The Missouri County-level Study followed standard U.S. Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS) methods and techniques. The questionnaire used for the interviews contained questions from the BRFSS and CDC Adult Tobacco Survey (ATS).

The 2011 CLS goal was to complete 47,200 landline interviews with Missouri adults ages 18 and older. The goals were as follows:

  • 800 interviews in Jackson County and St. Louis County with 400 interviews among African Americans and other races and 400 interviews among whites.
  • 800 interviews in St Louis City with 400 interviews among African Americans and 400 interviews among whites and other races.
  • 400 completed interviews in the rest of 112 counties.

Additionally, a goal was established to obtain 4,720 interviews with adult cell phone-only users. Data from cell phone interviews were combined with landline data for analysis at the state and regional levels.

Between January and December 2011, interviews were completed with 47,261 landline and 4,828 cell phone only users, totaling 52,089 completed interviews.

Data were weighted to be representative of the Missouri adult (18 years of age and older), non-institutionalized population of the area covered. A new and enhanced weighting methodology that was adopted by CDC to weight the 2011 BRFSS was utilized. A fact sheet explaining the new weighting methodology may be found at

Prevalence of chronic disease, conditions, and risk factors was generated at the county, region and state level. The age-adjusted prevalence was also produced using the 2000 U.S. Standard Population. Due to the rounding error, the total responses to certain questions may slightly exceed or be less than 100 percent. The study response rate was 58.72 percent (CASRO).

CLS findings are subject to limitations. The CLS did not collect information from institutionalized persons, thereby excluding persons residing in nursing homes, long-term care, and correctional facilities.

The CLS did not include persons residing in households without landline telephones that do not use a cell telephone or that do not speak English. As a self-report survey, the CLS is subject to recall bias.

For more information about the study design and weighting methodology, contact Katie Long, CLS Coordinator, Office of Epidemiology, Missouri Department of Health and Senior Services.

Suggested citation for data use: 2011 Missouri County-Level Study. Missouri Department of Health and Senior Services Community Data Profiles can be accessed at