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1.
NCHS Data Brief ; (465): 1-8, 2023 Apr.
Article in English | MEDLINE | ID: mdl-37093588

ABSTRACT

In 2021, 33.8 million people in the United States were food insecure, that is, they did not have consistent, dependable access to sufficient quality or quantity of food (1,2). Food insecurity affects health outcomes (3), increasing the risk of high cholesterol, hypertension, chronic health conditions, and changes in functional limitations (4-6), and is a social determinant of health. This report explores selected sociodemographic characteristics of adults aged 18 and over living in families experiencing food insecurity.


Subject(s)
Food Supply , Hypertension , Adult , Humans , United States , Adolescent , Chronic Disease , Food Insecurity
2.
Am J Clin Nutr ; 117(5): 847-858, 2023 05.
Article in English | MEDLINE | ID: mdl-36907514

ABSTRACT

NHANES needs urgent attention to ensure its future, which is facing emerging challenges associated with data collection, stagnant funding that has undercut innovation, and the increased call for granular data for subpopulations and groups at risk. The concerns do not rest merely on securing more funding but focus on the need for a constructive review of the survey to explore new approaches and identify appropriate change. This white paper, developed under the auspices of the ASN's Committee on Advocacy and Science Policy (CASP), is a call to the nutrition community to advocate for and support activities to prepare NHANES for future success in a changing nutrition world. Furthermore, because NHANES is much more than a nutrition survey and serves the needs of many in health fields and even commercial arenas, effective advocacy must be grounded in alliances among the survey's diverse stakeholders so that the full range of expertise and interests can engage. This article highlights the complicated nature of the survey along with key overarching challenges to underscore the importance of a measured, thoughtful, comprehensive, and collaborative approach to considering the future of NHANES. Starting-point questions are identified for the purposes of focusing dialog, discussion forums, and research. In particular, the CASP calls for a National Academies of Sciences, Engineering, and Medicine study on NHANES to articulate an actionable framework for NHANES going forward. With a well-informed and integrated set of goals and recommendations that could be provided by such a study, a secure future for NHANES is more readily achievable.


Subject(s)
Nutritional Status , Humans , Nutrition Surveys , Surveys and Questionnaires
3.
Natl Health Stat Report ; (172): 1-17, 2022 07.
Article in English | MEDLINE | ID: mdl-35876842

ABSTRACT

Objective-This report examines differences across two different sets of measures used to assess anxiety and depression in the National Health Interview Survey (NHIS).


Subject(s)
Anxiety , Depression , Anxiety/epidemiology , Anxiety Disorders/epidemiology , Depression/epidemiology , Health Surveys , Humans , United States
4.
NCHS Data Brief ; (432): 1-8, 2022 Feb.
Article in English | MEDLINE | ID: mdl-35230238

ABSTRACT

Food insecurity, which affects an estimated 15 million Americans (1), is the limited or uncertain availability of safe and nutritionally adequate foods, or the limited or uncertain ability to acquire acceptable foods in socially acceptable ways (2). Food insecurity has been consistently associated with poor health outcomes in children, including poorer overall health status, acute and chronic health problems, and limited healthcare access (3). This report describes the percentage of children aged 0-17 years living in food-insecure households during the past 30 days by selected sociodemographic and family characteristics using 2019-2020 National Health Interview Survey data.


Subject(s)
Family Characteristics , Food Supply , Adolescent , Child , Child, Preschool , Cross-Sectional Studies , Food Insecurity , Humans , Infant , Infant, Newborn , Surveys and Questionnaires , United States
5.
NCHS Data Brief ; (431): 1-8, 2022 Jan.
Article in English | MEDLINE | ID: mdl-35089855

ABSTRACT

Children with disabilities are at increased risk of experiencing stressful life events (1,2). These events include various forms of abuse, neglect, and household instability, such as exposure to violence, parental or guardian incarceration, and living with someone with mental illness or alcohol or drug problems (3). Stressful life events experienced in childhood may have lifelong effects on physical and mental health outcomes (4-11), as well as socioeconomic outcomes, including educational attainment and employment (12). This report presents disparities in four stressful life events among children aged 5-17 years by disability status using 2019 National Health Interview Survey (NHIS) data.


