Behavioral Risk Factor Surveillance System

(BRFSS) Montana

 

Assessing Disability and Secondary Health Conditions of Montana Adults: Results from the 2001 and 2003 Behavioral Risk Factor Surveillance System Surveys

Health Planning Section
Public Health and Safety Division
Montana Department of Public Health and Human Services
P.O. Box 202951
Helena, MT 59620-2951

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Acknowledgments

This report represents the collaborative endeavor of: The Health Planning Section of the Public Health and Safety Division, within the Montana Department of Public Health and Human Services (DPHHS), administers the Montana Behavioral Risk Factor Surveillance System (BFRSS). The Montana BRFSS is the primary source of information on health risk behaviors among the adult population in the state. The information collected in this statewide survey is used to improve health care and ultimately the health of citizens across Montana. The Behavioral Surveillance Branch of the Centers for Disease Control and Prevention (CDC) provides partial financial support for the Montana BRFSS. Additionally, the CDC provides technical expertise and support for processing and weighting the data.

The Montana Disability and Health Program: Living Well Under the Big Sky (MTDH) is a partnership of The University of Montana Rural Institute: A Center for Excellence in Disability Education, Research, and Service and the Montana Department of Public Health and Human Services (DPHHS). This partnership has established a focal point for developing and implementing specific programs and services designed to prevent secondary conditions, promote health, and reduce the health disparities existing between Montanans with and without disabilities. The MTDH is funded by the National Center on Birth Defects and Developmental Disabilities, Disability and Health, Centers for Disease Control and Prevention (CDC).

The following individuals prepared this report:

Susan J. Cummings, BSN, CPHQ, Analysis and Evaluation Consulting;
Joanne Oreskovich, PhD, BRFSS Director/Epidemiologist, Montana DPHHS;
Meg Ann Traci, PhD, Project Director, MTDH, University of Montana.

The following individuals reviewed this report:

Todd Harwell, MPH, Bob Moon, MPH, and Jane Smilie, MPH, of the Montana DPHHS;
Tom Seekins, PhD, Craig Ravesloot, PhD, Kathy Humphries, PhD, and Barbara Cowan, BA, of the University of Montana Rural Institute.

The BRFSS survey was conducted by:

Northwest Resource Consultants of Helena, Montana in 2001;
ORC Macro of Burlington, Vermont in 2003.

The information provided in this report was supported by the following cooperative agreements with the Centers for Disease Control and Prevention (CDC): Montana BRFSS, Cooperative Agreement Number U58/CCU822808-02; MTDH, Cooperative Agreement Numbers U59/CCU821224 and U59/CCU824603.

The contents of this report are solely the responsibility of the authors and do not necessarily represent the official views of the funding sources.

Table of Contents

Acknowledgments
List of Tables
List of Figures
Introduction
Disability and BRFSS in Montana
Definition of Disability
Purpose of this Report
Methodology
Survey Methods
Data Analysis
Survey Limitations
Other Considerations

Disability in Montana
Prevalence of Disability
Demographic Comparisons
Health Status
Health Care Access
Physical Activity
Overweight and Obesity
Weight Control
Cigarette Smoking
Alcohol Consumption
Falls and Injury
Immunization
Arthritis
Cardiovascular Disease
Cardiovascular Disease Risk Factors
Asthma
Diabetes

Disability Report Highlights
Summary
For Further Information
For Alternative Formats

List of Tables

Table 1: Prevalence of Disability, Montana Adults, 2001 and 2003.
Table 2: Demographic Characteristics of Montana Adults with and without Disability–2003.
Table 3: Health Status, Montana Adults with and without Disability, 2001 and 2003.
Table 3-b: Average Number of Poor Health Days (past 30 days), Montana Adults with and without Disability – 2003.
Table 4: Health Care Access, Montana Adults with and without Disability, 2001 and 2003.
Table 5: Physical Activity, Montana Adults with and without Disability, 2001 and 2003.
Table 6: Overweight and Obesity, Montana Adults with and without Disability, 2001 and 2003.
Table 7: Weight Control, Montana Adults with and without Disability, 2001 and 2003.
Table 8: Cigarette Smoking, Montana Adults with and without Disability, 2001 and 2003.
Table 9: Alcohol Consumption, Montana Adults with and without Disability, 2001 and 2003.
Table 10: Fall-related Injury, Montana Adults with and without Disability, 2001 and 2003.
Table 11: Immunization, Montana Adults with and without Disability, 2001 and 2003
Table 12: Arthritis, Montana Adults with and without Disability, 2001 and 2003
Table 13: Cardiovascular Disease, Montana Adults with and without Disability, 2001 and 2003
Table 14: Cardiovascular Disease Risk Factors, Montana Adults with and without Disability, 2001 and 2003.
Table 15: Asthma, Montana Adults with and without Disability, 2001 and 2003.
Table 16: Diabetes, Montana Adults with and without Disability, 2001 and 2003.
Year 2010 Health Objectives for the Nation: Summary of 2003 BRFSS Data for Montana Adults with and without Disability.

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List of Figures

Figure 1: Prevalence of disability, Montana adults – 2003.
Figure 2: Prevalence of disability by age and income, Montana adults – 2003.
Figure 3: Percent reporting annual household income less than $25,000, Montana adults – 2003.
Figure 4: Employment status, Montana adults age 18-64 years – 2003.
Figure 5
:Self-reported health status, Montana adults – 2003.
Figure 6: Access to health care, Montana adults age 18-64 years – 2003.
Figure 7: Prevalence of no leisure-time physical activity, Montana adults – 2003.
Figure 8: Prevalence of overweight and obesity, Montana adults – 2003.
Figure 9: Received health professional advice to lose weight in the past year, Montana adults – 2003.
Figure 10: Prevalence of current cigarette smoking, Montana adults – 2003.
Figure 11: Prevalence of binge drinking in the past 30 days, Montana adults – 2003.
Figure 12: Prevalence of fall-related injury in the past 3 months, Montana adults age 45 and older – 2003.
Figure 13: Immunization rates among Montana adults age 65 and older – 2003.
Figure 14: Arthritis prevalence, Montana adults – 2003.
Figure 15: Cardiovascular disease prevalence, Montana adults age 35 and older – 2003.
Figure 16: Prevalence of cardiovascular disease risk factors, Montana adults – 2003.
Figure 17: Current asthma prevalence, Montana adults – 2003.
Figure 18: Diabetes prevalence, Montana adults – 2003.

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Introduction

Healthy People 2010 Goal: Promote the health of people with disabilities, prevent secondary conditions, and eliminate disparities between people with and without disabilities in the U.S. population.

Nearly 54 million Americans nationwide are currently living with disabilities. This equates to about one in five Americans with “disability or limitation in major life activities because of physical, mental, or emotional conditions lasting 6 or more months (Reference: Centers for Disease Control and Prevention. Prevalence of disabilities and associated health conditions among adults: United States, 1999. Morbidity and Mortality Weekly Report. 2001; 50(7):120-125). Nationally, there has been a dramatic increase of interest in the health and wellness of people with disabilities. With the release of Healthy People 2010, disability secured a prominent place on the national health agenda. This national health initiative has two overarching goals, to: 1. “Increase the quality and years of healthy life; and 2. “Eliminate health disparities.”

In 2000, for the first time, a separate chapter (Chapter 6) was created within Healthy People 2010 devoted to the health and well being of people with disabilities (Reference: U.S. Department of Health and Human Services. Healthy People 2010. 2nd ed, 2 vols. Washington, DC: U.S. Government Printing Office; November 2000. Available at http://www.healthypeople.gov ).

As our population ages with chronic health conditions and more young people survive birth- and injury-related limitations, disability increases. But, while people with disabilities make up 17 percent of the national population at any one time, they account for more than 47 percent of the total health care expenditures (Reference: Turpin L, Rice DP, Max W. Medical Expenditures for People with Disabilities in the United States, 1987. Washington, DC: U.S. Government Printing Office; 1995).

There is now general agreement that prevention of secondary conditions should be a major component of health promotion for people with disabilities (References: Simeonsson R.J., Bailey D.B., Scandlin D., Huntington G.S., Roth, M. Disability, health, secondary conditions and quality of life: emerging issues in public health.  In Simeonsson R.J., McDevitt L.N., eds. Issues in Disability and Health: The Role of Secondary Conditions and Quality of Life. Chapel Hill: University of North Carolina Press; 1999:51-72; and Kinne S., Patrick D.L., Lochner D.D. Prevalence of secondary conditions among people with disabilities. American Journal of Public Health. 2004; 94(3):443-445.)

Secondary conditions of health are “those physical, medical, cognitive, emotional or psychosocial consequences to which persons with disabilities are more susceptible by virtue of an underlying condition, including adverse outcomes in health, wellness, participation, and quality of life” (Reference: Institute of Medicine. Disability in America: Toward a National Agenda for Prevention. Washington DC: National Academy Press; 1991).

More simply, a secondary condition is any condition to which a person is more susceptible by virtue of having a primary disabling condition. Secondary conditions encompass more than additional disease and include:

1. Non-medical events (e.g. social isolation);
2. Conditions that affect the general population, but which more greatly affect people with disabling conditions (e.g. obesity);
3. Problems that arise any time during the lifespan (e.g. inaccessible mammography). (Reference: Centers for Disease Control and Prevention, National Center for Birth Defects and Developmental Disability. Secondary Conditions: Children and Adults with Disabilities [fact sheet dated December 2004]).

It is well recognized that the movement toward removing barriers facing people with disabilities rests on establishing a firm foundation of population surveillance, the measurement of disability prevalence within the population, and obtaining information about the impact of common secondary conditions of health. Of the thirteen objectives in Chapter 6 of Healthy People 2010, the first objective emphasizes the need to include a standard set of questions that identify “people with disabilities” in all data collection sets and surveillance instruments. The other objectives of this chapter of Healthy People 2010 deal mainly with assessing the impact of secondary health conditions of the disabled population and eliminating those disparities.

Description of Figure 1. Prevalence of disability, Montana adults: 2003. A pie chart shows that one in five (21%) of Montana adults reported disability. End of description.

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Disability and BRFSS in Montana

The Centers for Disease Control and Prevention, Disability and Health Branch, has worked diligently since the mid-1980s on creating a multi-state disability surveillance system. Epidemiological goals are to assess the magnitude of disability in state populations, using existing survey instruments, with measurement based on the degree of functional limitation, rather than on specific etiology, diagnosis, or life stage characteristics of the disabled.

The Behavioral Risk Factor Surveillance System (BRFSS) has been the main source of state level estimates of health status and health risk behaviors of adults; the BRFSS complements surveys, such as the National Health Interview Survey (NHIS), that typically provide only national level health prevalence estimates.

The Montana Behavioral Risk Factor Surveillance System (BRFSS) is partially funded by the Centers for Disease Control and Prevention and is a collaborative effort to provide self-reported health risk behavior data at the state level; this nationwide effort now includes all 50 states, the District of Columbia, and several territories. The Montana BRFSS is an ongoing telephone survey that assesses the health status and health risk behaviors of adults in Montana. The survey monitors the prevalence of health risk behaviors that are linked with the leading causes of death – heart disease, cancer, stroke, diabetes, and injury – and other important health-related issues.

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Definition of Disability

In 2001, two identical disability survey items were included in the Behavioral Risk Factor Surveillance System (BRFSS) survey and the National Health Interview Survey (NHIS) in all fifty states. The two questions in the BRFSS core questionnaire establish the operational definition of disability and identify survey respondents with disability.

Disability is defined as a “Yes” response to either or both of the following questions:

1. “Are you limited in any way in any activities because of physical, mental, or emotional problems?”
2. “Do you now have any health problem that requires you to use special equipment, such as a cane, a wheelchair, a special bed, or a special telephone?”

Since 2003, the Centers for Disease Control and Prevention, Disability and Health Branch, has included the above two-item disability module every year in the core section of the BRFSS questionnaire.

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Purpose of this Report

The purpose of this report is to provide information about Montana adults with disability from the 2001 and 2003 Montana BRFSS. The health indicators highlighted in this report were selected because they were:

1. Healthy People 2010 Leading Health Indicators closely related to disability and secondary health conditions (Reference: U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Healthy People 2010: Leading Health Indicators…Touch Everyone. Available at http://www.healthypeople.gov/LHI/ . Accessed June 2005.)

2. Primary conditions known to be associated with activity limitation in adults (Reference: LaPlante, MP. Health Conditions and Impairments Causing Disability. San Francisco: University of California, San Francisco, Disability Statistics Rehabilitation Research and Training Center; 1996. Disability Statistics Abstract 16); 3. Socio-demographic and health status indicators that describe the experience of Montana adults with disability.

This information is presented for the first time and establishes a baseline for future comparison. It is the intent of Montana’s BRFSS to add “disability as a demographic” to all future publications to more adequately explain Montana”s adult population and their health status and health risk behaviors. The disparities that exist between adults with and without disability in Montana speak for themselves in the following pages.

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Methodology –

Survey Methods

All data in this report are from the 2001 and 2003 Montana BRFSS. In each of these years, a representative sample of non-institutionalized Montanans age 18 and older was selected for telephone interview. The total sample size was 3,338 adults in 2001 and 4,024 adults in 2003.

The methods for survey sampling and interviewing followed BRFSS protocol. Briefly, individual respondents were randomly selected from among all adults living in randomly sampled Montana households. The sample was stratified among three regions to ensure adequate representation of rural Montanans and American Indians (For further technical information see Montana Department of Public Health and Human Services, Montana Behavioral Risk Factor Surveillance System website, at http://www.brfss.mt.gov .For additional technical information see Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System website, Technical Information and Data, at http://www.cdc.gov/brfss/technical_infodata/index.htm ).

Trained, experienced professionals interviewed the selected respondents. Interviews were conducted on weekdays and weekends and at various hours to ensure the selected individual had ample opportunity to participate. The Montana BRFSS was conducted by Northwest Resource Consultants (Helena, MT) in 2001 and by ORC Macro (Burlington, VT) in 2003. Survey response rates were 70.8 percent and 59.0 percent, respectively.

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Data Analysis

SPSS 12.0 for Windows Complex Samples (trade mark). was used to compute prevalence estimates and standard errors for this report, using sample weights provided by CDC. Respondents who answered they did not know or refused to answer a question were excluded from the calculation of prevalence estimates.

Each year’s data were weighted to account for differences in the probability of selection. Additionally, post-stratification weighting, based on Montana population estimates, was applied to ensure the sample more closely reflected the adult population of Montana. Demographic characteristics of survey respondents with and without disability are described in Table 2.

