Behavioral Risk Factor Surveillance System
Indiana Statewide Survey Data, 2005
Table of Contents
Preface
Introduction:
Tables:
Core
1: Health Status
C01.01
Would you say that in general your health is excellent, very good, good, fair, or poor?
Core
2: Healthy Days
C02.01 Now thinking about your physical health, which includes physical illness and injury, for how many days during
the past 30 days was your physical health not good?
C02.02 Now thinking about your mental health, which includes stress, depression, and problems with emotions, for
how many days during the past 30 days was your mental health not good?
C02.03
During the past 30 days, for about how many days did poor physical or mental health keep you from doing your usual activities,
such as self-care, work, or recreation?
Core
3: Health Care Access
C03.01
Do you have any kind of health care coverage, including health insurance, prepaid plans such as HMOs, or government plans
such as Medicare?
C03.02 Do you have one person you think of as your personal doctor or health care provider?
C03.03
Was there a time in the past 12 months when you needed to see a doctor but could not because of the cost?
C03.04
About how long has it been since you last visited a doctor for a routine checkup?
Core
4: Exercise
C04.01
During the past month, other than your regular job, did you participate in any physical activities or exercises such
as running, calisthenics, golf, gardening, or walking for exercise?
Core
5: Diabetes
C05.01
Have you ever been told by a doctor that you have diabetes?
Core
6: Hypertension Awareness
C06.01
Have you ever been told by a doctor, nurse, or other health professional that you have high blood pressure?
C06.02
Are you currently taking medicine for your high blood pressure?
Core
7: Cholesterol Awareness
C07.01
Blood cholesterol is a fatty substance found in the blood. Have you ever had your blood cholesterol checked?
C07.02
About how long has it been since you last had your blood cholesterol checked?
C07.03
Have you ever been told by a doctor, nurse, or other health professional that your blood cholesterol is high?
Core
8: Cardiovascular Disease Prevalence
C08.01
Has a doctor, nurse, or other health professional ever told you that you had a heart attack, also called a myocardial
infarction?
C08.02
Has a doctor, nurse, or other health professional ever told you that you had angina or coronary heart disease?
C08.03
Has a doctor, nurse, or other health professional ever told you that you had a stroke?
Core
9: Asthma
C09.01
Have you ever been told by a doctor, nurse, or other health professional that you had asthma?
C09.02
Do you still have asthma?
Core
10: Immunization
C10.01
A flu shot is an influenza vaccine injected in your arm. During the past 12 months, have you had a flu shot?
C10.02
During the past 12 months, have you had a flu vaccine that was sprayed in your nose? The flu vaccine that is sprayed
in the nose is also called FluMist™.
C10.03
A pneumonia shot or pneumococcal vaccine is usually given only once or twice in a person’s lifetime and is different
from the flu shot. Have you ever had a pneumonia shot?
Core
11: Tobacco Use
C11.01
Have you smoked at least 100 cigarettes in your entire life?
C11.02
Do you now smoke cigarettes every day, some days, or not at all?
C11.03
During the past 12 months, have you stopped smoking for one day or longer because you were trying to quit smoking?
Core
12: Alcohol Consumption
C12.01
During the past 30 days, have you had at least one drink of any alcoholic beverage such as beer, wine, a malt beverage,
or liquor?
C12.02
During the past 30 days, how many days per week or per month did you have at least one drink of any alcoholic beverage?
C12.03
One drink is equivalent to a 12-ounce beer, a 5-ounce glass of wine, or a drink with one shot of liquor. During
the past 30 days, on the days when you drank, about how many drinks did you drink on the average?
C12.04
Considering all types of alcoholic beverages, how many times during the past 30 days did you have 5 or more drinks on
one occasion?
C12.05
During the past 30 days, what is the largest number of drinks you had on any occasion?
Core
13: Demographics
C13.12
What county do you live in?
C13.18
To your knowledge, are you now pregnant?
Core
14: Veteran’s Status
C14.01
Have you ever served on active duty in the United States Armed Forces, either in the regular military or in a National
Guard or military reserve unit?
Core
15: Disability
C15.01
Are you limited in any way in any activities because of physical, mental, or emotional problems?
C15.02
Do you now have any health problem that requires you to use special equipment, such as a cane, a wheelchair, a special
bed, or a special telephone?
Core
16: Arthritis Burden
C16.01
During the past 30 days, have you had symptoms of pain, aching, or stiffness in or around a joint?
C16.02
Did your joint symptoms first begin more than 3 months ago?