Subject(s)
Child Abuse , Mental Disorders , Child , Educational Status , Family Characteristics , Humans , Parents , United States/epidemiology
6.
NCHS Data Brief ; (416): 1-8, 2021 Sep.
Article in English | MEDLINE | ID: mdl-34581665

ABSTRACT

Stressful life events in childhood include various forms of abuse, neglect, and household instability, such as violence exposure, parental incarceration, or living with someone with mental health, alcohol, or drug problems (1). These events are key social determinants of a child's well-being and can have lifelong impacts on physical and mental health (2-9). This report presents sociodemographic disparities in stressful life events as reported by a knowledgeable adult, usually a parent, among children aged 5-17 years using the 2019 National Health Interview Survey data.


Subject(s)
Child Abuse , Adult , Child , Family Characteristics , Humans , Parents , United States/epidemiology
7.
Natl Health Stat Report ; (161): 1-9, 2021 08.
Article in English | MEDLINE | ID: mdl-34546873

ABSTRACT

Objective-This report examines differences in survey reports of disability between two sets of disability questions, the Short Set on Functioning (WG-SS) developed by the Washington Group on Disability Statistics (WG) and a set of disability questions developed for the American Community Survey (ACS).


Subject(s)
Disabled Persons , Humans , Surveys and Questionnaires , Washington/epidemiology
8.
NCHS Data Brief ; (414): 1-8, 2021 Jul.
Article in English | MEDLINE | ID: mdl-34319870

ABSTRACT

Difficulty hearing is related to other functional difficulties, such as communication, and can limit participation across a range of activities including employment, education, and civic activities. While hearing loss can occur at any age, it increases with age (1,2) and has been shown to be associated with cognitive and functional decline in older adults (3-6). This report presents difficulties with hearing even when using a hearing aid among U.S. adults aged 18 and over by level of difficulty and age, sex, and race and Hispanic origin. It also presents estimates of the prevalence of hearing aid use among adults aged 45 and over to focus on the age group with higher rates of hearing difficulties.


Subject(s)
Hearing Aids , Hearing Loss , Adolescent , Adult , Aged , Hearing , Hearing Loss/epidemiology , Hispanic or Latino , Humans , Prevalence , United States/epidemiology
9.
J Aging Health ; 28(7): 1299-314, 2016 10.
Article in English | MEDLINE | ID: mdl-27590803

ABSTRACT

OBJECTIVE: Initiatives designed to monitor health typically incorporate numerous specific measures of health and the health system to assess improvements, or lack thereof, for policy and program purposes. The addition of summary measures provides overarching information which is essential for determining whether the goals of such initiatives are met. METHOD: Summary measures are identified that relate to the individual indicators but that also reflect movement in the various parts of the system. RESULTS: A hierarchical framework that is conceptually consistent and which utilizes a succinct number of summary measures incorporating indicators of functioning and participation is proposed. DISCUSSION: While a large set of individual indicators can be useful for monitoring progress, these individual indicators do not provide an overall evaluation of health, defined broadly, at the population level. A hierarchical framework consisting of summary measures is important for monitoring the success of health improvement initiatives.


Subject(s)
Activities of Daily Living , Epidemiologic Measurements , Health Promotion/standards , Health Status Disparities , Health Status Indicators , Life Expectancy , Adult , Aged , Female , Health Promotion/methods , Humans , Male , Middle Aged , Mortality/trends
10.
Int J Environ Res Public Health ; 13(1): ijerph13010065, 2015 Dec 22.
Article in English | MEDLINE | ID: mdl-26703688

ABSTRACT

In the article, Measuring Disability: Comparing the Impact of Two Data Collection Approaches on Disability Rates, in Volume 12 of the Journal International Journal of Environmental Research and Public Health, Carla Sabariego et al. [1] raise several issues regarding the use of the short set of questions developed by the Washington Group on Disability Statistics (WG) as compared with the approach to disability measurement proposed through the Model Disability Survey (MDS). We address these below. [...].


