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Interview Survey (interview + survey)
Kinds of Interview Survey Selected AbstractsMost Latino smokers in California are low-frequency smokersADDICTION, Issue 2007Shu-Hong Zhu ABSTRACT Aims We examine the phenomenon of low-frequency smoking (non-daily smoking or smoking , 5 cigarettes daily) among California Latinos and address its implications for addiction theory and population tobacco control. Design, setting and participants Data gathered in 2001 and 2003 through the California Health Interview Survey (CHIS), the largest general health survey in California. The present study focused on Latino current smokers (n = 1254 for CHIS 2001; n = 946 for CHIS 2003). Measurement Latino smokers reporting either non-daily smoking or smoking ,5 cigarettes daily were identified and grouped into one category: low-frequency smokers. Findings Weighted by population parameters, more than 70% of Latino smokers in California were found to be low-frequency smokers [70.7% (CI = 67.2%, 73.9%) in 2001 and 70.8% (CI = 67.1%,74.2%) in 2003]. This high proportion cut across all demographic dimensions in both surveys, suggesting pervasiveness and reliability of this phenomenon. Proportions for non-daily smokers and low-rate daily smokers were 48.6% and 22.1% in 2001 and 54.9% and 15.9% in 2003. In both surveys, more than 80% of non-daily smokers consumed , 5 cigarettes on their smoking days. Conclusions The fact that most Latino smokers are low-frequency smokers calls for a new theoretical framework,beyond withdrawal-based theories,to account for the prevalence of this behavior on the population level. It also calls into question the harm-reduction approach as a tobacco control strategy for California Latino populations. Strategies emphasizing that every cigarette can hurt, and encouraging complete cessation, seem more fitting for this group of smokers. [source] Prevalence of Active Epilepsy and Health-Related Quality of Life among Adults with Self-Reported Epilepsy in California: California Health Interview Survey, 2003EPILEPSIA, Issue 10 2007Rosemarie Kobau Summary:,Purpose: To examine the prevalence of self-reported epilepsy and active epilepsy, associated burden of impaired health-related quality of life, risk factors, and access to care in adults with self-reported epilepsy, and those classified as having active epilepsy with and without recent seizures. Methods: We analyzed data from adults aged ,18 years (n = 41,494) who participated in the 2003 California Health Interview Survey (CHIS). Results: In California, 1.2% of adults reported ever being told they had epilepsy or seizure disorder, and 0.7% were classified as having active epilepsy. About three-fourths of adults with active epilepsy with recent seizures reported fair or poor health status. Adults with active epilepsy with recent seizures reported almost two weeks of poor physical or mental health and activity limitation days compared with two to 4 days per month in those without epilepsy. Among adults with active epilepsy and recent seizures, about one-quarter reported not taking any medicine to control their seizure disorder or epilepsy. About one-third reported physical disability/unable to work compared to a small proportion of the general population. The majority of adults with active epilepsy reported having a regular source of medical care. Conclusion: Our findings highlight the burden of epilepsy among adults in California. CHIS serves as a model demonstrating the value of including questions about epilepsy on public health surveillance systems to ascertain the burden of the disorder and to guide intervention research and public policy to improve HRQOL in people with epilepsy. [source] Most smokeless tobacco use is not a causal gateway to cigarettes: using order of product use to evaluate causation in a national US sampleADDICTION, Issue 8 2003Lynn T. Kozlowski ABSTRACT Aims, To evaluate non-causal and causal patterns of smokeless tobacco (SLT) and cigarette use; to assess the prevalence of ,non-gateway' and possible ,gateway' patterns of SLT use. Design and setting, Data from the Cancer Control Supplement to the 1987 National Health Interview Survey, a representative survey of non-institutionalized adults in the United States. From reported age at first use, participants were categorized by type and sequence of tobacco product use. SUDAAN 8.0.1 was used for statistical analyses. Participants, Males aged 18,34 (n = 3454), weighted to provide estimates of the US population. A subsample of males aged 23,34 (n = 2614) was analyzed to minimize the possibility of future product switching. Measurements, Smoking status, smokeless tobacco (snuff, chewing tobacco, both) use status, age at regular use of cigarettes, age at first use of smokeless tobacco. Findings, Of those 23,34-year-olds who had ever used SLT with or without cigarettes, 77.2% (95% CI: 71.3, 83.3) were classifiable as non-gateway users in that 35.0% (95% CI: 29.9, 40.1) had only used SLT and 42.2% (95% CI: 36.8, 47.7) had used cigarettes first. Cigarette use in younger cohorts was less common, despite increased SLT use. Those who used cigarettes before moist snuff were 2.1 times more likely to have quit smoking (95% CI 1.21,6.39) than cigarette-only users. Conclusions, The large majority of SLT users are non-gateway users. Causal gateway effects should be of minor concern for policy. SLT may be more likely to prevent smoking than cause it. [source] Population-Based U.S. Study of Severe Headaches in Adults: Psychological Distress and ComorbiditiesHEADACHE, Issue 2 2006Objective.,To examine the associations between severe headaches (SH), psychological distress, and comorbid conditions among U.S. adults. Background.,The lifetime prevalence of headaches is over 90% and headaches, particularly migraines, have been associated with disability, increased healthcare costs, and mood disorders. Methods.,We analyzed data obtained from adults aged 18 years or older (n = 29,828) who participated in the 2002 National Health Interview Survey, an ongoing, computer-assisted personal interview of a representative sample of the U.S. population. Results.,Approximately 15.1% of adults aged 18 years or older reported SH in the previous 3 months. Those reporting such headaches were significantly more likely, than those who did not, to report insomnia, excessive sleepiness, recurrent pain, and depressive or anxiety symptoms during the preceding 12 months. Approximately 