NHIS Citations 2

Surveillance of Mortality and Morbidity in U.S. Workers

National Health Interview Survey
Citations 2 (201-400)

Citations: 201-400

Citation <1>
Unique Identifier
9391660
Medline Identifier
98053148
Authors
Silbersiepe KA. Hardy AM.
Institution
Centers for Disease Control, National Center for Health Statistics,
Division of Health Interview Statistics, Hyattsville, MD 20782, USA.
Title
AIDS knowledge and risk perception of cocaine and crack users in a
national household survey.
Source
AIDS Education & Prevention. 9(5):460-71, 1997 Oct.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
Awareness of AIDS among cocaine and crack users has never been studied
using national data representative of the U.S. household population. Data
from the 1991 National Health Interview Survey were analyzed. Respondents
who reported cocaine (n = 448) or crack use (n = 100) in the past year were
compared with those who reported never using any form of cocaine (n =
17,259). AIDS knowledge, HIV testing, risk behavior, and perceived risk for
HIV were outcomes studied. Over 96% of the drug users know the term HIV
compared with 89% of the nonusers. A higher proportion of cocaine users
reorganized the effectiveness of condoms compared with nonusers (93% vs.
84%). Over 96% of all groups knew the risk of sharing needles. Cocaine and
crack users were more likely to have been tested for HIV (27% and 28%)
compared with nonusers (19%), yet less than one third of those tested
actually received HIV counseling. High-risk behavior was acknowledged by 22%
of cocaine users and 33% of crack user!
s. However, only 10% and 14% respectively considered themselves to be at
increased risk for having or getting HIV. These data suggest that cocaine
and crack users are knowledgeable regarding HIV/AIDS, however they are
underestimating their real risk of infection with HIV.

Citation <2>
Unique Identifier
9375257
Medline Identifier
98042827
Authors
Patten SB.
Institution
Alberta Heritage Foundation for Medical Research, Calgary.
patten@acs.ucalgary.ca
Title
Performance of the Composite International Diagnostic Interview Short Form
for major depression in community and clinical samples.
Source
Chronic Diseases in Canada. 18(3):109-12, 1997.
Abstract
The CIDI Short Form is a brief survey instrument designed to identify
episodes of major depression. The instrument was developed for inclusion in
the US National Health Interview Survey, but has also been used in the
Canadian National Population Health Survey (NPHS). In this study, data
deriving from use of the CIDI Short Form in the NPHS are compared to
published data from the Mental Health Supplement of the Ontario Health
Survey, which utilized a fully validated structured interview: the Composite
International Diagnostic Interview (CIDI). In an additional analysis, the
sensitivity and specificity of the Short Form were evaluated in relation to
the full CIDI mood disorders section in a clinical sample of 122 psychiatric
in-patients. Relative to published data from the Ontario Health Survey,
application of the CIDI Short Form in the NPHS resulted in an overestimation
of major depression prevalence by approximately 50%. In the clinical sample,
the CIDI Short Form was highly !
sensitive (98.4%), but not highly specific (72.7%). Active medical
conditions, substance use disorders and dysthymia were frequently observed
among subjects with false positive CIDI Short Form ratings. The CIDI Short
Form appears to overestimate the 12-month period prevalence of major
depression when it is applied in community samples. Since the Short Form
does not make exclusions for organically induced symptoms, it is probable
that some subjects with depressive symptoms secondary to physical illnesses
and/or drug exposures score above the instrument's threshold, perhaps
leading to an elevation in period prevalence rates.

Citation <3>
Unique Identifier
9350915
Medline Identifier
98010398
Authors
Liao Y. Cooper RS. Cao G. Kaufman JS. Long AE. McGee DL.
Institution
Department of Preventive Medicine and Epidemiology, Loyola University
Stritch School of Medicine, Maywood, Illinois 60153, USA.
yliao@luccpua.it.luc.edu
Title
Mortality from coronary heart disease and cardiovascular disease among
adult U.S. Hispanics: findings from the National Health Interview Survey
(1986 to 1994).
Source
Journal of the American College of Cardiology. 30(5):1200-5, 1997 Nov 1.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
OBJECTIVES: We sought to estimate the coronary heart disease (CHD) and
cardiovascular disease (CVD) mortality experience of U.S. Hispanics.
BACKGROUND: Limited information is available concerning the mortality from
CHD among U.S. Hispanics, the nation's second largest minority group.
METHODS: The study used data from the National Health Interview Survey (1986
to 1994), including representative national samples of 246,239 non-Hispanic
whites, 38,042 blacks and 14,965 Hispanics who were > or = 45 years old at
baseline. Mean follow-up of mortality was 5 years (range 1 to 10). RESULTS:
During the follow-up period, 27,702 whites (11%), 4,976 blacks (13%) and
1,061 Hispanics (7%) died. Among men, the age-adjusted total mortality per
100,000 person-years was 3,089 in whites and 2,466 in Hispanics, and among
women, it was 1,897 and 1,581 in whites and Hispanics, respectively. The
Hispanic/white mortality rate ratio for CHD was 0.77 (95% confidence
interval [CI] 0.64 to 0.93) and 0.8!
2 (95% CI 0.66 to 1.01) for men and women, respectively. The rate ratio was
0.79 (95% CI 0.68 to 0.91) and 0.80 (95% CI 0.69 to 0.94), respectively, for
mortality from cardiovascular diseases. Given the lower all-cause mortality
in Hispanics, the proportion of total deaths due to CHD and CVD was similar
between the two populations for the same gender and were, respectively,
29.7% and 44.7% in white men, 28.1% and 44.3% in Hispanic men, 24.9% and
43.2% in white women and 24.1% and 41% in Hispanic women. CONCLUSIONS: These
data from a cohort of a large national sample are consistent with vital
statistics that show that all-cause, CHD and CVD mortality is approximately
20% lower among adult Hispanics than among whites in the United States.

Citation <4>
Unique Identifier
9346146
Medline Identifier
98004132
Authors
Hurwitz EL. Morgenstern H.
Institution
Department of Epidemiology, School of Public Health, University of
California-Los Angeles 90095-1772, USA.
Title
The effects of comorbidity and other factors on medical versus
chiropractic care for back problems.
Source
Spine. 22(19):2254-63; discussion 2263-4, 1997 Oct 1.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
STUDY DESIGN: This study is a cross-sectional analysis of adults in the
United States who reported at least one back-related visit to a health care
professional during a 2-week reference period. OBJECTIVES: To estimate and
compare the effects of comorbidity and other factors on self-reported use of
medical and chiropractic care for back problems in the United States.
SUMMARY OF BACKGROUND DATA: Although back pain is the second most frequent
primary symptom reported by patients seeking medical care and the most
frequent primary symptom among chiropractic patients, there is a dearth of
research on the predictors of chiropractic and medical care among back pain
patients. METHODS: Data from the 1989 National Health Interview Survey were
used to perform a cross-sectional analysis of adults who sought care for a
back-related condition. The primary predictor variables included comorbidity
and associated disability, sociodemographic variables, and
back-problem-related variables. Wei!
ghted logistic regression modeling was performed to estimate odds ratios
adjusted for the effects of covariates. RESULTS: Of the 4790 adults with
reported back problems, 931 sought health care for their back condition
during the 2-week reference period. Adults with disabling comorbidities and
back-related restricted-activity days were relatively less likely to use
chiropractic care than primary medical care. Those who were male,
high-school educated, single, employed, and with more than nine doctor
visits during the previous 12 months were relatively more likely to use
chiropractic care than primary medical care. CONCLUSIONS: The presence of
comorbidity-related or back-related disability, as well as other factors,
affect the type of care sought for back conditions among adults in the
United States.

Citation <5>
Unique Identifier
9327082
Medline Identifier
97467906
Authors
Tanaka S. Wild DK. Cameron LL. Freund E.
Institution
Division of Surveillance, Hazard Evaluations, and Field Studies, Centers
for Disease Control and Prevention, Cincinnati, OH, USA.
Title
Association of occupational and non-occupational risk factors with the
prevalence of self-reported carpal tunnel syndrome in a national survey of
the working population.
Source
American Journal of Industrial Medicine. 32(5):550-6, 1997 Nov.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
To compare the association of occupational versus personal,
nonoccupational risk factors with the prevalence of carpal tunnel syndrome
(CTS), data from the 1988 National Health Interview Survey, Occupational
Health Supplement, were analyzed. When both occupational factors
(bending/twisting of the hands/wrists [B/T] and use of hand-held vibrating
tools) and personal nonoccupational factors (gender, race, age, body mass
index [BMI], smoking, education, and family income) were included in a
multivariate logistic regression model, adjusted odds ratios (AORs) of these
factors for reporting medically called CTS (MC-CTS) were: exposure to B/T,
5.5; exposure to vibration, 1.9; white race, 16.7; female gender, 2.3; BMI >
or = 25, 2.0; history of cigarette smoking, 1.6; age > or = 40, 1.2;
education > 12 years, 1.2; and annual family income > or = $20,000, 1.5.
Although both occupational and nonoccupational factors are associated with
reporting of CTS, repetitive bending/twisting of t!
he hands/wrists and use of vibrating tools remain important risk factors for
work-related carpal tunnel syndrome.

Citation <6>
Unique Identifier
9326910
Medline Identifier
97467701
Authors
Vernon SW.
Institution
University of Texas Health Science Center, Houston School of Public Health
77225, USA.
Title
Participation in colorectal cancer screening: a review.[comment]. [Review]
[214 refs]
Comments
Comment in: J Natl Cancer Inst. 1998 Mar 18;90(6):465; PMID: 9521172
Source
Journal of the National Cancer Institute. 89(19):1406-22, 1997 Oct 1.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
The purpose of this review is to evaluate the published literature on
adherence to colorectal cancer (CRC) screening with fecal occult blood
testing (FOBT) and sigmoidoscopy. Specifically, the review addresses the
following: 1) prevalence of FOBT and sigmoidoscopy; 2) interventions to
increase adherence to FOBT and sigmoidoscopy; 3) correlates or predictors of
adherence to FOBT and sigmoidoscopy; and 4) reasons for nonadherence. Other
objectives are to put the literature on CRC screening adherence in the
context of recently reported findings from experimental interventions to
change prevention and early detection behaviors and to suggest directions
for future research on CRC screening adherence. CRC screening offers the
potential both for primary and for secondary prevention. Data from the 1992
National Health Interview Survey show that 26% of the population more than
49 years of age report FOBT within the past 3 years and 33% report ever
having had sigmoidoscopy. The Year 2!
000 goals set forth in Healthy People 2000 are for 50% of the population
more than 49 years of age to report FOBT within the past 2 years and for 40%
to report that they ever had sigmoidoscopy. Thus, systematic efforts to
increase CRC screening are warranted. To date, attempts to promote CRC
screening have used both a public health model that targets entire
communities, e.g., mass media campaigns, and a medical model that targets
individuals, e.g., general practice patients. Most of these efforts,
however, did not include systematic evaluation of strategies to increase
adherence. The data on FOBT show that the median adherence rate to
programmatic offers of FOBT is between 40% and 50%, depending on the type of
population offered the test, e.g., patients or employees. Approximately, 50%
of those initially offered testing in unselected populations will respond to
minimal prompts or interventions. A salient issue for FOBT, however, is
whether or not the behavior can be sustained !
over time. Fewer studies examined adherence to sigmoidoscopy. Adherence was
highest in relatives of CRC cases and in employer-sponsored programs offered
to workers at increased risk of CRC. At present, we know very little about
the determinants of CRC screening behaviors, particularly as they relate to
rescreening. [References: 214]