Subject(s)
Data Collection , Disability Evaluation , Disabled Persons/statistics & numerical data , Female , Humans , Male
11.
Disabil Rehabil ; 35(13): 1070-3, 2013 Jun.
Article in English | MEDLINE | ID: mdl-23020151

ABSTRACT

PURPOSE: To describe the methods used by the Washington Group on Disability Statistics (WG) to develop internationally comparable questions on disability that can be used worldwide. METHOD: The WG approach to developing disability measures included careful consideration of the theoretical and conceptual issues associated with disability, translating disability concepts into measurement tools, and mixed-method evaluations of the proposed questions using both cognitive and field interviewing methodologies. RESULTS: Disability is a complex construct the measurement of which presents considerable challenges for survey methodologists. The Washington Group on Disability Statistics (WG), a UN Statistical Commission sponsored city group, was established to address the methodological and measurement challenges that have characterized disability statistics and to develop questions for use worldwide that will provide comparable, valid and reliable disability statistics. The WG used a variety of methods to meet these objectives and has finalized a short set disability measure for use in censuses worldwide. CONCLUSIONS: The methodologies adopted by the WG have resulted in question sets that greatly improve the international comparability of disability statistics and will advance our understanding of disability worldwide.


Subject(s)
Censuses , Disability Evaluation , Disabled Persons/statistics & numerical data , Health Surveys/instrumentation , Activities of Daily Living , Cooperative Behavior , Disabled Persons/classification , Female , Health Surveys/methods , Health Surveys/standards , Humans , Male , Surveys and Questionnaires , Washington
12.
BMC Public Health ; 11 Suppl 4: S4, 2011 May 31.
Article in English | MEDLINE | ID: mdl-21624190

ABSTRACT

The Washington Group on Disability Statistics is a voluntary working group made up of representatives of over 100 National Statistical Offices and international, non-governmental and disability organizations that was organized under the aegis of the United Nations Statistical Division. The purpose of the Washington Group is to deal with the challenge of disability definition and measurement in a way that is culturally neutral and reasonably standardized among the UN member states. The work, which began in 2001, took on added importance with the passage and ratification of the UN Convention on the Rights of Persons with Disabilities since the Convention includes a provision for monitoring whether those with and without disabilities have equal opportunities to participate in society and this will require the identification of persons with disabilities in each nation. The International Classification of Functioning, Disability and Health (ICF) developed by the World Health Organization provided a framework for conceptualizing disability. Operationalizing an ICF-based approach to disability has required the development of new measurement tools for use in both censuses and surveys. To date, a short set of six disability-related questions suitable for use in national censuses has been developed and adopted by the Washington Group and incorporated by the United Nations in their Principles and Recommendations for Population and Housing Censuses. A series of extended sets of questions is currently under development and some of the sets have been tested in several countries. The assistance of many National and International organizations has allowed for cognitive and field testing of the disability questionnaires in multiple languages and locations. This paper will describe the work of the Washington Group and explicate the applicability of its approach and the questions developed for monitoring the UN Convention on the Rights of Persons with Disabilities.


Subject(s)
Disability Evaluation , Disabled Persons/classification , Human Rights , District of Columbia , Humans , United Nations
13.
Vital Health Stat 3 ; (34): 1-29, 2010 Dec.
Article in English | MEDLINE | ID: mdl-25247324

ABSTRACT

Objective-Life expectancy without activity limitations or active life expectancy is one of the health expectancy measures that is used to summarize population health. The measure differentiates the remaining years of life that are expected to be spent with activity limitations from expected years of life without activity limitations. The objective of this study was to estimate life expectancy with and without activity limitations for the white and black populations of the United States in the years 2000-2006, focusing on expected years free of chronic condition-induced activity limitations. Methods-Life expectancies for the total as well as the white and black populations for the years 2000-2006 were calculated separately using abridged single decrement life tables. Expected years of life with and without chronic condition-induced activity limitations were calculated using Sullivan's method. The statistical analysis is based on data from the U.S. Census Bureau and the National Center for Health Statistics. Results-Results of the study show that during the 7-year period, expected years free of chronic condition-induced activity limitations increased for the total population as well as the white and black populations of both sexes. For the total population, all males and all females, years free of chronic condition-induced activity limitations increased significantly at all ages except at 85 and over. Expected years free of chronic condition-induced activity limitations increased at age 75 and under for the white population and at age 65 and under for the black population.

