presentation_1_brfss_presentation_2011

Utilization of the BRFSS to Explore Local Health Disparities

Doménica Niño, BA, UTPASuad Ghaddar, PhD, UTPAXiaohui Wang, PhD, UTPA

Liza Talavera-Garza, PhD, UTPAMelissa Valerio, PhD, University of Michigan

Pooja Chopra, MA, UTPA

The University of Texas-Pan American (UTPA)South Texas Border Health Disparities Center

28th Annual BRFSS Conference Atlanta, GA 2011 2

Our mission is to promote research related to health disparities along the Texas-Mexico border.

Health disparities are “differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the United States.”

SOUTH TEXAS BORDER HEALTH DISPARITIES CENTER


OUTLINE

Objective

Background

Methods

Results

Conclusion


To identify areas of health disparities among manufacturing workers in South Texas compared to state and county populations using questions from the BRFSS.

OBJECTIVE


BACKGROUND

CAMERON

STARR

HIDALGOWillacy

28th Annual BRFSS Conference Atlanta, GA 2011

Mainly Hispanic population Lower educational attainment Higher poverty rates Higher rates of uninsured Inadequate number of health providers High rates of diabetes and obesity

6

BACKGROUND


The data is part of a larger study on Health Literacy in the Manufacturing Workplace (HLW)

Sample: 228 employees from 8 manufacturing companies in Hidalgo County Survey, blood work, and anthropometric measures Incentive: $25 gift card per employee Survey dates: July and August 2010 Survey language: English and Spanish

METHODS SAMPLE


Survey: Socio-demographics Health status Health care coverage Prevention services Health information Health literacy Health behaviors

Clinical and anthropometric measures: Blood tests (HbA1c and cholesterol) Blood pressure Height and weight measurements

METHODS SURVEY INSTRUMENT


Fisher’s Exact test

Two-sample z-test for proportions

METHODS STATISTICAL ANALYSIS


Socio-Demographic Comparison Texas Hidalgo County HLW SampleAge (years) 33 27 39Female (%) 50 51 29Hispanic (%) 36 89 96Uninsured (%) 27 32 54Spanish speaking (%) 29 82 95*Individuals Below Poverty Level (%) 17 36 34*Percent who answered that they speak some level of Spanish in response to the question “In general, what language do you read and speak?”Source: U.S. Census Bureau: 2005-2009 American Community Survey 5-Year Estimates , 2007 Small Area Health Insurance Estimates (SAHIE)

SOCIO-DEMOGRAPHIC COMPARISON BY AREA


Health Behaviors Texas Hidalgo County HLW sample N 11K-12K 500-540 228

Fruit and Vegetable Consumption 5+ a Day¹ (%) 23.8 19.7 5.3**††

Participation in Any Physical Activity² (%) 72.7 59.8 55.2**Current Smoker (%) 17.9 14.7 25.4**††*p<.05 for comparison between rates for Texas and study sample**p<.01 for comparison between rates for Texas and study sample†p<.05 for comparison between rates for Hidalgo County and study sample††p<.01 for comparison between rates for Hidalgo County and study sample¹Adults who have consumed fruits and vegetables five or more times per day²During the past month, did you participate in any physical activities?Source: CDC: BRFSS Prevalence and Trends Data, 2009 and SMART: BRFSS City and County Data, 2009

RESULTS HEALTH BEHAVIORS


Screening and Prevention Texas Hidalgo County HLW sample N 3K-6K n/a§ 228Mammogram¹ (%) 72.6 n/a§ 48.6**Pap Smear² (%) 81.5 n/a§ 63.0**

Prostate Cancer Screening³ (%) 52.8 n/a§ 23.6**Colorectal Cancer Screening⁴ (%) 56.2 n/a§ 22.0***p<.05 for comparison between rates for Texas and study sample, Source CDC Smart county and state data: 2008 BRFSS **p<.01 for comparison between rates for Texas and study sample§data not available¹Women aged 40+ who have had a mammogram within the past two years²Women aged 18+ who have had a pap test within the past three years³Men aged 40+ who have had a PSA test within the past two years⁴Adults aged 50+ who have ever had a colonoscopySource: CDC: BRFSS Prevalence and Trends Data Texas, 2008

RESULTS SCREENING AND PREVENTION


Health Measurements Texas Hidalgo County HLW sample N 9K-11K 400-500 228Hypertension Awareness¹ (%) 29.1 25.3 21.0**Cholesterol Awareness² (%) 40.9 37.7 33.0*Diabetes³ (%) 9.3 9.8 7.0Obesity (Body Mass Index ≥30) (%) 29.5 35.5 46.0**††

Disability⁴ (%) 17.1 14.9 8.0**††*p<.05 for comparison between rates for Texas and for study sample**p<.01 for comparison between rates for Texas and study sample†p<.05 for comparison between rates for Hidalgo County and for study sample††p<.01 for comparison between rates for Hidalgo County and for study sample¹Adults who have been told they have high blood pressure²Adults who have had their blood cholesterol checked and have been told it was high³Have you ever been told by a doctor that you have diabetes?⁴Adults who are limited in any activities because of physical, mental or emotional problemsSource: CDC: BRFSS Prevalence and Trends Data, 2009 and SMART: BRFSS City and County Data, 2009

RESULTS HEALTH MEASUREMENTS


Self-Reported Health Status Texas Hidalgo County HWL SampleN 11558 534 228Excellent (%) 20 19 5Very Good (%) 30 19 19Good (%) 34 39 50Fair (%) 12 18 24Poor (%) 4 6 2Fisher’s Exact Test p <0.002Source: CDC: BRFSS Prevalence and Trends Data, 2009 and SMART: BRFSS City and County Data, 2009

RESULTS SELF-REPORTED HEALTH STATUS


Health disparities among manufacturing workers in South Texas are evident in the following areas: Health care coverage� Utilization of health screening services Chronic disease awareness Smoking rates� Physical activity levels� Fruit and vegetable consumption Obesity rates Self-reported health status

RESULTS SUMMARY


State and local surveillance accompanied by local research can highlight areas of health disparities for sectors of local communities.

Interventions promoting healthy behaviors are needed for manufacturing workers.

Low rates of health care coverage can account for low utilization of screening and prevention services.

Findings will inform the design of a health literacy and health promotion intervention within the workplace.

CONCLUSION


This research was funded by a grant from the Centers for Disease Control and Prevention (Grant H75DP001812). The contents of this presentation are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the South Texas Border Health Disparities Center.

FUNDING ACKNOWLEDGEMENT


ADDITIONAL INFORMATION

For additional information please contactDoménica Niño

[email protected]

mailto:[email protected]

presentation_1_brfss_presentation_2011

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