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Complete Health Indicator Report of Obesity Among Adults

Definition

Percentage of respondents aged 18 years and older who have a body mass index (BMI) greater than or equal to 30.0 kg/m^2^ calculated from self-reported weight and height.

Numerator

Number of respondents aged 18 years and older who have a body mass index (BMI) greater than or equal to 30.0 kg/m^2^ calculated from self-reported weight and height.

Denominator

Number of respondents aged 18 years and older for whom BMI can be calculated from their self-reported weight and height (excludes unknowns or refusals for weight and height).

Data Interpretation Issues

Respondents tend to overestimate their height and underestimate their weight leading to underestimation of BMI and the prevalence of obesity. 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. More details about these changes can be found at: [https://ibis.health.utah.gov/pdf/opha/resource/brfss/RakingImpact2011.pdf].

Why Is This Important?

Adults who are obese are at increased risk of morbidity from hypertension, high LDL cholesterol, type 2 diabetes, coronary heart disease, stroke, and osteoarthritis. Together, overweight and obesity make up the second leading cause of preventable death in the United States [U.S. Department of Health and Human Services. Overweight and obesity: a major public health issue. Prevention Report 2001;16]. Only smoking may exceed obesity in contributing to total U.S. mortality rates.

Healthy People Objective NWS-9:

Reduce the proportion of adults who are obese
U.S. Target: 30.5 percent
State Target: 24.0 percent

How Are We Doing?

According to a recent report from the Trust for America's Health and the Robert Wood Johnson Foundation, Utah has the sixth lowest adult obesity rate in the nation (see [http://healthyamericans.org/reports/stateofobesity2017/release.php?stateid=UT] ''The State of Obesity: Better Policies for a Healthier America'', August 2017). Over the past 16 years, the age-adjusted proportion of Utah adults who were obese has increased dramatically, from 19.5% in 2000 to 26.2% in 2016. While the sampling method changed in 2011, this change was still similarly pronounced in the years immediately prior to 2011. The highest rates of obesity were seen for adults ages 50 to 64. Age-adjusted rates are used to compare rates for race and local health districts to account for the differences in ages. In 2016, the Native Hawaiian/Pacific Islander and the American Indian/Alaskan Native populations had significantly higher rates than the state. An estimated 32.3 percent of Hispanic/Latino adults were obese, compared to 25.6% of non-Hispanic/Latino adults.

How Do We Compare With the U.S.?

The age-adjusted prevalence of obesity in Utah adults is slightly lower than the U.S. In 2016, the obesity prevalence rate in Utah adults was 26.2%. The obesity prevalence for U.S. adults in 2016 was 29.6%.

What Is Being Done?

In 2013, through funding from the Centers for Disease Control and Prevention (CDC), the Healthy Living through Environment, Policy, and Improved Clinical Care Program (EPICC) was established. EPICC works on Environmental Approaches that Promote Health. EPICC works: In Schools:[[br]] 1) Schools are encouraged to adopt the Comprehensive School Physical Activity Program. This framework encourages students to be physically active for 60 minutes a day through school, home and community activities.[[br]] 2) Height and weight trends are being tracked in a sample of elementary students to monitor Utah students.[[br]] 3) Action for Healthy Kids brings partners together to improve nutrition and physical activity environments in Utah's schools by implementing the school-based state plan strategies, working with local school boards to improve or develop policies for nutritious foods in schools. This includes recommendations for healthy vending options. In Worksites:[[br]] 1) The Utah Council for Worksite Health Promotion recognizes businesses that offer employee fitness and health promotion programs.[[br]] 2) EPICC partners with local health departments to encourage worksites to complete the CDC Scorecard and participate in yearly health risk assessment for their employees. EPICC provides toolkits and other resources for employers interested in implementing wellness programs through the [http://choosehealth.utah.gov choosehealth.utah.gov] website: [http://choosehealth.utah.gov/worksites/why-worksite-wellness.php] -- In Communities:[[br]] 1) Local health departments (LHDs) receive federal funding to partner with schools, worksites, and other community based organizations to increase access to fresh fruits and vegetables through farmers markets and retail stores. LHDs also work with cities within their jurisdictions to create a built environment that encourages physical activity. In Healthcare:[[br]] 1) EPICC works with health care systems to establish community clinical linkages to support individuals at risk for or diagnosed with diabetes or hypertension to engage in lifestyle change programs such as chronic disease self-management and diabetes prevention programs. In Childcare:[[br]] 1) Nine local health departments statewide have implemented the TOP Star program, which aims to improve the nutrition and physical activity environments and achieve best practice in child care centers and homes.[[br]] 2) EPICC works with state and local partners through the Childcare Obesity Prevention workgroup to implement policy and systems changes in early care and education across agencies statewide.