Weighted prevalence estimates and unweighted counts are tabulated in this report, along with 95% confidence intervals. The 95% confidence interval gives a range of values around the estimated prevalence where the actual prevalence in the Montana adult population can be expected to be located, with 95% certainty. Where confidence intervals do not overlap, differences between subgroups are statistically significant. A statistical test is needed to determine significant differences when confidence intervals overlap. Chi-square tests were calculated in a few instances where confidence intervals slightly overlapped and significant differences were reported in the text when the test p-value was . 0.05.

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Survey Limitations

The results in this report should be interpreted with consideration of the following limitations. Survey respondents may have the tendency to under-report behaviors perceived as socially undesirable or unhealthy and over-report those thought to be desirable. The ability of survey participants to recall past behaviors and events may also affect the accuracy of self-reported information.

Telephone surveys exclude households without telephone service and do not include cellular phones; and survey bias may result from under-representation of certain segments of the population.

The 2.8 percent of households without telephone service in Montana (Reference: U.S. Census Bureau. Census of Population and Housing, 2000: Summary File 3 (SF 3) Sample Data. Washington DC: U.S. Census Bureau. Available at http://www.census.gov/ . Accessed June 2005 ) may represent a segment with lower socio-economic status and associated higher risks for certain behaviors and conditions, including disability. However, a recent study suggests that population telephone surveys do not under-represent adults with disabilities (Reference: Kinne S., Topolski T.D. Inclusion of people with disabilities in telephone health surveillance surveys. American Journal of Public Health. 2005; 95(3):512-517.).

Two additional factors related to the current BRFSS methodology may have contributed to under-representation of adults with disability in the survey samples:

1. BRFSS methodology does not include adults with communication or other impairments that affect their ability to answer the telephone or telephone survey questions.

2. BRFSS methodology does not include adults who live in institutions in the survey sample. Institutions include nursing homes or other long-term care facilities, state facilities (e.g., Montana Developmental Center, Montana State Hospital), and prisons.

The BRFSS methodology also excludes adults who live in residential group homes. The information presented in this report is necessarily limited by the methodology and questionnaire content of the BRFSS. Telephone surveys are restricted in the type and quantity of information that can be collected. The optional modules included in the Montana questionnaire vary substantially from year to year, and certain core modules are included in alternating years only. In the 2001 and 2003 surveys, data on the

Leading Health Indicators were thus limited (e.g. substance abuse, sexual behavior, specific mental health data, violence); also, certain data that describe known areas of health disparities between people with and without disabilities were not collected in these years, when the disability questions were asked (e.g. cancer screening, women’s preventive health screening, oral health).

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Other Considerations

Survey respondents with disability were older than those without disability, in both survey years. Older adults tend to have more health-related problems and different risk behavior patterns than younger adults. The data in this report were analyzed and reported by age category to minimize age-associated differences and allow for meaningful comparisons. We presented age-specific rates as an alternative to age-adjustment, since age adjustment is a method for aggregating age-specific rates into an overall rate that reflects age differences in two or more populations. For further discussion, please see Fleiss, J.L. Statistical Methods for Rates and Proportions. 2nd ed. New York: John Wiley & Sons; 1981:237-247.

Although there may be gender-specific and other associations within the data that could be examined, the analyses required to discern them are beyond the scope of this report. These will be addressed in the future. Also, the sample sizes for specific race/ethnic groups, such as American Indians, were too small to make reliable generalizations about these sub-populations with disability.

Results from both the 2001 and 2003 Montana BRFSS are presented in most tables in this report. The results reported for the two years are similar; however, the 2003 sample size was larger and therefore prevalence estimates were more precise. For simplicity and clarity, the text and figures in the following pages highlight results from the 2003 BRFSS only.

The operational definition of disability used in this report, as explained in the introduction, is activity limitation and/or use of assistive devices. These are generally accepted indicators of disability in established health surveys, including the National Health Interview Survey (NHIS) of the National Center for Health Statistics and the Survey of Income and Program Participation (SIPP) of the U.S. Census Bureau.

This definition, now also used in the BRFSS, does not account for the duration and severity of disability, which can vary considerably during an individual’s life. Since the BRFSS is cross-sectional data, it does not allow for assessment of this dynamic nature of disability. In addition, these survey questions represent undocumented self-reported data that have not been validated as measures of disability to date. However, questions in surveys such as the BRFSS should allow for more uniform surveillance and public health research at the state and national level.

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Prevalence of Disability

Description of Table 1. Prevalence of Disability, Montana Adults, 2001 and 2003 (with 95% confidence intervals). In 2001, 19%of all 3,332 responding adults said that their activities are limited due to a health problem. Confidence interval: 17.2-20.8. In 2003, 19.9% of all 3,976 responding adults said that their activities are limited due to a health problem. Confidence interval: 18.3-21.5.

In 2001, 5.3% of 3,337 responding adults said that their health problem requires use of special equipment. Confidence interval: 4.3-6.2. In 2003, 6.4% of 3,993 responding adults said that their health problem requires use of special equipment. Confidence interval: 5.4-7.4.

In 2001, 20.2% of 3,333 responding adults said that they have a disability.  Confidence interval:18.4-22.0. In 2003, 21.4% of 3,976 responding adults said that they have a disability. Confidence interval: 19.7-23.1.

In 2001, 1,421 responding adults were male. 17.4% of those had a disability. Confidence interval: 14.9-19.9. 1,912 were female. 22.8% of those had a disability. Confidence interval: 20.2-25.4. In 2003, 1,724 responding adults were male. 19.4% of those had a disability. Confidence interval: 17.0-21.9. 2,252 were female. 23.4% of those had a disability. Confidence interval: 21.1-25.6.

In 2001, 245 respondents were ages 18-24. 12.9% of those had a disability. Confidence level: 7.2-18.6. In 2003, 245 respondents were ages 18-24. 9.7% of those had a disability. Confidence level: 5.0-14.4. 

In 2001, 459 respondents were ages 25-34. 10.4% of those had a disability. Confidence level: 7.0-13.8. In 2003, 502 respondents were ages 25-34. 13% of those had a disability. Confidence level: 9.2-15.6.

In 2001, 658 respondents were ages 35-44. 12.4% of those had a disability. Confidence level: 7.0-13.8. In 2003, 748 respondents were ages 35-44. 17.8% of those had a disability. Confidence level: 14.4-21.2.

In 2001, 752 respondents were ages 45-54. 23.6% of those had a disability.  Confidence Interval: 19.2-28.0. In 2003, 916 respondents were ages 45-54. 22.1% of those had a disability. Confidence Interval: 18.8-25.4.

In 2001, 481 respondents were ages 55-64. 30.4% had a disability. Confidence Interval: 24.9-35.9. In 2003, 664 respondents were ages 55 – 64. 24.7% had a disability. Confidence Interval: 20.6-28.8.

In 2001, 734 respondents were 65 or older. 31.7% had a disability. Confidence Interval: 27.3-36.1. In 2003, 869 respondents were 65 or older. 37.6% had a disability. Confidence interval: 33.2-42.0.

In 2001, 363 respondents had not completed high school. 31.5% had a disability. Confidence interval: 24.7-38.3. In 2003, 358 respondents had not completed high school. 30.9% had a disability. Confidence interval: 24.0-37.8.

In 2001, 1135 respondents had completed high school. 18.8% had a disability. Confidence interval: 15.7-21.9. In 2003, 1350 respondents had completed high school. 21.9% had a disability. Confidence interval: 19.0-24.8.

In 2001, 968 respondents had completed some college. 22.3% had a disability.  Confidence interval: 18.8-25.8. In 2003, 1128 respondents had completed some college. 21.6% had a disability. Confidence interval: 18.4-24.8.

In 2001, 861 respondents had completed a college degree. 15.2% had a disability. Confidence interval: 12.2-18.2. In 2003, 1136 respondents had completed a college degree. 18.1% had a disability. Confidence interval: 15.2-21.0.

In 2001, 334 respondents had incomes of less than $15,000. 34.3% had a disability. Confidence interval: 26.7-41.9. In 2003, 516 respondents had incomes of less than $15,000. 44.4% had a disability. Confidence interval: 38.4-50.3.

In 2001, 702 respondents had incomes of $15,000-$24,999. 20.3% had a disability. Confidence interval: 16.1-24.5. In 2003, 837 respondents had incomes of $15,000-$24,999. 28.1% had a disability. Confidence interval: 23.7-32.5.

In 2001, 970 respondents had incomes of $25,000-$49,999. 17.3% had a disability. Confidence interval: 14.1-20.5. In 2003, 1270 respondents had incomes of $25,000-$49,999. 19.1% had a disability. Confidence interval: 16.2-22.0.

In 2001, 321 respondents had incomes of $50,000-$74,999. 14.8% had a disability. Confidence interval: 9.7-19.9. In 2003, 518 respondents had incomes of $50,000-$74,999. 12.1% had a disability. Confidence interval: 8.7-15.5.

In 2001, 238 respondents had incomes over $75,000. 9.8% had a disability. Confidence interval: 4.7-14.9. In 2003, 411 respondents had incomes over $75,000. 11.4% had a disability. Confidence interval: 7.9-14.9. 

In 2001, 2789 respondents were White, non-Hispanic. 19.4% had a disability. Confidence interval: 17.5-21.3. In 2003, 3430 respondents were White, non-Hispanic. 21.2% had a disability. Confidence interval: 19.5-22.9.

In 2001, 523 respondents were non-White or Hispanic. 27.4% had a disability. Confidence interval: 21.9-32.9. In 2003, 522 respondents were non-White or Hispanic. 21.5% had a disability. Confidence interval: 15.7-27.3.

In 2001, 350 respondents were American Indian and/or Alaska Native only. 26.5% had a disability. Confidence interval: 20.1-32.9. In 2003, 359 respondents were American Indian and/or Alaska Native only. 21.7% had a disability. Confidence interval: 14.3-29.1.

In 2001, 173 respondents were all other non-White (including multiracial) or Hispanic. 28.3% had a disability. Confidence interval: 19.4-37.2. In 2003, 163 respondents were all other non-White (including multiracial) or Hispanic. 21.3% had a disability. Confidence interval: 12.3-30.3. End of description.

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Description of Figure 2. Bar chart showing prevalence of disability by age and income, Montana adults – 2003. In 2003, 245 respondents were ages 18-24. 9.7% of those had a disability. In 2003, 502 respondents were ages 25-34. 13% of those had a disability. In 2003, 748 respondents were ages 35-44. 17.8% of those had a disability. In 2003, 916 respondents were ages 45-54. 22.1% of those had a disability. In 2003, 664 respondents were ages 55 – 64. 24.7% had a disability. In 2003, 869 respondents were 65 or older. 37.6% had a disability.

In 2003, 516 respondents had incomes of less than $15,000. 44.4% had a disability. In 2003, 837 702 respondents had incomes of $15,000-$24,999. 28.1% had a disability. In 2003, 1270 respondents had incomes of $25,000-$49,999. 19.1% had a disability. In 2003, 518 respondents had incomes of $50,000-$74,999. 12.1% had a disability. In 2003, 411 respondents had incomes over $75,000. 11.4% had a disability. End of description.

Are you limited in any way in any activities because of physical, mental, or emotional problems? Twenty percent of Montana adults reported activity limitation in 2003. Do you now have any health problem that requires you to use special equipment, such as a cane, a wheelchair, a special bed, or a special telephone? Six percent of adult Montanans reported using special equipment due to a health problem in 2003.

Disability: defined as a “Yes” response to one or both of the above questions. Overall, one in five (21%) Montana adults lived with disability in 2003. Twenty-three percent of females and 19 percent of males reported disabilities. Disability increased significantly with increasing age – those 65 and older (38%) were more than twice as likely to have disabilities as those 18-64 years old (18%).

The prevalence of disability in Montana adults was inversely associated with income . Forty-four percent of those with household incomes less than $15,000 per year reported disabilities compared to 12 percent of those with incomes of $50,000 or more.

The prevalence of disability was higher among adults who had not completed high school (31%) than those with a college degree (18%).

In 2003, race was not a factor in the prevalence of disability in Montana – 21 percent of White, non-Hispanic adults and 22 percent of non-White or Hispanic adults reported disabilities.

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Demographic Comparisons

Description of Table 2. Demographic Characteristics of Montana Adults with and without Disability – 2003 (with 95% confidence intervals). 953 respondents had a disability. 393 (44.9%) were male. Confidence interval is 40.6-49.2. 560 were female (55.1%). Confidence interval is 50.8-59.4.

3023 respondents did not have disability. 1331 were male (50.7%). Confidence interval is 48.2-53.2. 1692 were female (49.3%) Confidence interval is 46.8-51.8.

946 people with disability (100.0%) responded to the question about age. 2998 people without disability (100.0%) responded to the question about age.

25 respondents with disability were ages 18 -24 (6.2%). Confidence interval is 3.3-9.1. 220 respondents without disability were ages 18-24 (15.8%). Confidence interval is 13.4-18.2.  58 respondents with disability were ages 25-34 (9.0%). Confidence interval is 5.9-12.1. 444 respondents without disability were ages 25-34 (16.5%). Confidence interval is 14.7-18.3.  143 respondents with disability were ages 35-44 (15.4%). Confidence interval is 12.5-18.3. 605 respondents without disability were ages 35-44 (19.4%). Confidence interval is 17.6-21.2.  225 respondents with disability were ages 45-54 (21.1%). Confidence interval is 18.0-24.2. 691 respondents without disability were ages 45-54 (20.3%). Confidence interval is 18.5-22.1. 185 respondents with disability were ages 55-64 (16.0%). Confidence interval is 13.1-18.9. 479 respondents without disability were ages 55-64 (13.3%). Confidence interval is 11.7-14.9. 310 respondents with disability were age 65 or older (32.2%). Confidence interval is 28.3-36.1. 559 respondents without disability were age 65 or older (14.6%) Confidence interval is 13.0-16.2.

952 people with disability answered the question about highest educational level attained (100.0%). 3020 people without disability answered the question about highest educational level attained (100.0%). 113 respondents with disability had not completed high school (12.1%). Confidence interval is 9.2-15.0. 245 respondents without disability had not completed high school (7.4%). Confidence interval is 6.0-8.8. 334 respondents with disability had completed high school (33.4%). Confidence interval is 29.5-37.3. 1016 respondents without disability had completed high school (32.5%). Confidence interval is 30.1-34.9.  280 respondents with disability had completed some college (28.6%). Confidence interval is 24.7-32.5. 848 respondents without disability had completed some college (28.3%) Confidence interval is 25.9-30.7. 225 respondents with disability had a college degree (25.9%.) Confidence interval is 22.0-29.8. 911 respondents without disability had a college degree (31.8%). Confidence interval is 29.6-34.0.

