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D-11 Data Details

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D-11 Increase the proportion of adults with diabetes who have a glycosylated hemoglobin measurement at least twice a year

About the Data: National

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

Data Source: 
Behavioral Risk Factor Surveillance System
Changed Since the Healthy People 2020 Launch: 
Yes
Measure: 
percent (age adjusted—see Comments)
Baseline (Year): 
66.3 (2012)
Target: 
72.9
Target-Setting Method: 
10 percent improvement
Numerator: 

Number of persons aged 18 years and over who report they have ever been diagnosed with diabetes and report that a doctor, nurse, or other health professional has checked the respondent’s glycosylated hemoglobin (HbA1c) two or more times in the past year

Denominator: 

Number of persons aged 18 years and over who report they have ever been diagnosed with diabetes

Comparable Healthy People 2010 Objective: 
Adapted from HP2010 objective
Questions Used to Obtain the National Baseline Data: 

    From the 2012 Behavioral Risk Factor Surveillance System:

    [NUMERATOR:]

    A test for "A one C" measures the average level of blood sugar over the past three months. About how many times in the past 12 months has a doctor, nurse, or other health professional checked you for "A one C"?

    1. _ _ Number of times [76=76 or more]
    2. None
    3. Never heard of "A one C" test
    4. Don't know/Not stated
    5. Refused

    [NUMERATOR AND DENOMINATOR:]

    Have you ever been told by a doctor that you have diabetes? [If "Yes" and respondent is female, ask:] Was this only when you were pregnant?

    1. Yes
    2. Yes, but female told only during pregnancy
    3. No
    4. No, pre-diabetes or borderline diabetes
    5. Don't know/Not stated
    6. Refused
Data Collection Frequency: 
Annual
Methodology Notes: 

    Persons are considered to have diabetes if they have ever been told by a doctor or health professional that they have diabetes or sugar diabetes. Women who report that the only time they have been diagnosed with diabetes was during pregnancy (gestational diabetes) are excluded. Persons who report that they have pre-diabetes or borderline diabetes are also excluded from the measure.

    Persons are considered to have been measured for glycosylated hemoglobin if they have been checked for HbA1c two or more times in the past 12 months.

    Age Adjustment Notes: 

    This Indicator uses Age-Adjustment Groups:

    • Total: 18-44, 45-64, 65+
    • Sex: 18-44, 45-64, 65+
    • Race/Ethnicity: 18-44, 45-64, 65+
    • Educational Attainment: 25-44, 45-64, 65+
    • Household Income (percent poverty threshold): 18-44, 45-64, 65+
    • Disability Status: 18-44, 45-64, 65+
    • Geographic Location: 18-44, 45-64, 65+
    • Health Insurance Status: 18-44, 45-64
    • Marital Status: 18-44, 45-64, 65+
    • Obesity Status: 18-44, 45-64, 65+
Caveats and Limitations: 
Persons who reported that they have never heard of an HbA1c test are counted as not having had the test. It is possible that some of these people have had an HbA1c test and reported that they do not know due to either communication or cognitive difficulties. The BRFSS is conducted independently by each state and therefore methodologies may vary. Pooled national estimates may not take into account these differences and so may differ from estimates obtained using data sources that use methodologies designed to produce national estimates.
Trend Issues: 
Data for this objective are collected using the core component and an optional module of the BRFSS, which is made available to States for administration annually. The number of States that select the diabetes module varies every year.
In 2012, 33 States used the optional diabetes module excluding: AZ, CA, CO, DC, FL, IL, IN, IA, LA, MD, MA, MO, MT, NH, NY, ND, RI, and WA.
In 2013, 37 States including DC used the optional diabetes module, excluding: CA, CO, ID, MD, MA, MS, NH, NY, RI, SD, UT, VT, WA, and WY.
In 2014, 24 States including DC used the optional diabetes module, including: AL, AZ, CO, DE, DC, FL, GA, IN, IA, LA, ME, MS, NJ, NM, NE, ND, OH, SC, SD, TN, TX, VA, WV, and WY.
In 2015, 38 States including DC used the optional module excluding: AL, AK, ID, ME, MA, MS, MO, ND, OH, OR, SD, and WV.
In 2017, 39 States including DC used the optional module excluding: AR, CT, HI, ID, IL, ME, MA, MS, OR, SD, TN, and WV.
The measure is the mean of data for the reporting States.
Changes Between HP2010 and HP2020: 
The measure is the same, however the data source has been redesigned and the data are no longer comparable with the data from the HP2010 objective.

About the Data: State

Description of the data source, numerator, denominator, survey questions, and other relevant details about the state-level data.

