Behavioral Risk Factor Surveillance System
Behavioral Risk Factor Surveillance System (BRFSS)
Years Survey Included Sexual and Gender Minority (SGM)-related Questions
2014 - Present
The Behavioral Risk Factor Surveillance System (BRFSS) is a collaborative project between all of the states in the United States (US) and participating US territories and the Centers for Disease Control and Prevention (CDC). The BRFSS is an ongoing surveillance system with the objective to collect uniform, state-specific data on U.S. adults’ health-related risk behaviors, chronic health conditions, and use of preventive services. The core sections include: health status, healthy days—health related quality of life, health care access, exercise, inadequate sleep, chronic health conditions, oral health, demographics, tobacco use, e-cigarettes, alcohol consumption, immunization, falls, seatbelt use, drinking and driving, breast and cervical cancer screening, prostate cancer screening, colorectal cancer screening and HIV/AIDS.
In 2013, the CDC developed a question module for BRFSS to collect data on Sexual Orientation and Gender Identity (SO/GI). The CDC began giving states the option to add this module to their BRFSS questionnaires in 2014 and is currently one of the 25 optional modules that are decided on by individual states each year.
Survey Sample Population
BRFSS completes more than 400,000 adult interviews each year, making it the largest continuously conducted health survey system in the world. All 50 states, the District of Columbia, Puerto Rico, and Guam collect data annually; American Samoa, the Federated States of Micronesia, and Palau collect survey data over a limited point-in-time (usually 1 to 3 months). The target population for this survey is the noninstitutionalized adult population ages 18 years of age and older.
Since 2011, the BRFSS is conducted using both landline telephone- and cellular telephone-based surveys. In 2014, 53 states or territories used Computer-Assisted Telephone Interview (CATI) systems. In conducting the BRFSS landline telephone survey, interviewers collect data from a randomly selected adult in a household. In conducting the cellular telephone version of the BRFSS questionnaire, interviewers collect data from an adult who participates by using a cellular telephone and resides in a private residence or college housing.
Following guidelines provided by the BRFSS, state health personnel or contractors conduct interviews. All health departments must ask the core component questions without modification in wording, however, the modules are optional. The SGM-related questions are included in an optional module of the survey. Some states have previously collected sexual orientation and gender identity (SO/GI) data on their own prior to the availability of the BRFSS optional modules. Some of those states maintained their own question wording rather than adopting the module version of the SOGI questions. See individual states BRFSS websites for more information. See below for a table that identifies which states use the SO/GI optional module.
States Asking the SO/GI Optional Module
SGM-Related Survey Questions
Do you consider yourself to be:
Do you consider yourself to be transgender?
Module 4: Caregiver
1. During the past 30 days, did you provide regular care or assistance to a friend or family member who has a health problem or disability? (313)
2. What is his or her relationship to you? For example, is he or she your (mother or daughter or father or son)? (314-315)
The BRFSS reports response rates and cooperation rates by state and does not aggregate to national level. Below are the links to the BRFSS website where the response rate tables can be found, specifically for the years that included SGM questions.
This source organizes the questionnaires by:
These links are to the general survey data and documentation for each year. You can find an overview, codebook, response rates, summary data quality report, comparability of data, and data files in a couple of formats. The navigating steps to access this information on the BRFSS website are to go to Survey Data and Documentation, Annual Survey Data then select the desired year. The most recent data can be found at the following link:
American Association for Public Opinion Research (AAPOR). Standard Definitions: Final Dispositions of Case Codes and Outcome Rates for Surveys. (2016).
Baker, KE., Hughes, M. Sexual Orientation and Gender Identity Data Collection in the Behavioral Risk Factor Surveillance System. Center for American Progress. (2016).https://cdn.americanprogress.org/content/uploads/2016/03/05064109/BRFSSdatacollect-brief-04.05.17.pdf
Centers for Disease Control and Prevention. National Center for Chronic Disease Prevention and Health Promotion. Division of Population Health. Behavioral Risk Factor Surveillance System.
Office of the Assistant Secretary for Health (OASH). United States Department of Health and Human Services (HHS). Developing Better Information. (2015).