Estimates of multiple behavioral risk factors for chronic disease among reproductive aged women: Behavioral Risk Factor Surveillance System, 2005

Background: Behavioral risk factors for chronic disease, such as obesity and smoking, are associated with poor pregnancy outcomes, yet they are potentially modifiable. It is important to monitor the prevalence of behavioral risk factors among women of reproductive age due to increased risks and need for appropriate preconception care.

Methods: Data from the 2005 Behavioral Risk Factor Surveillance System, a representative state-based telephone survey of health behavior in US adults, were analyzed among 71,810 women, aged 18-44. Age-standardized, weighted prevalence estimates of multiple behavioral risk factors(MBRF), defined as two or more, were determined. Multivariate logistic regression analysis evaluated race/ethnicity adjusted for age, household income, education, and health coverage.

Results: The risk factors considered were physical inactivity(prevalence=23.1%), smoking(21.9%), obesity(21.7%), and heavy alcohol intake(12.5%). Overall, 19.8% report MBRF with the prevalence greater among Native Americans (34.3%,95% CI=28.9-40.2) and non-Hispanic Blacks (23.3%,21.8-24.8), compared to non-Hispanic Whites (19.8%,19.2-20.4), Hispanics (18.2%,16.7-19.9), and Asians (6.0%,3.8-9.3). Lower levels of education, income, and no health coverage were associated with a higher prevalence of MBRF. After adjustment, the odds of MBRF remained higher in Native Americans (Adjusted Odds Ratio[AOR]=1.50,95%CI=1.13-1.98), became lower in non-Hispanic Blacks (AOR=0.89,0.81-0.99), and remained lower in Hispanics (AOR=0.53,0.47-0.61) and Asians (AOR=0.33,0.21-0.53), compared to non-Hispanic Whites.

Conclusions: Almost 20% (about 10 million) of US women of reproductive age have MBRF which demonstrates the burden and importance of addressing these risks during preconception health. Programs targeting the reduction of behavioral risk factors associated with chronic disease and eliminating disparities are critical to improving the overall health of women.