Attachment 7

Morbidity and Mortality Weekly Report
Surveillance Summaries / Vol. 60 / No. 6

May 20, 2011

Surveillance of Health Status in Minority
Communities — Racial and Ethnic
Approaches to Community Health Across
the U.S. (REACH U.S.) Risk Factor
Survey, United States, 2009

U.S. Department of Health and Human Services
Centers for Disease Control and Prevention

Surveillance Summaries

CONTENTS
Introduction.............................................................................................................2
Methods.....................................................................................................................3
Results........................................................................................................................5
Discussion.................................................................................................................9
Conclusion............................................................................................................. 11
References.............................................................................................................. 12

The MMWR series of publications is published by the Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention (CDC),
U.S. Department of Health and Human Services, Atlanta, GA 30333.
Suggested Citation: Centers for Disease Control and Prevention. [Title]. MMWR 2011;60(No. SS-#):[inclusive page numbers].

Centers for Disease Control and Prevention

Thomas R. Frieden, MD, MPH, Director
Harold W. Jaffe, MD, MA, Associate Director for Science
James W. Stephens, PhD, Office of the Associate Director for Science
Stephen B. Thacker, MD, MSc, Deputy Director for Surveillance, Epidemiology, and Laboratory Services
Stephanie Zaza, MD, MPH, Director, Epidemiology and Analysis Program Office

MMWR Editorial and Production Staff

Ronald L. Moolenaar, MD, MPH, Editor, MMWR Series
Christine G. Casey, MD, Deputy Editor, MMWR Series
Teresa F. Rutledge, Managing Editor, MMWR Series
David C. Johnson, Lead Technical Writer-Editor
Jeffrey D. Sokolow, MA, Project Editor

MMWR Editorial Board

Martha F. Boyd, Lead Visual Information Specialist
Malbea A. LaPete, Julia C. Martinroe,
Stephen R. Spriggs, Terraye M. Starr
Visual Information Specialists
Quang M. Doan, MBA, Phyllis H. King
Information Technology Specialists

William L. Roper, MD, MPH, Chapel Hill, NC, Chairman
Virginia A. Caine, MD, Indianapolis, IN
Patricia Quinlisk, MD, MPH, Des Moines, IA
Jonathan E. Fielding, MD, MPH, MBA, Los Angeles, CA
Patrick L. Remington, MD, MPH, Madison, WI
David W. Fleming, MD, Seattle, WA
Barbara K. Rimer, DrPH, Chapel Hill, NC
William E. Halperin, MD, DrPH, MPH, Newark, NJ
John V. Rullan, MD, MPH, San Juan, PR
King K. Holmes, MD, PhD, Seattle, WA
William Schaffner, MD, Nashville, TN
Deborah Holtzman, PhD, Atlanta, GA
Anne Schuchat, MD, Atlanta, GA
John K. Iglehart, Bethesda, MD
Dixie E. Snider, MD, MPH, Atlanta, GA
Dennis G. Maki, MD, Madison, WI
John W. Ward, MD, Atlanta, GA

Surveillance Summaries

Surveillance of Health Status in Minority Communities — Racial and
Ethnic Approaches to Community Health Across the U.S. (REACH U.S.)
Risk Factor Survey, United States, 2009
Youlian Liao, MD
David Bang, PhD
Shannon Cosgrove, MHA
Rick Dulin, BS
Zachery Harris, BS
Alexandria Stewart, BS
April Taylor, MPH
Shannon White, MPH
Graydon Yatabe, MPH
Leandris Liburd, PhD
Wayne Giles, MD
Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion

Abstract
Problem: Substantial racial/ethnic health disparities exist in the United States. Although the populations of racial and ethnic
minorities are growing at a rapid pace, large-scale community-based surveys and surveillance systems designed to monitor the
health status of minority populations are limited. CDC conducts the Racial and Ethnic Approaches to Community Health across
the U.S. (REACH U.S.) Risk Factor Survey annually in minority communities. The survey focuses on black, Hispanic, Asian
(including Native Hawaiian and Other Pacific Islander), and American Indian (AI) populations.
Reporting Period Covered: 2009.
Description of System: An address-based sampling design was used in the survey in 28 communities located in 17 states (Arizona,
California, Georgia, Hawaii, Illinois, Massachusetts, Michigan, New Mexico, New York, North Carolina, Ohio, Oklahoma, Pennsylvania,
South Carolina, Virginia, West Virginia, and Washington). Self-reported data were collected through telephone, questionnaire mailing,
and in-person interviews from an average of 900 residents aged ≥ 18 years in each community. Data from the community were compared
with data derived from the Behavioral Risk Factor Surveillance System (BRFSS) for the metropolitan and micropolitan statistical area
(MMSA), county, or state in which the community was located and also compared with national estimates.
Results: Reported education level and household income were markedly lower in black, Hispanic, and AI communities than that
among the general population living in the comparison MMSA, county, or state. More residents in these minority populations
did not have health-care coverage and did not see a doctor because of the cost.
Substantial variations were identified in the prevalence of health-related risk factors among minority populations and among communities within the same racial/ethnic population. In 2009, the median prevalence of obesity among Asian/Pacific Islander (A/PI) men and
women was 10.3% (range: 4.8%–45.3%) and 6.7% (range: 4.5%–38.2%), respectively, whereas it was 46.2% (range: 39.4%–53.6%)
and 45.5% (range: 35.1%–55.1%), respectively, among AI men and women. The median percentage of cigarette smoking among
black (28.0% in men and 19.9% in women) and AI communities (36.1% in men and 36.0% in women) was much higher than
the national median (19.6% in men and 16.8% in women) among the 50 states and the District of Columbia (DC). Among the
four minority communities, blacks had the highest median percentage of persons who reported engaging in no leisure-time physical
activity (28.5% in men and 31.6% in women). A much lower percentage of black women met physical activity recommendations
in almost all communities compared with that in the corresponding MMSA, county, or state.
Substantial variations were identified in self-perceived health status and prevalence of selected chronic conditions among minority populations and among communities within the same
racial/ethnic population. In 2009, the median percentage
of men who reported fair or poor health was 15.8% (range:
Corresponding author: Youlian Liao, MD, Division of Adult and
8.3%–29.3%) among A/PI communities and 26.3% (range:
Community Health, National Center for Chronic Disease Prevention
and Health Promotion, CDC, MS K-30, 4770 Buford Hwy, N.E.,
22.3%–30.8%) among AI communities. The median percentAtlanta, GA 30341. Telephone: 770-488-5299; Fax: 770-488-5974;
age of women who reported fair or poor health was 20.1%
E-mail: ycl1@cdc.gov.
(range: 13.3%–37.2%) among A/PI communities, whereas it
MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

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Surveillance Summaries

was 31.3% (range: 19.4%–44.2%) among Hispanic communities. AI and black communities had a high prevalence of self-reported
hypertension, cardiovascular disease, and diabetes. For most communities, prevalence was much higher than that in the corresponding MMSA, county, or state in which the community was located. The median percentages of persons who knew the signs
and symptoms of a heart attack and stroke were consistently lower in all four minority communities than the national median.
Variations were identified among racial/ethnic populations in the use of preventive services. Hispanics had the lowest percentages
of persons who had their cholesterol checked, of those with high blood pressure who were taking antihypertensive medication,
and of those with diabetes who had a glycosylated hemoglobin (HbA1C) test in the past year. AIs had the lowest mammography
screening rate within 2 years among women aged ≥40 years (median: 72.7%; range: 69.4%–76.2%). A/PIs had the lowest Pap
smear screening rate within 3 years (median: 74.4%; range: 60.3%–80.8%). The median influenza vaccination rates in adults
aged ≥65 years were much lower among black (57.3%) and Hispanic communities (63.3%) than the national median (70.1%)
among the 50 states and DC. Pneumococcal vaccination rates also were lower in black (60.5%), Hispanic (58.5%), and A/PI
(59.7%) communities than the national median (68.5%).
Interpretations: Data from the REACH U.S. Risk Factor Survey demonstrate that residents in most of the minority communities
continue to have lower socioeconomic status, greater barriers to health-care access, and greater risks for and burden of disease
compared with the general populations living in the same MMSA, county, or state. Substantial variations in prevalence of risk
factors, chronic conditions, and use of preventive services among different minority populations and different communities within
the same racial/ethnic population provide opportunities for public health intervention. These variations also indicate that different
priorities are needed to eliminate health disparities for different communities.
Public Health Action: These community-level survey data are being used by CDC and community coalitions to implement,
monitor, and evaluate intervention programs in each community. Continuous surveillance of health status in minority communities
is necessary so that community-specific, culturally sensitive strategies that include system, environmental, and individual-level
changes can be tailored to these communities.

Introduction
Substantial racial/ethnic health disparities have been
identified in the United States (1). In 2006, one of every four
U.S. residents identified themselves as being a racial or ethnic
minority (2). The U.S. Census Bureau projects that by 2050,
populations that have historically been called “minorities”
will make up approximately 50% of the U.S. population (3).
Achieving a healthy nation is impossible without healthy
minority populations and without eliminating racial/ethnic
health disparities. Eliminating health disparities was one of the
goals of Healthy People 2010 (4). Individual health is closely
linked to the health of the community* and environment
in which persons live, work, and play (4). The health of a
person is inseparable from the health of the larger community
and the health of every community in every state/territory
determines the overall health status of the nation. Healthy
People 2010 called for community partnerships in building
healthy communities (4).
* As used in this report, “community” has two possible meanings, referring either
to a locale (e.g., a community in Los Angeles county) or to members of an
minority population (e.g., the Hispanic community). Unless preceded by the
name of a racial/ethnic population group, the word should be understood as
meaning a locale (e.g., a neighborhood or county) in which data were collected.
On several occasions the word is used in the commonly accepted sense of
meaning the entire city, county, state, or nation as opposed to a segment of the
larger whole (e.g., “the health of the larger community”).

2

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CDC launched the Racial and Ethnic Approaches to
Community Health (REACH) in 1999 (5). During 2000–2006,
CDC funded the initial phase of the REACH project, REACH
2010, supporting 42 community coalitions in designing, implementing, and evaluating community-driven strategies to eliminate
health disparities (5). The project supported the development and
implementation of innovative approaches to working with racial
and ethnic minority populations. REACH 2010 demonstrated
that health disparities can be reduced and that the health status of
populations traditionally most affected by health inequities can be
improved (6). Building on the successes of the initial phase of the
project, a new funding phase, REACH Across the U.S. (REACH
U.S.), was launched in 2007. REACH U.S. endeavors to address
the social determinants of health through policy, environmental,
and system change and to disseminate effective strategies to more
community partners (7). A total of 40 communities were selected
competitively and funded by CDC on the basis of the cultural
relevance of the proposed intervention, investigator expertise,
community participatory strategies, and demonstrated success in
prior training, translation, and dissemination activities. These 40
funded communities focused on one or more racial and ethnic
population, including blacks, Hispanics, Asians (including Native
Hawaiians and Other Pacific Islanders), and American Indians
(AIs). The health focus areas include cardiovascular disease,
diabetes mellitus, breast and cervical cancer, adult/older adult
immunization, hepatitis B, asthma, and infant mortality.

Surveillance Summaries

In 2001, to monitor the health of racial/ethnic minority
communities and as part of the REACH project evaluation,
CDC began to conduct annual REACH 2010 Risk Factor
Surveys. Baseline data for the REACH 2010 project have been
published previously (8). This report presents data from the
first survey year of the REACH U.S. project collected during
May–November 2009.

Methods
Survey Communities
CDC contracted with the National Opinion Research
Center (NORC) at the University of Chicago to conduct the
REACH U.S. Risk Factor Survey in 28 of the 40 U.S. REACH
communities.† The survey included adult residents aged ≥18
years. The 28 communities participating in the survey were
located in 17 states.§
The survey areas and populations were consistent with the
focus of the intervention programs. The areas included specific
counties, census tracts, zip codes, neighborhood areas, or tribal
areas (Table 1). The size of the survey area varied by community,
ranging from a small neighborhood (e.g., within the boundaries
of four specific streets in west Philadelphia) to a whole county
(e.g., Pima County, Arizona) and from several census tracts
or zip codes to an entire state (e.g., Oklahoma). Among the
five communities in California, some geographic overlapping
occurred. The survey was conducted independently in each
community. The REACH project led by the Morehouse School
of Medicine, the Southeastern U.S. Collaborative Center of
Excellence for the Elimination of Disparities, involved several
areas in south Georgia, South Carolina, and North Carolina.
The survey for this project included only the intervention
areas in Fulton County, Georgia. In 20 REACH communities,
just one minority population was focused (black or Haitian
American: eight; Hispanic: four; Asian or Native Hawaiian/
Other Pacific Islander [Asian/Pacific Islander (A/PI)]: four;
and AI: four); six communities focused on both blacks and
Hispanics; and two communities focused on three minority
populations (blacks, Hispanics, and A/PIs) (Table 2).

† Five

communities whose targeted health priority was infant mortality were
excluded because the design of the survey on adult populations was not appropriate to study issues related to infant mortality. An additional seven communities whose interventions were widely spread geographically were excluded
because conducting the survey was not feasible.
§ Arizona, California, Georgia, Hawaii, Illinois, Massachusetts, Michigan, New
Mexico, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, South
Carolina, Virginia, West Virginia, and Washington

Address-Based Sampling Design
An address-based sampling method was used in the
REACH U.S. Risk Factor Survey to reduce the potential
coverage bias of traditional random-digit–dialing. When the
previous REACH 2010 Risk Factor Survey was initiated in
2001, random-digit–dialing was the preferred mode of data
collection, except in three communities in which in-person
face-to-face interviews were performed because of low telephone coverage (8). Since then, use of cellular telephones
has increased. In 2009, 25% of U.S. homes had only cellular
phones (9). In addition, 15% received most or all of their
calls on cellular phones even though they had a landline.
Therefore, up to 40% of U.S. homes might not be reachable
by traditional random-digit–dialing used in most surveys
targeting landlines. Minority populations have embraced cellular phones at a higher rate than the majority, increasing the
risk for coverage bias in REACH communities (9). The basis
of the address-based sampling frame is the U.S. Postal Service
delivery sequence file. This file contains nearly all addresses in
the United States that receive mail. Geographic information
systems technology was used to construct an address frame that
matched the intervention geographies of the REACH program.
After a sample of addresses was selected randomly, the addresses
were matched to telephone numbers. The median matching
rate was 60% (range: 40%–71%). Advance letters describing
the survey were sent to sampled households with known telephone numbers. The survey was conducted by telephone for
these addresses. Self-administered questionnaires were mailed
to households without a phone match and to those who did
not respond by telephone. Finally, an in-person follow-up to
a subset of nonresponders was conducted.
To increase the efficiency of the survey, designers purposely
selected those addresses that were more likely to be households
of the survey race/ethnicity. These addresses were identified by
aggregating data from multiple sources (e.g., residential directory
listings, administrative data, and consumer transactions).
For telephone and in-person interviews, the household
screening was conducted with any household member aged
≥18 years to ascertain the age and racial/ethnic eligibility of
each adult household member. Up to two eligible adults were
selected for further household member interviews. For the survey by mail, all household members were invited to complete
the mailed survey. The goal was to survey 900 adult household
members in each community.
Complete data were collected from 24,117 eligible household members. Of these, 19,177 (79%) were from telephone
interviews, 4,022 (17%) from questionnaire mailings, and

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Surveillance Summaries

918 (4%) from in-person interviews. Among household
members who were contacted by telephone, 43% cooperated with the screening interview (range: 25%– 65%). The
completion rate of detailed household member interviews
was 42% (range: 26%–58%) for eligible household members. In the questionnaire mailing, the mail return rate was
20% (range: 8%–25%). In the in-person survey, the screening completion rate was 75% (range: 48%–88%), and the
completion rate of household member interviews was 72%
(range: 50%–92%).

Questionnaires
A uniform questionnaire was used for all communities and was
administered in English, Spanish, Vietnamese, Khmer, Haitian
Creole, or Chinese (Mandarin or Cantonese). The questionnaire included questions regarding respondents’ demographics,
socioeconomic status (e.g., education and income), perceived
health status, health-care access, self-reported height and weight,
leisure-time physical activity, fruit and vegetable intake, cigarette
smoking, awareness of hypertension, cardiovascular diseases,
diabetes and diabetes care, and receipt of preventive services
(e.g., cholesterol screening, mammography, Papanicolaou [Pap]
smear test, and influenza and pneumococcal vaccination). The
questions were identical to those used in the Behavioral Risk
Factor Surveillance System (BRFSS) (10).

Comparison Populations
Health status and risk factor level in the REACH U.S.
communities were compared with those in the general population
from BRFSS. BRFSS is a state-based telephone survey of civilian
residents aged ≥18 years (10). Typically, BRFSS reports statelevel estimates. Since 2002, BRFSS has had sufficient samples
to produce area-level estimates for selected metropolitan and
micropolitan statistical areas (MMSAs), metropolitan divisions,
and selected counties. For 13 REACH U.S. communities, data
from each community were compared with data from BRFSS
in the MMSA in which the community was located (Table 1).
For eight communities, community data were compared with
county data from BRFSS. For the remaining seven communities
that could not be matched to a specific MMSA or county, statespecific BRFSS data were used for comparisons.
The sample size of respondents from the comparison populations was increased by combining MMSA- or county-level
data from 2007–2009 survey years and state-level data from
2008–2009 survey years (Table 2). Certain BRFSS data were
available only in the 2007 and 2009 survey years (e.g., meeting
physical activity recommendation, fruit and vegetable intake,
having cholesterol checked, awareness of hypertension, and the
use of antihypertensive medication among those who reported
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MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

having high blood pressure). Certain questions were included
in BRFSS as the optional modules that were asked only in
certain states (either all samples or subsamples) for selected
years. Therefore, state-level data from the combined years of
2007–2009 were used whenever available to compare with
community-level data for the following modules: signs and
symptoms of heart attack and stroke (2007 and 2009), diabetes
care (glycosylated hemoglobin [HbA1C] test, foot, and eye
exams) (2007–2009), and women’s health (mammography and
pap smear test) (2007–2009). Aggregated data across communities by race/ethnicity also were compared with the national
estimates for all 50 states and the District of Columbia (DC)
in the 2009 BRFSS (women’s health data in 2008).

Data Analysis
The prevalence of risk factors, chronic conditions, and
access to and use of preventive services was estimated by community, four racial/ethnic populations, and sex. In Boston,
Massachusetts, the surveyed minority population, Haitian
Americans, were reported under the “black” racial category. The
term “Asian/Pacific Islander (A/PI)” included various Asian
populations, Native Hawaiians, and Other Pacific Islanders.
For example, the community in Waianae, Hawaii, focused on
Native Hawaiians and Other Pacific Islanders. A community
in New York City focused on Chinese, Koreans, and other
Asians. Special Services for Groups in California focused on
Cambodians, Filipinos, Laotians, Vietnamese, and Samoans.
Orange County Asian and Pacific Islanders Community
Alliance focused on Cambodians, Hmong, Thais, Vietnamese,
Laotians, Native Hawaiians, Samoans, Tongans, Marshallese,
and Guamanians/Chamorros, all of whom were grouped under
A/PIs. So that sample sizes could be increased, data from men
and women were combined in the analyses for the following
variables: taking antihypertensive medication among those
with reported hypertension, HbA1C tests and foot and eye
examinations among persons with diabetes, and vaccinations
among persons aged ≥65 years.
In the calculation of prevalence, persons who replied “don’t
know” or who refused to answer the questions were excluded
from the denominator. If a denominator was <30, the prevalence estimate was considered unstable and was not presented.
SUDAAN was used in the analysis to account for the complex
sampling design and to calculate the 95% confidence intervals
for both the REACH U.S. and BRFSS data. For the REACH
U.S. survey, each sample was weighted to reflect the probability
of selection, the number of eligible members, and the number
of selected members at the sampled address and was adjusted
by age-gender population sizes of members of the surveyed
minority population. For BRFSS, each sample was weighted to

Surveillance Summaries

reflect the adult population for each MMSA, county, or state.
Use of MMSA, county, or state BRFSS as the standard permits
a percentage estimated from a community to be described as
being higher than the standard if the percentage in the MMSA,
county, or state is lower than the lower limit of the confidence
interval of the percentage in the community (11). Conversely,
the percentage estimated for the community can be described
as being lower than the standard if the percentage in MMSA,
county, or state is higher than the upper limit of the confidence
interval. These comparisons were not used as an indicator of
statistical significance in a formal statistical test.

Results
Social Demography and Access to
Health Care
Education
Among men, the median percentage of adults who reported having less than a high school education ranged from 6.3% in A/PI
communities to 29.5% in Hispanic communities (Table 3). Among
women, the median percentage ranged from 9.3% in A/PI communities to 31.5% in Hispanic communities. Except for A/PI men,
these medians were higher than the national median among the 50
states and the DC in the 2009 BRFSS (8.5% in men and 7.5%
in women). With a few exceptions, a much higher percentage of
black and Hispanic men and women in the surveyed communities
reported having less than a high school education compared with
that in the general populations from the same MMSA, county, or
state in BRFSS. Among minority populations, Hispanics reported
the lowest education level, whereas A/PIs had the highest education
level. However, substantial community variations were identified
within certain racial/ethnic populations. For example, <2% of A/PI
men or women reported having less than a high school education
in the surveyed community in Los Angeles and Orange Counties,
California, compared with 21.3% of men and 27.1%, of women
from the surveyed community in New York City.

Household Income
The median percentage of men who reported having annual
household income of <$25,000 ranged from 27.2% in A/PI
communities to 45.4% in Hispanic communities (Table 4). The
median percentage among women ranged from 27.6% in A/PI
communities to 50.5% in black communities. All these medians
were higher than the national median percentage of household
income of <$25,000 among the 50 states and DC in 2009
(21.3% in men and 26.4% in women).The median percentages
of persons with incomes of <$25,000 in black and Hispanic
communities were about twice the national level. A substantially

higher percentage of men and women reported low income in all
Hispanic and AI communities and in the vast majority of black
communities compared with that in the comparison MMSA,
county, or state populations. Substantial community variations
were identified within the same racial/ethnic population. For
example, 12.1% and 19.2% of A/PI men and women, respectively,
had an income of <$25,000 in the surveyed community in Seattle
and King County compared with 41.6% and 46.9%, respectively,
in the community in New York City.

Health-Care Coverage
Respondents were asked if they had any kind of health-care
coverage, including health insurance, prepaid plans such as
HMOs, or government plans such as Medicare. The median
percentage of men who reported having no health-care coverage ranged from 14.8% in A/PI communities to 29.2% in
Hispanic communities (Table 5). The median percentage
among women ranged from 15.2% in A/PI communities to
26.7% in AI communities. Except for A/PI men, these medians
were higher than the national median among the 50 states and
DC in 2009 (16.5% in men and 12.4% in women). Higher
percentages of men and women without health-care coverage
were reported in the majority of black, Hispanic, and AI communities compared with those in the corresponding MMSA,
county, or state in which the community was located. Within
the same racial/ethnic population, a two- to fourfold difference
was identified in coverage rates across communities.

Cost as a Barrier to Obtaining Health Care
Respondents were asked whether at any time in the previous
12 months they had needed to see a doctor but could not do so
because of cost. The median percentage of men who could not
see a doctor because of cost ranged from 10.6% in A/PI communities to 21.8% in Hispanic communities (Table 6). The median
percentage among women ranged from 14.0% in A/PI communities to 25.6% in Hispanic communities. Except for A/PIs,
these medians were higher than the national median in 2009
(12.2% in men and 14.7% in women). A higher percentage of
adults who had not seen a doctor because of the cost was reported
consistently in Hispanic communities compared with the corresponding MMSA, county, or state in which the community
was located. A greater variation in the one-on-one comparison
between the individual community and BRFSS counterpart was
observed in black, A/PI, and AI communities.

Chronic Disease Risk Factors
Obesity
Obesity is defined as body mass index ≥30 kg/m2 calculated from
self-reported height and weight. The median percentage of obesity
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among men ranged from 10.3% in A/PI communities to 46.2% in
AI communities (Table 7). The median percentage among women
ranged from 6.7% in A/PI communities to 45.5% in AI communities. Except for A/PI communities, these median percentages were
higher than the national median among the 50 states and DC in
2009 (28.6% in men and 26.0% in women). The prevalence of
obesity was substantially higher among both men and women in AI
communities and among women in black communities compared
with that in the comparison MMSA, county, or state in which the
community was located. Overall, approximately 45% of AI men
and women and black women were obese in the surveyed communities, whereas slightly more than one fourth of adults were
obese at the national level. Obesity was uncommon in most A/PI
communities. However, obesity prevalence in Native Hawaiians/
Other Pacific Islanders (45.3% in men and 38.2% in women) was
much higher than in the general population in Honolulu (24.5%
in men and 19.9% in women). Two- to threefold differences in
obesity prevalence were reported across black communities.

Cigarette Smoking
Cigarette smokers were defined as those who had ever
smoked ≥100 cigarettes and who currently smoke. The median
percentage of cigarette smoking among men ranged from 13.8%
in A/PI communities to 36.1% in AI communities (Table 8).
The median percentage among women ranged from 3.7% in
A/PI communities to 36.0% in AI communities. The median
percentages among black and AI communities were higher
than the national median among the 50 states and DC in 2009
(19.6% in men and 16.8% in women). Substantial community
variations in prevalence of smoking within the same racial/
ethnic population were identified. The difference could be up
to fourfold across communities. For example, the prevalence
of smoking was <5% in women in the majority of A/PI
communities, compared with 21.3% in Waianae, Hawaii.

