RESUMO
Data System. Federal health surveys, like the National Health Interview Survey (NHIS), represent important surveillance mechanisms for collecting timely, representative data that can be used to monitor the health and health care of the US population. Data Collection/Processing. Conducted by the National Center for Health Statistics (NCHS), NHIS uses an address-based, complex clustered sample of housing units, yielding data representative of the civilian noninstitutionalized US population. Survey redesigns that reduce survey length and eliminate proxy reporting may reduce respondent burden and increase participation. Such were goals in 2019, when NCHS implemented a redesigned NHIS questionnaire that also focused on topics most relevant and appropriate for surveillance of child and adult health. Data Analysis/Dissemination. Public-use microdata files and selected health estimates and detailed documentation are released online annually. Public Health Implications. Declining response rates may lead to biased estimates and weaken users' ability to make valid conclusions from the data, hindering public health efforts. The 2019 NHIS questionnaire redesign was associated with improvements in the survey's response rate, declines in respondent burden, and increases in data quality and survey relevancy. (Am J Public Health. 2023;113(4):408-415. https://doi.org/10.2105/AJPH.2022.307197).
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Confiabilidade dos Dados , Adulto , Criança , Estados Unidos , Humanos , Inquéritos Epidemiológicos , National Center for Health Statistics, U.S.RESUMO
BACKGROUND: General population surveys are increasingly offering broader response options for questions on sexual orientation-for example, not only gay or lesbian, but also "something else" (SE) and "don't know" (DK). However, these additional response options are potentially confusing for those who may not know what the terms mean. Researchers studying sexual orientation-based disparities face difficult methodological trade-offs regarding how best to classify respondents identifying with the SE and DK categories. OBJECTIVES: Develop respondent-level probabilities of sexual minority orientation without excluding or misclassifying the potentially ambiguous SE and DK responses. Compare 3 increasingly inclusive analytic approaches for estimating health disparities using a single item: (a) omitting SE and DK respondents; (b) classifying SE as sexual minority and omitting DK; and (c) a new approach classifying only SE and DK respondents with >50% predicted probabilities of being sexual minorities as sexual minority. MATERIALS AND METHODS: We used the sociodemographic information and follow-up questions for SE and DK respondents in the 2013-2014 National Health Interview Survey to generate predicted probabilities of identifying as a sexual minority adult. RESULTS: About 94% of the 144 SE respondents and 20% of the 310 DK respondents were predicted to identify as a sexual minority adult, with higher probabilities for younger, wealthier, non-Hispanic white, and urban-dwelling respondents. Using a more specific definition of sexual minority orientation improved the precision of health and health care disparity estimates. CONCLUSIONS: Predicted probabilities of sexual minority orientation may be used in this and other surveys to improve representation and categorization of those who identify as a sexual minority adult.
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Coleta de Dados/métodos , Comportamento Sexual/psicologia , Minorias Sexuais e de Gênero/psicologia , Inquéritos e Questionários/normas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Coleta de Dados/normas , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Fatores Socioeconômicos , Adulto JovemRESUMO
BACKGROUND: Previous reports suggest that adults with inflammatory bowel disease (IBD) receive suboptimal preventive care. AIMS: The population-based study compared the receipt of these services by US adults with and without IBD. METHODS: Adults aged ≥ 18 years with IBD (1.2%) and without IBD were identified from the 2015 and 2016 National Health Interview Survey (n = 66,610). Age-standardized prevalence of doctor visits, receipt of medical advice, and selected preventive care was calculated for adults with and without IBD. The model-adjusted prevalence ratios were estimated for receipt of preventive care associated with IBD. RESULTS: The prevalence of a doctor visit in the past 12 months was significantly higher among adults with IBD than those without. IBD was also associated with significantly higher prevalence of receiving medical advice about smoking cessation (83.9% vs. 66.4%) and diet (42.9% vs. 32.1%), having colon cancer screening in the past 12 months (44.0% vs. 26.7%), having ever had an HIV test (51.5% vs. 45.4%) or pneumococcal vaccine (75.3% vs. 64.0%), having received a tetanus vaccine in the past 10 years (72.0% vs. 61.8%), and having received a flu vaccine in the past 12 months (48.4% vs. 41.0%), but was not significantly associated with receiving cervical cancer screening and hepatitis A and B vaccines. CONCLUSIONS: Adults with IBD were more likely to receive many types of preventive care than adults without IBD. The findings can inform healthcare policy makers to make strategic decisions that enhance multidisciplinary coordination from various medical specialties to ensure optimal preventive care for IBD patients.