853 respondents with disability answered the question about income (100.0%). 2699 respondents without disability answered the question about income (100.0%). 240 respondents with disability had incomes of less than $15,000 (21.9%). Confidence interval is 18.6-25.2. 276 respondents without disability had incomes of less than $15,000 (7.6%). Confidence interval is 6.4-8.8  233 respondents with disability had incomes of $15,000-$24,999 (29.8%). Confidence interval is 25.3-34.3. 604 respondents without disability had incomes of $15,000 – $24,999 ( 21.1%). Confidence interval is 18.9-23.3.  254 respondents with disability had incomes of $25,000-$49,999 (31.9%). Confidence interval is 27.6-36.2. 1016 respondents without disability had incomes of $25,000-$49,999 (37.4%). Confidence interval is 34.9-39.9. 71 respondents with disability had incomes of $50,000-$74,999 (9.1%). Confidence interval is 6.6-11.6. 447 respondents without disability had incomes of $50,000-$74,999 (18.3%). Confidence interval is 16.3-20.3.  55 respondents with disability had incomes of $75,000+ (7.3%). Confidence interval is 4.9-9.7. 356 respondents without disability had incomes of $75,000+ (15.7%).  Confidence interval is 13.7-17.7.

Race/Ethnicity: 943 (100.0%) people with disability identified their race/ethnicity. 3,009 respondents without disability (100.0%) identified their race/ethnicity.  826 respondents with disability were White, non-Hispanic (90.5%). Confidence interval is 87.8-93.2. 2604 respondents without disability were White, non-Hispanic (90.7%). Confidence interval is 89.3-92.1.  117 respondents with disability were non-White or Hispanic (9.5%). Confidence interval is 6.8-12.2. 405 respondents without disability were non-White or Hispanic (9.3%). Confidence interval is 7.9-10.7.  80 respondents with disability were American Indian or Alaska Native only (5.1%). Confidence interval is 3.1-7.1. 279 respondents without disability American Indian or Alaska Native only (5.0%). Confidence interval is 4.0-6.0.  37 respondents with disability were all other non-White (including multiracial) or Hispanic (4.4%). Confidence interval is 2.4-6.4. 126 respondents without disability were all other non-White (including multiracial) or Hispanic ( 4.4%). Confidence interval is 3.2-5.6. End of description.

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Description of Figure 3. Percent Reporting Annual Household Incomes Less than $25,000 (bar graph), Montana Adults, 2003. Just over half of all adults with disability had annual household incomes less than $25,000. About 28% of all adults without disability had annual household incomes less than $25,000. In the 18-64 age range, about 49% of adults with disability had annual household incomes less than $25,000, and about 26% of adults without disability had annual household incomes less than $25,000. In the 65+ age range, about 58% of adults with disability had annual household incomes less than $25,000, and about 45% of adults without disability had annual household incomes less than $25,000. End of description.

Adults with disability were more likely to be female than adults without disability: Fifty-five percent of Montana adults with disability were female, compared to 49 percent of those without disability.

Adults with disability were significantly older than adults without disability: One in three (32%) adults with disability were age 65 or older. Among adults without disability, fewer than one in six (15%) were in this age category. Conversely, just 15 percent of adults with disability were 18-34 years of age, compared to 32 percent of those without disability. The median age of adults with disability was 54 years, ten years older than the median age of 44 for those without disability.

Adults with disability reported a lower level of educational attainment than those without disability: A significantly higher percentage of adults with disability (12%) reported they had not completed high school than adults without disability (7%). Those without disability were more likely to have a college degree (32% vs. 26% of those with disability).  Differences in educational attainment between adults with and without disability were attributable to those aged 18-64; among older adults, there were no differences in the level of educational attainment between those with and without disability.

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Description of Figure 4. Employment status, Montana adults age 18-64 years, 2003 (bar graph). 57% of respondents with disabilities are employed. 78% of respondents without disabilities are employed. 20% of respondents with disabilities are unable to work. 1% of respondents without disabilities are unable to work. 23% of respondents with disabilities are “other”. 22% of respondents without disabilities are “other”. End of description.

Adults with disability reported lower annual household incomes than those without disability: Over half (52%) of those with disability reported incomes less than $25,000 per year, compared to less than one-third (29%) of those without disability. Adults without disability (34%) were more than twice as likely to have incomes of $50,000 or more than adults with disability (16%).

Adults with disability were more likely to be unemployed than those without disability: Working age adults (age 18-64) with disability were significantly more likely to be unemployed (43%) or unable to work (20%) than their counterparts without disability (22% and 1% respectively).

However, 57 percent of working age adults with disability were employed or self-employed (Figure 4).

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Health Status

Description of Table 3. Health Status, Montana Adults with and without Disability, 2001 and 2003 (with 95% confidence intervals). For the 3,333 respondents reporting in 2001, 14.4% said that their general health is “fair” or “poor”. Confidence Interval is 12.8-16.0. For the 4,013 respondents reporting in 2003, 12.3% said that their general health is “fair” or “poor”. Confidence Interval is 11.1-13.5.

In 2001, of 741 adults with disability, 43.9% said that their general health is “fair” or “poor”. Confidence Interval is 39.0-48.8. In 2003, of 947 adults with disability, 37.1% said that their general health is “fair” or “poor”. Confidence Interval is 33.0-41.2.

In 2001, of 499 adults, ages 18-64, with disability, 41.3% said that their general health is “fair” or “poor”. Confidence Interval is 35.2-47.4. In 2003, of 630 adults, ages 18-64, with disability, 32.4% said that their general health is “fair” or “poor”. Confidence Interval is 27.7-37.1.

In 2001, of 242 adults, ages 65+, with disability, 50.3% said that their general health is “fair” or “poor”. Confidence Interval is 41.7-58.9. In 2003, of 310 adults, ages 65+, with disability, 46.5% said that their general health is “fair” or “poor”. Confidence Interval is 39.1-53.9.

In 2001, of 2,587 adults without disability, 7% said that their general health is “fair” or “poor”. Confidence Interval is 5.8-8.2. In 2003, of 3,018 adults without disability, 5.6% said that their general health is “fair” or “poor”. Confidence Interval is 4.6-6.6.

In 2001, of 2,094 adults, ages 18-64, without disability, 5.6% said that their general health is “fair” or “poor”. Confidence Interval is 4.4-6.8. In 2003, of 2,435 adults, ages 18-64, without disability, 4.4% said that their general health is “fair” or “poor”. Confidence Interval is 3.4-5.4.

In 2001, of 489 adults, ages 65+, without disability, 14.8% said that their general health is “fair” or “poor”. Confidence Interval is 10.9-18.7. In 2003, of 558 adults, ages 65+, without disability, 12.8% said that their general health is “fair” or “poor”. Confidence Interval is 9.3-16.3.

For the 3,304 respondents reporting in 2001, 30.9%said that their physical health was not good on one or more of the past 30 days. Confidence Interval is 28.7-33.1. For the 3,927 respondents reporting in 2003, 33.8% said that their physical health was not good on one or more of the past 30 days. Confidence Interval is 31.8-35.8.

In 2001, of 723 adults with disability, 56.1% said that their physical health was not good on one or more of the past 30 days. Confidence Interval is 51.0-61.2. In 2003, of 925 adults with disability, 64.2% said that their physical health was not good on one or more of the past 30 days. Confidence Interval is 59.9-68.5.

In 2001, of 492 adults with disability, ages 18-64, 57.4% said that their physical health was not good on one or more of the past 30 days. Confidence Interval is 51.3-63.5. In 2003, of 624 adults with disability, ages 18-64, 67.2% said that their physical health was not good on one or more of the past 30 days. Confidence Interval is 62.1-72.3.

In 2001, of 231 adults with disability, ages 65+, 52.9% said that their physical health was not good on one or more of the past 30 days. Confidence Interval is 44.3-61.5. In 2003, of 294 adults with disability, ages 65+, 58.3% said that their physical health was not good on one or more of the past 30 days. Confidence Interval is 50.7-65.9.

In 2001, of 2576 adults without disability, 24.7% said that their physical health was not good on one or more of the past 30 days. Confidence Interval is 22.3-27.1. In 2003, of 3000 adults without disability, 25.7% said that their physical health was not good on one or more of the past 30 days. Confidence Interval is 23.5-27.9. 

In 2001, of 2086 adults without disability, ages 18-64, 25.7% said that their physical health was not good on one or more of the past 30 days. Confidence Interval is 23.0-28.4. In 2003, of 2428 adults without disability, ages 18-64, 25.3% said that their physical health was not good on one or more of the past 30 days. Confidence Interval is 22.9-27.7.

In 2001, of 486 adults without disability, ages 65+, 19.3% said that their physical health was not good on one or more of the past 30 days. Confidence Interval is 14.6-24.0. In 2003, of 547 adults without disability, ages 65+, 28.7% said that their physical health was not good on one or more of the past 30 days. Confidence Interval is 23.8-33.6.

For the 3,298 respondents reporting in 2001, 22.8% said that their mental health was not good on one or more of the past 30 days. Confidence Interval is 20.8-24.8. For the 3,962 respondents reporting in 2003, 33.9% said that their mental health was not good on one or more of the past 30 days. Confidence Interval is 31.7-36.1.

For the 728 adults with disability reporting in 2001, 35.4% said that their mental health was not good on one or more of the past 30 days. Confidence Interval is 30.5-40.3. For the 927 adults with disability reporting in 2003, 45.3% said that their mental health was not good on one or more of the past 30 days. Confidence Interval is 41.0-49.6.

For the 493 adults with disability, ages 18-64 and reporting in 2001, 41.8% said that their mental health was not good on one or more of the past 30 days. Confidence Interval is 35.7-47.9. For the 617 adults with disability, ages 18-64 and reporting in 2003, 55.2% said that their mental health was not good on one or more of the past 30 days. Confidence Interval is 49.7-60.7.

For the 235 adults with disability, ages 65+ and reporting in 2001, 19.4% said that their mental health was not good on one or more of the past 30 days. Confidence Interval is 12.1-26.7 For the 304 adults with disability, ages 65+ and reporting in 2003, 25.0% said that their mental health was not good on one or more of the past 30 days. Confidence Interval is 18.5-31.5.

For the 2565 adults without disability reporting in 2001, 19.7% said that their mental health was not good on one or more of the past 30 days. Confidence Interval is 17.5-21.9. For the 2990 adults without disability reporting in 2003, 30.8% said that their mental health was not good on one or more of the past 30 days. Confidence Interval is 28.4-33.2.

For the 2079 adults without disability, ages 18-64 and reporting in 2001, 21.8% said that their mental health was not good on one or more of the past 30 days. Confidence Interval is 19.4-24.2. For the 2414 adults without disability, ages 18-64 and reporting in 2003, 33.7% said that their mental health was not good on one or more of the past 30 days. Confidence Interval is 31.0-36.4.

For the 482 adults without disability, ages 65+ and reporting in 2001, 8.3% said that their mental health was not good on one or more of the past 30 days. Confidence Interval is 5.2-11.4. For the 551 adults without disability, ages 65+ and reporting in 2003, 13.9% said that their mental health was not good on one or more of the past 30 days. Confidence Interval is 10.0-17.8.

For the 3,318 respondents reporting in 2001, 18.5% said that poor health prevented their usual activities one or more of the past 30 days. Confidence Interval is 16.7-20.3.  For the 3,991 respondents reporting in 2003, 19.5% said that poor health prevented their usual activities one or more of the past 30 days. Confidence Interval is 17.9-21.1.

For the 729 adults with disability reporting in 2001, 44.0% said that poor health prevented their usual activities one or more of the past 30 days. Confidence Interval is 38.9-49.1. For the 934 adults with disability reporting in 2003, 43.6%said that poor health prevented their usual activities one or more of the past 30 days. Confidence Interval is 39.3-47.9.

For the 494 adults, ages 18-64, with disability, reporting in 2001, 45.3% said that poor health prevented their usual activities one or more of the past 30 days. Confidence Interval is 39.2-51.4. For the 623 adults, ages 18-64, with disability, reporting in 2003, 49.6%said that poor health prevented their usual activities one or more of the past 30 days. Confidence Interval is 44.1-55.1.

For the 235 adults with disability, ages 65+, reporting in 2001, 40.6% said that poor health prevented their usual activities one or more of the past 30 days. Confidence Interval is 31.8-49.4. For the 305 adults with disability, ages 65+, reporting in 2003, 31.2% said that poor health prevented their usual activities one or more of the past 30 days. Confidence Interval is 24.3-38.1.

For the 2584 adults without disability reporting in 2001, 12.2% said that poor health prevented their usual activities one or more of the past 30 days. Confidence Interval is 10.4-14.0. For the 3009 adults without disability reporting in 2003, 13.1% said that poor health prevented their usual activities one or more of the past 30 days. Confidence Interval is 11.5-14.7.

For the 2092 adults without disability, ages 18-64, and reporting in 2001, 12.8% said that poor health prevented their usual activities one or more of the past 30 days. Confidence Interval is 10.8-14.8. For the 2434 adults without disability, ages 18-64, reporting in 2003, 13.6% Confidence Interval is 11.8-15.4.

For the 488 adults without disability, ages 65+, and reporting in 2001, 9.5% said that poor health prevented their usual activities one or more of the past 30 days. Confidence Interval is 6.0-13.0. For the 550 adults without disability, ages 65+, and reporting in 2003, 10.8% said that poor health prevented their usual activities one or more of the past 30 days. Confidence Interval is 7.3-14.3. End of description.

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Description of Figure 5. Self-reported health status, Montana adults, 2003. About 38% of respondents with disabilities said that their general health is “fair” or “poor”. About 5% of respondents without disabilities said that their general health is “fair” or “poor”.

About 64% of respondents with disabilities said that their physical health was “not good” on one or more days (in the past month). About 26% of respondents without disabilities said that their physical health was “not good” on one or more days (in the past month).

About 45% of respondents with disabilities said that their mental health was “not good” on one or more days (in the past month). About 31% of respondents without disabilities said that their mental health was “not good” on one or more days (in the past month). End of description.

Would you say that in general your health is excellent, very good, good, fair, or poor? Thirty-seven percent of Montana adults with disability described their general health as fair or poor. Six times as many adults with disability (37%) as adults without disability (6%) reported fair or poor general health.

