

2.7

(64.7--75.3)

Penobscot County, Maine

732

69.9

2.5

(64.9--74.9)

Sagadahoc County, Maine

343

68.0

3.3

(61.4--74.6)

York County, Maine

961

71.2

2.0

(67.2--75.2)

Anne Arundel County, Maryland

557

72.9

2.5

(68.1--77.7)

Baltimore County, Maryland

981

76.9

1.9

(73.2--80.6)

Cecil County, Maryland

246

64.1

3.8

(56.6--71.6)

Charles County, Maryland

309

69.9

3.3

(63.4--76.4)

Frederick County, Maryland

543

68.5

2.8

(63.1--73.9)

Harford County, Maryland

259

69.5

3.8

(62.0--77.0)

Howard County, Maryland

338

71.6

2.9

(66.0--77.2)

Montgomery County, Maryland

1,068

73.3

1.7

(69.9--76.7)

Prince George´s County, Maryland

634

80.3

2.1

(76.3--84.3)

Queen Anne´s County, Maryland

259

67.1

3.8

(59.6--74.6)

Washington County, Maryland

359

70.1

3.5

(63.2--77.0)

Baltimore City, Maryland

511

75.9

2.7

(70.6--81.2)

Bristol County, Massachusetts

2,949

80.4

1.8

(76.9--83.9)

Essex County, Massachusetts

2,298

77.8

1.8

(74.4--81.2)

Hampden County, Massachusetts

1,598

78.5

1.8

(74.9--82.1)

Hampshire County, Massachusetts

293

69.8

3.5

(62.8--76.8)

Middlesex County, Massachusetts

3,062

73.6

1.4

(70.8--76.4)

Norfolk County, Massachusetts

935

78.3

2.1

(74.2--82.4)

Plymouth County, Massachusetts

661

75.6

2.3

(71.1--80.1)

Suffolk County, Massachusetts

1,788

77.9

2.0

(74.0--81.8)

Worcester County, Massachusetts

2,044

75.0

1.8

(71.5--78.5)

Kent County, Michigan

461

70.0

3.1

(63.8--76.2)

Macomb County, Michigan

525

67.1

2.8

(61.6--72.6)

Oakland County, Michigan

938

71.7

2.1

(67.7--75.7)

Wayne County, Michigan

2,053

70.5

1.7

(67.1--73.9)

Anoka County, Minnesota

292

75.0

3.4

(68.4--81.6)

Dakota County, Minnesota

379

68.9

3.3

(62.5--75.3)

Hennepin County, Minnesota

1,133

72.8

1.9

(69.0--76.6)

Ramsey County, Minnesota

531

74.3

2.7

(69.1--79.5)

DeSoto County, Mississippi

626

62.6

3.1

(56.6--68.6)

George County, Mississippi

373

62.9

3.5

(56.1--69.7)

Hancock County, Mississippi

337

61.4

3.8

(53.9--68.9)

Harrison County, Mississippi

289

68.5

4.1

(60.4--76.6)

Hinds County, Mississippi

502

67.7

3.0

(61.8--73.6)

Jackson County, Mississippi

327

63.0

3.7

(55.8--70.2)

Rankin County, Mississippi

328

74.5

3.2

(68.3--80.7)


TABLE 9. (Continued) Estimated proportion of adults aged ≥18 years who visited a doctor for a routine checkup during the preceding 12 months, by county --- Behavioral Risk Factor Surveillance System, United States, 2009

County

Sample size

%

SE

(95% CI)

Stone County, Mississippi

327

60.7

3.7

(53.4--68.0)

Jackson County, Missouri

490

71.3

2.6

(66.3--76.3)

St. Louis County, Missouri

479

64.9

3.4

(58.3--71.5)

St. Louis City, Missouri

489

70.1

4.1

(62.2--78.0)

Flathead County, Montana

547

54.5

2.9

(48.8--60.2)

Gallatin County, Montana

586

56.7

3.2

(50.5--62.9)

Silver Bow County, Montana

571

61.4

3.0

(55.4--67.4)

Yellowstone County, Montana

573

55.9

2.8

(50.4--61.4)

Adams County, Nebraska

438

57.6

3.2

(51.3--63.9)

Dakota County, Nebraska

701

57.5

2.5

(52.6--62.4)

Douglas County, Nebraska

927

60.7

2.2

(56.3--65.1)

Hall County, Nebraska

586

58.2

2.8

(52.8--63.6)

Lancaster County, Nebraska

773

55.6

2.8

(50.0--61.2)

Lincoln County, Nebraska

487

61.7

3.3

(55.2--68.2)

Madison County, Nebraska

414

49.2

3.2

(43.0--55.4)

Sarpy County, Nebraska

577

67.4

3.1

(61.3--73.5)

Scotts Bluff County, Nebraska

748

55.4

2.5

(50.5--60.3)

Seward County, Nebraska

272

58.7

3.7

(51.4--66.0)

