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Background: National health surveys linked to vital statistics and health care information provide a growing source of individual-level population health data. Pooling linked surveys across jurisdictions would create comprehensive datasets that are larger than most existing cohort studies, and that have a unique international and population perspective. This paper's objectives are to examine the feasibility of pooling linked population health surveys from three countries, facilitate the examination of health behaviours, and present useful information to assist in the planning of international population health surveillance and research studies., Data and Methods: The design, methodologies and content of the Canadian Community Health Survey (2003 to 2008), the United States National Health Interview Survey (2000, 2005) and the Scottish Health Survey (SHeS) (2003, 2008 to 2010) were examined for comparability and consistency. The feasibility of creating common variables for measuring smoking, alcohol consumption, physical activity and diet was assessed. Sample size and estimated mortality events were collected., Results: The surveys have comparable purposes, designs, sampling and administration methodologies, target populations, exclusions, and content. Similar health behaviour questions allow for comparable variables to be created across the surveys. However, the SHeS uses a more detailed risk factor evaluation for alcohol consumption and diet data. Therefore, comparisons of alcohol consumption and diet data between the SHeS and the other two surveys should be performed with caution. Pooling these linked surveys would create a dataset with over 350,000 participants, 28,424 deaths and over 2.4 million person-years of follow-up., Discussion: Pooling linked national population health surveys could improve population health research and surveillance. Innovative methodologies must be used to account for survey dissimilarities, and further discussion is needed on how to best access and analyze data across jurisdictions.

The limited availability of Hispanic health data has hampered the development of targeted public health policies. Hispanics represent 11.5 percent of the population and are projected to become the largest minority group in the United States by the year 2010. This paper explores current issues in Hispanic health data collection, examines methodological concerns, and presents recommendations for future Hispanic public health data collection. Data are derived from statistical reports of the U.S. Bureau of the Census, National Center for Health Statistics, Bureau of Labor Statistics, and other empirical studies. Recommendations include: collecting both race and ethnic-specific data by Hispanic subgroup, designing appropriate data collection instruments and approaches, and selecting referent groups for comparison purposes. The authors conclude that the renewed national focus on health disparities among underserved populations requires an increased commitment to adequately identify Hispanic subgroups.

The last 10 years have seen increasing use of telephone surveys in public health research. This paper reviews issues of sampling, data quality, questionnaire development, scheduling of interviewers, respondent burden, interviewer effects, and the use of the computer in telephone interviewing. Throughout, the authors focus on findings from recent research, with particular emphasis on those studies suggesting new advances or protocols for conducting telephone health surveys. The findings of this review suggest four conclusions. First, telephone interviews can be highly recommended for follow-up interviews in panel surveys that use an initial face-to-face interview. Second, telephone surveys can be recommended as a viable alternative to costly face-to-face surveys in cross-sectional studies of the general population. Third, when the focus of the survey is on subgroups of the population that have both low telephone coverage and higher rates of nonresponse (e.g., low income and low education respondents), telephone interviews should be used more cautiously. In these situations, a dual sampling frame approach (using a combination of face-to-face and telephone interviewing) may be considered. Finally, computer-assisted telephone interviewing (CATI) represents one of the most important and innovative technologic advances in health survey research in recent years. The advantages of CATI in improving survey management are noteworthy and ideally suited for moderate- to large-sample surveys. CATI also provides an attractive (and largely untapped) resource for testing and refining other methodologic protocols in survey research.

Well-documented, large-scale abortion underreporting on U.S. surveys raises questions about the use of abortion self-reports for statistical inference. This paper is the first to evaluate the completeness of the abortion data in the National Longitudinal Study of Adolescent to Adult Health (Add Health). Comparisons of Add Health's estimated abortion rates to external sources show that the Add Health data capture 35% of expected abortions. Thus, Add Health performed no better than other surveys in collecting abortion data. Further, no differences in underreporting by race/ethnicity or age at abortion were found. We suggest that the current U.S. social environment generates high levels of abortion stigma, which yields abortion underreporting. We conclude that due to underreporting, survey self-reports of abortion need to be evaluated, contextualized, and used with caution. [ABSTRACT FROM AUTHOR]

Abstract: This paper analyzes the potential of using measures of social function as health indicators in dental research. It discusses existing methodologies and presents findings from a cross section of studies that adopt a social function perspective in the investigation of oral health status. While the literature in this area is small, much of the research concerns disability days associated with dental problems, The United States National Health interview Survey reported in 1981 than 4.87 million dental condition caused 17.7 million days of restricted activity. 6.73 million days of bed disability, and 7.05 million days of work loss. Other reports suggest that these data may be underestimates due to the National Health Surveys definition of disability days. Several other studies have found work loss to affect from 15 per ¢ to 33 per ¢ of samples studied resulting in many more work loss days than reported by the National Health Surveys. Our study concludes that traditional measures of oral health status such as decayed, missing, and filled teeth and the periodontal index--should be linked to measures of social outcome in order to place dental conditions within the broader context of health status in terms that are relevant to policy makers. [ABSTRACT FROM AUTHOR]

This paper examines the uses of some health status indices in measuring equity of access to medical care. Empirical examples are provided using data from national surveys of the U.S. population conducted from 1964 through 1976. A simple indicator, mean number of physician visits, suggests that between 1963 and 1976 the poor improved their position relative to the rest of the population and, indeed, currently enjoy the highest level of access. However, a second measure, the use-disability ratio indicates that the poor may still receive less care relative to their need. A third measure, the symptoms-response ratio suggests how norms of appropriate behavior might be incorporated into an access measure. [ABSTRACT FROM AUTHOR]

