In this report, we compared the prevalence rates of several chronic conditions, and behavioral and preventive health measures among Georgians with respective national (U.S.) and regional (Southeast) averages. We used nationally representative data from the 2021 Behavioral Risk Factor Surveillance System (BRFSS) and the last five waves (2017 to 2021) of the National Survey of Children’s Health (NSCH) to assess the prevalence rates across the following domains: sex, race/ethnicity, income, and residence (urban/rural). We further reported the prevalence rates by age group and educational attainment. We also assessed health insurance coverage using data from the 2021 American Community Survey (ACS) 1-Year Public Use Microdata Sample (PUMS), and COVID-19 vaccination coverage using data from the U.S. Centers for Disease Control and Prevention (CDC) COVID Data Tracker website.
Across chronic conditions, the prevalence of high cholesterol among Georgians is comparable to the national and regional averages. Prevalence of hypertension, however, is significantly higher among Georgian adults than the national average comparable to the regional average. Prevalence of obesity, in contrast, is comparable to the national average, but significantly lower than the regional average. Among noncommunicable diseases, Georgia has a significantly lower prevalence of cancer compared to the national and regional averages. Prevalence of CVD in Georgia, while higher than the national average, is significantly lower than the regional average.
Among behavioral health measures, prevalence of smoking among Georgian adults, though lower than the regional average, is higher than the national average. Georgians report lower prevalence of depressive disorders than the national and regional averages. Among preventive behaviors, the influenza vaccination (flu shot) rate in Georgia is significantly lower than both national and regional averages.
Across child health measures, children in Georgia have a higher prevalence of asthma than the national and regional averages. Breastfeeding among children in Georgia, though comparable to the regional average, is significantly lower than the national average. Prevalence of unmet medical care is significantly higher among children in Georgia compared to the national and regional averages.
Compared to both national and regional averages, health insurance coverage among Georgian adults is significantly lower. COVID-19 vaccination rates among Georgians are also lower than the rest of the U.S.
We analyzed the 2021 Behavioral Risk Factor Surveillance System (BRFSS) to report findings for chronic conditions, noncommunicable diseases, behavioral health, and preventive health. Of note, the BRFSS 2021 provides data on all U.S. states and the District of Columbia, except Florida. We analyzed data from the National Survey of Children’s Health (NSCH) to report findings on pediatric health. We pooled data from the 2017, 2018, 2019, 2020, and 2021 waves of the NSCH. For health insurance coverage, we abstracted data from the 2021 American Community Survey (ACS) 1-Year Public Use Microdata Sample (PUMS) data. Lastly, we obtained COVID-19 vaccination data from the COVID Data Tracker website of the U.S. Centers for Disease Control and Prevention (CDC).
Our sample size for respective topics are as follows:
|
Topic |
Georgia |
Southeast |
United States |
Data Source |
|
High Cholesterol |
8,111 |
69,010 |
428,549 |
BRFSS 2021 |
|
Hypertension |
8,137 |
69,227 |
429,753 |
|
|
Obesity |
7,076 |
62,508 |
385,204 |
|
|
Arthritis |
8,144 |
69,088 |
428,812 |
|
|
Asthma |
8,155 |
69,250 |
429,914 |
|
|
Cancer |
8,157 |
69,287 |
430,297 |
|
|
CVD |
8,177 |
69,446 |
431,282 |
|
|
COPD |
8,147 |
69,180 |
429,564 |
|
|
Diabetes |
8,167 |
69,357 |
430,680 |
|
|
Heavy Drinking |
7,250 |
63,503 |
397,033 |
|
|
Smoking |
7,444 |
65,184 |
406,873 |
|
|
Depressive Disorders |
8,123 |
69,111 |
429,148 |
|
|
Physical Activity |
8,169 |
69,364 |
430,714 |
|
|
Flu Shot |
7,341 |
64,265 |
401,835 |
|
|
Child Nutritious Meal Access |
3,739 |
38,979 |
171,243 |
NSCH 2017-2021 |
|
Child Obesity |
1,906 |
19,227 |
82,869 |
|
|
Child Asthma |
3,819 |
39,580 |
173,584 |
|
|
Child Breastfeeding |
1,033 |
11,256 |
49,118 |
|
|
Child Unmet Medical Care |
3,828 |
39,865 |
174,595 |
|
|
Child 3+ ACE Exposure |
3,847 |
40,020 |
175,231 |
|
|
COVID-19 Vaccination - Adult |
- |
- |
- |
CDC |
|
COVID-19 Vaccination - Child |
- |
- |
- |
|
|
Insurance Coverage - Adult |
77,859 |
674,421 |
2,624,206 |
ACS 2021 |
|
Insurance coverage - Child |
19,245 |
153,681 |
628,393 |
BRFSS reports household income in 11 categories as follows: i) < $10,000; ii) $10,000 to < $15,000; iii) $15,000 to < $20,000; iv) $20,000 to < $25,000; v) $25,000 to < $35,000; vi) $35,000 to < $50,000; vii) $50,000 to < $75,000; viii) $75,000 to < $100,000; ix) $100,000 to < $150,000; x) $150,000 to < $200,000; and xi) $200,000 or more. The percentage of income in relation to the federal poverty level (FPL) was determined as follows: Suppose a respondent’s household income was reported as $20,000 to $24,999. The midpoint of this category, $22,500, was considered as the imputed income level1. The family size was determined by adding the number of children and number of adults in the household. For a family size of four (for example, two children and two adults), the federal poverty level threshold in 2021 was $26,500 (except for Alaska and Hawaii). The income to poverty level ratio for this household would be ($22,500/$26,500) × 100% or 84.91%. Of note, midpoint for the top income category, i.e., income ≥ $200,000, was assumed to be $225,000.
Citation for methodology: Hest R. Four Methods for Calculating Income as a Percent of the Federal Poverty Guideline (FPG) in the Behavioral Risk Factor Surveillance System (BRFSS). State Health Access Data Assistance Center. 2019 May.
Prevalence rates were estimated using complex survey weights of the BRFSS, NSCH, and ACS. The differences across Georgia and the rest of the United States or the rest of the southeastern region were assessed using survey-weight adjusted Wald tests. Level of significance was set at the 10% level. The Southeastern region consists of the following 12 states: Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, and West Virginia.
Three-year moving average estimates were used to produce trend graph for their respective conditions. For example, the data point for 2017 in the trend graph is the average of prevalence rates in 2015, 2016, and 2017. Similarly, the data point for 2021 in the trend graph is the average of prevalence rates in 2019, 2020, and 2021. For hypertension and high cholesterol, for which data are available every other year, the prevalence rate for the missing year was imputed by taking the average of the preceding and succeeding years. For example, the prevalence rate of 2018 was imputed by averaging the prevalence rates of 2017 and 2019. Prevalence trends were reported for topics for which data were obtained from the BRFSS and the ACS surveys. Prevalence trends were not presented for child health measures, for which data were pooled from 2017 to 2021 waves to acquire state level representation.
The conditions were self-reported in the BRFSS and NSCH. The U.S. and Southeastern region averages for the topics using BRFSS data excluded observations from Florida due to data unavailability. The 2021 wave of the surveys were conducted amid the COVID-19 pandemic, and hence, the estimates could differ from that in a pre-pandemic year.