Leisure-Time Physical Activity
Respondents were asked if they had participated, other than as a
part of their regular job, in any physical activities or exercises (e.g.,
running, calisthenics, golf, gardening, or walking for exercise) during the past month. The median percentage of men who reported
having no leisure-time physical activity ranged from 23.6% in
A/PI communities to 28.5% in black communities (Table 9).
The median percentage among women ranged from 25.6% in
A/PI communities to 31.6% in black communities. Except for
women in A/PI communities, these median percentages were
higher than the national median among the 50 states and DC in
2009 (21.5% in men and 25.6% in women). Substantial variations were identified within the same racial/ethnic population in
one-on-one comparisons between individual communities and
the corresponding MMSA, county, or state.

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Met Physical Activity Recommendation
Respondents were asked to recall their overall frequency and
duration of time spent in moderate activities (e.g., brisk walking,
bicycling, vacuuming, or gardening) and vigorous activities (e.g.,
running, aerobics, or heavy yard work) in a typical week. Persons
were defined as meeting recommended physical activity levels if
they reported participating in either moderate physical activity
≥30 minutes/day, 5 days/week, or vigorous physical activity ≥20
minutes/day, 3 days/week (12). The median percentage of men
who met physical activity recommendations ranged from 39.8%
in A/PI communities to 47.9% in AI communities (Table 10).
The median percentage among women ranged from 34.6% in
black communities to 44.9% in AI communities. These median
percentages were all lower than the national median percentage
among the 50 states and DC in 2009 (52.4% in men and 47.8%
in women). With very few exceptions, a much lower percentage
of black women met physical activity recommendations in the
surveyed communities compared with that in the corresponding
MMSA, county, or state in which the community was located.
The results were less consistent in one-on-one comparisons
between individual communities and the corresponding BRFSS
counterparts for Hispanics, A/PIs, and AIs.

Fruit and Vegetable Intake
Fruit and vegetable intake was calculated from six questions
regarding the intake of fruit juices, fruit, green salad, potatoes,
carrots, and other vegetables. A national education program has
advocated eating at least five servings of fruits and vegetables
daily (13). The median percentage of men who reported eating
at least five fruits and vegetables daily ranged from 19.6% in
Hispanic communities to 23.8% in black and A/PI communities (Table 11). The median percentage among women ranged
from 23.5% in AI communities to 33.6% in A/PI communities.
Overall the differences between these medians and the national
median percentage (19.2% in men and 27.7% in women)
were small. The percentage of women who reported eating at
least five fruits and vegetables daily was much lower in most of
the Hispanic communities than in the corresponding MMSA,
county, or state. One-on-one comparisons between individual
communities and the corresponding BRFSS counterparts were
less consistent in other racial populations.

Health Status and Selected
Chronic Conditions
Perceived Health Status
Respondents were asked to rate their own general health
as either “excellent,” “very good,” “good,” “fair,” or “poor.”

Surveillance Summaries

The median percentages of men who reported fair or poor
health ranged from 15.8% in A/PI communities to 26.3% in
AI communities (Table 12). The median percentages among
women ranged from 20.1% in A/PI communities to 31.3%
in Hispanic communities. These medians were all higher
than the national median percentage among the 50 states and
DC in 2009 (13.4% in men and 15.3% in women). With
few exceptions, a substantially higher percentage of men and
women in Hispanic communities and women in black communities reported fair or poor health compared with that in
the comparison MMSA, county, or state populations. The
one-on-one comparisons between individual communities and
the corresponding BRFSS counterparts were less consistent for
A/PI and AI communities.

High Blood Pressure
The prevalence of high blood pressure was assessed by asking
respondents, “Have you ever been told by a doctor, nurse, or
other professional that you have high blood pressure?” Adults
who reported prehypertension or borderline high blood pressure,
and females who reported high blood pressure during pregnancy,
were not considered as having hypertension. The median prevalence of high blood pressure among men ranged from 22.8% in
Hispanic communities to 43.9% in AI communities (Table 13).
The median prevalence among women ranged from 24.0% in
A/PI communities to 46.2% in black communities. The medians
among black and AI communities were much higher than the
national median among the 50 states and DC in 2009 (29.8%
in men and 27.8% in women). With very limited exceptions,
the prevalence of high blood pressure was substantially higher in
black and AI communities than in the corresponding MMSA,
county, or state. The results of one-on-one comparisons between
individual communities and the corresponding BRFSS counterparts were less consistent for Hispanic and A/PI communities.
Substantial community variations in the prevalence of high blood
pressure were identified within the same racial/ethnic population. For example, the prevalence of high blood pressure was
12.9% and 15.0% in Hispanic men and women, respectively, in
the surveyed community in Seattle/King County, whereas it was
42.5% in Hispanic men in the surveyed community of Grant
and Hidalgo Counties, New Mexico, and 36.5% in Hispanic
women in the surveyed community of East Harlem, New York.
The prevalence of high blood pressure was 23.7% and 16.8%
in A/PI men and women, respectively in Seattle/King County,
whereas the prevalence was twice as high in A/PI men in the
surveyed community in Los Angeles and Orange Counties,
California (46.7%) and in A/PI women in the surveyed community of Waianae, Hawaii (38.1%).

Cardiovascular Diseases
The percentage of cardiovascular diseases was assessed by asking respondents if they had ever been told by a doctor that they
had any of the following conditions: heart attack or myocardial
infarction, angina or coronary heart disease, or stroke. The
median prevalence of cardiovascular diseases among men ranged
from 6.6% in A/PI communities to 13.4% in AI communities
(Table 14). The median prevalence among women ranged from
4.4% in A/PI communities to 12.3% in AI communities. The
medians were higher among AI communities, and lower among
Hispanic and A/PI communities than the national median
among the 50 states and DC in 2009 (8.8% in men and 6.3%
in women). A higher prevalence of cardiovascular diseases was
apparent among women in the majority of black and AI communities compared with that in the corresponding MMSA, county,
or state. One-on-one comparisons between the individual communities and the corresponding BRFSS counterparts were not
consistent for Hispanic and A/PI communities.

Diabetes
The prevalence of diagnosed diabetes was assessed by asking
respondents, “Have you ever been told by a doctor that you
have diabetes?” The median prevalence of diabetes (excluding
gestational, borderline, or prediabetes) among men ranged
from 10.0% in Hispanic communities to 18.0% in AI communities (Table 15). The median prevalence among women
ranged from 10.3% in A/PI communities to 18.4% in AI
communities. All these medians were higher than the national
median among the 50 states and DC in 2009 (8.8% in men
and 8.2% in women). With a few exceptions, the prevalence
of diabetes was substantially higher in both men and women
in black and AI communities than in the comparison MMSA,
county, or states. The prevalence was also much higher in
women in Hispanic communities compared with their BRFSS
counterparts. Substantial community variations (two- to fivefold difference) were identified in the prevalence of diabetes
within the same racial/ethnic population.

Knowledge of Heart Attack Symptoms
A respondent was considered as having knowledge of heart
attack signs and symptoms and the action to take if he or she
correctly answered “yes” to all five questions on symptoms of
heart attack, “no” to the incorrect symptom, and “call 911”
when the responder thought someone was having a heart attack
(14). The five symptoms of heart attack were 1) pain or discomfort in the jaw, neck, or back; 2) feeling weak, lightheaded,
or faint; 3) chest pain or discomfort; 4) pain or discomfort in

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Surveillance Summaries

the arms or shoulder; and 5) shortness of breath. An incorrect
symptom was sudden trouble seeing in one or both eyes. The
median percentage of men who knew heart attack symptoms
and action ranged from 3.2% in Hispanic communities to
8.7% in AI communities (Table 16). The median percentage
among women ranged from 4.7% in Hispanic communities
to 13.5% in AI communities. These median percentages were
all lower than the median percentage of 33 states¶ and DC in
the 2009 BRFSS (10.4% in men and 14.7% in women). The
percentage of adults who knew heart attack symptoms and
action was substantially lower in almost all black, Hispanic, and
A/PI communities than it was in the comparison states or the
median percentage of the 33 states and DC when state-specific
data were not available. Within the same racial/ethnic populations, community variations in the percentage of persons who
had knowledge of heart attack symptoms were substantial.

Knowledge of Stroke Symptoms
A respondent was considered as having knowledge of
stroke signs and symptoms and the action to take if he or she
correctly answered “yes” to all five questions on symptoms of
stroke, “no” to the incorrect symptom, and “call 911” when
the respondent thought that someone was having a stroke. The
five symptoms of stroke were 1) sudden confusion or trouble
speaking; 2) sudden numbness or weakness of the face, arm,
or leg, especially on one side; 3) sudden trouble seeing in one
or both eyes; 4) sudden trouble walking, dizziness, or loss of
balance; and 5) severe headache without known cause. An
incorrect symptom was sudden chest pain or discomfort.
The median percentage of men who knew stroke signs
and symptoms and what action to take ranged from 7.9% in
A/PI communities to 14.5% in AI communities (Table 17).
The median percentage among women ranged from 7.0% in
Hispanic communities to 15.4% in AI communities. These
median percentages were all much lower than the median
percentage among 33 states and DC in the 2009 BRFSS (19.4%
in men and 21.0% in women). With very few exceptions, the
percentage of adults who knew stroke symptoms and action was
substantially lower in black, Hispanic, and A/PI communities
than that in the corresponding states or the median of the 33
states and DC when state-specific data were not available.
Within the same racial/ethnic population, substantial
community variations were identified in the percentage of
persons who had the knowledge of stroke symptoms.
¶ Alabama, Arizona, Connecticut, Florida, Georgia, Hawaii, Idaho, Indiana, Iowa,

Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota,
Mississippi, Missouri, Montana, Nebraska, New York, North Carolina, Ohio,
Oklahoma, Rhode Island, South Carolina, Tennessee, Texas, Utah, Virginia,
Washington, West Virginia, and Wisconsin

8

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Clinical Care and Preventive Services
Blood Cholesterol Checked
The median percentage of men who reported having their
blood cholesterol checked during the preceding 5 years ranged
from 60.5% in Hispanic communities to 73.6% in black communities (Table 18). The median percentage among women
ranged from 67.4% in Hispanic communities to 80.5% in
black communities. The median percentage was much lower
than the national median percentage in both men (74.4%) and
women (79.2%) among the 50 states and DC. A substantially
lower percentage of men and women reported having cholesterol checked in the preceding 5 years in almost all Hispanic
communities compared with that of the population in the
comparison MMSA, county, or state in which the community
was located. One-on-one comparisons between the community
and corresponding MMSA, county, or state were less consistent
in other minority populations.

Antihypertensive Medication Usage
The median percentage of adults with hypertension who
reported taking antihypertensive medication ranged from
68.7% in Hispanic communities to 81.0% in black communities (Table 19). The median percentage among Hispanic
communities was lower than the national median percentage
(79.2%) among the 50 states and DC in 2009. The difference
between the median percentage and the national median was
small for the other three minority populations.

Preventive Care in Persons with Diabetes
Respondents who reported having diabetes were asked whether
in the preceding 12 months, they had 1) an HbA1C test, 2) their
feet checked for any sores or irritations by a health professional,
and 3) a dilated eye exam. The median percentages of respondents with diabetes who had none of these three exams were all
<3% in the four minority populations. The median percentage
of persons with all three exams ranged from 46.2% in Hispanic
communities to 59.6% in A/PI communities.
HbA1C. The median percentage of adults with diabetes who
reported having had an HbA1C test within the previous year
ranged from 64.1% in Hispanic communities to 79.5% in AI
communities (Table 20). The median percentage among black,
Hispanic, and A/PI communities was lower than the national
median percentage (79.7%) among 45 states (all states except
Arkansas, Idaho, Mississippi, Oklahoma, and South Dakota)
and DC in 2009. Substantially lower percentages of adults
having an HbA1C test within a year were reported in almost
all Hispanic communities compared with those in the comparison state populations. One-on-one comparisons between

Surveillance Summaries

individual communities and the corresponding states were less
consistent in other minority populations.
Foot exam. The median percentage of adults with diabetes who
reported having had their feet checked by a health professional
within the previous year ranged from 68.7% in Hispanic communities to 82.0% in black communities (Table 21). The median
percentage among Hispanic communities was lower, but higher
among black and AI communities, than the national median
percentage (73.4%) among 45 states and DC in 2009. Much
higher percentages of adults who had their feet checked within
the previous year were reported in the majority of black and AI
communities compared with those in the corresponding states.
Dilated eye exam. The median percentage of adults with diabetes who reported having had a dilated eye exam within the previous
year ranged from 71.3% in Hispanic communities to 78.3% in
A/PI communities (Table 22). These median percentages were
somewhat higher than the national median percentage (69.2%)
among 45 states and DC in 2009. However, no substantive difference in the eye exam rate was identified in the majority of the
one-on-one comparisons between the individual community and
the corresponding state in which the community was located.

Women’s Cancer Screening
Mammography
The median percentage of women aged ≥40 years who reported
having had a mammogram during the previous 2 years ranged
from 72.7% in AI communities to 80.7% in black communities
(Table 23). These medians were lower than the national median
percentage (83.2%) among the 50 states and DC in 2008
BRFSS. A lower mammography screening rate was reported in
AI communities than in the corresponding state in which the
community was located. The results of one-on-one comparisons
between individual communities and their BRFSS counterparts
were less consistent for the other minority populations.

Pap Smear Test
The median percentage of women with an intact uterine cervix
who reported having had a Pap smear screening during the previous 3 years ranged from 74.4% in A/PI communities to 85.0% in
black communities (Table 24). The median percentage among A/PI
communities, but not among the other three minority populations,
was lower than the national median percentage (82.9%) in 2008.
A lower percentage of women received Pap smear screening in
the majority of the A/PI communities compared with that in the
corresponding state. The differences were mostly small in the oneon-one comparisons between individual communities and their
BRFSS counterparts for the three other minority populations.

Immunization
Influenza Vaccination
The median percentage of adults aged ≥65 years who
reported that they had an influenza vaccination in the previous year ranged from 57.3% in black communities to 79.5%
in A/PI communities (Table 25). The median percentage
was lower than the national median (70.1%) in 2009 among
black and Hispanic communities, while higher among A/PI
communities. With very few exceptions, black communities
had a much lower rate of influenza vaccination than that in
the corresponding MMSA, county, or state population. The
differences were not significant in most of the one-on-one
comparisons between the individual community and BRFSS
counterpart for the three other minority populations.

Pneumococcal Vaccination
The median percentage of adults aged ≥65 years who
reported that they had ever had a pneumococcal vaccination
ranged from 58.5% in Hispanic communities to 78.7% in AI
communities (Table 26). Except among AI communities, the
median percentages among the other three minority communities were lower than the national median (68.5%) among the
50 states and DC in 2009. However, the vaccination rates in the
majority of the communities and those in the corresponding
MMSA, county, or state were not substantially different.

Discussion
Several population-based surveys have been conducted in
the individual states and the nation, including the National
Health Interview Survey, the National Health and Nutrition
Examination Survey, and BRFSS. These surveys were designed
to collect data in national or statewide probability samples to
obtain national or state-level estimates. They were not designed
specifically to monitor the health status of persons at the community level or to focus on minority communities. As a result,
surveillance data for racial/ethnic minorities often is lacking.
The previous REACH 2010 Risk Factor Survey (8) and the
current REACH U.S. Risk Factor Survey provide valuable
information at the community level on socioeconomic demographics, risk factors, chronic conditions, and the use of preventive services in the four minority populations surveyed.
Data from the REACH U.S. Risk Factor Survey indicate that
for the majority of health and socioeconomic indicators, black,
Hispanic, and AI communities do not fare as well as the general
populations in their respective MMSA, county, or state, or in the
United States as a whole. Socioeconomic status as measured by

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Surveillance Summaries

education level and household income was substantially lower
among these communities. Minorities in these communities had
less health insurance coverage, higher cost barriers to access health
care, and worse self-rated general health. Variations were identified
in the prevalence of risk factors and chronic condition burden
among the four minority populations. Obesity, smoking, high
blood pressure, cardiovascular diseases, and diabetes were the major
health risk and chronic conditions in black and AI communities.
Lack of physical activity was prominent in black communities,
especially among women. Lack of knowledge of heart attack and
stroke symptoms was prominent in black, Hispanic, and A/PI
communities. The cholesterol screening rate and the percentage of
persons who reported having high blood pressure and were taking
antihypertensive medication was lowest in Hispanic communities.
Underuse of selected preventive services was apparent, including
underuse of mammography screening in AI communities, of Pap
smear testing in A/PI communities, and of influenza vaccination
in black and Hispanic communities.
The substantial variations identified among the four racial/
ethnic minority populations in different risk factors and health
conditions indicate that different priorities are needed to eliminate health disparities. In the REACH 2010 and REACH U.S.
project, community-based coalitions were formed to address
community-specific health issues. These coalitions were driven
primarily by residents of the community at every stage of the
program, including setting health priorities, planning, implementation and evaluation. A unique feature of REACH was that
the project did not use a standardized intervention protocol but
was sufficiently flexible to allow community choices on the basis
of priorities, available resources, and local realities (6).
These survey data show an aggregation of socioeconomic
demographic factors (e.g., education and income), risk factors
(e.g., obesity, smoking, and physical inactivity) and chronic
diseases (e.g., high blood pressure, cardiovascular diseases, and
diabetes). This indicates that multifaceted and multisectoral
strategies are needed to make effective changes. REACH U.S.
grantees have identified numerous societal, policy, environmental, cultural, and individual-level factors that must be changed
to eliminate racial and ethnic disparities. Thus, each grantee
develops appropriate programs that address the complex root
causes of racial and ethnic health disparities.
The data demonstrate a substantial heterogeneity across
communities within the same broad racial/ethnic population. For example, obesity prevalence among black men was
13.0% in a community in Los Angeles and Orange Counties,
California, whereas it was 41.6% in a community in southern West Virginia. The smoking prevalence among Hispanic
men was 10.3% in a community in Santa Clara Valley,
California, whereas it was 34.4% in a community in Southeast
Chicago. Although smoking was rare among women in Asian
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communities, it was prevalent among Native Hawaii/Pacific
Islander women in Waianae, Hawaii. Differences in percentages
of persons receiving preventive services were also substantial
across communities. The rate of mammography screening
during the previous 2 years among women aged ≥40 years was
only 66.3% in the Hispanic population surveyed in Seattle and
King County, Washington compared with 93.5% among the
Hispanic population surveyed in Lawrence, Massachusetts.
Similarly, the rate of pneumococcal vaccination among blacks
aged ≥65 years was 42.7% in Humboldt Park and West Town,
Chicago, whereas the rate was 73.5% in the black population
surveyed in southern West Virginia. These wide variations in
prevalence of health-related behaviors, chronic conditions, and
use of preventive services across communities likely are related
to demographic, cultural, local laws, policies, and environmental influences among residents of these communities and
the majority of these influences are more or less modifiable,
depending on local circumstances. The salient variations and
intrapopulation differences also indicate that opportunities
and the possibility for change exist.
The baseline data of the previous REACH 2010 Risk Factor
Survey were collected in 21 communities in 2001 (7). Among
them, 11 communities also participated in the current REACH
U.S. Risk Factor Survey with complete geographic match in
seven and partial matches in four communities. Although a
list-assisted random-digit–dialing design instead of addressbased sampling, was used in the previous REACH 2010 survey,
the survey questionnaires were very similar. Since the previous
survey was conducted 8 years ago (8), many improvements have
occurred in the health and health care indicators in the four
minority populations. For example, among men, the median
prevalence of smoking was 28.8% in Hispanic communities 8
years ago, whereas it was 17.6% in the current survey. Likewise,
the median prevalence of smoking decreased from 30.5% to
13.8% in Asian men, consistent with the 5-year smoking trend
in REACH 2010 Asian communities reported previously (15).
These improvements are greater than the national decreasing trend in smoking (25.5% in 2001 and 19.6% in 2009).
Although an increase occurred in the percentage of adults who
met physical activity recommendations in the nation for men
(from 49.6% to 52.4%) and women (from 42.9% to 47.8%),
the increase was larger among REACH communities during
the same time period. Among men, the median percentage
increased from 36.2% to 43.8% in blacks, from 35.1% to
45.8% in Hispanics, from 24.1% to 39.8% in A/PIs, and from
42.9% to 47.9% in AIs. Among women, the corresponding
median percentage increased from 25.6% to 34.6% in blacks,
33.7% to 44.7% in Hispanics, 17.3% to 40.5% in A/PIs, and
35.9% to 44.9% in AIs, respectively. Similar trends also were
observed in fruit and vegetable intake (data not reported).

Surveillance Summaries

Improvements in the measures of health care and preventive
services were also evident in these communities. For example,
fewer than half of Hispanics who reported having hypertension
were taking medication for high blood pressure in the 2001
REACH 2010 survey; although still lower than the national
level, this percentage increased to more than two thirds in the
2009 REACH U.S. survey. The vaccination rate for pneumonia
increased from 50.5% to 60.5% in black communities, from
46.0% to 58.5% in Hispanic communities, from 37.5% to
59.7% in A/PI communities, and from 67.3% to 78.7% in
AI communities. Racial and ethnic health disparities have long
been recognized and actions have been called for to close the
gap (16,17). Many improvements in health indicators have
occurred during the past decade in minority communities (6).
However, vital statistics data indicate that black-white mortality
disparities widened during 1990–2005 in certain diseases (e.g.,
heart disease, breast cancer, and diabetes) at the national level,
especially in such urban areas as Chicago (18).

Limitations
The findings in this report are subject to at least eight limitations. First, because minority populations are not homogeneous,
substantial ethnic, cultural, and social diversity exists within
any racial/ethnic minority population. For example, Haitian
Americans were grouped under blacks. Hispanics comprised
multiple diverse subpopulations (e.g., Mexicans, Puerto Ricans,
Cubans, and Dominicans). A/PIs consisted of Native Hawaiian/
Pacific Islanders, and various Asian populations (e.g., Chinese,
Koreans, Vietnamese, Cambodians, and Filipinos). Second,
because AIs were sampled in only four different communities,
the data reported might not represent AIs from other communities in the United States. Third, although the survey sampled
an average of 900 adult residents in each community, sample
sizes in certain communities (e.g., Eastern Band of Cherokee
Indians, North Carolina, and Intertribal Council of Michigan)
were relatively small. Fourth, certain communities included
multiple racial/ethnic populations, reducing the sample size for
each minority population. Sample size was reduced further when
prevalence estimates were limited to women, specific ages (e.g.,
age ≥65 years), or those with certain chronic conditions (e.g.,
diabetes). As a result of limited sample size, estimated confidence intervals were wide for certain health indicators in certain
communities. Fifth, the response rates of the telephone and
questionnaire mailing components of this survey were somewhat
low. The survey aimed to collect representative samples from
each racial/ethnic minority population surveyed. Respondents
were weighted according to age and gender distribution of the

minority population in the community and accounted for varying inclusion probabilities among them. Approximately 42% of
the mail questionnaire respondents reported having only cellular
phones or no phone service. When compared with national data
for each racial/ethnic population, participants in the REACH
Risk Factor Survey tended to have lower income and educational
attainment. This most likely reflects the lower socioeconomic
status of the REACH communities along with the higher cellular phone coverage that was obtained in the REACH survey
compared with the BRFSS. Sixth, because estimates were based
on “having been told” and self-reported data and subject to
recall errors/bias or social desirability effects, the prevalence of
certain chronic conditions and use of preventive services might
be under- or overestimated. Seventh, the questions used in this
study related to physical activity were appropriate to evaluate
the percentage of persons who met an earlier physical activity
recommendation (12) but not the most current 2008 guideline
(19). Finally, the prevalence estimates for small area (i.e., MMSA
and county) might not be the same as those reported here if other
statistical methods (e.g., Bayesian methodology) are used.
Despite these limitations, the REACH U.S. survey has multiple strengths. Unlike previous national or state-based surveys,
it is the largest community-based survey that focuses on multiple
minority populations in the United States. The use of an addressbased sampling design, which included multiple data collection
modes (telephone, mailing, and in-person interviews), enabled
the survey to reach those without telephones or with only cellular
phones. The survey was conducted from a single center using
a uniform methodology across all communities. The questions
used in the survey were identical to those used in BRFSS, thus
allowing data from the two surveys to be compared.

Conclusion
Despite measurable improvements in the overall health of
the nation including minority populations, the REACH U.S.
Risk Factor Survey demonstrates that health disparities remain
widespread among members of racial and ethnic minority
populations. The data from this survey provide important
information for assessing, prioritizing, and planning intervention efforts in each community. These results underscore the
need for community-based approaches that include policy,
systems, environmental, and individual-level changes. They
also underscore the need to tailor prevention strategies to the
needs of specific communities to eliminate health disparities.
Continuing data collection is necessary for evaluating the
effectiveness of the interventions and for enhancing existing
programs and disseminating the lessons learned.