Clark County, Nevada

1,214

64.4

2.0

(60.5--68.3)

Washoe County, Nevada

1,245

65.5

1.9

(61.7--69.3)

Grafton County, New Hampshire

510

70.3

2.9

(64.6--76.0)

Hillsborough County, New Hampshire

1,427

72.0

2.1

(67.9--76.1)

Merrimack County, New Hampshire

626

69.6

2.6

(64.5--74.7)

Rockingham County, New Hampshire

991

74.1

2.0

(70.2--78.0)

Strafford County, New Hampshire

619

71.2

2.8

(65.8--76.6)

Atlantic County, New Jersey

920

78.1

2.1

(73.9--82.3)

Bergen County, New Jersey

628

76.8

2.6

(71.7--81.9)

Burlington County, New Jersey

546

81.0

2.2

(76.7--85.3)

Camden County, New Jersey

614

78.7

2.5

(73.7--83.7)

Cape May County, New Jersey

510

75.4

2.9

(69.7--81.1)

Essex County, New Jersey

1,051

77.7

2.0

(73.7--81.7)

Gloucester County, New Jersey

505

72.1

2.7

(66.8--77.4)

Hudson County, New Jersey

1,002

76.7

1.8

(73.1--80.3)

Hunterdon County, New Jersey

532

77.8

2.2

(73.4--82.2)

Mercer County, New Jersey

507

75.5

2.6

(70.4--80.6)

Middlesex County, New Jersey

615

76.3

2.3

(71.8--80.8)

Monmouth County, New Jersey

551

79.7

2.1

(75.6--83.8)

Morris County, New Jersey

708

69.6

2.6

(64.4--74.8)

Ocean County, New Jersey

518

76.6

2.6

(71.5--81.7)

Passaic County, New Jersey

500

73.6

2.9

(68.0--79.2)

Somerset County, New Jersey

553

74.1

2.4

(69.3--78.9)

Sussex County, New Jersey

483

75.5

2.9

(69.7--81.3)

Union County, New Jersey

519

83.5

2.0

(79.6--87.4)

Warren County, New Jersey

475

72.3

2.7

(66.9--77.7)

Bernalillo County, New Mexico

1,464

61.5

1.9

(57.7--65.3)

Dona Ana County, New Mexico

722

59.7

2.8

(54.2--65.2)

McKinley County, New Mexico

556

60.8

2.6

(55.6--66.0)

Sandoval County, New Mexico

643

66.2

2.8

(60.7--71.7)

San Juan County, New Mexico

885

58.3

2.4

(53.5--63.1)

Santa Fe County, New Mexico

766

62.0

2.6

(56.9--67.1)

Valencia County, New Mexico

384

57.1

3.4

(50.4--63.8)

Erie County, New York

452

76.4

2.9

(70.8--82.0)

Kings County, New York

448

78.3

2.5

(73.4--83.2)

Monroe County, New York

381

65.9

3.2

(59.7--72.1)

Nassau County, New York

441

72.9

2.8

(67.5--78.3)

New York County, New York

520

78.8

2.4

(74.2--83.4)

Queens County, New York

482

71.2

2.9

(65.5--76.9)

Suffolk County, New York

506

71.6

2.6

(66.6--76.6)

Westchester County, New York

341

75.0

3.4

(68.4--81.6)

Buncombe County, North Carolina

395

73.6

2.8

(68.1--79.1)

Cabarrus County, North Carolina

343

70.8

3.2

(64.6--77.0)

Catawba County, North Carolina

359

67.6

3.8

(60.2--75.0)

Cumberland County, North Carolina

378

79.5

2.7

(74.3--84.7)


TABLE 9. (Continued) Estimated proportion of adults aged ≥18 years who visited a doctor for a routine checkup during the preceding 12 months, by county --- Behavioral Risk Factor Surveillance System, United States, 2009

County

Sample size

%

SE

(95% CI)

Durham County, North Carolina

411

73.0

3.3

(66.6--79.4)

Gaston County, North Carolina

339

69.8

3.3

(63.2--76.4)

Guilford County, North Carolina

421

71.2

3.6

(64.2--78.2)

Henderson County, North Carolina

257

64.0

4.0

(56.1--71.9)

Johnston County, North Carolina

366

64.6

3.8

(57.1--72.1)

Mecklenburg County, North Carolina

609

66.8

2.6

(61.8--71.8)

New Hanover County, North Carolina

410

73.8

3.4

(67.1--80.5)

Orange County, North Carolina

364

69.9

3.4

(63.2--76.6)

Randolph County, North Carolina

350

72.9

3.0

(67.0--78.8)

Union County, North Carolina

364

71.4

3.3

(64.9--77.9)

Wake County, North Carolina

597

69.3

2.6

(64.2--74.4)

Burleigh County, North Dakota

556

66.8

2.8

(61.3--72.3)

