Potentials of local health surveys: a state-of-the-art summary

REPRINT OF: The Behavioral Risk Factor Surveys: I. State-Specific Prevalence Estimates of Behavioral Risk Factors

Editor's Note: This article is a reprint of a previously published article. For citation purposes, please use the original publication details: Marks JS, Hogelin GC, Gentry EM, et al. The Behavioral Risk Factor Surveys: I. State-specific prevalence estimates of behavioral risk factors. Am J Prev Med. 1985;1(6):1-8. The prevalence of most behavioral risk factors varies substantially among states. The prevalence of current cigarette smoking ranges from 22 percent to 38 percent. Estimates of alcohol use show geographic clustering, with lower rates in the southeastern states. The prevalence of sedentary lifestyle, uncontrolled hypertension, overweight, and seatbelt use differs markedly among states. These findings represent an initial step toward the analysis of state-specific baseline risk-factor data for use in developing state programs aimed at reducing the leading causes of death in the United States.

Correlates of mental health service utilization in married women in tehran 2011

OBJECTIVE

There are disparities in mental health services (MHS) utilization within and between populations and several factors are studied as its potential correlates. Identifying those correlates would help health policy makers to adjust service provision with characteristics of their community. To evaluate demographic, socioeconomic and system correlates of MHS utilization among married women from Tehran, Iran.

METHODS

A household survey of 615 married women residents of 22 municipal districts of Tehran selected via a cluster sampling method. All subjects were asked about health services utilization during last one and 12 months as well as need and access for MHS, demographic and socioeconomic factors. Independent correlates of MHS use were determined with logistic regression analysis.

RESULTS

Total 615 women, mean±SE age and duration of marital life of 42.6±0.9 and 22±0.8 years, respectively were selected, rate of MHS utilization during last one and 12 months were 5.2% and 10.1% respectively. 23.6% of women reported having mental illness and 19.3% and 17.9% had need for MHS and access to outpatient health services, respectively. Logistic regression models showed that need for MHS (OR:5.25, 95%CI:2.7-10.1), access to outpatient services (OR:2.17, 95%CI:1.04-4.52), smoking (OR:3.4, 95%CI:1.16-10.2) and crowding index (OR:0.69, 95%CI:0.48-0.99).

CONCLUSIONS

Rate of MHS utilization in women are low considering the near to estimated rate of perceived illness. Bridging the gap between perceived illness and need for services, then providing better access to services in areas with higher crowding index and higher rates of smoking in residents should considered in any mental health promotion programs.

DECLARATION OF INTEREST

None.

Health promotion data for state health departments: telephone versus in-person survey estimates of smoking and alcohol use

Abstract During 1988, more than 40 state health departments conducted telephone surveys to obtain state-specific population estimates of the prevalence of adult health behaviors and health practices. However, the comparability of estimates obtained from these telephone surveys with more expensive in-person surveys has not been assessed in an applied setting. This study compared the prevalence estimates of smoking and binge drinking obtained from a telephone survey (N = 1,492) with an in-person survey (N = 2,802) which were conducted by the state of Michigan during 1982-1983. Although the standard errors for the differences in the estimates for the two surveys were relatively large, the actual differences were consistently small within most age-, sex-, and education-specific groups. Despite certain limitations, telephone surveys provide a reasonable alternative to in-person surveys for estimating the prevalence of health behaviors. The data obtained from these surveys are being used to set state health objectives, to plan state-wide health promotion programs, and to support public health legislation.

Parents matter--but relations to parents do not explain gender differences in self-reported health in adolescents

The aim of the study was to explore whether parent-adolescent relations are associated to self-reported health of adolescents. Logistic regression analyses were performed on a cross-sectional data set consisting of 5060 adolescents, grades 7-9, from six municipalities in the northern part of Sweden. The study was approved by the Regional Ethical Review Board in Umeå, Sweden. Results showed that, in both boys and girls, experiencing low parental demands as well as perceiving the relationship quality and the communication with parents as poor were significantly associated with having poor general health, somatic complaints and feelings of stress. In general, girls scored lower on self-reported health than boys, but our findings indicate that these gender differences could not be explained by relations to parents. In conclusion, relations to parents play an important role for self-reported health of adolescents. Although no causal-effect statements can be determined in this study, it is implied that there is a need for health professionals, such as school nurses, school welfare officers, etc., to pay special attention to parent-adolescent relations in their work with adolescents.