14.
Vital Health Stat 2 ; (146): 1-24, 2008 May.
Article in English | MEDLINE | ID: mdl-25093608

ABSTRACT

Objective-Summary measures of population health are statistics that combine mortality and morbidity to represent overall population health in a single index. Such measures include healthy life expectancy, also called disability-free life expectancy and active life expectancy. Healthy life expectancy can be calculated using cross-sectional or longitudinal survey data. This report presents a comprehensive discussion of a method for calculating healthy life expectancy using data from longitudinal surveys. Methods-Healthy life expectancies are calculated using the multistate life table model. Expected life in various states of health is estimated using data from the Second Longitudinal Study of Aging and the Medicare Current Beneficiary Survey to illustrate the calculation of the statistics and the discussion of data and methodology related issues. Results-The study shows that estimating summary measures of population health using longitudinal survey data provides the opportunity of using incidence rather than prevalence rates. Health measures estimated based on incidence reflect the most recent health status of the population. Models that use longitudinal survey data measure transitions from good to poor health as well as poor to good health. That is, the models account for recovery from morbidity or illness. Longitudinal survey data canalsobeusedtocalculate healthy or active life expectancies by initial health states.

15.
Ann Epidemiol ; 15(4): 266-71, 2005 Apr.
Article in English | MEDLINE | ID: mdl-15780773

ABSTRACT

PURPOSE: To examine the association of elevated counts of white blood cell types with increased risk of coronary heart disease (CHD) and death. METHODS: Data were examined from the NHANES-I Epidemiologic Follow-up Study. RESULTS: Relative risks for death at ages 25 to 74 comparing the upper and lower tertiles of neutrophil count were: all causes 1.29 (95% CL, 1.14, 1.47), and cardiovascular causes 1.39 (95% CL, 1.15, 1.67) after adjusting for baseline risk factors. CONCLUSIONS: The increased risk of CHD and death from all causes and cardiovascular diseases appeared to be only partially due to effects of smoking. No association was seen for lymphocytes or monocytes.


Subject(s)
Cause of Death/trends , Coronary Disease/blood , Coronary Disease/mortality , Leukocyte Count , Lymphocyte Subsets , Adult , Aged , Female , Follow-Up Studies , Humans , Male , Middle Aged , Risk Factors , United States/epidemiology
16.
Public Health Rep ; 119(2): 192-205, 2004.
Article in English | MEDLINE | ID: mdl-15192907

ABSTRACT

OBJECTIVES: The 2000 Census, which provides denominators used in calculating vital statistics and other rates, allowed multiple-race responses. Many other data systems that provide numerators used in calculating rates collect only single-race data. Bridging is needed to make the numerators and denominators comparable. This report describes and evaluates the method used by the National Center for Health Statistics to bridge multiple-race responses obtained from Census 2000 to single-race categories, creating single-race population estimates that are available to the public. METHODS: The authors fitted logistic regression models to multiple-race data from the National Health Interview Survey (NHIS) for 1997-2000. These fitted models, and two bridging methods previously suggested by the Office of Management and Budget, were applied to the public-use Census Modified Race Data Summary file to create single-race population estimates for the U.S. The authors also compared death rates for single-race groups calculated using these three approaches. RESULTS: Parameter estimates differed between the NHIS models for the multiple-race groups. For example, as the percentage of multiple-race respondents in a county increased, the likelihood of stating black as a primary race increased among black/white respondents but decreased among American Indian or Alaska Native/black respondents. The inclusion of county-level contextual variables in the regression models as well as the underlying demographic differences across states led to variation in allocation percentages; for example, the allocation of black/white respondents to single-race white ranged from nearly zero to more than 50% across states. Death rates calculated using bridging via the NHIS models were similar to those calculated using other methods, except for the American Indian/Alaska Native group, which included a large proportion of multiple-race reporters. CONCLUSION: Many data systems do not currently allow multiple-race reporting. When such data systems are used with Census counts to produce race-specific rates, bridging methods that incorporate geographic and demographic factors may lead to better rates than methods that do not consider such factors.


