Recent National Survey Data Research Articles

Complementary feeding practices in South Asia: analyses of recent national survey data by the South Asia Infant Feeding Research Network

South Asian region has the highest global burden of child undernutrition, with almost 41% of children stunted, 16% wasted and 33% underweight. Improved feeding of children less than 2 years of age is particularly important because they experience rapid growth and development, and are vulnerable to illnesses such as acute respiratory infections and diarrhoeal diseases. The present supplement aimed to describe complementary feeding practices in five South Asian countries - Bangladesh, India, Nepal, Pakistan and Sri Lanka - using the new and updated global complementary feeding indicators and to identify determinants of inappropriate complementary feeding practices. The South Asia Infant Feeding Research Network held a series of workshops to study and discuss the operational guidelines for the new complementary feeding indicators in consultation with regional and international experts. The latest Demographic and Health Surveys for Bangladesh, Nepal, Pakistan and Sri Lanka, and the National Family Health Survey of India were used as data sources. Four key indicators were calculated: introduction of solid, semisolid or soft foods in 6-8 months aged, minimum dietary diversity, minimum meal frequency and minimum acceptable diet in 6-23-month-aged children. Univariate and multivariate logistic regression analyses were performed to identify determinants of poor complementary feeding practices. The papers in this supplement present results of these analyses for each individual country and a comparison between countries. The results have important implications for policies, programmes and research on infant and young child feeding in the region, especially for targeting groups at high risk for suboptimal practices.

Access-Related Measures and Out-of-System Utilization Among Veterans With Bipolar Disorder

This study examined associations between access-related measures and out-of-system health services utilization (general medicine and mental health services) among patients with bipolar disorder at a U.S. Department of Veterans Affairs (VA) medical center. VA patients (N=391) with bipolar disorder answered questions about health services access (non-VA insurance coverage, travel distance to their VA facility, service-connected disability status, and difficulty receiving needed mental health care) and out-of-system services utilization. Multivariable Tobit regression was used to evaluate associations between access measures and propensity to receive out-of-system services. More than half the veterans (56%) reported some non-VA utilization. Out-of-system utilization was more likely among patients who were married, younger, homeless, with private insurance, without service-connected disabilities, and who reported access difficulties. Out-of-system utilization was associated with multiple measures of access and indicators specific to VA and non-VA providers. Enhancing health system access for patients with bipolar disorder may reduce out-of-system utilization, potentially enhancing continuity of care.

Laboratory Animal Science in China: Current Status and Potential for the Adoption of Three R Alternatives

This paper aims to describe the development of laboratory animal science in China on the basis of historical evidence and recent national survey data, and to identify the problems facing the adoption of Three R alternatives. The authors undertook a national survey in 2006, by means of a questionnaire sent to 31 provinces, municipalities and autonomous regions, and also compared data from a variety of sources, including several national surveys and published papers. Laboratory animal science in China has developed rapidly over the past 30 years, as a result of a combination of economic, governmental and societal forces. More than 100,000 people work in the field of laboratory animal science, in 2,000 laboratory animal centres, institutes, universities, organisations, and companies. During the year of our survey, more than 19 million laboratory animals were produced from 320 licensed production facilities. Approximately 16 million laboratory animals were used in animal experiments, in 1530 facilities licensed for their use. The scale of the market for the supply and use of laboratory animals is huge, and thus it is very important to improve the level of adoption of these alternatives, in education, research and testing. For China, this presents a significant economic and technological opportunity in the field of biosciences research. The concept of the Three Rs first appeared in China in the 1980s, when the scale of laboratory animal sciences was starting to increase. In the 1990s, the Three Rs concept became commonly accepted among laboratory animal scientists, and began to appear in government documents. In the first decade of the 21st century, the Three Rs principles have become increasingly applied in our day-to-day work. But further time is still needed to achieve the full application of the Three Rs principles, especially the adoption of Three R alternatives. This paper describes the achievements in China relating to laboratory animal science, the use of Three R alternatives, and animal welfare, and shows that there is currently great potential for the adoption of alternatives. The information will help scientists and organisations around the world to gain better insight into the current state of laboratory animal science in China, and hopefully, will enable them to give advice on how we can improve the adoption of Three R alternatives in our country.

How Does Public Assistance Affect Family Expenditures? The Case of Urban China

Using recent national household survey data and a propensity score matching method, this study examines the effects of urban China’s primary public assistance program—Minimum Living Standard Assistance (MLSA)—on family expenditures, an important yet understudied indicator of family material well-being. We find that families receiving MLSA prioritized human capital investment (i.e., paying for education and health) rather than making the ends meet (e.g., paying for food, clothing, rent, and utilities). The policy implications of these findings are discussed.

