National Interview Survey Research Articles

Measured vs self-reported overweight/obesity in the Italian adult population: CUORE Project 2018-19

Abstract Background In monitoring population health and the effectiveness of public health strategies, the body mass index (BMI) is often assessed within national surveys from self-reported height and weight rather than measured values. Using data collected within a recent health examination survey (HES), the discrepancies between self-reported and measured values were assessed, and correction models were estimated and implemented on national interview survey data. Methods Within the CUORE Project, the Italian National Institute of Health conducted the HES 2018-2019 measuring height and weight as well as collecting data on self-reported values in random samples of general population aged 35-74 years residing in ten (of 20) Italian regions distributed in the North, Centre and South: 1033 men and 1061 women. Results Self-reported and measured data comparison showed greater differences in mean values of height than weight and in women than in men (height +2 cm in men and +3.2 in women; weight -0.7 kg and -1.4 kg, respectively) and a corresponding underestimation of BMI (-0.7 kg/m2 and -1.4 kg/m2, respectively). Differences were stable across age groups and educational levels, except for height discrepancy, which was greatest in women aged 65-74 years. Self-reported vs measured prevalence were: normal weight 39.7%-33.3% in men and 54.8%-44.7% in women, overweight 45.8%-46.1% and 26.0%-29.2%, obesity 13.8%-20.1% and 15.7%-23.9%. Linear regression models adjusted by sex and age classes were assessed for height and weight (R2 > =0.92) and implemented to estimate adjusted BMI and normal weight/overweight/obesity prevalence on the national multi-purpose interview survey data collected by the Italian National Institute of Statistics. Conclusions To provide more accurate prevalence of normal weight, overweight and obesity, self-reported values could be adjusted using correction models developed on the basis of the relationship between self-reported and measured height and weight values. Key messages • Discrepancies between self-reported and measured values of height and weoght were found. • Self-reported values could be adjusted using correction models developed on the basis of the relationship between self-reported and measured height and weight values.

Trends in short sleep duration in the National Health and Interview Survey 2004-2018: A Decomposition Analysis

Abstract Since the early 2000s, it is increasingly common that people have short sleep durations (<=6 per 24-hour), making this a high-prevalence public health issue, especially among Black individuals. We investigate how trends in short sleep duration are influenced by changes in population aging, socioeconomic factors (e.g., education, labor force participation, marital status), and health conditions and behaviors (e.g., pain, smoking, drinking, obesity, psychological distress). We use the pooled cross-sectional data from the 2004-2018 National Health and Interview Survey, a large and nationally representative study. We partition overall trends in short sleep duration into (a) compositional effects due to distributional changes in age structure, socioeconomic and health factors and (b) unexplained rate effects. Subsequently, we compare the relative contribution of each factor to the total compositional effects among Black and White participants. Results demonstrate that greater education is associated with greater prevalence of short sleep duration among Black Americans, but reduced prevalence among White Americans. For both racial groups, population aging contributes relatively little to temporal patterns in short sleep duration; by contrast, higher distress and lower labor force participation in recent years are associated with the increasing prevalence of short sleep duration.

Birth Cohort Trends in Health Disparities by Sexual Orientation.

Lesbian, gay, and bisexual-identified (LGB) people experience worse mental and physical health than their straight-identified counterparts. Given remarkable social and legal changes regarding LGB status in recent decades, we theorize that this profound health disadvantage may be changing across cohorts. Using data from the 2013–2018 National Health and Interview Surveys, we analyze five mental and physical health outcomes—psychological distress, depression, anxiety, self-rated physical health, and activity limitation—across three birth cohorts colloquially known as (1) Millennials, (2) Generation Xers, and (3) Baby Boomers and pre-Boomers. We find no evidence of reduced health disparities by sexual orientation across cohorts. Instead, relative to straight-identified respondents, the health disadvantages of gay, lesbian, and—most strikingly—bisexual-identified people have increased across cohorts. Findings highlight the importance of identifying the causes of increased health disparities as well as designing and implementing more direct public policies and programs to eliminate health disparities among more recent LGB cohorts.