Older adults were more likely to describe their health status as fair or poor than their younger counterparts. Among adults with disability, almost half (47%) of those age 65 and older reported fair or poor health, compared to one-third (32%) of those younger than 65.

How many days during the past 30 days was your physical health not good? Two in three (64%) Montana adults with disability indicated their physical health was not good on one or more of the previous 30 days.

More than twice as many adults with disability (64%), as adults without disability (26%), responded they had one or more days of poor physical health in the past month. One in three (34%) adults with disability reported 14 or more days of poor physical health in the past month – compared to just 4 percent of adults without disability.

Montana adults with disability reported an average 10.0 days of poor physical health in the past month – six times the average 1.6 days reported by adult without disability.

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Description of Table 3-b. Average Number of Poor Health Days (past 30 days), Montana Adults with and without Disability, 2003. Average number of days has 95% confidence intervals.

All responding adults with disabilities averaged 10.0 poor physical health days (Confidence interval is 9.0-11.0). All responding adults without disabilities averaged 1.6 poor physical health days (Confidence interval is 1.4-1.9).

Responding adults, ages 18-64, with disabilities averaged 9.7 poor physical health days (Confidence interval is 8.6-10.9). All responding adults, ages 18-64, without disabilities averaged 1.3 poor physical health days (Confidence interval is 1.1-1.5).

Responding adults, ages 65+, with disabilities averaged 10.7 poor physical health days (Confidence interval is 8.8-12.7). All responding adults, ages 65+, without disabilities averaged 3.6 poor physical health days (Confidence interval is 2.7-4.6).

All responding adults with disabilities averaged 6.0 poor mental health days (Confidence interval is 5.1-6.8). All responding adults without disabilities averaged 2.3 poor mental health days (Confidence interval is 2.0-2.6).

Responding adults, ages 18-64, with disabilities averaged 7.3 poor mental health days (Confidence interval is 6.2-8.4). All responding adults, ages 18-64, without disabilities averaged 2.5 poor mental health days (Confidence interval is 2.2-2.8).

Responding adults, ages 65+, with disabilities averaged 3.3 poor mental health days (Confidence interval is 2.0-4.5). All responding adults, ages 65+, without disabilities averaged 1.1 poor mental health days (Confidence interval is 0.6-1.5).

All responding adults with disabilities averaged 6.1 days when poor health prevented usual activities. (Confidence interval is 5.3-6.9). All responding adults without disabilities averaged 0.7 days when poor health prevented usual activities. (Confidence interval is 0.6-0.8).

Responding adults, ages 18-64, with disabilities averaged 6.4 days when poor health prevented usual activities. Confidence interval is 5.5-7.4). All responding adults, ages 18-64, without disabilities averaged 0.6 days when poor health prevented usual activities. (Confidence interval is 0.5-0.7).

Responding adults, ages 65+, with disabilities averaged 5.4 days when poor health prevented usual activities. (Confidence interval is 3.9-7.0). All responding adults, ages 65+, without disabilities averaged 1.3 days when poor health prevented usual activities. (Confidence interval is 0.7-1.9). End of description.

How many days during the past 30 days was your mental health not good? Forty-five percent of Montana adults with disability – compared to 31 percent of adults without disability – reported their mental health was not good on one or more of the past 30 days.

Four times as many adults with disability (20%), as adults without disability (5%), indicated 14 or more days of poor mental health in the past month.

Older adults (age 65 and older) were significantly less likely to report poor mental health than younger adults, regardless of disability status. Among adults with disability, the percentage of older adults reporting one or more days of poor mental health (25%) was about half that of younger adults (55%).

Adults with disability reported an average 6.0 days of poor mental health during the past 30 days – significantly higher than the average 2.3 days reported by those without disability.

During the past 30 days, about how many days did poor physical or mental health keep you from doing your usual activities? Forty-four percent of adults with disability reported that poor health kept them from doing their usual activities on one or more of the past 30 days – three times as many as adults without disability (13%).

Among Montanans with disability, younger adults (50%) were more likely to report one or more days of activity limitation in the past month than those age 65 and older (31%).

One in five adults with disability (21%) said poor health interfered with their usual activities on 14 or more of the past 30 days – ten times as many as those without disability (2%).

Adults with disability reported that poor health prevented their usual activities an average 6.1 days during the past month – compared to less than one day for adults without disability.

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Health Care Access

Description of Table 4. Health Care Access, Montana Adults with and without Disability, 2001 and 2003 (with 95% confidence intervals). In 2001, 16.9% of 3,331 respondents did not have health insurance. Confidence interval is 15.1-18.7. In 2003, 19.1% of 4,013 respondents did not have health insurance. Confidence interval is 17.3-20.9.

In 2001, 16.7% of 744 adults with disability did not have health insurance. Confidence interval is 12.8-20.6. In 2003, 18.2% of 950 adults with disability did not have health insurance. Confidence interval is 14.5-21.9.

In 2001, 23.1% of 500 adults with disability, ages 18-64, did not have health insurance.  Confidence interval is 17.8-28.4. In 2003, 25.7% of 635 adults with disability, ages 18-64, did not have health insurance. Confidence interval is 20.6-30.8.

In 2001, 0.9% of 244 adults with disability, ages 65+, did not have health insurance. Confidence interval is 0.1-1.7 In 2003, 2.2% of 308 adults, ages 65+, with disability did not have health insurance. Confidence interval is 0.2-4.2.

In 2001, 17.0% of 2,582 adults without disability, ages 18-64, did not have health insurance. Confidence interval is 15.0-19.0 In 2003, 19.5% of 3,016 adults without disability did not have health insurance. Confidence interval is 17.5-21.5.

In 2001, 19.9% of 2,088 adults without disability, ages 18-64, did not have health insurance. Confidence interval is 17.5-22.3. In 2003, 22.5% of 2434 adults without disability, ages 18-64, did not have health insurance. Confidence interval is 20.1-24.9.

In 2001, 1.7% of 490 adults, ages 65+, without disability, did not have health insurance. Confidence interval is 0.5-2.9 In 2003, 2.6% of 559 adults, ages 65+, without disability did not have health insurance. Confidence interval is 0.8-4.4.

In 2001, 27.7% of 3,333 respondents had no personal doctor or health care provider. Confidence interval is 25.5-29.9 4012. In 2003, 26.7% of 4,012 respondents had no personal doctor or health care provider. Confidence interval is 24.7-28.7.

In 2001, 16.9% of 743 adults with disability had no personal doctor or health care provider. Confidence interval is 13.4-20.4. In 2003, 17.2% of 952 adults with disability had no personal doctor or health care provider. Confidence interval is 13.5-20.9.

In 2001, 20.0% of 499 adults with disability, ages 18-64, had no personal doctor or health care provider. Confidence interval is 15.5-24.5. In 2003, 21.3% of 636 adults with disability, ages 18-64, had no personal doctor or health care provider. Confidence interval is 16.4-26.2.

In 2001, 9.4% of 244 adults, ages 65+, with disability, had no personal doctor or health care provider. Confidence interval is 4.9-13.9. In 2003, 8.5% of 309 adults with disability, ages 65+, had no personal doctor or health care provider. Confidence interval is 4.4-12.6.

In 2001, 30.5% of 2585 adults without disability had no personal doctor or health care provider. Confidence interval is 28.0-33.0. In 2003, 29.3% of 3012 adults without disability had no personal doctor or health care provider. Confidence interval is 26.9-31.7.

In 2001, 33.6% of 2093 adults without disability, ages 18-64, had no personal doctor or health care provider. Confidence interval is 30.7-36.5. In 2003, 32.7% of 2432 adults without disability, ages 18-64, had no personal doctor or health care provider. Confidence interval is 30.2-35.2.

In 2001, 13.7% of 488 adults, ages 65+, without disability, had no personal doctor or health care provider. Confidence interval is 9.8-17.6. In 2003, 9.9% of 557 adults, ages 65+, without disability, had no personal doctor or health care provider.  Confidence interval is 7.0-12.8.

In 2001, the survey didn’t ask the question about not seeing a doctor because of cost (past 12 mo.). Of all 4008 respondents in 2003, 12.9% could not see a doctor because of cost (in the last 12 months). Confidence interval is 11.5-14.3.  In 2003, 19.9% of 944 adults with disability could not see a doctor because of cost (past 12 mo.). Confidence interval is 16.4-23.4.

In 2003, 26.7% of 630 adults with disability, ages 18-64, could not see a doctor because of cost (past 12 mo.). Confidence interval is 22.0-31.4. In 2003, 5.6% of 307 adults with disability, ages 18-64, could not see a doctor because of cost (past 12 mo.).  Confidence interval is 2.3-8.9.

In 2003, 11.1% of 3017 adults without disability could not see a doctor because of cost (past 12 mo.). Confidence interval is 9.5-12.7. In 2003, 12.6% of 2433 adults, ages 18-64, without disability could not see a doctor because of cost (past 12 mo.). Confidence interval is 10.6-14.6. In 2003, 2.8% of 559 adults without disability, ages 65+, could not see doctor because of cost (past 12 mo.). Confidence interval is 1.2-4.4.  End of description.

Healthy People 2010 Objective(s):

1-1. Increase the proportion of persons with health insurance to 100 percent.
1-5. Increase the proportion of persons with a usual primary care provider to 85 percent.

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Description of Figure 6. Access to health care, Montana adults age 18-64 years, 2003. This bar graph shows that about 26% of respondents with disabilities had no health insurance, and about 22% of respondents without disabilities had no health insurance. About 21% of respondents with disabilities had no personal doctor or health care provider, and about 32% of respondents without disabilities had no personal doctor or health care provider. About 27% of respondents with disabilities could not afford to see a doctor in the past 12 months, and about 13% of respondents without disabilities could not afford to see a doctor in the past 12 months. End of description.

Do you have any kind of health care coverage? Eighteen percent of Montana adults with disability reported they were uninsured in 2003. There were no differences in the level of health care coverage between those with and without disability.

Adults age 18-64 (>22%) were more likely to report being uninsured than those 65 and older (<3%, most likely due to Medicare coverage) – both those with and without disability.

Do you have one person you think of as your personal doctor or health care provider? Seventeen percent of adults with disability in Montana did not have a personal doctor or health care provider.

Among adults age 18-64 years, those with disability were more likely to have a personal doctor or health care provider than those without disability – eight in ten (79%) compared to seven in ten (67%).

Among adults age 65 and older, there was no difference between those with and without disability – nine in ten reported having a personal doctor or health care provider.

Was there a time in the past 12 months when you needed to see a doctor but could not because of the cost? A significantly larger percentage of Montana adults with disability (20%) reported they could not afford to see a doctor in the past 12 months than adults without disability (11%).

Regardless of disability status, older Montanans (<6%) were less likely to delay a visit to the doctor because of cost than their younger counterparts (>12%). This is most likely due to Medicare coverage in the 65 and older population.

Among adults age 18-64 years, those with disability (27%) were twice as likely to report being unable to afford a doctor visit in the past 12 months as those without disability (13%).

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Physical Activity

Note: Moderate physical activity is defined as engaging in moderate activities (such as brisk walking, bicycling, vacuuming, gardening, or anything else that causes some increase in breathing or heart rate) at least ten minutes at a time for a total of at least 30 minutes per day, on 5 or more days per week.

Description of Table 5. Physical Activity, Montana Adults with and without Disability, 2001 and 2003 (with 95% confidence intervals). In 2001, 21.9% of all 3,337 responding adults had no leisure-time physical activity. Confidence interval is 20.1-23.7. In 2003, 20.2% of all 4,020 responding adults had no leisure-time physical activity. Confidence interval is 18.6-21.8.

In 2001, 34.5% of 744 responding adults with disability had no leisure-time physical activity. Confidence interval is 30.0-39.0. In 2003, 34.0% of 951 responding adults with disability had no leisure-time physical activity. Confidence interval is 29.9-38.1.

In 2001, 27.9% of 500 responding adults with disability, ages 18-64, had no leisure-time physical activity. Confidence interval is 22.8-33.0. In 2003, 29.6% of 635 responding adults with disability, ages 18-64, had no leisure-time physical activity. Confidence interval is 24.9-34.3.

In 2001, 50.5% of 244 responding adults with disability, ages 65+, had no leisure-time physical activity. Confidence interval is 42.1-58.9. In 2003, 42.7% of 309 adults with disability, ages 65+, had no leisure-time physical activity. Confidence interval is 35.3-50.1.

In 2001, 18.7% of 2,588 adults without disability had no leisure-time physical activity. Confidence interval is 16.7-20.7. In 2003, 16.6% of 3,021 adults without disability had no leisure-time physical activity. Confidence interval is 14.8-18.4.

In 2001, 18.2% of 2,094 adults without disability, ages 18-64, had no leisure-time physical activity. Confidence interval is 16.0-20.4. In 2003, 15.2% of 2,439 adults without disability, ages 18-64, had no leisure-time physical activity. Confidence interval is 13.2-17.2.

In 2001, 21.4% of 490 adults without disability, ages 65+, had no leisure-time physical activity. Confidence interval is 17.1-25.7. In 2003, 24.7% of 557 adults without disability, ages 65+, had no leisure-time physical activity. Confidence interval is 20.0-29.4.

Meets recommendations for moderate physical activity, 30 cumulative minutes per day, 5 or more days per week: In 2001, 51.2% of all 3,129 responding adults met recommendations for moderate physical activity. Confidence interval is 48.8-53.6. In 2003, 58.5% of all 3,750 responding adults met recommendations for moderate physical activity. Confidence interval is 56.3-60.7.

In 2001, 36.9% of 691 responding adults with disability met recommendations for moderate physical activity. Confidence interval is 31.8-42.0. In 2003, 48.8% of 881 responding adults with disability met recommendations for moderate physical activity. Confidence interval is 44.3-53.3.

In 2001, 40.6% of 467 responding adults with disability, ages 18-64, met recommendations for moderate physical activity. Confidence interval is 34.3-46.9. In 2003, 51.3% of 595 responding adults with disability, ages 18-64, met recommendations for moderate physical activity. Confidence interval is 45.8-56.8.

In 2001, 27.6% of 224 responding adults with disability, ages 65+, met recommendations for moderate physical activity. Confidence interval is 19.8-35.4. In 2003, 44.0% of 281 responding adults with disability, ages 65+, met recommendations for moderate physical activity. Confidence interval is 36.2-51.8.

In 2001, 54.7% of 2,434 responding adults without disability met recommendations for moderate physical activity. Confidence interval is 52.0-57.4. In 2003, 61.1% of 2,852 responding adults without disability met recommendations for moderate physical activity. Confidence interval is 58.7-63.5.

