Longitudinal and cross-sectional changes in active commuting to school among Brazilian schoolchildren

Objective

The objective of the study is to evaluate cross-sectional and longitudinal changes in children's commuting to school in a representative sample of a Brazilian city.

Methods

Two school-based studies were carried out in 2002 (n = 2936; 7-10 years old) and 2007 (n = 1232; 7-15 years old) in Florianopolis, Brazil. Cross-sectional data were collected from children aged 7 to 10 years in 2002 and 2007. Longitudinal analyses were performed with data from 733 children participating in both surveys. Children self-reported their mode of transportation to school using a validated illustrated questionnaire. Changes were tested with chi square statistics and McNemar's test.

Results

Cross-sectional data showed a 17% decline in active commuting; a decrease from 49% in 2002 to 41% in 2007. On the other hand, active commuting among the 733 children increased as they entered adolescence 5 years later, rising from 40% to 49%.

Conclusion

Active commuting to school decreased in Brazilian children aged 7-10 years over a five year period; whereas, it increased among children entering adolescence. Policies should focus on safety and environmental determinants to increase active commuting.     

Bicycling to school is associated with improvements in physical fitness over a 6-year follow-up period in Swedish children

Objective

To examine whether modes of commuting to school at baseline and changes in commuting were related to 6-year changes in cardiorespiratory fitness in youth.

Methods

A total of 262 (142 girls) Swedish children (9 years at entry) were measured at baseline (1998/9) and follow-up (2004/5). Mode of commuting to school was assessed by questionnaire and fitness by a maximal bicycle test.

Results

At baseline, 34% of children used passive modes of commuting (e.g., car, motorcycle, bus, train), 54% walked, and 12% bicycled to school. Six years later the percentage of bicyclists increased 19% and the percentage of walkers decreased 19%. On average, children who bicycled to school increased their fitness 13% (p = 0.03) more than those who used passive modes and 20% (p = 0.002) more than those who walked. Children who used passive modes or walked at baseline and bicycled to school at 6 years later increased their fitness 14% (p = 0.001) more than those who remained using passive modes or walking at follow-up.

Conclusions

Implementing initiatives that encourage bicycling to school may be a useful strategy to increase cardiorespiratory fitness of children.     

Active commuting to school in New Zealand children (2004-2008): a quantitative analysis

Objective

To describe trends in active commuting to school in children from Auckland region, New Zealand following implementation of the School Travel Plan (STP) program. The program included educational initiatives, enforcement activities and urban form changes around school environments.

Methods

Active commuting to school was estimated for 57,096 students, aged 5-10 years, from 56 elementary schools. Data were drawn from surveys conducted between 2004 and 2008.

Results

There was an overall increase in active commuting by the third year of STP implementation when compared to baseline levels (40.5% to 42.2%), [OR = 2.65, 95% CI = 1.75-4.02]. Students of high socio-economic background improved (38.9% to 39.1%) compared to those from mid [OR = 0.66, 95% CI = 0.82-1.01] and low [OR = 0.47, 95% CI = 0.32-0.68]. STP appealed to senior (43.6% to 44.3%), [OR = 1.33, 95% CI = 1.15-1.53] when compared to junior elementary students. The STP was equally effective in schools with small to medium student rolls compared to large schools (34.1% to 36.5%), [OR = 1.33, 95% CI = 1.09-1.63]. Schools in Auckland city (47.2% to 48.1%), [OR = 1.43, 95% CI = 1.20-1.70] showed significant improvements when compared to schools from North Shore City.

Conclusion

The STP was associated with increased active commuting in children after three years of implementation.     

Screen time and passive school travel as independent predictors of cardiorespiratory fitness in youth

Objective

The most prevalent sedentary behaviours in children and adolescents are engagement with small screen media (screen-time) and passive travel (by motorised vehicle). The objective of this research was to assess the independence of these behaviours from one another and from physical activity as predictors of cardiorespiratory fitness in youth.

Methods

We measured cardiorespiratory fitness in n = 6819 10-16 year olds (53% male) who self-reported their physical activity (7-day recall) school travel and screen time habits. Travel was classified as active (walking, cycling) or passive; screen time as < 2 h, 2-4 h or > 4 h.