Two sides, but not of the same coin: digitalization, productivity and unemployment

PurposeThis paper aims to examine how input from the digital restructuring of the workplace and productivity affects the risk of job loss and unemployment.Design/methodology/approachRelying on the concepts of technological unemployment and the productivity paradox as well as the theory of skills-biased technological change, the analysis incorporated micro-level individual determinants of job loss, macro-level economic determinants of input and the contribution from traditional (machinery and equipment) vs innovative (ICT) factors of production. The model has been also controlled for “traditional” indicators of “outsiderness” in the labour market. The Quality of Work Life Survey, which is a broad-based national interview survey produced by Statistics Finland, for 2018, the latest year available (N = 4,110) has been used in the analysis. Binomial logistic regression has been applied in order to estimate the effects of individual- and macro-level factors on the risk of job loss.FindingsThe results support arguments for the divergence between effects from labour- vs total-factor productivity on the risks of job loss, as well as the divergence between effects for temporary (layoff) vs permanent job loss (dismissal or unemployment). While the contribution from “traditional” factors of production to labour productivity potentially decreases the risk of permanent job loss, input from “innovative” factors of production on total-factor productivity potentially causes adverse effects (e.g. growing risks of permanent job loss).Originality/valueThe paper contributes to the theoretical discussion about technological unemployment and productivity by means of including two different concepts into a single econometric model, thus enabling examination of the research problem in an innovative way.

Falls and fear of falling among Israeli community-dwelling older people: a cross-sectional national survey

BackgroundFalls and fear of falling are a major problem for older people and a leading cause of functional decline and institutionalization. There is limited data on the prevalence of falls in a 12-month period among Israeli older adults. Our main objective was to evaluate the prevalence of falls among Israeli community-dwelling older people aged ≥65 years and to identify factors associated with falls and fear of falling.MethodsA national cross-sectional interview survey was conducted between February 2018 and April 2019 by the Israeli Center for Disease Control. The prevalence of falls was assessed by asking participants about falling within the 12 months prior to the survey. Fear of falling was assessed by asking participants about the fear of future falls. Multivariate analysis was used to identify factors associated with falls and with fear of falling.ResultsFrom 5281 households that were eligible for inclusion in this study, 3242 participants (61.4%) completed the survey. Falling at least once in the past year was reported by 23.8% of the respondents and fear of falling by 48.2%. The majority of the participants (91.1%) reported that they had never received any instruction about fall prevention from their medical care provider. In the multivariate analysis, falls and fear of falling were each a risk factor for the other; and were also significantly associated with female gender, major functional difficulties, the use of walking aids, cardiac disease, diabetes mellitus and psychotropic medications.ConclusionThe prevalence of falls and fear of falling among Israeli community-dwelling older people is comparable to the rates published in other countries. Efforts should be made to increase awareness about falls and their health consequences among older people. The development of specific interventions to target those at higher risk for falls and fear of falling is strongly recommended.

The challenge of defining chronic illness for health monitoring in children: opening a can of worms

Abstract Background A straightforward health monitoring definition of chronic illness in children would have great utility for estimation of health care and social service needs as well as resource allocation. Methods This study analyses various definitions of chronic illness in children and adolescents in cross-sectional national health surveys in Germany based on: the Children with Special Health Care Needs (CSHCN) 14-item-questionnaire, a list of 15 self-reported medical diagnoses in the past 12 months, and a generic single-question parent-reported chronic condition from the Minimum European Health Module (MEHM), also used in EU-SILC and EHIS surveys. Results 13.7% (95% CI 13.0-14.4) of children and adolescents aged 0-17 years had special health care needs in the first National Interview and Examination Survey in Children and Adolescents in Germany KiGGS 2003-2006. However, surprisingly, the prevalence was less than half in children with a migration background and was not associated with social status or income. The list of diagnoses identified a very high proportion of 31.5 (30.7-32.4) of children aged 0-17 years as chronically ill but does not take into account disease severity or impact. The generic MEHM-question in the KiGGS 2009-2012 survey identified 16.2% (15.3-17.1) of 0- to 17-year-olds as chronically ill, however, only one in five was affected in their daily activities. Parents denied chronic illness in 11.2% of children with epilepsy, 18.8% of children with asthma and 62.8% of children with attention deficit hyperactivity disorder. Conclusions None of the three definitions of chronically ill children is entirely satisfactory so far: CSHCN may need an adaptation of the German version to better capture inequalities, the disease list needs further severity differentiation and MEHM has recently shown low test-retest reliability (kappa 0.56) when administered twice within 6 months in a large Belgian sample and may need revisiting as well.

