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Complete Health Indicator Report of Blood Cholesterol: Doctor-diagnosed High Cholesterol

Definition

The proportion of adults who have ever been told by a doctor, nurse, or other health professional that they have high blood cholesterol.

Numerator

The number of adults who have ever been told by a doctor, nurse, or other health professional that they have high blood cholesterol.

Denominator

The total number of survey respondents (BRFSS survey) excluding those with missing or refused values in the numerator.

Data Interpretation Issues

Doctor-diagnosed hypercholesterolemia is based on the answer to the question: "Have you ever been told by a doctor, nurse, or other health professional that you have high blood cholesterol?" This question is asked in odd-numbered years. While this question is asked of all respondents, almost one third of respondents reported not having had their blood cholesterol checked in the past five years. This means that the actual prevalence of high cholesterol is probably higher than the numbers reported here. Due to small numbers, data by Utah Small Area are based on combined years. Some of these estimates may be statistically unreliable and should be interpreted with care. Beginning in 2011, BRFSS data include both landline and cell phone respondent data along with a new weighting methodology called iterative proportional fitting, or raking. This methodology utilizes additional demographic information (such as education, race, and marital status) in the weighting procedure. Both of these methodology changes were implemented to account for an increased number of U.S. households without landline phones and an under-representation of certain demographic groups that were not well-represented in the sample. More details about these changes can be found at: [https://ibis.health.utah.gov/pdf/opha/resource/brfss/RakingImpact2011.pdf].

Why Is This Important?

High blood cholesterol is a major risk factor for heart disease and stroke. It is preventable. If identified early, it can be controlled with medication and lifestyle changes, such as eating a diet low in saturated fat and cholesterol, increasing physical activity, and reducing excess weight. Because high blood cholesterol does not produce obvious symptoms, experts recommend that all adults aged 20 years and older have their cholesterol levels checked at least once every five years to help them take action to prevent or lower their risk of cardiovascular disease.

Healthy People Objective HDS-7:

Reduce the proportion of adults with high total blood cholesterol levels
U.S. Target: 13.5 percent

How Are We Doing?

In 2015, the age-adjusted percentage of Utah adults who reported being told they had high cholesterol was 24.5% (1 in 4 adults). However, this estimate likely underestimates the actual prevalence because Utah has a lower rate of 5-year cholesterol screens than most states. In 2015 doctor-diagnosed high cholesterol was significantly different by gender (21.2% for females and 24.3% for males). High cholesterol prevalence increased with age. Among Utahns aged 65 and over, 49.2% were diagnosed with high cholesterol. In 2015, none of the estimates for high cholesterol rates by race or ethnicity (Hispanic/non-Hispanic) were statistically different from the state rate.

How Do We Compare With the U.S.?

In 2015, the age-adjusted U.S. estimate for high cholesterol was 27.2% of adults. Utah's 2015 rate of high cholesterol (24.5%) was lower than the U.S. rate. In years 2005, 2007, and 2009, Utah had a lower rate of adults reporting 5-year cholesterol screens compared with other states. Nationally, the Centers for Disease Control and Prevention (CDC) documented an increase in cholesterol screening of 4.5 percent during these years. Utah's rate increased by 5.8 percent, but was the second lowest among the 50 states. Due to this low rate of cholesterol screening, it is likely that high cholesterol is under-diagnosed. For more information on how Utah compares to the U.S. and other states for cholesterol screening, please visit [http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6135a2.htm].

What Is Being Done?