Risky Behavior of Adolescent College Students

Nurses who provide care to adolescent college students are challenged to meet their diverse health care needs. Recent national survey data on American college students indicate that many participate in risky behaviors, which can have detrimental effects on their physical and psychosocial health. These data also reveal that college students rank health educators and health center medical staff as the most believable sources of health-related information. Thus, nurses are in key positions to screen for and educate about stress, coping styles, and mental health issues. In addition to decreasing barriers to access, nurses can inform students on the kinds of resources available and their locations. This article also describes interventions that may be effective on college campuses for the reduction of risks and the promotion of positive coping and health outcomes in this population.

EMERGING FORMS OF UNION FORMATION IN THE PHILIPPINES

This paper draws on recent national survey data for the Philippines to examine changes in multiple indicators of the union formation and sexual systems, and then describes the social distributions of various aspects of those behaviors. Some features of the pattern echo the ‘second demographic transition’ as reported in many other parts of the globe. This includes rising levels of premarital sex and cohabitation, but notably excludes the virtual collapse of family-building as seen in many other societies. The paper classifies the main types of union formation pattern at national scale for each of the sexes, and then disaggregates into the social distribution of each component of the overall pattern. This disaggregation is carried out in a framework defined by the cells of a socioeconomic grid based on simple urban versus rural residence and schooling dimensions. Employing this grid it is shown that the various components of the overall union and sexual system have contrasting social distributions which hint at the underlying processes involved. The analysis provides both a measurement approach suitable for large scale household surveys and a set of turn-of-the-century empirical benchmarks that will support ongoing survey-based monitoring of these important patterns.

Context Matters: A Community-Based Study of Maternal Mental Health, Life Stressors, Social Support, and Children's Asthma

Recent national survey data indicate an overall asthma prevalence of 12.2% for children who are younger than 18 years. Previous research in clinical samples of children with asthma suggests that their mothers are at greater risk for symptoms of depression. We describe the relationship between maternal symptoms of depression and having a child with asthma in a community-based sample. After a school-based ascertainment of asthma and asthma symptoms in 15 low-income, racially/ethnically diverse public elementary schools, 1149 eligible mothers agreed to participate in a longitudinal study. Mothers either had a child with previously diagnosed asthma or a child with symptoms consistent with possible asthma or were in the randomly selected comparison group in which no child in the household had asthma. During the first interview, mothers responded to questions about their own life stressors, supports and mental health, and their children's health. In bivariate analyses of a community-based sample of children who share low-income neighborhoods, mothers of children with diagnosed or with possible undiagnosed asthma had more symptoms of depression than did mothers of children who have no asthma. Mothers of children with diagnosed or with possible undiagnosed asthma also experienced more life stressors than did mothers of children without asthma. Using nested linear regression, we estimated a model of maternal symptoms of depression. Most of the variation in Center for Epidemiologic Studies-Depression score was accounted for by life stressors and social support. There were no independent effects of either asthma status or asthma status-specific child health status on maternal symptoms of depression. Children who are under care for chronic conditions such as asthma live and manage their illness outside the clinical setting. Their social context matters, and maternal mental health is related to their children's physical health. Although having a child with asthma may be "just" another stressor in the mother's social context, complex treatment plans must be followed despite the many other pressures of neighborhood and family lives.

Incorporating Veterinary Care into the Sheep Production Cycle

According to recent national survey data, roughly half of sheep producers in the United States regularly utilize veterinary consultation as a diagnostic service. A large proportion of health problems in conventional flocks is the result of management errors and is potentially preventable. Veterinarians are well positioned to provide consultation services to improve management practices as well as diagnostic services to monitor health and disease in the animals. A logical starting point is the introduction of certain practices that have high potential to provide direct economic benefit to the producer, such as fertility testing of rams. By 0ffering such services at opportune times, veterinarians can efficiently integrate their expertise into the annual flock production cycle.

Salary Structure Effects and the Gender Pay Gap in Academia

This paper presents estimates of the gender salary gap and discrimination based on the most recent national faculty survey data. New estimates for 1999 indicate that male faculty members still earn 20.7% more than comparable female colleagues. Depending upon which decomposition technique is employed, the portion of this gap attributable to discrimination is 17% or, 19–23%. Both estimates of the unexplained salary gap are lower than previous estimates. Furthermore, application of the Juhn technique shows that differences in salary structure, especially between research and liberal arts institutions, constitutes an important determinant of the relative gender pay gap between institutional types.

