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BACKGROUND: BRFSS is a state-based telephone survey designed to collect information about health risk behaviors, clinical preventive practices, and access to healthcare and utilization with the focus on chronic disease and injury. Traditionally, interviewers made calls to land-line (LL) telephone numbers only. However, the numbers of cellular phone-only (CP) households in the U.S. have increased by more than 700 percent during 2003-2009, prompting the CDC in 2011 to include households with CP in the BRFSS to obtain data that better represent the population.
METHODS: The Georgia BRFSS is an annual telephone survey of non-institutionalized adults 18 years and older. We analyzed the 2011 BRFSS data for Georgia (n=9,960) and compared LL-only (n=9,023) and CP-only (n=937) households on demographic characteristics (race/ethnicity, sex, age, income, education, and health coverage), certain risk behaviors (smoking, drinking alcohol, physical inactivity, and health coverage), and chronic diseases (diabetes, asthma, stroke, heart attack, obesity, and arthritis).
RESULTS: CP respondents were significantly more likely to be males (CP=58%, 95% CI=54.4–61.7 vs. LL=49%, 95% CI=46.6–50.5), Black/Non-Hispanic (CP=35%, 95% CI=31.4–39.0 vs. LL=28%, 95% CI= 26.3–29.9), aged 18-34 years (CP=63%, 95% CI=59.5-66.4 vs. LL=36%, 95% CI 30.3-34.7), and without a high school diploma (CP=23%, 95% CI=19.2–26.5 vs. LL=17%, 95% CI=15.8–18.8). Overall, the prevalence of risk behaviors was higher among CP respondents than LL respondents. Approximately 29% (95% CI=25.8–32.9) of CP respondents were smokers compared to 21% (95% CI=19.2–22.6) of LL respondents. Alcohol consumption was significantly higher among CP (60%, 95% CI=56.2–63.9) than LL respondents (48%, 95% CI=46.2–50.2). A larger proportion of LL households (74%, 95% CI=71.9–76.3) had some form of health coverage compared to CP households (54%, 95% CI=50.0–57.9). Chronic disease prevalence also differed from LL to CP households. LL respondents had higher prevalence of diabetes (LL= 11%, 95% CI=10.1–12.0 vs. CP=5%, 95% CI=3.5–6.1), and obesity (LL= 30%, 95% CI=28.0–31.6 vs. CP=24%, 95% CI=20.7–27.1), and were more likely to have had a previous heart attack (5%, 95% CI=4.1–5.4 vs. CP=2%, 95% CI=1.5–3.3).
CONCLUSIONS: Overall, the population in Georgia varies from cellular-only to landline-only household respondents in regards to demography, prevalence of chronic diseases and certain risk behaviors. Therefore, incorporating cellular-only respondents into the Georgia BRFSS is imperative to gathering a representative surveillance data on health risk behaviors, clinical preventive practices and health care access and utilization among Georgia adults.