The following are other resources for area level data, and their limitations.
The Behavioral Risk Factor Surveillance System (BRFSS) is the world's largest, on-going telephone health survey system, tracking health conditions and risk behaviors in the United States yearly since 1984. Conducted by the 50 state health departments as well as those in the District of Columbia, Puerto Rico, Guam, and the U.S. Virgin Islands with support from the Centers for Disease Control and Prevention (CDC), BRFSS provides state-specific information about issues such as asthma, diabetes, health care access, alcohol use, hypertension, obesity, cancer screening, nutrition and physical activity, and tobacco use. The following BRFSS data are available:
Limitations: For data up to 2010, households without landline telephone are not interviewed, possible nonresponse bias, and variability of estimates.
Through the National Health Interview Survey (NHIS), the National Center for Health Statistics, with data collection by the Bureau of the Census, monitors the health of the noninstitutionalized civilian population of the United States by collecting and analyzing data on a broad range of health topics. A major strength of this survey is its ability to display these health characteristics by many demographic and socioeconomic characteristics. Behavioral data are available for alcohol use, cigarette use, leisure-time physical activity, body weight status, and sleep.
Limitations: Collects data for about 25% of the U.S. counties, and that some of the sample sizes for counties are very small.
Model-assisted estimates could be computed to estimate county and state level estimates using data from both the Behavioral Risk Factor Surveillance System (BRFSS) and the National Health Interview Survey (NHIS). This method corrects for potential biases in the BRFSS estimates by manipulating the BRFSS statistical weights. Then, the estimates computed using the modified weights "look" more like the National Health Interview Survey (NHIS) estimates. For more information about this method see the reference below, where the method was applied using the NHIS public use files, with geographical identifiers available only at the regional level.
Limitations: While the model-assisted estimates correct for the non-coverage and nonresponse biases, they are still quite variable for many counties that have small sample sizes.
Elliott M, Davis W. Obtaining Cancer Risk Factor Prevalence Estimates in Small Areas: Combining data from two surveys. J R Stat Soc Ser C Appl Stat 2005;54:595-609.
Elliott M, Davis W. Corrigendum: Obtaining cancer risk factor prevalence estimates in small areas: combining data from two surveys. J R Stat Soc Ser C Appl Stat 2005;54(5):958.
The Tobacco Use Supplement to the Current Population Survey (TUS-CPS) is an NCI-sponsored survey of tobacco use that has been administered as part of the U.S. Census Bureau's Current Population Survey in 1992-1993, 1995-1996, 1998-1999, 2000, 2001-2002, and 2003, 2006-2007, 2010-2011, and 2014-2015. The TUS-CPS is a key source of national and state level data on smoking and other tobacco use in U.S. households. While proxy responses are allowed for the smoking questions, a majority of the responses are self reports. The responses are obtained via both household and telephone interviews. Details and results from the TUS-CPS can be found at its website.
Limitations: tobacco only, direct estimates below the state level are not available because of confidentiality and reliability consideration.
The California Health Interview Study (CHIS) is the largest state health survey in the United States. It is a telephone survey that provides health-related data or adults and children within the state of California. CHIS is a biennial survey that was fielded for the first time in 2001 and includes an important focus on diverse population groups such as African-Americans, Latinos and Hispanics, Native Americans and Alaska Natives, and Asian-Americans and Pacific Islanders. CHIS Data and Findings can be found at its website.
Limitations: California only, households without telephone are not interviewed, possible nonresponse bias.