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Doenças Inflamatórias Intestinais/terapia , Padrões de Prática Médica/tendências , Serviços Preventivos de Saúde/tendências , Adolescente , Adulto , Idoso , Estudos Transversais , Pesquisas sobre Atenção à Saúde , Humanos , Doenças Inflamatórias Intestinais/diagnóstico , Doenças Inflamatórias Intestinais/epidemiologia , Pessoa de Meia-Idade , Visita a Consultório Médico/tendências , Encaminhamento e Consulta/tendências , Fatores de Tempo , Estados Unidos/epidemiologia , Adulto JovemRESUMO
Inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis, involves chronic inflammation of the gastrointestinal tract. In 2015, an estimated 3.1 million adults in the United States had ever received a diagnosis of IBD (1). Nationally representative samples of adults with IBD have been unavailable or too small to assess relationships between IBD and other chronic conditions and health-risk behaviors (2). To assess the prevalence of health-risk behaviors and chronic conditions among adults with and without IBD, CDC aggregated survey data from the 2015 and 2016 National Health Interview Survey (NHIS). An estimated 3.1 million (unadjusted lifetime prevalence = 1.3%) U.S. adults had ever received a diagnosis of IBD. Adults with IBD had a significantly lower prevalence of having never smoked cigarettes than did adults without the disease (55.9% versus 63.5%). Adults with IBD had significantly higher prevalences than did those without the disease in the following categories: having smoked and quit (26.0% versus 21.0%; having met neither aerobic nor muscle-strengthening activity guidelines (50.4% versus 45.2%); reporting <7 hours of sleep, on average, during a 24-hour period (38.2% versus 32.2%); and having serious psychological distress (7.4% versus 3.4%). In addition, nearly all of the chronic conditions evaluated were more common among adults with IBD than among adults without IBD. Understanding the health-risk behaviors and prevalence of certain chronic conditions among adults with IBD could inform clinical practice and lead to better disease management.
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Doença Crônica/epidemiologia , Comportamentos de Risco à Saúde , Doenças Inflamatórias Intestinais/epidemiologia , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto JovemRESUMO
OBJECTIVES: To assess the extent to which lesbian, gay, and bisexual (LGB) adults aged 18 to 64 years experience barriers to health care. METHODS: We used 2013 National Health Interview Survey data on 521 gay or lesbian (291 men, 230 women), 215 bisexual (66 men, 149 women), and 25 149 straight (11 525 men, 13 624 women) adults. Five barrier-to-care outcomes were assessed (delayed or did not receive care because of cost, did not receive specific services because of cost, delayed care for noncost reasons, trouble finding a provider, and no usual source of care). RESULTS: Relative to straight adults, gay or lesbian and bisexual adults had higher odds of delaying or not receiving care because of cost. Bisexual adults had higher odds of delaying care for noncost reasons, and gay men had higher odds than straight men of reporting trouble finding a provider. By contrast, gay or lesbian women had lower odds of delaying care for noncost reasons than straight women. Bisexual women had higher odds than gay or lesbian women of reporting 3 of the 5 barriers investigated. CONCLUSIONS: Members of sexual minority groups, especially bisexual women, are more likely to encounter barriers to care than their straight counterparts.
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Pessoal de Saúde , Acessibilidade aos Serviços de Saúde/economia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Adolescente , Adulto , Feminino , Nível de Saúde , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Comportamento Sexual , Inquéritos e Questionários , Estados UnidosRESUMO
Crohn's disease and ulcerative colitis, collectively known as inflammatory bowel disease (IBD), are characterized by chronic inflammation of the gastrointestinal tract (1). IBD has been associated with poor quality of life and extensive morbidity and often results in complications requiring hospitalizations and surgical procedures (2-4). Most previous studies of IBD have used administrative claims data or data collected from limited geographic areas to demonstrate increases in estimated prevalence of IBD within the United States (5,6). Few national prevalence estimates of IBD among adults based on large, nationally representative data sources exist, and those that do tend to be based on older data. For example, the most recent national study used 1999 National Health Interview Survey (NHIS) data and estimated that 1.8 million (0.9%) U.S. adults had IBD (7). To examine the prevalence of IBD among the civilian, noninstitutionalized U.S. adult population, data from the 2015 NHIS were analyzed. Overall, an estimated 3.1 million, or 1.3%, of U.S. adults have received a diagnosis of IBD. Within population subgroups, a higher prevalence of IBD was identified among adults aged ≥45 years, Hispanics, non-Hispanic whites, and adults with less than a high school level of education, not currently employed, born in the United States, living in poverty, or living in suburban areas. The use of a nationally representative data source such as the NHIS to estimate the prevalence of IBD overall and by population subgroups is important to understand the burden of IBD on the U.S. health care system.