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Surveillance Summaries

References
1. CDC. CDC Health disparities and inequalities report—United States,
2011. MMWR 2011;60(Suppl).
2. CDC. Health, United States, 2006: With chartbook on trends in the
health of Americans. 2006. Hyattsville, MD: US Department of Health
and Human Services, CDC, National Center for Health Statistics; 2006.
Available at http://www.cdc.gov/nchs/data/hus/hus06.pdf. Accessed
March 30, 2011.
3. US Census Bureau, US interim projections by age, sex, race and Hispanic
origin: 2000–2050. Available at http://www.census.gov/population/
www/projections/usinterimproj. Accessed March 30, 2011.
4. US Department of Health and Human Services. Healthy people 2010.
Washington, DC: US Department of Health and Human Services; 2000.
5. Giles WH, Tucker P, Brown L, et al. Racial and ethnic approaches to
community health (REACH 2010): an overview. Ethn Dis
2004:14(Suppl):S5–8
6. CDC. REACHing across the divide: finding solutions to health disparities.
Atlanta, GA: US Department of Health and Human Services, CDC; 2007.
Available at http://www.cdc.gov/reach/pdf/health_disparities_101607.pdf.
Accessed March 30, 2011.
7. CDC. At glance: racial and ethnic approaches to community health
(REACH U.S.). Atlanta, GA: US Department of Health and Human
Services, CDC; 2008. Available at http://www.cdc.gov/reach. Accessed
March 30, 2011.
8. Liao Y, Tucker P, Okoro CA, et al. REACH 2010 surveillance of health
status in minority communities—United States, 2001–2002. MMWR
2004;53(No. SS-6).
9. Blumberg SJ, Luke JV. Wireless substitution: early release of estimates
from the National Health Interview Survey, July–December 2009.
Available at http://www.cdc.gov/nchs/data/nhis/earlyrelease/wireless201005.pdf Accessed March 30, 2011.

12

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

10. CDC. Public health surveillance for behavioral risk factors in a changing
environment. MMWR 2003;52(No. RR-9)
11. Rosner B. Fundamentals of biostatistics. 5th ed. Pacific Grove, California:
Duxbury Thomson Learning; 2000.
12. Pate RR, Pratt M, Blair SN, et al. Physical activity and public health: a
recommendation from the Centers for Disease Control and Prevention
and the American College of Sports Medicine. JAMA 1995;273:402–7.
13. CDC. About the National Fruit and Vegetable Program. Atlanta, GA:
US Department of Health and Human Services, CDC; 2011. Available
at http://www.fruitsandveggiesmatter.gov/health_professionals/about.
html. Accessed March 30, 2011.
14. Greenlund KJ, Keenan NL, Giles WH, et al. Public recognition of major
signs and symptoms of heart attack: seventeen states and the US Virgin
Islands, 2001. Am Heart J 2004;147:1010–6.
15. Liao Y, Tsoh JY, Chen R, et al. Decreases in smoking prevalence in Asian
communities served by the Racial and Ethnic Approaches to Community
Health (REACH) Project. Am J Public Health 2010;100:853–60.
16. US Department of Health and Human Service. Report of the Secretary’s
Task Force on Black and Minority Health. Bethesda, MD: US
Department of Health and Human Services; 1985. Available at http://
minorityhealth.hhs.gov/assets/pdf/checked/1/ANDERSON.pdf.
Accessed March 30, 2011.
17. US Public Law 106-525. Minority Health and Health Disparities
Research and Education Act of 2000. 106th Congress 2nd session,
November 22, 2000.
18. Orsi JM, Margellos-Anast H, Whitman S. Black-white health disparities
in the United States and Chicago: a 15-year progress analysis. Am J
Public health 2010;100:349–56.
19. US Department of Health and Human Services. 2008 physical activity
guidelines for Americans. Washington, DC: US Department of Health
and Human Services; 2008. Available at http://www.health.gov/paguidelines. Accessed March 30, 2011.

Surveillance Summaries

TABLE 1. Geographic descriptions of the 28 Racial and Ethnic Approaches to Community Health (REACH) U.S. communities, 2009, and the
comparison populations from the Behavioral Risk Factor Surveillance System (BRFSS), 2007–2009 — United States
Community

Community geography

BRFSS comparison area

Richmond, Virginia

12 census tracts in Richmond, Virginia

Richmond MMSA, Virginia

West Philadelphia, Pennsylvania

Within the boundaries of four specific streets in
West Philadelphia, Pennsylvania

Philadelphia County, Pennsylvania

Kanawha and McDowell Counties, West Virginia

15 zip codes in southern West Virginia

West Virginia

Boston, Massachusetts

Greater Boston area

Boston–Quincy and Cambridge–Newton–
Framingham MMSAs, Massachusetts

Charleston and Georgetown Counties, South
Carolina

Charleston and Georgetown Counties, South
Carolina

South Carolina

Fulton County, Georgia

23 census tracts in Fulton County, Atlanta, Georgia

Atlanta–Sandy Springs–Marietta MMSA, Georgia

YMCA of the Greater Cleveland, Ohio

11 census tracts in Cleveland, Ohio

Cleveland–Elyria–Mentor MMSA, Ohio

Community Health Council of Los Angeles,
California

16 zip codes in south Los Angeles and 2 zip codes
in Inglewood, California

Los Angeles–Long Beach–Glendale MMSA, California

City Neighborhoods of Chicago, Illinois

5 neighborhoods around the City of Chicago,
Illinois

Cook County, Illinois

Southeast Chicago, Illinois

4 neighborhoods in the Southeast Chicago, Illinois

Cook County, Illinois

South Los Angeles, California

20 zip codes in South Los Angeles, California

Los Angeles–Long Beach–Glendale MMSA, California

East Harlem, New York

25 census tracts in East Harlem, New York

New York–White Plains–Wayne MMSA, New York–New
Jersey

Southwest Bronx, New York

4 zip codes in southwest Bronx, New York

New York–White Plains–Wayne MMSA, , New
York–New Jersey

Humboldt Park and West Town, Chicago, Illinois

2 neighborhoods in Northwest Chicago, Illinois

Cook County, Illinois

YMCA of the Santa Clara Valley, California

8 census tracts in Gilroy, California

San Jose–Sunnyvale–Santa Clara MMSA, California

Pima County, Arizona

Pima County, Arizona

Pima County, Arizona

Grant and Hidalgo Counties, New Mexico

Grant and Hidalgo Counties, New Mexico

New Mexico

Lawrence, Massachusetts

Lawrence, Massachusetts

Essex County, Massachusetts

Seattle and King County, Washington

Seattle and King County, Washington

King County, Washington

Los Angeles and Orange Counties, California

79 zip codes in Los Angeles and Orange Counties,
California

Santa Ana–Anaheim–Irvine and Los Angeles–Long
Beach–Glendale MMSAs, California

Special Service for Group, California

32 zip codes within Los Angeles and Orange
Counties, California

Santa Ana–Anaheim–Irvine and Los Angeles–Long
Beach–Glendale MMSAs, California

Waianae, Hawaii

Waianae (zip code 96792), Hawaii

Honolulu County, Hawaii

New York City, New York

23 census tracts in New York City, New York

New York–White Plains–Wayne MMSA, New York–New
Jersey

Orange County A/PI Community Alliance, California

Entire Los Angeles and Orange Counties, California

Santa Ana–Anaheim–Irvine and Los Angeles–Long
Beach–Glendale MMSAs, California

Eastern Band of Cherokee Indians, North Carolina

2 zip codes in Jackson and Swain counties

North Carolina

Choctaw Nation of Oklahoma

11 counties in the southeast corners of Oklahoma

Oklahoma

Intertribal Council of Michigan

Tribal lands in 3 counties, Michigan

Michigan

Oklahoma

State of Oklahoma

Oklahoma

Abbreviations: MMSA = metropolitan and micropolitan statistical area and A/PI = Asian/Pacific Islander.

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

13

Surveillance Summaries

TABLE 2. Number of respondents in the 28 Racial and Ethnic Approaches to Community Health (REACH) U.S. communities, 2009, and the comparison
population samples from the Behavioral Risk Factor Surveillance System (BRFSS), 2007–2009, by sex and race/ethnicity — United States
REACH U.S. population samples

BRFSS

No. of respondents
Community

Sex

Richmond, Virginia

West Philadelphia, Pennsylvania

Kanawha and McDowell Counties, West
Virginia
Boston, Massachusetts

Charleston and Georgetown Counties,
South Carolina
Fulton County, Georgia

YMCA of the Greater Cleveland, Ohio

Community Health Council of Los Angeles,
California
City Neighborhoods of Chicago, Illinois

Southeast Chicago, Illinois

South Los Angeles, California

East Harlem, New York

Southwest Bronx, New York

Humboldt Park and West Town, Chicago,
Illinois
YMCA of the Santa Clara Valley, California

Pima County, Arizona

Grant and Hidalgo Counties, New Mexico

Lawrence, Massachusetts

Seattle and King County, Washington

Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female

Black
915
271
644
907
267
640
898
327
571
585
214
371
908
270
638
911
280
631
884
267
617
1,144
352
792
741
199
542
656
189
467
511
163
348
420
115
305
527
176
351
296
96
200
—
—
—
—
—
—
—
—
—
—
—
—
139
48
91

See table footnotes on page 15.
14

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

Hispanic
—†

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
523
201
322
289
97
192
229
92
137
495
154
341
424
139
285
273
96
177
945
362
583
1,073
413
660
907
333
574
914
332
582
187
96
91

MMSA/County/State*
A/PI
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
624
310
314

AI
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—

Name
Richmond MMSA

Philadelphia County

West Virginia

Boston–Quincy and Cambridge–
Newton–Framingham MMSAs
South Carolina

Atlanta–Sandy Springs–Marietta MMSA

Cleveland–Elyria–Mentor MMSA

Los Angeles–Long Beach–Glendale
MMSA
Cook County

Cook County

Los Angeles–Long Beach–Glendale
MMSA
New York–White Plains–Wayne MMSA

New York–White Plains–Wayne MMSA

Cook County

San Jose–Sunnyvale–Santa Clara MMSA

Pima County

New Mexico

Essex County

King County

No.
2,497
933
1,564
4,210
1,323
2,887
8,985
3,428
5,557
23,001
8,448
14,553
20,062
7,445
12,617
7,709
2,689
5,020
3,679
1,342
2,337
7,041
2,794
4,247
5,245
1,911
3,334
5,245
1,911
3,334
7,041
2,794
4,247
12,629
4,697
7,932
12,629
4,697
7,932
5,245
1,911
3,334
1,492
657
835
2,255
857
1,398
15,064
5,837
9,227
8,079
2,875
5,204
11,184
4,459
6,725

Surveillance Summaries

TABLE 2. (Continued) Number of respondents in the 28 Racial and Ethnic Approaches to Community Health (REACH) U.S. communities, 2009, and the
comparison population samples from the Behavioral Risk Factor Surveillance System (BRFSS), 2007–2009, by sex and race/ethnicity — United States
REACH U.S. population samples

BRFSS

No. of respondents
Community
Los Angeles and Orange Counties,
California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County AP/I Community Alliance,
California
Eastern Band of Cherokee Indians, North
Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma

Sex
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female

Black
99
35
64
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—

MMSA/County/State*

Hispanic

A/PI

AI

Name

768
282
486
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—

99
36
63
835
414
421
901
340
561
900
407
493
731
326
405
—
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
228
93
135
1,052
395
657
349
146
203
830
331
499

Santa Ana–Anaheim–Irvine and Los
Angeles–Long Beach–Glendale MMSAs
Santa Ana–Anaheim–Irvine and Los
Angeles–Long Beach–Glendale MMSAs
Honolulu County
New York–White Plains–Wayne MMSA
Santa Ana–Anaheim–Irvine and Los
Angeles–Long Beach–Glendale MMSAs
North Carolina
Oklahoma
Michigan
Oklahoma

Number
7,041
2,794
4,247
7,041
2,794
4,247
8,931
3,656
5,275
12,629
4,697
7,932
7,041
2,794
4,247
29,112
10,977
18,135
15,658
5,604
10,054
18,708
6,956
11,752
15,658
5,604
10,054

Abbreviations: AI = American Indian, A/PI= Asian/Pacific Islander, and MMSA = metropolitan and micropolitan statistical area.
* Data for MMSAs and counties are from survey years 2007–2009; data for states are from survey years 2008–2009.
† Not applicable.

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

15

Surveillance Summaries

TABLE 3. Percentage of adults who reported having less than a high school education, in 28 Racial and Ethnic Approaches to Community Health
(REACH) U.S. communities, 2009, and in the comparison populations from the Behavioral Risk Factor Surveillance System (BRFSS), 2007–2009,
by race/ethnicity and sex — United States
REACH U.S. racial/ethnic populations
Black
%

(95% CI)

Men
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

Community

25.3
19.8
7.8
24.3
18.4
15.5
17.8
8.5
16.3
10.7
9.5
23.0
19.4
18.2
—
—
—
—
8.3
3.6
—
—
—
—
—
—
—
—
17.1
3.6
25.3

(20.5–30.8)
(15.3–25.2)
(5.0–12.1)
(18.3–31.4)
(13.7–24.3)
(11.6–20.4)
(13.2–23.5)
(5.5–13.0)
(10.9–23.6)
(6.7–16.7)
(5.0–17.3)
(15.7–32.4)
(13.4–27.2)
(11.9–26.9)
—
—
—
—
(2.9–21.4)
(0.9–14.2)
—
—
—
—
—
—
—
—
—
—
—

Women
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

27.2
15.3
7.8
25.8
16.6
15.4
18.2
6.0
13.5
5.1
7.1
19.1
17.0
16.3
—
—
—
—
7.8
4.9
—
—
—
—
—
—
—
—
15.4
4.9
27.2

(23.9–30.9)
(12.8–18.3)
(5.8–10.4)
(21.3–31.0)
(14.0–19.7)
(12.9–18.4)
(15.3–21.5)
(4.6– 7.9)
(10.7–16.9)
(3.4– 7.6)
(4.5–11.0)
(14.6–24.5)
(13.1–21.7)
(11.4–22.7)
—
—
—
—
(3.8–15.5)
(1.6–14.2)
—
—
—
—
—
—
—
—
—
—
—

Hispanic
%

BRFSS

A/PI

AI

(95% CI)

%

(95% CI)

%

(95% CI)

—*
—
—
—
—
—
—
—
23.8
22.7
40.4
35.4
34.2
18.7
30.3
17.1
15.1
41.2
28.6
30.8
—
—
—
—
—
—
—
—
29.5
15.1
41.2

—
—
—
—
—
—
—
—
(17.9–30.8)
(14.7–33.5)
(29.1–52.9)
(27.5–44.3)
(25.6–44.1)
(11.5–28.9)
(25.4–35.6)
(13.5–21.6)
(11.3–19.8)
(35.4–47.3)
(19.8–39.4)
(25.4–36.8)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
6.0
1.7
5.6
8.9
21.3
6.6
—
—
—
—
6.3
1.7
21.3

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(3.8– 9.4)
(0.2–11.0)
(3.5– 8.9)
(6.2–12.5)
(17.4–25.8)
(4.3–10.0)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
18.0
15.7
20.8
20.1
19.1
15.7
20.8

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(11.6–26.8)
(12.1–20.2)
(14.5–28.9)
(14.9–26.4)
—
—
—

7.0
12.8
14.3
6.0
12.0
6.9
8.5
23.1
10.3
10.3
23.1
12.3
12.3
10.3
11.8
6.7
12.8
9.3
5.4
23.1
23.1
4.4
12.3
23.1
16.0
13.1
6.5
13.1
8.5†
4.5†
20.7†

(5.0– 9.9)
(9.2–17.3)
(13.0–15.8)
(5.2– 7.0)
(10.8–13.3)
(5.4– 8.8)
(6.4–11.2)
(20.8–25.6)
(8.5–12.4)
(8.5–12.4)
(20.8–25.6)
(10.8–14.0)
(10.8–14.0)
(8.5–12.4)
(8.3–16.3)
(4.7– 9.5)
(11.4–14.3)
(7.4–11.6)
(4.4– 6.6)
(20.8–25.6)
(20.8–25.6)
(3.6– 5.3)
(10.8–14.0)
(20.8–25.6)
(14.7–17.4)
(11.8–14.5)
(5.8– 7.4)
(11.8–14.5)
—
—
—

—
—
—
—
—
—
—
—
30.4
19.2
43.2
38.1
32.5
24.6
33.8
20.3
21.3
39.4
28.0
42.7
—
—
—
—
—
—
—
—
31.5
19.2
43.2

—
—
—
—
—
—
—
—
(25.3–36.0)
(14.3–25.3)
(32.9–54.0)
(33.0–43.5)
(26.4–39.4)
(18.6–31.6)
(29.8–38.0)
(17.2–23.8)
(17.8–25.2)
(35.1–43.8)
(19.2–38.9)
(38.2–47.3)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
9.8
1.4
8.8
6.9
27.1
10.2
—
—
—
—
9.3
1.4
27.1

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(7.0–13.7)
(0.2– 9.2)
(6.3–12.2)
(5.0– 9.4)
(23.2–31.3)
(7.4–13.9)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
15.8
10.3
10.7
13.2
12.0
10.3
15.8

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(10.7–22.7)
(8.2–13.0)
(7.3–15.5)
(10.1–17.1)
—
—
—

4.9
10.5
13.5
5.4
11.6
7.1
4.3
22.9
7.9
7.9
22.9
11.8
11.8
7.9
14.8
6.8
12.2
7.6
4.9
22.9
22.9
4.9
11.8
22.9
12.5
12.2
6.2
12.2
7.5†
3.6†
19.6†

(3.8– 6.3)
(8.6–12.6)
(12.5–14.7)
(4.8– 6.0)
(10.7–12.5)
(6.1– 8.3)
(3.4– 5.4)
(21.1–24.9)
(6.7– 9.2)
(6.7– 9.2)
(21.1–24.9)
(10.7–13.1)
(10.7–13.1)
(6.7– 9.2)
(11.3–19.2)
(5.2– 8.9)
(11.2–13.2)
(6.4– 9.1)
(4.1– 5.9)
(21.1–24.9)
(21.1–24.9)
(4.3– 5.7)
(10.7–13.1)
(21.1–24.9)
(11.7–13.3)
(11.4–13.0)
(5.6– 6.9)
(11.4–13.0)
—
—
—

Abbreviations: AI = American Indian, A/PI= Asian/Pacific Islander, CI = confidence interval, and MMSA = metropolitan and micropolitan statistical area.
* Not applicable.
† Data from 2009 BRFSS from the 50 states and the District of Columbia.

16

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

MMSA/County/State
%

(95% CI)

Surveillance Summaries

TABLE 4. Percentage of adults who reported having an annual household income of <$25,000, in 28 Racial and Ethnic Approaches to Community
Health (REACH) U.S. communities, 2009, and in the comparison populations from the Behavioral Risk Factor Surveillance System (BRFSS),
2007–2009, by race/ethnicity and sex — United States
REACH U.S. racial/ethnic populations
Black
Community

%

Men
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

49.9
52.2
36.0
41.6
47.9
46.2
54.6
38.6
50.6
40.9
35.8
42.9
46.9
44.2
—
—
—
—
22.7
20.6
—
—
—
—
—
—
—
—
43.6
20.6
54.6

Women
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

64.2
58.1
46.4
44.1
57.4
58.6
64.5
40.1
49.7
45.5
41.6
51.3
55.0
55.9
—
—
—
—
35.2
35.7
—
—
—
—
—
—
—
—
50.5
35.2
64.5

(95% CI)

Hispanic

BRFSS

A/PI

AI

MMSA/County/State

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

(43.1–56.7)
(45.3–59.0)
(29.9–42.5)
(33.7–49.9)
(40.8–55.1)
(40.0–52.6)
(47.8–61.2)
(32.4–45.1)
(41.9–59.3)
(32.7–49.8)
(26.5–46.3)
(33.3–53.0)
(38.2–55.9)
(33.1–55.9)
—
—
—
—
(11.7–39.5)
(11.1–35.1)
—
—
—
—
—
—
—
—
—
—
—

—*
—
—
—
—
—
—
—
41.3
25.4
54.1
56.7
61.8
47.4
38.4
32.8
36.7
55.7
43.4
47.8
—
—
—
—
—
—
—
—
45.4
25.4
61.8

—
—
—
—
—
—
—
—
(33.5–49.7)
(16.7–36.7)
(42.2–65.6)
(47.6–65.4)
(51.1–71.5)
(36.2–58.9)
(33.0–44.2)
(27.5–38.7)
(31.0–42.8)
(49.5–61.7)
(33.0–54.4)
(41.5–54.1)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
12.1
26.1
29.2
28.2
41.6
21.0
—
—
—
—
27.2
12.1
41.6

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(8.4–17.1)
(12.4–47.0)
(24.1–34.9)
(23.5–33.5)
(36.3–47.1)
(15.8–27.3)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
42.0
41.2
40.9
45.3
41.6
40.9
45.3

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(31.8–52.9)
(35.6–47.1)
(32.6–49.7)
(38.7–52.0)
—
—
—

14.1
28.0
25.5
15.8
23.5
13.3
18.9
32.9
23.7
23.7
32.9
23.2
23.2
23.7
16.6
22.7
28.9
16.2
13.1
32.9
32.9
11.8
23.2
32.9
26.8
29.5
20.5
29.5
21.3†
12.0†
36.0†

(11.0–18.0)
(22.9–33.7)
(23.7–27.4)
(14.4–17.3)
(21.8–25.3)
(11.3–15.6)
(16.0–22.2)
(30.2–35.7)
(21.0–26.6)
(21.0–26.6)
(30.2–35.7)
(21.3–25.2)
(21.3–25.2)
(21.0–26.6)
(12.6–21.5)
(18.6–27.5)
(27.1–30.9)
(13.9–18.7)
(11.7–14.7)
(30.2–35.7)
(30.2–35.7)
(10.5–13.2)
(21.3–25.2)
(30.2–35.7)
(25.2–28.4)
(27.8–31.2)
(19.2–21.9)
(27.8–31.2)
—
—
—

(60.2–68.1)
(53.9–62.2)
(41.9–51.0)
(38.0–50.3)
(52.8–61.8)
(53.9–63.0)
(60.3–68.4)
(36.0–44.3)
(44.7–54.8)
(40.4–50.8)
(34.8–48.7)
(45.2–57.3)
(48.3–61.6)
(47.9–63.6)
—
—
—
—
(25.2–46.8)
(24.2–49.0)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
47.9
41.1
72.1
69.9
70.8
47.1
44.0
39.9
48.5
67.5
47.9
65.5
—
—
—
—
—
—
—
—
48.2
39.9
72.1

—
—
—
—
—
—
—
—
(41.8–54.1)
(33.5–49.1)
(61.9–80.4)
(64.3–75.0)
(63.9–76.8)
(38.5–55.8)
(39.7–48.5)
(35.8–44.1)
(43.8–53.2)
(62.9–71.8)
(36.7–59.2)
(60.8–69.9)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
19.2
23.6
31.5
31.8
46.9
22.2
—
—
—
—
27.6
19.2
46.9

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(14.7–24.8)
(14.4–36.1)
(26.9–36.6)
(27.7–36.1)
(42.3–51.5)
(17.7–27.5)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
44.6
46.2
40.2
42.6
43.6
40.2
46.2

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(36.2–53.4)
(41.9–50.6)
(33.5–47.4)
(37.6–47.8)
—
—
—

14.9
38.3
33.1
19.1
31.1
22.4
26.9
40.8
29.1
29.1
40.8
30.7
30.7
29.1
21.6
25.0
35.4
22.7
14.3
40.8
40.8
17.6
30.7
40.8
30.7
34.7
25.6
34.7
26.4†
16.3†
42.1†

(12.6–17.5)
(34.6–42.1)
(31.6–34.7)
(18.1–20.1)
(29.6–32.6)
(20.6–24.4)
(24.4–29.4)
(38.6–43.0)
(27.1–31.3)
(27.1–31.3)
(38.6–43.0)
(29.1–32.4)
(29.1–32.4)
(27.1–31.3)
(17.6–26.1)
(21.6–28.7)
(33.8–37.1)
(20.7–24.9)
(13.1–15.6)
(38.6–43.0)
(38.6–43.0)
(16.3–19.0)
(29.1–32.4)
(38.6–43.0)
(29.4–32.0)
(33.4–35.9)
(24.4–26.8)
(33.4–35.9)
—
—
—

Abbreviations: AI = American Indian, A/PI= Asian/Pacific Islander, CI = confidence interval, and MMSA = metropolitan and micropolitan statistical area.
* Not applicable.
† Data from 2009 BRFSS from the 50 states and the District of Columbia.