Alcohol use among older adults and health care utilization

Objective Examinations of the association between health care utilization and levels of alcohol use are lacking in nationally representative samples of older adults. The present study set out to fill this gap by demonstrating how various aspects of health care utilization are associated with alcohol use among older adults in the United States. Method Cross-sectional panel data from 11 years of the National Health and Interview Survey were used to examine prevalence and rates of alcohol use among older adults (n = 106,511) and associations with demographic variables and recency of health care use, health care office visits, and use of emergency room/emergency department. Results About 70% of older adults (aged 65+; mean age = 74.1, SD = 0.04) had drunk alcohol in their lifetime, and 15.8% were current moderate or heavy drinkers. Results of an adjusted multinomial logistic regression revealed that individuals with any lifetime alcohol use had more recent health care visits and more office visits (but not current heavy users) than lifetime abstainers. Former alcohol users had more ER/ED visits but current moderate users at all levels had fewer ER/ED visits than lifetime abstainers, controlling for sex, race, educational attainment, marital status, and concurrent tobacco use. Conclusion Older adults who have any history of alcohol use are more likely than abstainers to have had recent health care visits, more office visits, (but not moderate or heavy users), and less likely to have had an emergency department visit.

The association between number of teeth and physical function limitation among older adults in the USA.

To examine the association between the number of teeth and physical function limitation (PFL), as an indicator of frailty, among older adults in the USA. Physical function limitation is common among the elderly and potentially associated with oral health, particularly the number of extracted teeth. Data from the Behavioral Risk Factor Surveillance System 2014 (BRFSS, 2014), a cross-sectional national interview survey of US population, were analyzed. The number of participating older adults aged 65 and over was 158962. The association between PFL, outcome and number of extracted teeth, demographic data, socio-economic status, smoking, general health, comorbidity conditions and body mass index (BMI) was assessed using logistic regression analyses. The prevalence of PFL was 28%. In the fully adjusted model, the number of extracted teeth had a significant association with PFL: edentulous older adults had higher odds for PFL, (odds ratio [OR]:1.36; 95%CI: 1.22, 1.52). Similarly, those who lost 6 teeth or more but not all were likely to have PFL (OR 1.35: 95% CI: 1.23, 1.48). There was a significant association between the number of extracted teeth and PFL among US older adults aged 65 and more, based on the data from BRFSS 2014. The findings indicate that losing teeth may be a potential risk for PFL.

What do parents and young people in England think about immunisation? A national interview survey

What do parents and young people in England think about immunisation? A national interview survey

What do parents and young people in England think about immunisation? A national interview survey

What do parents and young people in England think about immunisation? A national interview survey

Chronic neck pain and its relationship with stress symptoms: Regular physical exercise could be a protective factor?

Mental stress is usually associated with neck pain. Physical exercise is typically recommended to deal with stress and therefore, to relieve neck pain. We studied the relationship of these common variables. A national cross-sectional interview survey was carried out to the adult Peruvian population with a probabilistic sample on November 2016, through the market research institute GfK. Chronic neck pain was considered for those who referred pain in the neck, the nape and/or the upper shoulders at least once a week on average for the last 6 months. Mental stress was determined asking for eight common symptoms (headache/migraine, stomachache/heartburn, feeling tired, difficulty to sleep, irritability, nervousness, dizziness, and hands tremor - all without any reason or disease), and considered positive for those with 5 or more. Regular physical exercise was determined for those who responded making any sports activity two or more days a week on average, and the lack of it for those making it once a week or none. Odds ratio was calculated using multivariate simple logistic regression with IBM SPSS 20. A total of 1244 responded the survey. The OR between mental stress and chronic neck pain was 7.096, P > 0.000, adjusted for age, sex, socioeconomic status. The OR between the lack of regular physical exercise and neck pain was 0.978, P > 0.377 ( Table 1 ). The study confirms the usual belief about the strong association between chronic neck pain and mental stress but does not with the lack of regular physical exercise. We ought to consider the management of mental stress in the treatment of cervicalgia, but we should not recommend any sports activity to relieve it. Future studies may determine if specific exercises, such as aerobics or stretching, would be a protective factor.