Assessing physician/patient perceptions in rheumatoid arthritis. A vital component in patient education

Patient education surveys were completed by 101 patients with rheumatoid arthritis and by 28 rheumatologists to assess and compare patients' reports with physicians' perceptions of patients' needs regarding content, provider, and education program delivery methods. Both groups agreed on the importance of patients' education about arthritis, especially on the topics of medication, physician/patient communication, quackery, and maintaining ambulation. A higher proportion of physicians reported that patient education was needed in psychosocial areas, activities of daily living, sexual concerns, and community resources. Patients sought more education in disease process, diagnostic procedures, and nutrition. Patients rated pharmacists and nutritionists significantly more important as educational sources than did physicians. Both groups reported individual patient/practitioner meetings as the preferred delivery method. Physicians reported group education to be valuable for some psychosocial topics; patients disagreed significantly. Despite considerable consensus, disagreements were evident in the psychosocial area and in the role of allied health professionals. Clarification, understanding, and resolution of these differences should be sought before implementing patient education programs.

Application of epidemiology in community oriented primary care

Community oriented primary care (COPC) is the integrated practice of primary health care and community medicine, bringing together the care of individuals and the care of the community and its subgroups. Epidemiology plays an indispensable role in COPC. The specific features of epidemiology as it is applied in COPC include its pragmatic purpose, its locale, its content, its scale, its specific relevance to the community health programs of the practice, and its clinical setting. The functions of epidemiology in the phases of program development are in the appraisal of needs and priorities, in community diagnosis and health surveillance, in the formulation of objectives and targets, in the choice of strategies and the identification of target groups, and in the implementation, monitoring, and evaluation of programs--as well as in the stimulation of community involvement and as an aid to the clinical management of individual patients. Teaching the epidemiologic skills that are required for COPC necessitates exposure to an epidemiology curriculum which deals with these features and to a COPC practice. An urgent need exists to develop units that will practice, teach, and demonstrate COPC--units in which practitioners, teachers, and students can gain experience and develop, test, and evaluate approaches to the provision of COPC.

The effects of high voltage transmission lines on the health of adjacent resident populations

A community health survey of 438 individuals was taken to detect health problems related to high voltage electrical transmission among an adjacent residential population. Results revealed no significant or consistent relationships between exposure to a high-voltage DC power line and the perceived health problems that were measured. The sample was not, however, large enough to draw statistically significant conclusions regarding possible health effects with a very low incidence.

Personal versus telephone surveys for collecting household health data at the local level

Personal and telephone interview surveys were conducted simultaneously during 1981 in the same area (four counties in the area of Tampa Bay, Florida) and utilizing the same interview schedule. Following completion of the surveys, validity checks were made with the medical providers reported by a subsample of respondents to each mode. The telephone survey yielded a lower response rate but cost less than half the personal interview. There was some evidence of nonresponse bias in the telephone survey, and some relatively minor differences in responses were found between the two modes, but there was no conclusive evidence that the response differences resulted from mode effects. Telephone respondents appeared to be somewhat more accurate in their reporting of visits to medical providers, although accuracy comparisons must be interpreted with caution in view of the disparate success experienced for the two modes in securing permission forms for the release of medical record information.

Data requirements to measure progress on the objectives for the nation in health promotion and disease prevention

The Reagan Administration has adopted the policy guidelines developed over the previous few years in the disease prevention and health promotion initiative of the Carter Administration. Broad national consensus had been sought in the formulation of 226 measurable objectives for the decade. We classify the prevention objectives according to their position in an implied causal chain: 1) improved programs, 2) increased public and professional awareness, 3) reduced risk factors, and 4) improved health status. Prior to 1980, the data systems and periodic surveys sponsored by federal agencies and national organizations covered only four of the 42 objectives in the public and professional awareness category, whereas at least half of the objectives in each of the other three categories were covered by available national data sources, mostly federal. Sample surveys are needed to measure the majority of the currently unmeasured objectives in all four categories. Private and state health interview surveys are needed to supplement the federal capacity, especially in the face of federal cutbacks in survey capacity.