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

17

Surveillance Summaries

TABLE 5. Percentage of adults who reported having no health care coverage, in 28 Racial and Ethnic Approaches to Community Health (REACH)
U.S. communities, 2009, and in the comparison populations from the Behavioral Risk Factor Surveillance System (BRFSS), 2007–2009, by race/
ethnicity and sex — United States
REACH U.S. racial/ethnic populations
Black
Community

Hispanic

BRFSS

A/PI

AI

MMSA/County/State

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

Men
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

24.9
22.7
28.5
18.7
31.3
37.7
30.5
25.3
38.4
37.3
26.0
16.9
22.3
27.3
—
—
—
—
17.6
21.6
—
—
—
—
—
—
—
—
25.7
16.9
38.4

(19.4–31.4)
(17.5–28.9)
(22.5–35.3)
(13.1–26.0)
(24.8–38.6)
(31.6–44.2)
(24.5–37.3)
(19.5–32.1)
(30.5–46.9)
(29.2–46.1)
(17.6–36.7)
(10.7–25.5)
(15.4–31.1)
(18.2–38.7)
—
—
—
—
(9.5–30.1)
(10.1–40.3)
—
—
—
—
—
—
—
—
—
—
—

—*
—
—
—
—
—
—
—
39.1
29.2
43.9
37.0
21.3
29.2
27.5
22.3
20.9
21.5
51.2
43.2
—
—
—
—
—
—
—
—
29.2
20.9
51.2

—
—
—
—
—
—
—
—
(31.6–47.1)
(19.2–41.6)
(32.7–55.6)
(28.8–45.9)
(13.7–31.6)
(20.2–40.1)
(22.5–33.2)
(17.5–27.9)
(16.1–26.6)
(16.7–27.3)
(41.9–60.4)
(37.1–49.5)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
14.8
16.0
19.7
14.8
13.9
13.2
—
—
—
—
14.8
13.2
19.7

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(10.6–20.2)
(7.2–31.9)
(15.3–25.0)
(11.0–19.6)
(10.5–18.1)
(9.2–18.5)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
18.9
30.9
26.4
36.5
28.7
18.9
36.5

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(12.2–28.2)
(25.4–37.0)
(19.3–35.0)
(30.1–43.4)
—
—
—

10.3
17.8
18.7
6.0
19.0
15.2
11.1
19.0
20.6
20.6
19.0
17.2
17.2
20.6
10.2
16.6
20.9
6.8
11.5
19.0
19.0
6.9
17.2
19.0
19.9
19.7
15.2
19.7
16.5†
7.1†
25.4†

(7.7–13.8)
(13.4–23.2)
(16.9–20.6)
(5.1– 7.0)
(17.3–20.7)
(12.8–18.0)
(8.8–14.0)
(16.8–21.3)
(17.9–23.6)
(17.9–23.6)
(16.8–21.3)
(15.5–19.1)
(15.5–19.1)
(17.9–23.6)
(7.1–14.4)
(13.0–21.0)
(19.1–22.7)
(5.1– 9.0)
(10.2–13.1)
(16.8–21.3)
(16.8–21.3)
(5.7– 8.2)
(15.5–19.1)
(16.8–21.3)
(18.5–21.5)
(18.2–21.3)
(13.9–16.6)
(18.2–21.3)
—
—
—

Women
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

17.1
16.6
19.0
10.2
26.1
30.3
18.3
15.9
19.1
19.4
17.3
14.2
14.4
23.6
—
—
—
—
20.8
10.7
—
—
—
—
—
—
—
—
17.8
10.2
30.3

(14.1–20.5)
(13.5–20.2)
(15.4–23.2)
(7.0–14.7)
(22.1–30.5)
(26.3–34.7)
(15.2–21.8)
(12.9–19.4)
(15.4–23.5)
(15.4–24.2)
(12.6–23.5)
(10.5–18.8)
(10.2–19.9)
(17.3–31.4)
—
—
—
—
(12.9–31.8)
(4.8–22.0)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
38.5
29.4
44.4
20.1
16.2
34.3
21.0
20.3
17.2
11.4
41.7
39.9
—
—
—
—
—
—
—
—
25.2
11.4
44.4

—
—
—
—
—
—
—
—
(32.6–44.7)
(22.3–37.7)
(35.3–53.8)
(15.8–25.2)
(11.1–22.9)
(26.9–42.6)
(17.5–25.0)
(16.8–24.4)
(13.8–21.3)
(8.8–14.6)
(31.0–53.1)
(35.4–44.6)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
15.8
17.4
15.5
10.0
13.2
14.8
—
—
—
—
15.2
10.0
17.4

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(11.4–21.4)
(10.4–27.5)
(11.8–20.2)
(7.4–13.2)
(10.3–16.7)
(11.2–19.3)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
32.4
25.1
14.5
28.2
26.7
14.5
32.4

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(24.2–41.8)
(21.4–29.3)
(10.2–20.2)
(23.6–33.2)
—
—
—

7.0
10.6
15.1
3.5
15.0
14.4
9.6
18.7
14.3
14.3
18.7
13.1
13.1
14.3
8.5
11.3
18.6
3.9
9.1
18.7
18.7
4.7
13.1
18.7
16.1
19.0
10.2
19.0
12.4†
3.6†
25.0†

(5.2– 9.4)
(8.5–13.2)
(13.8–16.4)
(3.0– 4.0)
(13.9–16.2)
(12.8–16.1)
(7.9–11.6)
(17.0–20.5)
(12.6–16.1)
(12.6–16.1)
(17.0–20.5)
(11.8–14.4)
(11.8–14.4)
(12.6–16.1)
(5.9–12.1)
(9.0–14.2)
(17.2–20.0)
(3.2– 4.8)
(8.1–10.3)
(17.0–20.5)
(17.0–20.5)
(3.9– 5.8)
(11.8–14.4)
(17.0–20.5)
(15.0–17.2)
(17.9–20.1)
(9.4–11.1)
(17.9–20.1)
—
—
—

Abbreviations: AI = American Indian, A/PI= Asian/Pacific Islander, CI = confidence interval, and MMSA = metropolitan and micropolitan statistical area.
* Not applicable.
† Data from 2009 BRFSS from the 50 states and the District of Columbia.

18

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

Surveillance Summaries

TABLE 6. Percentage of adults who had had a time when they could not see a doctor during the previous 12 months because of the cost, in 28 Racial and
Ethnic Approaches to Community Health (REACH) U.S. communities, 2009, and in the comparison populations from the Behavioral Risk Factor Surveillance
System (BRFSS), 2007–2009, by race/ethnicity and sex — United States
REACH U.S. racial/ethnic populations
Black
Community

Hispanic
%

BRFSS

A/PI

%

(95% CI)

Men
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

(95% CI)

%

23.6
21.9
23.6
13.6
15.1
24.5
18.1
18.8
20.3
20.8
20.2
17.2
14.2
12.0
—
—
—
—
20.0
20.0
—
—
—
—
—
—
—
—
20.0
12.0
24.5

(18.2–30.0)
(17.1–27.7)
(18.1–30.2)
(9.0–20.0)
(10.8–20.6)
(19.2–30.6)
(13.5–23.7)
(14.0–24.8)
(14.2–28.2)
(14.9–28.2)
(12.8–30.5)
(11.1–25.8)
(8.9–21.8)
(6.1–22.4)
—
—
—
—
(10.5–34.8)
(9.4–37.6)
—
—
—
—
—
—
—
—
—
—
—

—*
—
—
—
—
—
—
—
21.7
21.8
31.4
23.5
19.5
23.5
21.6
20.8
20.3
21.6
23.1
24.9
—
—
—
—
—
—
—
—
21.8
19.5
31.4

—
—
—
—
—
—
—
—
(16.0–28.8)
(14.1–32.1)
(21.2–43.7)
(17.0–31.6)
(12.7–28.9)
(15.1–34.6)
(17.3–26.5)
(16.2–26.2)
(15.9–25.6)
(16.7–27.3)
(13.8–36.1)
(19.8–30.8)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
11.6
6.8
13.5
8.3
9.5
11.6
—
—
—
—
10.6
6.8
13.5

Women
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

20.6
20.2
21.0
16.6
25.4
30.3
21.1
19.9
18.0
22.6
14.6
15.3
12.9
18.1
—
—
—
—
23.4
13.2
—
—
—
—
—
—
—
—
20.1
12.9
30.3

(17.5–24.0)
(17.0–24.0)
(17.6–24.9)
(12.8–21.2)
(21.8–29.5)
(26.3–34.6)
(17.9–24.8)
(16.6–23.6)
(14.3–22.4)
(18.4–27.5)
(10.2–20.4)
(11.5–19.9)
(9.1–18.0)
(12.8–25.0)
—
—
—
—
(14.5–35.5)
(7.0–23.6)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
32.6
24.8
33.8
22.2
22.2
29.3
26.3
23.4
22.8
21.4
29.7
35.3
—
—
—
—
—
—
—
—
25.6
21.4
35.3

—
—
—
—
—
—
—
—
(27.0–38.8)
(18.3–32.6)
(24.3–44.8)
(18.0–27.1)
(17.0–28.5)
(22.6–37.0)
(22.6–30.4)
(19.9–27.2)
(19.0–27.0)
(17.9–25.2)
(20.2–41.5)
(31.0–40.0)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
11.9
23.0
13.7
13.7
14.3
15.5
—
—
—
—
14.0
11.9
23.0

(95% CI)

AI

MMSA/County/State

%

(95% CI)

%

(95% CI)

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(8.2–16.2)
(2.1–19.4)
(9.8–18.2)
(5.6–12.1)
(6.9–12.9)
(8.0–16.7)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
5.8
19.6
17.4
20.2
18.5
5.8
20.2

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(2.4–13.4)
(15.3–24.8)
(11.8–24.9)
(15.3–26.2)
—
—
—

9.6
14.0
16.2
5.6
13.5
12.4
10.9
14.6
15.2
15.2
14.6
13.8
13.8
15.2
9.1
10.1
14.2
6.3
8.5
14.6
14.6
4.9
13.8
14.6
14.5
14.7
12.4
14.7
12.2†
4.7†
18.3†

(6.9–13.4)
(10.2–18.9)
(14.6–17.9)
(4.8– 6.5)
(12.1–14.9)
(10.2–14.9)
(8.6–13.7)
(12.7–16.7)
(13.0–17.7)
(13.0–17.7)
(12.7–16.7)
(12.3–15.4)
(12.3–15.4)
(13.0–17.7)
(6.4–12.8)
(7.6–13.2)
(12.8–15.8)
(4.8– 8.2)
(7.3– 9.9)
(12.7–16.7)
(12.7–16.7)
(4.0– 5.8)
(12.3–15.4)
(12.7–16.7)
(13.3–15.8)
(13.4–16.1)
(11.3–13.6)
(13.4–16.1)
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(8.4–16.5)
(14.0–35.5)
(10.4–17.9)
(10.9–17.0)
(11.3–17.8)
(12.1–19.7)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
13.0
21.3
18.0
23.2
19.7
13.0
23.2

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(8.2–20.1)
(17.8–25.2)
(13.2–24.0)
(19.0–28.0)
—
—
—

9.7
14.4
19.6
6.3
18.6
18.5
12.2
19.7
15.7
15.7
19.7
15.4
15.4
15.7
13.9
14.1
18.1
7.6
11.6
19.7
19.7
6.2
15.4
19.7
19.0
20.7
14.0
20.7
14.7†
7.0†
24.3†

(7.9–11.8)
(11.8–17.4)
(18.3–21.0)
(5.6– 7.1)
(17.4–19.8)
(16.9–20.2)
(10.4–14.2)
(18.1–21.5)
(14.0–17.5)
(14.0–17.5)
(18.1–21.5)
(14.2–16.7)
(14.2–16.7)
(14.0–17.5)
(10.8–17.7)
(11.6–16.9)
(16.9–19.4)
(6.5– 9.0)
(10.4–12.8)
(18.1–21.5)
(18.1–21.5)
(5.3– 7.1)
(14.2–16.7)
(18.1–21.5)
(18.0–20.0)
(19.7–21.8)
(13.1–14.9)
(19.7–21.8)
—
—
—

Abbreviations: AI = American Indian, A/PI= Asian/Pacific Islander, CI = confidence interval, and MMSA = metropolitan and micropolitan statistical area.
* Not applicable.
† Data from 2009 BRFSS from the 50 states and the District of Columbia.

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

19

Surveillance Summaries

TABLE 7. Percentage of adults who are obese,* in 28 Racial and Ethnic Approaches to Community Health (REACH) U.S. communities, 2009, and in the
comparison populations from the Behavioral Risk Factor Surveillance System (BRFSS), 2007–2009, by race/ethnicity and sex — United States
REACH U.S. racial/ethnic populations
Black
Community
Men
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High
Women
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

%

(95% CI)

32.3
29.2
41.6
19.3
30.8
21.9
28.9
31.7
28.8
36.8
40.4
24.9
27.1
32.4
—
—
—
—
29.3
13.0
—
—
—
—
—
—
—
—
29.3
13.0
41.6
45.1
46.6
47.3
32.5
48.9
38.8
45.9
38.7
52.1
48.8
46.3
40.1
44.2
44.2
—
—
—
—
25.4
39.3
—
—
—
—
—
—
—
—
44.7
25.4
52.1

Hispanic

BRFSS

A/PI

%

(95% CI)

%

(26.4–38.9)
(23.7–35.3)
(35.3–48.2)
(13.5–26.8)
(24.9–37.4)
(17.2–27.3)
(23.4–35.1)
(25.9–38.1)
(22.0–36.6)
(29.2–45.0)
(31.2–50.4)
(17.5–34.2)
(20.5–35.0)
(22.6–44.0)
—
—
—
—
(17.2–45.3)
(5.0–30.0)
—
—
—
—
—
—
—
—
—
—
—

—†
—
—
—
—
—
—
—
33.9
45.0
28.2
32.0
25.9
35.1
28.4
36.9
30.6
25.1
32.3
32.0
—
—
—
—
—
—
—
—
32.0
25.1
45.0

—
—
—
—
—
—
—
—
(26.8–41.7)
(34.4–56.0)
(18.6–40.2)
(24.1–41.1)
(18.2–35.4)
(25.0–46.6)
(23.9–33.4)
(31.5–42.6)
(25.4–36.4)
(20.3–30.6)
(22.1–44.6)
(26.5–38.0)
—
—
—
—
—
—
—
—
—
—
—

(41.0–49.3)
(42.6–50.7)
(42.7–51.9)
(27.1–38.5)
(44.5–53.2)
(34.4–43.3)
(41.7–50.2)
(34.8–42.6)
(47.2–57.0)
(43.7–53.9)
(39.4–53.3)
(34.7–45.9)
(37.8–50.7)
(36.6–52.1)
—
—
—
—
(16.9–36.3)
(27.9–52.0)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
42.3
51.2
33.7
42.4
31.2
39.8
36.6
33.3
35.9
36.9
36.2
41.9
—
—
—
—
—
—
—
—
36.8
31.2
51.2

—
—
—
—
—
—
—
—
(36.0–48.7)
(43.4–59.0)
(23.7–45.5)
(36.9–48.0)
(25.2–37.8)
(32.0–48.2)
(32.3–41.0)
(29.5–37.4)
(31.6–40.4)
(32.7–41.3)
(25.8–48.0)
(37.3–46.6)
—
—
—
—
—
—
—
—
—
—
—

AI

(95% CI)

%

(95% CI)

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
10.9
20.4
9.6
45.3
8.7
4.8
—
—
—
—
10.3
4.8
45.3

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(7.7–15.4)
(8.4–41.7)
(6.6–13.7)
(39.9–50.9)
(6.2–12.1)
(2.8–8.1)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
53.6
39.4
43.1
49.3
46.2
39.4
53.6

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
5.8
8.6
6.7
38.2
6.6
4.5
—
—
—
—
6.7
4.5
38.2

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(3.7–9.1)
(3.5–19.5)
(4.5–10.0)
(34.0–42.6)
(4.6–9.2)
(2.5–7.9)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
50.2
35.1
55.1
40.7
45.5
35.1
55.1

%

(95% CI)

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(43.1–63.9)
(33.8–45.2)
(35.0–51.7)
(42.8–55.8)
—
—
—

28.6
29.4
31.8
22.1
29.8
25.4
28.4
24.1
27.0
27.0
24.1
21.8
21.8
27.0
17.7
28.0
25.7
25.5
22.0
24.1
24.1
24.5
21.8
24.1
29.9
32.5
30.3
32.5
28.6§
15.8§
35.0§

(24.5–33.0)
(24.5–34.8)
(30.0–33.7)
(20.8–23.5)
(28.0–31.6)
(23.0–28.0)
(25.4–31.7)
(21.7–26.6)
(24.4–29.8)
(24.4–29.8)
(21.7–26.6)
(20.1–23.6)
(20.1–23.6)
(24.4–29.8)
(14.4–21.7)
(23.9–32.6)
(24.0–27.5)
(22.8–28.4)
(20.5–23.6)
(21.7–26.6)
(21.7–26.6)
(22.8–26.3)
(20.1–23.6)
(21.7–26.6)
(28.4–31.4)
(30.8–34.1)
(28.9–31.8)
(30.8–34.1)
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(41.5–58.9)
(31.0–39.4)
(48.0–62.0)
(35.9–45.8)
—
—
—

27.2
32.4
31.8
17.9
30.9
23.6
26.4
23.9
26.6
26.6
23.9
22.4
22.4
26.6
22.2
23.9
25.6
18.7
20.3
23.9
23.9
19.9
22.4
23.9
29.8
30.6
29.5
30.6
26.0§
18.7§
36.0§

(24.1–30.4)
(29.0–36.0)
(30.3–33.4)
(16.9–18.9)
(29.5–32.4)
(22.0–25.3)
(24.2–28.8)
(22.1–25.7)
(24.7–28.7)
(24.7–28.7)
(22.1–25.7)
(21.1–23.8)
(21.1–23.8)
(24.7–28.7)
(18.4–26.5)
(20.8–27.2)
(24.2–27.0)
(16.8–20.7)
(19.0–21.6)
(22.1–25.7)
(22.1–25.7)
(18.5–21.3)
(21.1–23.8)
(22.1–25.7)
(28.6–31.0)
(29.4–31.7)
(28.4–30.7)
(29.4–31.7)
—
—
—

Abbreviations: AI = American Indian, A/PI= Asian/Pacific Islander, CI = confidence interval, and MMSA = metropolitan and micropolitan statistical area.
* Body mass index≥30.0 kg/m2 based on self–reported height and weight.
† Not applicable.
§ Data from 2009 BRFSS from the 50 states and the District of Columbia.

20

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

MMSA/County/State

Surveillance Summaries

TABLE 8. Percentage of adults who currently smoke, in 28 Racial and Ethnic Approaches to Community Health (REACH) U.S. communities, 2009, and
in the comparison populations from the Behavioral Risk Factor Surveillance System (BRFSS), 2007–2009, by race/ethnicity and sex — United States
REACH U.S. racial/ethnic populations
Black
Community

Hispanic

BRFSS

A/PI

AI

MMSA/County/State

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

Men
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

38.6
36.6
27.9
8.5
33.0
29.5
28.2
19.3
37.9
28.0
26.2
23.2
17.8
34.9
—
—
—
—
17.7
11.4
—
—
—
—
—
—
—
—
28.0
8.5
38.6

(32.4–45.2)
(30.6–43.1)
(22.2–34.3)
(4.7–15.0)
(26.5–40.2)
(24.0–35.5)
(22.6–34.7)
(14.5–25.3)
(30.2–46.3)
(21.2–36.0)
(17.8–36.9)
(16.1–32.2)
(12.6–24.5)
(24.9–46.3)
—
—
—
—
(8.7–32.5)
(4.2–27.4)
—
—
—
—
—
—
—
—
—
—
—

—*
—
—
—
—
—
—
—
25.4
34.4
17.7
22.7
15.5
20.0
10.3
17.5
20.3
15.0
14.0
17.3
—
—
—
—
—
—
—
—
17.6
10.3
34.4

—
—
—
—
—
—
—
—
(19.2–32.7)
(23.6–47.1)
(10.4–28.4)
(16.0–31.1)
(10.4–22.6)
(12.8–29.8)
(7.2–14.4)
(13.3–22.7)
(15.4–26.2)
(11.2–19.8)
(7.8–23.8)
(12.9–22.9)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
13.1
14.0
16.0
22.5
13.6
13.6
—
—
—
—
13.8
13.1
22.5

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(9.3–18.0)
(5.8–30.1)
(12.1–20.9)
(18.3–27.4)
(10.6–17.3)
(10.1–18.1)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
31.7
31.2
56.3
40.4
36.1
31.2
56.3

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(22.8–42.2)
(25.9–37.1)
(47.8–64.4)
(34.0–47.0)
—
—
—

21.0
29.9
26.8
15.5
21.5
18.0
17.7
16.0
23.8
23.8
16.0
17.1
17.1
23.8
11.9
19.4
20.9
16.5
12.5
16.0
16.0
18.0
17.1
16.0
23.4
26.8
21.8
26.8
19.6†
11.9†
27.7†

(17.2–25.4)
(25.0–35.4)
(25.0–28.8)
(14.2–16.9)
(19.9–23.2)
(15.8–20.5)
(15.2–20.5)
(14.0–18.2)
(21.2–26.6)
(21.2–26.6)
(14.0–18.2)
(15.5–18.8)
(15.5–18.8)
(21.2–26.6)
(8.8–15.9)
(15.9–23.4)
(19.3–22.6)
(14.1–19.2)
(11.3–13.9)
(14.0–18.2)
(14.0–18.2)
(16.4–19.8)
(15.5–18.8)
(14.0–18.2)
(22.1–24.9)
(25.2–28.5)
(20.5–23.2)
(25.2–28.5)
—
—
—

Women
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

30.7
24.4
24.3
2.9
12.8
15.8
29.5
15.3
24.6
26.5
17.6
20.1
19.6
23.5
—
—
—
—
9.1
11.6
—
—
—
—
—
—
—
—
19.9
2.9
30.7

(27.0–34.6)
(21.1–28.1)
(20.6–28.3)
(1.4– 5.8)
(10.2–16.1)
(13.0–19.1)
(25.8–33.6)
(12.6–18.4)
(20.9–28.8)
(22.2–31.4)
(12.5–24.2)
(16.1–24.8)
(14.9–25.4)
(17.1–31.2)
—
—
—
—
(5.1–15.7)
(5.6–22.4)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
6.4
11.9
10.2
16.7
12.1
14.5
8.0
11.1
15.4
10.0
12.6
6.9
—
—
—
—
—
—
—
—
11.5
6.4
16.7

—
—
—
—
—
—
—
—
(4.3– 9.5)
(7.9–17.5)
(5.3–18.7)
(12.9–21.2)
(8.3–17.4)
(9.8–21.0)
(5.8–10.8)
(8.6–14.1)
(12.2–19.3)
(7.4–13.3)
(6.6–22.6)
(4.9– 9.6)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
4.4
4.3
0.8
21.3
1.4
3.1
—
—
—
—
3.7
0.8
21.3

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(2.4– 7.8)
(1.0–17.3)
(0.3– 2.1)
(17.9–25.1)
(0.7– 3.1)
(1.6– 6.0)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
39.4
26.4
48.9
32.6
36.0
26.4
48.9

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(31.2–48.3)
(22.7–30.4)
(42.0–55.8)
(28.4–37.1)
—
—
—

16.1
21.4
25.3
13.1
19.0
14.9
19.0
8.9
16.3
16.3
8.9
12.5
12.5
16.3
5.1
14.7
16.5
15.2
10.7
8.9
8.9
12.5
12.5
8.9
18.0
23.5
18.3
23.5
16.8†
7.7†
24.2†

(13.7–18.8)
(18.5–24.5)
(23.9–26.8)
(12.2–14.1)
(17.8–20.2)
(13.4–16.5)
(16.9–21.3)
(7.7–10.3)
(14.8–18.0)
(14.8–18.0)
(7.7–10.3)
(11.6–13.6)
(11.6–13.6)
(14.8–18.0)
(3.7– 7.2)
(12.2–17.6)
(15.3–17.7)
(13.5–17.1)
(9.7–11.8)
(7.7–10.3)
(7.7–10.3)
(11.4–13.7)
(11.6–13.6)
(7.7–10.3)
(17.0–18.9)
(22.5–24.6)
(17.4–19.4)
(22.5–24.6)
—
—
—

Abbreviations: AI = American Indian, A/PI= Asian/Pacific Islander, CI = confidence interval, and MMSA = metropolitan and micropolitan statistical area.
* Not applicable.
† Data from 2009 BRFSS from the 50 states and the District of Columbia.