In 2001, 55.8% of 1,995 responding adults without disability, ages 18-64, met recommendations for moderate physical activity. Confidence interval is 52.9-58.7. In 2003, 62.2% of 2,344 responding adults without disability, ages 18-64, met recommendations for moderate physical activity. Confidence interval is 59.5-64.9.

In 2001, 47.9% of 435 responding adults without disability, ages 65+, met recommendations for moderate physical activity. Confidence interval is 41.8-54.0. In 2003, 54.6% of 487 responding adults without disability, ages 65+, met recommendations for moderate physical activity. Confidence interval is 48.9-60.3. End of description.

Healthy People 2010 Objective(s):

22-1. Reduce the proportion of adults who engage in no leisure-time physical activity to 20 percent.
22-2. Increase the proportion of adults who engage in regular, moderate physical activity to 30 percent.

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Description of Figure 7. Prevalence of no leisure-time physical activity, Montana adults, 2003. This bar graph shows that about 34% of all adults with disability had no leisure-time physical activity. 17% of adults without disability had no leisure-time physical activity. About 30% of all adults with disability, ages 18-64, had no leisure-time physical activity. About 16% of adults without disability, ages 18-64, had no leisure-time physical activity. About 42% of all adults with disability, ages 65+, had no leisure-time physical activity. About 24% of adults without disability, ages 65+, had no leisure-time physical activity. End of description.

One in three (34%) Montana adults with disability did not engage in leisure-time physical activity.

Twice as many adults with disability (34%), as without disability (17%) reported not engaging in leisure-time physical activity.

Among adults with disability, those age 65 and older (43%) were significantly more likely to report no leisure-time physical activity than younger adults (30%). This relationship, between age category and no leisure-time physical activity, was also found among adults without disability (25% vs. 15% respectively).

Meets recommendations for moderate physical activity: One half (49%) of adults with disability reported engaging in moderate physical activity.

Adults with disability (49%) were significantly less likely than adults without disability (61%) to meet moderate physical activity recommendations.

Among Montanans with disability, those age 65 and older (44%) were as likely to engage in moderate physical activity as their younger counterparts (51%).

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Overweight and Obesity

Description of Table 6. Overweight and Obesity, Montana Adults with and without Disability, 2001 and 2003. (with 95% confidence intervals). Overweight is defined as equal to or less than a Body Mass Index of 30. In 2001, 38.0% of all 3,202 responding adults were overweight. Confidence interval is 35.6-40.4. In 2003, 38.1% of all 3,854 responding adults were overweight. Confidence interval is 35.9-40.3.

In 2001, 36.1% of 711 responding adults with disability were overweight. Confidence interval is 31.2-41.0. In 2003, 38.4% of 921 responding adults with disability were overweight. Confidence interval is 34.1-42.7.

In 2001, 31.5% of 479 responding adults with disability, ages 18-64, were overweight. Confidence interval is 25.8-37.2. In 2003, 36.7% of 613 responding adults with disability, ages 18-64, were overweight. Confidence interval is 31.4-42.0.

In 2001, 47.4% of 232 responding adults with disability, ages 65+, were overweight. Confidence interval is 38.6-56.2. In 2003, 42.0% of 303 responding adults with disability, ages 65+, were overweight. Confidence interval is 34.6-49.4.

In 2001, 38.5% of 2,487 responding adults without disability were overweight. Confidence interval is 35.8-41.2. In 2003, 38.0% of 2,887 responding adults without disability were overweight. Confidence interval is 35.6-40.4.

In 2001, 38.6% of 2006 responding adults without disability, ages 18-64, were overweight. Confidence interval is 35.7-41.5. In 2003, 37.7% of 2.333 responding adults without disability, ages 18-64, were overweight. Confidence interval is 35.0-40.4.

In 2001, 37.8% of 477 responding adults without disability, ages 65+, were overweight.  Confidence interval is 32.1-43.5. In 2003, 40.5% of 539 responding adults without disability, ages 65+, were overweight. Confidence interval is 35.0-46.0.

Obesity is defined as a Body Mass Index of 30. In 2001, 18.8% of all 3,202 responding adults were obese. Confidence interval is 17.0-20.6. In 2003, 18.8% of all 3,854 responding adults were obese. Confidence interval is 17.2-20.4.

In 2001, 30.1% of 711 responding adults with disability were obese. Confidence interval is 25.6-34.6. In 2003, 27.6% of 921 responding adults with disability were obese. Confidence interval is 23.7-31.5.

In 2001, 33.7% of 479 responding adults with disability, ages 18-64, were obese. Confidence interval is 27.8-39.6. In 2003, 30.3% of 613 responding adults with disability, ages 18-64, were obese. Confidence interval is 25.4-35.2.

In 2001, 21.5% of 232 responding adults with disability, ages 65+, were obese. Confidence interval is 14.4-28.6. In 2003, 22.2% of 303 responding adults, ages 65+, with disability were obese. Confidence interval is 16.1-28.3.

In 2001, 15.9% of all 2,487 responding adults without disability were obese. Confidence interval is 13.9-17.9 In 2003, 16.4% of all 2,887 responding adults without disability were obese. Confidence interval is 14.6-18.2.

In 2001, 16.0% of 2006 responding adults without disability were obese. Confidence interval is 14.0-18.0 . In 2003, 16.8% of 2333 responding adults without disability were obese. Confidence interval is 14.8-18.8.

In 2001, 15.5% of 477 responding adults without disability, ages 65+, were obese. Confidence interval is 11.0-20.0. In 2003, 14.2% of 539 responding adults, ages 65+, without disability were obese. Confidence interval is 10.3-18.1. End of description.

Healthy People 2010 Objective(s):

19-1. Increase the proportion of adults who are at a healthy weight to 60 percent.
19-2. Reduce the proportion of adults who are obese to 15 percent.

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Description of Figure 8. Prevalence of overweight and obesity, Montana adults, 2003. This bar graph shows that 28% of all respondents with disabilities were obese and 38% were overweight. Of those respondents with disabilities, ages 18-64, 30% were obese and 37% were overweight. Of those respondents with disabilities, ages 65+, 22% were obese and 42% were overweight. 16% of all respondents without disabilities were obese and 38% were overweight. Of those respondents without disabilities, ages 18-64, 17% were obese and 38% were overweight. Of those respondents without disabilities, ages 65+, 14% were obese and 41% were overweight. End of description.

Overall: Two in three (66%) Montana adults with disability were overweight or obese. Among adults without disability, just over half (54%) were overweight or obese.

Note: Overweight and obesity are measured by calculating Body Mass Index (BMI) from the respondent’s self-reported weight and height. BMI is a ratio of weight to height [kg/m2 or (lbs x 700)/in2]. “Overweight”̈ is defined as BMI greater than or equal to 25 and less than 30. “Obese” is defined as BMI greater than or equal to 30. “Morbidly obese” is defined as BMI greater than or equal to 40.

Overweight adults: The prevalence of overweight did not differ between adults with and without disability – 38 percent of Montana adults were overweight. The prevalence of overweight did not differ substantially by age category.

Obese adults: Montana adults with disability (28%) were significantly more likely to be obese than those without disability (16%). Similarly, more adults with disability (4%), than without disability (1%), indicated they were morbidly obese.

Younger adults with disability were somewhat more likely to report obesity than their older counterparts – 30 percent compared to 22 percent respectively.

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Weight Control

Description of Table 7. Weight Control, Montana Adults with and without Disability, 2001 and 2003 (with 95% confidence intervals). In 2001, 50.4% of all 1,894 overweight/obese respondents had been trying to lose weight. Confidence interval is 47.3-53.5. In 2003, 50.8% of all 2,297 overweight/obese respondents had been trying to lose weight. Confidence interval is 48.1-53.5.

In 2001, 55.5% of 476 overweight/obese respondents with disabilities had been trying to lose weight. Confidence interval is 49.4-61.6. In 2003, 59.1% of 608 overweight/obese respondents with disabilities had been trying to lose weight. Confidence interval is 53.8-64.4.

In 2001, 61.9% of 329 overweight/obese respondents with disabilities, ages 18-64, had been trying to lose weight. Confidence interval is 54.8-69.0. In 2003, 65.1% of 412 overweight/obese respondents with disabilities, ages 18-64, had been trying to lose weight. Confidence interval is 58.6-71.6.

In 2001, 40.5% of 147 overweight/obese respondents with disabilities, ages 65+, had been trying to lose weight. Confidence interval is 29.9-51.1. In 2003, 46.6% of 194 overweight/obese respondents with disabilities, ages 65+, had been trying to lose weight. Confidence interval is 37.2-56.0.

In 2001, 48.8% of 1,415 overweight/obese respondents without disabilities had been trying to lose weight. Confidence interval is 45.3-52.3. In 2003, 48.2% of 1,664 overweight/obese respondents without disabilities had been trying to lose weight. Confidence interval is 44.9-51.5.

In 2001, 49.2% of 1,171 overweight/obese respondents without disabilities, ages 18-64, had been trying to lose weight. Confidence interval is 45.1-53.3. In 2003, 49.1% of 1,363 overweight/obese respondents without disabilities, ages 18-64, had been trying to lose weight. Confidence interval is 45.6-52.6.

In 2001, 46.2% of 242 overweight/obese respondents without disabilities, ages 65+, had been trying to lose weight. Confidence interval is 38.2-54.2. In 2003, 42.9% of 297 overweight/obese respondents without disabilities, ages 65+, had been trying to lose weight. Confidence interval is 35.5-50.3.

Health professional advice to lose weight (past 12 mo.) (adults who were overweight/obese): In 2001, 18.9% of all 1,897 overweight/obese respondents had been advised in the past 12 months by a health professional to lose weight. Confidence interval is 16.5-21.3. In 2003, 13.0% of all 2,296 overweight/obese respondents had been advised in the past 12 months by a health professional to lose weight. Confidence interval is 11.2-14.8.

In 2001, 31.5% of 477 overweight/obese respondents with disabilities had been advised in the past 12 months by a health professional to lose weight. Confidence interval is 25.6-37.4. In 2003, 22.1% of 608 overweight/obese respondents with disabilities had been advised in the past 12 months by a health professional to lose weight. Confidence interval is 17.8-26.4.

In 2001, 36.4% of 329 overweight/obese respondents with disabilities, ages 18-64, had been advised in the past 12 months by a health professional to lose weight. Confidence interval is 29.1-43.7. In 2003, 27.2% of 413 overweight/obese respondents with disabilities, ages 18-64, had been advised in the past 12 months by a health professional to lose weight. Confidence interval is 21.5-32.9.

In 2001, 20.0% of 148 overweight/obese respondents with disabilities, ages 65+, had been advised in the past 12 months by a health professional to lose weight. Confidence interval is 11.2-28.8. In 2003, 11.2% of 193 overweight/obese respondents with disabilities, ages 65+, had been advised in the past 12 months by a health professional to lose weight. Confidence interval is 5.9-16.5.

In 2001, 15.1% of 1,417 overweight/obese respondents without disabilities had been advised in the past 12 months by a health professional to lose weight. Confidence interval is 12.6-17.6. In 2003, 10.1% of 1,663 overweight/obese respondents without disabilities had been advised in the past 12 months by a health professional to lose weight. Confidence interval is 8.1-12.1.

In 2001, 14.5% of 1,173 overweight/obese respondents without disabilities, ages 18-64, had been advised in the past 12 months by a health professional to lose weight. Confidence interval is 11.8-17.2. In 2003, 10.0% of 1,362 overweight/obese respondents without disabilities, ages 18-64, had been advised in the past 12 months by a health professional to lose weight. Confidence interval is 7.8-12.2.

In 2001, 18.4% of 242 overweight/obese respondents without disabilities, ages 65+, had been advised in the past 12 months by a health professional to lose weight. Confidence interval is 11.9-24.9. In 2003, 10.4% of 297 overweight/obese respondents without disabilities, ages 65+, had been advised in the past 12 months by a health professional to lose weight. Confidence interval is 6.1-14.7. End of description.

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Weight Control, 2003:

Description of Figure 9. Received health professional advice to lose weight in the past year, Montana adults, 2003. Bar graph shows that 11% of overweight adults with disabilities were advised to lose weight and 6% of overweight adults without disabilities were advised to lose weight. 38% of obese adults with disabilities were advised to lose weight and 20% of obese adults without disabilities were advised to lose weight. End of description.

(Those who were overweight or obese). Are you now trying to lose weight?  More overweight or obese adults with disability (59%), than without disability (48%), reported they were trying to lose weight.

Among those with disability, adults age 18-64 (65%) were more likely to report they were trying to lose weight than older adults (47%).

In the past 12 months, has a doctor, nurse or other health professional advised you to lose weight? Twice as many overweight or obese adults with disability (22%), as without disability (10%), received advice from a health professional to lose weight. However, this may be due, all or in part, to differences in the frequency of health care visits between the two groups (not assessed in this survey).

Among those with disability, younger adults (27%) were significantly more likely to have received health professional advice to lose weight than those age 65 and older (11%).

Regardless of disability status, respondents who were obese were three times as likely to have been advised to lose weight as those who were overweight (Figure 9).

Note: “Overweight” is defined as BMI greater than or equal to 25 and less than 30.  “Obese” is defined as BMI greater than or equal to 30.

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Cigarette Smoking

Description of Table 8. Cigarette Smoking, Montana Adults with and without Disability, 2001 and 2003 (with 95% confidence intervals). Current cigarette smoking: In 2001, 21.9% of all 3,330 respondents currently smoked cigarettes. Confidence interval is 19.9-23.9. In 2003, 20.0% of all 4,017 respondents currently smoked cigarettes. Confidence interval is 18.4-21.6.

In 2001, 27.8% of 741 respondents with disabilities currently smoked cigarettes. Confidence interval is 23.3-32.3. In 2003, 24.1% of 950 respondents with disabilities currently smoked cigarettes. Confidence interval is 20.6-27.6.

In 2001, 35.0% of 498 respondents with disabilities, ages 18-64, currently smoked cigarettes. Confidence interval is 29.1-40.9. In 2003, 31.9% of 634 respondents with disabilities, ages 18-64, currently smoked cigarettes. Confidence interval is 27.0-36.8.

In 2001, 10.0% of 243 respondents with disabilities, ages 65+, currently smoked cigarettes. Confidence interval is 5.7-14.3. In 2003, 7.9% of 309 respondents with disabilities, ages 65+, currently smoked cigarettes. Confidence interval is 4.4-11.4.