88% of those who reported having had SH within the previous 3 months also indicated that they had at least one comorbid medical condition, relative to 67% of those without SH. Conclusion.,Despite their episodic nature, our results suggest that SH are associated with impairments in both physical and mental health. As the presence of SH may serve as an indicator of significant psychological distress and medical comorbidities, eliciting information about their occurrence during a standard medical examination appears to be warranted. [source] The effects of income, education and age on healthHEALTH ECONOMICS, Issue 8 2007Olga Kiuila Abstract We use the core interviews of the US Health Interview Survey for the years 1987,1994, to study the effects of socioeconomic status (SES) on mortality and self-reported health. We find, consistent with previous studies, that the relationship between mortality and indicators such as education and income diminishes with age. We consider new explanations for this result and conclude that general biological deterioration at old age is probably the principal one. One important piece of evidence for this conclusion is the finding that there is no relationship at all between mortality and SES for people whose self-reported health status at baseline is either fair or poor. Copyright © 2007 John Wiley & Sons, Ltd. [source] Assessing the Value of the NHIS for Studying Changes in State Coverage Policies: The Case of New YorkHEALTH SERVICES RESEARCH, Issue 6p2 2007Sharon K. Long Research Objective. (1) To assess the effects of New York's Health Care Reform Act of 2000 on the insurance coverage of eligible adults and (2) to explore the feasibility of using the National Health Interview Survey (NHIS) as opposed to the Current Population Survey (CPS) to conduct evaluations of state health reform initiatives. Study Design. We take advantage of the natural experiment that occurred in New York to compare health insurance coverage for adults before and after the state implemented its coverage initiative using a difference-in-differences framework. We estimate the effects of New York's initiative on insurance coverage using the NHIS, comparing the results to estimates based on the CPS, the most widely used data source for studies of state coverage policy changes. Although the sample sizes are smaller in the NHIS, the NHIS addresses a key limitation of the CPS for such evaluations by providing a better measure of health insurance status. Given the complexity of the timing of the expansion efforts in New York (which encompassed the September 11, 2001 terrorist attacks), we allow for difference in the effects of the state's policy changes over time. In particular, we allow for differences between the period of Disaster Relief Medicaid (DRM), which was a temporary program implemented immediately after September 11th, and the original components of the state's reform efforts,Family Health Plus (FHP), an expansion of direct Medicaid coverage, and Healthy New York (HNY), an effort to make private coverage more affordable. Data Sources. 2000,2004 CPS; 1999,2004 NHIS. Principal Findings. We find evidence of a significant reduction in uninsurance for parents in New York, particularly in the period following DRM. For childless adults, for whom the coverage expansion was more circumscribed, the program effects are less promising, as we find no evidence of a significant decline in uninsurance. Conclusions. The success of New York at reducing uninsurance for parents through expansions of both public and private coverage offers hope for new strategies to expand coverage. The NHIS is a strong data source for evaluations of many state health reform initiatives, providing a better measure of insurance status and supporting a more comprehensive study of state innovations than is possible with the CPS. [source] The Effects of Child-Only Insurance Coverage and Family Coverage on Health Care Access and Use: Recent Findings among Low-Income Children in CaliforniaHEALTH SERVICES RESEARCH, Issue 1 2006Sylvia Guendelman Objective. To compare the extent with which child-only and family coverage (child and parent insured) ensure health care access and use for low income children in California and discuss the policy implications of extending the State Children's Health Insurance Program (California's Healthy Families) to uninsured parents of child enrollees. Data Sources/Setting. We used secondary data from the 2001 California Health Interview Survey (CHIS), a representative telephone survey. Study Design. We conducted a cross-sectional study of 5,521 public health insurance,eligible children and adolescents and their parents to examine the effects of insurance (family coverage, child-only coverage, and no coverage) on measures of health care access and utilization including emergency room visits and hospitalizations. Data Collection. We linked the CHIS adult, child, and adolescent datasets, including the adolescent insurance supplement. Findings. Among the sampled children, 13 percent were uninsured as were 22 percent of their parents. Children without insurance coverage were more likely than children with child-only coverage to lack a usual source of care and to have decreased use of health care. Children with child-only coverage fared worse than those with family coverage on almost every access indicator, but service utilization was comparable. Conclusions. While extending public benefits to parents of children eligible for Healthy Families may not improve child health care utilization beyond the gains that would be obtained by exclusively insuring the children, family coverage would likely improve access to a regular source of care and private sector providers, and reduce perceived discrimination and breaks in coverage. These advantages should be considered by states that are weighing the benefits of expanding health insurance to parents. [source] Predicting Patterns of Mammography Use: A Geographic Perspective on National Needs for Intervention ResearchHEALTH SERVICES RESEARCH, Issue 4 2002Julie Legler Objective. To introduce a methodology for planning preventive health service research that takes into account geographic context. Data Sources. National Health Interview Survey (NHIS) self-reports of mammography within the past two years, 1987, and 1993,94. Area Resource File (ARF), 1990. Database of mammography intervention research studies conducted from 1984 to 1994. Design. Bayesian hierarchical modeling