C16.03
Have you ever seen a doctor or other health professional for these joint symptoms?
C16.04
Have you ever been told by a doctor or other health professional that you have some form of arthritis, rheumatoid arthritis,
gout, lupus, or fibromyalgia?
C16.05
Are you now limited in any way in any of your usual activities because of arthritis or joint symptoms?
Core
17: Fruits & Vegetables
C17.01
How often do you drink fruit juices such as orange, grapefruit, or tomato?
C17.02
Not counting juice, how often do you eat fruit?
C17.03
How often do you eat green salad?
C17.04
How often do you eat potatoes not including French fries, fried potatoes, or potato chips?
C17.05
How often do you eat carrots?
C17.06
Not counting carrots, potatoes, or salad, how many servings of vegetables do you usually eat? (Example: A serving of
vegetables at both lunch and dinner would be two servings.)
Core
18: Physical Activity
C18.01
When you are at work, which of the following best describes what you do? Would you say?
C18.02
Do you do moderate activities for at least 10 minutes at a time, such as brisk walking, bicycling, vacuuming, gardening,
or anything else that causes some increase in breathing or heart rate?
C18.03
How many days per week do you do these moderate activities for at least 10 minutes at a time?
C18.04
On days when you do moderate activities for at least 10 minutes at a time, how much total time per day do you spend doing
these activities?
C18.05
Do you do vigorous activities for at least 10 minutes at a time, such as running, aerobics, heavy yard work, or anything
else that causes large increases in breathing or heart rate?
C18.06
How many days per week do you do these vigorous activities for at least 10 minutes at a time?
C18.07 On days when you do vigorous activities for at least 10 minutes at a time, how much total time
per day do you spend doing these activities?
Core
19: HIV/AIDS
C19.01
Have you ever been tested for HIV? Do not count tests you may have had as part of a blood donation.
C19.03
Where did you have your last HIV test, at a private doctor or HMO, at a counseling and testing site, at a hospital, at
a clinic, in a jail or prison, at home, at a drug treatment facility, or somewhere else?
C19.04
I’m going to read you a list. When I’m done, please tell me if any of the situations apply to you. You don’t
need to tell me which one. Do any of these situations apply to you?
Core
20: Emotional Support & Life Satisfaction
C20.01
How often do you get the social and emotional support you need?
C20.02
In general, how satisfied are you with your life?
Module
1: Diabetes
M01.01
How old were you when you were told you have diabetes?
M01.02
Are you now taking insulin?
M01.03
Are you now taking diabetes pills?
M01.04
About how often do you check your blood for glucose or sugar? Include times when checked by a family member or
friend, but do not include times when checked by a health professional.
M01.05
About how often do you check your feet for any sores or irritations? Include times when checked by a family member
or friend, but do not include times when checked by a health professional.
M01.06
Have you ever had any sores or irritations on your feet that took more than four weeks to heal?
M01.07
About how many times in the past 12 months have you seen a doctor, nurse, or other health professional for your diabetes?
M01.08
A test for ‘A one C’ measures the average level of blood sugar over the past three months. About how many times
in the past 12 months has a doctor, nurse, or other health professional checked you for ‘A one C'?
M01.09
About how many times in the past 12 months has a health professional checked your feet for any sores or irritations?
M01.10
When was the last time you had an eye exam in which the pupils were dilated? This would have made you temporarily sensitive
to bright light.
M01.11
Has a doctor ever told you that diabetes has affected your eyes or that you had retinopathy?
M01.12
Have you ever taken a course or class in how to manage your diabetes yourself?
Module
9: Adult Asthma History
M09.01
How old were you when you were first told by a doctor or other health professional that you had asthma?
M09.02
During the past 12 months, have you had an episode of asthma or an asthma attack?
M09.03
During the past 12 months, how many times did you visit an emergency room or urgent care center because of your asthma?
M09.04
During the past 12 months, how many times did you see a doctor, nurse or other health professional for urgent treatment
of worsening asthma symptoms?
M09.05
During the past 12 months, how many times did you see a doctor, nurse or other health professional for a routine checkup
for your asthma?
M09.06
During the past 12 months, how many days were you unable to work or carry out your usual activities because of your asthma?
M09.07
Symptoms of asthma include cough, wheezing, shortness of breath, chest tightness, and phlegm production when you don’t
have a cold or respiratory infection.
During the past 30 days, how often did you have any symptoms of asthma?
Would you say?
