History of the BRFSS

At the beginning of the 20th century, infectious diseases were the major cause of death and disability in the United States. With the development of antibiotics and immunizations, many infectious diseases have been well controlled. Chronic diseases are now our nationís leading killers.

Starting in the 1970s there was growing evidence that personal behaviors influence health. These behaviors include:

o        Tobacco use

o        Physical activity

o        Diet

o        Routine health check-ups

o        Screening exams

Consequently, the public health community and the general public became increasingly interested in personal behavior and how behavior change can reduce the risks for chronic diseases, injuries, and preventable infectious diseases.

Surveillance of health-related behaviors is an essential part of any effort to promote health and prevent disease. It provides the necessary data to guide these efforts at the national, state and local levels. In the early 1980s, the Centers for Disease Control and Prevention (CDC) worked with the states to develop the Behavioral Risk Factor Surveillance System (BRFSS) in order to collect this important information at the state level.

Also in the early 1980s, telephone surveys proved to be a reliable and affordable way to collect risk behavior data. For this reason, the BRFSS was developed as a rapid, low-cost telephone surveillance system using random-digit dialing. It was initiated in 1984 with 15 states collecting data. By 1996, all 50 states, the District of Columbia and several U.S. territories participated in the BRFSS.

BRFSS Overview

The purpose of the BRFSS is to collect uniform, state-based data on preventive health practices and risk behaviors. Data are collected through monthly telephone interviews conducted among a random sample of each stateís non-institutionalized, civilian adult population living in households with a landline telephone. The BRFSS uses a scientifically selected telephone sample so that results can be generalized to the total population. The interviews are done monthly throughout the year in order to avoid seasonal variation in the data. Participation in the survey is strictly voluntary and personal identifiers such as names and addresses are not used.

The CDC edits and processes the data from each state monthly and supplies prevalence information and selected reports to all states quarterly. The data are also available on the CDCís BRFSS Web site at www.cdc.gov/brfss. Utah-specific data and reports are available on this site and from the Utah Department of Health by contacting the BRFSS Coordinator.

The BRFSS Questionnaire

Questions are designed to gather information from adults on their health-related knowledge, attitudes, and practices. The BRFSS questionnaire has three parts: (1) the core component, (2) optional modules and (3) state-added questions. The core component questions are asked of all states. The optional modules are sets of questions on specific topics that the states may choose to include. State-added questions are developed or acquired by individual states. Each year, the states and CDC agree on the content of the core component and optional modules. Topics include:

o        Health status and access to care

o        Tobacco and alcohol use

o        Diet (consumption of fruits and vegetables)

o        Physical activity

o        HIV and AIDS

o        Womenís health

o        Injury control (seats belts, bicycle helmets)

o        Demographic information

New questionnaires are implemented in January and usually remain unchanged throughout the year. However, the flexibility of state-added questions does permit additions, changes, and deletions at any time during the year. For a copy of the national BRFSS questionnaires go to www.cdc.gov/brfss/. The Utah BRFSS has been conducted in Spanish since January 2003.

Versatility of the BRFSS

The benefits of the BRFSS for states include the following:


Behavioral Risk Factor Surveillance System Operational and User's Guide, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Available on line at http://ftp.cdc.gov/pub/Data/Brfss/userguide.pdf.

Further information about Utahís BRFSS may be obtained by contacting Jennifer Wrathall, Utah BRFSS Coordinator, in the Office of Public Health Assessment, Utah Department of Health, P. O. Box 142101, Salt Lake City, UT 84114-2101. Phone: (801) 538-9259. Email: jwratha@utah.gov.

Page last updated on 2/11/2013