The 1987 survey included three questions regarding cholesterol testing and awareness. Respondents were asked whether they had ever had their cholesterol tested. If so, they were asked whether they had been told their cholesterol level, and those who had been given this information were asked what their level was.

The proportion of adults in each state who reported having had their cholesterol tested ranged from 29% to 57%, with a median of 47% (Table 1). The proportion of adults who reported being told their value ranged from 3% to 29%, with a median of 19%. Finally, the proportion of adults who were able to provide a value for their cholesterol ranged from 1% to 9%, with a median of 6% (Figure 1).

Although current levels of individual cholesterol awareness in the United States are low, they appear to be increasing. Surveys conducted by the NHLBI in 1983 and and again in 1986 show that the proportion of adults in the United States who reported that their serum cholesterol had been checked rose from 35% to 46%, and the proportion who claimed to know their cholesterol level rose from 3% to 7% (6). The proportion of U.S. adults who had had their cholesterol tested (46%) and who knew their cholesterol level (7%) in 1986 are similar to the median values of the states participating in the 1987 BRFSS (47% and 5%).

Reported by: R Strickland, Alabama Dept of Public Health. T Hughes, Arizona Dept of Health Svcs. L Parker, California Dept of Health Svcs. C Mitchell, District of Columbia Dept of Human Svcs. S Hoecherl, Florida Dept of Health and Rehabilitative Svcs. JD Smith, Georgia Dept of Human Resources. E Tash, Hawaii Dept of Health. J Mitten, Idaho Dept of Health and Welfare. B Stiner, Illinois Dept of Public Health. S Joseph, Indiana State Board of Health. K Bramblett, Kentucky Cabinet for Human Resources. M Gay, Maine Dept of Human Svcs. A Winestein, Maryland State Dept of Health and Mental Hygiene. L Koumjian, Massachusetts Dept of Public Health. N Salem, Minnesota Center for Health Statistics. M Van Tuinen, Missouri Dept of Health. R Moon, Montana State Dept of Health and Environmental Sciences. R Thurber, Nebraska State Dept of Health. K Zaso, New Hampshire State Dept of Health and Welfare. L Pendley,

FIGURE 1. Percentage of respondents who claim to know their cholesterol level, by state Behavioral Risk Factor Surveillance System, 1987

*Data from New Hampshire unavailable at time of publication.
*The sample size was used as the denominator for each estimate.

New Mexico Health and Environment Dept. H Bzduch, New York State Dept of Health. C Washington, North Carolina Dept of Human Resources. B Lee, North Dakota State Dept of Health. E Capwell, Ohio Dept of Health. J Cataldo, Rhode Island Dept of Health. D Lackland, South Carolina Dept of Health and Environmental Control. L Post, South Dakota State Dept of Health. D Ridings, Tennessee Dept of Health and Environment. J Fellows, Texas Dept of Health. C Chakley, Utah Dept of Health. K Tollestrup, Washington Dept of Social and Health Svcs. R Anderson, West Virginia State Dept of Health. R Miller, Wisconsin Center for Health Statistics. Div of Nutrition, Center for Health Promotion and Education, CDC.

Editorial Note: The proportion of adults who reported having had their cholesterol tested varied widely from state to state. This variation may reflect differences either in the availability and use of public or private cholesterol testing or in the respondents' awareness of the results of past testing.

Fewer than one in ten adults in the states participating in the BRFSS claimed to know their cholesterol value. This low level of awareness appears to result from several factors. First, fewer than half of the adults who had had their cholesterol tested said that they were told their value, and second, fewer than a third of those who were told their cholesterol level remembered it.

In recognition of the need for federal, state, and local activities supporting cholesterol awareness, April 1988 has been designated as "National Know Your Cholesterol Month" (4). Efforts such as this should be continued to encourage all adults to have their cholesterol tested, to encourage health-care providers to inform patients of their cholesterol value and its significance, and to help individuals to "know their numbers."

Continuing the downward trend of serum cholesterol levels in the United States will depend initially on improved awareness. However, long-term progress in reducing risk from elevated cholesterol will require broad, population-based changes in diet as well as adherence to drug regimens, when warranted. Data from the BRFSS can be useful in planning and monitoring the progress of population-based programs to improve cholesterol awareness.

References

1. Office of Medical Applications of Research, National Institutes of Health. Lowering blood cholesterol to prevent heart disease. JAMA 1985;253:2080-6.

2. Lipid Research Clinics Program. The lipid research clinics coronary primary prevention trial results. II. The relationship of reduction in incidence of coronary heart disease to cholesterol lowering. JAMA 1984;251:365-74.