The Healthy Living through Environment, Policy, and Improved Clinical Care Program (EPICC) was formed in 2013, consolidating three Utah Department of Health programs (Diabetes Prevention and Control Program, Heart Disease and Stroke Prevention Program, and the Physical Activity, Nutrition and Obesity Program). The purpose of the consolidation was to ensure a productive, collaborative, and efficient program focused on health outcomes. EPICC aims to reduce the incidence of diabetes, heart disease, and stroke by targeting risk factors including reducing obesity, increasing physical activity and nutritious food consumption, and improving diabetes and hypertension control. The program is organized around four domains: *Domain 1: Epidemiology and Surveillance--gather, analyze, and disseminate data and information and conduct evaluation to inform, prioritize, deliver, and monitor programs and population health. *Domain 2: Policy and Environment--environmental approaches the promote health and support and reinforce healthful behaviors (statewide in schools and childcare, worksites, and communities). *Domain 3: Health Systems--Health system interventions to improve the effective delivery and use of clinical and other preventive services in order to prevent disease, detect diseases early, and reduce or eliminate risk factors and manage complications. *Domain 4: Community Clinical Linkages--Strategies to improve community-clinical linkages ensuring that communities support and clinics refer patients to programs that improve management of chronic conditions. [[br]] The primary program strategies include: *Increasing healthy nutrition and physical activity environments in K-12 schools *Increasing healthy nutrition and physical activity environments in early care and education (childcare/preschool) *Increasing healthy nutrition and physical activity environments in worksites *Improving awareness of prediabetes and hypertension for Utahns *Improving the quality of medical care for people with diabetes and hypertension *Improving the linkages between health care providers and supporting community programs for Utahns with diabetes and hypertension *Improving access and availability to community health programs for Utahns with diabetes, hypertension, and obesity *Improving care and management of students with chronic conditions in Utah schools

Evidence-based Practices

High cholesterol is one of the most commonly treated medical conditions. Aggressive treatment focuses on lowering LDL ("bad" cholesterol levels). Lowering LDL cholesterol reduces the risk of coronary heart disease and ischemic stroke. Low cholesterol diet, increased exercise, and statin medications are the first line of treatment.

Health Program Information

In 2012, the Utah Heart Disease and Stroke Prevention Program published a statistical report titled the Impact of Heart Disease and Stroke in Utah. This report describes overall patterns in cardiovascular disease and risk factors at the state and national levels and among Utah sub-populations (age group, sex, race, ethnicity, and Utah Small Area). To download the full report, please visit [http://www.choosehealth.utah.gov/documents/pdfs/reports/HD_Stroke_Burden_Report2012.pdf].


Related Indicators

Relevant Population Characteristics

Prevalence of high cholesterol was highest among the 65 and over age category compared to younger age categories.

Related Relevant Population Characteristics Indicators:


Health Care System Factors

High cholesterol must be diagnosed by a physician therefore screening for high cholesterol should be integrated into routine care.

Related Health Care System Factors Indicators:


Risk Factors

The risk factors for high cholesterol include lack of exercise, overweight and obesity, cigarette smoking, and high cholesterol diet. Some risk factors can be reduced through lifestyle changes. Others, such as family history and liver functioning, are more difficult to control. Certain medications can contribute to high cholesterol as well. Individuals are encouraged to discuss their risk factors with a physician and request blood cholesterol screening at least every five years.

Related Risk Factors Indicators:


Health Status Outcomes

High blood cholesterol is a major risk factor for heart disease and stroke. Early identification and treatment of high cholesterol can decrease this risk.

Related Health Status Outcomes Indicators:




Graphical Data Views

Doctor-diagnosed Hypercholesterolemia (High Blood Cholesterol) by Year, Utah and U.S., 1991-2015

