Health Behaviors and Chronic Conditions of Movers: Out-of-state Interviews Among Cell Phone Respondents, BRFSS 2014

Since 2011, the Behavioral Risk Factor Surveillance System (BRFSS) has been conducting telephone surveys using landline and cell phones from all U.S. states. Due to the portability of cell phones, residents in one state can retain cell phone numbers with area codes from other states. Protocol dictates that BRFSS must interview such out-of-state respondents to complete the core BRFSS interview and collected data must then be transferred to the state of current residence. We used cell phone data from 2014 BRFSS to compare the demographic factors, health care access, health behaviors, history of chronic disease, and chronic conditions among out-of-state interview (movers) with those respondents whose cell phone numbers matched their current state of residence (did not move). The estimated weighted population percentage of movers was 10% nationwide and ranged from 1.5% in Hawaii to 21.0% in Nevada (median: 5.8%). Compared with respondents who did not move, movers were significantly more likely to be younger, white non-Hispanic, college graduate, never married, and more likely to have health care coverage. After adjusting for demographics, movers were 16% less likely to report no leisure time physical activity, 17% less likely to smoke, 7% less likely to be overweight or obese, 33% less likely to report diabetes, and 12% less likely to report having arthritis than respondents who did not move. Persons who might be left out of cell phone samples due to moving in or out of state may therefore represent a potential for bias in estimation of health behaviors and chronic conditions where transfer of data across state lines is not possible.