The paper describes SIPP data elements pertaining to health and disability, examines broad policy needs for health and disability issues from the perspective of the Department of Health and Human Services, and contains recommendations for future SIPP design. Specific health and disability items described include health insurance, health care utilization, participation in Federal disability programs, functional disability (i.e. ADLs and IADLs), work disability, and children's disability. The paper contains recommendations to more consistently collect health and disability data in SIPP. Although the goals of SIPP are to study the dynamics of Federal program participation and describe the income distribution of the population, since program participation and income are so closely influenced by health and disability, SIPP's goals cannot be fully met until health and disability data are collected more consistently. [ABSTRACT FROM AUTHOR]

The 2005 hurricane season caused extensive damage and induced a mass migration of approximately 1.1 million people from southern Louisiana in the United States. Current and accurate estimates of population size and demographics and an assessment of the critical needs for public services were required to guide recovery efforts. Since forecasts using pre-hurricane data may produce inaccurate estimates of the post-hurricane population, a household survey in 18 hurricane-affected parishes was conducted to provide timely and credible information on the size of these populations, their demographics and their condition. This paper describes the methods used, the challenges encountered, and the key factors for successful implementation. This post-disaster survey was unique because it identified the needs of the people in the affected parishes and quantified the number of people with these needs. Consequently, this survey established new population and health indicator baselines that otherwise would have not been available to guide the relief and recovery efforts in southern Louisiana. [ABSTRACT FROM AUTHOR]

Objectives. This paper analyzes the impact of seven chronic conditions (three nonfatal: arthritis, visual impairment, hearing impairment; four fatal: ischemic heart disease, chronic obstructive pulmonary disease, diabetes mellitus, malignant neoplasms) on US adults aged 18 and older. Impact refers to how readily a condition prompts activity limitations, physician visits, and hospital stays. Methods. Data come from three national health surveys and vital statistics. For comparability, a single disease classification scheme was applied, and new rates were estimated. Frequency, impact, and prominence of the target conditions are studied via rates, ratios of rates, and ranks, respectively. Results. In young adulthood, the nonfatal conditions prompt limitations less readily than do the fatal ones, but by older ages, arthritis and visual impairment have a limiting impact equivalent to that of fatal conditions. Despite high prevalence and limitations, nonfatal conditions stand well below fatal conditions for health services use. Conclusions. Although statistics on frequency, impact, and prominence all indicate conditions' "importance," they give only weak clues about specific service needs of affected persons. The persistent finding that nonfatal conditions do not receive health services care commensurate with their prevalence and impact reflects long-standing imbalanced attention on fatal conditions in research and medical care. [ABSTRACT FROM AUTHOR]

Survey researchers believe that self reports, in general, are more accurate than reports obtained by proxy. This paper focuses on the reassessment of previous self/proxy comparisons and presents findings from a telephone adaptation of the National Health Interview Survey (NHIS) designed to investigate response error associated with self and proxy reports. Unlike previous studies in which the type of report is confounded with characteristics of the population home at the time of the interview, the design of this study (random allocation to self or proxy reports. Unlike comparison of reports from similar populations. The results show that when self response is limited to a randomly selected respondent, the self respondents report fewer health events for themselves versus for others in their household. (Am J Public Health 1985; 75:639-644.) [ABSTRACT FROM AUTHOR]

This paper presents the preliminary results of the economic analyses of the National Hospice Study (NHS), mandated by the United States Congress to investigate the implications of including hospice services in Medicare. Data were collected over an 18-month period from approximately 4,000 patients receiving hospice and conventional terminal care in 25 hospices and 12 conventional care sites. Subsequent analysis may lead to changes in the specific results, and some of the differences may be due to confounding variables that cannot be adjusted for. According to these data, hospital based (HB) hospice costs per day are 44 per cent higher than home care (HC) hospice costs per day ($95 versus $66, respectively). In addition, per patient hospice costs are 24 per cent more for patients enrolled in HB than in HC hospices ($5.890 versus $4,758, respectively). The proportional difference between HB and HC in cost per patient is smaller than the cost per day difference due to the shorter average HB length of stay, 62.3 days compared to 72.5 days for HC. Regarding the cost savings of hospice compared to conventional care. HC hospice costs are lower than conventional care costs regardless of length of stay. However, HB costs seem lower than conventional care costs only for patients with lengths of stay less than two month, Hospice and conventional care patients appear to differ with respect to predisposition toward intensive health care utilization. When this difference is explored more thoroughly in subsequent analyses, the estimated cost differential between hospice and conventional care may change. (Am J Public Health 1984; 74:689-697.) [ABSTRACT FROM AUTHOR]

The article presents the author's view on the "A Critical Reassessment of the Evidence Bearing on Smoking as the Cause of Lung Cancer" by Theodore D. Sterling. According to Sterling, the level of lung cancer mortality in the U.S. among men especially non-white, the rates have increased and among women there was a dramatic increase in the rates during the 1950's. The smoking-lung cancer hypothesis sets the trends in women's mortality. Sterling cited the evidence that women have increased their smoking since 1955.