Cass County, North Dakota

746

66.0

2.5

(61.0--71.0)

Ward County, North Dakota

461

69.3

2.8

(63.8--74.8)

Cuyahoga County, Ohio

690

70.8

2.4

(66.1--75.5)

Franklin County, Ohio

658

65.1

2.5

(60.1--70.1)

Hamilton County, Ohio

692

67.6

2.4

(63.0--72.2)

Lucas County, Ohio

674

71.2

2.7

(65.9--76.5)

Mahoning County, Ohio

682

72.3

2.3

(67.8--76.8)

Montgomery County, Ohio

671

69.9

2.3

(65.3--74.5)

Stark County, Ohio

678

70.5

2.4

(65.7--75.3)

Summit County, Ohio

673

70.8

2.5

(65.9--75.7)

Canadian County, Oklahoma

263

58.5

3.7

(51.2--65.8)

Cleveland County, Oklahoma

416

52.6

3.3

(46.2--59.0)

Oklahoma County, Oklahoma

1,194

54.5

1.9

(50.8--58.2)

Tulsa County, Oklahoma

1,560

54.8

1.6

(51.6--58.0)

Clackamas County, Oregon

424

63.6

3.1

(57.6--69.6)

Multnomah County, Oregon

639

59.6

2.7

(54.3--64.9)

Washington County, Oregon

436

60.0

3.4

(53.3--66.7)

Allegheny County, Pennsylvania

709

71.4

2.3

(66.9--75.9)

Bucks County, Pennsylvania

303

68.2

3.4

(61.6--74.8)

Delaware County, Pennsylvania

258

67.5

3.9

(59.8--75.2)

Fayette County, Pennsylvania

811

78.1

2.3

(73.7--82.5)

Luzerne County, Pennsylvania

774

71.9

2.3

(67.5--76.3)

Montgomery County, Pennsylvania

390

69.9

2.9

(64.3--75.5)

Philadelphia County, Pennsylvania

491

73.6

2.8

(68.1--79.1)

Westmoreland County, Pennsylvania

252

73.0

3.3

(66.5--79.5)

Kent County, Rhode Island

854

80.8

1.7

(77.4--84.2)

Newport County, Rhode Island

473

76.3

2.8

(70.7--81.9)

Providence County, Rhode Island

3,998

77.3

1.1

(75.1--79.5)

Washington County, Rhode Island

695

76.5

2.5

(71.5--81.5)

Aiken County, South Carolina

451

70.7

2.9

(65.0--76.4)

Beaufort County, South Carolina

682

71.3

3.0

(65.4--77.2)

Berkeley County, South Carolina

354

73.6

4.0

(65.7--81.5)

Charleston County, South Carolina

680

69.2

3.9

(61.6--76.8)

Greenville County, South Carolina

534

63.8

3.4

(57.0--70.6)

Horry County, South Carolina

670

58.6

2.9

(52.9--64.3)

Richland County, South Carolina

730

68.6

3.4

(62.0--75.2)

Minnehaha County, South Dakota

601

76.0

2.6

(70.8--81.2)

Pennington County, South Dakota

789

68.9

2.2

(64.7--73.1)

Davidson County, Tennessee

436

77.5

3.4

(70.8--84.2)

Hamilton County, Tennessee

434

81.1

2.7

(75.8--86.4)

Shelby County, Tennessee

375

80.5

3.0

(74.6--86.4)

Sullivan County, Tennessee

359

77.4

3.8

(69.9--84.9)

Bexar County, Texas

674

57.9

2.7

(52.5--63.3)

Dallas County, Texas

310

62.1

4.2

(53.9--70.3)

El Paso County, Texas

909

54.7

2.2

(50.3--59.1)

Fort Bend County, Texas

693

59.1

3.0

(53.2--65.0)

Harris County, Texas

1,143

58.1

2.1

(54.0--62.2)

Hidalgo County, Texas

536

53.0

3.1

(47.0--59.0)

Lubbock County, Texas

505

67.0

3.2

(60.7--73.3)

Tarrant County, Texas

485

62.1

3.0

(56.2--68.0)

Travis County, Texas

923

63.1

3.1

(57.0--69.2)


TABLE 9. (Continued) Estimated proportion of adults aged ≥18 years who visited a doctor for a routine checkup during the preceding 12 months, by county --- Behavioral Risk Factor Surveillance System, United States, 2009

County

Sample size

%

SE

(95% CI)

Williamson County, Texas

597

63.2

3.6

(56.1--70.3)

Davis County, Utah

782

61.1

2.2

(56.8--65.4)

Salt Lake County, Utah

3,268

58.0

1.2

(55.7--60.3)

Summit County, Utah

493

60.9

2.9

(55.2--66.6)

Tooele County, Utah

491

58.1

3.1

(52.1--64.1)

Utah County, Utah

1,058

51.5

2.2

(47.1--55.9)