Data Source: 
Behavioral Risk Factor Surveillance System
Measure: 
percent (age adjusted—see Comments) (age adjusted—see Comments)
Numerator: 

Number of persons aged 18 years and over who report they have ever been diagnosed with diabetes and report that a doctor, nurse, or other health professional has checked the respondent’s glycosylated hemoglobin (HbA1c) two or more times in the past year

Denominator: 

Number of persons aged 18 years and over who report they have ever been diagnosed with diabetes

Questions Used to Obtain the State Data: 

      From the 2012 Behavioral Risk Factor Surveillance System:

      [NUMERATOR:]

      A test for "A one C" measures the average level of blood sugar over the past three months. About how many times in the past 12 months has a doctor, nurse, or other health professional checked you for "A one C"?

      1. _ _ Number of times [76=76 or more]
      2. None
      3. Never heard of "A one C" test
      4. Don't know/Not stated
      5. Refused

      [NUMERATOR AND DENOMINATOR:]

      Have you ever been told by a doctor that you have diabetes? [If "Yes" and respondent is female, ask:] Was this only when you were pregnant?

      1. Yes
      2. Yes, but female told only during pregnancy
      3. No
      4. No, pre-diabetes or borderline diabetes
      5. Don't know/Not stated
      6. Refused
Data Collection Frequency: 
Annual
Methodology Notes: 

      Persons are considered to have diabetes if they have ever been told by a doctor or health professional that they have diabetes or sugar diabetes. Women who report that the only time they have been diagnosed with diabetes was during pregnancy (gestational diabetes) are excluded. Persons who report that they have pre-diabetes or borderline diabetes are also excluded from the measure.

      Persons are considered to have been measured for glycosylated hemoglobin if they have been checked for HbA1c two or more times in the past 12 months.

    Age Adjustment Notes: 

    This Indicator uses Age-Adjustment Groups:

    • Total: 18-44, 45-64, 65+
    • Sex: 18-44, 45-64, 65+
    • Race/Ethnicity: 18-44, 45-64, 65+
    • Educational Attainment: 25-44, 45-64, 65+
    • Household Income (percent poverty threshold): 18-44, 45-64, 65+
    • Disability Status: 18-44, 45-64, 65+
    • Geographic Location: 18-44, 45-64, 65+
    • Health Insurance Status: 18-44, 45-64
    • Marital Status: 18-44, 45-64, 65+
    • Obesity Status: 18-44, 45-64, 65+
Caveats and Limitations: 
Persons who reported that they have never heard of an HbA1c test are counted as not having had the test. It is possible that some of these people have had an HbA1c test and reported that they do not know due to either communication or cognitive difficulties. The BRFSS is conducted independently by each state and therefore methodologies may vary. Pooled national estimates may not take into account these differences and so may differ from estimates obtained using data sources that use methodologies designed to produce national estimates.
Trend Issues: 
Data for this objective are collected using the core component and an optional module of the BRFSS, which is made available to States for administration annually. The number of States that select the diabetes module varies every year.
In 2012, 33 States used the optional diabetes module excluding: AZ, CA, CO, DC, FL, IL, IN, IA, LA, MD, MA, MO, MT, NH, NY, ND, RI, and WA.
In 2013, 37 States including DC used the optional diabetes module, excluding: CA, CO, ID, MD, MA, MS, NH, NY, RI, SD, UT, VT, WA, and WY.
In 2014, 24 States including DC used the optional diabetes module, including: AL, AZ, CO, DE, DC, FL, GA, IN, IA, LA, ME, MS, NJ, NM, NE, ND, OH, SC, SD, TN, TX, VA, WV, and WY.
In 2015, 38 States including DC used the optional module excluding: AL, AK, ID, ME, MA, MS, MO, ND, OH, OR, SD, and WV.
In 2017, 39 States including DC used the optional module excluding: AR, CT, HI, ID, IL, ME, MA, MS, OR, SD, TN, and WV.
The measure is the mean of data for the reporting States.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch: 
The data source, BRFSS, underwent a redesign in 2011. Due to changes in the weighting methodology and sampling frame, data collected in 2011 and later are not comparable with data collected before the redesign. In 2019, the baseline for this objective was revised to use 2012 data since more states used the diabetes module in 2012 than in 2011 and it was more desirable to set a national target using data that includes more states. As a result, the baseline was revised from 64.6% in 2008 to 66.3% in 2012. The target was revised from 71.1% to 72.9% based on the original target setting methodology of 10% improvement. In 2019, the template data lines for the age subpopulations were changed from displaying for (65-74, 75-84, 85+) to (65-74, 75+) because beginning in 2013 detailed age information beyond 80 years was rolled into one variable.