M09.08 During the past 30 days, how many days did symptoms of asthma make it difficult for you to stay asleep? Would you say:
M09.09
During the past 30 days, how many days did you take a prescription asthma medication to prevent an asthma attack from
occurring?
M09.10
During the past 30 days, how often did you use a prescription asthma inhaler during an asthma attack to stop it?
Module
10: Random Child Selection
Module
11: Childhood Asthma Prevalence
M11.01
Has a doctor, nurse, or other medical professional ever said that the child has asthma?
M11.02
Does the child still have asthma?
Module
15: Colorectal Cancer Screening
M15.01
A blood stool test is a test that may use a special kit at home to determine whether the stool contains blood. Have
you ever had this test using a home kit?
M15.02
How long has it been since you had your last blood stool test using a home kit?
M15.03
Sigmoidoscopy and colonoscopy are exams in which a tube is inserted in the rectum to view the colon for signs of cancer
or other health problems.
Have you ever had either of these exams?
M15.04
How long has it been since you had your last sigmoidoscopy or colonoscopy?
Module
17: Arthritis Management
M17.01
Earlier you indicated that you had arthritis or joint symptoms. Thinking about your arthritis or joint symptoms,
which of the following best describes you today?
M17.02
Has a doctor or other health professional ever suggested losing weight to help your arthritis or joint symptoms?
M17.03
Has a doctor or other health professional ever suggested physical activity or exercise to help your arthritis or joint
symptoms?
M17.04
Have you ever taken an educational course or class to teach you how to manage problems related to your arthritis or joint
symptoms?
Module
21: Smoking Cessation
M21.01
Previously you said you have smoked cigarettes. About how long has it been since you last smoked cigarettes?
M21.02
In the last 12 months, how many times have you seen a doctor, nurse, or other health professional to get any kind of
care for yourself?
M21.03
In the last 12 months, on how many visits were you advised to quit smoking by a doctor or other health professional?
M21.04
On how many visits did your health professional recommend or discuss medication to assist you with quitting smoking,
such as nicotine gum, patch, nasal spray, inhaler, lozenge, or prescription medication such as Wellbutrin/Zyban/Bupropion™?
M21.05
On how many visits did your doctor or other health provider recommend or discuss methods and strategies other than medication
to assist you with quitting smoking?
Risk
Factors
& Calculated Variables
RF01.01
Risk factor for health status.
RF04.01
Adults that report doing physical activity or exercise during the past 30 days other than their regular job.
RF06.01
Adults who have been told they have high blood pressure by a doctor, nurse, or other health professional.
RF07.01
Cholesterol check within past five years.
RF07.02
Adults who have had their cholesterol checked and have been told by a doctor, nurse, or other health professional that
it was high.
RF09.01
Adults who have ever been told they have asthma.
RF09.02
Adults who have been told they currently have asthma.
RF09.03
Computed asthma status.
RF10.01
Adults aged 65+ who have had a flu shot within the past year.
RF10.02
Adults aged 65+ who have ever had a pneumonia vaccination.
RF11.01
Four-level smoker status: Every-day smoker, Some-days smoker, Former smoker, Non-smoker.
RF11.02
Adults who are current smokers.
RF12.02
Binge drinkers (adults having five or more drinks on one occasion).
RF12.05
Heavy drinkers (adult men having more than two drinks per day and adult women having more than one drink per day).
RF12.06
Adult men that are heavy drinkers (having more than two drinks per day).
RF12.07
Adult women that are heavy drinkers (having more than one drink per day).
RF13.18
Three categories of Body Mass Index (BMI).
RF13.19
Adults who have a body mass index greater than 25.00 (Overweight or Obese).
RF16.01
Respondents that have had a doctor diagnose them as having some form of arthritis.
RF17.08
Summary index for fruits and vegetables calculated variable.
RF17.09
Consumed five or more servings of fruits or vegetables per day.
RF18.03
Three-level moderate physical activity category.
RF18.04
Three-level vigorous physical activity category.
RF18.05
Five-level physical activity category.
RF18.06
Adults that have reported participating in either moderate physical activity (30 or more minutes per day for 5 or more
days per week) or vigorous activity (20 or more minutes per day on 3 or more days).
RF18.07
Adults that have reported participating in vigorous activity for 20 or more minutes per day on 3 or more days.
RF18.08
Adult self-reported physical activity level status.
RF18.09
Adults that have reported participating in physical activity or exercise.
RF19.01
Adults aged 18-64 that have ever been tested for HIV.
RF19.02
Adults aged 18-64 that have ever participated in high-risk behavior.