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

21

Surveillance Summaries

TABLE 9. Percentage of adults who reported no leisure time physical activity during the preceding month, in 28 Racial and Ethnic Approaches
to Community Health (REACH) U.S. communities, 2009, and in the comparison populations from the Behavioral Risk Factor Surveillance System
(BRFSS), 2007–2009, by race/ethnicity and sex — United States
REACH U.S. racial/ethnic populations
Black
Community
Men
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High
Women
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahosma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

Hispanic

BRFSS

A/PI

AI

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

34.6
30.5
21.2
30.4
35.5
26.9
29.0
23.2
29.2
27.9
30.0
22.4
26.0
32.6
—
—
—
—
20.3
22.5
—
—
—
—
—
—
—
—
28.5
20.3
35.5

(28.5–41.2)
(24.5–37.1)
(16.7–26.5)
(23.8–38.1)
(28.9–42.7)
(21.7–32.8)
(23.1–35.7)
(18.2–29.0)
(22.3–37.3)
(21.0–36.0)
(21.6–40.0)
(15.4–31.4)
(19.0–34.5)
(22.3–44.9)
—
—
—
—
(10.0–36.8)
(11.3–40.0)
—
—
—
—
—
—
—
—
—
—
—

—*
—
—
—
—
—
—
—
27.9
16.6
22.5
32.3
29.8
23.2
24.5
26.0
23.9
37.6
28.1
27.1
—
—
—
—
—
—
—
—
26.6
16.6
37.6

—
—
—
—
—
—
—
—
(21.1–35.9)
(10.6–25.1)
(13.8–34.5)
(24.7–40.9)
(22.0–38.9)
(15.4–33.5)
(20.0–29.6)
(21.1–31.5)
(19.2–29.4)
(31.6–44.0)
(18.5–40.4)
(21.8–33.1)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
16.6
23.5
18.8
25.9
24.0
23.7
—
—
—
—
23.6
16.6
25.9

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(12.6–21.7)
(11.5–42.1)
(14.8–23.7)
(21.3–31.1)
(19.7–28.7)
(18.1–30.2)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
17.8
33.6
21.7
39.4
27.7
17.8
39.4

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(10.2–29.2)
(28.4–39.1)
(15.3–29.9)
(33.1–46.1)
—
—
—

18.1
23.8
28.6
18.5
22.6
18.3
21.1
23.4
21.7
21.7
23.4
24.6
24.6
21.7
15.2
20.9
19.9
21.0
14.1
23.4
23.4
15.1
24.6
23.4
22.2
29.2
22.2
29.2
21.5†
15.1†
29.4†

(15.2–21.4)
(19.6–28.6)
(26.8–30.5)
(17.2–19.9)
(21.1–24.3)
(16.1–20.7)
(18.5–24.0)
(21.2–25.8)
(19.3–24.4)
(19.3–24.4)
(21.2–25.8)
(22.8–26.5)
(22.8–26.5)
(19.3–24.4)
(11.9–19.3)
(17.1–25.2)
(18.4–21.5)
(18.5–23.7)
(12.9–15.5)
(21.2–25.8)
(21.2–25.8)
(13.7–16.5)
(22.8–26.5)
(21.2–25.8)
(20.9–23.4)
(27.7–30.8)
(21.0–23.6)
(27.7–30.8)
—
—
—

42.1
31.8
32.8
36.9
34.2
31.3
37.0
24.0
34.4
35.5
31.3
31.4
30.4
28.6
—
—
—
—
21.6
24.1
—
—
—
—
—
—
—
—
31.6
21.6
42.1

(38.2–46.1)
(28.1–35.8)
(28.6–37.3)
(31.3–42.9)
(30.0–38.6)
(27.1–35.7)
(33.0–41.3)
(20.8–27.6)
(29.8–39.2)
(30.8–40.6)
(25.3–38.0)
(26.1–37.3)
(24.8–36.6)
(22.0–36.3)
—
—
—
—
(13.3–33.1)
(14.8–36.9)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
29.4
28.3
28.1
41.7
43.0
36.7
25.9
22.3
28.2
42.3
34.3
32.3
—
—
—
—
—
—
—
—
30.9
22.3
43.0

—
—
—
—
—
—
—
—
(23.8–35.7)
(21.7–36.1)
(20.1–37.8)
(36.2–47.4)
(36.3–50.1)
(29.0–45.1)
(22.4–29.9)
(18.9–26.1)
(24.1–32.7)
(37.7–47.0)
(24.6–45.5)
(28.2–36.8)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
26.9
18.0
24.2
28.4
27.3
23.6
—
—
—
—
25.6
18.0
28.4

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(21.5–33.0)
(10.2–29.7)
(19.9–28.9)
(24.5–32.7)
(23.4–31.6)
(19.1–28.8)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
21.9
31.8
24.3
28.2
26.3
21.9
31.8

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(15.1–30.6)
(28.0–35.9)
(18.6–31.0)
(24.0–32.9)
—
—
—

22.9
36.5
35.5
20.8
30.4
23.9
27.5
24.6
28.5
28.5
24.6
31.3
31.3
28.5
20.7
23.3
26.2
22.8
17.0
24.6
24.6
23.4
31.3
24.6
28.7
33.5
26.3
33.5
25.6†
16.4†
36.8†

(20.0–26.1)
(33.0–40.2)
(34.0–37.0)
(19.9–21.8)
(29.1–31.8)
(22.2–25.7)
(25.4–29.9)
(22.8–26.5)
(26.6–30.5)
(26.6–30.5)
(22.8–26.5)
(29.8–32.8)
(29.8–32.8)
(26.6–30.5)
(17.2–24.8)
(20.4–26.5)
(24.8–27.7)
(20.9–24.8)
(15.8–18.3)
(22.8–26.5)
(22.8–26.5)
(21.9–24.8)
(29.8–32.8)
(22.8–26.5)
(27.6–29.8)
(32.4–34.6)
(25.3–27.4)
(32.4–34.6)
—
—
—

Abbreviations: AI = American Indian, A/PI= Asian/Pacific Islander, CI = confidence interval, and MMSA = metropolitan and micropolitan statistical area.
* Not applicable.
† Data from 2009 BRFSS from the 50 states and the District of Columbia.

22

MMSA/County/State

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

Surveillance Summaries

TABLE 10. Percentage of adults who met physical activity recommendations,* in 28 Racial and Ethnic Approaches to Community Health (REACH)
U.S. communities, 2009, and in the comparison populations from the Behavioral Risk Factor Surveillance System (BRFSS), 2007–2009, by race/
ethnicity and sex — United States
REACH U.S. racial/ethnic populations
Black
Community
Men
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High
Women
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

Hispanic

BRFSS

A/PI

AI

MMSA/County/State
%

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

(95% CI)

38.3
43.7
50.1
32.3
39.1
48.7
42.8
47.2
49.3
47.3
39.5
43.6
43.8
34.3
—
—
—
—
49.5
46.7
—
—
—
—
—
—
—
—
43.8
32.3
50.1

(31.7–45.4)
(37.3–50.3)
(43.6–56.6)
(25.4–39.9)
(32.3–46.3)
(42.4–55.0)
(36.0–49.8)
(40.8–53.7)
(40.9–57.7)
(39.0–55.7)
(29.9–49.9)
(33.3–54.5)
(35.4–52.6)
(23.9–46.5)
—
—
—
—
(34.6–64.4)
(29.4–64.8)
—
—
—
—
—
—
—
—
—
—
—

—†
—
—
—
—
—
—
—
34.4
53.8
50.5
45.7
44.5
57.1
45.9
53.0
54.1
40.0
35.0
42.1
—
—
—
—
—
—
—
—
45.8
34.4
57.1

—
—
—
—
—
—
—
—
(27.4–42.2)
(42.1–65.1)
(38.8–62.1)
(36.8–54.9)
(34.8–54.7)
(46.3–67.3)
(40.4–51.6)
(47.1–58.7)
(48.0–60.1)
(34.4–45.8)
(25.6–45.8)
(35.9–48.5)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
36.3
31.4
49.7
48.8
33.2
43.2
—
—
—
—
39.8
31.4
49.7

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(30.5–42.5)
(18.5–47.9)
(43.7–55.7)
(42.9–54.6)
(28.2–38.5)
(37.2–49.5)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
49.2
43.1
48.6
47.1
47.9
43.1
49.2

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(38.5–59.9)
(37.3–49.2)
(40.0–57.3)
(40.4–53.9)
—
—
—

55.6
49.6
36.8
51.1
48.8
49.3
53.4
48.2
49.7
49.7
48.2
49.8
49.8
49.7
45.9
54.4
56.4
51.2
54.9
48.2
48.2
54.1
49.8
48.2
50.1
48.0
52.7
48.0
52.4§
36.8§
63.3§

(49.9–61.1)
(42.5–56.8)
(34.0–39.6)
(48.9–53.3)
(45.9–51.7)
(45.5–53.0)
(49.1–57.6)
(44.4–52.0)
(46.0–53.3)
(46.0–53.3)
(44.4–52.0)
(47.0–52.6)
(47.0–52.6)
(46.0–53.3)
(39.0–52.9)
(48.3–60.3)
(53.7–59.1)
(46.9–55.6)
(52.6–57.2)
(44.4–52.0)
(44.4–52.0)
(51.7–56.6)
(47.0–52.6)
(44.4–52.0)
(47.5–52.7)
(45.4–50.6)
(50.3–55.1)
(45.4–50.6)
—
—
—

29.9
34.5
33.1
25.6
27.5
34.6
35.0
37.5
35.9
33.3
31.8
40.0
33.5
37.9
—
—
—
—
48.4
50.0
—
—
—
—
—
—
—
—
34.6
25.6
50.0

(26.1–34.0)
(30.5–38.8)
(28.8–37.8)
(20.8–31.2)
(23.7–31.7)
(30.3–39.1)
(30.9–39.3)
(33.6–41.7)
(31.3–40.7)
(28.6–38.2)
(25.8–38.5)
(34.3–45.9)
(27.5–40.1)
(30.5–45.8)
—
—
—
—
(37.1–59.8)
(37.4–62.6)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
46.7
40.5
49.4
40.6
32.7
44.2
49.1
45.2
46.1
36.8
45.3
39.5
—
—
—
—
—
—
—
—
44.7
32.7
49.4

—
—
—
—
—
—
—
—
(40.8–52.8)
(33.0–48.4)
(39.5–59.4)
(35.2–46.2)
(26.2–39.8)
(36.3–52.3)
(44.7–53.4)
(40.9–49.5)
(41.4–50.7)
(32.4–41.3)
(34.4–56.6)
(35.1–44.2)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
38.3
48.8
39.1
44.4
33.4
41.9
—
—
—
—
40.5
33.4
48.8

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(32.7–44.3)
(36.2–61.5)
(34.1–44.5)
(39.9–48.9)
(29.2–37.9)
(36.6–47.5)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
44.9
44.9
46.2
39.6
44.9
39.6
46.2

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(36.1–54.1)
(40.4–49.5)
(39.3–53.2)
(34.7–44.6)
—
—
—

48.6
39.1
33.1
51.5
39.6
45.9
47.9
45.9
46.6
46.6
45.9
43.4
43.4
46.6
48.4
51.4
48.4
50.6
51.5
45.9
45.9
47.4
43.4
45.9
41.0
45.1
47.8
45.1
47.8§
32.7§
55.9§

(44.3–52.9)
(34.5–43.9)
(31.1–35.3)
(49.8–53.2)
(37.4–41.7)
(43.3–48.4)
(44.6–51.2)
(43.0–48.8)
(43.8–49.3)
(43.8–49.3)
(43.0–48.8)
(41.4–45.6)
(41.4–45.6)
(43.8–49.3)
(42.3–54.6)
(46.8–55.9)
(46.3–50.5)
(47.3–54.0)
(49.5–53.5)
(43.0–48.8)
(43.0–48.8)
(45.3–49.5)
(41.4–45.6)
(43.0–48.8)
(39.1–42.9)
(43.3–46.9)
(45.9–49.7)
(43.3–46.9)
—
—
—

Abbreviations: AI = American Indian, A/PI= Asian/Pacific Islander, CI = confidence interval, and MMSA = metropolitan and micropolitan statistical area.
* Participating in moderate physical activity ≥30 minutes/day and 5 days/week or in vigorous physical activity ≥20 minutes/day and 3 days/week.
† Not applicable..
§ Data from 2009 BRFSS from the 50 states and the District of Columbia.

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

23

Surveillance Summaries

TABLE 11. Percentage of adults who reported eating at least five fruits and vegetables daily, in 28 Racial and Ethnic Approaches to Community
Health (REACH) U.S. communities, 2009, and in the comparison populations from the Behavioral Risk Factor Surveillance System (BRFSS), 2007–2009,
by race/ethnicity and sex — United States
REACH U.S. racial/ethnic populations
Black
Community

Hispanic

BRFSS

A/PI

AI

MMSA/County/State

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

Men
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

23.7
28.1
23.5
34.3
22.6
23.9
18.7
24.7
11.0
16.3
31.7
29.3
24.6
19.4
—
—
—
—
21.5
36.6
—
—
—
—
—
—
—
—
23.8
11.0
36.6

(18.2–30.3)
(22.4–34.6)
(18.5–29.4)
(27.4–41.9)
(17.0–29.4)
(19.1–29.6)
(13.9–24.7)
(19.5–30.7)
(7.0–16.8)
(11.5–22.7)
(22.7–42.2)
(20.8–39.5)
(18.0–32.7)
(12.1–29.7)
—
—
—
—
(11.5–36.4)
(20.9–55.7)
—
—
—
—
—
—
—
—
—
—
—

—*
—
—
—
—
—
—
—
11.8
15.5
22.8
29.1
19.2
14.7
19.9
19.5
19.7
23.6
19.4
22.1
—
—
—
—
—
—
—
—
19.6
11.8
29.1

—
—
—
—
—
—
—
—
(7.7–17.6)
(9.0–25.2)
(14.5–33.9)
(21.7–37.8)
(12.8–27.9)
(8.7–23.7)
(15.8–24.9)
(15.5–24.2)
(15.5–24.8)
(18.7–29.3)
(12.0–29.7)
(17.2–27.9)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
23.6
23.9
25.2
25.3
15.4
23.4
—
—
—
—
23.8
15.4
25.3

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(18.6–29.3)
(11.9–42.2)
(20.6–30.4)
(20.7–30.5)
(11.9–19.7)
(18.5–29.2)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
18.5
20.8
22.1
14.2
19.7
14.2
22.1

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(12.0–27.3)
(16.3–26.1)
(15.7–30.1)
(10.4–19.1)
—
—
—

22.2
22.0
13.3
20.6
13.9
22.4
16.1
21.1
20.5
20.5
21.1
23.6
23.6
20.5
20.7
25.9
19.3
19.4
23.2
21.1
21.1
20.9
23.6
21.1
17.4
12.4
18.5
12.4
19.2†
11.3†
28.4†

(18.2–26.9)
(17.1–27.8)
(11.5–15.4)
(19.0–22.4)
(12.1–16.0)
(19.4–25.7)
(13.2–19.4)
(18.3–24.2)
(17.7–23.6)
(17.7–23.6)
(18.3–24.2)
(21.3–26.1)
(21.3–26.1)
(17.7–23.6)
(15.9–26.4)
(21.2–31.2)
(17.5–21.3)
(16.4–22.8)
(21.3–25.2)
(18.3–24.2)
(18.3–24.2)
(19.0–22.9)
(21.3–26.1)
(18.3–24.2)
(15.6–19.3)
(10.7–14.3)
(16.6–20.5)
(10.7–14.3)
—
—
—

Women
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

29.5
31.7
27.7
22.4
29.2
23.8
21.0
34.0
23.3
21.2
29.3
26.2
25.7
32.0
—
—
—
—
31.6
23.8
—
—
—
—
—
—
—
—
27.0
21.0
34.0

(26.0–33.3)
(27.9–35.9)
(23.9–32.0)
(18.1–27.4)
(25.3–33.3)
(20.3–27.6)
(17.8–24.5)
(30.1–38.0)
(19.3–27.8)
(17.5–25.5)
(23.6–35.7)
(21.3–31.9)
(20.4–31.8)
(25.2–39.6)
—
—
—
—
(23.2–41.3)
(14.9–35.9)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
21.5
21.8
25.4
24.2
27.0
24.4
28.3
24.4
26.0
21.3
33.9
24.8
—
—
—
—
—
—
—
—
24.6
21.3
33.9

—
—
—
—
—
—
—
—
(16.8–27.1)
(15.7–29.5)
(17.3–35.7)
(19.9–29.1)
(21.2–33.7)
(18.5–31.6)
(24.7–32.2)
(20.9–28.3)
(22.2–30.2)
(17.8–25.3)
(24.0–45.4)
(21.2–28.8)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
34.8
35.7
35.8
28.3
20.8
32.4
—
—
—
—
33.6
20.8
35.8

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(29.3–40.8)
(24.8–48.2)
(31.0–41.0)
(24.5–32.3)
(17.3–24.8)
(27.5–37.6)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
25.4
23.1
23.8
19.0
23.5
19.0
25.4

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(18.5–33.9)
(19.8–26.8)
(18.2–30.4)
(15.7–22.9)
—
—
—

31.2
28.7
18.8
32.6
20.6
30.7
27.5
32.1
29.1
29.1
32.1
29.7
29.7
29.1
38.3
30.4
26.8
34.0
33.4
32.1
32.1
28.2
29.7
32.1
23.7
16.7
26.4
16.7
27.7†
16.7†
35.9†

(27.6–35.2)
(24.7–33.1)
(17.3–20.5)
(31.1–34.2)
(19.0–22.3)
(28.4–33.0)
(24.7–30.5)
(29.4–34.9)
(26.7–31.6)
(26.7–31.6)
(29.4–34.9)
(27.9–31.6)
(27.9–31.6)
(26.7–31.6)
(32.5–44.4)
(26.6–34.6)
(25.1–28.7)
(30.9–37.2)
(31.6–35.3)
(29.4–34.9)
(29.4–34.9)
(26.3–30.1)
(27.9–31.6)
(29.4–34.9)
(22.3–25.2)
(15.5–18.0)
(24.8–28.0)
(15.5–18.0)
—
—
—

Abbreviations: AI = American Indian, A/PI= Asian/Pacific Islander, CI = confidence interval, and MMSA = metropolitan and micropolitan statistical area.
* Not applicable.
† Data from 2009 BRFSS from the 50 states and the District of Columbia.

24

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

Surveillance Summaries

TABLE 12. Percentage of adults who reported fair or poor health, in 28 Racial and Ethnic Approaches to Community Health (REACH) U.S. communities, 2009, and in the comparison populations from the Behavioral Risk Factor Surveillance System (BRFSS), 2007–2009, by race/ethnicity
and sex — United States
REACH U.S. racial/ethnic populations
Black
Community

Hispanic

BRFSS

A/PI

AI

MMSA/County/State

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

Men
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

27.3
29.8
21.4
14.7
21.6
16.1
22.9
21.0
25.3
17.6
21.7
20.7
18.9
21.8
—
—
—
—
9.3
16.5
—
—
—
—
—
—
—
—
21.2
9.3
29.8

(22.0–33.3)
(24.3–35.9)
(17.1–26.5)
(10.3–20.7)
(16.7–27.5)
(12.3–20.7)
(17.9–28.7)
(16.8–25.9)
(19.0–32.8)
(12.4–24.4)
(14.8–30.6)
(14.4–29.0)
(13.8–25.3)
(14.0–32.2)
—
—
—
—
(3.7–21.8)
(7.8–31.7)
—
—
—
—
—
—
—
—
—
—
—

—*
—
—
—
—
—
—
—
24.1
29.5
34.8
34.5
24.6
20.1
23.3
17.6
20.8
31.0
18.6
30.2
—
—
—
—
—
—
—
—
24.4
17.6
34.8

—
—
—
—
—
—
—
—
(18.1–31.4)
(20.5–40.5)
(24.3–47.0)
(27.1–42.8)
(18.0–32.6)
(13.0–29.6)
(19.0–28.2)
(14.0–21.8)
(16.7–25.6)
(26.1–36.3)
(12.0–27.6)
(24.9–36.1)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
10.6
8.3
16.6
23.3
29.3
15.0
—
—
—
—
15.8
8.3
29.3

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(7.6–14.5)
(3.0–20.7)
(13.0–20.9)
(18.9–28.3)
(24.8–34.2)
(11.2–19.7)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
22.3
30.8
24.3
28.2
26.3
22.3
30.8

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(14.9–32.2)
(26.0–36.0)
(18.0–32.1)
(22.9–34.3)
—
—
—

13.2
19.0
23.5
10.7
14.5
11.6
14.1
20.0
16.2
16.2
20.0
15.9
15.9
16.2
12.2
15.2
16.3
13.9
8.8
20.0
20.0
13.2
15.9
20.0
17.0
18.4
14.3
18.4
13.4†
9.3†
24.0†

(10.2–16.8)
(15.5–23.2)
(22.0–25.2)
(9.8–11.7)
(13.4–15.7)
(9.8–13.8)
(12.1–16.4)
(17.8–22.3)
(14.2–18.5)
(14.2–18.5)
(17.8–22.3)
(14.4–17.6)
(14.4–17.6)
(14.2–18.5)
(9.0–16.2)
(12.4–18.5)
(14.9–17.6)
(11.9–16.1)
(7.9– 9.9)
(17.8–22.3)
(17.8–22.3)
(12.0–14.6)
(14.4–17.6)
(17.8–22.3)
(15.8–18.3)
(17.2–19.7)
(13.3–15.3)
(17.2–19.7)
—
—
—

Women
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

30.3
29.9
25.4
22.7
22.9
22.4
33.3
22.1
27.2
25.7
26.9
30.4
20.9
24.6
—
—
—
—
14.3
19.3
—
—
—
—
—
—
—
—
25.0
14.3
33.3

(26.7–34.1)
(26.4–33.7)
(21.7–29.4)
(18.8–27.2)
(19.7–26.5)
(19.3–25.9)
(29.5–37.2)
(19.2–25.2)
(23.3–31.5)
(21.8–30.1)
(21.1–33.6)
(25.5–35.8)
(16.6–25.9)
(18.7–31.5)
—
—
—
—
(9.0–22.1)
(11.3–30.9)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
28.9
19.4
32.3
43.0
44.2
37.5
30.3
21.7
28.9
40.5
25.6
37.1
—
—
—
—
—
—
—
—
31.3
19.4
44.2

—
—
—
—
—
—
—
—
(23.8–34.6)
(14.3–25.8)
(23.6–42.5)
(37.8–48.5)
(37.5–51.2)
(30.2–45.5)
(26.5–34.3)
(18.6–25.2)
(25.0–33.2)
(36.3–44.9)
(17.1–36.4)
(32.6–41.9)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
14.2
13.3
19.7
23.7
37.2
20.4
—
—
—
—
20.1
13.3
37.2

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(10.6–18.6)
(6.6–25.0)
(15.9–24.2)
(20.2–27.6)
(32.9–41.7)
(16.4–25.2)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
26.6
27.5
23.5
23.2
25.1
23.2
27.5

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(19.8–34.8)
(24.0–31.3)
(18.1–29.8)
(19.6–27.3)
—
—
—

13.3
22.7
24.2
11.6
17.8
13.3
15.1
23.0
18.3
18.3
23.0
18.5
18.5
18.3
15.8
14.7
18.9
13.4
10.8
23.0
23.0
14.6
18.5
23.0
18.5
19.8
14.9
19.8
15.3†
10.4†
23.5†

(11.3–15.6)
(19.9–25.8)
(23.0–25.5)
(10.9–12.3)
(16.8–18.9)
(12.1–14.6)
(13.3–17.1)
(21.2–24.9)
(16.7–20.0)
(16.7–20.0)
(21.2–24.9)
(17.3–19.8)
(17.3–19.8)
(16.7–20.0)
(12.5–19.7)
(12.5–17.1)
(17.8–20.1)
(12.0–14.9)
(9.9–11.7)
(21.2–24.9)
(21.2–24.9)
(13.5–15.8)
(17.3–19.8)
(21.2–24.9)
(17.6–19.5)
(18.9–20.8)
(14.1–15.7)
(18.9–20.8)
—
—
—

Abbreviations: AI = American Indian, A/PI= Asian/Pacific Islander, CI = confidence interval, and MMSA = metropolitan and micropolitan statistical area.
* Not applicable.
† Data from 2009 BRFSS from the 50 states and the District of Columbia.

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

25

Surveillance Summaries

TABLE 13. Percentage of adults who have been told by a health professional that they have high blood pressure, in 28 Racial and Ethnic Approaches
to Community Health (REACH) U.S. communities, 2009, and in the comparison populations from the Behavioral Risk Factor Surveillance System
(BRFSS), 2007–2009, by race/ethnicity and sex — United States
REACH U.S. racial/ethnic populations
Black
Community

Hispanic

BRFSS

A/PI

AI

MMSA/County/State

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

Men
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

38.9
44.0
53.6
23.7
40.9
31.6
40.9
41.3
39.1
31.9
41.6
35.7
29.3
45.1
—
—
—
—
23.1
35.9
—
—
—
—
—
—
—
—
39.0
23.1
53.6

(32.9–45.3)
(37.9–50.3)
(47.0–60.1)
(18.4–30.0)
(34.4–47.8)
(26.1–37.6)
(34.5–47.7)
(35.5–47.5)
(31.6–47.2)
(25.2–39.3)
(32.6–51.1)
(27.4–45.0)
(23.0–36.5)
(34.5–56.2)
—
—
—
—
(13.3–37.2)
(22.1–52.5)
—
—
—
—
—
—
—
—
—
—
—

—*
—
—
—
—
—
—
—
21.0
30.0
19.9
22.5
27.0
21.2
23.1
31.0
42.5
29.8
12.9
21.7
—
—
—
—
—
—
—
—
22.8
12.9
42.5

—
—
—
—
—
—
—
—
(15.5–27.9)
(21.5–40.1)
(12.9–29.4)
(16.8–29.3)
(20.4–34.9)
(14.1–30.6)
(19.0–27.7)
(26.4–36.1)
(36.6–48.6)
(25.1–35.0)
(8.3–19.6)
(17.3–26.9)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
23.7
46.7
33.5
41.6
26.4
26.0
—
—
—
—
30.0
23.7
46.7

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(19.2–28.9)
(31.1–63.1)
(28.6–38.8)
(36.2–47.3)
(22.1–31.1)
(21.2–31.5)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
45.9
42.5
33.7
45.2
43.9
33.7
45.9

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(35.4–56.7)
(37.1–48.2)
(26.5–41.8)
(38.8–51.8)
—
—
—

29.9
33.3
39.0
26.2
33.7
28.2
32.7
24.3
29.1
29.1
24.3
25.5
25.5
29.1
22.5
28.6
28.4
26.7
24.7
24.3
24.3
30.2
25.5
24.3
31.7
34.9
31.8
34.9
29.8†
22.1†
39.0†

(25.5–34.7)
(27.3–39.8)
(36.3–41.7)
(24.5–28.0)
(31.2–36.3)
(25.3–31.3)
(29.0–36.6)
(21.6–27.1)
(26.1–32.3)
(26.1–32.3)
(21.6–27.1)
(23.4–27.8)
(23.4–27.8)
(26.1–32.3)
(18.0–27.8)
(24.2–33.4)
(26.4–30.6)
(23.6–30.0)
(23.0–26.6)
(21.6–27.1)
(21.6–27.1)
(28.1–32.3)
(23.4–27.8)
(21.6–27.1)
(29.6–33.8)
(32.7–37.1)
(29.9–33.9)
(32.7–37.1)
—
—
—

Women
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

53.3
49.3
49.4
27.3
47.9
40.0
46.4
44.2
38.8
47.8
45.5
46.2
39.4
46.1
—
—
—
—
31.3
46.7
—
—
—
—
—
—
—
—
46.2
27.3
53.3

(49.1–57.4)
(45.2–53.4)
(44.8–54.1)
(22.8–32.3)
(43.5–52.3)
(36.0–44.3)
(42.4–50.4)
(40.4–48.1)
(34.4–43.5)
(42.7–53.0)
(39.1–52.2)
(40.7–51.9)
(33.6–45.5)
(38.6–53.8)
—
—
—
—
(22.8–41.2)
(35.1–58.7)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
19.3
21.7
23.5
36.5
36.0
25.6
28.5
27.4
34.7
33.1
15.0
26.3
—
—
—
—
—
—
—
—
26.9
15.0
36.5

—
—
—
—
—
—
—
—
(15.4–24.0)
(16.8–27.6)
(16.3–32.6)
(31.4–41.8)
(29.6–42.9)
(19.4–32.9)
(24.8–32.5)
(24.1–31.0)
(30.6–39.1)
(29.3–37.2)
(9.0–23.8)
(22.4–30.6)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
16.8
19.2
29.7
38.1
27.3
20.7
—
—
—
—
24.0
16.8
38.1

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(13.2–21.1)
(11.0–31.3)
(25.5–34.3)
(33.9–42.4)
(23.5–31.4)
(16.5–25.6)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
41.4
42.5
36.4
42.0
41.7
36.4
42.5

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(32.9–50.4)
(38.5–46.7)
(30.2–43.1)
(37.2–47.0)
—
—
—

26.6
34.5
36.3
23.3
31.7
26.1
29.5
24.5
28.7
28.7
24.5
26.1
26.1
28.7
20.9
24.8
24.9
23.6
21.8
24.5
24.5
30.0
26.1
24.5
31.4
33.8
27.8
33.8
27.8†
20.3†
38.9†

(23.4–30.0)
(30.5–38.8)
(34.4–38.3)
(22.1–24.6)
(29.9–33.6)
(24.2–28.0)
(26.8–32.3)
(22.3–26.9)
(26.5–31.0)
(26.5–31.0)
(22.3–26.9)
(24.5–27.8)
(24.5–27.8)
(26.5–31.0)
(17.0–25.5)
(21.7–28.2)
(23.4–26.3)
(21.4–25.9)
(20.5–23.2)
(22.3–26.9)
(22.3–26.9)
(28.3–31.9)
(24.5–27.8)
(22.3–26.9)
(29.8–33.1)
(32.3–35.4)
(26.5–29.2)
(32.3–35.4)
—
—
—

Abbreviations: AI = American Indian, A/PI= Asian/Pacific Islander, CI = confidence interval, and MMSA = metropolitan and micropolitan statistical area.
* Not applicable.
† Data from 2009 BRFSS from the 50 states and the District of Columbia.