Racially Biased Policing: Determinants of Citizen Perceptions

The current controversy surrounding racial profiling in America has focused renewed attention on the larger issue of racial bias by the police. Yet little is known about the extent of police racial bias and even less about public perceptions of the problem. This article analyzes recent national survey data on citizens' views of, and reported personal experiences with, several forms of police bias-including differential treatment of individuals and neighborhoods, police prejudice, and racial profiling. We find that attitudes toward the prevalence and acceptability of these practices are largely shaped by citizens' race, personal experiences with police discrimination, and exposure to news media reporting on incidents of police misconduct. The findings lend support to the group-position theory of race relations.

Binding the Generations: Household Formation Patterns among Vietnamese Refugees

Much of the analysis of refugee and immigrant adaptation has stressed the interaction of prior experience with the requirements of life in a new country. For refugees, that interaction has often been jarring because of the after-effects of their flight and their relative inability to prepare for a new life in a new country. Yet refugees have often done rather well in economic terms in that new country. The reasons for that relative success have been phrased in cultural terms {e.g., the predisposition toward education) and in general socioeconomic terms (e.g., refugees as educated and skilled). This article examines a set of factors that lie between these customary cultural and socioeconomic categories. Specifically, the paper examines key features of household formation among Vietnamese refugees. An examination of historical data from southern Vietnam indicates patterns in household formation that appear durable over time yet are not shared across the breadth of Vietnam and cannot thus be viewed as “cultural” in the usual sense. A comparison of the historical data with recent national survey data on refugees in the United States indicates that these patterns continue among Vietnamese refugees and are - as compared to other refugees - distinctive to them. These patterns of household formation provide Vietnamese refugees with important options in adaptation to a new country.

Race, ethnicity, and disparities in breast cancer: victories and challenges

Breast cancer is a disease for which early detection and treatment can improve survival. It is a disease for which access to care, patient attitudes and beliefs about cancer, physician attitudes and beliefs, as well as health care delivery systems’ organization can affect a woman’s risk of dying from breast cancer. 1 Ayanian J.Z. Kohler B.A. Abe T. Epstein A.M. The relation between health insurance coverage and clinical outcomes among women with breast cancer. N Engl J Med. 1993; 329: 326-331 Crossref PubMed Scopus (540) Google Scholar , 2 Perez-Stable E.J. Sabogal F. Otero-Sabogal Hiatt R.A. McPhee S.J. Misconceptions about cancer among Latinos and Anglos. JAMA. 1992; 268: 3219-3223 Crossref PubMed Scopus (255) Google Scholar , 3 Lannin D.R. Mathews H.F. Mitchell J. Swanson M.S. Swanson F.H. Edwards M.S. Influence of socioeconomic and cultural factors on racial differences in late-stage presentation of breast cancer. JAMA. 1998; 279: 1801-1807 Crossref PubMed Scopus (506) Google Scholar , 4 Bickell N.A. McEvoy M.D. Chassin M.R. Reasons for underuse the case of breast cancer. JGIM. 2000; 15: 103 PubMed Google Scholar , 5 Siminoff L.A. Zhang A. Saunders Sturm C.M. Colabianchi N. Referral of breast cancer patients to medical oncologists after initial surgical management. Med Care. 2000; 38: 696-704 Crossref PubMed Scopus (36) Google Scholar , 6 Burns R.B. Freund K.M. Moskowitz M.A. Kasten L. Feldman H. McKinlay J.B. Physician characteristics Do they influence the evaluation and treatment of breast cancer in older women?. Am J Med. 1997; 103: 263-269 Abstract Full Text Full Text PDF PubMed Scopus (22) Google Scholar , 7 Liberati A. Patterson W.B. Biener L. McNeil B.J. Determinants of physicians’ preferences for alternative treatments in women with early breast cancer. Tumori. 1987; 73: 601-609 PubMed Google Scholar , 8 Lazovich D.A. White E. Thomas D.B. Moe R.E. Underutilization of breast-conserving surgery and radiation therapy among women with stage I or II breast cancer. JAMA. 1991; 266: 3433-3438 Crossref PubMed Scopus (348) Google Scholar , 9 Lazovich D. White E. Thomas D.B. Moe R.E. Taplin S. Change in the use of breast conserving surgery in western Washington after the 1990 NIH Consensus Development Conference. Arch Surg. 1997; 132: 418-423 Crossref PubMed Scopus (33) Google Scholar , 10 Lee-Feldstein A. Anton-Culver H. Feldstein P.J. Treatment differences and other prognostic factors related to breast cancer survival delivery systems and medical outcomes. JAMA. 1994; 271: 1163-1168 Crossref PubMed Scopus (159) Google Scholar , 11 Bickell N.A. Young G.J. Coordination of care for early-stage breast cancer patients. J Gen Intern Med. 2001; 16: 737-742 Crossref PubMed Google Scholar , 12 Hand R. Saner S. Imperator J. Knawel J.C. Sylvester J.A. Fremgen A. Hospital variables associated with quality of care for breast cancer patients. JAMA. 1991; 266: 3429-3432 Crossref PubMed Scopus (103) Google Scholar For years, black women were less likely to get screening mammograms, more likely to present with later stage cancer, and less likely to get adjuvant treatments, so it was no surprise that they were more likely to die of breast cancer. Given this history, there was great excitement surrounding the release of this year’s national cancer statistics. Breast cancer death rates, on the decline among white women for the past several years, are starting to go down among black women as well. The increases in incident breast cancer cases seen in both black and white women are limited to the early-stage cancers; those stages with better prognoses and usually detected through screening efforts. Recent national survey data report increasing rates of mammography among all racial groups with whites, blacks, and Asians undergoing mammography at similar rates. 13 Blackman D.K. Bennet D.M. Miller D.S. Trends in self-reported use of mammograms (1989–1997) and Papanicolaou tests (1991–1997)—Behavioral Risk Factor Surveillance System. MMWR. 1999; 48: 1-13 Google Scholar , 14 Breen N. Wagener D.K. Brown M.L. Davis W.W. Ballard-Barbash R. Progress in cancer screening over a decade results of cancer screening from the 1987, 1992, and 1998 national Health Interview Surveys. J Natl Cancer Inst. 2001; 93: 1704-1713 Crossref PubMed Scopus (448) Google Scholar For more than a decade, there has been a national effort to reduce underuse of mammography and increase breast cancer screening among minority, poor, and elderly women; women at higher risk of death from breast cancer. It appears that national and local efforts to improve mammography screening rates may be succeeding in reducing racial disparities in screening and mortality from breast cancer. What are the lessons to be learned from the breast cancer story about reducing racial and ethnic disparities? What can be done to meet the 1998 presidential initiative to eliminate racial and ethnic disparities in cancer by the year 2010?