Wasatch County, Utah

521

56.6

3.4

(50.0--63.2)

Weber County, Utah

752

61.8

2.3

(57.3--66.3)

Chittenden County, Vermont

1,399

58.6

1.9

(54.8--62.4)

Franklin County, Vermont

442

65.8

2.8

(60.3--71.3)

Orange County, Vermont

356

67.4

3.1

(61.3--73.5)

Rutland County, Vermont

704

64.6

2.3

(60.0--69.2)

Washington County, Vermont

686

65.7

2.5

(60.8--70.6)

Windsor County, Vermont

648

68.3

2.2

(63.9--72.7)

Benton County, Washington

415

65.5

3.1

(59.3--71.7)

Chelan County, Washington

295

60.2

3.7

(53.0--67.4)

Clark County, Washington

1,114

58.2

2.2

(53.9--62.5)

Douglas County, Washington

262

65.1

4.5

(56.2--74.0)

King County, Washington

3,152

61.4

1.2

(59.1--63.7)

Kitsap County, Washington

926

64.8

2.1

(60.6--69.0)

Pierce County, Washington

1,731

63.5

1.7

(60.1--66.9)

Skamania County, Washington

248

57.5

3.9

(49.8--65.2)

Snohomish County, Washington

1,640

62.3

1.7

(59.0--65.6)

Spokane County, Washington

1,237

57.8

2.1

(53.8--61.8)

Thurston County, Washington

803

61.0

2.2

(56.6--65.4)

Yakima County, Washington

777

65.3

2.3

(60.8--69.8)

Kanawha County, West Virginia

552

78.0

2.5

(73.1--82.9)

Milwaukee County, Wisconsin

625

67.4

3.3

(60.9--73.9)

Fremont County, Wyoming

500

55.0

3.1

(49.0--61.0)

Laramie County, Wyoming

937

59.6

2.3

(55.1--64.1)

Natrona County, Wyoming

772

56.9

2.4

(52.2--61.6)

Median

69.1

Range

49.2--83.5

Abbreviations: SE = standard error; CI = confidence interval.

* Estimate not available if the unweighted sample size for the denominator was <50 or if the 95% CI half width is >10.


TABLE 10. Estimated proportion of adults aged ≥65 years who had received an influenza vaccination during the preceding 12 months, by state/territory --- Behavioral Risk Factor Surveillance System, United States, 2009

State/Territory

Sample size

%

SE

(95% CI)

Alabama

2,176

68.1

1.5

(65.2--71.0)

Alaska

380

62.1

3.5

(55.2--69.0)

Arizona

2,057

71.6

1.6

(68.6--74.6)

Arkansas

1,431

70.7

1.4

(67.9--73.5)

California

4,782

65.1

0.9

(63.2--67.0)

Colorado

3,092

75.2

0.9

(73.4--77.0)

Connecticut

2,109

73.7

1.2

(71.4--76.0)

Delaware

1,418

71.6

1.5

(68.7--74.5)

District of Columbia

1,051

67.1

1.7

(63.8--70.4)

Florida

4,534

64.8

1.1

(62.6--67.0)

Georgia

1,683

66.6

1.4

(63.8--69.4)

Hawaii

1,910

72.7

1.3

(70.2--75.2)

Idaho

1,668

64.1

1.4

(61.4--66.8)

Illinois

1,744

64.7

1.3

(62.1--67.3)

Indiana

2,754

67.7

1.1

(65.6--69.8)

Iowa

1,950

74.0

1.1

(71.9--76.1)

Kansas

6,057

69.4

0.6

(68.1--70.7)

Kentucky

2,934

70.5

1.3

(68.0--73.0)

Louisiana

2,747

68.1

1.1

(66.0--70.2)

Maine

2,430

72.9

1.0

(70.9--74.9)

Maryland

2,341

71.5

1.3

(69.0--74.0)

Massachusetts

4,483

73.0

0.9

(71.2--74.8)

Michigan

2,973

68.9

1.0

(67.0--70.8)

Minnesota

1,809

76.8

1.1

(74.7--78.9)

Mississippi

3,873

67.4

0.9

(65.6--69.2)

Missouri

1,632

72.5

1.4

(69.7--75.3)

Montana

2,439

68.7

1.1

(66.5--70.9)

Nebraska

5,826

73.9

0.9

(72.2--75.6)

Nevada

1,196

63.5

2.0

(59.5--67.5)

New Hampshire

1,846

71.9

1.3

(69.4--74.4)

New Jersey

3,235

67.2

1.1

(65.0--69.4)

New Mexico

2,637

68.3

1.1

(66.2--70.4)

New York

2,085

68.6

1.4

(65.9--71.3)

North Carolina

4,110

71.6

1.0

(69.6--73.6)

North Dakota

1,435

69.7

1.3

(67.1--72.3)

Ohio

3,005

67.5

1.1

(65.4--69.6)