Citation <7>
Unique Identifier
9310520
Medline Identifier
97456218
Authors
Byrd RS. Weitzman M. Auinger P.
Institution
Department of Pediatrics, University of Rochester School of Medicine and
Dentistry, Rochester General Hospital, Rochester, New York, USA.
Title
Increased behavior problems associated with delayed school entry and
delayed school progress.[comment].
Comments
Comment in: Pediatrics. 1998 Aug;102(2 Pt 1):434; discussion 435-6,
Comment in: Pediatrics. 1998 Aug;102(2 Pt 1):435; discussion 435-6; PMID:
9714657
Source
Pediatrics. 100(4):654-61, 1997 Oct.
Abstract
OBJECTIVE: To investigate whether students who are old-for-grade have
higher rates of reported behavior problems and to investigate whether this
association is independent of having been retained a grade in school.
METHODS: Cross-sectional analyses of parental reports from the nationally
representative sample of 9079 children ages 7 to 17 years who participated
in the Child Health Supplement to the 1988 National Health Interview Survey.
Students older than the modal age for their grade were considered
old-for-grade, either due to delayed school entry (those without grade
retention) or to delayed school progress (with history of grade retention).
Behavior problems were defined as scores >90th percentile on a
well-utilized, standardized Behavior Problem Index (BPI). RESULTS:
Twenty-six percent of 7- to 17-year-old children in the United States are
old-for-grade. Being old-for-grade is more common in males (31%), blacks
(33%), Hispanics (32%), those living in single-parent hous!
eholds (31%) or poverty (43%), and those with mothers with low educational
attainment (42%). Most children (84%) who repeated a grade are
old-for-grade, but only 54% of old-for-grade students have been retained.
For children who were old-for-grade, 19% of those grade-retained and 12% of
those nonretained had extreme BPI scores, and for those not old-for-grade,
17% of grade-retained and 7% of nonretained children had extreme BPI scores.
Although rates of extreme BPI scores were consistently lower for children
who were neither old-for-grade nor grade-retained, and consistently higher
for those with both, these rates increased with age for children who were
old-for-grade without being retained. Controlling for multiple potential
confounders with logistic regression, both old-for-grade status and grade
retention are independently associated with increased rates of behavior
problems. Separate logistic regression analyses for blacks and whites showed
that these findings pertained on!
ly to white children. CONCLUSIONS: Whereas grade retention is associated
with increased rates of behavior problems in children and adolescents,
simply being older than others in one's class, without having experienced
grade retention, is also associated with increased rates of behavior
problems, most noticeably among adolescents. These data suggest that there
may be latent adverse behavioral outcomes that result from delaying
children's school entry.

Citation <8>
Unique Identifier
9284871
Medline Identifier
97430772
Authors
Harnack L. Block G. Subar A. Lane S. Brand R.
Institution
Public Health Nutrition Program, University of California at Berkeley,
USA.
Title
Association of cancer prevention-related nutrition knowledge, beliefs, and
attitudes to cancer prevention dietary behavior.
Source
Journal of the American Dietetic Association. 97(9):957-65, 1997 Sep.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
OBJECTIVE: To examine the relationship of cancer prevention-related
nutrition knowledge, beliefs, and attitudes to cancer prevention dietary
behavior. SUBJECTS/SETTING: Noninstitutionalized US adults aged 18 years and
older. METHODS: Data collected in the 1992 National Health Interview Survey
Cancer Epidemiology Supplement were analyzed. The supplement included
questions to ascertain knowledge, beliefs, and attitudes and a food
frequency questionnaire to ascertain nutrient intake. STATISTICS:
Multivariate linear regression modeling was conducted to assess the
hypothesized relationships. RESULTS: After adjustment for relevant
covariates (age, sex, education, total energy, perceived barriers to eating
a more healthful diet), knowledge and belief constructs were predictive of
dietary behavior. Specifically, fat, fiber, and fruit and vegetable intakes
more closely approximated dietary recommendations for persons with more
cancer-prevention knowledge. The strength of the associat!
ions between these constructs and dietary behavior varied in some cases
according to level of education and perceived barriers to eating a healthful
diet. Of the perceived barriers to eating a healthful diet, perceived ease
of eating a healthful diet was most strongly and consistently predictive of
intake. CONCLUSIONS: Research findings challenge dietetics practitioners to
design diet- and health-promotion programs and activities that not only
educate the public about the importance of diet to health, but also address
barriers to dietary change.

Citation <9>
Unique Identifier
9279831
Medline Identifier
97425781
Authors
Brill PA. Giles WH. Keenan NL. Croft JB. Davis DR. Jackson KL.
Macera CA.
Institution
Prevention Center, School of Public Health, University of South Carolina,
Columbia, USA.
Title
Effect of body mass index on activity limitation and mortality among older
women: the National Health Interview Survey, 1986-1990.
Source
Journal of Women's Health. 6(4):435-40, 1997 Aug.
Abstract
We assessed the impact of body mass on the association between activity
limitations due to chronic conditions and mortality among 24,612
noninstitutionalized white or African American women aged > or = 65 years
who participated in a National Health Interview Survey between 1986 and
1990. We found that more African American women had activity limitations
than white women (59% vs 46%, respectively). The difference by race was
greatest (19% vs 10%) for the most severe limitation (unable to perform the
major activity). For women aged 65-69, the major activity was working or
keeping house; for those aged > or = 70, it was the ability to live
independently. For white women in all three categories of body mass index
(BMI) and for African American women with BMI 15%-85%, the risk of dying was
significantly higher for those unable to perform the major activity than for
those with no limitations, controlling for the effects of education, marital
status, and perceived health. The findi!
ngs confirm the established link between low BMI and mortality and between
activity limitations and mortality. Additionally, the findings further
suggest that activity limitations linked to chronic conditions increase the
risk of death within each stratum of BMI after adjusting for potential
confounders.

Citation <10>
Unique Identifier
9259752
Medline Identifier
97406291
Authors
Huang ZS. Chiang TL. Lee TK.
Institution
Department of Internal Medicine, College of Medicine, Taiwan, Republic of
China.
Title
Stroke prevalence in Taiwan. Findings from the 1994 National Health
Interview Survey. [Review] [30 refs]
Source
Stroke. 28(8):1579-84, 1997 Aug.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
BACKGROUND AND PURPOSE: Stroke has been the second leading cause of death
for all ages in Taiwan since 1983. However, despite the severity of the
threat, stroke prevalence in Taiwan has not yet been addressed in a
nationwide survey. In this study, the stroke prevalence in Taiwan was
investigated using data from the 1994 National Health Interview Survey.
METHODS: This nationwide survey sought to obtain a nationally representative
sample of households in Taiwan by using three-stage stratified random
sampling with a probability proportional to size. In the first stage, 58
townships were selected, from the 359 townships in Taiwan, according to
their administrative structure and level of socioeconomic development. In
the second stage, 149 basic administrative regions (tsun or li) were
selected from the selected 58 townships. Finally, 3814 households were
selected from the 149 selected tsuns or lis. Field interviews were carried
out between October 1994 and December 1994. Follow-u!
p interviews with families of stroke patients were made 2 years later.
RESULTS: Of the selected households 3119, or 81.8%, responded. A total of
11925 persons were interviewed, and 71 of them were stroke patients, with a
crude point prevalence rate of 5.95 per 1000. The stroke prevalence
increased steadily with age, from 0.51 per 1000 in persons aged 35 to 44
years to 113.6 per 1000 in persons aged 85 years or over. There was a weak
association with higher stroke prevalence for persons living in eastern
Taiwan or those of lower educational level. The overall male/female
prevalence ratio was 1.17. The results of follow-up interviews showed a
cumulative mortality rate of 25.4% within the 2-year period and an
ischemic/hemorrhagic stroke ratio of 1.33 in 35 patients whose stroke type
could be validated. CONCLUSIONS: Age was the most important factor
correlating to stroke prevalence. On the basis of this result, planning
policies and programs for stroke prevention in Taiwan should !
give a higher priority to (1) aggressive primary prevention for aged people
who are apparently at higher risk of stroke and (2) early reduction of
stroke risk factors in younger aged people whose immediate risk of stroke is
lower but would increase significantly with age. [References: 30]

Citation <11>
Unique Identifier
9237712
Medline Identifier
97379390
Authors
Guris D. Strebel PM. Tachdjian R. Bardenheier B. Wharton M. Hadler
SC.
Institution
National Immunization Program, Centers for Disease Control and Prevention,
Atlanta, Georgia, USA.
Title
Effectiveness of the pertussis vaccination program as determined by use of
the screening method: United States, 1992-1994.
Source
Journal of Infectious Diseases. 176(2):456-63, 1997 Aug.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
The screening method was used to evaluate the effectiveness of the
pertussis vaccination program in the United States during 1992-1994. The
formula VE = 1 - [PCV/(1 - PCV)][(1 - PPV)/PPV] was used (VE = vaccine
effectiveness; PCV = proportion of cases vaccinated; PPV = proportion of
population vaccinated). Data from the national Supplementary Pertussis
Surveillance System and the National Health Interview Survey were used to
determine PCV and PPV, respectively. Among children aged 7-18 months, VE for
3 doses of pertussis vaccine was 79% (95% confidence interval, 74%-83%) for
preventing culture-confirmed pertussis. Between the ages of 19 and 47
months, VE for > or = 4 doses was 90% (95% confidence interval, 88%-92%). VE
estimates appeared lower in epidemic (1993) than non-epidemic years (1992,
1994). VE estimates determined using the screening method were consistent
with the previous estimates from the United States. This method will
continue to be useful for assessing the ef!
fectiveness of the pertussis vaccination program in the United States, where
acellular pertussis vaccines are recommended for infants.

Citation <12>
Unique Identifier
9224449
Medline Identifier
97367746
Authors
Clark MA. Rakowski W. Kviz FJ. Hogan JW.
Institution
Department of Community Health, Brown University, USA.
Melissa_Clark.brown.edu
Title
Age and stage of readiness for smoking cessation.
Source
Journals of Gerontology Series B-Psychological Sciences & Social Sciences.
52(4):S212-21, 1997 Jul.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
Using the 1992 National Health Interview Survey Cancer Control Supplement,
relationships were analyzed between stage of readiness for smoking cessation
and background characteristics, smoking behaviors, and smoking-related
attitudes among smokers aged 18-29, 30-49, and > or = 50 years. For each age
group, an ordinal logistic regression model was computed to identify
correlates of readiness to quit. The youngest smokers had attitudes most
favorable to being ready to try to quit smoking. For smokers aged 30-49, the
influence of a medical provider and perceived health effects of smoking were
important correlates of readiness. Among smokers 50 and older, those with
realistic health consequences of smoking and those who perceived smoking as
addictive were more likely to be ready to quit. The effectiveness of smoking
cessation programs might be improved by matching interventions to a smoker's
age and stage in the smoking cessation process.