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Disparidades nos Níveis de Saúde , Doenças Inflamatórias Intestinais/epidemiologia , Adolescente , Adulto , Negro ou Afro-Americano/estatística & dados numéricos , Idoso , Feminino , Inquéritos Epidemiológicos , Hispânico ou Latino/estatística & dados numéricos , Humanos , Doenças Inflamatórias Intestinais/etnologia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Socioeconômicos , Estados Unidos/epidemiologia , População Branca/estatística & dados numéricos , Adulto JovemAssuntos
Dor Lombar/epidemiologia , Doenças Profissionais/epidemiologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Dor Lombar/fisiopatologia , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/fisiopatologia , Ocupações , Prevalência , Fatores de Risco , Inquéritos e Questionários , Estados Unidos/epidemiologiaRESUMO
INTRODUCTION: Research is needed on chronic health conditions among lesbian, gay, and bisexual populations. The objective of this study was to examine 10 diagnosed chronic conditions, and multiple (≥2) chronic conditions (MCC), by sexual orientation among US adults. METHODS: The 2013 National Health Interview Survey was used to generate age-adjusted prevalence rates and adjusted odds ratios of diagnosed chronic conditions and MCC for civilian, noninstitutionalized US adults who identified as gay/lesbian, straight, or bisexual, and separately for men and women. Chronic conditions were selected for this study on the basis of previous research. RESULTS: Hypertension and arthritis were the most prevalent conditions for all groups. Gay/lesbian adults had a 4.7 percentage-point higher prevalence of cancer than bisexual adults, and a 5.6 percentage-point higher prevalence of arthritis and a 2.9 percentage point higher prevalence of hepatitis than straight adults. The prevalence of chronic obstructive pulmonary disease was 8.1 percentage points higher among bisexual adults than among gay/lesbian adults and 7.0 percentage points higher than among straight adults. These differences remained in the multivariate analyses. Additional differences were found in the sex-stratified analyses. No significant differences were found in MCC by sexual orientation. CONCLUSION: After age adjustment and controlling for sociodemographic characteristics, only a few significant health disparities for diagnosed chronic conditions were found by sexual orientation, and none for MCC. However, for conditions where differences were found, magnitudes were relatively large. Further examination of these differences among gay/lesbian and bisexual adults could yield a better understanding of why these disparities exist.
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Artrite/epidemiologia , Disparidades nos Níveis de Saúde , Hipertensão/epidemiologia , Neoplasias/epidemiologia , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Sexualidade , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Inquéritos e Questionários , Estados UnidosRESUMO
Objective-This report presents a set of quality analyses of sexual orientation data collected in the 2013 National Health Interview Survey (NHIS). NHIS sexual orientation estimates are compared with those from the National Survey of Family Growth (NSFG) and the National Health and Nutrition Examination Survey (NHANES). Selected health outcomes by sexual orientation are compared between NHIS and NSFG. Assessments of item nonresponse, item response times, and responses to follow-up questions to the sexual orientation question are also presented. Methods-NHIS is a multipurpose health survey conducted continuously throughout the year by the Centers for Disease Control and Prevention's National Center for Health Statistics. Analyses in this report were based on NHIS data collected in 2013 from 34,557 adults aged 18 and over. Sampling weights were used to produce national estimates that are representative of the civilian noninstitutionalized U.S. adult population. Data from the 2006-2010 NSFG and 2009-2012 NHANES were used for the comparisons. Results-Based on the 2013 NHIS data, 96.6% of adults identified as straight, 1.6% identified as gay/lesbian, and 0.7% identified as bisexual. The remaining 1.1% of adults identified as ''something else,'' stated ''I don't know the answer,'' or refused to answer. Responses to follow-up questions suggest that the sexual orientation question is producing little classification error. In addition, largely similar patterns of association between sexual orientation and health were observed for NHIS and NSFG. Analyses of item nonresponse rates revealed few data quality issues, although item response times suggest possible shortcutting of the question and comprehension problems for select respondents.