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confidence limits

In 2015, the prevalence of high blood cholesterol continued to be lower among Utah adults than among the general U.S. adult population (24.5% UT, 27.2% U.S.).
BRFSS Utah vs. U.S.YearAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 28
UT Old Methodology199116.4%14.6%18.4%
UT Old Methodology199319.3%17.3%21.5%
UT Old Methodology199516.5%14.9%18.4%
UT Old Methodology199719.8%18.0%21.8%
UT Old Methodology199920.7%18.9%22.6%
UT Old Methodology200122.1%20.5%23.8%
UT Old Methodology200321.5%19.9%23.1%
UT Old Methodology200524.9%23.6%26.2%
UT Old Methodology200725.6%24.4%27.0%
UT Old Methodology200925.9%24.9%26.8%
US Old Methodology199117.7%17.3%18.1%
US Old Methodology199320.2%19.8%20.5%
US Old Methodology199519.6%19.2%20.0%
US Old Methodology199720.0%19.6%20.3%
US Old Methodology199921.1%20.8%21.4%
US Old Methodology200122.6%22.3%22.9%
US Old Methodology200325.1%24.8%25.4%
US Old Methodology200526.5%26.6%26.8%
US Old Methodology200733.2%32.8%33.6%
US Old Methodology200928.9%28.6%29.1%
UT New Methodology200925.3%24.4%26.3%
UT New Methodology201126.4%25.5%27.3%
UT New Methodology201223.6%22.3%24.9%
UT New Methodology201325.9%25.1%26.8%
UT New Methodology201524.5%23.7%25.4%
US New Methodology201128.7%28.5%29.0%
US New Methodology201328.9%28.6%29.1%
US New Methodology201527.2%27.0%27.4%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.   Age-adjusted to 2000 U.S. standard population. Note: At the time of this update, the BRFSS U.S. dataset did not include an age variable but did include five age categories up to age 80+ (vs. the typical weighting scheme that includes 85+). Comparisons with both weighting schemes were compared using Utah data, and the difference was about 1/100 of a percentage point. To reduce bias and more accurately represent population data, the BRFSS has changed survey methodology. In 2010, it began conducting surveys by cellular phone in addition to landline phones. It also adopted "iterative proportional fitting" (raking) as its weighting method.

Data Sources

  • Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health
  • U.S. Data: Behavioral Risk Factor Surveillance System (BRFSS), Division of Behavioral Surveillance, CDC Office of Surveillance, Epidemiology, and Laboratory Services


Doctor-diagnosed Hypercholesterolemia (High Blood Cholesterol) by Age and Sex, Utah, 2015

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confidence limits

The overall crude rate of high cholesterol was 22.8% (21.9%-23.7%) in 2015. The crude rate was 24.3% (23.0%-25.6%) for males and 21.2% (20.0%-22.5%) for females.
Males vs. FemalesAge GroupPercentage of AdultsLower LimitUpper Limit
Record Count: 14
Male18-346.2%5.0%7.8%
Male35-4923.2%20.7%25.9%
Male50-6441.4%38.3%44.5%
Male65+50.6%46.9%54.3%
Female18-345.3%4.1%6.9%
Female35-4915.3%13.3%17.7%
Female50-6435.5%32.7%38.4%
Female65+48.0%44.7%51.4%
Total18-345.8%4.9%6.9%
Total35-4919.3%17.6%21.1%
Total50-6438.4%36.3%40.5%
Total65+49.2%46.7%51.7%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Doctor-diagnosed Hypercholesterolemia (High Blood Cholesterol) by Education Level, Utah Adults 25+, 2015

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confidence limits

There are no statistically significant differences between education categories and the state rate.
Education LevelAge-adjusted Percentage of Adults 25+Lower LimitUpper Limit
Record Count: 9
Less Than High School25.2%21.3%29.6%
H.S. Grad or G.E.D.28.3%26.4%30.3%
Some Post High School28.0%26.3%29.8%
College Graduate28.5%27.0%30.0%
Total27.9%26.9%28.9%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.   For adults aged 25 years old and above. [[br]] Age-adjusted to 2000 U.S. standard population.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Doctor-diagnosed Hypercholesterolemia (High Blood Cholesterol) by Income Level, Utah, 2015

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confidence limits

There are no statistically significant differences between income categories and the state rate.
Income CategoryAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 5
<$25,00025.3%22.8%28.0%
$25,000-$49,99925.3%23.3%27.5%
$50,000-$74,99924.5%22.5%26.6%
$75,000+24.6%23.2%26.2%
Total24.5%23.7%25.4%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.   Age-adjusted to 2000 U.S. standard population.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Doctor-diagnosed Hypercholesterolemia (High Blood Cholesterol) by Ethnicity, Utah, 2015

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confidence limits

There are no statistically significant differences between ethnicity categories and the state rate.
Hispanic EthnicityAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 3
Hispanic22.1%18.6%26.1%
Non-Hispanic24.9%24.0%25.8%
All Utahns24.5%23.7%25.4%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.   Age-adjusted to the U.S. 2000 standard population.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Doctor-diagnosed Hypercholesterolemia (High Blood Cholesterol) by Race, Utah, 2015