describes mammography as a function of county-level socioeconomic data and explicitly estimates the geographic variation unexplained by the county-level data. This model produces county use estimates (both NHIS-sampled and unsampled), which are aggregated for entire states. The locations of intervention research studies are examined in light of the statewide mammography utilization estimates. Data Extraction. Individual level NHIS data were merged with county-level data from the ARF. Principal Findings. State maps reveal the estimated distribution of mammography utilization and intervention research. Eighteen states with low mammography use reported no intervention research activity. County-level occupation and education were important predictors for younger women in 1993,94. In 1987, they were not predictive for any demographic group. Conclusions. Opportunities exist to improve the planning of future intervention research by considering geographic context. Modeling results suggest that the choice of predictors be tailored to both the population and the time period under study when planning interventions. [source] Who Are the Uninsured Elderly in the United States?JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2004James W. Mold MD Because of the Medicare program, a common assumption is made that virtually all older Americans have health insurance coverage. Data from the 2000 National Health Interview Survey were analyzed to estimate the number of people aged 65 and older without health insurance; their stated reasons for being uninsured; and the associations between lack of insurance and sociodemographic variables, health status, and access to and use of healthcare services. In 2000, there were approximately 350,000 older Americans with no health insurance. Those without insurance were more likely to be younger, Hispanic, nonwhite, unmarried (widowed, divorced, or never married), poor, and foreign-born. They were less likely to hold U.S. citizenship. Despite relatively high rates of chronic medical conditions, they were unlikely to receive outpatient or home healthcare services. The most common reason given for lack of insurance was its cost. This study reveals important gaps in the availability of health insurance for the elderly, gaps that are likely to affect an increasing number of older Americans in the coming decade. [source] Medicaid matters: children's health and medicaid eligibility expansionsJOURNAL OF POLICY ANALYSIS AND MANAGEMENT, Issue 2 2002Kristine A. Lykens In the late 1980s, a series of federal laws were enacted which expanded Medicaid eligibility to more of the nation's children. States had a great amount of discretion in how fast and how far these expansions were implemented. As a result, there was great variation among the states in defining who was eligible for the program. This variation provides a rare opportunity to disentangle the effect of Medicaid from a child's socioeconomic status. Using data from the National Health Interview Survey, we address whether the Medicaid expansions improved the health and functional status of children. Econometric models were developed using fixed-effects regressions, and were estimated separately for white, black, and Hispanic children. White children experienced statistically significant reductions in acute health conditions and functional limitations. Black and Hispanic children showed some evidence of improved health conditions and functional status, but this evidence is inconclusive in the study sample. This may be due to differences in their access to appropriate health services or to the smaller sample size of minorities in each geographic area. The findings are also relevant to the implementation of the Children' Health Insurance Program (CHIP), the latest federal effort to expand access to health care to poor and near poor children. In many states, CHIP is being implemented in whole or in part through further Medicaid expansions. © 2002 by the Association for Policy Analysis and Management. [source] Prospective Study of Alcohol Consumption in the United States: Quantity, Frequency, and Cause-Specific MortalityALCOHOLISM, Issue 3 2008Rosalind A. Breslow Background:, Alcohol average volume (quantity multiplied by frequency) has been associated with mortality in drinkers. However, average volume may mask associations due to quantity or frequency alone. Methods:, We prospectively assessed relationships between alcohol quantity and frequency, and mortality from all-causes, cardiovascular disease, cancer, and other-causes in a cohort created by linking the 1988 National Health Interview Survey (response rate 87%) to the National Death Index through 2002. Participants were 20,765 current drinkers age , 18 years. At 14-year follow-up 2,547 had died. Results:, For quantity, among men who consumed ,5 drinks (compared to 1 drink) on drinking days, adjusted relative risks (RR) of mortality were: for cardiovascular disease, 1.30 [95% confidence interval (CI) 0.96,1.75; p for linear trend (p -trend) = 0.0295], for cancer, 1.53 (95% CI 1.11,2.09; p -trend = 0.0026), and for other-causes, 1.42 (95% CI 1.08,1.87; p -trend = 0.0029); among women for other-causes, 2.88 (95% CI 1.61,5.12; p -trend = 0.0010). For frequency, among men in the highest frequency quartile (compared to the lowest), RR were: for cardiovascular disease, 0.79 (95% CI 0.63,0.99; p -trend = 0.0330), for cancer, 1.23 (95% CI 0.95,1.59; p -trend = 0.0461), and for other-causes, 1.30 (95% CI 1.01,1.67; p -trend = 0.0070); among women, for cancer, 1.65 (95% CI 1.12,2.45, p -trend = 0.0031). Average volume obscured effects of quantity alone and frequency alone, particularly for cardiovascular disease in men where quantity and frequency trended in opposite directions. Conclusions:, Alcohol quantity and frequency were independently associated with cause-specific mortality. Accumulating evidence of their differential effects may, in the future, be useful for clinical and public health recommendations. [source] The impact of children's emotional and behavioural difficulties on their lives and their use of mental health servicesPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 5 2009Gloria A. Simpson Summary This paper examines the relationship between the impact of children's emotional and behavioural difficulties and the use of mental health services, using 3 years of nationally representative data from the National Health Interview Survey. Data for the years 2001, 2003 and 2004 were