PERCEPTIONS OF RACIAL PROFILING: RACE, CLASS, AND PERSONAL EXPERIENCE*

Racial profiling by the police has become an increasingly controversial issue in recent years, but we know little about the extent of the problem and even less about public perceptions of profiling. This article analyzes recent national survey data on citizens' views of racial profiling. We find that both race and personal experience with profiling are strong predictors of attitudes toward profiling and that, among blacks, social class affects views of the prevalence and acceptability of the practice. The findings on social class point to the need for further investigation and explanation of class influences on evaluations of the police.

Assessing self‐reported expenditures on gambling

AbstractEstimates of the proportion of gambling revenues derived from problem gamblers represent an important element in the rational calculus of public gambling policy. However, a critical concern in calculating such estimates is the accuracy of self‐reported expenditure data. In this paper, we review an emerging literature on estimating the proportion of expenditures from problem gamblers for different types of gambling, with a focus on the relationship between self‐reported estimates and known spending. We then examine recent national survey data pertaining to this matter. After detailing several of the challenges in the effort to assess self‐reported expenditures on different types of gambling, we recommend some methodological improvements that can be made in response to these problems. Copyright © 2001 John Wiley & Sons, Ltd.

Helping pregnant smokers quit: meeting the challenge in the next decade

Throughout the past decade, smoking has remained the single most important modifiable cause of poor pregnancy outcome in the USA. It accounts for 20% of low birth weight deliveries, 8%...

Does "white coat hypertension" increase the risk for any adverse outcome from hypertension?

