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2001 CHAP
Telephone Survey
What are Health Behaviors of Sedgwick
County Residents on Selected Indicators?
Because personal health behaviors
play a major role in premature morbidity and mortality, we
analyzed state-based behavioral risk factor information collected
by the Kansas Department of Health and Environment (KDHE).
Consequently, Sedgwick County data for 1998 and 1999 from the
Kansas Behavioral Risk Factor Surveillance System (BRFSS) were
combined to provide sufficient sample size for analysis. The
standard core questionnaire, which is collected annually, contains
health behavior questions relating to obesity, diabetes, tobacco
use, and women’s prevention service use as well as health
insurance coverage and health status. These questions were
analyzed as a portion of the 2001 CHAP.
Cigarette Smoking
According to 1999 BRFSS data,
just over 21.0% of Kansans smoked tobacco, comparable to the US
rate of 22.9%. (Sedgwick County data was not available for this
question). Of those who do smoke on a daily basis in Sedgwick
County, Kansas, and the US, the majority (76.3%, 79.8, and 81.2%,
respectively), smoke between 1 – 20 cigarettes per day (see
graph
14), while approximately 20% smoke between 21-40 cigarettes
(20.3%, 18.1% and 17.1%, respectively). A very small percentage
smoke greater than 40 cigarettes per day (3.4%, 2.1%, and 1.5%,
respectively.) Approximately 50.0% of Sedgwick County smokers
attempted to quit smoking during 1998-99. This rate is comparable
to rates for Kansas and the US, 48.5% and 51.3%, respectively (see
Graph 15). For those who have quit smoking cigarettes in Sedgwick
County, Kansas and the US, over 60% reported smoking cessation for
between 5 - 15 years, while over 15 % have quit for 1-5 years.
Across the three groups, less than 15.0% report a year or less
since they stopped smoking cigarettes (SC = 14.1%, KS = 14.7%, US
= 11.9%) (See Graph 16). The final analysis of this section is a
comparison of those who are at risk for smoking-related illness.
Just over 20% of Sedgwick County, Kansas and the US survey
respondents are at-risk for smoking related illness (see
graph
17).
Women’s Health
Several questions within the 1999
BRFSS core questionnaire relate to women’s preventive health
practices including clinical breast exam (CBE), mammography, and
Pap tests. Overall, Sedgwick County women compare favorably with
state and national rates for the screening practices for women.
Breast cancer is a major cause of
death among American women. Current statistics quoted by the
Department of Health and Human Services indicate that breast
cancer deaths are 27.7 per 100,000 females in 1998 (US Department
of Health and Human Services, 2000). Moreover, an estimated
175,000 new cases may be diagnosed within the year. About 43,700
U.S. women were expected to die from breast cancer in 1999,
accounting for about 16.5 percent of cancer deaths among women
(Landis et al, 1999). It has been estimated that one in every
nine women will develop breast cancer, with the greatest incidence
being in women 35 and older (American Cancer Society, 1999).
Death from breast cancer can be
reduced substantially if the tumor is discovered at an early
stage. Mammography is the most effective method for detecting
these early malignancies. Clinical trials have demonstrated that
mammography screening can reduce breast cancer deaths by 20 to 39
percent in women aged 50 to 74 years and about 17 percent in women
aged 40 to 49 years (Kerlikowske et al, 1995). To achieve Healthy
People 2010 goals for reduction of breast cancer death, a higher
percentage of females in the United States aged 40 years and older
need to comply with screening recommendations, including
mammography and breast self-exam (Fletcher et al, 1993, Champion,
1989).
The American Cancer Society’s
recommendations for monthly breast self-examination are 1)
professional or clinical breast examination (PBE or CBE) every
three years for women 10-40 years of age and annually thereafter,
and 2) baseline mammography screening every one to two years for
women 40 to 49 years and annually for women greater than or equal
50 years of age. Healthy People (HP) 2010 objective 3-13
advocates increasing the proportion of women aged 40 years and
older who have received a mammogram within the preceding 2 years.