combined (n = 29 265) to identify a sample of 1423 children aged 4,17 years with emotional/behavioural difficulties. Multivariable logistic regression analysis was used. About 5% of U.S. children had emotional or behavioural difficulties. Children whose difficulty was a burden on their family were almost twice as likely to have contact with a mental health professional. Younger children (aged 4,7 years), Hispanic children and non-Hispanic black children with emotional or behavioural difficulties were less likely to use mental health services. These findings indicate that children's emotional and behavioural difficulties influence their lives and those of their families, leading parents to seek help. Racial disparities in mental health service use exist when controlling for the severity and the burden of these difficulties. [source] Multiple imputation for national public-use datasets and its possible application for gestational age in United States Natality filesPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 2007Jennifer D. Parker Summary Multiple imputation (MI) is a technique that can be used for handling missing data in a public-use dataset. With MI, two or more completed versions of the dataset are created, containing possibly different but reasonable replacements for the missing data. Users analyse the completed datasets separately with standard techniques and then combine the results using simple formulae in a way that allows the extra uncertainty due to missing data to be assessed. An advantage of this approach is that the resulting public-use data can be analysed by a variety of users for a variety of purposes, without each user needing to devise a method to deal with the missing data. A recent example for a large public-use dataset is the MI of the family income and personal earnings variables in the National Health Interview Survey. We propose an approach to utilise MI to handle the problems of missing gestational ages and implausible birthweight,gestational age combinations in national vital statistics datasets. This paper describes MI and gives examples of MI for public-use datasets, summarises methods that have been used for identifying implausible gestational age values on birth records, and combines these ideas by setting forth scenarios for identifying and then imputing missing and implausible gestational age values multiple times. Because missing and implausible gestational age values are not missing completely at random, using multiple imputations and, thus, incorporating both the existing relationships among the variables and the uncertainty added from the imputation, may lead to more valid inferences in some analytical studies than simply excluding birth records with inadequate data. [source] Childhood asthma prevalence: the impact of the 1997 National Health Interview Survey redesignPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 4 2001Lj Akinbami No abstract is available for this article. [source] Declining health insurance access among US hispanic workers: Not all jobs are created equalAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 2 2010Kathryn E. McCollister PhD Abstract Introduction Approximately 18% of the U.S. population are uninsured, a proportion that may continue to rise, particularly among Hispanics, as the cost of medical care increases faster than the growth in wages. Methods Health insurance trends were analyzed by race,ethnic category, and among Hispanic workers by occupation type and industrial sector, using data on employed respondents ,18 years from 1997 to 2007 National Health Interview Survey (NHIS) (mean annual n,=,17,392, representing 123 million US workers on average over this 11 year period). Results From 1997 to 2007, the relative decline in health insurance coverage for US workers was greatest among Hispanics (7.0%). Hispanic workers in the Construction and Services industries had the greatest overall decline in coverage (24.9% and 14.7%), as well as Hispanic blue collar workers (14.0%). Conclusion Hispanic workers in general, and those employed in blue collar, construction, and services sectors in particular, are at greater risk for poor access to health care due to a lack of health insurance coverage. Am. J. Ind. Med. 53:163,170 2010. © 2009 Wiley-Liss, Inc. [source] Work-related non-fatal injuries among foreign-born and US-born workers: Findings from the U.S. National Health Interview Survey, 1997,2005AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 1 2009Xiaofei Zhang MD Abstract Background Millions of foreign-born workers are employed in the US. Population-based surveys have value in describing the non-fatal work-related injuries that these workers suffer. Methods Using data from the 1997,2005 National Health Interview Survey, we compared the rates of non-fatal work-related injuries among foreign-born and US-born adult workers. Logistic regression was used to produce work-related injury odds ratios (ORs) and 95% confidence intervals (95% CI) by nativity and years of residence while controlling for sex, age, race/ethnicity, education, poverty, family size, insurance status, delayed medical care, and alcohol use. Industry-specific rates were also compared. Results Foreign-born workers reported a lower rate of work-related injuries than US-born workers, 50 per 10,000 foreign-born workers versus 89 per 10,000 US-born workers (P,<,0.01). After controlling for confounding variables, the OR of work-related injuries for foreign-born workers as compared to US-born workers was 0.50 (95% CI,=,0.38,0.66). The construction, agriculture/forestry and fisheries, and manufacturing industries had the highest work-related injury rates for both groups of workers. Conclusions Foreign-born workers had a lower overall rate of work-related injury when compared to US-born workers. Both US-born and foreign-born workers face significant injury risks, especially in certain industries. Interventions tailored with ethnic and cultural differences in mind are still warranted. Am. J. Ind. Med. 52:25,36, 2009. © 2008 Wiley-Liss, Inc. [source] National Health Interview Survey mortality among US farmers and pesticide applicatorsAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 2 2003Lora E. Fleming MD Abstract Background The mortality experience of pesticide-exposed workers across the US has not been thoroughly studied. Methods Cox regression mortality analyses adjusted for the complex sample survey design were performed on mortality-linked 1986,1994 