Looking at the smartphone screen for a prolonged time is associated with chronic neck pain, specially in young adults

Never has a technology been so universally accepted as the smartphone. Of concern is the potential consequences of its prolonged use. Studies have conflictive results to find an association between them and musculoskeletal disorders. Looking at the small screen of these devices would be a crucial factor for bad neck posture, and therefore we studied if that would be related to chronic neck pain. A national cross-sectional interview survey was carried out to the adult Peruvian population with a probabilistic sample on February 2017, through the market research institute GfK. Chronic neck pain was considered for those who referred pain in the neck, the nape and/or the upper shoulders at least once a week on average for the last 6 months. Prolonged look at the smartphone's screen was defined for those who responded reading e-mails and news, watching photos or videos, or interacting with social networks for two or more hours a day on average. Odds ratios were calculated using multivariate simple logistic regression with IBM SPSS 20. A total of 1246 responded to the survey. The OR between chronic neck pain and prolonged look at the smartphone screen was 1.604, P > 0.01, and in the 18–24-yrs-old group was 3.078, P > 0.002. These results were adjusted for gender, socioeconomic status, mental stress and prolonged use of other computer devices (PC, laptop, tablet) (Table 1). We found an association between prolonged looking at the smartphone screen and chronic neck pain in the general population, being three times higher in young adults. The use of smartphones is not harmful per se, but it seems that the bad posture using them would be the critical factor. We recommend preventive health campaigns about proper posture when using these devices.

Patterns of vulnerability to non-fatal injuries in Sudan: initial evidence from a national cross-sectional survey

BackgroundSuccessful injury prevention requires identification and targeting of particularly vulnerable groups. Little is known about injury vulnerability patterns in Sudan. This paper aimed to fill this gap using survey data.MethodsData...

Misunderstandings, Mischaracterizations, and the Problematic Choice of a Specific Instance in Which the IE Should Never Be Applied

Misunderstandings, Mischaracterizations, and the Problematic Choice of a Specific Instance in Which the IE Should Never Be Applied

Kriterien für die Priorisierung medizinischer Leistungen im Licht eines regionalen Surveys – Ergebnisse und methodologische Fragen

In Germany, in contrast to many foreign countries, scientists and medical professionals have been discussing prioritisation in medicine almost without consulting German citizens. We address the question of what questionnaire surveys can contribute to the understanding of citizens' attitudes towards prioritisation - with a focus on some difficulties and challenges of the method. We conducted a postal survey with a random sample of 3 000 residents of the City of Lübeck (age ≥18). Respondents were asked to appraise different substantial and procedural criteria for prioritisation in medicine. In addition to descriptive statistical analyses, logistical regression models were performed to identify potential explanatory variables for the appraisal of prioritisation criteria. The response rate was 45.6% (N=1 363). Some prioritisation criteria are accepted by the majority: severity of disease, effectiveness of an intervention and a firm evidence base. Other criteria were appraised controversially: personal life-style, responsibility for family members and general prioritisation of children. A patient's responsibility in society and age as well as an intervention's cost-benefit ratio were generally rejected. The results of logistic regression analyses showed some significant but minor effects of demographic and health-related variables. The citizens in our study want decision-making procedures in health care to be transparent and equally applied to all patients. According to the survey respondents decisions about the catalogue of services of Germany's statutory health insurance should mainly be made by doctors. The statutory health insurance as well as patients and scientists also should take part in the decision-making procedure. Comparing our results to those of a national interview survey reveals some relevant differences: The respondents' assessment of some substantial criteria seems to vary according to the contextualisation and wording of the items. We found less difference - but still some inconsistent results - in the participants' appraisal of potential decision-makers in health care. To our surprise, the logistic regression models including standard demographic and health-related variables account for only a small proportion of the variance of all dependent variables. Our discussion emphasises some difficulties and challenges of questionnaire surveys on prioritisation criteria - reflecting on the state of the German debate on prioritisation. There has been hardly any public discussion on this issue prior to our survey in autumn 2009. It is thus unlikely that people have been able to state well-informed preferences. Instead they seem to have followed some kind of "social reflexes" depending on the context and wording of each item. Subsequent studies on preferences and priorities should (i) more closely assess the understanding of each item in advance and (ii) adapt the aims of their study and its methodology to the actual stage of the public discourse on the topic in question.