Background: This study evaluated the effect of increased physical activity on annual medical expenditures among people with disability, as well as people without disability. Methods: We performed a cross-sectional study with linked national survey data from 2004 to 2013 Medical Expenditure Panel Survey and from 2002 to 2012 National Health Interview Study. We investigated the effect of physical activity on the annual medical expenditures in 2013 US dollars, among people with and without disability who were 18- to 64-year-old adults. Results: For people with disability, we found a statistically significant effect (P <.05) of physical activity on annual medical expenditures. Among people without disability, being inactive was associated with higher medical expenditures, compared with being sufficiently active. In our counterfactual analysis, among inactive people with disability, increasing activity to even a low level of activity could potentially save on average $2150.06 (95% confidence interval, 770.39 to 3529.72) annual medical costs. Conclusions: This analysis provides evidence that when an individual with a disability moves from inactive to active, the savings in medical expenditures are substantially larger than the savings for an individual without a disability ($2564.33 vs $393.34). Despite the challenge of participating in physical activity for people with disability, completing “some” activity may have large public health implications. [ABSTRACT FROM AUTHOR]

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Abstract: National data indicate that there was almost no change in the accuracy of body weight assessments of overweight women over the past 20years. The accuracy in weight assessment is influenced by a number of social-demographic and economic factors; many of them have opposite effects and cancel out each other. This paper examines changes in misperception of body weight among overweight women in the United States, using data from the 1988–1994 and 1999–2004 National Health and Nutrition Examination Survey. Changes in characteristics of the population, such as the increased share of Hispanics in the US population, between these two time periods explain only a small portion of the changes in the accuracy of body weight assessment. Most of the differences come from changes in the association between population characteristics and the likelihood an overweight woman underestimates her weight status. Results also indicate that overweight women who receive benefits from the Supplemental Nutrition Assistance Program (formerly Food Stamp Program) are consistently more likely to misperceive themselves as healthy weight or underweight than higher income overweight women. [Copyright &y& Elsevier]

To address the obesity crisis, public health experts recommend major reductions in the marketing of unhealthy food to youth. However, policies to restrict food marketing are not currently viewed as politically feasible. This paper examines attitudes and knowledge about food marketing and support for restricting unhealthy food marketing among one group of constituents: parents. A survey of 807 parents found that those most likely to support food marketing restrictions were also more likely to have negative views of current food practices. These findings suggest that increased public education about the harm caused by food marketing may increase public support for policy interventions. [ABSTRACT FROM AUTHOR]

Abstract: This paper focused on the extent to which factors that are modifiable by health policies or provider recommendations influenced the level and changes in the burden of childhood asthma. Demographic factors, access to health care services, and asthma control activities were posited to potentially influence the level and changes in health burden of children with asthma. The Medical Expenditure Panel Survey data from 1996–1999 on 3–11 year old U.S. children with asthma (N=784) were used. The findings of multilevel models of perceived burden indicated unfavorable trajectories among those families who had public health insurance. Asthma control activities were associated with favorable trajectories of both perceived and objectively measured burden. These findings emphasized the significance of asthma control and access to high quality and stable health care services as health policy targets. [Copyright &y& Elsevier]

Abstract: This paper investigates the effects of expanding public health insurance eligibility for older children. Using data from the National Health Interview Surveys from 1986 to 2005, we first show that although income continues to be an important predictor of children''s health status, the importance of income for predicting health has fallen for children 9–17 in recent years. We then investigate the extent to which the dramatic expansions in public health insurance coverage for these children in the past decade are responsible for the decline in the importance of income. We find that while eligibility for public health insurance unambiguously improves current utilization of preventive care, it has little effect on current health status. However, we find some evidence that Medicaid eligibility in early childhood has positive effects on future health. This may indicate that adequate medical care early on puts children on a better health trajectory, resulting in better health as they grow. [Copyright &y& Elsevier]

Abstract: U.S. agencies that fund addiction research have recently made major efforts to bridge “the gap between research and treatment”. One strategy developed by the National Institute on Drug Abuse is the “Clinical Trials Network”, which is designed to conduct effectiveness studies in real world, community-based programs rather than research settings. While a step in the right direction, these studies have focused almost exclusively on the effectiveness of standard treatment interventions using limited research methodologies. Health services issues that will determine the long-term acceptance or rejection of these interventions in the community have been largely ignored: the effects of process variables, how public health policy facilitates or hinders implementation, the perspectives and experiences of various stakeholders, and the relationships between addiction treatment and other community-based services. This paper suggests that addiction researchers need to look beyond the question of whether an intervention is “effective” and examine the community context within which those interventions are delivered. Adding this health services view to compliment clinical trials research requires examination of new research questions, broader designs of studies, modifications in the collection of data, and assessment of addiction policy. Recent studies examining recovery from addiction in sober living and Oxford houses are described as examples of community relevant research that could benefit from additional health services research. [Copyright &y& Elsevier]

Despite efforts to decrease health disparities they continue to exist and have increased in some health areas. Interventions are needed that educate the public about health disparities and to determine ways to implement culturally appropriate and gender specific programs that include evaluation and monitoring tools. After the intervention has been completed it is important to track what progress the intervention made towards attaining the target goals outlined by Healthy People 2010. This paper documents health behaviors related to diet, nutrition and physical activity of African Americans living in the Midwest, compares their health outcomes to the targeted Healthy People 2010 goals, and determines whether the designed intervention improved their health behaviors. [ABSTRACT FROM AUTHOR]

The earliest sickness survey of the US Public Health Service, which started in 1915, was the Service's first socioeconomic study of an industrial community. It was also the first to define illness as a person's inability to work. The survey incorporated the Metropolitan Life Insurance Company's definition of illness, which, instead of sickness rates, focused on duration of illness as a proxy of time lost from work. This kind of survey took place in the broader context of the reform movements of the Progressive Era and the social surveys conducted in the United States, which led to the creation of the Federal Commission on Industrial Relations, where the Service's sickness survey originated. The Service's focus on the socioeconomic classification of families and definition of illness as the inability to work enabled it to show the strong link between poverty and illness among industrial workers. The leader of the survey, Edgar Sydenstricker, and the Metropolitan Life Insurance Company came up with new ways to measure the health of the population, which also influenced the Service's studies of the effects of the Great Depression on public health and the National Health Survey of 1935–1936. (Am J Public Health. 2021; 111(11):1960–1968. https://doi.org/10.2105/AJPH.2021.306454) [ABSTRACT FROM AUTHOR]