26

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

%

(95% CI)

Surveillance Summaries

TABLE 14. Percentage of adults who reported having cardiovascular diseases,* in 28 Racial and Ethnic Approaches to Community Health
(REACH) U.S. communities, 2009, and in the comparison populations from the Behavioral Risk Factor Surveillance System (BRFSS), 2007–2009, by
race/ethnicity and sex — United States
REACH U.S. racial/ethnic populations
Black
Community
Men
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High
Women
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

Hispanic

BRFSS

A/PI

AI

MMSA/County/State

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

11.8
13.0
12.8
2.2
10.8
8.2
11.6
7.9
12.2
8.8
8.0
8.1
6.5
11.1
—
—
—
—
4.4
10.0
—
—
—
—
—
—
—
—
9.4
2.2
13.0

(8.8–15.7)
(9.6–17.5)
(9.7–16.6)
(1.1– 4.4)
(7.4–15.5)
(5.8–11.5)
(8.3–15.9)
(5.7–10.9)
(7.9–18.3)
(5.5–13.7)
(4.4–14.2)
(4.3–14.5)
(3.9–10.6)
(6.5–18.3)
—
—
—
—
(1.4–13.0)
(3.8–24.2)
—
—
—
—
—
—
—
—
—
—
—

—†
—
—
—
—
—
—
—
6.0
9.9
7.1
11.8
7.7
3.2
7.7
6.7
13.0
9.0
7.2
7.6
—
—
—
—
—
—
—
—
7.7
3.2
13.0

—
—
—
—
—
—
—
—
(3.3–10.9)
(5.0–18.7)
(2.9–16.0)
(7.5–18.0)
(4.6–12.7)
(1.3– 7.6)
(5.2–11.3)
(4.6– 9.5)
(9.7–17.2)
(6.5–12.3)
(2.8–17.3)
(5.0–11.4)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
4.8
6.3
7.7
14.3
6.9
6.3
—
—
—
—
6.6
4.8
14.3

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(2.9– 7.9)
(2.0–18.3)
(5.5–10.6)
(11.0–18.4)
(5.0– 9.5)
(4.1– 9.5)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
12.8
16.5
12.7
14.0
13.4
12.7
16.5

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(7.4–21.0)
(13.1–20.5)
(8.4–18.6)
(10.8–18.0)
—
—
—

8.4
9.3
14.1
7.5
10.2
6.9
10.2
5.9
6.9
6.9
5.9
7.0
7.0
6.9
5.4
7.7
8.2
8.8
6.1
5.9
5.9
7.0
7.0
5.9
9.8
11.3
9.5
11.3
8.8§
5.5§
13.6§

(6.7–10.5)
(7.0–12.4)
(12.9–15.3)
(6.8– 8.1)
(9.3–11.1)
(5.9– 7.9)
(8.6–11.9)
(5.0– 6.9)
(5.7– 8.2)
(5.7– 8.2)
(5.0– 6.9)
(6.2– 7.9)
(6.2– 7.9)
(5.7– 8.2)
(3.8– 7.5)
(6.2– 9.6)
(7.4– 9.1)
(7.4–10.4)
(5.4– 6.8)
(5.0– 6.9)
(5.0– 6.9)
(6.2– 8.0)
(6.2– 7.9)
(5.0– 6.9)
(9.0–10.8)
(10.5–12.2)
(8.8–10.2)
(10.5–12.2)
—
—
—

11.5
13.7
11.8
2.9
6.0
7.4
12.1
8.6
8.8
9.7
11.2
11.8
6.7
10.9
—
—
—
—
12.5
5.9
—
—
—
—
—
—
—
—
10.3
2.9
13.7

(9.2–14.3)
(11.3–16.5)
(9.4–14.7)
(1.6– 5.2)
(4.5– 8.1)
(5.9– 9.4)
(9.8–14.9)
(7.0–10.5)
(6.7–11.5)
(7.4–12.7)
(7.7–16.2)
(8.8–15.7)
(4.9– 9.2)
(7.1–16.4)
—
—
—
—
(7.2–20.7)
(2.2–15.0)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
4.3
5.6
2.8
10.7
8.3
8.6
5.3
3.5
8.2
6.1
2.5
5.7
—
—
—
—
—
—
—
—
5.7
2.5
10.7

—
—
—
—
—
—
—
—
(2.5– 7.2)
(3.4– 9.2)
(1.1– 7.1)
(7.5–15.0)
(5.8–11.7)
(5.6–13.0)
(3.7– 7.6)
(2.3– 5.2)
(6.3–10.6)
(4.6– 8.2)
(0.6–10.9)
(3.9– 8.3)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
2.7
4.0
3.5
8.4
4.7
4.7
—
—
—
—
4.4
2.7
8.4

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(1.5– 4.9)
(1.3–11.7)
(2.3– 5.3)
(6.4–10.9)
(3.2– 6.9)
(2.5– 8.4)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
11.8
13.5
12.7
11.1
12.3
11.1
13.5

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(7.7–17.5)
(11.2–16.1)
(8.7–18.3)
(8.8–13.8)
—
—
—

6.4
10.3
12.7
5.1
7.6
5.6
6.9
5.7
7.0
7.0
5.7
6.3
6.3
7.0
5.0
6.1
6.0
5.7
4.2
5.7
5.7
5.4
6.3
5.7
7.4
9.2
7.8
9.2
6.3§
4.2§
11.6§

(5.1– 7.9)
(8.4–12.4)
(11.8–13.6)
(4.6– 5.5)
(7.0– 8.2)
(4.9– 6.4)
(6.0– 8.0)
(4.9– 6.7)
(6.1– 8.0)
(6.1– 8.0)
(4.9– 6.7)
(5.6– 7.1)
(5.6– 7.1)
(6.1– 8.0)
(3.5– 7.2)
(5.0– 7.4)
(5.5– 6.6)
(4.9– 6.8)
(3.8– 4.7)
(4.9– 6.7)
(4.9– 6.7)
(4.7– 6.1)
(5.6– 7.1)
(4.9– 6.7)
(6.9– 8.0)
(8.6– 9.8)
(7.3– 8.3)
(8.6– 9.8)
—
—
—

Abbreviations: AI = American Indian, A/PI= Asian/Pacific Islander, CI = confidence interval, and MMSA = metropolitan and micropolitan statistical area.
* Had any of the following: heart attack or myocardial infarction, angina or coronary heart diseases, or stroke.
† Not applicable.
§ Data from 2009 BRFSS from the 50 states and the District of Columbia.

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

27

Surveillance Summaries

TABLE 15. Percentage of adults who have been told by a doctor that they have diabetes*, in 28 Racial and Ethnic Approaches to Community
Health (REACH) U.S. communities, 2009, and in the comparison populations from the Behavioral Risk Factor Surveillance System (BRFSS), 2007–2009,
by race/ethnicity and sex — United States
REACH U.S. racial/ethnic populations
Black
Community
Men
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High
Women
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

Hispanic

BRFSS

A/PI

AI

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

19.3
18.6
21.2
14.1
15.7
10.8
13.5
14.7
12.2
13.3
15.7
12.3

(15.0–24.4)
(14.5–23.6)
(16.9–26.4)
(10.3–19.1)
(11.8–20.6)
(7.9–14.6)
(9.9–18.2)
(11.4–18.9)
(8.5–17.1)
(9.2–18.8)
(10.8–22.2)
(7.8–18.8)

—†
—
—
—
—
—
—
—
9.8
10.2
9.0
12.5

—
—
—
—
—
—
—
—
(6.4–14.8)
(6.0–16.7)
(4.8–16.0)
(8.6–17.9)

—
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—

8.2
11.0
12.0
7.8
10.7
8.3
9.9
9.0
9.0
9.0
9.0
8.3

(6.6–10.3)
(8.3–14.4)
(10.9–13.2)
(7.1– 8.6)
(9.8–11.8)
(7.1– 9.6)
(8.4–11.7)
(7.9–10.4)
(7.6–10.6)
(7.6–10.6)
(7.9–10.4)
(7.3– 9.3)

13.9
21.7
—
—
—
—
9.3
3.6
—
—
—
—
—
—
—
—
14.0
3.6
21.7

(9.6–19.7)
(14.3–31.6)
—
—
—
—
(3.7–21.8)
(0.9–13.6)
—
—
—
—
—
—
—
—
—
—
—

9.1
8.6
12.1
14.3
16.4
12.8
4.9
9.7
—
—
—
—
—
—
—
—
10.0
4.9
16.4

(5.8–14.0)
(4.5–15.7)
(9.2–15.7)
(11.0–18.5)
(12.9–20.8)
(9.7–16.6)
(2.3–10.0)
(6.9–13.3)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
7.8
10.0
14.7
18.0
12.3
10.0
—
—
—
—
11.2
7.8
18.0

—
—
—
—
—
—
(5.4–11.2)
(4.1–22.4)
(11.1–19.1)
(14.3–22.4)
(9.5–15.7)
(7.4–13.4)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
30.4
11.6
23.1
12.9
18.0
11.6
30.4

—
—
—
—
—
—
—
—
—
—
—
—
(21.9–40.5)
(8.9–15.1)
(16.8–30.9)
(9.7–17.0)
—
—
—

8.3
9.0
6.8
10.4
8.4
6.7
6.7
9.0
9.0
7.8
8.3
9.0
9.2
11.1
10.0
11.1
8.8§
6.0§
13.1§

(7.3– 9.3)
(7.6–10.6)
(4.9– 9.4)
(8.0–13.4)
(7.6– 9.3)
(5.5– 8.1)
(5.9– 7.6)
(7.9–10.4)
(7.9–10.4)
(6.9– 8.8)
(7.3– 9.3)
(7.9–10.4)
(8.5– 9.9)
(10.2–12.0)
(9.3–10.8)
(10.2–12.0)
—
—
—

20.0
19.0
17.0
10.7
20.1
13.5
15.9
12.9
15.6
13.4
15.9
16.2
13.1
17.2
—
—
—
—
11.0
20.8
—
—
—
—
—
—
—
—
15.9
10.7
20.8

(17.2–23.2)
(16.1–22.2)
(14.1–20.4)
(8.1–14.1)
(17.1–23.4)
(11.2–16.1)
(13.3–18.9)
(10.8–15.3)
(12.8–18.8)
(10.7–16.7)
(12.0–20.8)
(12.7–20.4)
(9.6–17.7)
(12.6–23.1)
—
—
—
—
(6.3–18.4)
(12.7–32.1)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
7.4
14.1
10.3
14.5
14.9
11.8
12.8
12.9
15.9
12.5
4.5
11.7
—
—
—
—
—
—
—
—
12.7
4.5
15.9

—
—
—
—
—
—
—
—
(5.2–10.4)
(10.3–19.1)
(6.4–16.2)
(11.3–18.5)
(11.1–19.8)
(7.8–17.4)
(10.3–15.7)
(10.6–15.7)
(13.1–19.1)
(10.2–15.3)
(1.8–10.8)
(9.0–14.9)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
4.7
9.3
11.2
14.5
11.6
5.3
—
—
—
—
10.3
4.7
14.5

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(2.8– 7.7)
(4.1–19.6)
(8.6–14.5)
(11.8–17.7)
(9.1–14.6)
(3.4– 8.2)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
23.4
16.2
20.6
15.4
18.4
15.4
23.4

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(17.1–31.1)
(13.6–19.2)
(15.5–26.8)
(12.5–18.7)
—
—
—

6.7
12.1
12.3
6.4
9.8
8.3
8.5
8.8
9.1
9.1
8.8
8.4
8.4
9.1
8.4
6.8
8.1
7.4
5.2
8.8
8.8
8.9
8.4
8.8
9.7
10.1
8.5
10.1
8.2§
5.0§
12.9§

(5.5– 8.1)
(10.2–14.4)
(11.4–13.3)
(5.9– 6.9)
(9.1–10.5)
(7.5– 9.3)
(7.3– 9.8)
(7.7–10.0)
(8.0–10.3)
(8.0–10.3)
(7.7–10.0)
(7.6– 9.1)
(7.6– 9.1)
(8.0–10.3)
(6.2–11.2)
(5.5– 8.3)
(7.4– 8.8)
(6.4– 8.5)
(4.7– 5.8)
(7.7–10.0)
(7.7–10.0)
(8.0– 9.8)
(7.6– 9.1)
(7.7–10.0)
(9.1–10.4)
(9.4–10.7)
(7.9– 9.0)
(9.4–10.7)
—
—
—

Abbreviations: AI = American Indian, A/PI= Asian/Pacific Islander, CI = confidence interval, and MMSA = metropolitan and micropolitan statistical area.
* Did not include gestational diabetes, prediabetes, or borderline diabetes.
† Not applicable.
§ Data from 2009 BRFSS from the 50 states and the District of Columbia.

28

MMSA/County/State

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

Surveillance Summaries

TABLE 16. Percentage of adults who know signs and symptoms of heart attack, in 28 Racial and Ethnic Approaches to Community Health
(REACH) U.S. communities, 2009, and in the comparison populations from the Behavioral Risk Factor Surveillance System (BRFSS), 2007–2009, by
race/ethnicity and sex — United States
REACH U.S. racial/ethnic populations
Black
Community
Men
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High
Women
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

Hispanic

BRFSS

A/PI

AI

State

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

7.3
2.1
6.2
2.5
4.2
6.8
1.9
4.2
2.9
4.0
3.1
6.7
2.7
2.4
—
—
—
—
6.0
15.9
—
—
—
—
—
—
—
—
4.1
1.9
15.9

(4.3–12.2)
(1.0– 4.3)
(3.7–10.1)
(1.1– 5.8)
(2.1– 7.9)
(4.1–11.2)
(0.8– 4.2)
(2.3– 7.5)
(1.5– 5.6)
(1.9– 8.3)
(1.0– 9.3)
(3.2–13.5)
(1.2– 6.1)
(0.8– 7.3)
—
—
—
—
(2.2–15.4)
(6.7–33.2)
—
—
—
—
—
—
—
—
—
—
—

—*
—
—
—
—
—
—
—
3.6
3.2
0.0
2.5
2.6
3.1
4.6
5.6
8.0
2.0
5.4
2.2
—
—
—
—
—
—
—
—
3.2
0.0
8.0

—
—
—
—
—
—
—
—
(1.6– 8.0)
(1.2– 8.8)
—
(1.0– 6.4)
(0.9– 7.4)
(1.3– 7.5)
(3.0– 7.1)
(3.8– 8.3)
(5.4–11.8)
(0.9– 4.3)
(2.3–12.3)
(1.0– 4.8)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
5.9
9.1
3.1
7.5
4.2
5.6
—
—
—
—
5.8
3.1
9.1

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(3.7– 9.3)
(3.4–22.4)
(1.7– 5.5)
(5.1–10.8)
(2.4– 7.1)
(2.9–10.4)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
7.4
9.8
7.5
10.8
8.7
7.4
10.8

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(3.6–14.4)
(6.7–14.1)
(4.3–12.6)
(7.2–16.1)
—
—
—

9.7
10.4†
13.7
9.1
8.4
9.3
12.6
10.4†
10.4†
10.4†
10.4†
12.3
12.3
10.4†
10.4†
10.6
10.4†
9.1
15.0
10.4†
10.4†
7.7
12.3
10.4†
8.9†
8.2
11.4
8.2
10.4†
6.9†
15.0†

(8.5–11.2)
—
(11.9–15.7)
(7.4–11.2)
(7.1– 9.9)
(8.2–10.5)
(10.4–15.0)
—
—
—
—
(10.1–14.9)
(10.1–14.9)
—
—
(8.4–13.4)
—
(7.4–11.2)
(13.3–16.7)
—
—
(5.9– 9.8)
(10.1–14.9)
—
(8.0– 9.8)
(7.1– 9.5)
(9.2–14.0)
(7.1– 9.5)
—
—
—

5.7
7.7
7.6
3.2
6.5
6.1
5.7
7.4
6.8
7.6
7.2
7.3
3.0
6.9
—
—
—
—
10.2
11.6
—
—
—
—
—
—
—
—
7.1
3.0
11.6

(4.1– 8.0)
(5.7–10.4)
(5.6–10.2)
(1.5– 6.4)
(4.7– 9.1)
(4.2– 8.9)
(3.9– 8.1)
(5.5– 9.9)
(4.8– 9.5)
(5.3–10.8)
(4.2–12.0)
(4.5–11.6)
(1.5– 5.9)
(3.7–12.5)
—
—
—
—
(5.2–19.0)
(5.8–21.8)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
(0.9– 4.4)
(3.7–10.6)
(0.1– 1.2)
(2.3– 6.6)
(2.6– 8.6)
(2.4– 8.8)
(3.1– 6.7)
(7.3–12.6)
(9.5–16.2)
(2.7– 6.4)
(2.6–11.9)
(2.2– 5.6)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
10.0
8.5
4.9
4.8
3.1
4.0
—
—
—
—
4.9
3.1
10.0

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(7.3–13.7)
(3.5–19.2)
(3.0– 7.8)
(3.2– 7.1)
(1.8– 5.1)
(2.2– 7.1)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
11.6
11.1
15.8
15.4
13.5
11.1
15.8

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(7.1–18.5)
(8.7–14.1)
(11.5–21.5)
(12.1–19.4)
—
—
—

16.7
14.7†
18.1
17.7
13.8
13.3
16.7
†
14.7
14.7†
14.7†
14.7†
14.6
14.6
14.7†
14.7†
14.6
14.7†
17.7
19.6
14.7†
14.7†
10.4
14.6
14.7†
13.8
13.3
17.7
13.3
14.7†
10.0†
19.6†

(15.5–18.0)
—
(16.6–19.7)
(15.6–19.9)
(12.4–15.4)
(12.4–14.3)
(14.8–18.9)
—
—
—
—
(12.8–16.6)
(12.8–16.6)
—
—
(12.6–16.8)
—
(15.6–19.9)
(18.1–21.1)
—
—
(8.6–12.6)
(12.8–16.6)
—
(13.1–14.6)
(12.4–14.3)
(15.4–20.2)
(12.4–14.3)
—
—
—

—
—
—
—
—
—
—
—
2.0
6.3
0.3
3.9
4.8
4.7
4.6
9.6
12.5
4.2
5.7
3.5
—
—
—
—
—
—
—
—
4.7
0.3
12.5

Abbreviations: AI = American Indian, A/PI= Asian/Pacific Islander, CI = confidence interval, and MMSA = metropolitan and micropolitan statistical area.
* Not applicable.
† Data from 2009 BRFSS from 33 states (Alabama, Arizona, Connecticut, Florida, Georgia, Hawaii, Idaho, Indiana, Iowa, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan,
Minnesota, Mississippi, Missouri, Montana, Nebraska, New York, North Carolina, Ohio, Oklahoma, Rhode Island, South Carolina, Tennessee, Texas, Utah, Virginia, Washington, West Virginia,
and Wisconsin) and the District of Columbia.

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

29

Surveillance Summaries

TABLE 17. Percentage of adults who know signs and symptoms of stroke, in 28 Racial and Ethnic Approaches to Community Health (REACH)
U.S. communities, 2009, and in the comparison populations from the Behavioral Risk Factor Surveillance System (BRFSS), 2007–2009, by race/
ethnicity and sex — United States
REACH U.S. racial/ethnic populations
Black
Community
Men
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High
Women
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

Hispanic

BRFSS

A/PI

AI

State

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

7.7
7.3
11.8
3.4
9.3
13.8
6.2
12.6
2.7
5.9
10.4
9.1
5.0
8.4
—
—
—
—
11.2
8.2
—
—
—
—
—
—
—
—
8.3
2.7
13.8

(4.8–12.3)
(4.7–11.2)
(8.2–16.6)
(1.5– 7.7)
(6.0–14.3)
(9.7–19.3)
(3.6–10.6)
(9.0–17.4)
(1.3– 5.5)
(3.4– 9.9)
(5.4–19.0)
(4.9–16.2)
(1.9–12.4)
(3.9–17.3)
—
—
—
—
(4.3–26.0)
(2.7–22.6)
—
—
—
—
—
—
—
—
—
—
—

—*
—
—
—
—
—
—
—
6.5
15.4
3.9
5.5
1.3
3.8
11.4
12.1
11.9
7.3
10.4
9.9
—
—
—
—
—
—
—
—
8.6
1.3
15.4

—
—
—
—
—
—
—
—
(3.4–12.0)
(8.3–26.8)
(1.2–11.5)
(2.5–11.5)
(0.4– 4.1)
(1.4–10.0)
(8.3–15.4)
(8.8–16.3)
(8.5–16.3)
(4.8–11.1)
(5.8–18.1)
(6.7–14.4)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
12.4
7.2
7.1
8.5
6.4
10.0
—
—
—
—
7.9
6.4
12.4

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(8.9–16.9)
(2.1–21.8)
(4.5–10.9)
(5.9–12.1)
(4.3– 9.5)
(6.8–14.5)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
15.5
15.5
13.4
13.1
14.5
13.1
15.5

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(8.6–26.4)
(11.6–20.5)
(8.6–20.1)
(9.5–17.9)
—
—
—

21.6
19.4†
19.2
20.8
15.8
19.2
20.0
19.4†
19.4†
19.4†
19.4†
18.8
18.8
19.4†
19.4†
19.3
19.4†
20.8
27.9
19.4†
19.4†
14.5
18.8
19.4†
16.9
13.6
20.8
13.6
19.4†
14.4†
27.9†

(19.4–23.9)
—
(17.1–21.5)
(17.9–23.9)
(13.9–17.9)
(17.5–21.0)
(17.4–23.0)
—
—
—
—
(16.2–21.6)
(16.2–21.6)
—
—
(15.9–23.1)
—
(17.9–23.9)
(25.8–30.1)
—
—
(12.1–17.1)
(16.2–21.6)
—
(15.7–18.1)
(12.2–15.1)
(17.7–24.3)
(12.2–15.1)
—
—
—

10.7
13.6
11.4
8.4
11.2
8.4
10.8
10.2
11.4
15.4
10.6
8.2
6.9
9.8
—
—
—
—
18.5
10.4
—
—
—
—
—
—
—
—
10.7
6.9
18.5

(8.2–13.8)
(10.8–16.9)
(8.9–14.6)
(5.7–12.2)
(8.8–14.1)
(6.1–11.5)
(8.4–13.9)
(7.8–13.2)
(8.7–14.8)
(12.0–19.5)
(7.0–15.8)
(5.6–11.8)
(4.2–11.3)
(5.7–16.1)
—
—
—
—
(11.5–28.6)
(5.0–20.4)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
5.6
8.6
1.1
3.5
3.0
6.5
10.8
13.7
13.2
5.3
11.6
7.4
—
—
—
—
—
—
—
—
7.0
1.1
13.7

—
—
—
—
—
—
—
—
(3.4– 9.0)
(5.0–14.4)
(0.3– 4.1)
(1.9– 6.4)
(1.0– 8.5)
(3.5–11.9)
(8.4–13.8)
(10.9–17.2)
(10.3–16.9)
(3.7– 7.7)
(6.6–19.6)
(5.2–10.3)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
17.1
7.1
6.8
8.1
8.8
9.2
—
—
—
—
8.5
6.8
17.1

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(13.3–21.8)
(2.6–18.2)
(4.5–10.3)
(5.9–11.1)
(6.5–11.8)
(6.5–12.8)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
13.3
14.4
16.4
19.1
15.4
13.3
19.1

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(8.3–20.7)
(11.6–17.8)
(11.8–22.4)
(15.5–23.2)
—
—
—

23.6
21.0†
21.1
24.0
19.3
20.0
19.9
21.0†
21.0†
21.0†
21.0†
19.1
19.1
21.0†
21.0†
21.0
21.0†
24.0
26.8
21.0†
21.0†
16.1
19.1
21.0†
20.0
17.6
23.4
17.6
21.0†
16.1†
26.8†

(22.1–25.2)
—
(19.5–22.8)
(21.7–26.5)
(17.6–21.0)
(18.8–21.2)
(17.8–22.1)
—
—
—
—
(17.1–21.3)
(17.1–21.3)
—
—
(18.4–23.9)
—
(21.7–26.5)
(25.1–28.6)
—
—
(13.8–18.7)
(17.1–21.3)
—
(19.1–20.9)
(16.5–18.7)
(21.0–26.1)
(16.5–18.7)
—
—
—

Abbreviations: AI = American Indian, A/PI= Asian/Pacific Islander, CI = confidence interval, and MMSA = metropolitan and micropolitan statistical area.
* Not applicable.
† Data from 2009 BRFSS from 33 states (Alabama, Arizona, Connecticut, Florida, Georgia, Hawaii, Idaho, Indiana, Iowa, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan,
Minnesota, Mississippi, Missouri, Montana, Nebraska, New York, North Carolina, Ohio, Oklahoma, Rhode Island, South Carolina, Tennessee, Texas, Utah, Virginia, Washington, West Virginia,
and Wisconsin) and the District of Columbia.

