Abstract
Problem/ConditionPersons living in rural areas are recognized as a health disparity population because the prevalence of disease and rate of premature death are higher than for the overall population of the United States. Surveillance data about health-related behaviors are rarely reported by urban-rural status, which makes comparisons difficult among persons living in metropolitan and nonmetropolitan counties.Reporting Period2013.Description of SystemThe Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing, state-based, random-digit-dialed landline- and cellular-telephone survey of noninstitutionalized adults aged ≥18 years residing in the United States. BRFSS collects data on health-risk behaviors, chronic diseases and conditions, access to health care, and use of preventive health services related to the leading causes of death and disability. BRFSS data were analyzed for 398,208 adults aged ≥18 years to estimate the prevalence of five self-reported health-related behaviors (sufficient sleep, current nonsmoking, nondrinking or moderate drinking, maintaining normal body weight, and meeting aerobic leisure time physical activity recommendations) by urban-rural status. For this report, rural is defined as the noncore counties described in the 2013 National Center for Health Statistics Urban-Rural Classification Scheme for Counties.ResultsApproximately one third of U.S. adults practice at least four of these five behaviors. Compared with adults living in the four types of metropolitan counties (large central metropolitan, large fringe metropolitan, medium metropolitan, and small metropolitan), adults living in the two types of nonmetropolitan counties (micropolitan and noncore) did not differ in the prevalence of sufficient sleep; had higher prevalence of nondrinking or moderate drinking; and had lower prevalence of current nonsmoking, maintaining normal body weight, and meeting aerobic leisure time physical activity recommendations. The overall age-adjusted prevalence of reporting at least four of the five health-related behaviors was 30.4%. The prevalence among the estimated 13.3 million adults living in noncore counties was lower (27.0%) than among those in micropolitan counties (28.8%), small metropolitan counties (29.5%), medium metropolitan counties (30.5%), large fringe metropolitan counties (30.2%), and large metropolitan centers (31.7%).InterpretationThis is the first report of the prevalence of these five health-related behaviors for the six urban-rural categories. Nonmetropolitan counties have lower prevalence of three and clustering of at least four health-related behaviors that are associated with the leading chronic disease causes of death. Prevalence of sufficient sleep was consistently low and did not differ by urban-rural status.Public Health ActionChronic disease prevention efforts focus on improving the communities, schools, worksites, and health systems in which persons live, learn, work, and play. Evidence-based strategies to improve health-related behaviors in the population of the United States can be used to reach the Healthy People 2020 objectives for these five self-reported health-related behaviors (sufficient sleep, current nonsmoking, nondrinking or moderate drinking, maintaining normal body weight, and meeting aerobic leisure time physical activity recommendations). These findings suggest an ongoing need to increase public awareness and public education, particularly in rural counties where prevalence of these health-related behaviors is lowest.
Highlights
Consistent with provisions of the Minority Health and Health Disparities Research and Education Act of 2000, Public Law 106-525, the Health Disparities Strategic Plan : 1) establishes the health disparities research priorities, objectives, and activities proposed throughout the National Institutes of Health (NIH); 2) includes an estimated budget by Institutes and Centers (ICs) of the funding required to accomplish the objectives for each overarching goal; and 3) describes the means for achieving stated objectives, and the dates objectives are expected to be achieved
This creates an avenue for integrated coordination across the different ICs, which are distinct in their missions and operations, providing sound and cohesive means to accomplish agency-wide strategic goals
Conduct Genetics of Renal Disease in African Americans --This study aims to understand genetic predisposition to kidney disease in the African American population
Summary
Prior versions of the plan had identified Research, Research Capacity Building, and Community Outreach, Information Dissemination and Public Health Education as overarching goals. Within the areas of emphasis, the individual programs, initiatives and planned or proposed activities are listed under the individual ICs, including many that involve multiple ICs. Consistent with provisions of the Minority Health and Health Disparities Research and Education Act of 2000, Public Law 106-525, the Health Disparities Strategic Plan : 1) establishes the health disparities research priorities, objectives, and activities proposed throughout the NIH; 2) includes an estimated budget by IC of the funding required to accomplish the objectives for each overarching goal; and 3) describes the means for achieving stated objectives, and the dates objectives are expected to be achieved.
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