Results

The multivariate odds of being fit were higher in active travel (Boys: OR 1.32, 95% CI: 1.09-1.59; Girls: OR 1.46, 1.15-1.84) than in passive travel groups. Boys reporting low screen time were more likely to be fit than those reporting > 4 h (OR 2.11, 95% CI: 1.68-2.63) as were girls (OR 1.66, 95% CI: 1.24-2.20). These odds remained significant after additionally controlling for physical activity.

Conclusion

Passive travel and high screen time are independently associated with poor cardiorespiratory fitness in youth, and this relationship is independent of physical activity levels. A lifestyle involving high screen time and habitual passive school travel appears incompatible with healthful levels of cardiorespiratory fitness in youth.     

Weather factor impacts on commuting to work by bicycle

Objective

Quantify the impact of weather conditions on individual decisions to commute to work by bicycle among a diverse panel of adults who commute ≥ 2 miles each way.

Method

Working adults (n = 163) in a northern U.S. state reported transportation mode for four seven-day periods in 2009-2010 that maximized seasonal weather variations. Personal characteristics, trip to work distances, and commuting mode data were linked to location- and time-specific weather data and daylight hours. Analyses focused on effect of weather conditions on reports of commuting by bicycle.

Results

Participants were diverse in age, gender and bicycle use, but were relatively well-educated; they traveled to work by bicycle on 34.5% of the logged commuting days. Modeling indicated that the likelihood of bicycle commuting increased in the absence of rain (odds ratio = 1.91; 95% confidence interval 1.42, 2.57) and with higher temperatures (1.03; 1.02, 1.04), and decreased with snow (0.90; 0.84, 0.98) and wind (0.95; 0.92, 0.97). Independent effects also were found for bicycle commuting distance, gender, and age, but not for daylight hours.

Conclusion

Precipitation, temperature, wind and snow conditions had significant and substantial independent effects on the odds of travel to work by bicycle among a diverse panel of adult bicycle commuters.     

The effect of a school-based active commuting intervention on children's commuting physical activity and daily physical activity

Objective

To investigate the effect of a school-based intervention called Travelling Green (TG) on children's walking to and from school and total daily physical activity.

Method

A quasi-experiment with 166 Scottish children (8-9 years) was conducted in 2009. One group (n = 79) received TG and another group (n = 87) acted as a comparison. The intervention lasted 6 weeks and consisted of educational lessons and goal-setting tasks. Steps and MVPA (daily, a.m. commute, p.m. commute, and total commute) were measured for 5 days pre- and post-intervention using accelerometers.

Results

Mean steps (daily, a.m., p.m., and total commute) decreased from pre- to post-intervention in both groups (TG by 901, 49, 222, and 271 steps/day and comparison by 2528, 205, 120, and 325 steps/day, respectively). No significant group by time interactions were found for a.m., p.m., and total commuting steps. A medium (partial eta squared = 0.09) and significant (p < 0.05) group by time interaction was found for total daily steps. MVPA results were similar to step results.

Conclusions

TG has a little effect on walking to and from school. However, for total daily steps and daily MVPA, TG results in a smaller seasonal decrease than for children who do not receive the intervention.     

The importance of Active Transportation to and from school for daily physical activity among children

Objective

To investigate if students who use of Active Transportation (AT) to and from school among urban and rural Canadian children are more likely to meet physical activity recommendations.

Methods

The Raising healthy Eating and Active Living in Alberta (REAL Kids Alberta) study is a population-based health survey among Grade 5 students. In 2009, physical activity levels were measured using time-stamped pedometers (number of steps/hour) among 688 children. Parents reported mode of transportation to and from school (AT/non-AT). Multilevel multiple linear regression analyses with corresponding β coefficients were conducted to quantify the relationship between mode of transportation to and from school with (1) overall step count, and (2) the likelihood of achieving at least 13,500 steps per day recommended for optimal growth and development.

Results

Among urban children, those who used AT to and from school accumulated more steps [β = 1124(95% CI = 170,2077)] and although not significant, were more likely to achieve the recommended 13,500 steps/day compared to those not using AT to and from school [OR = 1.61(95% CI = 0.93,2.81)].

Conclusion

Using AT to and from school appears to be beneficial to children by supplementing their physical activity, particularly those living in urban regions. Strategies to promote physical activity are needed, particular for children residing in rural regions and smaller towns.     

Vaccination status and sequence of vaccinations as risk factors for hospitalisation among outpatients in a high mortality country

Background

Most developing countries are implementing the WHO immunisation programme. Although vaccines reach most children, many modifications of the recommended schedule are observed in practice. We investigated the association between vaccination status and risk of hospitalisation in Guinea-Bissau.