30

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

Surveillance Summaries

TABLE 18. Percentage of adults who had cholesterol checked during the preceding 5 years, in 28 Racial and Ethnic Approaches to Community
Health (REACH) U.S. communities, 2009, and in the comparison populations from the Behavioral Risk Factor Surveillance System (BRFSS), 2007–2009,
by race/ethnicity and sex — United States
REACH U.S. racial/ethnic populations
Black
Community
Men
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High
Women
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

Hispanic

BRFSS

A/PI

AI

MMSA/County/State

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

74.6
73.9
74.9
68.6
81.0
70.3
69.1
75.8
67.0
65.6
67.9
80.7
80.1
80.4
—
—
—
—
71.5
73.2
—
—
—
—
—
—
—
—
73.6
65.6
81.0

(67.8–80.5)
(67.2–79.7)
(68.1–80.7)
(60.4–75.8)
(74.0–86.5)
(64.0–75.9)
(62.0–75.4)
(69.1–81.3)
(57.9–75.0)
(56.7–73.5)
(57.0–77.2)
(69.3–88.6)
(71.5–86.6)
(67.6–89.0)
—
—
—
—
(54.8–83.9)
(58.7–84.0)
—
—
—
—
—
—
—
—
—
—
—

—*
—
—
—
—
—
—
—
60.5
63.1
41.0
60.5
60.9
76.4
59.5
63.3
70.4
57.1
45.3
60.5
—
—
—
—
—
—
—
—
60.5
41.0
76.4

—
—
—
—
—
—
—
—
(52.5–68.0)
(50.7–74.0)
(29.9–53.1)
(51.6–68.7)
(51.1–69.8)
(65.6–84.7)
(53.5–65.3)
(57.2–68.9)
(64.5–75.7)
(50.9–63.0)
(36.2–54.7)
(54.3–66.5)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
71.5
71.8
77.8
72.1
77.8
73.4
—
—
—
—
72.8
71.5
77.8

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(65.1–77.2)
(49.6–86.8)
(72.0–82.7)
(66.6–77.1)
(72.7–82.2)
(66.3–79.4)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
80.7
64.2
61.3
65.8
65.0
61.3
80.7

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(70.3–88.1)
(58.2–69.8)
(52.3–69.6)
(58.9–72.1)
—
—
—

79.9
73.9
78.6
82.3
76.0
76.9
77.2
71.5
74.8
74.8
71.5
80.7
80.7
74.8
75.2
73.3
70.0
81.6
74.8
71.5
71.5
74.2
80.7
71.5
75.2
72.0
76.5
72.0
74.4†
67.5†
83.8†

(73.9–84.8)
(66.5–80.1)
(75.7–81.2)
(80.3–84.1)
(73.1–78.7)
(72.8–80.5)
(72.8–81.2)
(67.9–74.9)
(71.2–78.1)
(71.2–78.1)
(67.9–74.9)
(78.2–82.9)
(78.2–82.9)
(71.2–78.1)
(67.7–81.4)
(66.8–78.9)
(67.1–72.6)
(77.4–85.2)
(72.4–77.1)
(67.9–74.9)
(67.9–74.9)
(71.7–76.5)
(78.2–82.9)
(67.9–74.9)
(72.4–77.8)
(69.4–74.5)
(74.1–78.7)
(69.4–74.5)
—
—
—

80.4
83.4
78.1
66.7
82.3
72.1
77.3
82.2
83.1
80.5
79.7
79.7
80.9
87.2
—
—
—
—
70.2
89.7
—
—
—
—
—
—
—
—
80.5
66.7
89.7

(76.6–83.7)
(79.8–86.4)
(73.7–81.9)
(60.4–72.4)
(78.4–85.6)
(67.5–76.4)
(73.2–80.9)
(78.3–85.5)
(78.5–86.9)
(75.5–84.6)
(72.3–85.6)
(74.4–84.2)
(74.5–86.0)
(80.1–92.0)
—
—
—
—
(58.3–79.9)
(78.6–95.4)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
70.7
73.8
57.0
69.7
67.4
72.1
63.2
67.3
72.8
65.1
52.0
65.3
—
—
—
—
—
—
—
—
67.4
52.0
73.8

—
—
—
—
—
—
—
—
(64.9–75.9)
(65.7–80.5)
(46.2–67.2)
(64.0–74.9)
(60.0–74.0)
(64.4–78.7)
(58.7–67.4)
(62.8–71.5)
(68.1–77.0)
(60.6–69.4)
(40.9–62.9)
(60.6–69.7)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
76.1
82.4
82.6
76.8
78.8
74.8
—
—
—
—
77.8
74.8
82.6

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(70.1–81.2)
(72.2–89.5)
(77.5–86.7)
(72.6–80.5)
(74.7–82.3)
(69.5–79.4)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
79.5
72.5
78.5
72.4
75.5
72.4
79.5

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(70.5–86.3)
(68.0–76.5)
(72.1–83.7)
(67.5–76.8)
—
—
—

80.6
80.4
82.1
86.0
81.9
80.9
80.1
80.4
77.8
77.8
80.4
83.0
83.0
77.8
81.1
77.2
73.9
85.2
77.8
80.4
80.4
79.7
83.0
80.4
81.2
76.9
82.6
76.9
79.2†
67.6†
86.6†

(76.3–84.3)
(75.4–84.6)
(80.1–83.9)
(84.4–87.4)
(79.8–83.9)
(78.3–83.2)
(76.9–82.9)
(77.9–82.6)
(75.1–80.3)
(75.1–80.3)
(77.9–82.6)
(81.1–84.7)
(81.1–84.7)
(75.1–80.3)
(75.4–85.8)
(72.3–81.5)
(71.8–76.0)
(81.9–87.9)
(75.7–79.8)
(77.9–82.6)
(77.9–82.6)
(77.6–81.6)
(81.1–84.7)
(77.9–82.6)
(79.2–83.1)
(75.2–78.5)
(80.9–84.2)
(75.2–78.5)
—
—
—

Abbreviations: AI = American Indian, A/PI= Asian/Pacific Islander, CI = confidence interval, and MMSA = metropolitan and micropolitan statistical area.
* Not applicable.

† Data from 2009 BRFSS from the 50 states and the District of Columbia.

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

31

Surveillance Summaries

TABLE 19. Percentage of adults with hypertension who are taking medication for high blood pressure, in 28 Racial and Ethnic Approaches to
Community Health (REACH) U.S. communities, 2009, and in the comparison populations from the Behavioral Risk Factor Surveillance System
(BRFSS), 2007–2009, by race/ethnicity — United States
REACH U.S. racial/ethnic populations
Black
Community
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

Hispanic

BRFSS

A/PI

AI

MMSA/County/State

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

81.8
81.8
85.0
86.3
86.8
74.2
79.6
80.7
71.6
79.0
82.2
80.8
74.9
83.8
—
—
—
—
81.2
80.7
—
—
—
—
—
—
—
—
81.0
71.6
86.8

(77.6–85.4)
(77.4–85.5)
(80.6–88.5)
(79.5–91.1)
(82.4–90.2)
(68.4–79.3)
(74.4–84.0)
(76.1–84.6)
(64.2–77.9)
(72.4–84.3)
(74.2–88.1)
(74.1–86.1)
(67.3–81.2)
(74.4–90.2)
—
—
—
—
(65.7–90.7)
(65.1–90.4)
—
—
—
—
—
—
—
—
—
—
—

—*
—
—
—
—
—
—
—
51.4
73.7
59.2
74.7
71.7
68.3
68.6
77.3
72.5
68.7
61.3
65.4
—
—
—
—
—
—
—
—
68.7
51.4
77.3

—
—
—
—
—
—
—
—
(40.9–61.8)
(60.2–83.8)
(44.3–72.5)
(66.5–81.4)
(62.5–79.5)
(54.6–79.4)
(62.3–74.3)
(71.4–82.3)
(66.8–77.6)
(62.6–74.3)
(43.3–76.7)
(57.9–72.3)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
72.9
78.1
88.3
78.5
76.3
70.7
—
—
—
—
77.2
70.7
88.3

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(64.1–80.2)
(52.6–92.0)
(83.3–92.0)
(73.5–82.8)
(70.2–81.5)
(62.3–77.9)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
77.4
77.2
73.7
76.0
76.6
73.7
77.4

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(67.3–85.0)
(71.9–81.7)
(65.0–80.9)
(69.8–81.2)
—
—
—

82.7
78.3
82.3
76.4
80.9
78.9
78.7
67.7
78.3
78.3
67.7
78.3
78.3
78.3
77.9
79.3
73.3
82.8
71.2
67.7
67.7
78.6
78.3
67.7
81.6
79.3
79.2
79.3
79.2†
66.9†
86.7†

(77.6–86.8)
(72.0–83.5)
(79.8–84.6)
(73.7–78.9)
(77.9–83.6)
(74.9–82.5)
(74.2–82.6)
(63.4–71.7)
(74.3–81.7)
(74.3–81.7)
(63.4–71.7)
(75.3–81.0)
(75.3–81.0)
(74.3–81.7)
(70.0–84.2)
(73.7–84.0)
(70.4–75.9)
(78.8–86.2)
(68.5–73.8)
(63.4–71.7)
(63.4–71.7)
(76.2–80.9)
(75.3–81.0)
(63.4–71.7)
(79.4–83.6)
(77.2–81.3)
(77.0–81.3)
(77.2–81.3)
—
—
—

Abbreviations: AI = American Indian, A/PI= Asian/Pacific Islander, CI = confidence interval, and MMSA = metropolitan and micropolitan statistical area.
* Not applicable.
† Data from 2009 BRFSS from the 50 states and the District of Columbia.

32

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

Surveillance Summaries

TABLE 20. Percentage of adults with diabetes who had a glycosylated hemoglobin (HbA1C) test during the preceding 12 months, in 28 Racial
and Ethnic Approaches to Community Health (REACH) U.S. communities, 2009, and in the comparison populations from the Behavioral Risk
Factor Surveillance System (BRFSS), 2007–2009, by race/ethnicity — United States
REACH U.S. racial/ethnic populations
Black
Community
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

Hispanic

%

(95% CI)

%

(95% CI)

65.9
78.6
85.3
57.1
79.2
78.8
66.2
72.3
76.0
83.7
62.2
65.0
68.7
70.8
—
—
—
—

(58.7–72.4)
(71.8–84.1)
(79.8–89.5)
(46.7–66.9)
(72.5–84.6)
(71.3–84.9)
(58.2–73.4)
(65.2–78.4)
(68.3–82.4)
(75.3–89.6)
(51.2–72.1)
(53.2–75.2)
(57.3–78.2)
(57.3–81.4)
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—

—*
—
—
—
—
—
—
—
64.1
62.6
64.1
55.5
55.4
53.7
68.0
72.7
78.6
67.9

—
—
—
—
—
—
—
—
(48.7–77.1)
(48.3–75.0)
(44.9–79.6)
(44.2–66.3)
(42.7–67.3)
(36.5–70.0)
(59.8–75.2)
(64.3–79.7)
(71.7–84.1)
(59.2–75.4)
—
(53.2–73.1)
—
—
—
—
—
—
—
—
—
—
—

†
†

—
—
—
—
—
—
—
—
71.6
57.1
85.3

†

63.7
—
—
—
—
—
—
—
—
64.1
53.7
78.6

BRFSS

A/PI
%

(95% CI)

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
81.8 (66.9–90.9)
†
—
70.4 (62.0–77.7)
82.1 (75.0–87.6)
63.3 (54.2–71.6)
61.3 (48.4–72.9)
—
—
—
—
—
—
—
—
70.4
—
61.3
—
82.1
—

AI
%
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
87.2
81.6
72.0
77.4
79.5
72.0
87.2

(95% CI)

State
%

—
78.6
—
79.5
—
79.1
—
84.0
—
76.0
—
78.5
—
78.0
—
87.3
—
80.9
—
80.9
—
87.3
—
77.0
—
77.0
—
80.9
—
87.3
—
75.3
—
76.7
—
84.0
—
84.4
—
87.3
—
87.3
—
76.4
—
77.0
—
87.3
(75.8–93.7) 76.3
(75.1–86.6) 75.7
(60.6–81.1) 75.4
(69.4–83.8) 75.7
—
79.7§
—
71.2§
—
91.4§

(95% CI)
(75.8–81.0)
(77.1–81.8)
(76.8–81.1)
(81.2–86.4)
(74.0–77.9)
(75.9–80.8)
(74.8–81.0)
(84.2–89.8)
(76.5–84.7)
(76.5–84.7)
(84.2–89.8)
(71.2–81.9)
(71.2–81.9)
(76.5–84.7)
(84.2–89.8)
(71.4–78.8)
(74.0–79.3)
(81.2–86.4)
(83.2–85.6)
(84.2–89.8)
(84.2–89.8)
(73.0–79.6)
(71.2–81.9)
(84.2–89.8)
(74.4–78.2)
(72.3–78.8)
(72.3–78.3)
(72.3–78.8)
—
—
—

Abbreviations: AI = American Indian, A/PI= Asian/Pacific Islander, CI = confidence interval, and MMSA = metropolitan and micropolitan statistical area.
* Not applicable.
† Sample size <30; data not reported.
§ Data from 2009 BRFSS from 45 states (all states except Arkansas, Idaho, Missouri, Oklahoma, and South Dakota) and the District of Columbia.

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

33

Surveillance Summaries

TABLE 21. Percentage of adults with diabetes who had their feet checked by a health professional during the preceding 12 months, in 28 Racial
and Ethnic Approaches to Community Health (REACH) U.S. communities, 2009, and in the comparison populations from the Behavioral Risk
Factor Surveillance System (BRFSS), 2007–2009, by race/ethnicity — United States
REACH U.S. racial/ethnic populations
Black
Community
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

Hispanic

%

(95% CI)

%

(95% CI)

78.0
79.8
82.1
72.3
85.9
84.9
78.4
77.5
87.4
81.9
80.1
84.3
86.7
84.8
—
—
—
—

(70.8–83.8)
(72.6–85.4)
(76.0–86.9)
(61.6–81.0)
(80.1–90.3)
(76.9–90.5)
(70.0–85.0)
(70.1–83.4)
(80.7–92.1)
(72.6–88.5)
(68.1–88.4)
(72.8–91.5)
(76.5–92.9)
(72.5–92.2)
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—

—*
—
—
—
—
—
—
—
58.3
67.5
65.3
62.9
73.8
70.1
72.3
73.3
74.2
68.7

—
—
—
—
—
—
—
—
(42.0–73.0)
(52.9–79.3)
(45.0–81.3)
(51.0–73.4)
(58.5–84.9)
(50.6–84.2)
(63.9–79.4)
(65.4–80.0)
(66.8–80.5)
(59.7–76.5)
—
(56.4–76.3)
—
—
—
—
—
—
—
—
—
—
—

†
†

—
—
—
—
—
—
—
—
82.0
72.3
87.4

†

67.1
—
—
—
—
—
—
—
—
68.7
58.3
74.2

BRFSS

A/PI
%

(95% CI)

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
75.3 (59.1–86.5)
†
—
72.9 (63.4–80.6)
81.5 (73.9–87.3)
60.7 (51.3–69.4)
61.4 (48.0–73.3)
—
—
—
—
—
—
—
—
72.9
—
60.7
—
81.5
—

AI

State

%

(95% CI)

%

(95% CI)

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
83.3
75.3
83.6
77.3
80.3
75.3
83.6

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(70.8–91.1)
(67.4–81.9)
(72.6–90.8)
(68.5–84.2)
—
—
—

73.1
77.3
69.4
81.2
72.9
72.4
72.9
64.4
72.3
72.3
64.4
77.7
77.7
72.3
64.4
66.6
74.1
81.2
74.5
64.4
64.4
74.8
77.7
64.4
76.4
66.8
70.4
66.8
73.4§
63.2§
86.3§

(70.2–75.7)
(74.9–79.6)
(66.9–71.9)
(77.9–84.2)
(70.7–75.0)
(69.7–74.9)
(69.3–76.2)
(60.5–68.1)
(67.3–76.7)
(67.3–76.7)
(60.5–68.1)
(72.0–82.6)
(72.0–82.6)
(67.3–76.7)
(60.5–68.1)
(62.1–70.7)
(71.4–76.7)
(77.9–84.2)
(73.0–75.9)
(60.5–68.1)
(60.5–68.1)
(71.6–77.8)
(72.0–82.6)
(60.5–68.1)
(74.3–78.3)
(63.0–70.4)
(67.1–73.5)
(63.0–70.4)
—
—
—

Abbreviations: AI = American Indian, A/PI= Asian/Pacific Islander, CI = confidence interval, and MMSA = metropolitan and micropolitan statistical area.
* Not applicable.
† Sample size <30; data not reported.
§ Data from 2009 BRFSS from 45 states (all states except Arkansas, Idaho, Missouri, Oklahoma, and South Dakota) and the District of Columbia.

34

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

Surveillance Summaries

TABLE 22. Percentage of adults with diabetes who had a dilated eye exam during the preceding 12 months, in 28 Racial and Ethnic Approaches
to Community Health (REACH) U.S. communities, 2009, and in the comparison populations from the Behavioral Risk Factor Surveillance System
(BRFSS), 2007–2009, by race/ethnicity — United States
REACH U.S. racial/ethnic populations
Black
REACH U.S. community
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

Hispanic

BRFSS

A/PI

AI

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

67.9
74.0
65.4
87.2
75.3
72.9
79.8
71.2
77.5
76.5
73.3
82.9
79.2
69.0
—
—
—
—

(60.7–74.4)
(66.4–80.3)
(57.1–72.9)
(77.5–93.1)
(68.2–81.2)
(64.5–80.0)
(71.8–86.0)
(63.3–78.0)
(68.6–84.5)
(64.9–85.2)
(59.6–83.7)
(72.1–90.1)
(66.4–88.0)
(53.5–81.2)
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—

—*
—
—
—
—
—
—
—
50.8
66.5
61.6
74.2
71.5
67.3
61.9
72.3
72.6
85.6

—
—
—
—
—
—
—
—
(35.7–65.8)
(51.4–78.8)
(42.1–78.1)
(63.1–82.9)
(58.2–81.9)
(49.7–81.1)
(52.8–70.2)
(62.7–80.3)
(64.3–79.7)
(77.9–90.9)
—
(61.0–79.8)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
78.3

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(61.3–89.1)
—
(68.7–86.4)
(76.6–88.7)
(68.8–84.4)
(50.2–74.9)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
76.3
71.0
80.4
69.4
73.7
69.4
80.4

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(64.0–85.4)
(63.2–77.7)
(69.4–88.2)
(60.9–76.7)
—
—
—

†
†

—
—
—
—
—
—
—
—
74.7
65.4
87.2

†

71.3
—
—
—
—
—
—
—
—
71.3
50.8
85.6

†

78.9
83.5
77.5
63.4
—
—
—
—
78.3
63.4
83.5

State
%
71.4
73.1
66.6
77.3
67.6
69.6
68.7
70.0
64.8
64.8
70.0
74.2
74.2
64.8
70.0
71.4
69.0
77.3
71.3
70.0
70.0
72.4
74.2
70.0
69.6
62.3
69.9
62.3
69.2§
58.4§
81.8§

(95% CI)
(68.5–74.1)
(70.8–75.3)
(64.0–69.1)
(73.7–80.6)
(65.3–69.9)
(66.8–72.2)
(65.0–72.2)
(66.1–73.6)
(59.5–69.8)
(59.5–69.8)
(66.1–73.6)
(67.6–79.8)
(67.6–79.8)
(59.5–69.8)
(66.1–73.6)
(67.1–75.3)
(66.2–71.7)
(73.7–80.6)
(69.7–72.8)
(66.1–73.6)
(66.1–73.6)
(69.1–75.5)
(67.6–79.8)
(66.1–73.6)
(67.5–71.6)
(58.4–66.0)
(66.6–73.0)
(58.4–66.0)
—
—
—

Abbreviations: AI = American Indian, A/PI= Asian/Pacific Islander, CI = confidence interval, and MMSA = metropolitan and micropolitan statistical area.
* Not applicable.
† Sample size <30; data not reported.
§ Data from 2009 BRFSS from 45 states (all states except Arkansas, Idaho, Missiouri, Oklahoma, and South Dakota) and the District of Columbia.

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

35

Surveillance Summaries

TABLE 23. Percentage of women aged ≥40 who reported having received a mammogram during the previous 2 years, in 28 Racial and Ethnic
Approaches to Community Health (REACH) U.S. communities, 2009, and in the comparison populations from the Behavioral Risk Factor Surveillance
System (BRFSS), 2007–2009, by race/ethnicity — United States
REACH U.S. racial/ethnic populations
Black
Community
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

Hispanic

BRFSS

A/PI

%

(95% CI)

%

(95% CI)

%

76.5
79.5
81.5
87.6
86.7
78.8
82.2
81.1
80.3
83.2
78.1
84.1
79.0
83.2
—
—
—
—
70.7
78.3
—
—
—
—
—
—
—
—
80.7
70.7
87.6

(72.4–80.1)
(75.8–82.8)
(77.5–85.0)
(82.4–91.3)
(83.1–89.7)
(74.8–82.4)
(78.1–85.6)
(77.7–84.1)
(75.8–84.1)
(78.6–87.0)
(71.3–83.7)
(78.4–88.5)
(73.1–83.8)
(75.8–88.7)
—
—
—
—
(57.9–80.9)
(64.8–87.6)
—
—
—
—
—
—
—
—
—
—
—

—*
—
—
—
—
—
—
—
77.1
75.1
80.9
82.9
88.8
77.4
83.6
82.0
71.9
93.5
66.3
77.9
—
—
—
—
—
—
—
—
79.4
66.3
93.5

—
—
—
—
—
—
—
—
(69.4–83.4)
(66.8–81.9)
(70.2–88.3)
(77.1–87.4)
(83.6–92.5)
(67.7–84.8)
(79.3–87.1)
(78.5–85.1)
(67.4–75.9)
(90.4–95.6)
(51.4–78.5)
(72.3–82.6)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
79.4
78.5
80.2
84.9
75.0
80.3
—
—
—
—
79.8
75.0
84.9

(95% CI)

AI
%

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(73.3–84.3) —
(63.2–88.5) —
(74.8–84.7) —
(81.0–88.1) —
(69.6–79.7) —
(75.1–84.7) —
—
69.4
—
72.3
—
76.2
—
73.0
—
72.7
—
69.4
—
76.2

State

(95% CI)

%

(95% CI)

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(59.6–77.7)
(68.2–76.1)
(67.5–83.2)
(68.0–77.5)
—
—
—

85.3
83.5
82.5
89.6
82.6
84.7
82.3
86.7
83.2
83.2
86.7
86.1
86.1
83.2
86.7
85.0
79.5
89.6
82.8
86.7
86.7
83.4
86.1
86.7
85.2
76.9
84.9
76.9
83.2†
75.6†
89.6†

(83.3–87.2)
(82.2–84.8)
(80.5–84.3)
(88.6–90.5)
(80.8–84.2)
(83.6–85.6)
(81.0–83.6)
(85.4–87.8)
(81.4–84.8)
(81.4–84.8)
(85.4–87.8)
(84.7–87.4)
(84.7–87.4)
(81.4–84.8)
(85.4–87.8)
(82.5–87.2)
(77.5–81.3)
(88.6–90.5)
(81.8–83.7)
(85.4–87.8)
(85.4–87.8)
(82.3–84.4)
(84.7–87.4)
(85.4–87.8)
(84.1–86.2)
(75.3–78.5)
(83.6–86.1)
(75.3–78.5)
—
—
—

Abbreviations: AI = American Indian, A/PI= Asian/Pacific Islander, CI = confidence interval, and MMSA = metropolitan and micropolitan statistical area.
* Not applicable.
† Data from 2008 BRFSS from the 50 states and the District of Columbia.