Citation <13>
Unique Identifier
9215355
Medline Identifier
97358235
Authors
Rodgers W. Miller B.
Institution
Institute for Social Research, University of Michigan, USA.
wrodgers@umich.edu
Title
A comparative analysis of ADL questions in surveys of older people.
Source
Journals of Gerontology Series B-Psychological Sciences & Social Sciences.
52 Spec No:21-36, 1997 May.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
This article describes questions designed to assess limitations with
respect to activities of daily living (ADLs) that were asked on the first
wave of the AHEAD study, and it assesses their cross-sectional measurement
properties. It also provides comparisons between those questions and
parallel questions that have been asked on two other surveys of the elderly
population in the United States: the 1984 Supplement on Aging (SOA) to the
National Health Interview Survey and the screener for the 1982 National Long
Term Care Survey (NLTCS). It also compares a single item from the 1990
Census. It then compares the ways in which the same individuals answer these
different versions of ADL questions, using data from subsamples of the AHEAD
respondents who were also asked the SOA, NLTCS, or Census questions. The
analysis shows that there is a substantial amount of measurement error in
the answers to ADL questions, and it suggests that this is a major
contributor to apparent improvement!
s and declines in functional health observed in longitudinal data.

Citation <14>
Unique Identifier
9207805
Medline Identifier
97351523
Authors
Ruchlin HS.
Institution
Department of Public Health, Cornell University Medical College, New York,
New York, USA.
Title
Prevalence and correlates of breast and cervical cancer screening among
older women.
Source
Obstetrics & Gynecology. 90(1):16-21, 1997 Jul.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
OBJECTIVE: To identify and assess differences in cancer screening patterns
among women 55-64, 65-74, 75-84, and over 84 years of age. METHODS:
Nationally representative data reported in the 1990 Health promotion and
Disease Prevention Supplement to the National Health Interview Survey of
28,584,574 women were analyzed secondarily. The dependent variables were a
knowledge of breast self-examination, over having had a mammogram, and a
Papanicolaou smear within the last 3 years. Independent variables were age
and various sociodemographic, health-status, and health-belief measures.
RESULTS: More than half (58%) of the women had ever had a mammogram, and of
these, 91% had had between one and five mammograms. Over a third (35%) of
those who had not had a mammogram attributed the omission to a lack of a
recommendation by a physician. Almost half (45%) had had a breast
examination by a physician within the last year, and 84% knew how to examine
their own breasts. Approximately 87% h!
ad a Papanicolaou smear with the last 3 years. Age, race, education, and
living in a large city were significantly associated with all three
screening measures, but prevalent health beliefs were significantly
associated only with breast-cancer screening. CONCLUSION: Lack of mammogram
screening in a substantial number of women, attributed to lack of physician
recommendation, decreased screening in the older age groups, and the
negative association of three screening tests with race and residence in a
large city suggest that new interventions are needed by health care
providers and the public health community to increase older women's use of
effective cancer screening techniques.

Citation <15>
Unique Identifier
9200155
Medline Identifier
97343616
Authors
Breslow RA. Subar AF. Patterson BH. Block G.
Institution
Applied Research Branch, National Cancer Institute, Bethesda, MD 20892,
USA. BreslowR@dcpcepn.nci.nih.gov
Title
Trends in food intake: the 1987 and 1992 National Health Interview
Surveys.
Source
Nutrition & Cancer. 28(1):86-92, 1997.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
To examine food intake trends in the US population, cross-sectional
nationally representative food intake data were obtained from the 1987 and
1992 National Health Interview Survey Cancer Control Supplements. In each of
these years, approximately 10,000 respondents completed methodologically
consistent food frequency questionnaires containing the same 57 food items.
Between 1987 and 1992, the proportion of Americans consuming high-fat foods,
including fried fish, fried chicken, bacon, eggs, whole milk, and butter,
decreased. The proportion of Americans drinking alcoholic beverages also
decreased: fewer drank wine and hard liquor in 1992. The proportion of fruit
and vegetable consumers remained stable over time. These results are similar
to those obtained from more detailed national surveys. National guidelines
urge Americans to avoid intake of high-fat foods, increase consumption of
fruits and vegetables, and practice moderation when drinking alcoholic
beverages to prevent c!
ancer and other chronic diseases. The direction of Americans' apparent
changes in food usage between 1987 and 1992, evaluated using limited data
from food frequency questionnaires, suggests greater behavioral changes in
the direction of guidelines recommending avoidance of foods that may
increase the risk of cancer than in the direction of guidelines recommending
increased consumption of foods that may confer protection.

Citation <16>
Unique Identifier
9184511
Medline Identifier
97327953
Authors
Pappas G. Hadden WC. Kozak LJ. Fisher GF.
Institution
National Center for Health Statistics, Centers for Disease Control and
Prevention, Hyattsville, MD 20782, USA.
Title
Potentially avoidable hospitalizations: inequalities in rates between US
socioeconomic groups.
Source
American Journal of Public Health. 87(5):811-6, 1997 May.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
OBJECTIVES: The National Hospital Discharge Survey (NHDS) was used to
evaluate potentially avoidable hospital conditions as an indicator of equity
and efficiency in the US health care system. METHODS: With the use of 1990
data from the NHDS, the National Health Interview Survey, and the census,
national rates of hospitalization were calculated for avoidable conditions
by age, race, median income of zip code, and insurance status. RESULTS: An
estimated 3.1 million hospitalizations were for potentially avoidable
conditions. This was 12% of all hospitalizations in 1990 (excluding
psychiatric admissions, women with deliveries, and newborns). Rates of
potentially avoidable hospitalizations were higher for persons living in
middle- and low-income areas than for persons living in high-income areas,
and were higher among Blacks than among Whites. These class and racial
differences were also found among the privately insured. Differences among
income and racial groups for persons age!
d 65 and over were not significant. CONCLUSIONS: Inequalities in potentially
avoidable hospitalizations suggest inequity and inefficiency in the health
care delivery system. Avoidable hospital conditions are a useful national
indicator to monitor access to care.

Citation <17>
Unique Identifier
9170964
Medline Identifier
97314814
Authors
Caplan LS.
Institution
Department of Preventive Medicine, State University of New York at Stony
Brook, USA.
Title
Disparities in breast cancer screening: is it ethical?.
Source
Public Health Reviews. 25(1):31-41, 1997.
Abstract
Breast cancer incidence and mortality rise dramatically as women get
older. Approximately 48% of newly diagnosed breast cancers occur in women 65
and over, while nearly 57% of the breast cancer deaths occur in these same
women. A number of studies have found that elderly women are at increased
risk for being diagnosed with advanced-stage breast cancer; nevertheless, it
appears that elderly women do not have more poor prognostic factors that are
associated with early relapse or short survival than younger women.
Considering the fact that the population is aging and the increased
incidence and mortality of breast cancer in the elderly, it is important to
determine what can be done to reduce breast cancer mortality in the older
segments of the population. Breast cancer screening with clinical breast
exam and mammography, by leading to earlier diagnosis and therapy, improves
the prognosis for survival. Nevertheless, data from the 1992 US National
Health Interview Survey revealed!
that about 27% of women 65 and over had never even had a single mammogram.
Of those who did have a mammogram, fewer than two-thirds had it within one
year prior to the survey. The data for clinical breast exam were less
discouraging, but nearly 20% of these women had never had an exam. From an
ethical perspective, women in their mid-70s have an average of about 12
years of life remaining, and should be given every opportunity to live out
these years in good health.

Citation <18>
Unique Identifier
9145997
Medline Identifier
97291434
Authors
Jones CA. Nyberg L.
Institution
National Institute of Diabetes, Digestive and Kidney Diseases, National
Institutes of Health, Bethesda, Maryland 20892-6600, USA.
Title
Epidemiology of interstitial cystitis. [Review] [45 refs]
Source
Urology. 49(5A Suppl):2-9, 1997 May.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
OBJECTIVES: To discuss what is currently known about the population
prevalence of interstitial cystitis (IC) and demographic characteristics of
IC patients. METHODS: Changes over time in the criteria for diagnosis of IC
are described. The 3 published studies of the population prevalence of IC
are reviewed. Epidemiologic issues important in the design of studies of IC
are cited. RESULTS: IC is a disease of chronic voiding symptoms. There is
very little reliable information published on the etiology, risk factors, or
number of persons affected. The criteria used for diagnosis of IC by
different investigators have been variable. In 1988, research criteria for a
case definition of IC were published, to be applied for IC patients enrolled
in National Institutes of Health-funded studies. Three published studies of
the population prevalence of IC are available. Each study used different
criteria for defining a case of IC, and none used the NIH research criteria
to define a case. Pr!
evalence estimates for IC vary significantly, from 10 cases/100,000 reported
in Finland in 1975, (based on hospital record review), to 30/100,000 in the
United States in 1987, (based on a mailed survey of board certified
urologists), to 510 cases/100,000 in the United States in 1989, (based on
participant self-report in the 1989 National Health Interview Survey). It is
unclear the extent to which these estimates represent true differences in
prevalence, rather than reflect the different methods used to define an IC
case. Several investigators have reported demographic characteristics of the
IC patients followed in their clinics. All studies of adults show a marked
female predominance, with reported onset of symptoms generally in the middle
years of life. Patients may experience a delay of years from the onset of
symptoms to the time of definitive diagnosis. The natural history of
symptoms of IC has been reported to be that of a subacute onset with a rapid
peak in severity, and!
then a relatively constant plateau of chronic symptoms thereafter. However,
many patients do experience remissions and flares in their disease symptoms.
CONCLUSIONS: Few therapies for IC have been evaluated using rigorous
epidemiologic methods. Many questions remain to be answered. New studies of
IC should include epidemiologic consultation at the stage of study design.
[References: 45]

Citation <19>
Unique Identifier
9141645
Medline Identifier
97286478
Authors
Zheng D. Macera CA. Croft JB. Giles WH. Davis D. Scott WK.
Institution
Prevention Center, School of Public Health, University of South Carolina,
Columbia 29208, USA.
Title
Major depression and all-cause mortality among white adults in the United
States.
Source
Annals of Epidemiology. 7(3):213-8, 1997 Apr.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
PURPOSE: Depression is the most common psychiatric illness affecting
adults. Despite the importance of a potential link between major depression
and mortality, research has been surprisingly sparse. METHODS: Information
on 57,897 white adults aged 25 years and older who were included in the
mental health supplement of the 1989 National Health Interview Survey was
linked with the National Death Index to examine the relationship of major
depression to mortality. Death status was obtained through December 1991.
Sex-specific hazard rate ratios for mortality were calculated by Cox
proportional hazards regression and Poisson regression to adjust for
potential confounders (age, education, marital status, body mass index, and
whether the target subject or a family member completed the survey about the
subject). RESULTS: Major depression was reported for 223 (0.8%) of 27,345
men and 392 (1.3%) of 30,552 women. During the 2.5-year follow-up, death
certificate data were obtained for 84!
8 (3.1%) men and 651 (2.1%) women. The adjusted hazard rate ratios for
all-cause mortality associated with major depression were 3.1 (95%
confidence interval; 2.0-4.9) for men and 1.7 (95% confidence interval;
0.9-3.1) for women. CONCLUSIONS: These results suggest that major depression
increases risk of all-cause mortality, particularly among men. Further
research is needed to explain the mechanism.