Evidence-based Practices

The EPICC program promotes evidence based practices collected by the Center TRT. The Center for Training and Research Translation (Center TRT) bridges the gap between research and practice and supports the efforts of public health practitioners working in nutrition, physical activity, and obesity prevention by: *Reviewing evidence of public health impact and disseminating population-level interventions; *Designing and providing practice-relevant training both in-person and web-based; *Addressing social determinants of health and health equity through training and translation efforts; and, *Providing guidance on evaluating policies and programs aimed at impacting healthy eating and physical activity. [[br]] Appropriate evidence based interventions can be found at: [http://www.centertrt.org/?p=interventions_interventions_overview]

Available Services

Gold Medal School Initiative - for more information, call 801-538-6142 Action for Healthy Kids Local School Policy CD - for more information, call 801-538-6142 The Utah Department of Health houses the Healthy Living through Environment, Policy and Improved Clinical Care (EPICC). The EPICC website has information on healthy living, including prevention of diabetes, heart disease and stroke on [http://www.choosehealth.utah.gov]. Utah Worksite Wellness Council is a non-profit organization made up of volunteers from organizations across Utah. Information is available at [http://utahworksitewellness.org].


Related Indicators

Relevant Population Characteristics

The age-adjusted proportion of Utahns aged 18 or older with a BMI indicating obesity (>=30) has increased steadily since 1990 (from 9.9% in 1990 to 26.2% in 2016). Obesity rates are higher than the state rate for certain populations, including for Native American/American Indians and Native Hawaiians, Pacific Islanders. Highest rates are seen in adults aged 50 to 64.

Related Relevant Population Characteristics Indicators:


Health Care System Factors

Obesity-related illnesses are estimated to have health care costs $190 billion a year, or "nearly 21% of annual medical spending in the United States." (Economic Costs of Obesity | Healthy Communities for a Healthy Future; [http://www.healthycommunitieshealthyfuture.org/learn-the-facts/economic-costs-of-obesity])

Related Health Care System Factors Indicators:


Risk Factors

Genetic or familial factors may increase the risk for being obese for some people, but anyone whose calorie intake exceeds the number of calories burned is at risk. Physical activity and a healthy diet are both important for obtaining and maintaining a healthy weight. Adults who are obese are at increased risk of morbidity from hypertension, elevated LDL cholesterol, type 2 diabetes, coronary heart disease, stroke, osteoarthritis, sleep apnea, respiratory problems, and endometrial, breast, prostate, and colon cancers.

Related Risk Factors Indicators:


Health Status Outcomes

Almost two-thirds of all adults are overweight or obese (61.6% in 2016, age-adjusted rate - see [[a href="indicator/view/OvrwtObe.html" Overweight or Obese Indicator Report]]). The obesity epidemic among Utahns threatens to reverse the decades-long progress made in reducing death from cardiovascular disease, diabetes, and certain cancers.

Related Health Status Outcomes Indicators:




Graphical Data Views

Adult Obesity, Utah and U.S., 1989-2016

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confidence limits

Obesity in the U.S. and in Utah continue to increase, although rates in Utah may be beginning to level off.
BRFSS Utah vs. U.S.YearAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 58
UT Old Methodology198910.5%8.9%12.1%
UT Old Methodology19909.9%8.3%11.5%
UT Old Methodology199111.0%9.3%12.7%
UT Old Methodology199212.4%10.6%14.2%
UT Old Methodology199312.0%10.3%13.7%
UT Old Methodology199412.4%10.7%14.0%
UT Old Methodology199513.7%12.0%15.4%
UT Old Methodology199613.9%12.1%15.7%
UT Old Methodology199715.8%14.1%17.5%
UT Old Methodology199816.5%14.5%18.4%
UT Old Methodology199916.9%15.1%18.8%
UT Old Methodology200019.5%17.6%21.5%
UT Old Methodology200119.3%17.7%21.0%
UT Old Methodology200219.0%17.4%20.6%
UT Old Methodology200321.5%19.8%23.3%
UT Old Methodology200421.1%19.7%22.4%
UT Old Methodology200522.1%20.7%23.5%
UT Old Methodology200622.8%21.5%24.3%
UT Old Methodology200723.1%21.7%24.6%
UT Old Methodology200824.0%22.6%25.5%
UT Old Methodology200924.8%23.7%25.9%
UT Old Methodology201024.0%22.9%25.1%
US Old Methodology198911.3%10.9%11.7%
US Old Methodology199011.9%11.5%12.3%
US Old Methodology199112.8%12.4%13.2%
US Old Methodology199213.5%13.2%13.9%
US Old Methodology199314.4%14.1%14.8%
US Old Methodology199415.1%14.8%15.5%
US Old Methodology199515.9%15.5%16.3%
US Old Methodology199616.4%16.1%16.7%
US Old Methodology199716.9%16.6%17.3%
US Old Methodology199818.4%18.1%18.8%
US Old Methodology199919.4%19.1%19.8%
US Old Methodology200020.3%20.0%20.7%
US Old Methodology200121.6%21.3%21.9%
US Old Methodology200221.8%21.4%22.1%
US Old Methodology200322.7%22.4%23.0%
US Old Methodology200423.4%23.1%23.7%
US Old Methodology200524.4%24.1%24.7%
US Old Methodology200625.0%24.6%25.3%
US Old Methodology200725.9%25.6%26.2%
US Old Methodology200825.5%26.2%26.8%
US Old Methodology200927.1%26.8%27.4%
US Old Methodology201027.4%27.1%27.7%
UT New Methodology200925.5%24.4%26.6%
UT New Methodology201025.2%24.2%26.3%
UT New Methodology201125.2%24.2%26.2%
UT New Methodology201225.0%24.0%26.0%
UT New Methodology201325.1%24.1%26.0%
UT New Methodology201426.6%25.7%27.4%
UT New Methodology201525.2%24.2%26.2%
UT New Methodology201626.2%25.1%27.4%
US New Methodology201127.4%27.1%27.6%
US New Methodology201227.7%27.4%28.0%
US New Methodology201328.3%28.0%28.6%
US New Methodology201429.0%28.7%29.2%
US New Methodology201528.9%28.6%29.2%
US New Methodology201629.6%29.4%29.9%

Data Notes

Obesity is defined as a BMI of 30 or more. BMI is calculated by dividing weight in kilograms by the square of height in meters. In 2016, Utah BRFSS modified its methodology for age adjustment to align with U.S. age adjustment. Data has been updated from 2011 onward in all chart views to reflect this modification.   [[br]] [[br]] Age-adjusted to U.S. 2000 standard population. [[br]] U.S. data does not include U.S. territories, but does include Dist. of Columbia. [[br]] 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. Comparisons between 2011 and prior years should be made with caution. More details about these changes can be found at: [https://ibis.health.utah.gov/pdf/opha/resource/brfss/RakingImpact2011.pdf].

Data Sources

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


Adult Obesity by Age and Sex, Utah, 2016

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confidence limits

Rates shown are crude rates. Obesity rates are highest for adults aged 50-64 for both males and females, and lowest for adults aged 18-34 for both males and females.
Males vs. FemalesAge GroupCrude Percentage of AdultsLower LimitUpper Limit
Record Count: 12
Male18-3416.2%13.9%18.9%
Male35-4930.6%27.3%34.0%
Male50-6434.0%30.6%37.6%
Male65+28.7%25.5%32.1%
Female18-3417.5%14.9%20.5%
Female35-4929.9%26.6%33.4%
Female50-6432.0%28.7%35.5%
Female65+24.9%22.2%27.8%
Total18-3416.8%15.0%18.8%
Total35-4930.3%27.9%32.7%
Total50-6433.1%30.7%35.5%
Total65+26.8%24.7%29.0%

Data Notes

Obesity is defined as a BMI of 30 or more. BMI is calculated by dividing weight in kilograms by the square of height in meters. In 2016, Utah BRFSS modified its methodology for age adjustment to align with U.S. age adjustment. Data has been updated from 2011 onward in all chart views to reflect this modification.

Data Source

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


Adult Obesity by Local Health District, Utah, 2016

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confidence limits

Weber-Morgan and TriCounty Local Health Departments have the highest rates of adult obesity, followed closely by San Juan Local Health Department
Local Health DistrictAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 15
Bear River29.8%25.5%34.6%
Central27.4%23.4%31.9%
Davis County26.5%23.5%29.9%
Salt Lake County25.1%23.1%27.2%
San Juan31.3%23.7%40.2%
Southeast28.2%22.5%34.7%
Southwest23.0%19.3%27.1%
Summit14.1%8.8%21.9%
Tooele28.7%23.5%34.5%
TriCounty33.4%28.8%38.3%
Utah County25.8%23.2%28.6%
Wasatch22.5%16.1%30.4%
Weber-Morgan33.8%30.1%37.7%
State of Utah26.2%25.1%27.4%
U.S.29.6%29.4%29.9%

Data Notes

Obesity is defined as a BMI of 30 or more. BMI is calculated by dividing weight in kilograms by the square of height in meters. In 2016, Utah BRFSS modified its methodology for age adjustment to align with U.S. age adjustment. Data has been updated from 2011 onward in all chart views to reflect this modification.   [[br]] [[br]] Percentages have been age-adjusted to the U.S. 2000 standard population. [[br]] [[br]]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.