Re-examining the price sensitivity of demand for cigarettes with quantile regression

Existing studies suggest that teenagers, young adults, and individuals of low socioeconomic status are more sensitive to changes in cigarette prices. However, little is known as to whether there are differences in price sensitivity between heavy and light smokers. To examine this gap, the present study uses quantile regression to estimate price sensitivity of demand for smokers with different levels of tobacco consumption. We conducted a national personal interview survey in Taiwan and the results showed price sensitivity is positively associated with the level of cigarette consumption. The data indicate that pricing strategies are more likely to notably reduce cigarette consumption for heavy smokers. Our findings suggest policymakers can meet target control for cigarette consumption by effectively adjusting market prices of cigarettes.

Abstract WP204: Paradoxical Increase in Stroke Mortality Among Asian Indians in United States

Background and Purpose: Asian Indians are one of the largest groups of Asians living in the United States. Due to a paucity of data, we performed this study to better characterize the stroke mortality and risk factors among Asian Indians in the United States. Methods: Analysis of the U.S. multiple-cause-of-death files for 2004 to 2009 and National Health and Interview Survey (2004-2005 and 2009-2010) were analyzed. Age-adjusted fatal stroke incidence, stroke rate ratio with 95% confidence interval (CI), and average annual percentage change over 5 years were also calculated. Results: The annual incidence of fatal strokes was lowest among Asian Indians (194 per 100,000) followed by American Indians and Alaska Natives (207 per 100,000), Whites (282 per 100,000) and African Americans (362 per 100,000). Compared with Whites, the stroke rate ratio was 0.7(95% CI 0.5-0.8) for Asian Indians. Significantly lower rates of hypertension and cigarette smoking among Asian Indians in 2004-2005 (compared with whites) explained the lower rates of fatal stroke. The average annual percentage change over 5 years was 12.2%, -0.6%, -2.6%, and -2.6% Asian Indians, American Indians and Alaska Natives, Whites, and African Americans, respectively. The increase in stroke mortality among Asian Indians was observed despite lower rates of hypertension and cigarette smoking in 2009-2010. Conclusions: The paradoxical increase in stroke mortality among Asian Indians over the last 5 years (in contrast to other population subsets) is concerning. A better understanding of the predisposing factors for the observed increase is required through targeted efforts.

Self‐reported cost‐prohibitive dental care needs among Canadians

To explore self-reported cost-prohibitive dental treatment needs among Canadians. Data were collected through a national telephone interview survey of 1006 randomly selected Canadian adults. Descriptive analyses based on socio-demographic characteristics and dental-related behaviours were undertaken. Logistic regression was used to determine the predictors of experiencing a cost-prohibitive dental care need. Chi-square tests were used to determine significant differences in the treatments reported as unaffordable by socio-demographic characteristics and dental-related behaviours. Those of low income, no insurance coverage and poor self-rated oral health were more likely to report having a cost-prohibitive dental care need. The top needs reported as unaffordable were fillings, cleanings and check-ups. Comparatively, preventive services were selected as cost-prohibitive more often by the insured, dentures by the oldest group and extractions by those with a high school education or less. This study confirms that there are significant relationships between socio-demographic factors, dental-related behaviours and the types of dental services that are selected as unaffordable. Indirectly, this shows us how socio-demographic factors may influence the types of dental services that are reported as 'needed' by certain groups. Difficulties in distinguishing between the services that are 'needed' from and those that are 'wanted' demonstrate some of the policy complexity associated with publicly financed dental care.

P1-192 A small area analysis of injuries and related factors: 2009 community health survey, Korea

IntroductionAs the incidence and death rate of injury are relatively high in Korea, the public health concerns are now increasing. The aim of this study are (1) to describe the...

Disability days in Canada associated with dental problems: a pilot study

The aim of this study was to explore disability days, or bed days and cut-down days, associated with dental problems in Canada. Data were collected through a national telephone interview survey of 1005 Canadians aged 18 years and over using random digit dialling. Participants were asked to enumerate the number of disability days associated with dental problems in the previous 2-week period. Descriptive and bivariate logistic regression analyses were undertaken. In the previous 2-week period, 33 people, or 3.3% of the sample, reported spending a day in bed because of a dental problem. Of these, 22 people also reported having to cut down on their normal activity because of the dental problem. It appears that younger age groups, those with the lowest incomes, college educations, no dental insurance, oral pain and a history of visiting a hospital emergency room for a dental problem, were all more likely to report a dental disability day. These data demonstrate the potential economic impacts of dental problems in Canada, yet they must be interpreted with caution because of the very low prevalence of the main outcome measure, the potential for selection bias and the relative inconsistency with existing historical estimates.