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Highlights 2004

Behavioral Risk Factor Surveillance System (BRFSS)

Highlights from the 2004 North Carolina BRFSS survey results:

For the 2004 survey, the North Carolina BRFSS Program conducted a record 15,053 interviews in both English and Spanish, making the NC-BRFSS second largest state-based health survey in the nation. The sample size was large enough to provide estimates of health indicators such as obesity, smoking, asthma, and diabetes for each major minority group in North Carolina: African Americans, American Indians, Asians, and Hispanics. Local (county) level data are available for 22 of the largest counties and 13 regions which consist of the remaining 78 counties. The 2004 results for each question are available on the BRFSS web site by sex, race, Hispanic origin and language (English, Spanish-only), age group, education level, household income, disability status, veteran status, county, region, and Area Health Education Center (AHEC).

Health Care Access:

  • An estimated one million North Carolina adults under age 65 (one in five adults) had no health insurance coverage. The rate of no health insurance coverage did not change between 2003 and 2004. Minorities had much lower rates of health insurance coverage (20.6% among African Americans and 26.7% among American Indians) possibly contributing health disparities in North Carolina between minority groups and whites (12%). Only one in three Hispanics reported having health insurance coverage.
  • Sixteen percent of adults were contacted by a collection agency about owing money for medical bills and one in five North Carolina adults had problems paying their medical bills.
  • Approximately seventeen percent of North Carolina adults could not get medical care when they needed it in the past 12 months due to cost. Approximately half of these adults, who could not get medical care due to cost, had health insurance.

Health Risks:

  • The good news is that fewer North Carolina adults smoked cigarettes in 2004 compared to 2003 (declined from 24.8% in 2003 to 22.5% in 2004). This is second year in a row which has seen a modest decline in smoking rates. Smoking prevalence was highest among adults with less than a high school education (31.3%).
  • Across North Carolina in 2004, the lowest smoking rates were in Wake (14.5%), Orange (16.1%), and Union (16.9%) counties and the highest rates were in Rowan (31.3%), Onslow (30.5%), and Robeson (30.4%) counties. More people in rural areas reported smoking compared to those in urban areas.
  • The bad news is that prevalence of both obesity and overweight increased again by another one percentage point in 2004 compared to 2003. Approximately two thirds of North Carolina adults were either overweight or obese and of those, one in four was obese. The adult male obesity rate caught up with the rate for adult females and both were approximately twenty-five percent in 2004. Also, obesity prevalence was much higher among Native Americans and African Americans than whites.
  • Approximately 8.4% of adults reported binge-drinking (5 or more drinks on at least one occasion) in the past month.
  • Overall, a quarter of North Carolina adults reported no leisure-time activity.
  • Approximately 16% of adults reported that they had some kind of illness or symptoms caused by poor indoor air and 12% of adults reported some kind of illness or symptom caused by outdoor air pollution in the past 12 months.

Chronic Conditions:

  • The prevalence of diabetes increased 19% in 2004 (from 8.1% in 2003 to 9.6% in 2004) and it has been steadily increasing for many years across all socio-demographic groups. Diabetes prevalence was higher among African Americans (13.7%) and Native Americans (10.2%) than among whites (9.1%).
  • Robeson County had the highest rate of diabetes (14.5%) in North Carolina along with Gaston (13.6%) and eastern North Carolina counties.
  • The prevalence of ever being diagnosed with asthma increased again slightly in 2004 to 12.6%, up from 11.3% in 2003. Asthma prevalence was somewhat higher among Native Americans and African Americans than whites.

Quality of Life:

  • Approximately 30% of North Carolina adults reported some kind of disability. The rate of disability was much higher in the eastern and western part of the state than in the Piedmont.
  • One in five of North Carolinians rated their overall health as fair or poor.
  • Approximately 14% of North Carolinians reported that their physical health was not good for at least 8 days out of the past 30 days.
  • Approximately 12% of North Carolinians reported that their mental health was not good for at least 8 days out of the past 30 days.
  • Approximately 9% of North Carolinians reported that due to poor physical or mental health they could not do their usual activities, such as self-care, work, or recreation for at least 8 days out of the past 30 days.

Preventive Health Behaviors:

  • The rate of ever having a mammogram increased in North Carolina from 65% in 2002 to 69% in 2004 (among women ages 18+). However, having a mammogram within the past two years (recommended) for women ages 40 + declined from 81.2% in 2002 to 77.9% in 2004.
  • Approximately 90% of women who were ages 21 + and had intact cervix had a Pap smear within the past 3 years.
  • The rate of ever having a Prostate-Specific Antigen (PSA) test (a test for screening for prostate cancer) has increased from 62.4% in 2002 to 65.2% in 2004 for males ages 40 and older.
  • The rate of ever having a sigmoidoscopy/colonoscopy exam (used for colorectal cancer screening) increased significantly from 47.7% in 2002 to 55.1% in 2004 for adults ages 50 and older.
  • About one-third of all North Carolinians had a flu shot in the last 12 months; however, this rate was only about 20% in December 2004 due to the flu vaccine shortage. Mainly high risk groups received flu shots in November and December of 2004.
  • The percentage of people getting a pneumonia vaccination increased only slightly from 21.8% in 2003 to 22.7 % in 2004.

About the BRFSS survey

The Behavioral Risk Factor Surveillance System (BRFSS) is a random telephone survey of state residents age 18 and older in households with telephones. The BRFSS Survey was initially developed in the early 1980s by the Centers for Disease Control and Prevention (CDC) in collaboration with state health departments, and is currently being conducted in all 50 states, the District of Columbia, and three United States territories. The BRFSS is the longest running and largest telephone health survey in the world.

For the 2004 survey, the North Carolina BRFSS Program conducted interviews in both English and Spanish and interviewed a total of 15,053 adults. The 2004 questionnaire included 167 questions covering many different topics: Health Status, Health Care Access, Exercise, Environmental Factors, Excess Sun Exposure, Tobacco Use, Alcohol Consumption, Asthma, Diabetes, Oral Health, Immunization, Women’s Health, Prostate Cancer Screening, Colorectal Cancer Screening, Family Planning, Disability, HIV/AIDS, Firearms, Sexual Behavior, Folic Acid, Other Tobacco Products, Smoking Cessation, Secondhand Smoke Policy, Health Care Cost/Underinsurance, Diabetes Counseling and Screening, Skin Cancer Prevention, Quit Now NC, Care Giving (Aging), and Winner’s Circle. (see the 2004 questionnaire on our web site)

The 2004 sample design included over-sampling of 22 counties and 13 regions which consist of the remaining 78 smaller counties to produce county or regional BRFSS estimates. The 2004 results for each question are available on the BRFSS web site by sex, race, Hispanic origin and language (English, Spanish-only), age group, education level, household income, disability status, veteran status, county, region, and Area Health Education Center (AHEC). The new BRFSS Survey results provide public health planners and program managers with a closer look at the health and well-being of North Carolina's minority populations, as well as that of the state's general population. The 2004 data provide estimates on the health of Native Americans and Hispanics speaking Spanish-only.

It should be noted that the county-level percentages may vary substantially from year to year due to random variation resulting from a relatively small survey sample size. The margin of error for the county indicators is approximately plus or minus 5%, so fairly large changes in the percentages over time may be expected. Please pay attention to the 95% confidence interval information that is provided with each percentage on the BRFSS web site.

Return to 2004 BRFSS Annual Results Table of Contents