BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
What We Know About Adults
with Disabilities:
Public Health Resources for Planning
bruce.steiner@illinois.net
August 21, 2014
Bruce Steiner
Illinois Department of Public Health
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
Objectives
1. Reveal demographic
characteristics of Illinois adults
with disabilities
2. Illustrate how their health and
well-being are affected.
3. Identify data resources to aid in
planning.
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
Behavioral Risk
Factor Surveillance
System
BRFSS
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
BRFSS
• Federally funded program operating
in every state.
• Conducts telephone interviews
among Illinois adults
• Sample include landline and cellular
telephones
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
BRFSS
• Trained interviewers
• Scripted interviews
• Questions about health conditions
and behaviors
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
BRFSS
• Carefully controlled data collection
• Random sample drawn for telephone
interviews.
• Represents entire adult population
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
Sample Size
• Statewide
– 5,000 per year
– Strata approx. 1,000 per year
• County
– 400 per county
– Aggregate approx. 40,000 per round
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
Data Preparation
• Adherence to rigorous procedures
• Weighting data
– Equalizes probability of selection
– Adjusts for variation of age/race/sex
subgroups
– Permits generalizations to entire adult
population
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
Uses of BRFSS data
1. Document need for public
health interventions
2. Target resources for high risk
populations.
3. Evaluate previous efforts
4. Establish public policy
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
Topics
•
•
•
•
•
•
•
•
•
Alcohol
Arthritis
Asthma
Cardiovascular
Colorectal
Diabetes
Disability
Health care coverage
Health care
utilization
• Health status
•
•
•
•
•
•
•
•
•
•
Immunizations
Injury control
Nutrition
Obesity
Oral health
Physical activity
Quality of life
Tobacco
Weight control
Women’s Health
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
Search for
Illinois
BRFSS
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
http://app.idph.state.il.us/brfss/
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
Disability
• Activity Limitation due to health
problem
• Health problems requiring special
equipment
= Disability
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
Disability
Limitation
Equipment
16.80%
7.20%
Disability
18.70%
1,841,272 Adults
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
Activities of Daily Living
• Blind
• Decisions
• Walking
• Dressing
• Errands
• Difficulty Seeing / Blind
• Difficulty concentrating
or remembering
• Difficulty walking or
climbing stairs
• Difficulty dressing or
bathing
• Difficulty doing errands
alone
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
Limitation
Blind
Decisions
Walking
Dressing
Errands
3.9 %
8.0 %
11.4 %
2.8 %
5.5 %
Any Impairment 19.2 %
1,892,243 Adults
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
Assumption
People with one or more activity
limitation are likely to require
support from at least other
individual.
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
Assumption
The greater the number of
activity limitations a person has
increases their reliance on
others and decreases their
independence.
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
Percent Adults with 1 ADL
Age Options
18.8%
Central Illinois
20.0%
Chicago DFSS
19.8%
East Central Illinois
15.6%
Egyptian Area
27.5%
Lincolnland
18.1%
Midland
19.7%
Northeastern
18.5%
Northwestern
19.0%
Southeastern Illinois
16.6%
Southwestern Illinois
23.9%
West Central Illinois
17.2%
Western Illinois
19.2%
Illinois
19.2%
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
30.0%
20.0%
10.0%
.0%
Percent of Adults With ADL by Service Area
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
Multiple ADLs by Service Area
3 or More
30%
25%
20%
15%
10%
5%
0%
2
1
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
Comparison of ADLs to Age Group Proportion
ADLs
Proportion
40%
35%
30%
25%
20%
15%
10%
5%
0%
18-24
25-44
45-64
65+
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
Percent of ADLs by Race
30%
20%
10%
0%
White
Black
Other
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
Percent with ADL by
Education
Percent with ADL by
Income
40%
50%
40%
30%
30%
20%
20%
10%
0%
10%
0%
< HS HS Grad Some
Grad
Coll
College
Grad
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
Perceived Health by ADL Status
40%
30%
20%
10%
0%
Excellent
Very good
Good
Fair
Poor
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
Healthy Days by Number of
ADL Status
in Past Month
30
20
10
0
1
2
3
4
5
None
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
Health Care Utilization by ADL Status
100%
80%
60%
40%
20%
0%
Health Care
Coverage
Primary Care
Provider
Avoided Dr. Due
to Cost
Checkup within
Past Year
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
Chronic Diseases by ADL Status
50%
47.6%
40%
36.1%
30%
22.1%
20%
17.8%
14.0%
12.6%
10.4%
10%
7.0%
6.0%
4.8%
0%
ARTHRITIS
DEPRESSION
DIABETES
ASTHMA
CANCER
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
Cardiovascular Issues by ADL Status
12%
10%
8%
6%
4%
2%
0%
HEART DISEASE
HEART ATTACK
STROKE
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
Risk Factors by ADL Status
80%
60%
40%
20%
0%
OBESE
SMOKER
EXERCISE 30 days
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
Percent Adults with 1 ADL
Age Options
18.8%
Central Illinois
20.0%
Chicago DFSS
19.8%
East Central Illinois
15.6%
Egyptian Area
27.5%
Lincolnland
18.1%
Midland
19.7%
Northeastern
18.5%
Northwestern
19.0%
Southeastern Illinois
16.6%
Southwestern Illinois
23.9%
West Central Illinois
17.2%
Western Illinois
19.2%
Illinois
19.2%
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
30.0%
20.0%
10.0%
.0%
Percent of Adults With ADL by Service Area
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 
 BRFSS  BRFSS  BRFSS  BRFSS  BRFSS  BRFSS BRFSS BRFSS 