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Measuring bereavement prevalence in a complex sampling survey: the 2019 Georgia Behavioral Risk Factor Surveillance

Changle Li¹, Toni P Miles², Ye Shen¹

¹Department of Epidemiology and Biostatistics, University of Georgia, Athens, USA.

BMC Medical Research Methodology

|June 13, 2023

Summary

Recent bereavement can be measured in surveys, with an estimated 45.38% of Georgia adults experiencing loss in 2018-2019. This analysis explores methods to accurately estimate bereavement prevalence using survey data.

Keywords:

Aging BRFSS Bereavement Grief Multiple Imputation Population Surveillance Public Health Weighting

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Area of Science:

Public Health Surveillance
Epidemiology
Survey Methodology

Background:

The Behavioral Risk Factor Surveillance System (BRFSS) is a key tool for monitoring public health trends.
A new 3-item module was piloted in Georgia (GA) in 2019 to assess bereavement in adults aged 18+.

Purpose of the Study:

To determine if bereavement prevalence can be accurately estimated from survey data without significant sampling errors or small subsamples.
To evaluate the effectiveness of multiple imputation techniques for handling non-response and missing data in bereavement research.

Main Methods:

Two analysis scenarios were used: Scenario 1 (weighted data with imputation) reflecting public health use, and Scenario 2 (unweighted data with missing data removal) reflecting social science use.
Data from the 2019 Georgia BRFSS survey was analyzed, focusing on participants who reported the death of a close contact in 2018 or 2019.

Main Results:

The bereavement screening item had a response rate of 69.1%.
Scenario 1 estimated bereavement prevalence at 45.38% (3,739,120 adults).
Scenario 2 yielded a slightly higher prevalence estimate (46.02%) and overestimated by 1.39%, highlighting the impact of data handling methods.

Conclusions:

Bereavement can be measured in population surveillance surveys, but response biases must be considered.
Accurate estimation of bereavement prevalence is crucial for population health assessments.
The study highlights limitations including a single state, a single year, and exclusion of individuals under 18.