General Release Notes

2019 BRFSS

The default report has been changed to the statewide estimate for the most recent three years of data. This change was implemented to better align with our other reporting systems within IBIS. Users can still view all years of data and data by county by clicking on the Modify Query Definition, selecting all available years (Step 2: TIME PERIOD), setting the geography to county (Step 3: GEOGRAPHIC AREA), selecting geography as the display by (category) (Step 8), and clicking submit.

New BRFSS indicators added in 2019

There are many new indicators available:

Demographics

• Census race
• Primary care service area
• Food security - food stamps or SNAP benefits
• Food security - received free food

Health Behavior

• Alcohol - max number of drinks (cat)
• Cessation - used a program or support group, past 12 months
• Cessation - used a quitline, past 12 months
• Cessation - used one-on-one counseling, past 12 months
• Cessation - used patch, gum, or meds, past 12 months
• Cessation - without help, past 12 months
• Cigarettes - among adults with poor mental health
• Cigarettes - among binge drinkers
• Cigarettes - among heavy or binge drinkers
• Daily frequency of total fruit and vegetable consumption (2017+, cat)
• Daily frequency of total vegetable consumption (2017+, cat)
• Family planning - any, last intercourse
• Family planning - method used (cat)
• Family planning - reason none used (cat)
• Fell - treatment received, past 12 months (45+, cat)
• Injury - can swim
• Injury - ocean-based recreation
• Physical activity - in neighborhood, past 30 days (cat)
• Physical activity - neighborhood supports
• Prescription meds - pain meds, past year
• Read calories in restaurants (cat)
• Read calories in restaurants, ever
• Seat belt - seen or heard seat belt back seat msg
• SSB - consumption per day (cat)
• SSB - consumption per week (cat)
• Sweetened drinks - consumption per day (cat)
• Sweetened drinks - consumption per week (cat)

Access to Health Care

• Caregiving - main health problem (cat)
• HCP arranged home health services
• HCP referred to community based services
• Health care access - have personal doctor
• Health insurance - have Medicaid (2017+)

Screening and Preventive Services

• Cholesterol - check in the last 5 yrs
• HIV - high risk situations (18-64, 2017+)
• Preventive services - checkup within the past year
• Shingles - ever received vaccine (50+)

Chronic Diseases and Conditions

• Asthma - current prevalence
• Cancer - number of different types (cat)
• Cholesterol - taking medicine for high blood cholesterol
• Chronic conditions - 1 or more
• Chronic conditions - count (cat)
• Diabetes - prediabetes prevalence
• Diabetes - self-management plan (cat)
• Diabetes - self-management plan ever
• HBP - self-management plan (cat)

New BRFSS dimensions added in 2019

A new geographic dimension was added in 2019 to allow users to view reports by Primary Care Service Area.

There are also several new dimensions available to allow users to view reports by other health behaviors or conditions:

• Diabetes
• Obese (BMI greater than or equal to 30)
• Cancer (ever diagnosed with any kind of cancer)
• Current Cigarette Smoker
• Meets Physical Activity Recommendations (aerobic and strengthening)

2018 BRFSS

Changes in the race/ethnicity dimensions.

In 2018, the Hawaii Department of Health (DOH) revised how it collects race/ethnicity information in the Behavioral Risk Factor Surveillance System (BRFSS). The new methodology better aligns with national data collection standards and complies with the race/ethnicity algorithm used by the Office of Health Status Monitoring in DOH.

There are now two versions of DOH race/ethnicity: (2011+, new) and (2011-2017).

• DOH race/ethnicity (2011+, new) includes data from 2011-2017 which have been harmonized with 2018 data to be consistent across survey years and instruments. We will be supporting this dimension going forward.
• DOH race/ethnicity (2011-2017) is the old version which you have seen in the past. Because of the changes, the 2018 BRFSS data is not available for the DOH race/ethnicity (2011-2017) dimension.

For a limited time, both versions of DOH race/ethnicity will be available, to give users an opportunity to compare and assess the impact of this change on indicators that are of interest to them. Please plan on transitioning to the new (2011+, new) race/ethnicity dimension going forward, as this is the new standard for DOH.