National Health Interview Survey (NHIS) data. Results Nine thousand four hundred seventy-one farmers and pesticide applicators with 571 deaths were compared to 438,228 other US workers with 11,992 deaths. Age-adjusted risk of accidental death, as well as cancers of the nervous and lymphatic/hematopoietic systems, was significantly elevated in male and female pesticide-exposed workers; breast, prostate, and testicular cancer mortality risks were not elevated. Conclusions Compared to all other workers, farmers and pesticide applicators were at greater risk of accidental mortality. These pesticide-exposed workers were not at an increased risk of cancers possibly associated with exposure to estrogen analogue compounds, but were at an increased risk of hematopoietic and nervous system cancers. NHIS mortality follow-up represents an important occupational health surveillance instrument. Am. J. Ind. Med. 43: 227,233, 2003. © 2003 Wiley-Liss, Inc. [source] Update: Health Insurance and Utilization of Care Among Rural AdolescentsTHE JOURNAL OF RURAL HEALTH, Issue 4 2005Janice C. Probst PhD ABSTRACT: Context: Adolescence is critical for the development of adult health habits. Disparities between rural and urban adolescents and between minority and white youth can have life-long consequences. Purpose: To compare health insurance coverage and ambulatory care contacts between rural minority adolescents and white and urban adolescents. Methods: Cross-sectional design using data from the 1999,2000 National Health Interview Survey, a nationally representative sample of US households. Analysis was restricted to white, black, and Hispanic children aged 12 through 17 (8,503 observations). Outcome measures included health insurance, ambulatory visit within past year, usual source of care (USOC), and well visit within past year. Independent variables included race, residence, demographics, facilitating/enabling characteristics, and need. Results: Across races, rural adolescents were as likely to have insurance (86.8% vs 87.7%) but less likely to report a preventive visit (60.1% vs 65.5%) than urban children; residence did not affect the likelihood of a visit or a USOC. Minority rural adolescents were less likely than whites to be insured, report a visit, or have a USOC. Most race-based differences were not significant in multivariate analysis holding constant living situation, caretaker education, income, and insurance. Low caretaker English fluency, limited almost exclusively to Hispanics, was an impediment to all outcomes. Conclusions: Most barriers to care among rural and minority youth are attributable to factors originating outside the health care system, such as language, living situation, caretaker education, and income. A combination of outreach activities and programs to enhance rural schools and economic opportunities will be needed to improve coverage and utilization among adolescents. [source] Projections of US prevalence of arthritis and associated activity limitationsARTHRITIS & RHEUMATISM, Issue 1 2006Jennifer M. Hootman Objective To update the projected prevalence of self-reported, doctor-diagnosed arthritis and arthritis-attributable activity limitations among US adults ages 18 years and older from 2005 through 2030. Methods Baseline age- and sex-specific prevalence rates of arthritis and activity limitation, using the latest surveillance case definitions, were estimated from the 2003 National Health Interview Survey, which is an annual, cross-sectional, population-based health interview survey of ,31,000 adults. These estimates were used to calculate projected arthritis prevalence and activity limitations for 2005,2030 using future population projections obtained from the US Census Bureau. Results The prevalence of self-reported, doctor-diagnosed arthritis is projected to increase from 47.8 million in 2005 to nearly 67 million by 2030 (25% of the adult population). By 2030, 25 million (9.3% of the adult population) are projected to report arthritis-attributable activity limitations. In 2030, >50% of arthritis cases will be among adults older than age 65 years. However, working-age adults (45,64 years) will account for almost one-third of cases. Conclusion By 2030, the number of US adults with arthritis and its associated activity limitation is expected to increase substantially, resulting in a large impact on individuals, the health care system, and society in general. The growing epidemic of obesity may also significantly contribute to the future burden of arthritis. Improving access and availability of current clinical and public health interventions aimed at improving quality of life among persons with arthritis through lifestyle changes and disease self-management may help lessen the long-term impact. [source] Social Inequality: Social inequality in perceived oral health among adults in AustraliaAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2 2004Anne E. Sanders Objective: To establish population estimates of self-assessed tooth loss and subjective oral health and describe the social distribution of these measures among dentate adults in Australia. Methods: Self-report data were obtained from a nationally representative sample of 3,678 adults aged 18,91 years who participated in the 1999 National Dental Telephone Interview Survey and completed a subsequent mail survey. Oral health was evaluated using (1) self-assessed tooth loss, (2) the 14-item Oral Health Impact Profile, and (3) a global six-point rating of oral health. Results: While the absolute difference in tooth loss across household income levels increased at each successive age group (18,44 years, 45,64 years, 65+ years) from 0.7 teeth to 6.1 teeth, the magnitude of the difference was approximately twofold at each age group. For subjective oral health measures, the magnitude of difference across income groups was most pronounced in the 18,44 years age group. In multivariate analysis, low household income, blue-collar occupation, and high residential area disadvantage were positively associated with social impact from oral conditions and pathological tooth loss. Speaking other than English at home (relative to English), low household income (relative to high income), and vocational relative to tertiary education were each associated with more than twice the odds of poor self-rated oral health. Conclusions: Significant social differentials in perceived oral health exist among dentate adults. Inequalities span the socio-economic