Background: Diet, as a modifiable factor, plays an important role in cognitive function. However, the association between adherence to the 2015-2020 Dietary Guidelines for Americans (DGA), measured by Healthy Eating Index (HEI)-2015, and cognitive function remains unclear. This study aims to explore whether HEI-2015 is associated with various cognitive domains and whether such association is modified by age, gender, or ethnicity in the US adults aged 60 years or older using data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014.Methods: HEI-2015 scores were calculated from 24-h dietary recall interviews. Cognitive function was evaluated by Digit Symbol Substitution Test (DSST, a measure of processing speed), Animal Fluency Test (AFT, a measure of executive function), a subtest from Consortium to Establish a Registry for Alzheimer's disease (CERAD, a measure of memory), and a composite-z score calculated by summing z scores of individual tests. The associations between HEI-2015 scores and cognitive performance were explored using multiple linear regression models.Results: A total of 2450 participants aged 60 years or older were included. Participants with higher HEI-2015 scores were more likely to have higher DSST, AFT as well as composite-z scores (P<0.05). Significant interaction effects were identified between HEI-2015 and ethnicity in specific cognitive domains (Pinteraction<0.05). Among HEI-2015 components, higher intakes of whole fruits and seafood and plant protein were associated with better cognitive performance (P<0.05).Conclusion: Higher adherence to DGA is associated with better cognitive performance, especially regarding processing speed and executive function among the US adults aged 60 years or older. [ABSTRACT FROM AUTHOR]

The present analysis examined sample attrition in a one-year longitudinal health survey that made use of telephone follow-up interviews (N = 1210). Overall, respondent attrition had little impact on the sociodemographic and health status characteristics of the sample at the final interview. However, certain subgroups were statistically less likely to participate in the follow-up interviews, including younger respondents, the non-employed, people from the lower socioeconomic groups, and those who initially rated their health as fair or poor. Reports of physical illness and disability obtained at the initial interview were unrelated to rates of sample attrition. [ABSTRACT FROM AUTHOR]

Data from the 1973 National Health Interview Survey, a probability sample of the United States population, are used to examine the relationship between Pap testing and four socioeconomic variables. It was found that women at highest risk of cervical cancer are least likely to have had Pap tests. The proportion of women who report never having had a Pap test is greater among Blacks, the poor, the elderly and nonmetropolitan residents. In particular, poor Black women in nonmetropolitan areas have extremely high proportions reporting no Pap test. However, high risk women are only slightly less likely to have visited a doctor in the two years preceding interview. These results surest that improvement in Pap test coverage among high risk women could be attained by encouraging the use of the Pap test in regular ambulatory medical care. [ABSTRACT FROM AUTHOR]

The article provides information on the estimation on demand for food safety regulation in the U.S. The primary purpose of the food safety regulation is to help people avoid food-borne illnesses and mortality risk. A survey is conducted to examine the generated estimate of food security demand among the public. It also reviews people's values to be comparatively sensitive to change such as severity, illness lenght and mortality risk. The survery discovers that the households with children are less sensitive to change compared from household without children. The survey concludes that self-protection and risk management is the two main components of effective and more efficient food safety policy.

Background and aims: The long‐term population health impact of nicotine vaping products (NVPs) use among smokers is unknown, and subject to a range of plausible assumptions about the use and health consequences of NVPs. While NVPs use may substitute for cigarette smoking and thereby aid in quitting cigarette use, it is also possible that smokers who would have otherwise quit would instead delay quitting cigarettes. We aimed to develop a cohort‐specific simulation model of the impact of NVPs on smoking cessation by adult smokers and resulting premature deaths (PD) and life years lost (LYL). Design A cohort‐specific simulation model of the impact of NVPs on smoking cessation by adult smokers and resulting premature deaths (PD) and life years lost (LYL) was developed by gender for two birth cohorts, aged 30 and 50 years in 2012. Extensive sensitivity analyses were conducted. Setting: United States. Participants: Smokers in two birth cohorts, aged 30 and 50 years in 2012. Measurements Data were from the 1965–2012 National Health Interview Surveys and the 2014/15 Tobacco Use Supplement of the Current Population Survey. The model incorporated a range of plausible assumptions from published literature about transition rates from regular smoking to exclusive NVP and dual use, from dual use to exclusive NVP use and from exclusive NVP use to no use. Findings Compared with the no‐NVP scenario, the male (female) model projected 17.8% (19.3%) fewer PDs and 22.9% (26.6%) fewer LYL for the 1982 cohort and 5.4% (7.3%) fewer PDs and 7.9% (11.4%) fewer LYL for the 1962 cohort. These gains were sensitive to NVP use over time, age of initial NVP use, transitions from smoking to dual, exclusive NVP and no use and relative NVP mortality risks. Conclusions: Nicotine vaping product (NVP) use in the United States is projected to have a net positive impact on population health over a wide range of plausible levels of NVP use, transitions to dual, exclusive NVP and no use and NVP risks. However, net impact is sensitive to parameter estimates. [ABSTRACT FROM AUTHOR]

Background: The 2003 Bureau of Labor Statistics American Time Use Survey (ATUS) contains 438 distinct primary activity variables that can be analyzed with regard to how time is spent by Americans. The Compendium of Physical Activities is used to code physical activities derived from various surveys, logs, diaries, etc to facilitate comparison of coded intensity levels across studies. Methods: This article describes the methods, challenges, and rationale for linking Compendium estimates of physical activity intensity (METs, metabolic equivalents) with all activities reported in the 2003 ATUS. Results: The assigned ATUS intensity levels are not intended to compute the energy costs of physical activity in individuals. Instead, they are intended to be used to identify time spent in activities broadly classified by type and intensity. This function will complement public health surveillance systems and aid in policy and health-promotion activities. For example, at least one of the future projects of this process is the descriptive epidemiology of time spent in common physical activity intensity categories. Conclusions: The process of metabolic coding of the ATUS by linking it with the Compendium of Physical Activities can make important contributions to our understanding of American's time spent in health-related physical activity. [ABSTRACT FROM AUTHOR]