• Program race/ethnicity (2011+, new) has also changed and includes data from 2011 forward. This dimension has been streamlined into 15 categories, down from 40 categories, based on changes in the data collection instrument.
• In 2018, the Department of Health (DOH) revised how it collects race/ethnicity information in the Behavioral Risk Factor Surveillance System (BRFSS). The new methodology better aligns with national data collection standards and complies with the race/ethnicity algorithm used by the Office of Health Status Monitoring in DOH.

Poverty Level (2014+) dimension.

This new socioeconomic indicator dimension is based on multiple questions including the number of people living in the household and the annual household income from all sources. These numbers are compared to the annual US Department of Health and Human Services Poverty Guidelines to approximate the respondent's Federal Poverty Level percentage. This data is available from 2014 to the most recent year. Queries that request an indicator by this dimension will only include data from 2014 forward.

Sexual and Gender Minority (2014+) dimension.

This new demographic indicator dimension is based on sexual orientation and transgender identity. Adults who identify their sexual orientation as gay, lesbian, bisexual or something else, or who identify as transgender are coded as "yes" all others are coded as "no". This data is available from 2014 to the most recent year. Queries that request an indicator by this dimension will only include data from 2014 forward.

Transgender (2014+) dimension.

This new demographic indicator dimension is based on transgender identity. Adults who identify as transgender (male-to-female, female-to-male or gender non-conforming) are coded as "yes" all others are coded as "no". This data is available from 2014 to the most recent year. Queries that request an indicator by this dimension will only include data from 2014 forward.

2017 BRFSS

The underlying SAS code was modified to more accurately generate the asymmetric confidence intervals that occur when point prevalences approach 0 and 1. This code change will impact all BRFSS Hawaii-IBIS reports. As a result, there may be slight differences in confidence intervals and relative standard errors, and hence, reportability, from previous years. Please check your query results carefully and re-run reports as necessary. Hawaii-IBIS runs on SAS version 9.4 (SAS Institute Inc: Cary, NC).

All Years

Race/Ethnicity Data

Respondents are asked the following question to ascertain their race/ethnicity:

• Which one or more of the following would you say is your race?

This question is used to create the Race/ Ethnicity classifications. In IBIS, the most granular level is the program race/ethnicity (PRG) which rolls up into the DOH standard race/ethnicity (DOH), which rolls up into Census race reporting categories (Census). The table below illustrates how the data is aggregated.

Race/Ethnicity Classifications
Source Race/Ethnicity	Program Race/Ethnicity (PRG)	DOH Race/Ethnicity (DOH)	Census Race (Census)
American Indian/Alaska Native/Eskimo/Inuit	American Indian/Alaska Native/Eskimo/Inuit	Other	Other
Asian Indian	Asian Indian	Other Asian	Asian
Black	Black	Black	Black or African American
Caucasian	Caucasian	Caucasian	Caucasian
Chinese	Chinese	Chinese	Asian
Filipino	Filipino	Filipino	Asian
Guamanian or Chamorro	Guamanian or Chamorro	Other Pacific Islander	Native Hawaiian and Other Pacific Islander
Hawaiian	Hawaiian	Native Hawaiian	Native Hawaiian and Other Pacific Islander
Japanese	Japanese	Japanese	Asian
Korean	Korean	Other Asian	Asian
Samoan	Samoan	Other Pacific Islander	Native Hawaiian and Other Pacific Islander
Vietnamese	Vietnamese	Other Asian	Asian
Other Asian	Other Asian	Other Asian	Asian
Other Pacific Islander	Other Pacific Islander	Other Pacific Islander	Native Hawaiian and Other Pacific Islander
Other	Other	Other	Other

Other Information

Note about indicator/dimension titles:

The BRFSS is constantly changing. HHDW staff carefully review the BRFSS survey instrument each year to assess how changes in the survey instrument impact indicators and dimensions within the Hawaii-IBIS system. When an indicator or dimension is not available across all years in Hawaii-IBIS, this information will be added to the name. For example, there are two versions of Adults with at least one disability (2016+) and (2013-2016). In 2016, a question about auditory disability was added to the BRFSS so a new indicator was created to capture any disability including hearing issues--Adults with at least one disability (2016+). Poverty level (2014+) is available from 2014 forward only based on when questions about household members for cell phone respondents were added to the survey. A query with data by Poverty level (2014+) dimension will only contain data from 2014+ regardless of the years of data for the base indicator. If you have questions, check the Question Wording in the Data Notes section of the report.