National Health and Nutrition Examination Survey

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National Health and Nutrition Examination Survey
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National Health and Nutrition Examination Survey
(NHANES)
Objective To assess the health and nutritional
status of adults and children in the United
States
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National Health and Nutrition
Examination Surveys
Survey
Dates
Ages
NHES I 1960-62 18-79 years NHES II 1963-65 6-11
years NHES III 1966-70 12-17 years NHANES
I 1971-75 1-74 years NHANES II 1976-80 6 mo.-74
years HHANES 1982-84 6 mo.-74 years NHANES
III 1988-94 2 mo. NHANES 1999- All ages
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NHANES topics

• Cardiovascular disease
• Diabetes, lower extremity disease
• Bone status, osteoporosis
• Oral health
• Vision
• Hearing and balance
• Fitness and strength

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NHANES topics

• Nutrition
• Anthropometry
• Mental health
• Risk behaviors
• Reproductive health
• Environmental exposures
• Infectious diseases

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NHANES survey methods

• Eligible population
• Civilian, non-institutionalized household
  population
• All states and D.C.
• All ages

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NHANES sample design

• Oversample
• African Americans
• Mexican Americans
• Adolescents aged 12-19
• Older persons aged 60
• Pregnant women
• Low income whites

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Stage 1 Counties
Stage 2 Segments
Stage 3 Households
Stage 4 SPs
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NHANES information flow
Informed consent
Advance letter
In-home interview
Screening
Exam
Biologic Specimens
Lab
NCHS
Participant
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Field interviews
Pentop handheld computer
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NHANES Mobile Exam Center
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NHANES mobile examination centers

• Standard environment
• Standard equipment
• Standard specimen collection
• Standard staff procedures
• Automated data collection
• Minimal site-specific error

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NHANES Mobile Examination Center (MEC)staff

• Physician
• Dentist
• Dietary interviewers (2)
• Private health interviewers (2)
• Health technicians (3)
• Phlebotomist (1)
• Manager
• Coordinator

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Health Examination

• Exam duration 1-4 hours
• Remuneration 100
• Several examinations, private health interviews
• Participants receive exam findings

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NHANES report of findings
Time after exam
Report

• On day of exam Preliminary report of findings
  referrals
• 1-2 weeks Notification of abnormal values -
  (letter sent by mail)

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NHANES report of findings
Time after exam
Report

• 4 weeks Sexually transmitted disease test
  reporting (self-initiated telephone reporting,
  toll-free line)
• 12-16 weeks Final report of findings
• (sent by mail)

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NHANES key response rates
Current
1999
2000
2001
total
Percent
78
85
86
83
Interviewed
71
80
81
78
MEC examined
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ISIS architecture
Household interviews
Westat home office
T1
T1
National Frame Relay Network
Field office
T1
64kb
NCHS
MEC
Labs graders
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Data release process

• QA/QC
• Editing/cleanup
• Weighting
• Data preparation
• Documentation
• Confidentiality review

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NHANES data dissemination

• Public use files
• 1999-2000 NHANES available on internet as of
  June 21, 2002
• Plan for 2001-2002 release in 2004 and 2003-2004
  release in 2006

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NHANES web site

• http//www.cdc.gov/nchs/nhanes.htm

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Reports and Data Briefs 1999 NHANES

• Blood and hair mercury levels
• Blood lead levels
• Folate status in women
• Prevalence of overweight
• National report on human exposures to
  environmental chemicals

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