The Behavioral Risk Factor Surveillance System (BRFSS) is the largest continuously conducted health survey system in the world, with more than 400,000 American adults participating each year. The BRFSS was established in 1984 by the Centers for Disease Control and Prevention (CDC). Indiana was one of the 15 states that participated since its inception. By 1993, all states and several U.S. territories had implemented the BRFSS. The Indiana Department of Health (IDOH) is responsible for collecting this vital information for our state so we all can know more about the health status of Hoosiers.
What is a Behavioral Risk Factor?
Every day, people make decisions that impact their health. Some behavioral risk factors that can impact a person’s health include poor eating and sleeping habits, substance abuse, smoking cigarettes, being physically inactive, and not obtaining immunizations or routine medical care. These are shown to lead to a variety of poor health outcomes, such as illness, injury, or even premature death. Using the BRFSS survey to track these behaviors supports the efforts of public health professionals in their development of effective health interventions to address them.
Indiana uses information from the BRFSS to:
- Learn more about critical or emerging health issues.
- Identify potential areas of disparity in terms of health-related outcomes.
- Help various nonprofits around the state plan interventions for people diagnosed with or at risk for specific conditions such as arthritis, cancer, diabetes, and heart disease.
- Produce educational materials to increase awareness of Indiana's health status.
- Provide policymakers and other decision-makers with data-driven information regarding the health of Indiana residents.
- Assist IDOH program areas and other governmental agencies within Indiana with measuring progress towards achieving their strategic goals.
- Monitor statewide progress toward national Healthy People 2030 objectives.
- Provide metrics to support various grants for IDOH and other health-related organizations, including supplying data to the Robert Wood Johnson Foundation and the 500 Cities Project by CDC so county- and city-level analysis of health outcomes are possible.
Frequently Asked Questions
- How was I selected?
You were randomly selected based on your phone number. We receive a sample of both listed and unlisted phone numbers in your area and randomly pick whom to call. This is called random sampling. All adult Hoosiers with a phone have an equal chance of being selected to participate in this survey. You just got lucky!
- Why should I participate?
We greatly appreciate your participation and know that your time is valuable. The information you provide is critical to decision-makers across the state and is the only source of consistent information on a number of vitally important health-related topics. While participation is voluntary, we strongly encourage you to participate. If you opt out, we cannot replace you in our sample, which means that people like you could be underrepresented in our state’s prevalence estimates. This could mean your particular health needs may be underestimated or ignored. Please help your fellow Hoosiers by participating in this survey. For those of you who have already participated, thank you.
- Is my information safe?
Yes. We do not collect identifying information and will never ask you for personal information such as your name, address, date of birth, social security number, etc. We will ask you for your county and zip code and ask questions regarding your demographic characteristics. Your responses to these questions cannot be tied to you. Additionally, you have the option to refuse to answer any question(s) you do not wish to answer.
- I am busy. Can you call back?
Yes. If you answer the call, you can ask the interviewer to schedule a call-back at a more convenient time for you.
- Can you stop calling me?
Yes. You can be placed on a Do Not Call list for our survey. However, please reconsider as you are irreplaceable in our sample. If you still want to be removed from our call list, please contact the Indiana State BRFSS Coordinator at email@example.com.
- How can I know whether the call is legitimate or a scam?
If you feel certain that someone is fraudulently claiming to collect data on our behalf, please contact:
Attorney General’s Office
If you are unsure and would like to speak to someone at IDOH about this survey, please contact the Indiana State BRFSS Coordinator at firstname.lastname@example.org.
The BRFSS is a telephone-based survey. Households are selected from blocks of potential phone numbers in an area (including unlisted numbers). One adult in the household is randomly selected to be interviewed. Participants are chosen at random to ensure that the collected data is generalizable to other residents in our state.
Once responses are compiled, the CDC analyzes the demographic characteristics of the sample and assigns weights to each of the responses to ensure estimates are reflective of the known population. This weighting allows us to generalize the results of the BRFSS survey to the population as a whole. Because some groups are harder to reach than others, the CDC also weights to compensate for non-selection or non-response bias. In other words, the CDC adjusts for overrepresentation or underrepresentation of certain groups in the sample.
Limitations of the Data
The BRFSS is used to generate prevalence estimates, which are estimates of the true incidence of a particular phenomenon for the population the sample is supposed to represent. Like data compiled from any survey, there are certain limitations associated with the BRFSS data and various ways that error can be introduced into the data.
The reliability of the estimate is directly related to the number of actual unweighted responses for each category or subgroup. If the number of collected responses is small, the estimate may be misleading. Measurement error can occur if a question is not understood by a respondent or if an interviewer states the question in a way that alters the understanding of the question. Non-response bias is always present in any survey. It is impossible to know whether those who refused to participate in the survey would have answered the questions similarly to those who did. Some examples of response error are when a person does not answer a question accurately because they cannot recall the right information or the data collector codes the response incorrectly. Social desirability is a phenomenon where a respondent alters their answer to present a favorable impression to the interviewer or to avoid association with socially stigmatized behaviors.
The questionnaire has four sections:
- Fixed core sections include standard questions that must be asked by every state/participating territory each year.
- Rotating core sections include questions that are collected every two, three, or four years by every state/territory. In off years, the rotating core sections may be offered as optional modules.
- Each year, the CDC offers a selection of optional modules that states can elect to add to their questionnaire. By limiting the number of modules offered each year, the CDC can gather information on specific topics across multiple states/territories.
- State-added questions are questions of special interest to the state that are not offered as an optional module.
Sometimes there is an emerging core section, which is a small group of questions that are added to the core section. These are usually time-sensitive, topical questions. An example of an emerging core section would be one that collects information on a nationwide outbreak (e.g. H1N1, COVID-19).
Indiana BRFSS Reports
Health Disparities Among Sexual Minority Adults in Indiana (Published July 2022)
Childhood Substance Abuse Exposure and Prescription Opioid Misuse in Adulthood (Published June 2021)
Association Between Informal Caregivers and Risk of Psychological Distress (Published May 2021)
The Prevalence of Adverse Childhood Experiences and their Association with Adult Health (Published July 2020)
BRFSS INsight: Disparities in Diabetes Care (Published August 2023)
BRFSS INsight: Health Disparities Among Sexual Minority Adults in Indiana (Published January 2023)
BRFSS INsight: Alcohol and Drug Recovery Experiences in Indiana (Published July 2022)
BRFSS INsight: ACEs and Smoking Among Indiana Adults (Published May 2022)
BRFSS INsight: Unwanted Sexual Experiences (Published April 2022)
BRFSS INsight: Marijuana and Tobacco Dual Use (Published November 2021)
Adverse Childhood Experiences: 2018 BRFSS Data (Published July 2020)
Indiana BRFSS Data Questionnaires, Codebooks and Variable Reports
Indiana BRFSS datasets can be accessed on the Centers for Disease Control and Prevention website. Below you will find Indiana-specific questionnaires, codebooks, and variable reports.