Linking behavior risk factor surveillance system data and air quality data to study the impact of air pollutions to health behaviors

Background –Environmental pollution have been linked to chronic diseases such as cancer, asthma, and cardiovascular health. However, very little is known about the impact of ambient air quality on health behaviors. The Behavioral Risk Factors Surveillance System (BRFSS) provides information about the risk behaviors and health conditions from non-institutionalized adults aged 18 and above.  It is not designed to measure  environmental pollution. Using outdoor air quality data in conjunction with BRFSS may help us to explore the links between air pollutions and chronic diseases.

Objective – To illustrate how BRFSS can be used in conjunction with the Environmental Protection Agency air quality data (EPA).

Methods – EPA air quality summary data were merged with BRFSS (2001-2003) at metropolitan area level. Statistic analyses were conducted to examine the correlation of PM_2.5 air pollutions and several risk factors and health conditions.

Results –Ischemic heart attack (AOR=1.6, 95%CI: 1.1-2.52), physical inactivity (AOR=1.33, 95%CI: 1.68, 1.97), and low quality of life (AOR=1.3, 95%CI: 1.1-1.7) were found associated with outdoor ambient PM_2.5 air pollutions.

Conclusions –Our study demonstrates an association of PM2.5 with selected risk behavior and chronic conditions. This approach can be served as a model for using other environmental data sources with BRFSS.

Key Words – BRFSS; air quality; air pollutions; risk behaviors; chronic disease