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confidence limits

The doctor-diagnosed high cholesterol rates for each race group were comparable to the state rate. According to the Utah Office of Health Disparities, Hispanic persons who may be White often report their race as "Other."
Race/EthnicityAge-adjusted Percentage of AdultsLower LimitUpper LimitNote
Record Count: 7
American Indian, Alaskan Native17.5%11.3%26.1%
Asian19.2%12.0%29.1%
Black, African American18.2%10.6%29.5%*Estimate may not be reliable.
Native Hawaiian, Pacific Islander23.9%14.0%37.7%
White24.3%23.4%25.2%
Other21.5%17.4%26.2%
All Races/Ethnicities23.9%23.0%24.7%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.   The federal government (United States Census Bureau) considers Hispanic to be an ethnicity rather than a race, a separate data table and chart compares high cholesterol among non-Hispanic and Hispanic Utahns. Data are age-adjusted to the 2000 U.S. standard population using 3 age groups for standardization. Unreliables estimates: Use caution in interpreting Black, African American category. The estimate has a coefficient of variation >30% and is therefore deemed unreliable by Utah Department of Health standards.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Doctor-diagnosed Hypercholesterolemia (High Blood Cholesterol) by Local Health District, Utah, 2015

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confidence limits

None of the local health departments had rates that were statistically significantly different than the state rate.
Local Health DistrictAge-adjusted Percentage of AdultsLower LimitUpper LimitNote
Record Count: 14
Bear River23.4%20.4%26.8%
Central20.3%16.6%24.5%
Davis County26.2%23.5%29.0%
Salt Lake County25.0%23.6%26.5%
San Juan28.0%18.1%40.6%*Estimate may not be reliable.
Southeast27.2%21.5%33.7%
Southwest23.8%21.0%26.8%
Summit21.6%16.0%28.7%
Tooele26.1%20.5%32.5%
TriCounty25.7%20.9%31.1%
Utah County22.8%20.7%25.0%
Wasatch19.2%13.2%26.9%
Weber-Morgan25.5%22.6%28.7%
State of Utah24.5%23.7%25.4%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.   Age-adjusted to the U.S. 2000 standard population. Unreliables estimates: Use caution in interpreting San Juan. The estimate has a coefficient of variation >30% and is therefore deemed unreliable by Utah Department of Health standards.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Doctor-diagnosed Hypercholesterolemia (High Blood Cholesterol) by Utah Small Area, 2013-2015

