2025 Technical Appendix

Sociodemographic domains

Race/ethnicity: White, Black, and Asian refer to self-identified non-Hispanic White, non-Hispanic Black, and non-Hispanic Asian respectively. The “other” category includes American Indian, Native Hawaiian/Pacific Islander, multiracial and other.

Residence: The BRFSS reports whether the respondent resides in an urban or a rural county. Urban refers to large central-, large fringe-, medium-, or small- metropolitan, and micropolitan counties. Rural refers to noncore counties. Rural/urban determination was not available in the NSCH and ACS 1-Year data.

Household income: 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 level.1 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 2023 was $30,000 (except for Alaska and Hawaii). The income to poverty level ratio for this household would be ($22,500/$30,000) × 100% or 75.00%. Of note, midpoint for the top income category, i.e., income ≥ $200,000, was assumed to be $225,000.

Prevalence estimation

Prevalence rates were estimated using complex survey weights of the BRFSS, NSCH, and ACS. The differences between “Georgia and rest of US” and “Georgia and rest of the Southeast region” were assessed using survey-weight adjusted Wald tests. The level of significance was set at 5% level.

Prevalence trend

Three-year moving average estimates were used to produce trend graph for their respective conditions. For example, the data point for 2019 in the trend graph is the average of prevalence rates in 2017, 2018, and 2019. Similarly, the data point for 2023 in the trend graph is the average of prevalence rates in 2021, 2022, and 2023. For hypertension, high cholesterol, and physical activity 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.

Distribution by State

In the distribution chart, state level prevalence rates are presented in descending order. Along with Georgia, the neighboring five states (Alabama, Florida, North Carolina, South Carolina, and Tennessee) were highlighted.

Georgia Ranking Trends

For each year since 2011 (depending on data availability), states were ranked (in descending order) by prevalence rates for respective conditions. The ranking of Georgia for each year from 2011 to 2023 (as appropriate) are presented in the ranking trend chart.

Current rate as percentage of pre-COVID rate

For each state, the current prevalence rate (i.e., of 2023) was expressed as a percentage of pre-COVID rate (i.e., of 2019). Georgia and the neighboring five states (Alabama, Florida, North Carolina, South Carolina, and Tennessee) were highlighted.

Prevalence rate data

Condition	Georgia	Southeast	USA
Asthma	9.31	9.42	9.74
Cancer	7.10	8.67	7.94
CVD	8.56	10.53	8.68
COPD	6.17	7.58	6.19
Diabetes	12.73	13.52	11.99
Flu vaccination	36.97	39.24	42.27
Skin Cancer	5.26	6.63	5.41
Heavy Drinking	5.49	5.95	5.74
High Cholesterol	31.55	33.21	31.47
Hypertension	35.66	38.36	34.35
Long COVID	7.32	7.43	7.12
Cigarette Smoking	12.03	12.82	11.42
Mental Health	15.60	16.16	15.56
Multimorbidity	49.69	53.65	50.11
Obesity	35.00	34.76	32.76
Physical Activity	29.59	28.93	29.97
Vaping	7.65	8.32	7.44
Child Nutritious Meal Access	68.89	65.70	69.10
Child Obesity	14.87	17.10	16.30
Child Asthma	8.07	6.90	6.60
Child Breastfeeding	45.31	42.20	49.50
Child Unmet Medical Care	3.72	3.50	3.50
Child 3+ ACE Exposure	6.89	7.10	6.20
Insurance Coverage - Adult	86.39	89.39	91.09
Insurance coverage - Child	94.04	94.47	94.81
Opiod Use	3.40	3.52	3.41
Methamphetamine Use	0.88	1.04	1.04
Suicide*	7.90	8.04	6.83
Suicide - firearm related*	5.33	5.46	3.83
HIV*	779.70	535.12	437.90
Chlamydia*	646.40	559.46	492.23
Gonorrhea*	274.80	213.94	179.56
Syp	75.30	69.35	62.48

*per 100,000 people

¹Hest 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.