State Trends in Health Risk Factors and Receipt of Clinical Preventive Services Among US Adults During the 1990s

CONTEXT Monitoring trends is essential for evaluating past activities and guiding current preventive health program and policy efforts. Although tracking progress toward national health goals is helpful, use of national estimates is limited because most preventive health care activities, policies, and other efforts occur at the state or community level. There may be important state trends that are obscured by national data. OBJECTIVE To estimate state-specific trends for 5 health risk factors and 6 clinical preventive services. DESIGN Telephone surveys were conducted from 1991 through 2000 as part of the Behavioral Risk Factor Surveillance System. SETTING AND PARTICIPANTS Randomly selected adults aged 18 years or older from 49 US states. Annual state sample sizes ranged from 1188 to 7543. MAIN OUTCOME MEASURES Statistically significant changes (P