Chronic Disease Risk Factors among Women in Tennessee

Background: Tennessee has been disproportionally burdened with high levels of chronic disease and poor overall health. About 14% of adults in Tennessee have three or more of the following chronic health conditions: arthritis, asthma, chronic kidney disease, chronic obstructive pulmonary disease, cardiovascular disease (heart disease, heart attack or stroke), cancer (excluding skin), depression and diabetes. Prior studies have found associations between multiple risk factors and chronic diseases, however, less is known about risk factors specific to women. This study aimed to close that knowledge gap. Methods: We used cross-sectional data from the 2019 Behavioral Risk Factor Surveillance System, a nationally representative U.S. telephone-based survey of adults aged 18 years or older for the State of Tennessee (n=6,242). Logistic regression analyses were conducted to test the association between gender and chronic disease status. We coded chronic disease as 1, 2 or more, and 0 (referent). We controlled for the past month\u27s alcohol use, income, race, educational status, and age. Results: Overall, 52.6% of females, and 56.9% of males reported at least one chronic disease, while 24.5% of males and 22.7% of females reported 2 or more chronic diseases. Among females, less than high school education (RRR=2.97, 95% CI, 1.97, 3,74), lifetime smoked \u3e100 cigarettes (RRR=2.30, 95% CI, 1.90, 3,01), low income (RRR=1.43, 95% CI, 1.19, 1.78) were associated with a higher risk of 2 or more chronic disease. Conclusions: The high prevalence of multiple chronic diseases is one of the major health challenges faced by the residents of Tennessee. Among the female population, less than high school education, lifetime smoking of \u3e100 cigarettes, low income was significantly associated with a higher risk of 2 or more chronic diseases. These findings underscore the need for a more comprehensive and targeted effort to address chronic disease among women, particularly amongst underserved, low-income populations. These include protection policies that encourage healthy eating, regular physical activity, more stringent smoking laws, and curb alcohol intake