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


Adult Obesity by Utah Small Area, 2014-2016

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confidence limits

There is considerable variation in the rates of obesity for small areas.
Utah Small AreasAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 62
Brigham City28.3%22.9%34.4%
Box Elder Co (Other)32.2%26.5%38.5%
Logan25.5%22.0%29.5%
Cache Co (Oth)/Rich Co (All)29.9%25.4%34.9%
Ben Lomond34.7%30.4%39.3%
Morgan Co (All)/Weber Co (E)23.0%19.1%27.5%
Ogden (Downtown)32.3%26.9%38.1%
South Ogden29.5%24.6%34.9%
Roy/Hooper32.7%28.1%37.7%
Riverdale32.7%26.5%39.5%
Clearfield/Hill AFB30.6%26.7%34.9%
Layton27.7%24.2%31.6%
Syracuse/Kaysville23.6%20.1%27.5%
Farmington/Centerville22.2%17.7%27.3%
Woods Cross/North Salt Lake25.7%20.6%31.6%
Bountiful21.3%17.6%25.4%
SLC (Rose Park)33.4%26.9%40.6%
SLC (Avenues)7.5%4.9%11.3%
SLC (Foothill/U of U)11.3%7.7%16.2%
Magna34.1%27.8%41.0%
SLC (Glendale)31.5%25.2%38.6%
West Valley (West)33.9%29.8%38.1%
West Valley (East) V233.8%28.0%40.1%
SLC (Downtown)18.4%14.8%22.7%
South Salt Lake30.2%23.2%38.3%
Millcreek20.2%16.5%24.4%
Holladay23.2%18.2%29.1%
Kearns V233.4%27.6%39.7%
Taylorsville (E)/Murray (W)28.0%22.8%33.8%
Taylorsville (West)31.6%26.5%37.2%
Murray26.9%21.3%33.4%
Midvale24.8%18.9%31.8%
West Jordan (NE) V223.6%18.5%29.6%
West Jordan (SE)34.0%28.3%40.1%
West Jordan (W)/Copperton27.8%22.5%33.7%
South Jordan22.1%18.5%26.2%
Sandy (Center)23.5%19.6%27.9%
Sandy (NE)19.6%14.5%26.0%
Sandy (SE)19.1%14.1%25.2%
Riverton/Draper23.8%20.9%27.0%
Tooele Co29.7%26.3%33.3%
Lehi/Cedar Valley29.3%25.5%33.4%
American Fork/Alpine22.0%18.4%26.2%
Pleasant Grove/Lindon24.1%20.2%28.5%
Orem (North)27.0%21.7%33.1%
Orem (West)30.2%24.4%36.8%
Orem (East)24.1%18.5%30.9%
Provo (North)/BYU21.9%16.9%27.8%
Provo (South)33.8%28.4%39.7%
Springville/Spanish Fork24.6%21.4%28.2%
Utah Co (South)29.1%23.8%35.1%
Summit Co14.3%11.2%18.1%
Wasatch Co19.5%15.8%23.9%
TriCounty LHD31.1%28.0%34.5%
Juab/Millard/Sanpete Co28.9%25.6%32.5%
Sevier/Piute/Wayne Co26.6%22.1%31.6%
Carbon/Emery Co26.4%22.5%30.8%
St George19.1%16.0%22.7%
Washington Co (Other)27.0%22.9%31.6%
Cedar City26.1%21.7%31.1%
Southwest LHD (Other)24.3%19.5%29.8%
State26.0%25.4%26.6%

Data Notes

Obesity is defined as a BMI of 30 or more. BMI is calculated by dividing weight in kilograms by the square of height in meters. In 2016, Utah BRFSS modified its methodology for age adjustment to align with U.S. age adjustment. Data has been updated from 2011 onward in all chart views to reflect this modification.   `[[br]] [[br]] Percentages have been age-adjusted to the U.S. 2000 standard population. [[br]] [[br]]A description of the Utah Small Areas and details about Small Area reclassification 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


