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Complete Health Indicator Report of Blood Cholesterol Screening

Definition

Percentage of adults aged 18 years and older who have had their cholesterol checked within 5 years.

Numerator

Number of BRFSS survey respondents aged 18 years and older who have had their cholesterol checked within the past 5 years.

Denominator

Number of surveyed adults aged 18 years and older.

Data Interpretation Issues

BRFSS data are self-reported. Patients may not be aware of the specific tests conducted in clinical settings on their blood samples. However, BRFSS is a large, population-based survey that provides the only state-level assessment of high blood cholesterol screening and prevalence every 2 years. Due to small numbers, data by race, ethnicity, and geographic area are based on combined years. Some estimates may be statistically unreliable and should be interpreted with care.

Why Is This Important?

High blood cholesterol is a leading risk factor in the development of atherosclerosis and coronary heart disease (CHD). The risks associated with high blood cholesterol can be reduced by screening and early treatment, which includes medication and lifestyle changes. Lifestyle changes could include eating a diet low in saturated fat and cholesterol, engaging in moderate to vigorous exercise on a regular basis, 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 5 years to help them take action to prevent or lower their risk of cardiovascular disease.

Healthy People Objective HDS-6:

Increase the proportion of adults who have had their blood cholesterol checked within the preceding 5 years
U.S. Target: 82.1 percent

Other Objectives

CSTE Chronic Disease Indicators

How Are We Doing?

The percentage of adults for Utah who have had a cholesterol check in the shows a slight but steady increase. The most recent estimate in 2013 indicates that 70.5% of Utah adults had at least one cholesterol screening in the past five years, rising from 68.8% in 2009 and from 69.1% in 2011.

How Do We Compare With the U.S.?

According to the Centers for Disease Control and Prevention (CDC), Utah has consistently had lower rates of cholesterol screenings compared to other states and the U.S. as a whole. In 2011, 69.1% of Utah adults had had a cholesterol screening in the past five years. U.S. data for 2011 indicates that 74.4% of adults had a cholesterol screening in the past five years. The 2011 data is the most recent data available for the U.S. at this time.

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]] [[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

A wide variety of community and medical treatment activities address cholesterol screening and treatment. For example, the Utah Heart Disease and Stroke Prevention Program supports implementing evidence-based practices in community and clinical settings, specifically highlighting cholesterol control within communities. Therapeutic lifestyle changes are an important approach that incorporates a low-fat, high-fiber diet and physical activity on most days. If cholesterol-lowering drugs are needed, they are used together with therapeutic lifestyle changes. Healthy People 2020 objectives aim to increase awareness of current cholesterol recommendations and provide targets for stakeholders. The Million Hearts initiative, a national federal/private partnership, is a recent, innovative alignment and coordination of clinical and community activities targeting leading causes of cardiovascular disease morbidity and mortality, including high blood cholesterol. These and other community and clinical activities are important measures to combat the impact of high blood cholesterol nationally.

Health Program Information

In 2012, the Utah Department of Health 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). [[br]] To download the full report, please visit www.hearthighway.org. [[br]] Individual sections of the report can be viewed at www.hearthighway.org/burden.html.


Related Indicators

Relevant Population Characteristics

Nationally, the Centers for Disease Control and Prevention have documented that screening for high blood cholesterol is lowest among those 18-44 years, Hispanics, and those with lower levels of education. They recommend that public health practitioners, health care providers, and educators emphasize cholesterol screening among these populations and among men. (Source: MMWR, Prevalence of cholesterol screening and high cholesterol among adults--United States, 2005, 2007, and 2009. September 7, 2102/61(35); 697-702).

Related Relevant Population Characteristics Indicators:


Health Care System Factors

Early detection of high blood cholesterol through screening is the first important step to treatment and reducing the risk for heart attack and stroke. To reach high blood cholesterol screening targets, public health practitioners, health-care providers, and educators should emphasize cholesterol screening, especially for young adults, men, Hispanics, and those with lower levels of education. The National Cholesterol Education Program provides evidenced-based resources and recommendations to health-care providers, and new guidelines for cholesterol are currently being developed.