Oklahoma

2,593

72.3

1.0

(70.4--74.2)

Oregon

1,482

64.6

1.3

(62.0--67.2)

Pennsylvania

2,990

72.8

1.0

(70.8--74.8)

Rhode Island

1,852

75.7

1.1

(73.5--77.9)

South Carolina

3,341

69.7

1.2

(67.3--72.1)

South Dakota

2,301

75.0

1.1

(72.9--77.1)

Tennessee

1,875

70.1

1.3

(67.5--72.7)

Texas

3,374

67.3

1.4

(64.7--69.9)

Utah

2,490

68.8

1.1

(66.6--71.0)

Vermont

1,930

72.0

1.1

(69.8--74.2)

Virginia

1,416

69.9

1.6

(66.8--73.0)

Washington

6,351

70.1

0.7

(68.7--71.5)

West Virginia

1,502

70.4

1.3

(67.9--72.9)

Wisconsin

1,287

72.0

1.8

(68.5--75.5)

Wyoming

1,842

70.7

1.2

(68.4--73.0)

Guam

161

50.4

4.7

(41.3--59.5)

Puerto Rico

1,458

26.8

1.3

(24.3--29.3)

Virgin Islands

500

38.8

2.5

(33.9--43.7)

Median

69.8

Range

26.8--76.8

Abbreviations: SE = standard error; CI = confidence interval.


TABLE 11. Estimated proportion of adults aged ≥65 years who had received an influenza vaccination during the preceding 12 months, by metropolitan and micropolitan statistical area (MMSA) --- Behavioral Risk Factor Surveillance System, United States, 2009

MMSA

Sample size

%

SE

(95% CI)

Akron, Ohio

264

66.8

3.4

(60.1--73.5)

Albuquerque, New Mexico

768

70.8

1.9

(67.1--74.5)

Alexandria, Louisiana

158

69.2

4.3

(60.8--77.6)

Allentown--Bethlehem--Easton, Pennsylvania--New Jersey

268

69.5

4.1

(61.4--77.6)

Anchorage, Alaska

83

NA*

NA

NA

Asheville, North Carolina

310

74.1

2.7

(68.9--79.3)

Atlanta--Sandy Springs--Marietta, Georgia

580

66.4

2.4

(61.6--71.2)

Atlantic City--Hammonton, New Jersey

253

58.8

4.4

(50.1--67.5)

Augusta--Richmond County, Georgia--South Carolina

296

73.2

3.2

(66.8--79.6)

Augusta--Waterville, Maine

197

74.8

3.5

(67.9--81.7)

Austin--Round Rock, Texas

400

74.5

3.2

(68.1--80.9)

Baltimore--Towson, Maryland

818

71.5

1.9

(67.7--75.3)

Bangor, Maine

218

69.7

3.5

(62.8--76.6)

Barre, Vermont

202

73.2

3.4

(66.6--79.8)

Baton Rouge, Louisiana

341

71.6

2.7

(66.2--77.0)

Bethesda--Frederick--Gaithersburg, Maryland

414

76.3

3.1

(70.1--82.5)

Billings, Montana

202

73.6

3.3

(67.2--80.0)

Birmingham--Hoover, Alabama

344

65.9

3.1

(59.9--71.9)

Bismarck, North Dakota

231

63.6

3.4

(56.9--70.3)

Boise City--Nampa, Idaho

396

69.4

2.6

(64.3--74.5)

Boston--Quincy, Massachusetts

887

74.3

1.9

(70.6--78.0)

Bozeman, Montana

147

66.4

4.2

(58.1--74.7)

Bremerton--Silverdale, Washington

297

74.3

2.7

(69.0--79.6)

Bridgeport--Stamford--Norwalk, Connecticut

636

73.9

2.4

(69.3--78.5)

Buffalo--Niagara Falls, New York

206

72.7

3.5

(65.9--79.5)

Burlington--South Burlington, Vermont

533

69.5

2.2

(65.2--73.8)

Butte--Silver Bow, Montana

218

72.5

3.3

(66.0--79.0)

Cambridge--Newton--Framingham, Massachusetts

789

76.3

2.1

(72.2--80.4)

Camden, New Jersey

430

72.8

2.5

(67.9--77.7)

Canton--Massillon, Ohio

236

70.6

3.2

(64.3--76.9)

Casper, Wyoming

252

76.9

2.9

(71.2--82.6)

Cedar Rapids, Iowa

173

80.3

3.2

(74.0--86.6)

Charleston, West Virginia

273

69.2

3.2

(62.8--75.6)

Charleston--North Charleston--Summerville, South Carolina

372

67.7

3.9

(60.1--75.3)

Charlotte--Gastonia--Concord, North Carolina--South Carolina

510

67.0

2.6

(61.9--72.1)

Chattanooga, Tennessee--Georgia

204

64.8

4.5

(56.0--73.6)

Cheyenne, Wyoming

303

75.9

2.7

(70.5--81.3)