Postneonatal mortality among neonatal survivors and the distribution of age at death among infant deaths were examined for births occurring in upstate New York, 1968-1979. Postneonatal mortality rates increased among infants weighing 501-1500 grams. Infants weighing 1501- 2000 grams experienced an increase in postneonatal mortality during the mid-1970s later returning to the level of 1968. Among infants 2001-- grams. postneonatal mortality declined throughout the study period. Among all levels of birthweight, the proportion of infant deaths occurring as postneonatal deaths increased. [ABSTRACT FROM AUTHOR]

The author reflects on election polls and public health research in relation to the 2016 U.S. presidential election and voters' selection of American businessman Donald Trump as the 45th president of the U.S. The author's views about American presidential candidate Hillary Clinton, who lost to Trump in 2016, are examined, including her inability to reach population subgroups in Wisconsin and other parts of the U.S. Public health interventions and surveys are also assessed.

Commentary to: A framework for evaluating the public health impact of e-cigarettes and other vaporized nicotine products [ABSTRACT FROM AUTHOR]

Purpose: Summarizing patient-reported outcomes (PROs) on a quality-adjusted life year (QALY) scale is an essential component to any economic evaluation comparing alternative medical treatments. While multiple studies have compared PRO items and instruments based on their psychometric properties, no study has compared the preference-based summary of the EQ-5D-3L and Patient Reported Outcomes Measurement Information System (PROMIS-29) instruments. As part of this comparison, a major aim of this manuscript is to transform PROMIS-29 utility values to an EQ-5D-3L scale.Methods: A nationally representative survey of 2623 US adults completed the 29-item PROMIS health profile instrument (PROMIS-29) and the 3-level version of the EQ-5D instrument (EQ-5D-3L). Their responses were summarized on a health utility scale using published estimates. Using regression analysis, PROMIS-29 and EQ-5D-3L utility weights were compared with each other as well as with self-reported general health.Results: PROMIS-29 utility weights were much lower than the EQ-5D-3L weights. However, a correlation coefficient of 0.769 between the utility values of the two instruments suggests that the main discordance is simply a difference in scale between the measures. It is also possible to map PROMIS-29 utility weights onto an EQ-5D-3L scale. EQ-5D-3L losses equal .1784 × (PROMIS-29 Losses).7286.Conclusions: The published estimates of the PROMIS-29 produce lower utility values than many other health instruments. Mapping the PROMIS-29 estimates to an EQ-5D-3L scale alleviates this issue and allows for a more straightforward comparison between the PROMIS-29 and other common health instruments. [ABSTRACT FROM AUTHOR]

Purpose: To assess the equivalence of self-reports of physical functioning between pediatric respondents to the English- and Spanish-language patient-reported outcomes measurement information system (PROMIS®) physical functioning item banks.Methods: The PROMIS pediatric physical functioning item banks include 29 upper extremity items and 23 mobility items. A sample of 5091 children and adolescents (mean age = 12 years, range 8-17; 49% male) completed the English-language version of the items. A sample of 605 children and adolescents (mean age = 12 years, range 8-17; 55% male; 96% Hispanic) completed the Spanish-language version of the items.Results: We found language (English versus Spanish) differential item functioning (DIF) for 4 upper extremity items and 7 mobility items. Product-moment correlations between estimated upper extremity and mobility scores using the English versus the equated Spanish item parameters for Spanish-language respondents were 0.98 and 0.99, respectively. After excluding cases with significant person misfit, we found DIF for the same 4 upper extremity items that had DIF in the full sample and for 12 mobility items (including the same 7 mobility items that had DIF in the full sample). The identification of DIF items between English- and Spanish-language respondents was affected slightly by excluding respondents displaying person misfit.Conclusions: The results of this study provide support for measurement equivalence of self-reports of physical functioning by children and adolescents who completed the English- and Spanish-language surveys. Future analyses are needed to replicate the results of this study in other samples. [ABSTRACT FROM AUTHOR]

Comparability of population surveys across countries is key to appraising trends in population health. Achieving this requires deep understanding of the methods used in these surveys to examine the extent to which the measurements are comparable. In this study, we obtained detailed protocols of 8 nationally representative surveys from 2007-2013 from Brazil, Chile, Colombia, Mexico, the United Kingdom(England and Scotland), and the United States--countries that that differ in economic and inequity indicators. Data were collected on sampling frame, sample selection procedures, recruitment, data collection methods, content of interview and examination modules, and measurement protocols. We also assessed their adherence to the World Health Organization's "STEPwise Approach to Surveillance" framework for population health surveys. The surveys, which included half a million participants, were highly comparable on sampling methodology, survey questions, and anthropometric measurements. Heterogeneity was found for physical activity questionnaires and biological samples collection. The common age range included by the surveys was adults aged 18--64 years. The methods used in these surveys were similar enough to enable comparative analyses of the data across the 7 countries. This comparability is crucial in assessing and comparing national and subgroup population health, and to assisting the transfer of research and policy knowledge across countries. [ABSTRACT FROM AUTHOR]