In 2001, 20.5% of 2,584 respondents without disabilities currently smoked cigarettes. A current smoker is someone who has smoked 100 or more lifetime cigarettes and now smokes every day or some days. Confidence interval is 18.3-22.7. In 2003, 18.8% of 3,019 respondents without disabilities currently smoked cigarettes. Confidence interval is 16.8-20.8.

In 2001, 22.1% of 2,092 respondents without disabilities, ages 18-64, currently smoked cigarettes. Confidence interval is 19.6-24.6. In 2003, 20.4% of 2,437 respondents without disabilities, ages 18-64, currently smoked cigarettes. Confidence interval is 18.2-22.6.

In 2001, 11.9% of 489 respondents without disabilities, ages 65+, currently smoked cigarettes. Confidence interval is 8.2-15.6. In 2003, 8.6% of 557 respondents without disabilities, ages 65+, currently smoked cigarettes. Confidence interval is 5.9-11.3. End of description.

Healthy People 2010 Objective: 27-1a. Reduce cigarette smoking by adults to 12 percent.

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Description of Figure 10. Prevalence of current cigarette smoking, Montana adults, 2003. A current smoker is someone who has smoked 100+ lifetime cigarettes and now smokes every day or some days. Current cigarette smoking: This bar graph shows that about 23% of all adults with disability currently smoke and about 19% of all adults without disability currently smoke. For ages 18-64, about 32% of adults with disability currently smoke and about 20% of adults without disability currently smoke. For ages 65+, about 8% of adults with disability currently smoke and about 9% of adults without disability currently smoke. End of description.

One in four (24%) Montana adults with disability reported current cigarette smoking, while one in five (19%) adults without disability were current smokers.

Among adults age 18-64, significantly more of those with disability (32%), than those without disability (20%), reported current cigarette smoking.

Among adults age 65 and older, there was no difference in the prevalence of current cigarette smoking between those with (8%) and without disability (9%).

Among those with disability, younger adults (32%) reported current cigarette smoking at four times the rate of adults age 65 and older (8%).

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Alcohol Consumption

Description of Table 9. Alcohol Consumption, Montana Adults with and without Disability, 2001 and 2003 (with 95% confidence intervals). Binge drinking is defined as five or more drinks on one occasion in the past 30 days. For 2001, 16.7% of all 3,264 respondents had practiced binge drinking. Confidence interval is 14.7-18.7. For 2003, 19.1% of all 4,004 respondents had practiced binge drinking. Confidence interval is 17.3-20.9.

For 2001, 12.9% of 731 respondents with disability had practiced binge drinking. Confidence interval is 9.2-16.6. For 2003, 14.0% of 946 respondents with disability had practiced binge drinking. Confidence interval is 10.7-17.3.

For 2001, 26.2% of 174 respondents with disability, ages 18-44, had practiced binge drinking. Confidence interval is 16.6-35.8. For 2003, 29.4% of 225 respondents with disability, ages 18-44, had practiced binge drinking. Confidence interval is 20.8-38.0.

For 2001, 11.1% of 316 respondents with disability, ages 45-64, had practiced binge drinking. Confidence interval is 6.0-16.2. For 2003, 10.8% of 406 respondents with disability, ages 45-64, had practiced binge drinking. Confidence interval is 6.9-14.7.

For 2001, 2.3% of 241 respondents with disability, ages 65+, had practiced binge drinking. Confidence interval is 0.0-4.8. For 2003, 3.0% of 308 respondents with disability, ages 65+, had practiced binge drinking. Confidence interval is 0.6-5.4.

For 2001, 17.7% of 2,528 respondents without disability had practiced binge drinking.  Confidence interval is 15.3-20.1. For 2003, 20.6% of 3,012 respondents without disability had practiced binge drinking. Confidence interval is 18.4-22.8.

For 2001, 25.5% of 1,159 respondents without disability, ages 18-44, had practiced binge drinking. Confidence interval is 21.8-29.2. For 2003, 28.7% of 1,266 respondents without disability, ages 18-44, had practiced binge drinking. Confidence interval is 25.2-32.2.

For 2001, 11.5% of 889 respondents without disability, ages 45-64, had practiced binge drinking. Confidence interval is 9.0-14.0. For 2003, 15.5% of 1,169 respondents without disability, ages 45-64, had practiced binge drinking. Confidence interval is 12.8-18.2.

For 2001, 2.5% of 476 respondents without disability, ages 65+, had practiced binge drinking. Confidence interval is 0.7-4.3. For 2003, 3.8% of 553 respondents without disability, ages 65+, had practiced binge drinking. Confidence interval is 1.8-5.8.

Heavy drinking (more than 2 drinks per day for men; more than1 drink per day for women): For 2001, 4.4% of all 3,270 respondents had practiced heavy drinking. Confidence interval is 3.4-5.4. For 2003, 6.7% of all 4,001 respondents had practiced heavy drinking. Confidence interval is 5.5-7.9.

For 2001, 3.9% of 735 respondents with disability had practiced heavy drinking. Confidence interval is 1.9-5.9. For 2003, 7.1% of 947 respondents with disability had practiced heavy drinking. Confidence interval is 4.6-9.6.

For 2001, 5.1% of 175 respondents with disability, ages 18-44, had practiced heavy drinking. Confidence interval is 0.6-9.6. For 2003, 12.7% of 224 respondents with disability, ages 18-44, had practiced heavy drinking. Confidence interval is 5.6-19.8.

For 2001, 5.5% of 318 respondents with disability, ages 45-64, had practiced heavy drinking. Confidence interval is 2.0-9.0. For 2003, 6.4% of 408 respondents with disability, ages 45-64, had practiced heavy drinking. Confidence interval is 3.3-9.5.

For 2001, 0.4% of 242 respondents with disability, ages 65+, had practiced heavy drinking. Confidence interval is 0.0-1.0. For 2003, 2.5% of 308 respondents with disability, ages 65+, had practiced heavy drinking. Confidence interval is 0.1-4.9.

For 2001, 4.6% of 2,530 respondents without disability had practiced heavy drinking. Confidence interval is 3.4-5.8. For 2003, 6.6% of 3,007 respondents without disability had practiced heavy drinking. Confidence interval is 5.4-7.8.

For 2001, 6.2% of 1,157 respondents without disability, ages 18-44, had practiced heavy drinking. Confidence interval is 4.2-8.2. For 2003, 7.5% of 1,261 respondents without disability, ages 18-44, had practiced heavy drinking. Confidence interval is 5.5-9.5.

For 2001, 2.9% of 892 respondents without disability, ages 45-64, had practiced heavy drinking. Confidence interval is 1.7-4.1. For 2003, 5.7% of 1,168 respondents without disability, ages 45-64, had practiced heavy drinking. Confidence interval is 3.9-7.5.

For 2001, 2.2% of 477 respondents without disability, ages 65+, had practiced heavy drinking. Confidence interval is 0.4-4.0. For 2003, 5.4% of 554 respondents without disability, ages 65+, had practiced heavy drinking. Confidence interval is 2.9-7.9. End of description.

Healthy People 2010 Objective: 26-11c. Reduce the proportion of adults engaging in binge drinking in the past month to 6 percent.

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Description of Figure 11. Prevalence of binge drinking in the past 30 days, Montana adults, 2003. Binge drinking is defined as five or more drinks on one occasion in the past 30 days. This bar graph shows that about 14% of all adults with disabilities had practiced binge drinking and about 21% of adults without disabilities had practiced binge drinking. About 29% of all adults with disabilities, between the ages of 18 and 44, had practiced binge drinking and about 28% of adults without disabilities, between the ages of 18 and 44, had practiced binge drinking. About 11% of all adults with disabilities, between the ages of 45 and 64, had practiced binge drinking and about 15% of adults without disabilities, between the ages of 45 and 64, had practiced binge drinking. About 3% of all adults with disabilities, ages 65 and older, had practiced binge drinking and about 4% of adults without disabilities, ages 65 and older, had practiced binge drinking. End of description.

Binge drinking in the last 30 days: Overall, 14 percent of adults with disability in Montana were at risk for binge drinking. Fewer Montana adults with disability (14%) reported binge drinking in the past 30 days than adults without disability (21%). However, this difference is at least partially due to the older age, overall, of adults with disability in Montana.

The risk for binge drinking decreased significantly with increasing age category. Among adults with disability, three in ten (29%) of those 18-44 years old reported binge drinking — compared to one in ten (11%) age 45-64 years and 3 percent of those 65 and older.

Heavy drinking in the past 30 days. Heavy drinking is more than 2 drinks per day for men; more than1 drink per day for women.  Seven percent of Montana adults with disability reported heavy drinking in 2003. This did not differ from heavy drinking among adults without disability (7%).

Among those with disability, adults age 18-44 (13%) were more likely to report heavy drinking than those age 65 and older (3%).

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Falls and Injury

Description of Table 10. Fall-related Injury, Montana Adults, ages 45 and older, with and without disability, 2003 (with 95% confidence intervals). This question was not asked in 2001. 5.6% of all 2,466 respondents had fallen and been injured in the previous 3 months. Confidence interval is 4.4-6.8. 11.6% of 718 respondents with disability had fallen and been injured in the previous 3 months. Confidence interval is 8.7-14.5.

15.2% of 409 respondents with disability, ages 45-64, had fallen and been injured in the previous 3 months. Confidence interval is 10.9-19.5.

7.5% of 309 respondents with disability, ages 65+, had fallen and been injured in the previous 3 months. Confidence interval is 3.8-11.2.

3.1% of 1,728 respondents without disability had fallen and been injured in the previous 3 months. Confidence interval is 2.1-4.1.

2.4% of 1,169 respondents without disability, ages 45-64, had fallen and been injured in the previous 3 months. Confidence interval is 1.2-3.6.

4.6% of 559 respondents without disability, ages 65+, had fallen and been injured in the previous 3 months. Confidence interval is 2.4-6.8. End of description.

Healthy People 2010 Objective: 15-14. (Developmental) Reduce non-fatal unintentional injuries.

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Description of Figure 12. Prevalence of fall-related injury in the past 3 months, Montana adults age 45 and older, 2003. This bar graph shows that about 12% of adults with disabilities had a fall-related injury and about 3% of adults without disabilities had a fall-related injury. About 15% of adults with disabilities, ages 45-64, had a fall-related injury and about 2% of adults without disabilities, ages 45-64, had a fall-related injury. About 8% of adults with disabilities, ages 65+, had a fall-related injury and about 4% of adults without disabilities, ages 65+, had a fall-related injury. End of description.

Fall-related injury means a fall caused the respondent to limit their regular activities for at least a day or to go see a doctor. Fall-related injury in the past 3 months (age 45 and older):

Twenty-seven percent of Montana adults with disability reported they had fallen in the past three months – twice as many as those without disability (14%). Adults with disability (12%) were four times as likely to report fall-related injuries as adults without disability (3%).

Among younger adults (45-64 years), those with disability (15%) sustained fall-related injuries at six times the rate of those without disability (2%).

Among older adults (65 and older), there was essentially no difference in the prevalence of fall-related injury between those with and without disability – overall 6 percent of older adults reported fall-related injuries.

Among those with disability, younger adults were significantly more likely to report fall-related injuries than older adults (15% vs. 8%). Among adults without disability, the difference between younger and older adults (2% vs. 5%) was not statistically significant.

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Immunization

Description of Table 11. Immunization, Montana adults with and without disability, 2001 and 2003 (with 95% confidence intervals). Had a flu vaccination in the past 12 months (adults age 65 and older): In 2001, 73.1% of all 738 respondents, ages 65+, had a flu vaccination in the past 12 months. Confidence interval is 69.0-77.2. In 2003, 72.8% of all 881 respondents, ages 65+, had a flu vaccination in the past 12 months. Confidence interval is 69.1-76.5.

In 2001, 74.8% of 244 respondents with disability, ages 65+, had a flu vaccination in the past 12 months. Confidence interval is 67.5-82.1. In 2003, 78.0% of 309 respondents with disability, ages 65+, had a flu vaccination in the past 12 months. Confidence interval is 72.1-83.9.

In 2001, 72.2% of 490 respondents without disability, ages 65+, had a flu vaccination in the past 12 months. Confidence interval is 67.1-77.3. In 2003, 70.0% of 558 respondents without disability, ages 65+, had a flu vaccination in the past 12 months. Confidence interval is 65.1-74.9.

Ever had a pneumonia vaccination (adults age 65 and older): In 2001, 67.9% of all 731 respondents, ages 65+, had a pneumonia vaccination . Confidence interval is 63.4-72.4. In 2003, 69.1% of all 873 respondents, ages 65+, had a pneumonia vaccination. Confidence interval is 65.2-73.0.

In 2001, 74.7% of 241 respondents with disability, ages 65+, had a pneumonia vaccination. Confidence interval is 67.4-82.0. In 2003, 76.0% of 306 respondents with disability, ages 65+, had a pneumonia vaccination. Confidence interval is 69.9-82.1.

In 2001, 64.3% of 486 respondents without disability, ages 65+, had a pneumonia vaccination. Confidence interval is 58.6-70.0. In 2003, 65.7% of 552 respondents without disability, ages 65+, had a pneumonia vaccination. Confidence interval is 60.6-70.8. End of description.

Healthy People 2010 Objective(s):

14-29a. Increase the proportion of adults who are vaccinated annually against influenza to 90 percent (age 65 and older).
14-29b. Increase the proportion of adults ever vaccinated against pneumococcal disease to 90 percent (age 65 and older).

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Description of Figure 13. Immunization rates among Montana adults age 65 and older, 2003. This bar graph shows that about 78% of respondents with disability had a flu shot in the previous 12 months and about 70% of respondents without disability had a flu shot in the previous 12 months. About 76% of respondents with disability had ever had a pneumonia vaccination and about 66% of respondents without disability had ever had a pneumonia vaccination. End of description.

For those age 65 and older, in the past 12 months, have you had a flu shot? Seventy-eight percent of adults with disability age 65 and older reported they had a flu shot in the past 12 months.

Adults with disability age 65 and older (78%) were significantly more likely to report immunization against flu than the same age group without disability (70%).

Have you ever had a pneumonia shot? Seventy-six percent of adults with disability age 65 and older reported they had ever received a pneumonia shot.

Adults with disability age 65 and older (76%) were significantly more likely to report  immunization against pneumonia than their counterparts without disability (66%).

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Arthritis

Description of Table 12. Arthritis, Montana Adults with and without Disability, 2001 and 2003 (with 95% confidence intervals). 2001 data for chronic joint symptoms are not comparable to 2003 data and are not included.  “Chronic joint symptoms” means that an individual had joint symptoms within the past 30 days with onset more than 3 months ago. 38.5% of all 3,995 respondents had chronic joint symptoms. Confidence interval is 36.5-40.5.