Chicago--Naperville--Joliet, Illinois--Indiana--Wisconsin

1,219

62.1

1.8

(58.5--65.7)

Cincinnati--Middletown, Ohio--Kentucky--Indiana

485

70.7

2.8

(65.3--76.1)

Cleveland--Elyria--Mentor, Ohio

343

70.7

2.9

(65.1--76.3)

Colorado Springs, Colorado

271

73.0

3.1

(66.9--79.1)

Columbia, South Carolina

375

71.4

3.6

(64.3--78.5)

Columbus, Ohio

358

70.0

2.7

(64.6--75.4)

Concord, New Hampshire

197

73.1

3.5

(66.1--80.1)

Dallas--Plano--Irving, Texas

153

76.4

4.2

(68.2--84.6)

Davenport--Moline--Rock Island, Iowa--Illinois

180

69.9

4.7

(60.6--79.2)

Dayton, Ohio

268

68.6

3.7

(61.4--75.8)

Denver--Aurora, Colorado

1,160

78.2

1.3

(75.6--80.8)

Des Moines--West Des Moines, Iowa

280

77.1

2.7

(71.8--82.4)

Detroit--Livonia--Dearborn, Michigan

660

66.3

2.3

(61.8--70.8)

Dover, Delaware

401

69.6

2.5

(64.6--74.6)

Durham, North Carolina

253

81.4

3.1

(75.3--87.5)

Edison--New Brunswick, New Jersey

606

65.8

2.4

(61.1--70.5)

El Paso, Texas

206

61.4

3.7

(54.1--68.7)

Evansville, Indiana--Kentucky

187

67.8

4.0

(59.9--75.7)

Fargo, North Dakota--Minnesota

212

76.3

4.1

(68.2--84.4)

Farmington, New Mexico

240

61.4

3.9

(53.8--69.0)

Fayetteville, North Carolina

135

69.9

4.5

(61.0--78.8)

Fayetteville--Springdale--Rogers, Arkansas--Missouri

238

67.8

4.0

(60.0--75.6)

Fort Collins--Loveland, Colorado

147

70.2

3.9

(62.5--77.9)

Fort Wayne, Indiana

166

56.6

4.2

(48.3--64.9)

Fort Worth--Arlington, Texas

162

71.2

3.9

(63.5--78.9)

Gallup, New Mexico

110

67.4

5.0

(57.6--77.2)


TABLE 11. (Continued) Estimated proportion of adults aged ≥65 years who had received an influenza vaccination during the preceding 12 months, by metropolitan and micropolitan statistical area (MMSA) --- Behavioral Risk Factor Surveillance System, United States, 2009

MMSA

Sample size

%

SE

(95% CI)

Grand Island, Nebraska

305

75.0

2.8

(69.5--80.5)

Grand Rapids--Wyoming, Michigan

193

68.1

3.9

(60.5--75.7)

Greeley, Colorado

124

71.8

4.4

(63.1--80.5)

Greensboro--High Point, North Carolina

245

75.3

3.3

(68.7--81.9)

Greenville--Mauldin--Easley, South Carolina

286

76.2

3.5

(69.4--83.0)

Gulfport--Biloxi, Mississippi

342

73.5

3.6

(66.4--80.6)

Hagerstown--Martinsburg, Maryland--West Virginia

192

72.9

3.9

(65.3--80.5)

Hartford--West Hartford--East Hartford, Connecticut

675

76.3

1.9

(72.7--79.9)

Hastings, Nebraska

226

72.7

3.2

(66.4--79.0)

Heber, Utah

119

72.0

5.0

(62.2--81.8)

Hickory--Lenoir--Morganton, North Carolina

275

69.7

3.5

(62.8--76.6)

Hilo, Hawaii

392

69.5

2.6

(64.5--74.5)

Hilton Head Island--Beaufort, South Carolina

367

73.3

2.5

(68.3--78.3)

Honolulu, Hawaii

950

73.1

1.7

(69.8--76.4)

Houma--Bayou Cane--Thibodaux, Louisiana

155

61.3

4.4

(52.6--70.0)

Houston--Sugar Land--Baytown, Texas

484

65.0

2.6

(59.8--70.2)

Huntington--Ashland, West Virginia--Kentucky--Ohio

220

77.1

3.2

(70.8--83.4)

Idaho Falls, Idaho

143

55.4

4.5

(46.5--64.3)

Indianapolis--Carmel, Indiana

638

69.9

2.4

(65.1--74.7)

Jackson, Mississippi

381

64.5

2.8

(59.0--70.0)

Jacksonville, Florida

326

68.1

3.2

(61.8--74.4)

Kahului--Wailuku, Hawaii

380

68.7

2.9

(63.0--74.4)

Kalispell, Montana

185

62.3

4.3

(53.9--70.7)

Kansas City, Missouri--Kansas

1,784

70.3

1.8

(66.7--73.9)