Subject(s)
Censuses , Ethnicity , Racial Groups , Vital Statistics , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Data Collection , Female , Humans , Infant , Infant, Newborn , Interviews as Topic , Logistic Models , Male , Middle Aged , Mortality/trends , National Center for Health Statistics, U.S. , Sample Size , United States
17.
J Natl Med Assoc ; 96(5): 625-34, 2004 May.
Article in English | MEDLINE | ID: mdl-15160977

ABSTRACT

A number of studies have found hypertension prevalence to be higher in the southeast region of the United States than in other U.S. regions. To test the hypotheses that hypertension incidence is higher in the southeast than in other regions, and that higher levels of known hypertension risk factors in the southeast explain the difference in incidence, data from a nationally representative, longitudinal cohort study of a sample drawn from the U.S. population, the NHANES I Epidemiologic Follow-Up Study (1971-1984), were analyzed. In the United States, age-adjusted relative odds of incident hypertension between 1971 and 1984 did not vary consistently with region or with urbanization level. There was only a trend of higher relative odds in nonmetropolitan areas than in suburbs in the southeast in younger white men and older white women. Thus, convincing evidence to support the hypothesis of elevated hypertension incidence in the southeast region or in nonmetropolitan areas was not obtained. Further studies of region and hypertension incidence are needed to assess regional variation in larger, more recent cohorts.


Subject(s)
Black or African American/statistics & numerical data , Hypertension/ethnology , White People/statistics & numerical data , Adult , Aged , Female , Follow-Up Studies , Geography , Humans , Hypertension/epidemiology , Incidence , Longitudinal Studies , Male , Middle Aged , Nutrition Surveys , Odds Ratio , Risk Assessment , Risk Factors , Southeastern United States/epidemiology , United States/epidemiology
18.
Ann Epidemiol ; 13(10): 692-7, 2003 Nov.
Article in English | MEDLINE | ID: mdl-14599733

ABSTRACT

PURPOSE: We sought to assess the long-term association of bone mineral density with total, cardiovascular, and non-cardiovascular mortality. METHODS: The First National Health and Nutrition Examination Survey data were obtained from a nationally representative sample of non-institutionalized civilians. A cohort aged 45 through 74 years at baseline (1971-1975) was observed through 1992. Subjects were followed for a maximum of 22 years. Included in the analyses were 3501 white and black subjects. Death certificates were used to identify a total of 1530 deaths. RESULTS: Results were evaluated to determine the relative risk for death per 1 SD lower bone mineral density, after controlling for age at baseline, smoking status, alcohol consumption, history of diabetes, history of heart disease, education, body mass index, recreational physical activity, and blood pressure medication. Bone mineral density showed a significant inverse relationship to mortality in white men and blacks, but did not reach significance in white women. Based on 1 SD lower bone mineral density, the relative risk for white men was 1.16 (95% confidence interval (CI), 1.07-1.26, p<.01), while for white women the relative risk was 1.10 (95% CI, 0.99-1.23, p=.07), and in blacks the relative risk was 1.22 (95% CI, 1.05-1.42, p<.01). Bone mineral density was also associated with non-cardiovascular mortality in all three race-gender groups. An association between bone mineral density and cardiovascular mortality was found only in white men. CONCLUSIONS: Bone mineral density is a significant predictor of death from all causes (white men, blacks), cardiovascular (white men only) and other causes combined, in whites and blacks.


