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History of BRFSS

In the early 1980’s, national estimates of health risk behaviors among U.S. adult populations had been periodically obtained through surveys conducted by the National Center for Health Statistics (NCHS); however, these data were not available on a state-specific basis nor were the data gathered in a systematic manner.

State health agencies with the primary responsibility to reduce behavioral risks and their consequent illnesses viewed this lack of state-specific data as critical. The Centers for Disease Control and Prevention (CDC) concurred and recognized that state and local agency participation was necessary to achieve national health goals.

Thus, the BRFSS surveys were developed and conducted to monitor state-level prevalence of the major behavioral risks associated with premature morbidity and mortality. The CDC collaborated with individual states to develop the BRFSS survey questions which were designed to gather data from adults about their self-reported health and health-risk behaviors.

To determine feasibility of behavioral surveillance, initial point-in-time state surveys were conducted in 29 states from 1981-1983. Montana was among the first states to participate during this period. In 1984, the Centers for Disease Control and Prevention (CDC) established the Behavioral Risk Factor Surveillance System (BRFSS), and 15 states participated in monthly data collection. Although the BRFSS was designed to collect state-level data, a number of states from the outset stratified their samples to allow them to estimate prevalence for regions within their respective states.

CDC developed a standard core questionnaire for states to use to provide data that could be compared across states. The BRFSS, administered and supported by the Division of Adult and Community Health; CDC, is an on-going data collection program. By 1994, all states, the District of Columbia, and three territories were participating in the BRFSS.