Empirical research on naturalistic hearing voices movement groups (HVG) has been limited to date. In an effort to better understand facilitator perspectives and variations in the structure of groups in the USA, we conducted a facilitator-led national survey of HVG facilitators. The survey included both close-ended and open-ended questions and was available online for 1 year. Participants were asked about the structure and composition of their groups, their perspectives on membership, clinician involvement, facilitator training and perceived impact of group participation on members. Thirty-two facilitators participated. The results underscore the diversity of HVG in the USA. The authors highlight three findings of interest: (1) participants’ disagreements or uncertainty regarding a narrower HVG focus on experiences that would traditionally be described as “sensory hallucinations” versus a broader subset of extreme or unusual experiences (including “beliefs”); (2) tensions regarding HVG collaboration with clinicians; and (3) insights into impact. [ABSTRACT FROM PUBLISHER]

Introduction: Falls are the leading cause of unintentional injuries in the U.S.; however, national estimates for all community-dwelling adults are lacking. This study estimated the national incidence of falls and fall-related injuries among community-dwelling U.S. adults by age and gender and the trends in fall-related injuries across the adult life span. Methods: Nationally representative data from the National Health Interview Survey (NHIS) 2008 Balance and Dizziness supplement was used to develop national estimates of falls, and pooled data from the NHIS was used to calculate estimates of fall-related injuries in the U.S. and related trends from 2004–2013. Costs of unintentional fall-related injuries were extracted from the CDC’s Web-based Injury Statistics Query and Reporting System. Results: Twelve percent of community-dwelling U.S. adults reported falling in the previous year for a total estimate of 80 million falls at a rate of 37.2 falls per 100 person-years. On average, 9.9 million fall-related injuries occurred each year with a rate of 4.38 fall-related injuries per 100 person-years. In the previous three months, 2.0% of older adults (65+), 1.1% of middle-aged adults (45–64) and 0.7% of young adults (18–44) reported a fall-related injury. Of all fall-related injuries among community-dwelling adults, 32.3% occurred among older adults, 35.3% among middle-aged adults and 32.3% among younger adults. The age-adjusted rate of fall-related injuries increased 4% per year among older women (95% CI 1%–7%) from 2004 to 2013. Among U.S. adults, the total lifetime cost of annual unintentional fall-related injuries that resulted in a fatality, hospitalization or treatment in an emergency department was 111 billion U.S. dollars in 2010. Conclusions: Falls and fall-related injuries represent a significant health and safety problem for adults of all ages. The findings suggest that adult fall prevention efforts should consider the entire adult lifespan to ensure a greater public health benefit. [ABSTRACT FROM AUTHOR]

The article analyzes the findings of the 2011-2014 National Youth Tobacco Surveys (NYTS). It notes that e-cigarettes became the most popular tobacco product used by 3.9 percent of middle school students and 13.4 percent of high school students in the U.S. The NYTS also showed that 24.6 percent of high school students used a tobacco product, with 12.7 percent of these confirming their use of two or more kinds of tobacco products.

Objective: Reported associations between socioeconomic status (SES) and obesity are inconsistent depending on gender and geographic location. Globally, these inconsistent observations may hide a variation in the contextual effect on individuals' risk of obesity for subgroups of the population. This study explored the regional variability in the association between SES and BMI in the USA and in Canada, and describes the geographical variance patterns by SES category. Methods: The 2009–2010 samples of the Behavioral Risk Factor Surveillance System (BRFSS) and the Canadian Community Health Survey (CCHS) were used for this comparison study. Three-level random intercept and differential variance multilevel models were built separately for women and men to assess region-specific BMI by SES category and their variance bounds. Results: Associations between individual SES and BMI differed importantly by gender and countries. At the regional-level, the mean BMI variation was significantly different between SES categories in the USA, but not in Canada. In the USA, whereas the county-specific mean BMI of higher SES individuals remained close to the mean, its variation grown as SES decreased. At the county level, variation of mean BMI around the regional mean was 5 kg/m2 in the high SES group, and reached 8.8 kg/m2 in the low SES group. Conclusions: This study underlines how BMI varies by country, region, gender and SES. Lower socioeconomic groups within some regions show a much higher variation in BMI than in other regions. Above the BMI regional mean, important variation patterns of BMI by SES and place of residence were found in the USA. No such pattern was found in Canada. This study suggests that a change in the mean does not necessarily reflect the change in the variance. Analyzing the variance by SES may be a good way to detect subtle influences of social forces underlying social inequalities. [ABSTRACT FROM AUTHOR]

Purpose: Surgical conditions represent a significant source of global disease burden. Little is known about the epidemiology of inguinal hernia in resource-poor settings. We present a method to estimate inguinal hernia disease burden in Tanzania. Methods: Using data from the United States National Health and Nutrition Examination Survey (NHANES) prospective cohort study and Tanzanian demographic figures, we calculated inguinal hernia incidence and prevalence in Tanzanian adults under three surgical rate scenarios. Gender-specific incidence figures from NHANES data were adjusted according to Tanzanian population age structure. Hernia duration was adjusted for Tanzanian life expectancy within each age group. Results: The prevalence of inguinal hernia in Tanzanian adults is 5.36 % while an estimated 12.09 % of men had hernias. Today, 683,904 adults suffer from symptomatic inguinal hernia in Tanzania. The annual incidence of symptomatic hernias in Tanzanian adults is 163 per 100,000 population. At Tanzania's current hernia repair rate, a backlog of 995,874 hernias in need of repair will develop over 10 years. 4.4 million disability-adjusted life-years would be averted with repair of prevalent symptomatic hernias in Tanzania. Conclusions: Our data indicate the extent of inguinal hernia disease burden in Tanzania. By adjusting our figures for the age structure of Tanzania, we have demonstrated that while the incidence of symptomatic cases may be lower than previously thought, prevalence of inguinal hernia in Tanzania remains high. This approach provides an update to our previously described methodology for calculation of inguinal hernia epidemiology in resource-poor settings that may be used in multiple country contexts. [ABSTRACT FROM AUTHOR]

