Variation in Clinician Advice to Modify Health Risk Behaviors: A Cross-Sectional Study

Clinician's advice to modify health behaviors can vary by patient race/ethnicity and sex, although prior studies are mixed and show variation over time. Research examining the role of insurance type is limited.

The 2022 National Health Information Survey was analyzed in 2024 to estimate survey-weighted proportions of receiving clinician advice and associations with demographic factors among 3 at-risk groups: (1) adults who smoke cigarettes; (2) adults who engage in heavy drinking; and (3) adults with diabetes, hypertension, and/or obesity, who are insufficiently active.

In each relevant population, 47.5% received advice to quit smoking, 6.8% received advice to decrease drinking, and 35.7% received advice to increase physical activity. The odds of receiving advice to quit smoking were lower among non-Hispanic Black (AOR=0.68, 95% CI=0.53, 0.87) and Hispanic adults (AOR=0.46, 95% CI=0.30, 0.69) than among non-Hispanic White adults, and among adults with no insurance (AOR=0.36, 95% CI=0.24, 0.56) and private insurance (AOR=0.55, 95% CI=0.39, 0.77) than among those with Medicare. Men had higher odds (AOR=2.36, 95% CI=1.84, 3.02) of being advised to decrease drinking. Hispanic adults (AOR=1.27, 95% CI=1.05, 1.54) had higher odds of receiving advice to increase physical activity; uninsured adults (AOR=0.51, 95% CI=0.35, 0.73), men (AOR=0.85, 95% CI=0.76, 0.96), and adults aged >64 years had lower odds. Adults aged 18-34 years were the least likely to receive smoking or alcohol counseling.

Many at-risk adults do not receive clinician's advice to modify relevant health behaviors. Counseling rates vary by patient demographic factors, highlighting opportunities to improve health equity in preventive care.