Subject(s)
Bone Density , Mortality/trends , Aged , Cardiovascular Diseases/mortality , Female , Follow-Up Studies , Humans , Linear Models , Longitudinal Studies , Male , Middle Aged , Nutrition Surveys , Proportional Hazards Models , Risk Factors , United States/epidemiology
19.
Vital Health Stat 2 ; (135): 1-55, 2003 Sep.
Article in English | MEDLINE | ID: mdl-14556588

ABSTRACT

OBJECTIVES: The objectives of this report are to document the methods developed at the National Center for Health Statistics (NCHS) to bridge the Census 2000 multiple-race resident population to single-race categories and to describe the resulting bridged race resident population estimates. METHOD: Data from the pooled 1997-2000 National Health Interview Surveys (NHIS) were used to develop models for bridging the Census 2000 multiple-race population to single-race categories. The bridging models included demographic and contextual covariates, some at the person-level and some at the county-level. Allocation probabilities were obtained from the regression models and applied to the Census Bureau's April 1, 2000, Modified Race Data Summary File population counts to assign multiple-race persons to single-race categories. RESULTS: Bridging has the most impact on the American Indian and Alaska Native (AIAN) and Asian or Pacific Islander (API) populations, a small impact on the Black population and a negligible impact on the White population. For the United States as a whole, the AIAN, API, Black, and White bridged population counts are 12.0, 5.0, 2.5, and 0.5 percent higher than the corresponding Census 2000 single-race counts. At the sub-national level, there is considerably more variation than observed at the national level. The bridged single-race population counts have been used to calculate birth and death rates produced by NCHS for 2000 and 2001 and to revise previously published rates for the 1990s, 2000, and 2001. The bridging methodology will be used to bridge postcensal population estimates for later years. The bridged population counts presented here and in subsequent years may be updated as additional data become available for use in the bridging process.


Subject(s)
Censuses , Models, Statistical , Racial Groups , Demography , Humans , Logistic Models , United States
20.
Stroke ; 34(5): e20-2, 2003 May.
Article in English | MEDLINE | ID: mdl-12663880

ABSTRACT

BACKGROUND AND PURPOSE: We sought to assess the long-term predictive usefulness of bone mineral density (BMD) for stroke incidence and stroke mortality. METHODS: The First National Health and Nutrition Examination Survey data were obtained from a nationally representative sample of noninstitutionalized civilians. A cohort of 3402 white and black subjects 45 through 74 years of age at baseline (1971 to 1975) was observed through 1992. Hospital records and death certificates were used to identify a total of 416 new stroke cases. RESULTS: Results were evaluated to determine the relative risk (RR) for stroke per 1-SD decrease in BMD, after controlling for age at baseline, smoking status, alcohol consumption, history of diabetes, history of heart disease, education, body mass index, recreational physical activity, and blood pressure medication. In Cox proportional-hazards analyses, incidence of stroke was not associated with a decrease in BMD in any of the 3 race-sex groups: white men (RR, 1.01; 95% CI, 0.86 to 1.19; P=0.88), white women (RR, 1.13; 95% CI, 0.93 to 1.38; P=0.21), or blacks (RR, 0.93; 95% CI, 0.72 to 1.21; P=0.60). No association between BMD and stroke mortality was found (RR, 1.03; 95% CI, 0.86 to 1.23; P=0.77). CONCLUSIONS: In a large national study, no significant associations of BMD and stroke incidence or mortality were found for whites or blacks.


Subject(s)
Bone Density , Stroke/epidemiology , Aged , Alcohol Drinking/epidemiology , Antihypertensive Agents/therapeutic use , Black People , Body Mass Index , Cohort Studies , Comorbidity , Death Certificates , Educational Status , Exercise , Female , Follow-Up Studies , Health Surveys , Heart Diseases/epidemiology , Humans , Hypertension/drug therapy , Hypertension/epidemiology , Incidence , Longitudinal Studies , Male , Middle Aged , Nutrition Surveys , Predictive Value of Tests , Risk , Risk Factors , Smoking/epidemiology , Stroke/mortality , United States/epidemiology , White People
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