Prevalence of Cardiometabolic Diseases Among Racial and Ethnic Subgroups in Adults — Behavioral Risk Factor Surveillance System, United States, 2013–2021

Methods

Study Population

BRFSS is an annual random-digit–dialed landline and cellular telephone-based survey representative of noninstitutionalized adults aged ≥18 years from all 50 states, the District of Columbia, and three U.S. territories.** BRFSS includes questions on health-related behavioral risk factors, health care access, and chronic conditions. The study period included 2013, the first year that BRFSS collected disaggregated data on selected race and ethnicity subgroups, through 2021. Among the 4,030,567 total respondents, the analysis excluded 58,743 (1.5%) who were missing data on age, sex, or race and ethnicity, and 1,525 (0.4%) who did not include data on any cardiometabolic diseases. The analysis included the remaining 3,970,904 (98.5%) respondents. This activity was reviewed by CDC, deemed not research, and was conducted consistent with applicable federal law and CDC policy.^††

Measurements

Demographic information included age and sex. Respondents who reported Hispanic or Latino (Hispanic) ethnicity were categorized as Hispanic regardless of race. Non-Hispanic respondents were categorized by race. Race and ethnicity choices and corresponding disaggregated subgroups on the questionnaire included Hispanic (Cuban, Mexican, Puerto Rican, or Other Hispanic), non-Hispanic American Indian or Alaska Native (AI/AN), non-Hispanic Asian (Asian [Chinese, Filipino, Indian, Japanese, Korean, Vietnamese, or Other Asian]), non-Hispanic Black or African American (Black), non-Hispanic Pacific Islander (Pacific Islander [Guamanian or Chamorro, Native Hawaiian, Samoan, or other Pacific Islander]), non-Hispanic White (White), non-Hispanic Multiracial, and non-Hispanic Other. Other variables included weight status (underweight, normal, overweight, or obesity as determined by body mass index [BMI] in kg/m2 using World Health Organization criteria for Asian and non-Asian populations) (4), physical activity (defined as leisure-time physical activity at least one time in the last month), and smoking status (current, former, or never). Prevalence of cardiometabolic diseases (diabetes [excluding gestational diabetes], myocardial infarction [MI], angina or coronary heart disease [CHD], or stroke) was based on self-reported diagnosis by a physician or other health care professional.

Statistical Analysis

Prevalence of each cardiometabolic disease was estimated from multivariable logistic models adjusted for age, sex, and survey year. Sample weights and design variables were used to account for the complex survey design. Two-sided p-values <0.05 were considered statistically significant. Analyses were conducted using SAS (version 9.4; SAS Institute) and SUDAAN (version 11.0.1; Research Triangle Institute).