Citation <20>
Unique Identifier
9128309
Medline Identifier
97274161
Authors
Sonnenberg A. Everhart JE.
Institution
Gastroenterology, VA Medical Center, Albuquerque, NM 87108, USA.
Title
Health impact of peptic ulcer in the United States.
Source
American Journal of Gastroenterology. 92(4):614-20, 1997 Apr.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
OBJECTIVES: To assess the general outcome and impact of current and
previous peptic ulcer disease on health status in the United States.
METHODS: During the National Health Interview Survey of 1989, a special
questionnaire on digestive diseases was administered to 41,457 randomly
selected individuals. Various measures of impaired health in ulcer patients
were expressed by their age- and sex-standardized prevalence rates. RESULTS:
Ten to 15% of all subjects with a recent ulcer reported that they had been
in poor health, incapable of major activity, or unable to work for some time
during the 12 months preceding the interview. Twenty to 25% of the subjects
with recent ulcers complained about restricted activity and had spent 7 or
more days per year in bed. About 40% of all ulcer subjects had seen a
physician five or more times within 12 months before the interview. These
percentages were significantly lower in patients with previous ulcer
histories but no active ulcer within 12!
months, but they were still significantly higher than in subjects with no
ulcer history at all. In the United States, expenditures attributed to
recent ulcers amounted to $5.65 billion per year. CONCLUSIONS: In the United
States, peptic ulcer disease is associated with major morbidity. Ulcer cure
would result in large economic and medical savings.

Citation <21>
Unique Identifier
9120528
Medline Identifier
97246669
Authors
Scott WK. Macera CA. Cornman CB. Sharpe PA.
Institution
Department of Epidemiology and Biostatistics, School of Public Health,
University of South Carolina, Columbia 29208, USA.
Title
Functional health status as a predictor of mortality in men and women over
65.
Source
Journal of Clinical Epidemiology. 50(3):291-6, 1997 Mar.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
This study evaluated the effect of functional health status on mortality
in a sample of community-dwelling older people. White and African-American
self-respondents to the 1986 National Health Interview Survey Functional
Health Supplement (n = 5, 320) were included in the study. Functional health
status was measured by a ten-item unidimensional activities of daily
living-instrumental activities of daily living (ADL-IADL) scale and a
three-item cognitive ADL scale. Proportional hazards regression was used to
evaluate the effect of increasing score on the ten-item ADL-IADL scale on
risk of mortality over a 5-year period while controlling for demographic,
social, and health status covariates. In both men and women, increasing
score on the ADL-IADL scale was predictive of mortality, adjusting for
increasing age, poor self-rated health, low body mass index in women, and
being an unmarried man. These findings indicate that a unidimensional scale
consisting of both ADL and IADL ite!
ms is useful in predicting mortality, controlling for the effect of
covariates in sex-specific models.

Citation <22>
Unique Identifier
9103108
Medline Identifier
97226127
Authors
Nebeling LC. Forman MR. Graubard BI. Snyder RA.
Institution
Division of Cancer Control and Prevention, National Cancer Institute,
Bethesda, Md 20892-7326, USA.
Title
The impact of lifestyle characteristics on carotenoid intake in the United
States: the 1987 National Health Interview Survey.
Source
American Journal of Public Health. 87(2):268-71, 1997 Feb.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
OBJECTIVES: This study compared mean carotenoid intake in the United
States by demographic and lifestyle variables to identify potential
high-risk subgroups for disease. METHODS: Adults 18 to 99 years of age (n =
22 080) completed a food frequency questionnaire in the 1987 National Health
Interview Survey, and mean carotenoid intakes were estimated. RESULTS:
Carotenoid intakes were lower among Whites (vs Blacks), current smokers (vs
nonsmokers), nondrinkers (vs drinkers), adults 18 to 39 years of age (vs
those 40 to 69 years of age), frequent restaurant consumers (vs those who
ate at home), and less educated (vs college-educated) persons. CONCLUSIONS:
The benefits of a carotenoid-rich diet should be communicated to high-risk
subgroups.

Citation <23>
Unique Identifier
9046382
Medline Identifier
97198328
Authors
Hanna EZ. Chou SP. Grant BF.
Institution
National Institute on Alcohol Abuse and Alcoholism, Division of Biometry
and Epidemiology, Bethesda, Maryland 20892-7003, USA.
Title
The relationship between drinking and heart disease morbidity in the
United States: results from the National Health Interview Survey.
Source
Alcoholism: Clinical & Experimental Research. 21(1):111-8, 1997 Feb.
Abstract
This study, based on data drawn from the responses of 18,323 males and
25,440 females to the 1988 National Health Interview Survey, a nationally
representative, multistage probability sample of the United States, attempts
to define more precisely the level of drinking at which the relationship
between heart disease and alcohol consumption is a protective one. Its
attempt at precision derives from (1) using drinking categories that
represent various points within the range of moderate drinking (1-6 drinks)
defined in the literature as protective; (2) adjusting for underreporting
that commonly occurs in population surveys by using consumption at time of
heaviest drinking; and (3) controlling for age, body mass, smoking, former
drinker, and former smoker status, duration of drinking, and
sociodemographic factors. It also examines whether the relationship derived
from these levels conforms to the U-shaped curve that demonstrates the
protective effect of moderate drinking when ab!
stainers are not used as the reference group. Relative to infrequent
drinkers (less than 1 drink per day), men report more heart disease at the
level of more than five drinks per day. However, black men also report more
heart disease, relative to infrequent drinkers, at the greater than two
drinks per day level; and women report more heart disease at the level of
more than two drinks per day at the time of their heaviest drinking. Former
drinkers of both genders, considered as an independent variable in the
regression analysis, were more likely to report having heart disease.
Abstainers, light drinkers, and infrequent drinkers were not significantly
different in their reports of heart disease. Our results are consistent with
studies that suggest protection from heart disease occurs only at lower
levels of drinking.

Citation <24>
Unique Identifier
9034948
Medline Identifier
97187495
Authors
Harari D. Gurwitz JH. Avorn J. Bohn R. Minaker KL.
Institution
Massachusetts General Hospital Geriatric Medicine Unit, Boston 02114, USA.
Title
How do older persons define constipation? Implications for therapeutic
management.[comment].
Comments
Comment in: J Gen Intern Med. 1997 Jan;12(1):75; PMID: 9034951
Source
Journal of General Internal Medicine. 12(1):63-6, 1997 Jan.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
This study examined the relation between bowel-related symptoms and
self-report of constipation in 10,875 subjects aged 60 years and over, who
participated in the 1989 National Health Interview Survey. Subjects
reporting constipation "always" or "mostly" over the past 12 months (n =
594) were compared with those who reported never having the symptom (n =
4,192). Straining (adjusted odds ratio 66.7; 95% confidence interval 31.5,
142.4) and hard bowel movements (25.6; 16.7, 38.7) were most strongly
associated with self-report of constipation. These findings suggest that
treatment for constipation in the older population should be directed as
much or more at facilitating comfortable rectal evacuation, as increasing
bowel movement frequency.

Citation <25>
Unique Identifier
9015877
Medline Identifier
97168260
Authors
Ettner SL.
Institution
Harvard Medical School, Department of Health Care Policy, Boston, MA
02115, USA.
Title
Measuring the human cost of a weak economy: does unemployment lead to
alcohol abuse?.
Source
Social Science & Medicine. 44(2):251-60, 1997 Jan.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
This paper uses two-stage instrumental variables methods to examine
whether unemployment affects alcohol use and symptoms of dependence, and if
so, in which direction. Data were obtained from the 1988 National Health
Interview Survey. The outcomes examined were average daily consumption
during the previous two weeks and a summary measure of the number of
symptoms related to alcohol dependence during the previous year. After
eliminating potential bias due to reverse causality, evidence was found that
non-employment significantly reduces both alcohol consumption and dependence
symptoms, probably due to an income effect. Involuntary unemployment had a
mixed effect-job loss increased the consumption of alcohol in the overall
sample but reduced dependence symptoms among single respondents. Studies of
the impact of alcohol use on economic outcomes should take potential reverse
causality into account.

Citation <26>
Unique Identifier
8986247
Medline Identifier
97139648
Authors
Lalich NR. Sestito JP.
Title
Occupational health surveillance: contributions from the National Health
Interview Survey.
Source
American Journal of Industrial Medicine. 31(1):1-3, 1997 Jan.
Local Messages
Title Available at Calder Library, Check Catalog

Citation <27>
Unique Identifier
10728246
Medline Identifier
20192490
Authors
Hogan DP. Msall ME. Rogers ML. Avery RC.
Institution
Population Studies and Training Center, Brown University, Providence,
Rhode Island 02912, USA. Dennis_Hogan@brown.edu
Title
Improved disability population estimates of functional limitation among
American children aged 5-17.
Source
Maternal & Child Health Journal. 1(4):203-16, 1997 Dec.
Abstract
OBJECTIVES: This paper (a) creates and validates measures for population
survey data to assess functional limitation in mobility, self-care,
communication, and learning ability for school-age American children; (b)
calculates rates of functional limitation using these measures, and provides
population estimates of the number of children with limitations; and (c)
examines these limitations as a function of socioeconomic factors. METHOD:
The study is based on data for children aged 5-17 collected in the 1994
National Health Interview Survey on Disability. Ordinal values are assigned
to survey items in the four functional areas and analyzed to produce scales
of high reliability. These measures are used to identify within a 95%
confidence interval the number of children with these limitations. Ordered
logistic regression models measure the effects of functional limitations on
disability and societal limitation. Socioeconomic differences are measured
with an ordered logistic regr!
ession model that predicts severity and comorbidity. RESULTS: Limitations in
learning ability (10.6%) and communication (5.5%) are the most common, with
mobility (1.3%) and self-care (0.9%) occurring less often. Six percent of
children have one serious functional limitation and 2.0% have two or more
serious functional limitations. This corresponds to 4.0 million school-age
American children with serious functional limitations. Functional limitation
is strongly linked to socioeconomic disadvantage and to residence in
single-mother households. CONCLUSIONS: Future population research should use
multiple-item scales for four distinct areas of functional limitation, and a
summary that takes into account both severity and comorbidity. The improved
estimates of the number of school-age children with functional limitation in
this paper may help contribute to a more informed scientific and policy
discussion of functional limitation and disability among American school-age
children. Fut!
ure research on the disability process among children must consider the role
of socioeconomic disadvantage and family structure.

Citation <28>
Unique Identifier
10186695
Medline Identifier
98428324
Authors
Madans JH. Hunter EL.
Institution
Vital and Health Statistics Systems, National Center for Health
Statistics, Hyattsville, Maryland, USA.
Title
Improving and integrating data systems for public health surveillance.
Source
Journal of Public Health Management & Practice. 2(4):42-4, 1996 Fall.
Abstract
The National Center for Health Statistics (NCHS) is the nation's principal
health statistics agency, with a primary mission to collect, disseminate,
and analyze health data. NCHS has a clear commitment to a wide range of
improvements in surveillance and public health information systems. Building
on its long history of conducting multipurpose surveys where the needs and
interests of a variety of programmatic interests have to be accommodated,
NCHS is working on a number of fronts to improve and better integrate data
systems so that they will be more useful for public health surveillance.
Examples include the redesign of the National Health Interview Survey, the
integration of the Department of Health and Human Services' health surveys,
the retooling of the vital statistics system, and the movement to
subnational data collection.