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BACKGROUND: Little nationally representative information on job insecurity, work-family imbalance, and hostile work environments experienced by workers in the US is available. METHODS: Prevalence rates from the 2010 National Health Interview Survey (NHIS) were calculated for three workplace psychosocial factors (job insecurity, work-family imbalance, bullying/harassment) using SUDAAN to account for the complex NHIS sample design. RESULTS: Data were available for 17,524 adults who worked in the 12 months that preceded the interview. Overall prevalence rates were 31.7% for job insecurity, 16.3% for work-family imbalance, and 7.8% for hostile work environment (being bullied or harassed). The highest prevalence rate of job insecurity was found for construction and extraction occupations. Workers in legal occupations had the highest prevalence rate of work-family imbalance. Workers in protective service occupations had the highest prevalence rate of hostile work environment. CONCLUSIONS: We identified demographic characteristics along with industries and occupations with the highest prevalence rates for three adverse workplace psychosocial factors. These data can be used for benchmarking and identification of targets for investigation and intervention activities.
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Indústrias/estatística & dados numéricos , Doenças Profissionais/psicologia , Exposição Ocupacional , Saúde Ocupacional , Estresse Psicológico/psicologia , Local de Trabalho/psicologia , Adulto , Relações Familiares , Feminino , Inquéritos Epidemiológicos , Hostilidade , Humanos , Relações Interprofissionais , Entrevistas como Assunto , Satisfação no Emprego , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/epidemiologia , Ocupações , Prevalência , Psicologia , Medição de Risco , Estresse Psicológico/epidemiologia , Estados Unidos/epidemiologia , Local de Trabalho/estatística & dados numéricos , Adulto JovemRESUMO
BACKGROUND: Surveillance is needed to capture work organization characteristics and to identify their trends. METHODS: Data from the 2010 National Health Interview Survey (NHIS) were used to calculate prevalence rates for four work organization characteristics (long work hours, non-standard work arrangements, temporary positions, and alternative shifts) overall, and by demographic characteristics, and industry and occupation of current/recent employment. RESULTS: Data were available for 27,157 adults, of which 65% were current/recent workers. Among adults who worked in the past 12 months, 18.7% worked 48 hr or more per week, 7.2% worked 60 hr or more per week, 18.7% had non-standard work arrangements, 7.2% were in temporary positions, and 28.7% worked an alternative shift. CONCLUSIONS: Prevalence rates of work organization characteristics are provided. These national estimates can be used to help occupational health professionals and employers to identify emerging occupational safety and health risks, allow researchers to examine associations with health, and use the data for benchmarking.
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Emprego/organização & administração , Indústrias/organização & administração , Doenças Profissionais/epidemiologia , Tolerância ao Trabalho Programado , Local de Trabalho/organização & administração , Adulto , Distribuição por Idade , Idoso , Intervalos de Confiança , Feminino , Inquéritos Epidemiológicos , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Inovação Organizacional , Prevalência , Medição de Risco , Distribuição por Sexo , Fatores Socioeconômicos , Estados Unidos , Adulto JovemRESUMO
OBJECTIVE: Assess the national prevalence of current workplace exposure to potential skin hazards, secondhand smoke (SHS), and outdoor work among various industry and occupation groups. Also, assess the national prevalence of chronic workplace exposure to vapors, gas, dust, and fumes (VGDF) among these groups. METHODS: Data were obtained from the 2010 National Health Interview Survey (NHIS). NHIS is a multistage probability sample survey of the civilian non-institutionalized population of the US. Prevalence rates and their variances were calculated using SUDAAN to account for the complex NHIS sample design. RESULTS: The data for 2010 were available for 17,524 adults who worked in the 12 months that preceded interview. The highest prevalence rates of hazardous workplace exposures were typically in agriculture, mining, and construction. The prevalence rate of frequent handling of or skin contact with chemicals, and of non-smokers frequently exposed to SHS at work was highest in mining and construction. Outdoor work was most common in agriculture (85%), construction (73%), and mining (65%). Finally, frequent occupational exposure to VGDF was most common among mining (67%), agriculture (53%), and construction workers (51%). CONCLUSION: We identified industries and occupations with the highest prevalence of potentially hazardous workplace exposures, and provided targets for investigation and intervention activities.