Kapaa, Hawaii

188

71.8

3.8

(64.4--79.2)

Kennewick--Pasco--Richland, Washington

191

69.0

3.9

(61.4--76.6)

Kingsport--Bristol--Bristol, Tennessee--Virginia

187

80.4

3.5

(73.6--87.2)

Lake Charles, Louisiana

208

69.9

3.6

(62.8--77.0)

Las Cruces, New Mexico

254

64.8

3.3

(58.3--71.3)

Las Vegas--Paradise, Nevada

367

61.6

2.9

(55.9--67.3)

Lawrence, Kansas

170

77.3

3.5

(70.4--84.2)

Lebanon, New Hampshire--Vermont

426

72.0

2.4

(67.3--76.7)

Lewiston, Idaho--Washington

200

67.6

3.5

(60.8--74.4)

Lincoln, Nebraska

356

75.9

2.7

(70.6--81.2)

Little Rock--North Little Rock--Conway, Arkansas

265

72.7

3.3

(66.3--79.1)

Los Angeles--Long Beach--Glendale, California

511

63.3

2.5

(58.3--68.3)

Louisville/Jefferson County, Kentucky--Indiana

769

69.6

3.0

(63.7--75.5)

Lubbock, Texas

196

67.9

3.7

(60.6--75.2)

Manchester--Nashua, New Hampshire

425

71.8

2.9

(66.1--77.5)

Manhattan, Kansas

174

63.9

4.1

(55.9--71.9)

McAllen--Edinburg--Mission, Texas

178

61.9

4.1

(53.9--69.9)

Memphis, Tennessee--Mississippi--Arkansas

481

65.5

3.3

(59.0--72.0)

Miami--Fort Lauderdale--Pompano Beach, Florida

348

59.8

3.6

(52.7--66.9)

Milwaukee--Waukesha--West Allis, Wisconsin

201

77.6

4.0

(69.8--85.4)

Minneapolis--St. Paul--Bloomington, Minnesota--Wisconsin

859

76.9

1.8

(73.5--80.3)

Minot, North Dakota

162

67.0

4.1

(59.0--75.0)

Mobile, Alabama

244

65.5

3.4

(58.8--72.2)

Myrtle Beach--North Myrtle Beach--Conway, South Carolina

261

68.3

3.2

(62.0--74.6)

Nashville--Davidson--Murfreesboro--Franklin, Tennessee

271

72.2

3.0

(66.3--78.1)

Nassau--Suffolk, New York*

282

69.1

3.1

(63.1--75.1)

Newark--Union, New Jersey--Pennsylvania

828

67.0

2.1

(62.8--71.2)

New Haven--Milford, Connecticut

525

73.7

2.4

(68.9--78.5)

New Orleans--Metairie--Kenner, Louisiana

468

70.6

2.4

(65.8--75.4)

New York--White Plains--Wayne, New York--New Jersey

1,127

61.5

2.1

(57.4--65.6)

Norfolk, Nebraska

206

71.3

3.4

(64.7--77.9)

North Platte, Nebraska

195

69.0

3.8

(61.5--76.5)

Oakland--Fremont--Hayward, California

364

67.0

3.6

(59.9--74.1)

Ocean City, New Jersey

190

72.0

3.6

(65.0--79.0)

Ogden--Clearfield, Utah

386

70.3

2.6

(65.2--75.4)

Oklahoma City, Oklahoma

646

72.8

1.9

(69.0--76.6)

Olympia, Washington

237

70.7

3.3

(64.2--77.2)

Omaha--Council Bluffs, Nebraska--Iowa

684

76.9

2.1

(72.9--80.9)

Orlando--Kissimmee, Florida

298

65.2

3.5

(58.2--72.2)


TABLE 11. (Continued) Estimated proportion of adults aged ≥65 years who had received an influenza vaccination during the preceding 12 months, by metropolitan and micropolitan statistical area (MMSA) --- Behavioral Risk Factor Surveillance System, United States, 2009

MMSA

Sample size

%

SE

(95% CI)

Pascagoula, Mississippi

241

70.6

3.9

(62.9--78.3)

Peabody, Massachusetts

593

72.1

2.9

(66.4--77.8)

Philadelphia, Pennsylvania

510

74.5

2.2

(70.1--78.9)

Phoenix--Mesa--Scottsdale, Arizona

517

72.1

2.5

(67.3--76.9)

Pittsburgh, Pennsylvania

765

73.6

2.1

(69.5--77.7)

Portland--South Portland--Biddeford, Maine

814

76.5

1.6

(73.3--79.7)

Portland--Vancouver--Beaverton, Oregon--Washington

923

65.9

1.9

(62.1--69.7)

Providence--New Bedford--Fall River, Rhode Island--Massachusetts

2,678

73.2

1.2

(70.9--75.5)

Provo--Orem, Utah

250

67.2

3.3

(60.7--73.7)