Adult Obesity by Ethnicity, Utah, 2016

::chart - missing::
confidence limits

Hispanic adults have higher rates of obesity (adjusted for age differences) than non-Hispanic adults.
Hispanic EthnicityAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 3
Hispanic32.3%27.6%37.3%
Non-Hispanic25.6%24.5%26.8%
All Utahns26.2%25.1%27.4%

Data Notes

Obesity is defined as a BMI of 30 or more. BMI is calculated by dividing weight in kilograms by the square of height in meters. In 2016, Utah BRFSS modified its methodology for age adjustment to align with U.S. age adjustment. Data has been updated from 2011 onward in all chart views to reflect this modification.   [[br]] [[br]] 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


Adult Obesity by Race, Utah, 2016

::chart - missing::
confidence limits

The highest rate of obesity is seen for Pacific Islander adults. The lowest rate is reported for Asian adults, but the estimate has a coefficient of variation greater than 30% and does not meet UDOH standards for reliability. Note: Race may be Hispanic or non-Hispanic ethnicity.
Race/EthnicityAge-adjusted Percentage of AdultsLower LimitUpper LimitNote
Record Count: 7
American Indian, Alaskan Native37.1%27.7%47.6%
Asian11.1%5.3%21.8%^
Black, African American33.2%20.8%48.6%
Native Hawaiian, Pacific Islander45.3%30.8%60.7%
White25.8%24.6%27.0%
Other31.4%25.7%37.7%
All Races/Ethnicities26.1%25.0%27.3%

Data Notes

Obesity is defined as a BMI of 30 or more. BMI is calculated by dividing weight in kilograms by the square of height in meters. In 2016, Utah BRFSS modified its methodology for age adjustment to align with U.S. age adjustment. Data has been updated from 2011 onward in all chart views to reflect this modification.   [[br]] [[br]] Age-adjusted to U.S. 2000 standard population with three age groups.[[br]] [[br]] ^Unreliable estimate: the estimate has a coefficient of variation greater than 30% and does not meet UDOH standards for reliability.

Data Source

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


Adult Obesity by Education (Ages 25+), Utah, 2016

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confidence limits

Data are limited to adults aged 25 or older. Lower rates of obesity are observed for adults who have a college degree.
Education LevelAge-adjusted Percentage of Adults 25+Lower LimitUpper Limit
Record Count: 9
Less Than High School33.5%27.8%39.8%
H.S. Grad or G.E.D.32.8%30.1%35.5%
Some Post High School29.6%27.5%31.9%
College Graduate23.8%22.1%25.5%
Total28.8%27.5%30.0%

Data Notes

Obesity is defined as a BMI of 30 or more. BMI is calculated by dividing weight in kilograms by the square of height in meters. In 2016, Utah BRFSS modified its methodology for age adjustment to align with U.S. age adjustment. Data has been updated from 2011 onward in all chart views to reflect this modification.   [[br]] [[br]] 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


Adult Obesity by Income, Utah, 2016

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confidence limits

There is an inverse association between income and prevalence of obesity.
Income CategoryAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 5
<$25,00029.8%26.5%33.3%
$25,000-$49,99929.7%27.0%32.5%
$50,000-$74,99926.8%24.3%29.5%
$75,000+22.6%20.8%24.5%
Total26.2%25.1%27.4%

Data Notes

Obesity is defined as a BMI of 30 or more. BMI is calculated by dividing weight in kilograms by the square of height in meters. In 2016, Utah BRFSS modified its methodology for age adjustment to align with U.S. age adjustment. Data has been updated from 2011 onward in all chart views to reflect this modification.   [[br]] [[br]] 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

References and Community Resources

Resources: Making the Healthy Choice the Easy Choice, The Utah Nutrition and Physical Activity Plan 2010-2020. [http://choosehealth.utah.gov/documents/pdfs/U-PAN_State_Plan.pdf] The National Center for Chronic Disease Prevention and Health Promotion provides consumer information at [https://www.cdc.gov/obesity/index.html] NHLBI Obesity Education Initiative at [https://www.nhlbi.nih.gov/about/org/oei] The State of Obesity: Better Policies for a Healthier America at [http://healthyamericans.org/report/115/] The Surgeon General's Call to Action to Prevent and Decrease Overweight & Obesity at [https://www.surgeongeneral.gov/library/calls/] More information on the Behavioral Risk Factor Surveillance System may be found on the website of the Centers for Disease Control and Prevention - [http://www.cdc.gov/brfss/] Trust for America's Health [http://healthyamericans.org/reports/stateofobesity2017]

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 11/01/2017, Published on 11/28/2017
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 Tue, 23 January 2018 10:39:46 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Tue, 28 Nov 2017 14:08:01 MST