65.1% of 949 respondents with disability had chronic joint symptoms. Confidence interval is 60.8-69.4.

63.1% of 632 respondents with disability, ages 18-64, had chronic joint symptoms. Confidence interval is 57.6-68.6.

69.2% of 310 respondents with disability, age 65+, had chronic joint symptoms.  Confidence interval is 62.3-76.1.

31.2% of 3,013 respondents without disability had chronic joint symptoms. Confidence interval is 29.0-33.4.

30.3% of 2,434 respondents without disability, ages 18-64, had chronic joint symptoms. Confidence interval is 27.9-32.7.

36.7% of 555 respondents without disability, age 65+, had chronic joint symptoms.  Confidence interval is 31.4-42.0.

Have you ever been told you have arthritis (In 2003, arthritis also included gout, lupus, and fibromyalgia)?  In 2001, 24.2% of all 3,332 respondents had been told that they had arthritis.  Confidence interval is 22.2-26.2.  In 2003, 26.3% of all 3,992 respondents had been told that they had arthritis. Confidence interval is 24.5-28.1.

In 2001, 51.9% of 739 respondents with disability had been told that they had arthritis. Confidence interval is 46.8-57.0. In 2003, 50.3% of 948 respondents with disability had been told that they had arthritis. Confidence interval is 46.0-54.6.

In 2001, 46.0% of 498 respondents with disability, ages 18-64, had been told that they had arthritis. Confidence interval is 39.9-52.1. In 2003, 41.1% of 632 respondents with disability, ages 18-64, had been told that they had arthritis. Confidence interval is 36.0-46.2.

In 2001, 66.2% of 241 respondents with disability, age 65+, had been told that they had arthritis. Confidence interval is 58.2-74.2. In 2003, 69.2% of 309 respondents with disability, age 65+, had been told that they had arthritis. Confidence interval is 62.3-76.1.

In 2001, 17.1% of 2,588 respondents without disability had been told that they had arthritis. Confidence interval is 15.1-19.1. In 2003, 19.7% of 3,014 respondents without disability had been told that they had arthritis. Confidence interval is 17.9-21.5.

In 2001, 12.5% of 2,094 respondents without disability, ages 18-64, had been told that they had arthritis. Confidence interval is 10.5-14.5. In 2003, 15.0% of 2,433 respondents without disability, ages 18-64, had been told that they had arthritis. Confidence interval is 13.2-16.8.

In 2001, 41.3% of 490 respondents without disability, age 65+, had been told that they had arthritis. Confidence interval is 35.6-47.0. In 2003, 47.3% of 557 respondents without disability, age 65+, had been told that they had arthritis. Confidence interval is 41.8-52.8. End of description.

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Description of Figure 14. Arthritis prevalence, Montana adults, 2003. This bar graph shows that about 50% of all respondents with disability reported arthritis and about 20% of all respondents without disability reported arthritis. About 41% of all respondents with disability, ages 18-64, reported arthritis and about 15% of all respondents without disability, ages 18-64, reported arthritis. About 69% of all respondents with disability, ages 65+, reported arthritis and about 48% of all respondents without disability, ages 65+, reported arthritis. End of description.

Chronic joint symptoms. Chronic joint symptoms are defined as a “Yes” response to: “During the past 30 days, have you had any symptoms of pain, aching, or stiffness in or around a joint (excluding the back or neck)?” and “Did your joint symptoms first begin more than three months ago?”

Sixty-five percent of Montana adults with disability reported the presence of chronic joint symptoms – more than twice as many as adults without disability (31%).

The reported prevalence of chronic joint symptoms did not differ significantly between age categories within the same disability status group.

Have you ever been told by a doctor or other health professional that you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?

Among Montana adults with disability, one in two (50%) reported they had been told they had arthritis – compared to one in five (20%) of those without disability.

Significant differences in the reported prevalence of arthritis between those with and without disability persisted within each age category. Among adults age 18-64 years, those with disability (41%) were almost three times as likely to report arthritis as those without disability (15%).

The prevalence of self-reported arthritis increased with age, regardless of disability status. Among adults with disability, those 18-64 years old were less likely to report arthritis than those age 65 and older (41% and 69% respectively).

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Cardiovascular Disease

Description of Table 13. Cardiovascular Disease, Montana Adults with and without Disability, 2001 and 2003 (with 95% confidence intervals). Cardiovascular disease includes heart attack, angina (coronary heart disease), and stroke. Data are for adults, age 35 and older.  In 2001, 11.7% of all 2,616 respondents had been told that they had cardiovascular disease. Confidence interval is 9.9-13.5. In 2003, 9.1% of all 3,109 respondents had been told that they had cardiovascular disease. Confidence interval is 7.7-10.5.

In 2001, 24.6% of 660 respondents with disability had been told that they had cardiovascular disease. Confidence interval is 20.1-29.1. In 2003, 17.5% of 839 respondents with disability had been told that they had cardiovascular disease. Confidence interval is 14.0-21.0.

In 2001, 21.1% of 418 respondents with disability, ages 35-64, had been told that they had cardiovascular disease. Confidence interval is 15.6-26.6. In 2003, 12.4% of 540 respondents with disability, ages 35-64, had been told that they had cardiovascular disease. Confidence interval is 8.7-16.1.

In 2001, 31.2% of 242 respondents with disability, age 65+, had been told that they had cardiovascular disease. Confidence interval is 23.4-39.0. In 2003, 25.9% of 299 respondents with disability, age 65+, had been told that they had cardiovascular disease. Confidence interval is 19.0-32.8.

In 2001, 7.6% of 1,952 respondents without disability had been told that they had cardiovascular disease. Confidence interval is 6.0-9.2. In 2003, 6.2% of 2,252 respondents without disability had been told that they had cardiovascular disease. Confidence interval is 4.8-7.6.

In 2001, 4.5% of 1,465 respondents without disability, ages 35-64, had been told that they had cardiovascular disease. Confidence interval is 2.9-6.1. In 2003, 3.4% of 1,719 respondents without disability, ages 35-64, had been told that they had cardiovascular disease. Confidence interval is 2.2-4.6.

In 2001,17.8% of 487 respondents without disability, age 65+, had been told that they had cardiovascular disease. Confidence interval is 13.5-22.1 In 2003, 16.9% of 533 respondents without disability, age 65+, had been told that they had cardiovascular disease. Confidence interval is 12.8-21.0. End of description.

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Description of Figure 15. Cardiovascular disease prevalence, Montana adults age 35 and older. Cardiovascular disease includes heart attack, angina (coronary heart disease), and stroke. This bar graph shows that about 18% of adults with disability have cardiovascular disease and about 6% of adults without disability have cardiovascular disease. About 13% of adults with disability, ages 35-64, have cardiovascular disease and about 3% of adults without disability, ages 35-64, have cardiovascular disease. About 26% of adults with disability, ages 65+, have cardiovascular disease and about 17% of adults without disability, ages 65+, have cardiovascular disease. End of description.

For those age 35 and older, has a doctor, nurse, or other health professional ever told you that you had cardiovascular disease? Eighteen percent of adults with disability indicated they had been told they had cardiovascular disease.

The prevalence of self-reported cardiovascular disease among adults with disability (18%) was three times as high as that among adults without disability (6%).

Differences in the prevalence of cardiovascular disease between those with and without disability were found primarily among those 35-64 years old. In this age group, those with disability (12%) were four times as likely to report cardiovascular disease as those without disability (3%).

The prevalence of self-reported cardiovascular disease increased with age. Among adults with disability, those 35-64 years old (12%) were half as likely to have cardiovascular disease as those 65 and older (26%).

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Cardiovascular Disease Risk Factors

Description of Table 14. Cardiovascular Disease Risk Factors, Montana Adults with and without Disability, 2001 and 2003 (with 95% confidence intervals). In 2001, 26.8% of all 3,335 respondents had ever been told they have high blood pressure. Confidence interval is 24.8-28.8. In 2003, 21.3% of all 4,021 respondents had ever been told they have high blood pressure. Confidence interval is 19.7-22.9.

In 2001, 40.6% of 743 respondents with disability had ever been told they have high blood pressure. Confidence interval is 35.7-45.5. In 2003, 36.9% of 951 respondents with disability had ever been told they have high blood pressure. Confidence interval is 32.8-41.0.

In 2001, 36.5% of 499 respondents with disability, ages 18-64, had ever been told they have high blood pressure. Confidence interval is 30.6-42.4. In 2003, 29.8% of 634 respondents with disability, ages 18-64, had ever been told they have high blood pressure. Confidence interval is 25.1-34.5.

In 2001, 50.6% of 244 respondents with disability, ages 65+, had ever been told they have high blood pressure. Confidence interval is 42.2-59.0. In 2003, 52.0% of 310 respondents with disability, ages 65+, had ever been told they have high blood pressure. Confidence interval is 44.6-59.4.

In 2001, 23.2% of 2,587 respondents without disability had ever been told they have high blood pressure. Confidence interval is 21.0-25.4. In 2003, 16.9% of 3,022 respondents without disability had ever been told they have high blood pressure. Confidence interval is 15.3-18.5.

In 2001, 17.6% of 2,094 respondents without disability, ages 18-64, had ever been told they have high blood pressure. Confidence interval is 15.4-19.8. In 2003, 12.7% of 2,439 respondents without disability, ages 18-64, had ever been told they have high blood pressure. Confidence interval is 11.1-14.3.

In 2001, 53.1% of 490 respondents without disability, ages 65+, had ever been told they have high blood pressure. Confidence interval is 47.4-58.8. In 2003, 41.0% of 559 respondents without disability, ages 65+, had ever been told they have high blood pressure. Confidence interval is 35.7-46.3.

Of adults who had ever had their blood cholesterol checked: In 2001, 29.0% of all 2,477 respondents had ever been told that their blood cholesterol is high. Confidence interval is 26.6-31.4. In 2003, 29.8% of all 3,094 had ever been told that their blood cholesterol is high. Confidence interval is 27.7-31.9.

In 2001, 38.2% of 603 respondents with disability had ever been told that their blood cholesterol is high. Confidence interval is 32.7-43.7. In 2003, 38.9% of 784 respondents with disability had ever been told that their blood cholesterol is high. Confidence interval is 34.4-43.4.

In 2001, 37.4% of 383 respondents with disability, ages 18-64, had ever been told that their blood cholesterol is high. Confidence interval is 30.5-44.3. In 2003, 34.9% of 497 respondents with disability, ages 18-64, had ever been told that their blood cholesterol is high. Confidence interval is 29.6-40.2.

In 2001, 39.9% of 220 respondents with disability, ages 65+,had ever been told that their blood cholesterol is high. Confidence interval is 30.9-48.9. In 2003, 46.4% of 282 respondents with disability, ages 65+, had ever been told that their blood cholesterol is high. Confidence interval is 38.6-54.2.

In 2001, 26.5% of 1,869 respondents without disability had ever been told that their blood cholesterol is high. Confidence interval is 24.0-29.0. In 2003, 26.9% of 2,274 respondents without disability had ever been told that their blood cholesterol is high. Confidence interval is 24.5-29.3.

In 2001, 22.5% of 1,433 respondents without disability, ages 18-64, had ever been told that their blood cholesterol is high. Confidence interval is 19.6-25.4. In 2003, 22.8% of 1,749 respondents without disability, ages 18-64, had ever been told that their blood cholesterol is high. Confidence interval is 20.3-25.3.

In 2001, 41.5% of 434 respondents without disability, ages 65+, had ever been told that their blood cholesterol is high. Confidence interval is 35.4-47.6. In 2003, 45.3% of 505 respondents without disability, ages 65+, had ever been told that their blood cholesterol is high. Confidence interval is 39.6-51.0.

In 2001, 69.9% of 3,257 respondents had their blood cholesterol checked in the previous 5 years. Confidence interval is 67.7-72.1. In 2003, 70.1% of 3,914 respondents had their blood cholesterol checked in the previous 5 years. Confidence interval is 67.9-72.3.

In 2001, 77.7% of 722 respondents with disability had their blood cholesterol checked in the previous 5 years. Confidence interval is 73.4-82.0. In 2003, 75.3% of 928 respondents with disability had their blood cholesterol checked in the previous 5 years.  Confidence interval is 71.2-79.4.

In 2001, 72.7% of 487 respondents with disability, ages 18-64, had their blood cholesterol checked in the previous 5 years. Confidence interval is 67.2-78.2. In 2003, 68.7% of 623 respondents with disability, ages 18-64, had their blood cholesterol checked in the previous 5 years. Confidence interval is 63.4-74.0.

In 2001, 90.3% of 235 respondents with disability, ages 65+,had their blood cholesterol checked in the previous 5 years. Confidence interval is 85.0-95.6. In 2003, 89.5% of 298 respondents with disability, ages 65+, had their blood cholesterol checked in the previous 5 years. Confidence interval is 84.6-94.4.

In 2001, 67.9% of 2,530 respondents without disability had their blood cholesterol checked in the previous 5 years. Confidence interval is 65.4-70.4. In 2003, 68.5% of 2,941 respondents without disability had their blood cholesterol checked in the previous 5 years. Confidence interval is 66.1-70.9.

In 2001, 64.1% of 2,050 respondents without disability, ages 18-64, had their blood cholesterol checked in the previous 5 years. Confidence interval is 61.2-67.0. In 2003, 64.4% of 2,373 respondents without disability, ages 18-64, had their blood cholesterol checked in the previous 5 years. Confidence interval is 61.7-67.1.

In 2001, 87.5% of 477 respondents without disability, ages 65+, had their blood cholesterol checked in the previous 5 years. Confidence interval is 83.8-91.2. In 2003, 91.0% of 544 respondents without disability, ages 65+, had their blood cholesterol checked in the previous 5 years. Confidence interval is 88.1-93.9. End of description.

Healthy People 2010 Objective(s):

12-9. Reduce the proportion of adults with high blood pressure to 16 percent.
12-14. Reduce the proportion of adults with high total blood cholesterol levels to 17 percent.

12-15. Increase the proportion of adults who have had their blood cholesterol checked within the preceding five years to 80 percent.