Methods

From May 2003 to May 2004, all consultations of children less than five years of age at the outpatient clinic of the paediatric ward at the national hospital in Bissau were registered. For each consultation, information was collected about the child's name, sex, age and socio-cultural conditions, as well as diagnosis and whether the child was hospitalised. Information about vaccinations was also registered from the child's vaccination card. We analysed the association between vaccination status and risk of hospitalisation in age intervals according to the pre-dominant vaccines. We particularly emphasised the comparison of those who had received the recommended vaccination for the age groups and those who were delayed and only had the previous vaccinations. We also examined those who had received the vaccines out of sequence.

Results

Information about vaccinations was available for 11,949 outpatient children of whom 2219 (19%) were hospitalised. Among children less than 3 months of age, unvaccinated children compared to BCG children had as expected a higher risk of hospitalisation; controlled for important determinants of hospitalisation, the hospitalisation risk ratio (HRR) was 1.99 (95% CI 1.37-2.89). In contrast, there was no difference in the HRR for children aged 1 ½ -8 months who were delayed and had only received BCG compared to those who as recommended had received diphtheria-tetanus-pertussis (DTP) vaccine after BCG (HRR = 1.10 (0.77-1.59)). In the age interval 9-17 months of age, children who were delayed and had only received DTP had significantly higher risk of hospitalisation compared with children who as recommended had measles vaccine (MV) as the most recent vaccination (HRR = 1.39 (1.16-1.66)). Having received DTP after MV (HRR = 1.60 (1.15-2.24)) or MV and DTP simultaneously (HRR = 1.51 (1.16-1.97)) was also associated with higher risk than MV only as most recent vaccination. In contrast, the children aged 18-59 months who as recommended had received a DTP booster after MV did not have lower risk of hospitalisations compared with children who were delayed and had received only MV (RR = 0.90 (0.75-1.07)). After 9 months of age, there was a significant difference in the female-male HRR for children who had MV (HRR = 0.85 (0.72-1.00)) or DTP (HRR = 1.08 (0.96-1.22)) as most recent vaccination (p = 0.02, test of interaction).

Conclusion

Following the recommended vaccination schedule for BCG and MV is associated with a reduced risk of hospitalisation but this is not the case for DTP and booster DTP. Receiving DTP simultaneously with MV or after MV is associated with increased risk of hospitalisation. Vaccines have sex-differential effects on the risk of hospitalisation.     

Risk factors associated with parents claiming personal-belief exemptions to school immunization requirements: community and other influences on more skeptical parents in Oregon, 2006

Background and objectives

With vaccine-preventable diseases at record lows, few studies investigate rising parent-claimed exemptions to school immunization requirements. After finding exemption clusters in Oregon, we hypothesized that exemption risk factors may vary among communities. We surveyed parents to identify risk factors for exemptions and evaluated risk factor differences among communities with differing exemption rates.

Design

Retrospective cohort study, multi-staged, population-proportionate sampling.

Setting and participants

Parents of 2004-05 Oregon elementary school children (N = 2900).

Main outcome measure

Parent-reported exemption status.

Results

The response rate was 55%. Compared to vaccinators, exemptors were significantly more likely to have: strong vaccine concerns (weighted adjusted odds ratio (aOR) = 15.3, 95% CI 6.4-36.7); “vaccine-hesitant” concerns (aOR = 2.3; 95% CI 1.0-5.0); >1 childbirth(s) at a non-hospital, alternative setting (aOR = 3.6; 95% CI 1.6-8.0); distrust of local doctors (aOR = 2.7; 95% CI 1.0-7.5); reported chiropractic healthcare for their youngest school-age child (aOR = 3.9; 95% CI 1.8-8.5); and reported knowledge of someone with a vaccine-hurt child (aOR = 1.8; 95% CI 0.9-3.4). Exemptors were less likely to have “pro-vaccine” beliefs (aOR = 0.2; 95% CI 0.0-0.6) and less likely to report relying on print materials (aOR = 0.4; 95% CI 0.2-0.8).The strengths of association differed significantly for those with strong vaccine concerns and those reporting knowledge of someone with a vaccine-hurt child, depending on residence in exemption-rate areas, e.g., exemptors in medium-rate areas were more likely to have strong vaccine concerns (aOR = 13.5; 95% CI 5.4-34.0) than those in high-rate areas (aOR = 9.7; 95% CI 3.7-25.4).