36

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

Surveillance Summaries

TABLE 24. Percentage of women who reported having a Papanicolaou (Pap) smear test during the previous 3 years, in 28 Racial and Ethnic
Approaches to Community Health (REACH) U.S. communities, 2009, and in the comparison populations from the Behavioral Risk Factor Surveillance
System (BRFSS), 2007–2009, by race/ethnicity — United States
REACH U.S. racial/ethnic populations
Black
Community
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

Hispanic

BRFSS

A/PI

AI

State

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

85.0
86.0
87.0
81.2
85.6
89.4
87.0
82.1
84.7
84.9
83.4
85.0
84.5
90.6
—
—
—
—
86.5
75.6
—
—
—
—
—
—
—
—
85.0
75.6
90.6

(81.2–88.1)
(82.5–89.0)
(82.7–90.3)
(75.6–85.7)
(81.5–88.8)
(86.0–92.1)
(83.3–90.0)
(77.8–85.7)
(79.7–88.7)
(80.1–88.6)
(75.7–89.0)
(79.5–89.2)
(78.2–89.2)
(83.6–94.8)
—
—
—
—
(75.2–93.1)
(58.8–87.1)
—
—
—
—
—
—
—
—
—
—
—

—*
—
—
—
—
—
—
—
82.4
76.6
85.2
81.0
85.4
77.6
88.1
78.2
79.7
91.4
83.8
84.6
—
—
—
—
—
—
—
—
83.1
76.6
91.4

—
—
—
—
—
—
—
—
(76.5–87.1)
(68.5–83.1)
(76.1–91.3)
(75.2–85.7)
(77.7–90.7)
(68.7–84.5)
(84.4–91.1)
(73.6–82.1)
(74.7–84.0)
(87.9–94.0)
(72.4–91.1)
(80.3–88.1)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
74.2
75.5
74.5
80.8
60.3
69.7
—
—
—
—
74.4
60.3
80.8

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(67.7–79.8)
(62.4–85.2)
(68.6–79.6)
(76.5–84.5)
(55.2–65.2)
(63.8–75.0)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
84.9
79.4
88.5
82.1
83.5
79.4
88.5

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(75.3–91.2)
(74.4–83.7)
(82.1–92.7)
(76.7–86.4)
—
—
—

83.2
82.0
80.8
87.6
86.1
86.9
82.7
84.1
83.8
83.8
84.1
83.3
83.3
83.8
84.1
82.3
80.7
87.6
82.7
84.1
84.1
82.4
83.3
84.1
86.9
81.4
80.1
81.4
82.9†
74.0†
88.9†

(79.5–86.3)
(80.3–83.6)
(78.3–83.1)
(86.3–88.8)
(84.1–87.8)
(85.7–87.9)
(81.0–84.2)
(82.5–85.6)
(81.6–85.7)
(81.6–85.7)
(82.5–85.6)
(81.4–85.1)
(81.4–85.1)
(81.6–85.7)
(82.5–85.6)
(78.1–85.9)
(77.6–83.5)
(86.3–88.8)
(81.4–83.8)
(82.5–85.6)
(82.5–85.6)
(81.2–83.6)
(81.4–85.1)
(82.5–85.6)
(85.5–88.2)
(79.6–83.0)
(78.4–81.6)
(79.6–83.0)
—
—
—

Abbreviations: AI = American Indian, A/PI= Asian/Pacific Islander, CI = confidence interval, and MMSA = metropolitan and micropolitan statistical area.
* Not applicable.
† Data from 2008 BRFSS from the 50 states and the District of Columbia.

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

37

Surveillance Summaries

TABLE 25. Percentage of adults aged ≥65 years who had received an influenza vaccination during the preceding 12 months, in 28 Racial and
Ethnic Approaches to Community Health (REACH) U.S. communities, 2009, and in the comparison populations from the Behavioral Risk Factor
Surveillance System (BRFSS), 2007–2009, by race/ethnicity — United States
REACH U.S. racial/ethnic populations
Black
Community
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

Hispanic

%

(95% CI)

%

(95% CI)

50.9
59.8
62.4
65.6
57.2
54.4
61.6
56.8
52.5
49.8
59.5
63.2
57.4
43.9
—
—
—
—

(45.1–56.7)
(53.6–65.7)
(56.4–68.1)
(55.8–74.2)
(51.3–62.9)
(47.6–61.0)
(55.6–67.3)
(52.3–61.2)
(45.2–59.6)
(42.6–57.1)
(53.7–65.1)
(53.9–71.5)
(49.1–65.4)
(33.2–55.2)
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—

—*
—
—
—
—
—
—
—
59.5
63.3
58.7
67.6
60.4
54.0
67.5
75.0
66.1
71.6

—
—
—
—
—
—
—
—
(44.8–72.8)
(47.7–76.5)
(44.9–71.3)
(58.1–75.9)
(49.4–70.4)
(33.7–73.0)
(58.7–75.1)
(67.8–81.0)
(60.1–71.7)
(63.0–78.9)
—
(48.5–68.8)
—
—
—
—
—
—
—
—
—
—
—

†
†

—
—
—
—
—
—
—
—
57.3
43.9
65.6

†

59.0
—
—
—
—
—
—
—
—
63.3
54.0
75.0

BRFSS

A/PI
%

(95% CI)

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
76.0 (68.3–82.2)
†
—
80.1 (75.7–83.9)
77.6 (71.1–82.9)
83.4 (77.9–87.7)
79.5 (66.5–88.3)
—
—
—
—
—
—
—
—
79.5
—
76.0
—
83.4
—

AI

MMSA/County/State

%

(95% CI)

%

(95% CI)

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
55.9
70.6
75.8
72.5
71.6
55.9
75.8

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(42.0–68.9)
(65.2–75.6)
(60.0–86.7)
(66.2–78.0)
—
—
—

76.1
68.7
70.7
76.2
68.9
66.1
72.5
66.8
61.9
61.9
66.8
65.1
65.1
61.9
72.1
76.4
69.0
72.9
72.1
66.8
66.8
76.8
65.1
66.8
72.3
72.7
69.4
72.7
70.1§
62.1§
76.8§

(72.4–79.4)
(63.8–73.3)
(68.8–72.6)
(74.8–77.7)
(67.2–70.5)
(63.4–68.8)
(69.6–75.3)
(63.5–70.0)
(58.9–64.8)
(58.9–64.8)
(63.5–70.0)
(62.8–67.3)
(62.8–67.3)
(58.9–64.8)
(65.5–77.8)
(73.1–79.5)
(67.3–70.6)
(69.9–75.7)
(70.2–73.9)
(63.5–70.0)
(63.5–70.0)
(74.8–78.6)
(62.8–67.3)
(63.5–70.0)
(71.0–73.5)
(71.3–74.1)
(68.0–70.8)
(71.3–74.1)
—
—
—

Abbreviations: AI = American Indian, A/PI= Asian/Pacific Islander, CI = confidence interval, and MMSA = metropolitan and micropolitan statistical area.
* Not applicable.
† Sample size <30; data not reported.
§ Data from 2009 BRFSS from the 50 states and the District of Columbia.

38

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

Surveillance Summaries

TABLE 26. Percentage of adults aged ≥65 years who had ever received a pneumococcal vaccination, in 28 Racial and Ethnic Approaches to
Community Health (REACH) U.S. communities, 2009, and in the comparison populations from the Behavioral Risk Factor Surveillance System
(BRFSS), 2007–2009, by race/ethnicity — United States
REACH U.S. racial/ethnic populations
Black
Community
Richmond, Virginia
West Philadelphia, Pennsylvania
Kanawha and McDowell Counties, West Virginia
Boston, Massachusetts
Charleston and Georgetown Counties, South Carolina
Fulton County, Georgia
YMCA of the Greater Cleveland, Ohio
Community Health Council of Los Angeles, California
City Neighborhoods of Chicago, Illinois
Southeast Chicago, Illinois
South Los Angeles, California
East Harlem, New York
Southwest Bronx, New York
Humboldt Park and West Town, Chicago, Illinois
YMCA of the Santa Clara Valley, California
Pima County, Arizona
Grant and Hidalgo Counties, New Mexico
Lawrence, Massachusetts
Seattle and King County, Washington
Los Angeles and Orange Counties, California
Special Service for Group, California
Waianae, Hawaii
New York City, New York
Orange County A/PI Community Alliance, California
Eastern Band of Cherokee Indians, North Carolina
Choctaw Nation of Oklahoma
Intertribal Council of Michigan
Oklahoma
Median
Low
High

Hispanic

BRFSS

A/PI

AI

%

(95% CI)

%

(95% CI)

%

(95% CI)

%

(95% CI)

59.2
59.2
73.5
49.4
65.0
64.2
69.7
68.3
51.8
53.9
61.8
53.2
68.2
42.7
—
—
—
—

(52.9–65.1)
(52.9–65.2)
(67.6–78.6)
(38.9–59.8)
(58.8–70.7)
(57.2–70.6)
(63.9–74.9)
(63.7–72.5)
(44.2–59.3)
(46.3–61.3)
(55.7–67.6)
(43.7–62.5)
(59.6–75.7)
(32.4–53.6)
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—

—*
—
—
—
—
—
—
—
44.6
77.1
48.2
59.9
59.1
45.4
58.3
70.7
67.2
58.5

—
—
—
—
—
—
—
—
(29.8–60.4)
(62.0–87.4)
(34.2–62.4)
(49.3–69.5)
(47.2–70.0)
(26.2–66.0)
(49.2–66.8)
(62.9–77.5)
(61.3–72.6)
(49.5–67.1)
—
(41.7–64.1)
—
—
—
—
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
59.7

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(49.3–69.3)
—
(56.5–66.3)
(67.8–80.3)
(45.5–59.3)
(38.3–65.6)
—
—
—
—
—
—
—

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
74.4
80.7
81.5
76.6
78.7
74.4
81.5

—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
(60.1–84.8)
(75.7–84.9)
(65.8–91.0)
(70.3–82.0)
—
—
—

†
†

—
—
—
—
—
—
—
—
60.5
42.7
73.5

†

53.1
—
—
—
—
—
—
—
—
58.5
44.6
77.1

†

61.5
74.6
52.4
52.1
—
—
—
—
59.7
52.1
74.6

MMSA/County/State
%
71.4
60.0
68.5
69.9
68.0
64.2
72.5
57.4
56.0
56.0
57.4
55.3
55.3
56.0
65.3
75.1
66.8
67.6
69.5
57.4
57.4
66.0
55.3
57.4
69.3
71.7
66.9
71.7
68.5§
59.9§
73.9§

(95% CI)
(67.2–75.2)
(54.8–65.1)
(66.5–70.4)
(68.3–71.4)
(66.3–69.6)
(61.4–66.9)
(69.4–75.4)
(53.8–60.9)
(52.9–59.1)
(52.9–59.1)
(53.8–60.9)
(53.0–57.6)
(53.0–57.6)
(52.9–59.1)
(58.2–71.8)
(71.6–78.4)
(65.1–68.5)
(64.4–70.6)
(67.6–71.4)
(53.8–60.9)
(53.8–60.9)
(63.7–68.2)
(53.0–57.6)
(53.8–60.9)
(67.9–70.7)
(70.2–73.1)
(65.4–68.3)
(70.2–73.1)
—
—
—

Abbreviations: AI = American Indian, A/PI= Asian/Pacific Islander, CI = confidence interval, and MMSA = metropolitan and micropolitan statistical area.
* Not applicable.
† Sample size <30; data not reported.
§ Data from 2009 BRFSS from the 50 states and the District of Columbia.

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

39

Surveillance Summaries

Racial and Ethnic Approaches to Community Health Across the U.S. (REACH U.S.) Risk Factor Survey
Participating Communities and Organizations

CDC, National Center for Chronic Disease Prevention and Health Promotion, Division of Adult and Community Health: David Bang, PhD, Joyce
Buckner-Brown, PhD, Shannon Cosgrove, MHA, Rick Dulin, BS, Wayne Giles, MD, Zachery Harris, BS, Youlian Liao, MD, Leandris Liburd, PhD,
Thijuanie Lockhart, BBA, Aisha Penson, MEd, Mark Rivera, PhD, Paul Siegel, MD, Sakeena Smith, MPH, Alexandria Stewart, April Taylor, MPH, Pattie
Tucker, DrPH, Shannon White, MPH, Graydon Yatabe, MPH.
National Opinion Research Center at the University of Chicago: Ashley Amaya, MS, Martin Barron, PhD, Keeshawna Brooks, MA, Michael Bush, Kari
Carris, PhD, Angela DeBello, MA, Katie Dekker, MA, Ned English, MS, Julie Gasparac, Carmelita Grady, PhD, Sheri Hamilton, Kate Hobson, MA, Adish
Jain, MS, Michele Koppelman, MA, MBA, Peter Kwok, MS, Heather Leaver-Spear, Jeffrey Leintz, Moazzam Lokhandwala, Lauren McNamara, Corey Miller,
Hiroaki Minato, MA, Robert Montgomery, MA, Whitney Murphy, MS, Edward Sipulski, Colm O’Muircheartaigh, PhD, Debra Oliver, Diane Preciado,
Hee-Choon Shin, PhD, Kelly Van Hao, Kirk Wolter, PhD, Kanru Xia, MA, field and telephone interviewing staff.
Richmond, Virginia: Vernon J. Harris East End Community Health Center: Lawrence Cary, Tracy Causey, MSPH, Ashlee Miller, Candace Nelms, Karen
Wilson, MSW, Denise Wise, James Woody, BS; East End Partnership with Families-EEPF, Healthy Hearts Plus ll, Inc.
West Philadelphia, Pennsylvania: To Our Children’s Future with Health, Inc: Charmaine Sudler Milligan, Erica J. Purkett, MSW, Robin Foster-Drain, MD,
Marsha Zibalese-Crawford, DSW; Haddington Community Health Project Collaborative.
Kanawha and McDowell Counties, West Virginia: West Virginia Department of Health and Human Resources: Charlene Hickman, Regina Mitchell, Amber Stohr.
Boston, Massachusetts: Center for Community Health, Education, and Research, Inc., Haitian-American Public Health Initiatives, Haitian Multiservice Service,
Massachusetts Community Health Services, Cambridge Health Alliance, Boston Medical Center, Caribbean U-Turn, Greater Boston Nazarene Compassionate Center.
Charleston and Georgetown Counties, South Carolina: Medical University of South Carolina, Charleston Diabetes Coalition, Georgetown Diabetes CORE
Group, Alpha Kappa Alpha Sorority, Carolinas and Georgia Chapter of American Society of Hypertension, Diabetes Initiative of South Carolina, East Cooper
Community Outreach, Franklin C. Fetter Family Health Center, Greater St. Peters Church of Our Lord Jesus Christ, Inc. (Palmetto Diocese), MUSC College
of Nursing, SC DHEC Diabetes Prevention and Control Program (DPCP) and Epidemiology, SC DHEC Region 7, St. James-Santee Family Health Center,
Tri-County Black Nurses Association, Trident United Way, Trident Urban League, Healthy Lifestyles Network, Palmetto Project.
Fulton County, Georgia: Southeastern US Collaborative Center of Excellence for the Elimination of Disparities, Morehouse School of Medicine Prevention
Research Center: Daniel S. Blumenthal, MD, MPH, Venice Haynes, LeRoy Reese, PhD, John Wingfield, PhD; Fulton County Department of Health and
Wellness: Deborah Cherry, Patrice Harris, MD, Larry Johnson, MPH, Vivian Moore, BS, Colet Odenigbo, MPA.
YMCA of the Greater Cleveland, Ohio: YMCA of the Greater Cleveland, Ohio /Clevelanders in Motion Branch: Barbara Clint, Tara Taylor, Alan Armstrong.
Community Health Council of Los Angeles, California: Lark Galloway-Gilliam, MPA; Gwendolyn Flynn; Jonathan Nomachi, MPP; Mia Boykin; University
of Southern California: David S. Sloane, PhD; LaVonna Blair Lewis, PhD; African Americans Building a Legacy of Health Consortium.
City Neighborhoods of Chicago, Illinois: Chicago Department of Public Health, Lawndale Christian Health Center, Sinai Community Institute, Family
Focus, Dr. Jorge Family Health Center.
Southeast Chicago, Illinois: Southeast Chicago Development Commission, Healthy Southeast Chicago: Dinah Ramirez, Chicago Department of Public
Health: Herminia Vanna; South Shore Hospital: Earline Thomas; Advocate Health System: Joel Barron; Midwest Latino Health Research Training and Policy
Center, University of Illinois at Chicago: Eve Pinsker.
South Los Angeles, California: Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center/South Los Angeles Health Projects: Steve Baranov,
Jennifer Chiprich, PhD, Diane Gaspard, MA, Lizz Romo, Terry Silberman, DrPH, Akisha White, MPH, Immunize LA Families Coalition: Oliver Brooks, MD.
East Harlem, New York: Center of Excellence in the Elimination of Disparities – Communities IMPACT Diabetes Center, Mount Sinai School of Medicine:
Carol R. Horowitz MD, Michelle Ramos MPH, Lawrence Kleinman, MD, Ellen Simon, DSW, Barbara Brenner, DrPH, Guedy Arniella, LCSW, Maida
Galvez, MD, Hector Nazario, Pearl Barkley, Union Settlement Association, Bethel Gospel Assembly, Community Education Council for District 4, Lighthouse
International, Little Sisters of the Assumption Family Health Service, Neighborhood Open Space Coalition, NYC Strategic Alliance for Health, Thomas
Jefferson Houses Tenants Association, Yorkville Common Pantry, The East Harlem Diabetes Center of Excellence, The East Harlem Partnership for Diabetes
Prevention; Communities IMPACT Diabetes Center Taskforce.
Southwest Bronx, New York: National Center to Eliminate Racial and Ethnic Disparity, the Institute for Family Health, Bronx Health REACH Coalition,
New York Academy of Medicine: Neil Calman, MD, Maxine Golub, MPH, Charmaine Ruddock, MS.
Humboldt Park and West Town, Chicago, Illinois: University of Illinois at Chicago (UIC)’s Midwest Latino Health Research, Training and Policy Center
at Jane Addams College of Social Work (JACSW and UIC Healthy Cities Collaborative of the Neighborhood Initiative and Chicago Department of Public
Health: Aida L. Giachello, Cynthia Barnes-Boyd, Joseph Harrington, Co-Principal Investigator, Sheila R. Castillo, Rosemary George, Jose Arrom, Amparo
Castillo, Angela Ellison, Mayra Estrella, Ericka Garduno, Hong Hu, Natalie Meza, Sabrina Nelson, Eve Pinsker, Charles Williams, Yong Zhou.
YMCA of the Santa Clara Valley, California: Chronic Disease and Injury Prevention, Santa Clara County Public Health Department: Lillian Castillo RD,
CLE; Community Health Saint Louise Regional Hospital: Sr. Rachela Silvestri; Generations Community Wellness: Dan McClure; Bay Area Women’s Sports
Initiative: Marlene Bjornsrud; Project Cornerstone: Anne Ehresman; Digital Clubhouse Network: Warren Hegg; Mexican American Community Services
Agency: Art Barron; Hatchuel Tabernik & Associates; South County Collaborative of Santa Clara County.
Pima County, Arizona: Arizona Board of Regents, University of Arizona, Pima County Cervical Cancer Prevention Partnership, Pima County Health
Department, UA Zuckerman College of Public Health Center of Excellence in Women’s Health, El Rio Community Health Center, Marana Community
Health Center, Southeast Arizona Area Health Education Center, Sunnyside Unified School District, Sunnyside and Elvira Advocates for Health, Saint
Elizabeth Health Center, Planned Parenthood.
Grant and Hidalgo Counties, New Mexico: Hidalgo Medical Services, Grant County Community Health Council, Hidalgo Health Consortium, New
Mexico Department of Health, the University of New Mexico, the New Mexico State University Cooperative Extension Offices, the Volunteer Center of
Grant County, LULAC Grant County Chapter, The Wellness Coalition, Gila Regional Medical Center, SWORD (Southwest Outreach for Diabetes), FAN-C
(Fitness and Nutrition in the Community group), Knights of Columbus, various community members.

40

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

Surveillance Summaries

Lawrence, Massachusetts: Greater Lawrence Family Health Center, Inc, Latino CEED Lawrence Partners/ Lawrence Council on Aging, Home Care Inc.,
YWCA of Greater Lawrence, City of Lawrence Department of Planning and Development, UMASS Worcester and Massachusetts Department of Public
Health. Steering Committee Members: G. Dean Cleghorn, EdD; Suzanne Cashman, ScD, Martha Cruz, Patricia Daly, MSN, Milagro Grullon, MM, Vilma
Lora, Jean Lussier, Theresa Petrie, Donna Rivera, MSW, Trinidad Tellez, MD, Martha Velez.
Seattle and King County, Washington: Seattle King County Department of Public Health: Roxana Chen, Cheza Garvin, Janet Kapp, Blishda Lacet; Center
for MultiCultural Health: Eudora Carter, Shelley Cooper-Ashford, Devon Love, Edna Nunn; International Community Health Services: Sefie Cabiao, Michael
McKee, Julie Siliga, Tammy Tai, Angela Wan, Minh Nguyen Wichman, Abbie Zahler, Sea Mar Community Health Centers: Antoinette Angulo, Valerie
Baldisserotto, Mayra Carrillo, Edgar Lopez, Jackie Vasquez; Washington State University Extension: Juana Royster; University of Washington: Allen Cheadle;
and University of Washington/Public Health-Seattle and King County: Noel Chrisman.
Los Angeles and Orange Counties, California: The Regents of the University of California, Los Angeles: Antronette K. Yancey, MD, Roshan Bastani, PhD,
Joyce Jones Guinyard, Annette Maxwell, PhD, and members of the C.H.A.T. Coalition.
Special Service for Group, California: Ailee Moon, PhD, Danielle E. Rose, PhD, David J. Yim, MSW, Michelle Y. Wong, MPH, and the REACH US
HAPAS member agencies: Cambodian Association of America, St. Mary Medical Center/Families in Good Health, Samoan National Nurses Association.
Waianae, Hawaii: Waianae District Comprehensive Health and Hospital Board (Waianae Coast Comprehensive Health Center), Waianae High School,
Hawaiian Electric Company, Hawaii Department of Agriculture, University of Hawaii School of Social Work, Hawaii Farm Bureau Federation.
New York City, New York: B Free National Center of Excellence in the Elimination of Hepatitis B Disparities (B Free CEED), New York University School
of Medicine: Simona C. Kwon, DrPH, Chia-hui Peng, MPH, Henry Pollack, MD, Mariano J. Rey, MD, Chau Trinh-Shevrin, DrPH, and coalition partners
Asian American Hepatitis B Program/B Free New York City, Charles B. Wang Community Health Center: Perry Pong, MD, Korean Community Services of
Metropolitan New York, Inc.: Kay Chun, MD, NYU Center for the Study of Asian American Health.
Orange County Asian and Pacific Islander Community Alliance, California: Promoting Access to Health for Pacific Islander and Southeast Asian Women
(PATH for Women) Center of Excellence to Eliminate Disparities and the partner/coalition agencies: Families in Good Health/St. Mary Medical Center, Guam
Communications Network, Pacific Islander Health Partnership, Samoan National Nurses Association, Tongan Community Service Center/Special Service
for Groups, Union of Pan-Asian Communities, California State University, Fullerton - Asian American Studies Program and Health Science Department,
University of California Los Angeles - Asian American Studies Center and School of Public Health.
Eastern Band of Cherokee Indians, North Carolina: Cherokee Choices: Jeff Bachar, Robin Callahan, Tinker Jenks, Tara McCoy, Lori Reed, Phyll Reed,
Yvette Rivera-Colmant.
Choctaw Nation of Oklahoma: Choctaw Nation of Oklahoma REACH Coalition.
Intertribal Council of Michigan, Michigan: The Inter-Tribal Council of Michigan’s REACH US tribes, the Bay Mills Indian Community, the Hannahville
Indian Community, and one additional tribe that wishes to be unnamed.
Oklahoma: Oklahoma State Department of Health: Absentee Shawnee Tribe, Cheyenne and Arapaho Tribes, Cherokee Nation, Chickasaw Nation, Choctaw
Nation, Indian Health Care Resource Center of Tulsa, Pawnee Nation of Oklahoma, Wichita and Affiliated Tribes, Muscogee (Creek) Nation, Otoe-Missouria
Tribe, Association of American Indian Physicians, Central Oklahoma American Indian Health Council Inc., Northeastern Tribal Health System, Central
Oklahoma Integrated Network Systems Inc., Native Youth Preventing Diabetes Corporation.

MMWR  /  May 20, 2011  /  Vol. 60  /  No. 6

41

Surveillance Summaries

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