Behavioral Risk Factor Surveillance System (BRFSS): Impact on Population Health - Massachusetts BRFSS Project Abstract Summary The Massachusetts Department of Public Health (MDPH) proposes to implement a statewide Massachusetts Behavioral Risk Factor Surveillance System (MA BRFSS) that advances health equity by improving data collection, analysis, and dissemination among Massachusetts’ (MA’s) disability and rural communities. The BRFSS is a cornerstone of MDPH’s surveillance system for monitoring health status and risk-related behaviors of MA adults and an important source of public health information for MA towns, cities, counties, and regions. In 1986, MA began participating in the BRFSS and created the MDPH Health Survey Program to coordinate its administration, ensuring adherence to the requirements set forth by the Centers for Disease Control and Prevention. Over the next 38 years, the Health Survey Program expanded the scope of MA BRFSS by adding optional modules and state-specific questions, using a split-sample design, and adding cell-phone mode. More recently, MDPH has improved and expanded its data collection, analysis, and dissemination with a focus on underrepresented groups. These improvements focused on increasing the MA BRFSS capacity for small area estimates for cities and towns and expanding external partnerships with community data users. People with disabilities and those living in rural areas are underrepresented in MA data systems and data communication products. According to 2022 MA BRFSS, people with disabilities make up 27.5% of the Massachusetts population. However, internal MDPH estimates suggest that that number may be as high as 69%. Fifty-three percent of MA’s land mass is rural, encompassing 10% of the state population. Many who live in rural communities lack access to the social determinants of health, such as public transportation or health care services, and have poorer health outcomes than those in metropolitan settings. Yet MDPH lacks sufficient data products focused on rural communities to support programs and policies for improved health. Over the next five years, MDPH will improve the reporting of MA BRFSS health outcomes and advance health equity by: 1) collecting the data and developing an innovative BRFSS plan (Strategy 1) that includes geo-stratification of samples into rural clusters and a state-added question that aims to better identify people with disabilities – especially those with intellectual and mental health disabilities, 2) building partnerships with the disability and rural communities (Strategy 2) through collaboration with an existing community advisory group, called the Health and Disability Partnership, that will guide MDPH’s use of MA BRFSS to document outcomes for people with disabilities and through partnerships with two rural communities that have an identified need for better data to inform their programs and policies, 3) conducting outreach and education to people who are disabled and who live in rural communities (Strategy 3) based on outreach, education, and media plans that will be developed in collaboration with the engaged partnerships and MDPH programs and that will result in at least two community meetings in which MDPH shares data and discusses the MA BRFSS program. Anticipated short and intermediate outcomes from this program include more timely access to BRFSS data for local areas, expanded communication and marketing campaigns with underrepresented communities’ partners and advisory groups related to accessing the data, and greater sharing and use of data among partners who promote health equity within underrepresented communities. We aim to achieve the long-term outcomes of enhanced policies at local, state, and federal levels that boost health outcomes for all with special attention on the under-represented communities of people with disabilities and people who live in rural communities.