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Substâncias Perigosas/efeitos adversos , Doenças Profissionais/epidemiologia , Doenças Profissionais/etiologia , Exposição Ocupacional/efeitos adversos , Local de Trabalho , Adulto , Distribuição por Idade , Idoso , Poluentes Ocupacionais do Ar/efeitos adversos , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/fisiopatologia , Saúde Ocupacional , Ocupações , Prevalência , Medição de Risco , Distribuição por Sexo , Estados Unidos/epidemiologia , Adulto JovemRESUMO
BACKGROUND: Prevalence patterns of dermatitis among workers offer clues about risk factors and targets for prevention, but population-based estimates of the burden of dermatitis among US workers are lacking. METHODS: Data from an occupational health supplement to the 2010 National Health Interview Survey (NHIS-OHS) were used to estimate the prevalence of dermatitis overall and by demographic characteristics and industry and occupation (I&O) of current/recent employment. RESULTS: Data were available for 27,157 adults, including 17,524 current/recent workers. The overall prevalence rate of dermatitis among current/recent workers was 9.8% (range among I&O groups: 5.5-15.4%), representing approximately 15.2 million workers with dermatitis. The highest prevalence rates were among I&O groups related to health care. Overall, 5.6% of dermatitis cases among workers (9.2% among healthcare workers) were attributed to work by health professionals. CONCLUSIONS: Dermatitis affected over 15 million US workers in 2010, and its prevalence varied by demographic characteristics and industry and occupation of employment. The prevalence rate of work-related dermatitis based on the NHIS-OHS was approximately 100-fold higher than incidence rates based on the Bureau of Labor Statistics' Survey of Occupational Illness and Injury.
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Dermatite Ocupacional/diagnóstico , Dermatite Ocupacional/epidemiologia , Saúde Ocupacional , Ocupações , Adulto , Distribuição por Idade , Idoso , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Prevalência , Medição de Risco , Distribuição por Sexo , Estados Unidos/epidemiologia , Local de TrabalhoRESUMO
BACKGROUND: Patterns of prevalence and work-relatedness of carpal tunnel syndrome (CTS) among workers offer clues about risk factors and targets for prevention. METHODS: Data from an occupational health supplement to the 2010 National Health Interview Survey were used to estimate the prevalence of self-reported clinician-diagnosed CTS overall and by demographic characteristics. The proportion of these cases self-reported to have been attributed to work by clinicians was also examined overall and by demographic characteristics. In addition, the distribution of industry and occupation (I&O) categories to which work-related cases of CTS were attributed was compared to the distribution of I&O categories of employment among current/recent workers. RESULTS: Data were available for 27,157 adults, including 17,524 current/recent workers. The overall lifetime prevalence of clinician-diagnosed CTS among current/recent workers was 6.7%. The 12-month prevalence was 3.1%, representing approximately 4.8 million workers with current CTS; 67.1% of these cases were attributed to work by clinicians, with overrepresentation of certain I&O categories. CONCLUSIONS: CTS affected almost 5 million U.S. workers in 2010, with prevalence varying by demographic characteristics and I&O.
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Síndrome do Túnel Carpal/epidemiologia , Doenças Profissionais/epidemiologia , Saúde Ocupacional , Ocupações , Adulto , Distribuição por Idade , Síndrome do Túnel Carpal/etiologia , Síndrome do Túnel Carpal/fisiopatologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , National Institute for Occupational Safety and Health, U.S. , Doenças Profissionais/diagnóstico , Prevalência , Medição de Risco , Índice de Gravidade de Doença , Distribuição por Sexo , Inquéritos e Questionários , Estados Unidos/epidemiologiaRESUMO
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).
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Pessoas com Deficiência , Humanos , Inquéritos e Questionários , Washington/epidemiologiaRESUMO
Objective-This report presents prevalence estimates of prescription opioid use among U.S. adults with chronic pain.
