Health-risk behaviors among our nation's youth: United States, 1992.

This report presents national estimates of the prevalence of selected health risk behaviors among youth ages 12-21 years, by sex, Hispanic origin, and race for youth of non-Hispanic origin. Topics include: cigarette and other tobacco use, alcohol and other drug use, sexual experience, HIV/AIDS education, runaway and homeless experiences, violence, unintentional injury control, weight control, and participation in physical activities. Data are from the 1992 National Health Interview Survey's Youth Risk Behavior Survey.

AIDS knowledge and attitudes for 1992. Data from the National Health Interview Survey.

In 1992, levels of knowledge about the major modes of human immunodeficiency (HIV) transmission remained high in all sociodemographic groups examined. Knowledge about other aspects of acquired immunodeficiency syndrome (AIDS) was more variable with older and less educated adults generally being less knowledgeable. Changes in knowledge between 1991 and 1992 included: An increase from 86 to 95 percent in the proportion who had heard the AIDS virus referred to as "HIV" An increase from 15 to 22 percent in the proportion of young adults (18-29 years of age) who planned to be tested in the next year An increase from 13 to 17 percent in the proportion of adults who had a coworker, relative, or friend with AIDS An increase from 69 to 75 percent in the proportion of parents of 10-17-year-olds who had ever discussed AIDS with their children.

Health of the foreign-born population: United States, 1989-90.

The health status of immigrants is of vital interest to health policy planners as the number of immigrants in the United States increases. This report has shown that, overall, foreign-born persons had better health than the U.S.-born population, although this health advantage varied by length of residence in the United States. In virtually every measure of health status, and with regard to almost every sociodemographic characteristic, the most recent immigrants were healthier than foreign-born persons who have lived in the United States 10 years or more as well as healthier than the U.S.-born population. Immigrants who had lived in the United States 10 years or longer were generally healthier than U.S.-born adults, although the differences were not as striking as between recent immigrants and the native-born population. These findings may be explained in several ways. First, recent cohorts of immigrants may have been healthier than earlier cohorts of immigrants at the time of immigration. If so, as their duration of residence in the United States increases, they will continue to be significantly healthier than native-born persons. Second, earlier cohorts of immigrants may have been as healthy as recent cohorts at the time of immigration, but their health has deteriorated with increased duration of residence in the United States. This suggests that immigrants had or acquired physical conditions or behaviors that put them at risk in their new environment or that access to health care has been limited. It also suggests that more recent cohorts of immigrants could experience a similar deterioration of health as their duration of residence in the United States increases. Finally, these findings may reflect a combination of these influences or other factors not considered. To understand these patterns will require additional research, including comparative studies of the health of immigrants in the United States with the health of nonmigrants (stayers) in the countries of immigrant origin.

Serious mental illness and disability in the adult household population: United States, 1989.

The major significance of the current report is that it provides estimates and characteristics for that portion of the civilian SMI population living in households. Survey results show that approximately 3.3 million adult Americans have mental disorders that seriously interfere with one or more aspects of daily life and that about 2.6 million of these persons are currently limited in one or more functional areas. These results suggest that the household component of the SMI population is comprised of between 2.6 and 3.3 million adults, depending upon the criteria employed for inclusion. Undoubtedly, both of these numbers are conservative because of the likelihood of underreporting in the survey. Placed in the context of the entire adult population, these findings suggest that the SMI population can be conservatively estimated to include 4 to 5 million adult Americans, or 2.1 to 2.6 øpercent of the adult population. In addition to the household population, it is estimated that 200,000 SMI persons are homeless on any given day (13). An additional 1 million to 1.1 million are residents of nursing homes (14), approximately 50,000 to 60,000 are patients of mental hospitals, and approximately 50,000 are inmates of State prisons (15). A major remaining need is to collect similar data on all SMI persons, whether their residence is a household, an institutional or noninstitutional group quarter, or some other setting, including streets and shelters. In order to formulate more effective national policy to address the needs of these disabled Americans, a need exists to examine the longitudinal relationship between course of disorder and functioning as they relate to service and program participation.

Exposure to alcoholism in the family: United States, 1988.

About 43 percent of U.S. adults--76 million people--have been exposed to alcoholism in the family: they grew up with or married an alcoholic or a problem drinker or had a blood relative who was ever an alcoholic or problem drinker. Exposure was higher among women (46.2 percent) than among men (38.9 percent) and declined with age. Exposure to alcoholism in the family was strongly related to marital status, independent of age: 55.5 percent of separated or divorced adults had been exposed to alcoholism in some family member, compared with 43.5 percent of married, 38.5 percent of never married, and 35.5 percent of widowed persons. Nearly 38 percent of separated or divorced women had been married to an alcoholic, but only about 12 percent of currently married women were married to an alcoholic. These findings are highlights of an analysis of the 1988 National Health Interview Survey on Alcohol that is presented in this report.

Developmental, learning, and emotional problems. Health of our nation's children, United States, 1988.