The HP 2010 target is 70%. The 1998 baseline is 68%.
Of those women surveyed in
1998-99 in Sedgwick County, and 1999 in Kansas, approximately
85.0% report having had a CBE in the past (85.2%, 85.4%,
respectively). National CBE rates are slightly higher (89.0%)
(See graph 18). Nearly 80% of women surveyed report having had a CBE in the past one year in Sedgwick County, Kansas, and the US
(76.5%, 78.2%, 75.9%, respectively). However, 15.2% of Sedgwick
County respondents report 1-2 years since their last CBE, slightly
higher than state (13.1%) and national (12.9%) rates. Rates for
CBE of two or more years are slightly lower for Sedgwick County in
comparison to Kansas and the US (7.5%, 8.7%, and 11.3%,
respectively) (see graph 19).
Only 60.0% of women surveyed
during the same time period report ever having had a mammogram (SC
= 60.6%, Ks = 62.0%, US = 60.6%) (See
graph 20). A majority of
women report having a mammogram within the past year (SC = 61.6%,
Ks = 69.0%, US = 65.6%) (See graph 19). Nearly 90% of women
report the main reason for a mammogram is a routine checkup (SC =
88.3%, Ks = 93.4%, US = 88.8%) (See
graph 20). Although the
Kansas rate nears the HP 2010 goal of 70%, Sedgwick County’s rate
is somewhat below the target.
Pap Test
Cervical cancer affects fewer
women than breast cancer, but it remains the 10th most
common cancer among females in the US and accounts for 1.8% of
cancer deaths among women. It was anticipated that in 1999 an
estimated 12,800 new cases would be diagnosed, and the rate of new
cases remains higher among racial and ethnic minority women.
Invasive cervical cancer is generally preceded by precancerous
changes in cervical cells identifiable through a Pap test. With
early detection, the probability of survival is almost 100% with
appropriate treatment and followup (HP2010 pg 3-14). HP 2010
objective 3-11a advocates increasing the proportion of women aged
18 and older who have ever received a Pap test to 97%. The 1998
baseline is 92%. In addition, HP 2010 objective 3-11b advocates
for women aged 18 years and older receive a Pap test within the
preceding 3 years. The 1998 baseline is 79% whereas the 2010
target is 90%.
Nearly 95% of women report having
had a Pap test in the past (SC = 93.8%, Ks = 95.1%, US = 95.1%)
(See graph 23). However, only 70% report having had a Pap test in
the past year (SC = 71.9%, Ks = 72.0%, US = 69.2%). In addition,
15.8% of Sedgwick County respondents report 1-2 years since their
last Pap test, slightly higher than state (13.1%) and national
(13.4%) rates. Rates for Pap test of two or more years are
slightly lower for Sedgwick County in comparison to Kansas and the
US (10.7%, 15.0%, and 17.0%, respectively) (see
graph 24). Nearly
95% of women report the main reason for a mammogram is a routine
checkup (SC = 98.0%, Ks = 97.7%, US = 94.4%) (See
graph 25).
Self-reported hysterectomy rates
for Sedgwick County (21.5%) are slightly lower than those for
Kansas (24.0%) and the US (22.7%) (See
graph 26). Approximately
5.0% percent of women reported being pregnant at the time of the
survey (SC = 5.8%, Ks = 6.4%, US = 4.9%) (See
graph 27).
Diabetes
When
BRFSS survey respondents were asked, “Have you ever been told by a
doctor that you have diabetes?” 6.0% or less respond yes.
Self-reported diabetes rates for Sedgwick County (6.0%) are
slightly higher than those for Kansas (5.6%) and the US (5.6%)
(See graph 28).
Obesity
The BRFSS
core questionnaire collects height and weight from survey
participants, and from this information, an at-risk score for
obesity is calculated. Approximately 1/3 of Sedgwick County
citizens are at risk for obesity, which is marginally lower
(30.4%) than for Kansas at 33.4% or the US at 33.7% (see
graph
29).
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