Analysis of BRFSS HRQOL Study

The Behavioral Risk Factor Surveillance System (BRFSS) is an annual, state-based system of health surveys that collect information about health status and health risk behaviors. Several questions on the BRFSS ask about Health-Related Quality of Life (HRQOL). This study examined the performance of the HRQOL questions among people with and without disabilities.


We analyzed BRFSS data from 2001 and 2002 because these were the most recent years in which several states included a set of optional HRQOL items.  We conducted both exploratory and confirmatory factor analyses of the BRFSS HRQOL items.


Exploratory factor analyses found that the BRFSS HRQOL items could be combined into two scales assessing physical and mental HRQOL. 

We also analyzed BRFSS data from 1998-2000.  In these years, some states used a detailed set of disability questions that provided information about age of disability onset.  Analyses of differences in HRQOL by age of disability onset revealed that people with earlier onset disabilities reported more positive HRQOL than people who acquired disabilities later in life. 

Confirmatory factor analyses with the same dataset found that the factor structure was consistent for both people with and without disabilities.  However, the strength of factor loadings for individual items differed significantly between the two groups. 

Further Reading About New Measure

Population-Based Health Measure, Part I: Can Commonly Used Survey Items be Grouped to Reflect Key Aspects of Health-Related Quality of Life? - Read the Brief  from our 2008 State of the Science Conference Proceedings.

Population Based Measure of Health, Part II: Do the Questions on Surveys Mean the Same Thing to People with and without Disabilities? - Read the Brief from our 2008 State of the Science Conference Proceedings.

Journal Articles

Horner-Johnson W, Suzuki R, Krahn GL, Andresen EM, Drum CE, the RRTC Expert Panel on Health Measurement. Structure of health-related quality of life among people with and without functional limitations. Quality of Life Research 2010;19:977-984.

Horner-Johnson W, Krahn G, Andresen E, Hall T, the RRTC Expert Panel on Health Status Measurement. Developing summary scores of health-related quality of life for a population-based survey. Public Health Reports 2009;124(1):103-110.

Jamoom EW, Horner-Johnson W, Suzuki R, Andresen EM, Campbell VA, the RRTC Expert Panel on Health Status Measurement. Age at disability onset and self-reported health status. BMC Public Health 2008;8:10.