Citation <29>
Unique Identifier
9110793
Medline Identifier
97265007
Authors
Abu-Realh MH. Magwood G. Narayan MC. Rupprecht C. Suraci M.
Institution
Health Policy Office, George Mason University, Fairfax, Va., USA.
Title
The use of complementary therapies by cancer patients. [Review] [30 refs]
Source
Nursingconnections. 9(4):3-12, 1996 Winter.
Local Messages
Title Available at Richter Library
Abstract
Since the beginning of time, persons with acute or chronic diseases have
sought added control over their fates in the form of whatever therapies
offered hope. Although conventional treatments for cancer have been proven
to lower mortality rates significantly, patients continue to look for more
ways to combat their illnesses. Little in the literature supports the actual
frequency of use of such therapies, nor do we have published data to support
the general assumption that their popularity is growing. This group of
researchers reanalyzed data from the Cancer Survivorship Questionnaire of
the 1992 National Health Interview Survey to compare the use of self-healing
and psychosocial techniques before and after 1987. Using Martha Roger's
conceptual framework of the Science of Unitary Human Beings, these therapies
were viewed as unitary field practice modalities. Results of the secondary
analysis of data from 2970 patients revealed that use of additional
therapies increased by 63.!
9% after 1987. [References: 30]

Citation <30>
Unique Identifier
9089528
Medline Identifier
97244752
Authors
Horowitz AM. Nourjah PA.
Institution
National Institute of Dental Research, National Institutes of Health,
Bethesda, MD 20892-6401, USA.
Title
Factors associated with having oral cancer examinations among US adults 40
years of age or older.
Source
Journal of Public Health Dentistry. 56(6):331-5, 1996 Fall.
Abstract
OBJECTIVES: This study describes factors associated with having an oral
cancer examination among US adults 40 years of age or older. METHODS: Data
used in this study are from the Cancer Control supplement of the 1992
National Health Interview Survey, which included questions about having had
an oral cancer screening examination and knowledge of risk factors for oral
cancers. The survey was administered to a national sample 18 years of age
and older (n = 12,035). Questions regarding beliefs and opinions about
cancers in general also were asked and their associations with responses to
having had an oral cancer examination studied. Analyses are limited to those
respondents 40 years of age and older (n = 6,538). RESULTS: Fifteen percent
of the adults reported having had an oral cancer examination. Of these, 48
percent had the exam during the past year and 31 percent had an exam one to
three years ago. Respondents who were above the poverty level, white,
non-Hispanic, 40 to 64 ye!
ars of age, and who had more than a high school education and a higher level
of knowledge about risk factors for oral cancer were more likely to have had
an oral cancer examination. CONCLUSIONS: These findings demonstrate the need
for vigorous health education and health promotion interventions aimed at
health care providers and the public to increase knowledge about risk
factors for oral cancers and to increase oral cancer examinations.

Citation <31>
Unique Identifier
8909641
Medline Identifier
97066160
Authors
Pearlman DN. Rakowski W. Ehrich B. Clark MA.
Institution
Center for Gerontology and Health Care Research, Brown University,
Providence, RI 02912, USA.
Title
Breast cancer screening practices among black, Hispanic, and white women:
reassessing differences.
Source
American Journal of Preventive Medicine. 12(5):327-37, 1996 Sep-Oct.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
INTRODUCTION: We examine racial and ethnic variations in use of screening
mammography. We first review recent literature on Blacks', Hispanics', and
non-Hispanic Whites' mammography use. Here we extend that body of literature
through use of a comprehensive national database and discussion of the
implications of race- and nonrace-stratified mammography modeling. METHODS:
Data were extrapolated from the 1990 National Health Interview Survey. Using
the Transtheoretical Model as a conceptual guide, we derived a women's stage
of mammography adoption by integrating screening history with intention to
have a future mammogram. The outcome variables included (1) not being
screened at regular intervals and (2) not intending to have a mammogram in
the future. Analyses were stratified by three groups: Blacks, Hispanics, and
non-Hispanic Whites. RESULTS: The results from the multiple logistic
regressions demonstrate that race continues to be a factor influencing
mammography use. Across a!
ll three groups, women who reported less regular cancer screening by
clinical breast exam (CBE), Pap smear testing, or breast self-examination
were less frequent users of mammography. However, the magnitude of the
associations varied for the groups being compared. The findings also
demonstrate that there were unique factors associated with not being
screened routinely and not intending to have a mammogram in the future for
all three racial/ethnic groups. CONCLUSIONS: Researchers must give explicit
attention, both empirically and methodologically, to how race and ethnicity
interact with sociodemographic factors, health practices, and access to
health care to refine our understanding of barriers to breast cancer
screening. Common barriers to routine screening may be perceived differently
by Black, Hispanic, and White women and may contribute to underuse of
mammography in distinct ways.

Citation <32>
Unique Identifier
8870304
Medline Identifier
97023984
Authors
Katz SJ. Hofer TP. Manning WG.
Institution
Department of Internal Medicine and Health Management and Policy,
University of Michigan, Ann Arbor 48109-0376, USA.
Title
Hospital utilization in Ontario and the United States: the impact of
socioeconomic status and health status.
Source
Canadian Journal of Public Health. Revue Canadienne de Sante Publique.
87(4):253-6, 1996 Jul-Aug.
Local Messages
Title Available at Richter Library
Abstract
We compared hospital use in Ontario and the United States for persons with
different socioeconomic and health status. METHODS: Cross-sectional study
using the 1990 Ontario Health Survey and the 1990 National Health Interview
Survey. RESULTS: Admission rates averaged 31% higher in Ontario than in the
United States, but international differences varied markedly across income
and health status. At each level of health status, poor Canadians received
one quarter to one third more admissions than their counterparts in the
United States. However, higher income Canadians reporting excellent to good
health had 50% more admissions than Americans, whereas those reporting fair
or poor health had 10% fewer admissions. CONCLUSIONS: The observation that
higher income sick persons receive less hospital care in Ontario than in the
U.S. provides support at the population level for what has been observed for
specific technologies. This represents, in part, a redistribution of
inpatient care t!
o those most vulnerable to illness, such as the poor, who receive
substantially more hospital care in Ontario.

Citation <33>
Unique Identifier
8868541
Medline Identifier
97022181
Authors
Husten CG. Chrismon JH. Reddy MN.
Institution
Office on Smoking and Health, Centers for Disease Control and Prevention,
Atlanta, Georgia, USA.
Title
Trends and effects of cigarette smoking among girls and women in the
United States, 1965-1993.
Source
Journal of the American Medical Womens Association. 51(1-2):11-8, 1996
Jan-Apr.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
Each year, cigarette smoking causes more than 140,000 deaths among women
in the United States. Here, we describe smoking trends among girls and
women, including women of reproductive age and pregnant women. We also
provide data regarding the prevalence of indicators of nicotine dependence
among women in the United States. The data were derived from the National
Health Interview Survey, High School Seniors Survey, National Household
Survey on Drug Abuse, and Teenage Attitudes and Practices Survey. The
prevalence of smoking among women overall is now declining at a rate
comparable to that of men, and women are attempting cessation and
maintaining abstinence at the same rate as men. However, smoking prevalence
among women in certain demographic groups such as American Indians and
Alaska Natives is high. Although the prevalence of smoking increased among
young women (particularly women of lower educational attainment) in the
early 1980s, more recent surveys show it is declining.!
Smoking prevalence among young black and Hispanic women is decreasing, but
progress in decreasing smoking prevalence among young white women is slow.
Young women appear to be as nicotine dependent as older women, and light
smokers of all ages report indicators of nicotine dependence.

Citation <34>
Unique Identifier
8860273
Medline Identifier
97013437
Authors
Nelson DE. Davis RM. Chrismon JH. Giovino GA.
Institution
Office on Smoking and Health, Centers for Disease Control and Prevention,
Atlanta, Georgia 30341, USA.
Title
Pipe smoking in the United States, 1965-1991: prevalence and attributable
mortality.
Source
Preventive Medicine. 25(2):91-9, 1996 Mar-Apr.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
BACKGROUND. National pipe-smoking prevalence data have rarely been
reported, and mortality associated with pipe smoking has not been estimated.
METHODS. We analyzed National Health Interview Survey data from 1965, 1966,
1970, 1987, and 1991 to estimate adult pipe-smoking prevalence in the United
States. For each of these years, we estimated pipe smoking-attributable
mortality from chronic obstructive pulmonary disease and cancers of the oral
cavity, larynx, esophagus, and lung. RESULTS. From 1965 to 1991, the
prevalence of current pipe smoking for men declined 12.1 percentage points
(from 14.1% to 2.0%) while pipe smoking remained very uncommon among women.
By 1991, pipe smoking was a behavior found primarily among men age 45 years
or older. Most men who smoked pipes also used other tobacco products,
especially cigarettes. About 830 deaths (range 720-2,495) in 1965 and 1,095
deaths (range 655-2,820) in 1991 were attributable to pipe smoking.
CONCLUSIONS. If current trends co!
ntinue, pipe smoking will become extremely rare in the United States by the
year 2000. Reasons for the decline in pipe smoking may include the lack of
appeal of pipe smoking to women and adolescents or the increasingly
unfavorable image of smoking behavior in general. Prevention and cessation
efforts need to be directed against all forms of tobacco, including
smokeless tobacco use, cigar smoking, and pipe smoking.

Citation <35>
Unique Identifier
8853827
Medline Identifier
97006534
Authors
Waldman HB.
Institution
Department of General Dentistry, State University of New York at Stony
Brook, NY 11794-8706, USA.
Title
Just say no! sounds right, but...
Source
Journal of Dentistry for Children. 63(3):216-21, 1996 May-Jun.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
A review is provided of the results from the National Health Interview
Survey of health-risk behavior among our nation's youth. The results
indicate a high prevalence of risk taking among preteen and teenage girls
and boys.

Citation <36>
Unique Identifier
8826141
Medline Identifier
96423540
Authors
Martin LM. Parker SL. Wingo PA. Heath CW Jr.
Title
Cervical cancer incidence and screening: status report on women in the
United States.
Source
Cancer Practice. 4(3):130-4, 1996 May-Jun.
Abstract
PURPOSE: Population-based estimates of cervical cancer incidence and
screening are described. DESCRIPTION OF STUDY: Data from the Surveillance
Epidemiology and End Results and from the 1992 National Health Interview
Survey Cancer Control Supplement were used to examine differences in disease
rates, stage at diagnosis, and screening practices among population groups.
RESULTS: The overall age-adjusted incidence rate for invasive cervical
cancer was 8.5 per 100,000 women in 1988-1992. Rates for black women were
66% higher than those for white women. At the youngest ages, rates were
similar for both races--about 2.0 per 100,000. At older ages, rates
diverged, increasing to 17.2 for white women ages 60 to 64 and 47.0 for
black women aged 85 and older. Most cervical cancers were diagnosed at the
localized stage, and older women and minority women were more likely to be
diagnosed with advanced stage disease. Almost 25% of women reported they had
not had a Papanicolaou smear test wi!
thin the past 3 years. Among women younger than 45, whites were more likely
than blacks not to have been screened. Among black women, there were
regional differences in the use of Papanicolaou test, with those who lived
in the South most likely not to be screened. CLINICAL IMPLICATIONS: Although
rates for some groups appear to be converging, disparities still exist.
Targeted approaches to screening, follow-up, and treatment are necessary to
ensure that trends in cervical cancer incidence continue to improve.