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Dor Crônica , Transtornos Relacionados ao Uso de Opioides , Adulto , Analgésicos Opioides/efeitos adversos , Dor Crônica/tratamento farmacológico , Dor Crônica/epidemiologia , Humanos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Prescrições , Prevalência , Estados Unidos/epidemiologiaRESUMO
Objective-To measure health care utilization among adults with inflammatory bowel disease (IBD) and compare with adults without IBD. Methods-Adults aged 18 and over with IBD (1.2%) and without IBD were identified from the 2015 and 2016 National Health Interview Survey (n = 66,610). This study presents age-adjusted percentages and model-adjusted prevalence ratios (APRs) of selected health service use to identify differences by IBD status. IBD status and use of health care services are based on self-reports. Results-Compared with adults without IBD, adults with IBD were more likely to have visited any doctor or mental health provider in the past 12 months. IBD was also associated with higher prevalence of being prescribed medication, and having received acute care services, such as emergency room visits, overnight hospitalizations, or surgeries. Differences by IBD status were greatest for visiting a specialist (APR: 1.98; 95% confidence interval [CI]: 1.82-2.14) and home visits (APR: 1.80; 95% CI: 1.25-2.59) in the past 12 months. Conclusions-Adults with IBD had higher health service use than adults without IBD. Future studies may assess patient characteristics and outcomes associated with increased utilization among IBD patients.
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Colite , Doença de Crohn , Doenças Inflamatórias Intestinais , Adolescente , Adulto , Hospitalização , Humanos , Doenças Inflamatórias Intestinais/epidemiologia , Doenças Inflamatórias Intestinais/terapia , Aceitação pelo Paciente de Cuidados de Saúde , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: We hypothesize that a substantial portion of individuals who forgo conventional care in a given year turn to some form of alternative medicine. This study also examines whether individuals who use only alternative medicine will differ substantially in health and sociodemographic status from individuals using neither alternative medicine nor conventional care in a given year. To identify those factors that predict alternative medicine use in those not using conventional care, we employed the socio-behavioral model of healthcare utilization. METHODS: The current study is a cross-sectional regression analysis using data from the 2002 National Health Interview Survey. Data were collected in-person from 31,044 adults throughout the 50 states and the District of Columbia. RESULTS: 19.3% of adults (38.3 million) did not use conventional care in a 12 month period, although 39.5% of these individuals (14.7 million) reported having one or more problems with their health. Of those not using conventional care, 24.8% (9.5 million) used alternative medicine. Users of alternative medicine had more health needs and were more likely to delay conventional care because of both cost and non-cost factors compared to those not using alternative medicine. While individual predisposing factors (gender, education) were positively associated with alternative medicine use, enabling factors (poverty status, insurance coverage) were not. CONCLUSIONS: We found that a quarter of individuals who forgo conventional care in a given year turn towards alternative medicine. Our study suggests that the potential determinants of using only alternative medicine are multifactorial. Future research is needed to examine the decision process behind an individual's choice to use alternative medicine but not conventional medicine and the clinical outcomes of this choice.
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Terapias Complementares/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Estados Unidos , Adulto JovemRESUMO
Chronic pain (1) and chronic pain that frequently limits life or work activities, referred to in this report as high-impact chronic pain (2), are among the most common reasons adults seek medical care (3) and are associated with decreased quality of life, opioid dependence, and poor mental health (1,4,5). This report examines chronic pain and high-impact chronic pain in the past 3 months among U.S. adults aged 18 and over by selected demographic characteristics and urbanization level.
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Dor Crônica/epidemiologia , Adulto , Fatores Etários , Idoso , Etnicidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , População Rural , Estados Unidos/epidemiologia , População Urbana , Adulto JovemRESUMO
Privacy, achieved through self-administered modes of interviewing, has long been assumed to be a necessary prerequisite for obtaining unbiased responses to sexual identity questions due to their potentially sensitive nature. This study uses data collected as part of a split-ballot field test embedded in the National Health Interview Survey (NHIS) to examine the association between survey mode (computer-assisted personal interviewing (CAPI) versus audio computer-assisted self-interviewing (ACASI)) and sexual minority identity reporting. Bivariate and multivariate quantitative analyses tested for differences in sexual minority identity reporting and non-response by survey mode, as well as for moderation of such differences by sociodemographic characteristics and interviewing environment. No significant main effects of interview mode on sexual minority identity reporting or nonresponse were found. Two significant mode effects emerged in subgroup analyses of sexual minority status out of 35 comparisons, and one significant mode effect emerged in subgroup analyses of item nonresponse. We conclude that asking the NHIS sexual identity question using CAPI does not result in estimates that differ systematically and meaningfully from those produced using ACASI.