Background: Previous studies have demonstrated gaps in achievement of low-density lipoprotein-cholesterol (LDL-C) goals among U.S. individuals at high cardiovascular disease risk; however, recent studies in selected populations indicate improvements. Objective: We sought to define the longitudinal trends in achieving LDL-C goals among high-risk United States adults from 1999–2008. Methods We analyzed five sequential population-based cross-sectional National Health and Nutrition Examination Surveys 1999–2008, which included 18,656 participants aged 20–79 years. We calculated rates of LDL-C goal achievement and treatment in the high-risk population. Results: The prevalence of high-risk individuals increased from 13% to 15.5% (p = 0.046). Achievement of LDL-C <100 mg/dL increased from 24% to 50.4% (p<0.0001) in the high-risk population with similar findings in subgroups with (27% to 64.8% p<0.0001) and without (21.8% to 43.7%, p<0.0001) coronary heart disease (CHD). Achievement of LDL-C <70 mg/dL improved from 2.4% to 17% (p<0.0001) in high-risk individuals and subgroups with (3.4% to 21.4%, p<0.0001) and without (1.7% to 14.9%, p<0.0001) CHD. The proportion with LDL-C ≥130 mg/dL and not on lipid medications decreased from 29.4% to 18% (p = 0.0002), with similar findings among CHD (25% to 11.9% p = 0.0013) and non-CHD (35.8% to 20.8% p<0.0001) subgroups. Conclusion: The proportions of the U.S. high-risk population achieving LDL-C <100 mg/dL and <70 mg/dL increased over the last decade. With 65% of the CHD subpopulation achieving an LDL-C <100 mg/dL in the most recent survey, U.S. LDL-C goal achievement exceeds previous reports and approximates rates achieved in highly selected patient cohorts. [ABSTRACT FROM AUTHOR]

Objectives: Smoking among migrants is known to differ from the host population, but migrants’ smoking is rarely ever compared to the prevalence of smoking in their country of origin. The goal of this study is to compare the smoking prevalence among migrants to that of both the US-born population and the countries of origin. Further analyses assess the influence of sex, age at time of entry to the US and education level. Methods: Data of 248,726 US-born and migrants from 14 countries were obtained from the Tobacco Use Supplement to the Current Population Survey (TUS-CPS) from 2006–2007. Data on 108,653 respondents from the corresponding countries of origin were taken from the World Health Survey (WHS) from 2002–2005. Results: The prevalence of smoking among migrants (men: 14.2%, women: 4.1%) was lower than both the US-born group (men: 21.4%, women: 18.1%) and countries of origin (men: 39.4%, women: 11.0%). The gender gap among migrants was smaller than in the countries of origin. Age at time of entry to the US was not related to smoking prevalence for migrants. The risk of smoking for high-educated migrants was closer to their US counterparts. Conclusions: The smoking prevalence among migrants is consistently lower than both the country of origin levels and the US level. The theory of segmented assimilation is supported by some results of this study, but not all. Other mechanisms that might influence the smoking prevalence among migrants are the ‘healthy migrant effect’ or the stage of the smoking epidemic at the time of migration. [ABSTRACT FROM AUTHOR]

Background and Aims: Anecdotal reports and studies of select populations suggest that the use of proton pump inhibitors (PPIs) has increased since their introduction. We sought to determine recent trends in PPI use in the U.S. outpatient setting and characteristics of patients and physicians that may predict their use. Methods: We used data from the National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS) to estimate the prevalence of visits in which patients used PPIs from 2002 to 2009. We tested for associations between PPI use and patient, physician, and practice characteristics using data from 2009. We also estimated the prevalence of visits in which PPIs were used by patients without gastrointestinal complaints, diagnoses, or other indications for their use and tested for associations between patient and physician characteristics and PPI use in patients with no documented indication. Results: PPIs were used in 4.0% of visits in 2002 and 9.2% in 2009 (p<0.001 for trend across years). The use of omeprazole (0.9% in 2002 to 3.9% in 2009, p<0.001), esomeprazole (0.9% in 2002 to 2.3% in 2009, p<0.001), and pantoprazole (0.6% in 2002 to 1.6% in 2009, p<0.001) increased significantly over the study period. Among visits by patients using PPIs, 62.9% documented no gastrointestinal complaints, gastrointestinal diagnoses, or other indicated reason for their use. Conclusions: We found that PPI use increased significantly from 2002 to 2009 as did documented indications for their use. Newly-prescribed PPI use did not change from 2006 to 2009. More research is needed to determine whether PPIs are overused in the U.S. outpatient setting. [ABSTRACT FROM AUTHOR]

The article discusses the evolution and challenges of public health surveillance in the U.S. Topics discussed include the use of public health surveillance in health problems and epidemics detection, the role of surveillance data in the demographic and geographic distribution of health events that can be used to facilitate public health planning, and the impact of information sciences dissemination and data system proliferation on public health surveillance.

Background: There is mounting evidence that discriminatory experiences can harm health. However, previous research has mainly focused on the health effects of racial discrimination in U.S. or European countries although there is pervasive discrimination by gender, age, education and other factors in Asian countries. Methods: We analyzed the data from the 7th wave of Korean Labor and Income Panel Study to investigate the association between perceived discriminatory experience and poor self-rated health in South Korea. Perceived discriminatory experiences were measured in eight situations through a modified Experience of Discrimination questionnaire. In each of eight situations, the lifetime prevalence of perceived discriminatory experience was compared between men and women and the main causes of those experiences were identified separately by gender. After adjusting for potential confounders, we examined the association between perceived discriminatory experience and poor self-rated health in each of eight social situations and also checked the association using the number of situations of perceived discriminatory experiences. Results: For both men and women, education level and age were the main sources of work-related perceived discriminatory experiences. Gender was one of the main causes among women across eight situations and more than 90% of women reported their gender as a main cause of discriminatory experience in getting higher education and at home. Discriminatory experiences in four situations were positively associated with poor self-rated health. The odds ratio for poor self-rated health for those exposed to one, two, three or four or more social situations of perceived discrimination were respectively 1.06 (95% CI : 0.87-1.29), 1.15 (95% CI : 0.96-1.55), 1.59 (95% CI : 1.19-2.14), and 1.78 (95% CI :1.26-2.51). Conclusion: There is consistent association between perceived discriminatory experience and poor self-rated health across eight social situations in South Korea. [ABSTRACT FROM AUTHOR]