Citation <37>
Unique Identifier
8795853
Medline Identifier
96388452
Authors
Mannino DM. Siegel M. Husten C. Rose D. Etzel R.
Institution
Air Pollution and Respiratory Health Branch, Centers for Disease Control
and Prevention, Atlanta, Georgia 30341-3724, USA.
Title
Environmental tobacco smoke exposure and health effects in children:
results from the 1991 National Health Interview Survey.
Source
Tobacco Control. 5(1):13-8, 1996 Spring.
Abstract
OBJECTIVE: To determine the effect of environmental tobacco smoke exposure
on the health of children in the United States. DESIGN AND SETTING:
Cross-sectional study of children who participated in the 1991 National
Health Interview Survey. PARTICIPANTS: 17448 children residing in the United
States. MAIN OUTCOME MEASURES: Rates of respiratory illnesses and all
illnesses, and the morbidity due to these illnesses, in children exposed to
environmental tobacco smoke in the home daily compared with those in
children not exposed in the home. Our analyses controlled for age,
socioeconomic status, race, family size, sex, season, and region of the
country. RESULTS: Children who were exposed to environmental tobacco smoke
had a higher incidence of acute respiratory illnesses (relative risk (RR) =
1.10, 95% confidence interval (CI) 0.95 to 1.26) and all chronic respiratory
diseases (RR = 1.28, 95% CI 0.99 to 1.65) than children who were not
exposed, although both CIs included unity, and!
chance cannot be ruled out as being responsible for these findings.
Children who were exposed to environmental tobacco smoke had, on average,
1.87 more days of restricted activity (95% CI 0.20 to 3.54), 1.06 more days
of bed confinement (95% CI 0.20 to 1.92), and 1.45 more days of school
absence (95% CI 0.40 to 2.50) per year than children who were not exposed.
CONCLUSIONS: Environmental tobacco smoke exposure in the home, which is
completely preventable, is an important predictor of increased morbidity in
children.

Citation <38>
Unique Identifier
8776296
Medline Identifier
96372481
Authors
Pearlman DN. Rakowski W. Ehrich B.
Institution
Center for Gerontology and Health Care Research, Brown University,
Providence, Rhode Island 02912, USA.
Title
Mammography, clinical breast exam, and pap testing: correlates of combined
screening.
Source
American Journal of Preventive Medicine. 12(1):52-64, 1996 Jan-Feb.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
This study examines the correlates of screening for both breast and
cervical cancer combined in a single indicator. Data used were from the 1990
National Health Interview Survey of Health Promotion and Disease Prevention.
We used two indices to characterize the receipt of breast and cervical
cancer screening among women 50-75 years of age. The first measure compared
women who had three screening exams--clinical breast examination (CBE),
mammography, and Pap test--in the past two years with those who had not
received all three exams. The second measure compared women who had a Pap
test and at least one breast screening exam (i.e., mammogram or CBE) in the
previous two years with women who were underscreened. Age, level of
education, smoking status, and access to health care were associated with
both outcome measures. Black women were more likely to use screening
services in the office setting (i.e., CBE and Pap), without a corresponding
use of mammography. Nevertheless, more !
black than white women received a routine Pap test in combination with a
CBE, a very positive trend with respect to the successful diffusion of at
least two screening procedures among older black women. The data suggest
that barriers to mammography screening remain even among women who are
screened by CBE and Pap. Perhaps the biggest challenge is to educate primary
care physicians and their patients to view different components of
preventive health--CBE, Pap smear testing, breast self-examination, and
mammographic screening--as equally necessary and interrelated. Medical
Subject Headings (MeSH): screening, mammography, cervical cancer, Pap,
breast exam.

Citation <39>
Unique Identifier
8687247
Medline Identifier
96293434
Authors
Eheman CR. Ford E. Garbe P. Staehling N.
Institution
Division of Environmental Hazards and Health Effects, National Center for
Environmental Health, Center for Disease Control and Prevention, Atlanta, GA
USA.
Title
Knowledge about indoor radon in the United States: 1990 National Health
Interview Survey.
Source
Archives of Environmental Health. 51(3):245-7, 1996 May-Jun.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
The Year 2000 objectives for environmental health include radon testing in
40% of residences overall and in 50% of residences that house a smoker,
former smoker, or a child. Baseline data about radon and radon testing were
determined by questions included in the 1990 Health Promotion and Disease
Prevention supplement for the National Health Interview Survey. Minorities
and individuals with low income or minimal education were significantly less
likely to have heard of indoor radon than were whites and those with more
education or income. In this survey, only 3%-5% of residences had been
tested for radon. A substantial increase above the rate of testing noted for
1990 will be needed to achieve the Year 2000 objectives for indoor radon.

Citation <40>
Unique Identifier
8777072
Medline Identifier
96269137
Authors
Martin LM. Calle EE. Wingo PA. Heath CW Jr.
Institution
Department of Epidemiology and Surveillance Research, American Cancer
Society, Atlanta, Georgia 30329, USA.
Title
Comparison of mammography and Pap test use from the 1987 and 1992 National
Health Interview Surveys: are we closing the gaps?.
Source
American Journal of Preventive Medicine. 12(2):82-90, 1996 Mar-Apr.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
Using data from the National Health Interview Survey Cancer Control
Supplements, we examined the trends in mammogram and Pap smear test
screening between 1987 and 1992 and the demographic characteristics
associated with the use of those screening tests in 1992. In 1992, 67% of
women 40 years of age and older reported ever having had a mammogram
compared with 36% in 1987. A mammogram within the past year was reported by
29% of women in 1992, an increase from 14% in 1987. Among women 18 and
older, 91% had ever had a Pap smear test in 1992, and 43% had one within the
past year, an increase from 89% and 38%, respectively, in 1987. These
changes represented significant increases in the use of both mammograms and
Pap smear tests between 1987 and 1992 (P < .05). Race was not significantly
associated with underutilization of mammograms, but income showed a
significant relationship, with a declining likelihood of mammogram use as
income decreased (odds ratio [OR] = 0.4, 95% confidenc!
e interval [CI] = 0.3, 0.6 for the income less than poverty level). Pap
smear tests were less likely to be reported by older women ( > or = 65),
widows, and never-married women, African-American women were more likely
than Caucasian women to have had a Pap smear test, and women of other races
were the least likely of any race/ethnic group to have ever had one (OR =
0.2, 95% CI = 0.1, 0.4). Women with less than 12 years of education had
about a 40% decreased risk of having had a recent mammogram or Pap smear
test. Women without a usual source of medical care also underutilized both
screening procedures. Significant gains in the use of mammograms were found
for all groups between 1987 and 1992. However, for the Pap smear test, some
groups reported no differences during the five-year period. Although race
and ethnic differences in the rates of screening use have been reduced
somewhat, socioeconomically disadvantaged women and those with poor access
to health care are still import!
ant target populations for increasing screening, particularly mammograms.

Citation <41>
Unique Identifier
8610199
Medline Identifier
96179080
Authors
Nowjack-Raymer RE. Gift HC.
Institution
Disease Prevention and Health Promotion Branch, National Institute of
Dental Research, Natcher Building, Room 3AN-44D, Bethedsa MD 20892-6401 USA.
Title
Use of mouthguards and headgear in organized sports by school-aged
children.
Source
Public Health Reports. 111(1):82-6, 1996 Jan-Feb.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
Sports-related orofacial trauma is a serious problem that can be prevented
by wearing protective mouthguards and headgear. While this equipment is
available, few studies have been done of wearing practices. This study
assesses the wearing practices using data from the Child Health Supplement
of the 1991 National Health Interview Survey. Results indicate that football
was the only sport in which the majority of children used mouthguards and
headgear. While statistically significant differences (p<.05) were found in
use of the equipment in all sports by grade level, gender, parent's
education, ethnicity, and by region of the the country, these differences
were not consistent across sports. Healthy People 2000 calls for extending
requirements for use of orofacial protective devices to all organizations
sponsoring sports that pose risk to injury. Given the complex nature of the
findings, multifaceted initiatives that include the promulgation of rules
must be developed and tested!
to determine what approaches are effective in ensuring consistent use.

Citation <42>
Unique Identifier
9452642
Medline Identifier
98114713
Authors
Manski RJ. Goldfarb MM.
Institution
Department of Oral Health Care Delivery, University of Maryland,
Baltimore, USA.
Title
Dental utilisation for older Americans aged 55-75.
Source
Gerodontology. 13(1):49-55, 1996 Jul.
Abstract
OBJECTIVES: The purpose of this study was to analyze a comprehensive
nationally representative data set to determine the effect of economic and
non-economic determinants on the decision to seek care and the decision to
select a specific number of dental visits. DESIGN: The conduct of this study
involved the examination and analyses of secondary data available from the
National Health Interview Survey. A two-part choice logistic regression
model was utilized to first describe the decision to seek care and second to
describe factors associated with the decision to select a specific number of
dental visits as a function of income, education, family size, age, marital
status, presence of teeth, employment status, health status, gender, race,
insurance status, and reason for dental visit. SUBJECTS: Data analysis
focused on 5.327 non-institutional older adults between the ages of 55 and
75 who were not eligible for Medicaid. RESULTS: Results provide supporting
evidence that income!
, presence of dental insurance, presence of teeth, gender, family size,
education race and age are associated with the decision to seek dental care
and that income, presence of dental insurance, gender, family size,
education, and race are associated with the number of dental visits among
users even when the effects of other variables are controlled for.
DISCUSSION: Analyses suggest that employment may have a surprisingly limited
effect on dental utilisation and that among explanatory variables there are
differences in significance and magnitude between the decision to seek care
and the decision to select a specific number of dental visits. In addition,
in contrast with some prior studies, health status does not appear to be
associated with the decision to seek care or associated with the number of
dental visits among respondents.

Citation <43>
Unique Identifier
9136291
Medline Identifier
97282044
Authors
Kaplan RM. Alcaraz JE. Anderson JP. Weisman M.
Institution
Department of Family and Preventive Medicine, University of California,
San Diego, La Jolla 92093-0622, USA.
Title
Quality-adjusted life years lost to arthritis: effects of gender, race,and
social class.
Source
Arthritis Care & Research. 9(6):473-82, 1996 Dec.
Abstract
OBJECTIVE: To estimate the public health impact of self-reported arthritis
in terms of Quality-Adjusted Life Years. METHOD: The Quality of Well-being
Scale (QWB) is a general measure of health-related quality of life that
scores levels of wellness on a continuum between death (0.0) and optimum
functioning (1.0). Values for the QWB were imputed for the National Health
Interview Survey. These estimates were adjusted for mortality based on the
life tables. Age-specific estimates were obtained for those reporting
arthritis and compared to estimators for the population not reporting
arthritis. These estimates were broken down by race (white versus nonwhite),
gender and socioeconomic status. RESULTS: The expected life years lost
because of arthritis were 1.86 (95% confidence interval 1.40-2.32 years).
Arthritis was reported more often among those of lower income, those living
in rural areas, those of lower educational attainment, and older
respondents. Men and women did not differ!
in rates of reporting arthritis, but men with arthritis had lower QWB
scores than women with arthritis. CONCLUSION: Arthritis has a significant
public health impact.