Related Health Care System Factors Indicators:


Risk Factors

Some risk factors for high cholesterol can be reduced through lifestyle changes. The risk factors include lack of exercise, overweight and obesity, cigarette smoking, and high cholesterol diet. Some risk factors are more difficult to control, such as family history and liver functioning. 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 5 years.

Related Risk Factors Indicators:


Health Status Outcomes

Early identification and treatment of high cholesterol can reduce risk of coronary artery disease and other types of heart disease.

Related Health Status Outcomes Indicators:




Graphical Data Views

Percentage of Persons Who Reported Having Their Cholesterol Checked Within the Past Five Years, Utah and U.S., 1989-2013, odd years

::chart - missing::
confidence limits

BRFSS Utah vs. U.S.YearAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 30
UT Old Methodology198950.3%47.5%53.0%
UT Old Methodology199159.5%56.9%62.2%
UT Old Methodology199364.4%61.9%66.7%
UT Old Methodology199565.6%63.4%67.7%
UT Old Methodology199767.7%65.5%69.8%
UT Old Methodology199965.5%63.4%67.6%
UT Old Methodology200169.8%68.0%71.6%
UT Old Methodology200368.4%66.6%70.2%
UT Old Methodology200567.0%65.5%68.5%
UT Old Methodology200769.3%67.7%70.9%
UT Old Methodology200970.4%69.2%71.6%
US Old Methodology198957.2%56.6%57.8%
US Old Methodology199167.4%66.8%67.9%
US Old Methodology199369.7%69.2%70.2%
US Old Methodology199571.4%70.9%71.9%
US Old Methodology199769.5%69.1%69.9%
US Old Methodology199970.6%70.2%70.9%
US Old Methodology200172.5%
US Old Methodology200373.1%72.8%73.5%
US Old Methodology200572.6%72.3%73.0%
US Old Methodology200774.6%74.3%74.9%
US Old Methodology200976.0%75.6%76.3%
UT New Methodology200968.8%67.7%70.0%
UT New Methodology201169.1%68.1%70.1%
UT New Methodology201370.5%69.5%71.5%
US New Methodology201174.4%74.1%74.7%

Data Notes

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: [http://health.utah.gov/opha/publications/brfss/Raking/Raking%20impact%202011.pdf].   Rates are age-adjusted to the U.S. 2000 standard population.

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


Percentage of Persons Who Reported Having Their Cholesterol Checked Within the Past Five Years (Crude Rates) by Age and Sex, Utah, 2013

::chart - missing::
confidence limits

Among adults in the youngest age groups, females had higher screening rates than males.
Males vs. FemalesAge GroupPercentage of AdultsLower LimitUpper Limit
Record Count: 10
Male18-3444.4%41.4%47.5%
Male35-4970.9%67.9%73.8%
Male50-6484.8%82.0%87.2%
Male65+92.4%90.0%94.3%
Female18-3446.6%43.6%49.7%
Female35-4974.2%71.4%76.7%
Female50-6489.4%87.4%91.1%
Female65+92.5%90.6%94.1%

Data Notes

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: [http://health.utah.gov/opha/publications/brfss/Raking/Raking%20impact%202011.pdf].   This graph is based on the new methodology.

Data Source

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


Percentage of Persons Who Reported Having Their Cholesterol Checked Within the Past Five Years by Ethnicity, Utah, 2013

::chart - missing::
confidence limits

Hispanic EthnicityAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 3
Hispanic61.7%57.6%65.6%
Non-Hispanic71.6%70.6%72.6%
All Utahns70.5%69.5%71.5%

Data Notes

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: [http://health.utah.gov/opha/publications/brfss/Raking/Raking%20impact%202011.pdf].   This graph is based on the new methodology. Rates are age-adjusted to U.S. 2000 standard population.