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Description of Figure 16. Prevalence of cardiovascular disease risk factors, Montana adults, 2003. This bar graph shows that about 30% of respondents with disabilities who are ages 18-64 have high blood pressure. About 12% of respondents without disabilities who are ages 18-64 have high blood pressure. About 52% of respondents with disabilities who are ages 65+ have high blood pressure. About 41% of respondents without disabilities who are ages 65+ have high blood pressure. Of those who have ever had their blood cholesterol checked, about 35% of respondents with disabilities who are ages 18-64 have high blood cholesterol. About 23% of respondents without disabilities who are ages 18-64 have high blood cholesterol. Of those who have ever had their blood cholesterol checked, about 46% of respondents with disabilities who are ages 65+ have high blood cholesterol. About 45% of respondents without disabilities who are ages 65+ have high blood cholesterol. End of description.

Have you ever been told by a health professional that you have high blood pressure?  Thirty-seven percent of adults with disability reported they had been told they have high blood pressure — compared to 17 percent of those without disability.

More than twice as many younger adults with disability (30%), as younger adults without disability (13%), reported they have high blood pressure.

Among adults age 65 and older, 52 percent of those with disability were told they have high blood pressure – compared to 41 percent of those without disability.

Have you ever been told by a health professional that your blood cholesterol is high? (Those who have ever had their blood cholesterol checked). Overall, 39 percent of adults with disability and 27 percent of adults without disability indicated they had been told their blood cholesterol was high.

Among adults age 18-64 years, those with disability were more likely to report they had ever been told their blood cholesterol was high than those without disability – one in three (35%) compared to one in four (23%).

Among older adults, those with and without disability were equally likely to have been told their blood cholesterol was high – 46 percent and 45 percent respectively.

Blood cholesterol was checked in the past five years: Seventy-five percent of adults with disability reported their blood cholesterol was checked within the past five years, significantly more than those without disability (69%).

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Asthma

Description of Table 15. Asthma, Montana Adults with and without Disability, 2001 and 2003 (with 95% confidence intervals). Current asthma is defined as a “Yes” response to: “Have you ever been told by a doctor, nurse or other health professional that you had asthma?” and “Do you still have asthma?”. In 2001, 8.0% of all 3,329 respondents currently had asthma. Confidence interval is 6.6-9.4. In 2003, 7.9% of 4,009 respondents currently had asthma. Confidence interval is 6.7-9.1.

In 2001, 12.9% of 737 respondents with disability currently had asthma. Confidence interval is 9.2-16.6. In 2003, 13.9% of 947 respondents with disability currently had asthma. Confidence interval is 11.0-16.8.

In 2001, 13.7% of 494 respondents with disability, ages 18-64, currently had asthma. Confidence interval is 9.2-18.2. In 2003, 13.8% of 631 respondents with disability, ages 18-64, currently had asthma. Confidence interval is 10.1-17.5.

In 2001, 11.1% of 243 respondents with disability, ages 65+, currently had asthma. Confidence interval is 5.2-17.0. In 2003, 13.8% of 309 respondents with disability, ages 65+, currently had asthma. Confidence interval is 8.7-18.9.

In 2001, 6.8% of 2,587 respondents without disability currently had asthma. Confidence interval is 5.4-8.2. In 2003, 6.3% of 3,016 respondents without disability currently had asthma. Confidence interval is 5.1-7.5.

In 2001, 6.4% of 2,093 respondents without disability, ages 18-64, currently had asthma. Confidence interval is 5.0-7.8. In 2003, 6.6% of 2,433 respondents without disability currently had asthma. Confidence interval is 5.4-7.8.

In 2001, 8.4% of 490 respondents without disability, ages 65+, currently had asthma. Confidence interval is 4.9-11.9. In 2003, 5.2% of respondents without disability, ages 65+, currently had asthma. Confidence interval is 558 2.8-7.6. End of description.

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Description of Figure 17. Current asthma prevalence, Montana adults, 2003. Current asthma is defined as a “Yes” response to: “Have you ever been told by a doctor, nurse or other health professional that you had asthma?” and “Do you still have asthma?”. This bar graph shows that about 14% of all adults with disability currently have asthma. About 6% of adults without disability currently have asthma. About 14% of all adults with disability, ages 18-64, currently have asthma. About 6% of adults without disability, ages 18-64, currently have asthma. About 14% of all adults with disability, ages 65+, currently have asthma. About 5% of adults without disability, ages 65+, currently have asthma. End of description.

Do you currently have asthma? Fourteen percent of adult Montanans with disability reported they currently had asthma, significantly more than adults without disability (6%).

The prevalence of current asthma among Montana adults, both with and without disability, did not differ by age category.

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Diabetes

Description of Table 16. Diabetes, Montana Adults with and without Disability, 2001 and 2003 (with 95% confidence intervals). The definition excludes gestational diabetes. In 2001, 5.6% of all 3,335 respondents had ever been told that they had diabetes. Confidence interval is 4.6-6.6. In 2003, 5.5% of 4,020 respondents had ever been told that they had diabetes. Confidence interval is 4.7-6.3.

In 2001, 12.2% of 743 respondents with disability had ever been told that they had diabetes. Confidence interval is 9.1-15.3. In 2003, 10.6% of 951 respondents with disability had ever been told that they had diabetes. Confidence interval is 8.2-13.0.

In 2001, 9.2% of 499 respondents with disability, ages 18-64, had ever been told that they had diabetes. Confidence interval is 5.9-12.5. In 2003, 8.5% of 635 respondents with disability, ages 18-64, had ever been told that they had diabetes. Confidence interval is 6.0-11.0.

In 2001, 19.5% of 244 respondents with disability, ages 65+, had ever been told that they had diabetes. Confidence interval is 12.8-26.2. In 2003, 15.2% of 309 respondents with disability, ages 65+, had ever been told that they had diabetes. Confidence interval is 10.1-20.3.

In 2001, 3.9% of 2,587 respondents without disability had ever been told that they had diabetes. Confidence interval is 2.9-4.9. In 2003, 4.2% of 3,021 respondents without disability had ever been told that they had diabetes. Confidence interval is 3.4-5.0.

In 2001, 2.7% of 2,093 respondents without disability, ages 18-64, had ever been told that they had diabetes. Confidence interval is 1.7-3.7. In 2003, 3.2% of 2,437 respondents without disability had ever been told that they had diabetes. Confidence interval is 2.4-4.0.

In 2001, 10.2% of 490 respondents without disability, ages 65+, had ever been told that they had diabetes. Confidence interval is 6.9-13.5. In 2003, 10.4% of 559 respondents without disability, ages 65+, had ever been told that they had diabetes. Confidence interval is 7.3-13.5. End of description.

Healthy People 2010 Objective: 5-3. Reduce the overall rate of diabetes that is clinically diagnosed to 25 cases per 1000 population (2.5 percent).

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Description of Figure 18. Diabetes prevalence, Montana adults, 2003. The definition excludes gestational diabetes. This bar graph shows that about 11% of all adults with disabilities had ever been told by a doctor that they had diabetes. About 4% of all adults without disabilities had ever been told by a doctor that they had diabetes. About 9% of adults with disabilities, ages 18-64, had ever been told by a doctor that they had diabetes. About 3% of all adults without disabilities, ages 18-64, had ever been told by a doctor that they had diabetes. About 15% of adults with disabilities, ages 64+, had ever been told by a doctor that they had diabetes. About 10% of all adults without disabilities, ages 65+, had ever been told by a doctor that they had diabetes. End of description.

Have you ever been told by a doctor that you have diabetes?  Eleven percent of adults with disability in Montana reported that a doctor had ever told them that they had diabetes.

More than twice as many adults with disability (11%) had been told they had diabetes than adults without disability (4%).

Among adults age 18-64, those with disability (9%) had a significantly higher self-reported prevalence of diabetes than those without disability (3%). Among adults 65 and older, the difference between those with and without disability (15% and 10% respectively) was not statistically significant.

Among adults with disability, those age 65 and older (15%) were more likely to have been told they had diabetes than those who were younger (8%).

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Disability Report Highlights

Year 2010 Health Objectives for the Nation: Summary of 2003 Behavioral Risk Factor Surveillance System Data for Montana Adults with and without Disability.

Note: Healthy People 2010: National Health Promotion and Disease Prevention Objectives – Full Report with Commentary was published by the Public Health Service, U.S. Department of Health and Human Services, Washington, D.C., in 2000.

Description of Table: Healthy People 2010 Objective and Year 2010 Target for Montana Adults, and Montana Adults With and Without Disability.

1-1. Increase the proportion of persons with health insurance to 100 percent. The goal for Montana adults is 81%. The goal for Montana adults with disability is 82%. The goal for Montana adults without disability is 81%.

1-5. Increase the proportion of persons with a usual primary care provider to 85 percent. The goal for Montana adults is 73%. The goal for Montana adults with disability is 83%. The goal for Montana adults without disability is 71%.

2-2. Reduce the proportion of adults with chronic joint symptoms who experience a limitation in activity due to arthritis to 21 percent. The goal for Montana adults is 28%. The goal for Montana adults with disability is 61%. The goal for Montana adults without disability is 12%.

2-5. Increase the employment rate among adults with arthritis in the working-aged population (age 18-64) to 78 percent. The goal for Montana adults is 63%. The goal for Montana adults with disability is 44%. The goal for Montana adults without disability is 73%.

5-3. Reduce the overall rate of diabetes that is clinically diagnosed to 25 cases per 1000 population. The goal for Montana adults is 55 per 1000. The goal for Montana adults with disability is 106 per 1000. The goal for Montana adults without disability is 42 per 1000.

12-9. Reduce the proportion of adults with high blood pressure to 16 percent. The goal for Montana adults is 21%. The goal for Montana adults with disability is 37%. The goal for Montana adults without disability is 17%.

12-14. Reduce the proportion of adults with high total blood cholesterol levels to 17 percent. The goal for Montana adults is 30%. The goal for Montana adults with disability is 39%. The goal for Montana adults without disability is 27%.

12-15. Increase the proportion of adults who have had their blood cholesterol checked within the past five years to 80 percent. The goal for Montana adults is 70%. The goal for Montana adults with disability is 75%. The goal for Montana adults without disability is 69%.

14-29a. Increase the proportion of adults who are vaccinated annually against influenza to 90 percent (age 65 and older). The goal for Montana adults is 73%. The goal for Montana adults with disability is 78%. The goal for Montana adults without disability is 70%.

14-29b. Increase the proportion of adults ever vaccinated against pneumococcal disease to 90 percent (age 65 and older). The goal for Montana adults is 69%. The goal for Montana adults with disability is 76%. The goal for Montana adults without disability is 66%.

19-1. Increase the proportion of adults who are at a healthy weight to 60 percent. The goal for Montana adults is 43%. The goal for Montana adults with disability is 34%. The goal for Montana adults without disability is 46%.

19-2. Reduce the proportion of adults who are obese to 15 percent. The goal for Montana adults is 19%. The goal for Montana adults with disability is 28%. The goal for Montana adults without disability is 16%.

22-1. Reduce the proportion of adults who engage in no leisure time physical activity to 20 percent. The goal for Montana adults is 20%. The goal for Montana adults with disability is 34%. The goal for Montana adults without disability is 17%.

22-2. Increase the proportion of adults who engage in regular, moderate physical activity to 30 percent. The goal for Montana adults is 59%. The goal for Montana adults with disability is 49%. The goal for Montana adults without disability is 61%.

26-11c. Reduce the proportion of adults engaging in binge drinking in the past month to 6 percent. The goal for Montana adults is 19%. The goal for Montana adults with disability is 14%. The goal for Montana adults without disability is 21%.

27-1a. Reduce cigarette smoking by adults to 12 percent. The goal for Montana adults is 20%. The goal for Montana adults with disability is 24%. The goal for Montana adults without disability is 19%. End of description.

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Summary and Highlights

Montana adults with disability compared positively to those without disability in attaining certain Healthy People 2010 objectives. Adults with disability were more likely to have:

1. A usual primary health care provider;
2. Regular blood cholesterol screening;
3. Immunizations against influenza and pneumococcal disease;
4. A lower overall prevalence of binge drinking.

Conversely, Montana adults with disability reported significant health gaps and disparities in the attainment of other Healthy People 2010 objectives — particularly those related to chronic joint symptoms and diabetes. In summary, adults with disability in Montana were more likely to:

1. Have chronic joint symptoms and arthritis;
2. Report clinically diagnosed diabetes;
3. Have high blood pressure or blood cholesterol;
4. Be obese;
5. Not engage in leisure-time physical activity;
6. Sustain fall-related injuries;
7. Smoke cigarettes.

Focusing on reducing these gaps and disparities could contribute substantially to achieving Healthy People 2010 objectives in Montana, and more importantly, to improving the health and well-being of Montana adults with disability.

The table on the preceding page, “Healthy People 2010 Objective and Year 2010 Target for Montana Adults, and Montana Adults With and Without Disability” highlights and augments the Healthy People 2010 information presented in this report.

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For further information, contact

Joanne Oreskovich, PhD
BRFSS Director/Epidemiologist
Health Planning Section Supervisor
Public Health and Safety Division of DPHHS
1400 Broadway, C314A Cogswell
P.O. Box 202951
Helena, MT 59620-2951
Phone: (406) 444-2973
Fax: (406) 444-7465
Email: joreskovich@mt.gov

Meg Traci, Director  matraci@ruralinstitute.umt.edu
Montana Disability and Health Program
The University of Montana Rural Institute
52 Corbin Hall, Missoula, MT 59812-7056
888-268-2743 toll-free;
406-243-5467 Voice;
406-243-4200 TTY
406-243-2349 (fax)
http://rtc.ruralinstitute.umt.edu
http://mtdh.ruralinstitute.umt.edu

The Montana Behavioral Risk Factor Surveillance System (BRFSS) website: http://www.brfss.mt.gov/

The University of Montana Rural Institute website: http://mtdh.ruralinstitute.umt.edu

The Centers for Disease Control and Prevention BRFSS website: http://www.cdc.gov/brfss/

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For alternative formats of this report

The Montana Department of Public Health and Human Services (DPHHS) attempts to provide reasonable accommodations for disability that may interfere with a person participating in any service, program, or activity of the department. Alternative accessible formats of this document will be provided upon request. For assistance, please contact:

Montana Behavioral Risk Factor Surveillance System
Phone: (406) 444-2973 (BRFSS Director) or (406) 444-4111 (BRFSS Coordinator)
Public Health and Safety Division of DPHHS
1400 Broadway, C314A Cogswell
P.O. Box 202951
Helena, MT 59620-2951
Montana Department of Public Health and Human Services TDD Number: (406) 444-2590.

Or e-mail: ruralinstitute@ruralinstitute.umt.edu

1,000 copies of this public document were published at an estimated cost of $8.08 per copy, for a total cost of $8,080.00, which includes $8,080.00 for printing and $0.00 for distribution.

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