Raleigh--Cary, North Carolina

229

75.3

3.4

(68.6--82.0)

Rapid City, South Dakota

314

75.6

2.6

(70.5--80.7)

Reno--Sparks, Nevada

357

67.4

2.7

(62.1--72.7)

Richmond, Virginia

227

70.2

3.5

(63.3--77.1)

Riverside--San Bernardino--Ontario, California

529

59.7

2.6

(54.7--64.7)

Riverton, Wyoming

155

67.3

4.2

(59.1--75.5)

Rochester, New York

176

80.3

3.2

(74.1--86.5)

Rockingham County--Strafford County, New Hampshire

453

71.0

2.3

(66.4--75.6)

Rutland, Vermont

208

69.9

3.5

(63.0--76.8)

Sacramento--Arden--Arcade--Roseville, California

382

69.0

2.9

(63.4--74.6)

St. Louis, Missouri--Illinois

498

72.9

2.7

(67.7--78.1)

Salt Lake City, Utah

993

70.0

1.7

(66.6--73.4)

San Antonio, Texas

250

69.0

3.5

(62.0--76.0)

San Diego--Carlsbad--San Marcos, California

495

67.5

2.6

(62.4--72.6)

San Francisco--San Mateo--Redwood City, California

289

69.1

3.6

(62.0--76.2)

San Jose--Sunnyvale--Santa Clara, California

246

73.6

3.6

(66.5--80.7)

Santa Ana--Anaheim--Irvine, California

434

69.3

2.8

(63.8--74.8)

Santa Fe, New Mexico

226

65.6

3.6

(58.5--72.7)

Scottsbluff, Nebraska

296

67.0

3.1

(60.8--73.2)

Scranton--Wilkes-Barre, Pennsylvania

312

63.4

3.7

(56.1--70.7)

Seaford, Delaware

614

71.3

2.0

(67.4--75.2)

Seattle--Bellevue--Everett, Washington*

1,327

69.4

1.7

(66.0--72.8)

Shreveport--Bossier City, Louisiana

231

64.1

3.5

(57.2--71.0)

Sioux City, Iowa--Nebraska--South Dakota

362

73.4

4.4

(64.8--82.0)

Sioux Falls, South Dakota

267

76.8

2.8

(71.3--82.3)

Spokane, Washington

376

66.7

2.7

(61.4--72.0)

Springfield, Massachusetts

576

71.0

2.7

(65.7--76.3)

Tacoma, Washington

494

71.3

2.4

(66.6--76.0)

Tallahassee, Florida

146

NA

NA

NA

Tampa--St. Petersburg--Clearwater, Florida

372

61.3

2.9

(55.5--67.1)

Toledo, Ohio

265

67.0

3.5

(60.2--73.8)

Topeka, Kansas

621

70.1

2.0

(66.1--74.1)

Trenton--Ewing, New Jersey

153

76.3

3.8

(68.8--83.8)

Tucson, Arizona

280

77.3

2.8

(71.8--82.8)

Tulsa, Oklahoma

746

72.7

1.8

(69.1--76.3)

Virginia Beach--Norfolk--Newport News, Virginia--North Carolina

285

72.8

3.3

(66.3--79.3)

Warren--Troy--Farmington Hills, Michigan

570

64.3

2.3

(59.8--68.8)

Washington--Arlington--Alexandria, District of Columbia--Virginia--Maryland--West Virginia

1,483

68.5

2.7

(63.3--73.7)

Wenatchee, Washington

206

74.7

3.7

(67.5--81.9)

Wichita, Kansas

1,198

69.4

1.5

(66.5--72.3)

Wilmington, Delaware--Maryland--New Jersey

528

71.4

2.3

(66.9--75.9)

Wilmington, North Carolina

190

76.7

4.8

(67.3--86.1)

Worcester, Massachusetts

534

71.8

2.6

(66.8--76.8)

Yakima, Washington

261

64.3

3.2

(58.0--70.6)

Youngstown--Warren--Boardman, Ohio--Pennsylvania

297

63.0

4.3

(54.7--71.3)

Median

70.3

Range

55.4--81.4

Abbreviations: SE = standard error; CI = confidence interval.

* Estimate not available if the unweighted sample size for the denominator was <50 or if the 95% CI half width is >10.

Metropolitan division.


TABLE 12. Estimated proportion of adults aged ≥65 years who had received an influenza vaccination during the preceding 12 months, by county --- Behavioral Risk Factor Surveillance System, United States, 2009

County

Sample size

%

SE

(95% CI)

Jefferson County, Alabama

176

66.1

4.0

(58.2--74.0)

Mobile County, Alabama

244

65.5

3.4

(58.8--72.2)

Anchorage Municipality, Alaska

62

NA*

NA

NA

Maricopa County, Arizona

380

72.8

2.7

(67.6--78.0)

Pima County, Arizona

280