hierarchy. Implications: In addition to improving overall levels of oral health in the adult community, goals and targets should aim to reduce social inequalities in the distribution of outcomes. [source] Low rates of colorectal, cervical, and breast cancer screening in Asian Americans compared with non-Hispanic whitesCANCER, Issue 1 2006Cultural influences or access to care? Abstract BACKGROUND Asian Americans have lower cancer screening rates compared with non-Hispanic whites (NHWs). Little is known about mechanisms that underlie disparities in cancer screening. The objectives of the current study were 1) to determine the relation between nativity, years in the United States, language, and cancer screening in NHWs and Asian Americans, independent of access to care and 2) to determine whether Asians reported different reasons than NHWs for not obtaining cancer screening. METHODS This population-based study included 36,660 NHWs, 1298 Chinese, 944 Filipinos, 803 Koreans, 857 Vietnamese, and 1036 Other Asians from the 2001 California Health Interview Survey. The main study outcomes were 1) self-reported colorectal, cervical, and breast cancer screening and 2) reasons for not obtaining cancer screening. RESULTS After adjusting for access to care, several Asian subgroups still had significantly lower rates of all types of cancer screening compared with NHWs. Adjusting for nativity, years in the United States, and English language attenuated the relation between Asian ethnicity and lower rates of colorectal and breast cancer screening. When they were asked what the most important reason was for not having each screening test, foreign-born Asians were significantly more likely than United States-born NHWs to report that they "didn't have problems/symptoms" (P<.01). CONCLUSIONS Nativity, years in the United States, and English language may be markers of cultural differences that are mediating cancer screening disparities. Foreign-born Asians may believe that cancer screening is in response to symptoms rather than tests that are used prior to the development of symptoms. Health education messages must consider how to communicate effectively that "cancer screening is valuable, because it finds cancer before it is advanced enough to cause symptoms." Cancer 2006. © 2006 American Cancer Society. [source] A population-based survey of prostate-specific antigen testing among California men at higher risk for prostate carcinomaCANCER, Issue 4 2006Benjamin A. Spencer M.D., M.P.H. Abstract BACKGROUND Despite the lack of evidence demonstrating a survival benefit from prostate-specific antigen (PSA) screening, its use has become widespread, organizations have encouraged physicians to discuss early detection of prostate carcinoma, and two higher risk groups have been recognized. In the current study, the authors examined whether African-American men and men who had a family history of prostate carcinoma underwent PSA testing preferentially, and patterns of test use were examined according to age, race, and other factors. METHODS Data regarding self-reported PSA test use in the past year among men age 50 years and older without a history of prostate carcinoma (n = 8713 men) were analyzed from the 2001 California Health Interview Survey. RESULTS The overall rate of PSA use was 43.0%. Older age, higher socioeconomic status, having a usual source of healthcare, and a family history of prostate carcinoma were the strongest predictors of testing. Higher risk African-American men age 50 years and older were no more likely to be tested than white men. Men at higher risk who had a family history of prostate carcinoma were more likely to have been tested than men who had no such family history. CONCLUSIONS Rates of PSA use among higher risk men who had a family history of prostate carcinoma were higher compared with the rates among men without such a family history. However, PSA testing rates among higher risk African-American men were no different than the rates among lower risk white men, suggesting that some risk factors for prostate carcinoma (but not others) are associated with preferential testing. Testing in all groups was associated with access to care variables, highlighting the importance of removing barriers to preventive healthcare services. Cancer 2006. © 2006 American Cancer Society. [source] Progress in cancer screening practices in the United States,CANCER, Issue 6 2003Results from the 2000 National Health Interview Survey Abstract BACKGROUND Understanding differences in cancer screening among population groups in 2000 and successes or failures in reducing disparities over time among groups is important for planning a public health strategy to reduce or eliminate health disparities, a major goal of Healthy People 2010 national cancer screening objectives. In 2000, the new cancer control module added to the National Health Interview Survey (NHIS) collected more detailed information on cancer screening compared with previous surveys. METHODS Data from the 2000 NHIS and earlier surveys were analyzed to discern patterns and trends in cancer screening practices, including Pap tests, mammography, prostate specific antigen (PSA) screening, and colorectal screening. The data are reported for population subgroups that were defined by a number of demographic and socioeconomic characteristics. RESULTS Women who were least likely to have had a mammogram within the last 2 years were those with no usual source of health care (61%), women with no health insurance (67%), and women who immigrated to the United States within the last 10 years (61%). Results for Pap tests within the last 3 years were similar. Among both men and women, those least likely to have had a fecal occult blood test or endoscopy within the recommended screening interval had no usual source of care (14% for men and 18% for women), no health insurance (20% for men and 18% for women), or were recent immigrants (20% for men and 18% for women). An analysis of changes in test use since the 1987 survey indicates that the disparities are widening among groups with no usual source of care. CONCLUSIONS No striking improvements have been observed for the groups with greatest need. Although screening use for most groups has increased since 1987, major disparities remain. Some groups, notably individuals with no usual source of care and the uninsured are falling further behind; and, according to the 2000 data, recent immigrants also experience a significant gap in screening