Citation <44>
Unique Identifier
9003133
Medline Identifier
97156743
Authors
Hofer TP. Katz SJ.
Institution
Ann Arbor Veterans Affairs Health Services Research and Development Field
Program, Mich., USA.
Title
Healthy behaviors among women in the United States and Ontario: the effect
on use of preventive care.
Source
American Journal of Public Health. 86(12):1755-9, 1996 Dec.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
OBJECTIVES: This study examined how several healthy behaviors among women
in Ontario and the United States explained (1) the use of preventive health
services, (2) differences in use between socioeconomic groups, and (3)
differences in use between the two health systems. METHODS: 1990 data on
women from the Ontario Health Survey (n = 22,985) and the US National Health
Interview Survey (n = 19,092) were analyzed. A woman who avoided smoking and
obesity, used seatbelts, and regularly engaged in aerobic exercise was
defined as having a healthy lifestyle. Women were considered screened if
they reported a mammogram or a breast exam within the previous year or a Pap
smear within 2 years. RESULTS: A healthy lifestyle was more common in the
United States than Canada among more highly educated groups (odds ratio [OR]
= 1.40; 95% confidence interval [CI] = 1.22, 1.60 for college educated) but
less common in the United States for those with less than a high school
education (OR = 0.52;!
95% CI = 0.40, 0.67). Each additional unhealthy behavior decreased the odds
of having undergone a mammogram in the previous year by 20%. However,
adjusting for the number of unhealthy behaviors did not substantially change
the relationship between socioeconomic status and use of preventive
services. CONCLUSIONS: The number of healthy behaviors is an important
measure of demand for preventive health services. This measure varies across
country and socioeconomic group.

Citation <45>
Unique Identifier
9001367
Medline Identifier
97154649
Authors
Slesinski MJ. Subar AF. Kahle LL.
Institution
Division of Cancer Prevention and Control, National Cancer Institute,
Bethesda, MD 20892, USA.
Title
Dietary intake of fat, fiber and other nutrients is related to the use of
vitamin and mineral supplements in the United States: the 1992 National
Health Interview Survey.
Source
Journal of Nutrition. 126(12):3001-8, 1996 Dec.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
Supplement intake is hypothesized to increase the risk of some diseases
while decreasing the risk of others. Both diet and lifestyle behaviors,
however, may be associated with supplement use and confound observed
associations. Nutrient intake from a food frequency questionnaire,
demographic characteristics and lifestyle among supplement users and
nonusers were examined in 11,643 adults who participated in the 1992
National Health Interview Survey Epidemiology Supplement. Forty-six percent
reported taking a supplement in the past year; 24% reported daily use. Daily
use was highest among women, whites, those 75 y of age or older, those at or
above the poverty level, those with more than 12 y of education, former
smokers, and light drinkers consuming less than one alcoholic beverage per
week. When controlled for sociodemographic factors, smoking status and
drinking habits, there were no significant (P < 0.01) differences in dietary
nutrient intake between daily and occasional s!
upplement users. Compared with those of nonusers, diets of vitamin
supplement users were lower (P < 0.001) in fat and higher in fiber and
vitamins A and C for both men and women and higher in vitamin E and calcium
for women only. In general, diet, demographic and lifestyle characteristics
of supplement users are typical of patterns associated with low risk of
chronic disease.

Citation <46>
Unique Identifier
8997888
Medline Identifier
97151955
Authors
Rogers RG.
Institution
Population Program, University of Colorado, Boulder 80309-0484, USA.
Richard.Rogers@colorado.edu
Title
The effects of family composition, health, and social support linkages on
mortality.
Source
Journal of Health & Social Behavior. 37(4):326-38, 1996 Dec.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
This study reveals how family living arrangements influence mortality. I
use the National Health Interview Survey, Supplement on Aging, and
discrete-time hazard rate models to show that some family arrangements
result from strong social bonds, but others are a result of financial needs
or health problems. In some instances, it is not family living arrangements
that influence the risk of mortality but vice versa: The family rearranges
itself to deal with ill health and disability among its members. The family
strives to promote health, prevent disease, and encourage economic security.
However, family members who endure economic or health hardships face
increased risk of death.

Citation <47>
Unique Identifier
10164037
Medline Identifier
97140113
Authors
Mullahy J. Sindelar J.
Institution
Trinity College, New Haven, CT 06106, USA.
Title
Employment, unemployment, and problem drinking.
Source
Journal of Health Economics. 15(4):409-34, 1996 Aug.
Local Messages
Title Available at Richter Library
Abstract
The misuse of alcohol is estimated to result in enormous economic costs,
composed largely of reduced labor market productivity. However, there has
been debate on this issue. The purpose of this paper is to help to resolve
this debate by presenting sound structural estimates of the relationship
between measures of problem drinking and of employment and unemployment. The
analysis is based on the 1988 Alcohol Supplement of the National Health
Interview Survey. We find that for both men and women, problem drinking
results in reduced employment and increased unemployment.

Citation <48>
Unique Identifier
8935244
Medline Identifier
97089336
Authors
McDermott S. Coker AL. Mani S. Krishnaswami S. Nagle RJ.
Barnett-Queen LL. Wuori DF.
Title
A population-based analysis of behavior problems in children with cerebral
palsy.
Source
Journal of Pediatric Psychology. 21(3):447-63, 1996 Jun.
Local Messages
Title Available at Richter Library
Abstract
Used the National Health Interview Survey, Child Health Supplement for
1981 and 1988, to analyze parent-reported behavior problems of children,
ages 4-17 years, with cerebral palsy (n = 47), with mental retardation (n =
50), with other chronic conditions (n = 6,038), and with no known health
problem (n = 5,930), using the Behavior Problem Index (developed by Zill &
Peterson). Behaviors with scores greater than the 90th percentile of the
entire sample were considered problem behaviors. Parent-reported behavior
problems were 5 times more likely in children with cerebral palsy (25.5%)
compared with children having no known health problem (5.4%). The adjusted
odds ratio for behavior problems of children with cerebral palsy without
mental retardation was 4.9 and of children with mental retardation without
cerebral palsy was 7.9. Specific behaviors that were most problematic for
children with cerebral palsy were identified as dependency, headstrong, and
hyperactive.

Citation <49>
Unique Identifier
8931198
Medline Identifier
97084864
Authors
LaVange LM. Stearns SC. Lafata JE. Koch GG. Shah BV.
Institution
Quintiles, Inc., Research Triangle Park, NC 27709-3979, USA.
Title
Innovative strategies using SUDAAN for analysis of health surveys with
complex samples.
Source
Statistical Methods in Medical Research. 5(3):311-29, 1996 Sep.
Abstract
Large-scale health surveys provide a wealth of information for addressing
problems in health sciences research. Designed for multiple purposes, these
surveys frequently have large sample sizes and extensive measurements of
demographic and socioeconomic characteristics, risk factors, disease
outcomes and health care service use and costs. Complex features of the
sampling design typically employed to select the survey sample, coupled with
the vast amount of information available from the survey database, underlie
issues that must be addressed during data processing and analysis. Numerous
articles in the literature have focused on the debate of whether or not, and
how, to control for features of the sample design during data analysis.
Traditional statistical methods for simple random samples and the software
that accompanies them have historically not had the capacity to account for
the survey design. Recent advancements in statistical methodology for survey
data analysis have !
greatly expanded the analytical tools available to the survey analyst.
Commercial software packages that incorporate these methods offer the
analyst convenient ways for applying such tools to large survey databases in
an easy and efficient manner. We present an overview of analysis strategies
for survey data and illustrate their application via the SUDAAN software
system. Examples for analyses are provided through data from two large US
health surveys, the National Health Interview Survey and the Longitudinal
Study of Aging. Questions of both a cross-sectional and longitudinal nature
are addressed. The examples involve logistic regression, time-to-event
analysis, and repeated measures analysis.

Citation <50>
Unique Identifier
8918185
Medline Identifier
97075794
Authors
Caplan LS. Haynes SG.
Institution
Department of Preventive Medicine, State University of New York at Stony
Brook, USA.
Title
Breast cancer screening in older women.
Source
Public Health Reviews. 24(2):193-204, 1996.
Abstract
BACKGROUND: There is currently an epidemic of breast cancer in women 65
years of age and older. The purposes of this paper are to explore the breast
cancer screening behaviors of older women and to identify some of the
determinants of screening in these women. METHODS: Data were analyzed from
the 1987 National Health Interview Survey, a continuous nationwide household
interview survey of the U.S. civilian, noninstitutionalized population.
RESULTS: As in other studies, the utilization of breast cancer screening by
older women was less in older women than in younger women. This was true for
both mammography and clinical breast examination. A number of determinants
of screening in older women were identified here. Women with a usual source
of care and/or no activity limitation, as well as high school graduates,
were the ones most likely to have received a screening mammogram and/or a
screening clinical breast exam during the past year. DISCUSSION: The failure
of older women to !
receive adequate breast cancer screening is an important concern which
should be reevaluated, given the breast cancer epidemic in this population.
This study identified a number of determinants of breast cancer screening in
older women. For the most part, these determinants point to the primary care
physician as the key to breast cancer screening in these women. Therefore,
the primary care physician must be informed of, and encouraged to follow,
the recommendations for periodic breast cancer screening in older women.

Citation <51>
Unique Identifier
8916524
Medline Identifier
97073975
Authors
Zhu BP. Giovino GA. Mowery PD. Eriksen MP.
Institution
Office on Smoking and Health, Centers for Disease Control and Prevention,
Atlanta, Ga 30341-3724, USA.
Title
The relationship between cigarette smoking and education revisited:
implications for categorizing persons' educational status.[comment][erratum
appears in Am J Public Health 1997 Feb;87(2):168].
Comments
Comment in: Am J Public Health. 1996 Nov;86(11):1525-6; PMID: 8916514
Source
American Journal of Public Health. 86(11):1582-9, 1996 Nov.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
OBJECTIVE: This study sought to reassess the relationship between
cigarette smoking and education. METHODS: Data from the 1983 to 1991
National Health Interview Survey for participants aged 25 years and older
were used to plot the prevalence of current smoking, ever smoking, heavy
smoking, and smoking cessation, as well as the adjusted log odds ratios, by
years of education. RESULTS: The "less than high school graduate" category
consisted of two groups with distinct smoking patterns: persons with 0 to 8
years and persons with 9 to 11 years of education. The latter were the most
likely to be current, ever, and heavy smokers and the least likely to have
quit smoking, whereas the former were similar to persons having 12 years of
education. After 11 years of education, the likelihood of smoking decreased
and that of smoking cessation increased with each successive year of
education. These results persisted after the statistical adjustment for age,
sex, ethnicity, poverty status,!
employment status, marital status, geographic region, and year of survey.
CONCLUSIONS: The relationship between smoking and education is not
monotonic. Thus, when evaluating smoking in relation to education,
researchers should categorize years of education as follows: 0 to 8, 9 to
11, 12, 13 to 15, and 16 or more years.

