Health Status
Additional
Indicators
Methods
Vermont Data Sources
Analysis Geography
Suggested Citation
The data contained in these maps, tables, and graphs represent the
most complete and recent information available to the Vermont
Department of Health about health status indicators of
the Vermont population. However, as with any data, there are some
limitations to keep in mind when interpreting the results.
Data Quality: Several precautions were taken to ensure the reliability and
validity of the data for each objective. Survey questionnaires were carefully
designed and thoroughly tested by the Centers for Disease Control and
Prevention. Survey results are statistically adjusted or “weighted” so that the
sample accurately represents Vermonters. Non-survey data rely on completeness
and methodology checks as well. Finally, all analyses were performed in
duplicate. These precautions can reduce some sources of error, but not all.
Comparisons: It is natural to want to compare Vermont to the U.S. as a
whole as well as to other states. Unless data sources and methodology are
equivalent, we do not recommend this. Within Vermont we have used consistent
data sources and methodology but we urge caution in making comparisons between
counties, Health Department district offices areas (Districts), and hospital
service areas (HSAs). Often there are many underlying differences in a region
that are important context for understanding the story told by the data.
Additionally, small differences may not be statistically different and may
simply be a function of normal sampling error. Given this, we have chosen to
display the statistical comparison, based on 95% confidence intervals, between
the statewide statistic and the local region. Comparisons across regions are
not displayed.
What, not Why: These health status indicators reveal what
behaviors Vermonters are doing. However, the indicators alone cannot answer why
they are doing those behaviors.
This list of indicators is a subset of important indicators from the
Behavioral Risk Factor Surveillance System (BRFSS) survey; it is not a
comprehensive list of health status indicators that the Health Department
monitors.
To view the
indicators that make up Vermont’s State Health Assessment visit: Healthy
Vermonters 2020
Additional
indicators included in this map are:
|
% of adults whose
health is fair or poor |
|
% of adults with
poor physical health |
|
% of adults with
poor mental health |
|
% of adults
dissatisfied with life |
|
% of adults who
rarely or never get emotional support |
|
% of adults who
are disabled |
|
% of adults 65
and older who fell in the last 12 months |
|
% of adults 65
and older who fell and were injured the last 12 months |
|
% of adults with
diabetes whose health is fair or poor |
Prevalence and percentages were calculated by using descriptive statistical
procedures using software such as SPSS, SAS, and/or SUDAAN. These statistics describe the proportion of
individuals with a given trait in the population during a specified period of
time.
In U.S. data,
age adjustment is used for comparison of regions with varying age
breakdowns. In order to remain
consistent with the methods of comparison at a national level, some statistics
in Vermont were age adjusted. In cases
where age adjustment was noted as being part of the statistical analysis, the
estimates were adjusted based on the proportional age breakdowns of the U.S.
population in 2000. For more detailed
information on age adjustment visit http://www.cdc.gov/nchs/data/statnt/statnt20.pdf.
Confidence Intervals were used for
statistical comparisons between the state and the various sub-geographies
statistics. A confidence interval represents the
range in which a parameter estimate would fall which is calculated based on the
observed data. For this analysis, we
used a 95% confidence interval, meaning that we are 95% confident that the true
value of the parameter being examined falls within the specified confidence
interval. Statistical significance is
assessed by comparing the confidence intervals of different groups. If the confidence intervals from two groups,
such as that for the state and a specific county, do not overlap we consider
the estimates to be significantly different from one another.
Behavioral Risk Factor Surveillance System -- BRFSS
Vermont tracks risk behaviors using a telephone survey of adults called
the Behavioral Risk Factor Surveillance Survey (BRFSS). The results are used to
plan, support, and evaluate health promotion and disease prevention programs.
These are used to track Department of Health goals (e.g. Healthy Vermonters 2020),
and many other BRFSS data reports.
Since 1990, Vermont, along with the 49 other states, Washington D.C. and
U.S. territories, has participated in the BRFSS with the Centers for Disease Control
and Prevention. The CDC
provides the Vermont Department of Health with funding each year to carry out
the survey. Currently, ICF Macro with an office in Burlington, Vermont, is the interviewing contractor for the
Vermont BRFSS.
Several thousand Vermonters are randomly and anonymously selected and
called annually. An adult (18 or older) in the household is asked a uniform set
of questions. The results are weighted to represent the adult population of the
state.
Beginning in 2009, Vermont started interviewing adult residents on
cellular telephones as well as landline telephones. This change ensures the survey is conducted
among a representative sample of Vermont adults and was made due to changing
telephone patterns with more households using primarily cellular telephones.
Beginning in 2011, the CDC implemented changes to the BRFSS weighting
methodology in order to more accurately represent the adult population. In 2011 and later, weights are
calculated using an iterative proportional fitting (or "raking")
methodology. This allows
the weights to be calculated using a smaller sample size, adjusts for more
demographic variables, and incorporates cell phone interview data into
estimates. While these
adjustments make the calculations more representative of the population, the
changes in methodology also limit the ability to compare results from 2011
forward with those from previous years. The Vermont Department of Health
recommends that comparisons between BRFSS data from 2011 forward and earlier
years be made with caution. Statistical differences may be due to
methodological changes, rather than changes in opinion or behavior.
For more information
about the Behavioral Risk Factor Surveillance System, please contact:
Jessie Hammond, M.P.H., Program Coordinator
802-863-7663
jessie.hammond@vermont.gov
The Vermont Department of Health routinely uses
three substate geographies: counties, Department of Health district office
area, and hospital services areas. For most population health measures, there
are too few respondents by town to allow appropriate statistical analysis. For
this reason, data collected from residents of individual towns are aggregated
to county, district, and hospital service areas.
Citing a specific data point:
Model: Vermont Department of Health. INDICATOR WORDING (GEOGRAPHY,
DATA SOURCE, YEAR(S) OF DATA) in Behavioral Risk Factor Surveillance System: “TOPIC” Maps & Trends Vermont Health Indicators.
Accessed DATE (E.G. TODAY). WEBLINK
Example: Vermont Department of Health. Percent of adults who are disabled (Bennington County, Behavioral Risk Factor
Surveillance System, 2009) in Behavioral Risk Factor Surveillance System: “Health
Status” Maps & Trends Vermont Health
Indicators. Accessed 7/1/15. http://healthvermont.gov/research/brfss/IA/HealthStatus/County/atlas.html
Citing the webpage more generally:
Model: Vermont Department of Health. Behavioral Risk Factor
Surveillance System: “TOPIC” Maps &
Trends Vermont Health Indicators, by GEOGRAPHY. Accessed DATE (E.G.TODAY). WEBLINK
Example: Vermont Department of Health. Behavioral Risk Factor
Surveillance System: “Health Status”
Maps & Trends Vermont Health Indicators, by County. Accessed 7/1/15.
http://healthvermont.gov/research/brfss/IA/HealthStatus/County/atlas.html
Parenthetical citation within text:
Model: (Vermont Department of Health, DATA SOURCE, YEAR(S) OF
DATA).
Example: (Vermont Department of Health, Behavioral Risk
Factor Surveillance System, 2009).