Patients with “white coat hypertension” have elevated blood pressures when measured in health care settings but normal blood pressures otherwise. First described in 1940, white coat hypertension has been estimated to account for about 20% of all cases of hypertension.1 Unlike the consensus reached on the diagnosis and treatment of sustained hypertension—disseminated in periodic reports from the Joint National Committee on the Detection, Evaluation, and Treatment of High Blood Pressure—the diagnosis, treatment, and clinical implications of white coat hypertension remain uncertain and controversial. Periodic monitoring of patients for evidence of early target organ damage or sustained hypertension is prudent White coat hypertension is best diagnosed by obtaining normal average daytime blood pressure measurements, using 24-hour ambulatory blood pressure monitoring, in patients who have elevated blood pressures in health care settings. These monitors are often programmed to measure blood pressures every 15 to 30 minutes during a patient's usual daily activities. A daytime average blood pressure of greater than 135/85 mm Hg in an ambulatory person has been proposed as a reasonable cutoff for diagnosing the presence of hypertension. Unfortunately, population norms for average 24-hour daytime blood pressures have not been determined, and published studies have often used different definitions for white coat hypertension.2,3 Although not reported consistently, white coat hypertension has been associated in some studies with an increased risk of sustained hypertension4 and target organ damage, such as left ventricular hypertrophy.5 The actual risk posed by white coat hypertension on cardiovascular disease end points—such as stroke, myocardial infarction, and hypertensive nephropathy—however, remains unclear. To date, few prospective studies have been done of patients with white coat hypertension diagnosed by ambulatory blood pressure measurement. Khattar and colleagues in a recent study reported that white coat hypertension was an independent predictor of cardiovascular disease events during a period of 9 years of follow-up, but the risk of such events was lower than among patients with sustained hypertension.6 Other prospective studies of shorter duration have failed to observe any relation between white coat hypertension and an increased risk of cardiovascular morbidity.7 Data from follow-ups longer than 9 years are not available. In general, the risk for target organ damage and cardiovascular disease events associated with white coat hypertension appears to be intermediate between that of normotensive persons and patients with sustained hypertension. For most practitioners, the biggest challenge remains the detection, treatment, and adequate control of sustained hypertension. Recent national survey data indicate that hypertension goes undetected in about 30% of people who have the disease, 50% of those whose hypertension is detected are not taking medication, and 70% of those taking antihypertensive medication continue to have blood pressures higher than 140/90 mm Hg.8 White coat hypertension may not be an entirely benign condition Because white coat hypertension has a comparatively benign prognosis, at least in the short term, most authorities would, in the absence of evidence of target organ damage, defer pharmacologic treatment of patients having this diagnosis. Nevertheless, white coat hypertension may not be an entirely benign condition, and periodic monitoring of patients for evidence of early target organ damage or sustained hypertension is prudent. A greater use of 24-hour ambulatory blood pressure monitoring is also warranted to identify the disorder and to prevent the unnecessary pharmacologic treatment of patients diagnosed as having it.

Race, Class, and Perceptions of Discrimination by the Police

Previous research has shown that Blacks are more likely than Whites to hold unfavorable opinions of criminal justice agencies in America, but the literature has rarely examined whether social class also affects these opinions. Using recent national survey data on perceptions of racial discrimination by the police and the criminal justice system, this study examines the effects of race and class on citizen attitudes. The findings indicate that (1) race is a strong predictor of attitudes and (2) class affects several of these views. An important finding is that middle-class Blacks are sometimes more critical of the police and justice system than are lower-class Blacks.

Ethnic Origin, Class Origin and Educational Attainment in Canada: Further Evidence on the Mosaic Thesis

In this paper, we extend the analysis of status attainment in Canada in three key ways. First, we treat education, not as an intervening or control variable in the status attainment process, but as an important dependent variable in its own right. Second, we use recent representative national survey data to compare the relative effects of ethnic origin and class origin on status attainment, using education as the attainment measure. Third, we examine ethnicity and class effects on education while determining if these effects differ for foreign-born and native-born Canadians. The results, both with and without controls on other variables, indicate that ethnicity has a significant influence on educational attainment. However, the ethnicity effect is weak compared to the effects of three class-related background measures: mother’s education, father’s education, and father’s occupation. The three class variables account for a large portion of the ethnic differences in education, and explain much more of the variance in educational attainment than do ethnicity or the various controls. There are also notable differences in how ethnic groups rank on education, when foreign-born and native-born respondents are considered separately. The implications of the findings for future research on status attainment in Canada are briefly discussed.

Characteristics and policy issues in the aging of China's population

Based on recent years' national and local census and survey data, the present paper analyzes the characteristics of aging in China's population, and investigates important policy issues involved in dealing with these issues. Some emphasis is given to the reform of the urban social security system in China.

Race in the Workplace: Black/White Differences in the Sources of Job Satisfaction

Previous research on job satisfaction largely ignores possible race differences in its determinants. This study examines two explanations of a race/job satisfaction relationship: a structural perspective focuses on objective job rewards; a dispositional, on the role of worker orientations. The former implies that characteristics of race; the latter, that race leads to distinctive job needs and values and thus contributes to black/white differences in the sources of satisfaction. Analysis of recent national survey data supports the structural model: similarities outweigh differences in the predictors of job satisfaction across races. Blacks’ lower workplace satisfaction is a function, not of racial differences in the process that determines satisfaction, but of their lower scores on the factors that tend to promote it.