3. National Center for Health Statistics; National Heart, Lung, and Blood Institute Collaborative Lipid Group. Trends in serum cholesterol levels among U.S. adults aged 20 to 74 years: data from the National Health and Nutrition Examination Surveys, 1960 to 1980. JAMA 1987; 257:937-42.

4. Cleeman JI, Lenfant C. The U.S. National Cholesterol Education Program: raising health professional and public awareness about the importance of lowering high blood cholesterol. In: Grundy SM, Bearn AG, eds. The role of cholesterol in atherosclerosis: new therapeutic opportunities. Philadelphia: Hanley & Belfus, 1988:213-29.

5. Remington PL, Smith MY, Williamson DF, et al. Design, characteristics, and usefulness of state-based behavioral risk factor surveillance: 1981-1987. Public Health Rep (in press).

6. Schucker B, Bailey K, Heimbach JT, et al. Change in public perspective on cholesterol and heart disease: results from two national surveys. JAMA 1987; 258:3527-31.

Current Trends

Trends in Years of Potential Life Lost Due to Infant Mortality and
Perinatal Conditions, 1980-1983 and 1984-1985

The majority of deaths from three of the seven leading causes of years of potential life lost (YPLL) occur during the first year of life (1). Analysis of overall YPLL from infant deaths and of YPLL from perinatal conditions* for 1980-1983 (2) and 1984-1985 reveals that YPLL for all genders and races has declined.

Data from the national mortality computer tapes and natality statistics (3) from the National Center for Health Statistics, CDC, were used for this analysis. The classification scheme for perinatal and other causes of death and the formula used for calculating YPLL have been described (2,4). Since YPLL from infant deaths for any given year should be evaluated in light of the number of live births for that year, average YPLL per 1,000 live births was calculated.

Between 1980-1983 and 1984-1985, the average annual YPLL per 1,000 live births declined for all genders and races. Declines were greatest for white female infants (14%) and white male infants (13%). Black male infants and male infants of other races had a 12% decline, and black and other female infants had a 10% decline. YPLL rates declined most rapidly for deaths caused by birth trauma/asphyxia (Table 1). The average YPLL for birth trauma/asphyxia dropped 33% for whites (from 36/1,000 live births to 24/1,000) and 31% for blacks and others (from 59/1,000 to 41/1,000).

For 1980-1983, the average annual YPLL for deaths occurring within the first year of life was 2,787,465; 1,861,691 (66.8%) occurred because of deaths during the neonatal period (<28 days), and 925,774, because of deaths during the postneonatal period (28 days to<1 year) (2). For 1984-1985, the average annual YPLL within the first year of life was 2,579,920; 1,685,549 (65.3%) occurred because of deaths during the neonatal period, and 896,741, because of deaths during the postneonatal period.

*Conditions arising between 28 weeks gestation and 7 days of life.

TABLE 1. Average years of potential life lost (YPLL) and percentage decline in average YPLL per 1,000 live births due to perinatal conditions, by race United States, 1980-1983 and 1984-1985

Perinatal

White

Average YPLL/1,000 Live Births

Black and Other

1980-1983 1984-1985 Decline (%) 1980-1983 1984-1985 Decline (%)

Conditions

Prematurity/

Low Birthweight

The average YPLL per 1,000 live births declined from 749 for the period 1980–1983 to 694 for 1984-1985.

Conditions arising during the perinatal period were responsible for 47% (1,301,746) of YPLL among infants from 1980-1983 (2) and 45% (1,162,490) of YPLL among infants from 1984-1985. During both study periods, respiratory conditions accounted for approximately one-third of the average YPLL due to perinatal conditions; respiratory distress syndrome was the most frequent respiratory condition. Male infants had higher annual YPLL rates than female infants (Table 2). Differences in YPLL rates by gender were greatest for deaths due to respiratory distress syndrome; the rate for male infants exceeded the rate for female infants by 34%. The ratio of blacks to whites for all perinatal conditions was 2.3 for male infants and 2.5 for female infants. Reported by: Pregnancy Epidemiology Br, Research and Statistics Br, Div of Reproductive Health, Center for Health Promotion and Education, CDC.

Editorial Note: Deaths due to prematurity as defined in Table V (see page 255) exclude conditions such as slow fetal growth and fetal maturation (International

TABLE II. Notifiable diseases of low frequency, United States

*Because AIDS cases are not received weekly from all reporting areas, comparison of weekly figures may be misleading. *One of the 34 reported cases for this week was imported from a foreign country or can be directly traceable to a known internationally imported case within two generations.