Trends in Health Behavior Patterns Among U.S. Adults, 2003–2015

Background: Over the last two decades, considerable resources from U.S. federal and philanthropic entities were dedicated to improving preventive and reducing chronic disease risk behaviors. Purpose: Given the population health efforts to improve health behaviors in adults, this study explored how health behavior patterns shifted over the years by exploring multiple health behavior patterns. Methods: Data were obtained from the odd years between 2002 and 2016 Behavioral Risk Factor Surveillance System. Latent class analyses including fruit and vegetables, physical activity, cigarette smoking, and heavy and binge drinking were conducted for each year. Results: Three-class models best fit the data and were most interpretable. Each year included Healthy or Physically Active (preventive behaviors, no risk behaviors), Apathetic (no preventive/risk behaviors), and Binge-drinking groups. Gender and age consistently distinguished the Healthy/Physically Active groups from the Apathetic and Binge-drinking groups across the years. Conclusions: This study confirms health behavior clusters exist and have been stable across time. This is encouraging as trends have not gotten worse, but there is room for improvement. Repetition of the groups across years suggests that despite population-level interventions, a large segment of the U.S. population at risk for chronic diseases are not engaging in preventive health.