Citation <52>
Unique Identifier
8914499
Medline Identifier
97071653
Authors
Callahan CM. Wolinsky FD.
Institution
Department of Medicine, Indiana University School of Medicine, USA.
callahan_c@regenstrief.iupui.edu
Title
Hospitalization for pneumonia among older adults.
Source
Journals of Gerontology Series A-Biological Sciences & Medical Sciences.
51(6):M276-82, 1996 Nov.
Abstract
BACKGROUND: Hospitalizations and mortality due to pneumonia increase
steadily with age. The purpose of this study is to describe the frequency,
costs, and risk factors for hospitalization for pneumonia among older adults
with particular attention to the effect of functional disability. METHODS:
The Longitudinal Study of Aging (LSOA) is the follow-up to the Supplement on
Aging, which was appended to the 1984 National Health Interview Survey.
Participants included a nationally representative sample of 7,527
community-dwelling adults aged 70 and older in 1984 who were followed
prospectively for 8 years. The LSOA data are linked to the National Death
Index and to yearly abstracts from the Medicare Automated Data Retrieval
System (1984-1991). RESULTS: From 1984 to 1991, 617 subjects (8.2%) had at
least one hospitalization for pneumonia, 4,333 (57.5%) had at least one
hospitalization for any reason, and 2,867 (38.1%) of the LSOA subjects died.
The yearly frequency of hospitalizati!
on for pneumonia increased over time from 0.6% in 1984 to 2.4% in 1991. The
median length of stay was 8 days, and the median hospital charge was $5,100.
Over 8 years, median discounted charges for a pneumonia hospitalization
increased 75% while length of stay remained relatively constant. Patients
hospitalized for pneumonia had greater comorbidity, total hospital resource
use, and mortality, but over 80% survived their first hospitalization for
pneumonia. Hospitalization for pneumonia was associated with age, male
gender, malnutrition, history of hip fracture, prior hospitalizations, and
lower body limitations. CONCLUSIONS: Hospitalization for pneumonia was
frequent and accounted for 6% of the Medicare expenditures over 8 years
among this cohort of older adults. Hospitalization for pneumonia occurred
most often among subjects with prior evidence of failing health, but most
subjects survived the first hospitalization for pneumonia. Even controlling
for comorbidity, prior hospit!
alizations, and functional impairment, hospitalization for pneumonia was
independently associated with age.

Citation <53>
Unique Identifier
8903258
Medline Identifier
97060223
Authors
Hoffman C. Rice D. Sung HY.
Institution
Institute for Health and Aging at the University of California, San
Francisco, USA.
Title
Persons with chronic conditions. Their prevalence and costs.[comment].
Comments
Comment in: JAMA. 1997 Feb 5;277(5):375-6; PMID: 9010165
Source
JAMA. 276(18):1473-9, 1996 Nov 13.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
OBJECTIVES: To determine (1) the number and proportion of Americans living
with chronic conditions, and (2) the magnitude of their costs, including
direct costs (annual personal health expenditures) and indirect costs to
society (lost productivity due to chronic conditions and premature death).
DESIGN: Analysis of the 1987 National Medical Expenditure Survey for
prevalence and direct health care costs; indirect costs based on the 1990
National Health Interview Survey and Vital Statistics of the United States.
SETTING: US population. PARTICIPANTS: For the estimate of prevalence and
direct costs, the National Medical Expenditure Survey sample of persons who
reported health conditions associated with (1) use of health services or
supplies or (2) periods of disability. INTERVENTIONS: None. MAIN OUTCOME
MEASURES: The number of persons with chronic conditions, their annual direct
health care costs, and indirect costs from lost productivity and premature
deaths. RESULTS: In 1987, 9!
0 million Americans were living with chronic conditions, 39 million of whom
were living with more than 1 chronic condition. Over 45% of
noninstitutionalized Americans have 1 or more chronic conditions and their
direct health care costs account for three fourths of US health care
expenditures. Total costs projected to 1990 for people with chronic
conditions amounted to $659 billion--$425 billion for direct health care
costs and $234 billion in indirect costs. CONCLUSIONS: The prevalence and
costs of chronic conditions as a whole have rarely been estimated. Because
the number of persons with limitations due to chronic conditions is more
regularly reported in the literature, the total prevalence of chronic
conditions has perhaps been minimized. The majority of persons with chronic
conditions are not disabled, nor are they elderly. Chronic conditions affect
all ages. Because persons with chronic conditions have greater health needs
at any age, their costs are disproportionately hi!
gh.

Citation <54>
Unique Identifier
8888151
Medline Identifier
97042953
Authors
Hiatt RA. Pasick RJ.
Institution
Northern California Cancer Center, Union City 94587, USA.
Title
Unsolved problems in early breast cancer detection: focus on the
underserved.
Source
Breast Cancer Research & Treatment. 40(1):37-51, 1996.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
In the last decade, numerous research and programmatic efforts have
attempted to improve cancer screening practices among women from diverse
race/ethnic backgrounds on the assumption that observed differences in
breast cancer survival were largely due to differences in early detection
practices. Recent data from the 1992 National Health Interview Survey and a
1992 survey in San Francisco Bay Area multiethnic communities indicate that
rates of self-reported breast cancer screening tests among African American,
Hispanic, and white women no longer differ significantly. However, there are
large, persistent socioeconomic differences as reflected in educational and
income levels, the recency of immigration, and English language proficiency.
This emphasizes the continuing need for interventions tailored specifically
for the underserved, with the racial, ethnic, and cultural composition of
the intended audience informing educational messages and strategies.
However, effective resear!
ch interventions are complex and costly throughout the spectrum of outreach,
inreach, and follow-up. Thus the generalizability of these strategies to
under-founded providers and agencies in low-income communities may be
limited. Therefore, as ongoing research continues to refine strategies, the
application of effective community-based intervention should seek out
potential partnerships with programs that provide the critical access to
services. Cancer control scientists are well positioned to advocate for
community-based infrastructures that facilitate translation of research into
practice.

Citation <55>
Unique Identifier
8885213
Medline Identifier
97039661
Authors
Meltzer AA. Everhart JE.
Institution
Social & Scientific Systems, Inc., Bethesda, MD 20814, USA.
Title
Correlations with self-reported weight loss in overweight U.S. adults.
Source
Obesity Research. 4(5):479-86, 1996 Sep.
Local Messages
Title Available at Richter Library
Abstract
The authors investigated two issues among overweight men and women in the
U.S.: 1) what is the influence of the self-expressed intention to lose
weight in the presence of other potential predictors of loss and 2) what are
easily identifiable predictors of intentional weight loss during a 1-year
recall period. The sample consisted of 1996 overweight men (body mass index
(BMI > or = 27.8 kg/m2) and 2586 overweight women (BMI > or = 27.3 kg/m2)
who answered questions regarding 1-year weight change in a Current Health
Topic supplement of the population-based 1989 National Health Interview
Survey. Of these overweight persons, 56.8% of men and 72.1% of women
attempted to lose weight during the previous year. The most important
characteristic associated with weight loss was the expressed intention
itself. For any weight loss, the odds ratios (95% confidence intervals) for
intention were 4.6 (3.6-5.9) for men and 3.8 (2.8-5.0) for women.
Controlling for other factors reduced the odd!
s only slightly, to 4.3 for men and 3.5 for women. Among women, older age,
having a greater frequency of blood pressure checks, and being in poorer
health reduced the influence of intent as a predictor of loss. To address
the second objective, the identification of predictors of intentional 1-year
weight loss, analysis was restricted to overweight persons who attempted to
lose weight. For both sexes, statistically significant predictors (p < 0.05)
included never being married, smoking, higher BMI, being diabetic, and
having a higher number of blood pressure checks. Being divorced or separated
was predictive of weight loss in men only. Also, men were more likely to
achieve weight loss than women. In conclusion, 1-year weight loss among the
overweight was primarily a function of the intention to lose weight,
although other factors contributed to determine whether weight loss was
achieved.

Citation <56>
Unique Identifier
8876807
Medline Identifier
97030866
Authors
Blanc PD. Faucett J. Kennedy JJ. Cisternas M. Yelin E.
Institution
Division of Occupational and Environmental Medicine, School of Medicine,
University of California San Francisco 94143-0924, USA.
Title
Self-reported carpal tunnel syndrome: predictors of work disability from
the National Health Interview Survey Occupational Health Supplement.
Source
American Journal of Industrial Medicine. 30(3):362-8, 1996 Sep.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
The objective of this study was to identify risk factors for work
disability among persons with carpal tunnel syndrome (CTS). The study was
designed to analyze data from the Occupational Health Supplement of the
National Health Interview Survey, a nationwide, population-based survey.
Subjects included 544 survey respondents with self-report of CTS and 32,688
survey respondents without CTS, all aged 18-64 years, and with a history of
labor force participation. Measurements were as follows: Dependent variables
were work disability, defined either as cessation of employment without
attribution of cause or, alternatively, as cessation of employment or job
change specifically attributed to CTS by the survey respondent. Independent
variables were ergonomic risk of work disability, defined by minutes of
workplace repetitive hand and wrist bending for the most recent job held.
This measure was derived from responses categorized by an occupation and
industry matrix independent of CTS!
status. Socio-demographic and health status risk factors for work
disability were based on the respondent report. The main results were as
follows: Among 544 persons with CTS, 58 (11%, CI 8-13%) reported work
disability specifically attributed to CTS, representing an estimated
national prevalence of 240,578 persons with this limitation. Workplace
ergonomic risk, measured as repetitive hand or wrist bending in the
occupation and industry of last employment, was a significant factor
predictive of CTS-attributed work disability (per 120 min of daily exposure,
OR 1.7, CI 1.1-2.6), even after taking into account socio-demographic
factors and health status. The conclusions were that work disability among
persons with CTS is common. For those with CTS, working conditions
characterized by repetitive bending of the hand or wrist may increase the
risk of work disability associated with this condition.

Citation <57>
Unique Identifier
8862168
Medline Identifier
97015487
Authors
Anderson JE.
Institution
Division of Adolescent and School Health, National Center for Chronic
Disease Prevention and Health Promotion, Centers for Disease Control and
Prevention, Atlanta, GA 30333, USA.
Title
CDC data systems collecting behavioral data on HIV counseling and testing.
Source
Public Health Reports. 111 Suppl 1:129-32, 1996.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
This paper describes two systems, the HIV Counseling and Testing Data
System and the National Health Interview Survey, AIDS Knowledge and
Attitudes Supplement, that collect behavioral information on HIV counseling
and testing in the United States. Together these data sources provide
valuable information for planning and evaluating counseling and testing
programs. While these two systems are not designed primarily for behavioral
research, they both collect behavioral data, including the behavioral risk
category of persons being tested.

Citation <58>
Unique Identifier
8862167
Medline Identifier
97015486
Authors
Safran MA. Wilson RW.
Institution
Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB
Prevention, Centers for Disease Control and Prevention (CDC), 30341-3724,
USA.
Title
Surveillance of HIV knowledge, attitudes, beliefs, and behaviors in the
general population.
Source
Public Health Reports. 111 Suppl 1:123-8, 1996.
Local Messages
Title Available at Calder Library, Check Catalog
Abstract
This article discusses methods and elements of three major national health
survey systems, particularly as they relate to HIV infection and AIDS. The
National Health Interview Survey and the Behavioral Risk Factor Surveillance
System provide information about health-related knowledge, attitudes,
beliefs, and behaviors of adults in the United States. The Youth Risk
Behavior Surveillance System measure health-related behaviors of American
youth. Questions and survey designs differ among the three surveys, but all
three surveys utilize probability sampling. The National Health Interview
Survey's AIDS Knowledge and Attitudes Supplement is administered to a
subsample of approximately 20,000 people annually. The Behavioral Risk
Factor Surveillance System consists of telephone surveys providing data for
all 50 states and the District of Columbia, with an average annual sample
size of approximately 2,000 per state. The Youth Risk Beha