The data presented in this report show that developmental, learning, and behavioral disorders are among the most prevalent chronic conditions of childhood and adolescence. Overall, nearly 20 percent of young people ages 3-17 years were found to have had one or more of these conditions. By the time they reached ages 12-17 years, 1 in 4 adolescents, and nearly 3 in 10 male adolescents, had experienced one of these disorders. When very young children with developmental delays were included, the total number of U.S. children affected came to about 10.7 million. As high as these figures may seem, it is altogether possible that they are underestimates of the true prevalence of the conditions. The only childhood disorders counted in NHIS-CH were those that had been recognized by parents or identified by physicians, psychologists, or teachers and communicated to parents with sufficient clarity that the parents were able to report them to survey interviewers. There is reason to believe that some developmental, learning, and emotional disorders of children are not recognized as such, or the assessment of teachers or health professionals are not understood or not accepted by parents. Confusion over changing diagnostic terminology and simple forgetting of problems that occurred in the past probably work to reduce the reporting of these conditions as well. Despite the limitations of parental reporting, it is useful to have data on the prevalence of psychological disorders in young people based on standard survey questions put to the parents of a large and nationally representative sample of children. Estimates derived from NHIS-CH provide national benchmarks on the overall frequency of recognized psychological disorders in children and on the relative frequency of such problems in different population groups. The findings with regard to overall prevalence were that 4.0 percent of all children 17 years of age and under had delays in growth or development, 6.5 percent of children ages 3-17 years had learning disabilities, and 13.4 percent had significant emotional or behavioral problems. The proportions of all children ages 3-17 years who had ever received treatment or counseling for the conditions were about 2 percent for developmental delays, just over 5 percent for learning disabilities, and more than 10 percent for emotional or behavioral problems. These proportions fall within the range of prevalence estimates that have appeared in the literature.(ABSTRACT TRUNCATED AT 400 WORDS)

'Common courtesy' and the elimination of passive smoking. Results of the 1987 National Health Interview Survey.

The tobacco industry recommends "common courtesy" as the solution to potential conflicts over smoking in public places and as an alternative to policies that restrict or ban smoking. Specifically, the industry suggests that nonsmokers "mention annoyances in a pleasant and friendly manner" and that smokers ask others, "Do you mind if I smoke?" We analyzed data for 22,000 adults who responded to the 1987 National Health Interview Survey of Cancer Epidemiology and Control to determine if common courtesy is being used in passive-smoking situations. Almost half (47%) of smokers said they light up inside public places without asking if others mind. When someone lights up a cigarette inside a public place, only 4% of nonsmokers ask the person not to smoke despite the fact that most nonsmokers consider secondhand smoke harmful and annoying. We compared these data with similar data collected by the Roper Organization in the 1970s and found that smokers today are less likely to smoke inside public places. However, nonsmokers' actions in response to secondhand smoke have changed very little. These findings show that the common courtesy approach endorsed by the tobacco industry is unlikely, by itself, to eliminate exposure to environmental tobacco smoke. Though no one would oppose the use of common courtesy, we conclude that legislative or administrative mechanisms are the only effective strategies to eliminate passive smoking.

Adult health practices in the United States and Canada.

The prevalence levels of 12 health practices in the United States and Canada are compared in this study: smoking; drinking status; average daily alcohol consumption; physical activity; eating breakfast; use of seatbelts and child safety restraints; ownership of smoke detectors; recency of blood pressure checks, breast examinations, and Pap tests; and practice of breast self-examination. Data for two additional variables--drinking and driving and blood pressure awareness--are shown for the two countries, but the statistics cannot be strictly compared. Data are presented for four age groups by sex and for three levels of education. Trends in smoking and seatbelt use between 1979 and 1985 are also discussed.

Health habits of U.S. adults, 1985: the "Alameda 7" revisited.

Seven health habits, commonly referred to as the "Alameda 7," were shown to be associated with physical health status and mortality in a pioneer longitudinal study initiated in 1965 in Alameda County, CA. These habits are having never smoked, drinking less than five drinks at one sitting, sleeping 7-8 hours a night, exercising, maintaining desirable weight for height, avoiding snacks, and eating breakfast regularly. The Alameda study focused attention on the importance of everyday practices for the maintenance of good health and, ultimately, for longer life. This report presents selected findings on the prevalence of the seven Alameda practices (defined slightly differently in some cases) among the general U.S. population aged 18 years and older, by sex, according to age, education, income, and race. In general, men are more likely than women to smoke, drink, and exercise. Younger people are more likely than older people to skip breakfast, snack, and drink, and younger women are more likely than older women to smoke. Education, income, and racial differences were found for most health practices. Of all subgroups discussed, blacks, particularly black women, are the most likely to have lifestyles that would be considered unhealthy using the Alameda criteria. Overall, the data reported suggest that although large numbers of U.S. adults have healthy habits, many do not, particularly persons in socially and economically disadvantaged groups.