Data Source

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


Percentage of Persons Who Reported Having Their Cholesterol Checked Within the Past Five Years by Race, Utah, 2011-2013 (Combined Years)

::chart - missing::
confidence limits

Race/EthnicityAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 7
American Indian, Alaskan Native70.5%63.7%76.5%
Asian70.3%64.0%76.0%
Black, African American66.9%57.6%75.1%
Native Hawaiian, Pacific Islander71.3%63.0%78.4%
White70.7%70.0%71.5%
Other59.6%56.0%63.1%
All Races/Ethnicities69.9%69.1%70.6%

Data Notes

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: [http://health.utah.gov/opha/publications/brfss/Raking/Raking%20impact%202011.pdf].   This graph is based on the new methodology. 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


Percentage of Persons Who Reported Having Their Cholesterol Checked Within the Past Five Years by Income Level, Utah, 2013

::chart - missing::
confidence limits

Income CategoryAge-adjusted Percentage of PersonsLower LimitUpper Limit
Record Count: 5
<$25,00060.8%58.1%63.4%
$25,000-$49,99968.7%66.5%70.9%
$50,000-$74,99974.7%72.2%76.9%
$75,000+78.8%76.8%80.7%
Total70.5%69.5%71.5%

Data Notes

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: [http://health.utah.gov/opha/publications/brfss/Raking/Raking%20impact%202011.pdf].   This graph is based on the new methodology. 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


Percentage of Persons Who Reported Having Their Cholesterol Checked Within the Past Five Years by Education Level, Utah, 2011-2013 (Combined Years)

::chart - missing::
confidence limits

Education LevelAge-adjusted Percentage of Persons 25+Lower LimitUpper Limit
Record Count: 4
Less Than High School54.3%51.2%57.3%
H.S. Grad or G.E.D.64.6%63.2%66.1%
Some Post High School71.6%70.5%72.8%
College Graduate76.8%75.2%78.3%

Data Notes

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: [http://health.utah.gov/opha/publications/brfss/Raking/Raking%20impact%202011.pdf].   This graph is based on the old methodology. Age 25 years old and above. 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


Cholesterol Checked Within the Past Five Years by Local Health District, Utah 2011-2013

::chart - missing::
confidence limits

Local Health DistrictAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 14
Bear River66.8%63.8%69.5%
Central60.2%56.3%64.0%
Davis County74.3%72.3%76.1%
Salt Lake County71.1%69.8%72.3%
San Juan61.4%52.3%69.7%
Southeast69.6%64.6%74.1%
Southwest66.3%63.3%69.2%
Summit70.8%65.7%75.3%
Tooele71.6%67.4%75.6%
TriCounty67.9%64.1%71.6%
Utah County68.5%66.8%70.2%
Wasatch66.3%60.9%71.3%
Weber-Morgan73.6%71.2%75.9%
State of Utah69.9%69.2%70.6%

Data Notes

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: [http://health.utah.gov/opha/publications/brfss/Raking/Raking%20impact%202011.pdf].   [[br]][[br]]Age-adjusted to the U.S. 2000 standard population. Prior to 2015 San Juan County was part of the Southeast Local Health District. In 2015 the San Juan County Local Health District was formed. Data reported are for all years using the current boundaries.

Data Source

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

References and Community Resources

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. See what you can do to be part of the solution. Visit http://millionhearts.hhs.gov/be_one_mh.html for more information. For information about the Million Hearts initiative, please visit www.millionhearts.hhs.gov. For more information on how Utah compared to the U.S. and other states for cholesterol screening between 2005 and 2009,, please visit http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6135a2.htm.

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 07/27/2015, Published on 07/27/2015
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, 21 November 2018 2:34:25 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Fri, 26 May 2017 14:51:46 MDT