Background: Ideally, the distribution of research funding for different types of cancer should be equitable with respect to the societal burden each type of cancer imposes. These burdens can be estimated in a variety of ways; "Years of Life Lost" (YLL) measures the severity of death in regard to the age it occurs, "Disability-Adjusted Life-Years" (DALY) estimates the effects of non-lethal disabilities incurred by disease and economic metrics focus on the losses to tax revenue, productivity or direct medical expenses. We compared research funding from the National Cancer Institute (NCI) to a variety of burden metrics for the most common types of cancer to identify mismatches between spending and societal burden. Methods: Research funding levels were obtained from the NCI website and information for societal health and economic burdens were collected from government databases and published reports. We calculated the funding levels per unit burden for a wide range of different cancers and burden metrics and compared these values to identify discrepancies. Results: Our analysis reveals a considerable mismatch between funding levels and burden. Some cancers are funded at levels far higher than their relative burden suggests (breast cancer, prostate cancer, and leukemia) while other cancers appear underfunded (bladder, esophageal, liver, oral, pancreatic, stomach, and uterine cancers). Conclusions: These discrepancies indicate that an improved method of health care research funding allocation should be investigated to better match funding levels to societal burden. [ABSTRACT FROM AUTHOR]

ObjectiveTo develop a method to validate an FFQ for reported intake of episodically consumed foods when the reference instrument measures short-term intake, and to apply the method in a large prospective cohort.DesignThe FFQ was evaluated in a sub-study of cohort participants who, in addition to the questionnaire, were asked to complete two non-consecutive 24 h dietary recalls (24HR). FFQ-reported intakes of twenty-nine food groups were analysed using a two-part measurement error model that allows for non-consumption on a given day, using 24HR as a reference instrument under the assumption that 24HR is unbiased for true intake at the individual level.SettingThe National Institutes of Health–AARP Diet and Health Study, a cohort of 567 169 participants living in the USA and aged 50–71 years at baseline in 1995.SubjectsA sub-study of the cohort consisting of 2055 participants.ResultsEstimated correlations of true and FFQ-reported energy-adjusted intakes were 0·5 or greater for most of the twenty-nine food groups evaluated, and estimated attenuation factors (a measure of bias in estimated diet–disease associations) were 0·4 or greater for most food groups.ConclusionsThe proposed methodology extends the class of foods and nutrients for which an FFQ can be evaluated in studies with short-term reference instruments. Although violations of the assumption that the 24HR is unbiased could be inflating some of the observed correlations and attenuation factors, results suggest that the FFQ is suitable for testing many, but not all, diet–disease hypotheses in a cohort of this size. [ABSTRACT FROM AUTHOR]

ObjectiveTo assess convergent validity, factorial validity, test–retest reliability and internal consistency of a diet quality food behaviour checklist (FBC) for low-literate, low-income Spanish speakers.DesignParticipants (n 90) completed three dietary recalls, the Spanish-language version of the US Department of Agriculture (USDA) Household Food Security Survey Module (HFSSM) and the Spanish-language FBC. Factor structure was examined using principal component analysis. Spearman correlation coefficients between FBC item responses and nutrient intakes from 24 h recalls were used to estimate convergent validity. Correlation coefficients were also calculated between FBC item responses at two time points in another group of participants (n 71) to examine test–retest reliability. Cronbach's α coefficient was determined for items within each sub-scale.SettingNon-profit community agencies serving low-income clients, migrant farm worker camps and low-income housing sites in four California counties.SubjectsSpanish-speaking women (n 161) who met income eligibility for the SNAP-Ed (Supplemental Nutrition Assistance Program–Education).ResultsFactor analysis resulted in six sub-scales. Responses to nineteen food behaviour items were significantly correlated with hypothesized 24 h recall data (with a maximum correlation of 0·44 for drinking milk and calcium) or the USDA HFSSM (0·42 with the food security item). Coefficients for test–retest reliability ranged from 0·35 to 0·79. Cronbach's α ranged from 0·49 for the diet quality sub-scale to 0·80 for the fruit and vegetable sub-scale.ConclusionsThe twenty-two-item FBC and instruction guide will be used to evaluate USDA community nutrition education interventions with low-literate Spanish speakers. This research contributes to the body of knowledge about this at-risk population in California. [ABSTRACT FROM AUTHOR]

The U.S. National Health Interview Survey (NHIS) is the world's longest survey time series of health data and a rich source of information on health conditions, behaviors, and care from the 1960s to the present. NHIS public-use files are difficult to use for long-term analysis, due to complex file structure, changes in questionnaire content, and evolving variable names and coding schemes. Researchers at the Minnesota Population Center have created the Integrated Health Interview Series (IHIS) to overcome these problems. IHIS provides access to thousands of consistently coded and well-documented NHIS variables on the Internet and makes it easy to analyze health trends and differentials. IHIS multiplies the value of NHIS data by allowing researchers to make consistent comparisons over half a century and thus to study U.S. health status as a dynamic process. This article describes the main features of IHIS and suggests fruitful avenues for historical research using these invaluable health data. [ABSTRACT FROM AUTHOR]