utilization. More attention is needed to overcome screening barriers for these groups if the population benefits of cancer screening are to be achieved. Cancer 2003;97:1528,40. Published 2003 by the American Cancer Society. DOI 10.1002/cncr.11208 [source] Characteristics of sleep disturbances in Poland , results of the National Health Interview SurveyACTA NEUROPSYCHIATRICA, Issue 3 2004Andrzej Kiejna Background:, Apart from insomnia, poor quality of sleep, decreased sleep duration, tiredness after awakening and frequency of using sleeping drugs are important indicators of sleep problems. Objectives:, The aim of this study was to assess the prevalence of indicators of sleep disturbance, such as quality of sleep, sleep duration, feeling of restfulness in the morning and drug utilization in a randomly selected Polish adult population. Methods:, A stratified scheme of sampling involving two steps was used. A representative Polish population sample of 47 924 non-institutionalized adults was interviewed. Assessments of sleep-related problems were based on six questions. Standardized prevalence ratios (SPRs and their 95% confidence intervals) were calculated. Results:, Almost one-tenth of Polish inhabitants usually slept badly or very badly, a problem that was more common among women than men. Quality of sleep decreased together with ageing and this process was more rapid in women than in men over 40 years of age. Highly educated respondents had the highest quality of sleep. Up to one-fifth of the general Polish population usually woke up tired in the morning. Mean sleep duration was 7.7 h, with no gender differences. Usage of over-the-counter (OTC) medications was significantly lower than usage of those prescribed by the physician (5 vs. 16%). Women used OTC drugs twice as often as men. Conclusions:, It would appear to be necessary to introduce educational programmes for the community as well as for general practitioners in order to correct improper attitudes. [source] Prevalence of insomnia in Poland , results of the National Health Interview SurveyACTA NEUROPSYCHIATRICA, Issue 2 2003A. Kiejna Background: Sleep disturbances are one of the most common underdiagnosed and undertreated health problems among the adult population. Objectives: The aim of the study was to assess the prevalence of sleeping problems and their relation to sociodemographic characteristics in the Polish population, based on the results of the National Health Interview Survey carried out by the Central Statistical Office in 1996. Methods: A stratified sampling scheme, involving two steps, was used. Standardized prevalence ratios (SPRs and their 95% confidence intervals) were calculated. Assessment of sleep-related problems was based on six questions. A representative Polish sample (47 924 non-institutionalized, adult respondents) was interviewed. Results: Nearly one-fourth of Polish inhabitants suffered from insomnia. The percentage was significantly higher among women (28.1%) than among men (18.1%). The prevalence of insomnia increased with age and was highest in divorced respondents. Respondents of both sexes with higher educational levels suffered from insomnia less often than individuals with lower levels of education. The problem of insomnia applies in a similar degree to inhabitants of both rural and urban regions. About one-twentieth of inhabitants of Poland experienced recent sleep deterioration related to problems. It was associated positively with age, female gender and lower education. About 20% of the population get up not rested in the morning, women significantly more often than men, urban residents more often than rural ones. Conclusions: Sleep-related problems are common and the results are comparable with those from other countries. The findings have important implications, such as the necessity of better education of the public community about the identification and possibilities of treatment of sleep disturbance. [source] Methodologic Implications of Allocating Multiple-Race Data to Single-Race CategoriesHEALTH SERVICES RESEARCH, Issue 1 2002Article first published online: 18 MAR 200 Objective. To illustrate methods for comparing race data collected under the 1977 Federal Office of Management and Budget (OMB) directive, known as OMB-15, with race data collected under the revised 1997 OMB standard. Data Sources/Study Setting.,Secondary data from the 1993,95 National Health Interview Surveys. Multiple-race responses, available on in-house files, were analyzed. Study Design.,Race-specific estimates of employer-sponsored health insurance were calculated using proposed allocation methods from the OMB. Estimates were calculated overall and for three population subgroups: children, those in households below poverty, and Hispanics. Principal Findings.,Although race distributions varied between the different methods, estimates of employer-sponsored health insurance were similar. Health insurance estimates for the American Indian/Alaska Native group varied the most. Conclusions.,Employer-sponsored health insurance estimates for American Indian/Alaska Natives from data collected under the 1977 OMB directive will not be comparable with estimates from data collected under the 1997 standard. The selection of a method to distribute to the race categories used prior to the 1997 revision will likely have little impact on estimates of employer-sponsored health insurance for other groups. Additional research is needed to determine the effects of these methods for other health service measures. [source] Why Is Late-Life Disability Declining?THE MILBANK QUARTERLY, Issue 1 2008ROBERT F. SCHOENI Context: Late-life disability has been declining in the United States since the 1980s. This study provides the first comprehensive investigation into the reasons for this trend. Methods: The study draws on evidence from two sources: original data analyses and reviews of existing studies. The original analyses include trend models of data on the need for help with daily activities and self-reported causes of such limitations for the population aged seventy and older, based on the National Health Interview Surveys from 1982 to 2005. Findings: Increases in the use of assistive and mainstream technologies likely have been important, as have declines in heart and circulatory conditions, vision, and musculoskeletal conditions as reported causes of disability. The timing of the improvements in these conditions corresponds to the expansion in medical procedures