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Nearly year-round, the South Carolina Department of Health and Environmental Control (DHEC) participates in the Behavioral Risk Factor Surveillance System (BRFSS)—the world's largest continuously conducted health survey system in the world. The BRFSS is a random telephone survey of non-institutionalized individuals aged 18 or older that is used to track health risks, behaviors and preventative health practices in the United States. In 1981, the Centers for Disease Control and Prevention (CDC), in collaboration with selected states, initiated a telephone based behavioral risk factor surveillance system to monitor health risk behaviors. As of 1993, participation in the BRFSS expanded to include all 50 States, the District of Columbia, Guam, Puerto Rico, and the Virgin Islands. South Carolina has been administering the BRFSS since 1984. The basic philosophy is to collect data on actual behaviors, rather than on attitudes or knowledge, that would be especially useful for planning, initiating, supporting, and evaluating health promotion and disease prevention programs.