2003 Child Asthma Data: Technical Information

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BRFSS Questionnaire

The BRFSS survey was conducted in all 50 states, the District of Columbia and in three U.S. territories (Guam, Puerto Rico and the Virgin Islands). In each area where interviews are conducted, respondents are randomly selected from noninstitutionalized civilian adults (18 years of age or older) living in households with a telephone (Chapter 4, page 7 of the BRFSS User's Guide [PDF - 1.7 MB]).

Child asthma prevalence data are produced from the responses to two asthma questions on the BRFSS Childhood Asthma Optional Module. An optional module is comprised of questions on specific topics that states elect to use on their questionnaire. The randomly selected adult provided responses to the child asthma questions.

The States and Territories that used the BRFSS Childhood Asthma Optional Module in 2003 are:

Delaware, Georgia, Hawaii, Idaho, Indiana, Iowa, Maryland, Michigan, Minnesota, New Hampshire, New Jersey, New Mexico, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Texas, Vermont, Virginia and Wisconsin. Guam is excluded from the tables because the required data elements, metropolitan area definitions and population estimates were not available to create weights.

Lifetime asthma: Question number 7.01
“Earlier you said there were [fill in number] children age 17 or younger living in your household. How many of these children have ever been diagnosed with asthma?” (variable name: CASTHDX)

Current asthma: Question number 7.02
If the response to 9.01 was one or more children, then question 9.02 was asked: “Does this child/How many of these children still have asthma?” (variable name: CASTHNOW)

Survey Design and Sample Weights

The survey design is described in the technical document, entitled, “BRFSS Overview" at http://www.cdc.gov/brfss/annual_data/annual_2003.htm.

Sample weights are assigned, according to the child weighting methodology below, to the variable CHILDWT_HH.

Child Weighting Formula

CHILDWT_HH = (_FINALWT/(POSTSTRAT*NAD))*POSTSTRAT2

All of the components in _FINALWT, which are not specific to adults were included in the creation of the weights for children. Converting _FINALWT into a child weight involved the following steps:

1. Dividing out the number of adults (NAD) in the household.
    
2. Dividing out the post-stratification coefficient (POSTSTRAT) for the adult population and replacing it with the post-stratification coefficient for the state’s child population (POSTSTRAT2).

CHILDWT_HH is the child household weight assigned to each respondent with children in the household. If the number of children (CHILDREN) in the household was zero or unknown, CHILDWT_HH has a value of zero. This weight does not factor in total number of children in the household (CHILDREN), which makes it applicable to only variables that include information for all children in the household.

_FINALWT is the weight assigned to each adult respondent.

POSTSTRAT is the adult post-stratification coefficient.

NAD is the number of adults in the respondent’s household.

POSTSTRAT2 is the child post-stratification coefficient. It is the census child population count by state and urban/rural status divided by the weighted number of children sampled by state and urban/rural status.

2003 child post-stratification data sources:

• Urban/rural status was defined according to the Office of Management and Budget, December 2003 metropolitan area definitions. County codes used to identify urban/rural status were obtained from the U.S. Census Bureau’s website at: http://www.census.gov/population/estimates/metro-city/0312msa.txt.
   
• Child population estimates by state were obtained from the U.S. Census Bureau’s website at: http://www.census.gov/popest/counties/asrh/CC-EST2003-agesex.html.
   
• Missing county codes were imputed using a database provided by the Behavioral Surveillance Branch, Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention.

Note: This procedure was developed by Research Triangle Institute under a contract with CDC.

Data Analysis

Data Used:

The BRFSS 2003 Survey Data file was used to calculate estimates for 2003.

Software:

Prevalence and standard error estimates were calculated using SUDAAN Release 9.0.0 (Research Triangle Institute, P.O. Box 12194, Research Triangle Park, NC 27709).

Data Management:

Responses of “don’t know/not sure,” “refused,” or missing values were excluded.

Confidence Intervals and Prevalence Numbers:

The 95% Confidence Intervals were calculated using the following formulas:

Lower 95% Confidence Interval = % prevalence – t (se_p)
Upper 95% Confidence Interval = % prevalence + t (se_p)

Where se_p is the standard error of the prevalence percent and t equals the z distribution. The t-value of 1.96 was used to calculate confidence intervals.

Prevalence Percents:

In 2003, Delaware’s current and lifetime prevalence percents are high compared to 2002. We are currently investigating this issue.

Table Conventions:

In the tables, states are listed in Federal Information Processing Standard (FIPS) code order, except for Illinois in 2002.