and pharmacologic treatment for cardiovascular disease, increases in cataract surgery, increases in knee and joint replacements, and expansion of medications for arthritic and rheumatic conditions. Greater educational attainment, declines in poverty, and declines in widowhood also appear to have contributed. Changes in smoking behavior, the population's racial/ethnic composition, the proportion of foreign born, and several specific conditions were eliminated as probable causes. Conclusions: The substantial reductions in old-age disability between the early 1980s and early 2000s are likely due to advances in medical care as well as changes in socioeconomic factors. More research is needed on the influence of health behaviors, the environment, and early- and midlife factors on trends in late-life disability. [source] Private dental visits per dentist in Spain from 1987 to 1997COMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 5 2002An analysis from the Spanish National Health Interview Surveys Abstract Objectives: In view of the sharp increase in the number of dentists in Spain, the aim of the present study was to analyse changes in the private dentist workload in Spain over the period 1987,97. Methods: Data were taken from censuses of the population and of dental practitioners, and from the Spanish National Health Interview Surveys. The percentage of people that had visited the dentist in the 3 months prior to the survey was calculated, and of these, the percentage whose last visit was private. The total number of visits made by those people was taken as the estimate of total private visits in Spain during 3 months. Total private activity in 1 year was derived by multiplying this estimate by four. Annual private activity was then divided by the number of dentists. Results: From 1987 to 1997, the Spanish population grew 2.5% (from 38.7 to 39.7 million) and the number of dentists increased by 136.1% (from 6373 to 15 044). The total annual number of private dental visits (±SE) was 35.7 ± 1.0 million in 1987, and 48.9 ± 2.0 million in 1997 , a 36.8% increase. Thus, the mean number of private dental visits per dentist decreased 42.0% (from 5610 ± 152 to 3251 ± 133). Conclusion: A significant reduction in private dental visits per dentist is taking place in Spain. [source] Prevalence and characteristics of older community residents with mild cognitive declineGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 2 2002Yoshinori Fujiwara Background:, Cognitive impairment is a major health issue, but epidemiological data on mild cognitive decline have been almost absent in Japan. Methods: Of all residents aged 65 years and over living in Yoita town, Niigata Prefecture, Japan in the year 2000 (n = 1673), 1544 participated in the interview survey held at community halls or at home (92.3% response). They underwent the Mini-Mental State Examination (MMSE) for assessment of cognitive function and answered questionnaires comprising socio-demographic, psychological, physical and medical, and social activity items. Higher-level functional capacities were evaluated with the Tokyo Metropolitan Index of Competence (TMIG-Index of Competence). According to subject's age and MMSE score, all subjects were classified into 3 groups: control (MMSE,>,1 SD below age-specific means), mild cognitive decline (MMSE,,,21 and ,,1 SD below age-specific means), and severe cognitive decline (MMSE,,,20), and compared various characteristics among these groups. Results: Mean MMSE score of the subjects showed a linear decline with advancing age. Among the participants, 232 (15.2%) were classified as mild cognitive decline. Compared with the controls, the subjects with mild cognitive decline reported poorer subjective health, more depressive moods, more history of stroke, more prevalence of basic activity of daily living (BADL) disability, and lower higher-level functional capacity, even after controlling for possible confounding factors. They also reported a low level of social activities: both participating in group activities and enjoying hobbies were less frequent. Their food intake pattern tended to be monotonous. Conclusions: Older persons with mild cognitive decline comprised a substantial proportion (15.2%) of the community-dwelling older population. In addition to lower cognitive function, they had lower levels of functional capacity and social activity. [source] Combating deceptive advertisements and labelling on food products , an exploratory study on the perceptions of teachersINTERNATIONAL JOURNAL OF CONSUMER STUDIES, Issue 3 2003Wai-ling Theresa Lai Yeung People are becoming more health conscious nowadays, but most of them are not able to adopt a lifestyle with adequate physical exercise and a healthier eating pattern. Many attempt to compensate by taking ,health foods'. Despite the recent economic recession, the functional food market expands rapidly in Asian countries. Recent statistics indicate a huge increase in weight loss and functional food product advertising expenditure in Hong Kong and other Asian countries. In a massive survey conducted by the Hong Kong Consumer Council, it was found that 85% of the medicines, health food and therapies sampled contain questionable claims and misleading messages (Consumer Council, 1999). In fact, young people do not understand much about modern food processing, in particular those present in low energy and functional foods, and they know very little about the modern food marketing strategies. The situation is detrimental to consumer welfare especially to the younger generation. This study attempts to reflect critically on the implications of these issues for the health and well-being of young people in Hong Kong. It explores directions for designing relevant and effective education programmes to empower young people in understanding food advertising strategies and making informed decisions on food choice. The paper will begin with a critical review on the current situation in Hong Kong. An interview survey on preservice and in-service teachers' perception towards misleading food advertising and labelling will then be reported. The situations at schools will be defined and problems faced by teachers in providing relevant consumer education programmes to students will be identified. Finally, the study will look to the future, with a view to developing students' critical skills in evaluating claims offered in food advertisements. [source] | |||||||||||||||||||||||||||||||||||||