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confidence limits

Rates of high cholesterol were significantly higher than the state rate for Sandy (NE) (32.4%), Woods Cross/North Salt lake (32.2%), Murray (31.6%) and Bountiful (29.9%). Rates significantly lower than the state were American Fork/Alpine (20.2%), Orem (East) (18.4%), and Grand County (15.7%).
Utah Small AreasAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 66
Brigham City26.7%20.7%33.7%
Box Elder Co (Other)22.2%17.0%28.3%
Logan23.9%20.5%27.7%
Cache Co (Oth)/Rich Co (All)24.5%20.4%29.1%
Ben Lomond27.8%23.4%32.7%
Morgan Co (All)/Weber Co (E)24.5%20.1%29.4%
Ogden (Downtown)23.8%18.9%29.5%
South Ogden24.7%20.4%29.5%
Roy/Hooper28.5%24.0%33.4%
Riverdale26.3%20.2%33.4%
Clearfield/Hill AFB23.5%19.1%28.6%
Layton28.0%24.5%31.8%
Syracuse/Kaysville21.8%18.1%26.1%
Farmington/Centerville30.2%25.0%36.1%
Woods Cross/North Salt Lake32.2%26.2%38.8%
Bountiful29.9%25.2%35.0%
SLC (Rose Park)23.9%17.7%31.6%
SLC (Avenues)21.3%16.7%26.8%
SLC (Foothill/U of U)25.6%20.0%32.1%
Magna29.2%22.2%37.3%
SLC (Glendale)25.2%18.7%33.0%
West Valley (West)26.6%22.9%30.7%
West Valley (East) V229.8%24.3%36.0%
SLC (Downtown)22.3%17.8%27.6%
South Salt Lake22.8%16.8%30.2%
Millcreek24.0%20.3%28.1%
Holladay23.2%19.4%27.5%
Cottonwood22.8%18.7%27.4%
Kearns V226.8%21.2%33.3%
Taylorsville (E)/Murray (W)23.1%18.7%28.3%
Taylorsville (West)29.6%24.7%35.1%
Murray31.6%25.5%38.4%
Midvale25.3%19.6%32.0%
West Jordan (NE) V226.5%20.1%34.0%
West Jordan (SE)29.4%23.7%35.7%
West Jordan (W)/Copperton24.6%18.8%31.5%
South Jordan27.3%23.3%31.7%
Sandy (Center)26.1%21.8%30.9%
Sandy (NE)32.4%25.4%40.3%
Sandy (SE)24.4%19.6%29.9%
Riverton/Draper23.2%20.4%26.3%
Tooele Co27.3%23.6%31.4%
Lehi/Cedar Valley26.3%22.2%30.8%
American Fork/Alpine20.2%16.6%24.3%
Pleasant Grove/Lindon20.7%16.6%25.4%
Orem (North)21.9%16.8%28.2%
Orem (West)25.6%19.2%33.3%
Orem (East)18.4%13.5%24.4%
Provo (North)/BYU27.4%21.3%34.6%
Provo (South)28.3%22.3%35.2%
Springville/Spanish Fork25.0%21.5%28.8%
Utah Co (South)20.0%15.2%25.8%
Summit Co22.5%18.9%26.5%
Wasatch Co22.7%18.5%27.4%
TriCounty LHD25.9%22.8%29.2%
Juab/Millard/Sanpete Co22.5%19.3%26.1%
Sevier/Piute/Wayne Co24.2%19.9%29.2%
Carbon/Emery Co28.9%24.7%33.6%
Grand County15.7%10.9%22.3%
San Juan County25.7%18.4%34.8%
St George24.3%21.0%27.9%
Washington Co (Other)21.3%17.6%25.6%
Cedar City25.0%20.5%30.2%
Southwest LHD (Other)26.8%21.4%33.1%
State25.2%24.6%25.8%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.   Age-adjusted to U.S. 2000 standard population. A description of the Utah Small Areas may be found on IBIS at the following URL: [http://ibis.health.utah.gov/resource/Help.html].

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health

References and Community Resources

'''Impact of Heart Disease and Stroke in Utah'''[[br]] In 2012, the Utah Heart Disease and Stroke Prevention Program published a statistical report titled the Impact of Heart Disease and Stroke in Utah. This report describes overall patterns in cardiovascular disease and risk factors at the state and national levels and among Utah subpopulations (age group, sex, race, ethnicity, and Utah Small Area). To download the full report, please visit [http://www.choosehealth.utah.gov/documents/pdfs/reports/HD_Stroke_Burden_Report2012.pdf] '''Million Hearts Initiative'''[[br]] Heart disease and stroke are the first and fourth leading causes of death in the United States. Heart disease is responsible for 1 of every 3 deaths in the country. Million Hearts is a national initiative that has set an ambitious goal to prevention 1 million heart attacks and strokes by 2017. The impact will be even greater over time. Million Hearts aims to prevent heart disease and stroke by: *Improving access to effective care *Improving the quality of care for the ABCS (appropriate aspirin prescription, blood pressure control, cholesterol control, and smoking cessation) *Focusing clinical attention on the prevention of heart attack and stroke *Activating the public to lead a heart-healthy lifestyle *Improving the prescription and adherence to appropriate medications for the ABCS [[br]] See what you can do to be part of the solution. Visit [http://choosehealth.utah.gov/healthcare/million-hearts.php] for more information.

More Resources and Links

Evidence-based community health improvement ideas and interventions may be found at the following sites:

Additional indicator data by state and county may be found on these Websites:

Medical literature can be queried at the PubMed website.

For an on-line medical dictionary, click on this Dictionary link.

Page Content Updated On 10/27/2017, Published on 11/29/2017
The information provided above is from the Department of Health's Center for Health Data IBIS-PH web site (http://ibis.health.state.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Wed, 25 April 2018 2:52:38 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Wed, 29 Nov 2017 14:06:22 MST