Conclusions

Vaccine beliefs were important risk factors. That differing community-level exemption use modified the effects of several individual-level factors suggests that communities also influence parent decisions. Therefore, understanding community contexts and norms may be important when designing interventions.     

"Where have all the bicycles gone?" Are bicycle sales in Australia translated into health-enhancing levels of bicycle usage?

Objective

To explore whether the reported increase in bicycle sales in Australia is corroborated by increases in numbers of cyclists.

Methods

Australian representative data on cycling from annual Exercise, Recreation and Sport Surveys (ERASS) from 2001 to 2008 were used. Based on the weighted proportion of cyclists and ‘regular cyclists’ each year, the number of ‘new’ riders each year was calculated. Generous assumptions about the number of new bicycle purchased by new riders plus replacement bicycles by regular riders were compared with industry sales figures.

Results

Any cycling increased from 9.5% of all adults in 2001 to 11.6% in 2008, an increase of 2.1% [95% CI: 1.14 to 2.76]. This 2.1% represents an overall increase in cyclists of around 343,552 (95% CI from 186,500 to 441,710 new cyclists). The difference between the estimated number bought and the actual industry total average number of bicycles sold (n = 753,843 per annum) numbered at least 395,000 unused adult bicycles sold each year after sensitivity analyses.

Conclusions

There appear to be many more bicycles sold in Australia than are used. Further improvements may be needed in the cycling environment before a possible latent desire for cycling translates to participation.     

Improvement of the lipid profile with exercise in obese children: a systematic review

Objective

The objective of this systematic review was to assess the effectiveness of different physical exercise interventions on the lipid profile (high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and triglycerides (TG)) of obese children.

Method

A computerized search was made of seven databases using keywords. Effect sizes (ES) and 95% confidence intervals were calculated, and the heterogeneity (I²) of the studies was estimated using Cochran's Q-statistic applied to the effect size means. The studies were grouped according to the intervention program—aerobic alone or combined (aerobic fitness, strength, and flexibility).

Results

Seven studies were selected for review as satisfying the inclusion criteria. Six were randomized controlled trials (n = 318) and one was a controlled clinical trial (groups not randomly assigned) (n = 38). The main cumulative evidence indicates that the programs based on aerobic exercise alone have a moderate (ES = − 0.49; I² = 87) and a large effect (ES = − 0.55; I² = 77) on LDL-C and TG concentrations, respectively; and the programs based on combined exercise have a moderate effect (ES = 0.50; I² = 0) on HDL-C concentration.

Conclusions

The programs based on aerobic exercise (60 min, 3 times/week, ≤ 75% maximum heart rate) improve the LDL-C and TG concentrations. Moreover, the programs based on combined exercise (≥ 60 min, > 75% maximum heart rate) also improve the HDL-C concentration.     

Awareness of and behaviors related to child-to-mother transmission of cytomegalovirus

Objective

Congenital cytomegalovirus (CMV) infection is a common cause of hearing loss and intellectual disability. We assessed CMV knowledge and the frequency of women's behaviors that may enable CMV transmission to inform strategies for communicating prevention messages to women.

Methods

We analyzed survey responses from 4184 participants (2181 women, 2003 men) in the 2010 HealthStyles survey, a national mail survey designed to be similar to the United States population.

Results

Only 7% of men and 13% of women had heard of congenital CMV. Women with children under age 19 (n = 918) practiced the following risk behaviors at least once per week while their youngest child was still in diapers: kissing on the lips (69%), sharing utensils (42%), sharing cups (37%), and sharing food (62%). Women practiced protective, hand cleansing behaviors most of the time or always after: changing a dirty diaper (95%), changing a wet diaper (85%), or wiping the child's nose (65%), but less commonly after handling the child's toys (26%).

Conclusions

Few women are aware of CMV and most regularly practice behaviors that may place them at risk when interacting with young children. Women should be informed of practices that can reduce their risk of CMV infection during pregnancy.     

Determinants of the public intent to receive the seasonal influenza vaccine and protective behaviors: A population-based study in Taiwan

Background and study aims

this study aims to identify the determinants of perceived changes in protective behaviors against seasonal influenza and the intent to receive the seasonal influenza vaccine among Taiwanese in 2011.

Methods

During the early 2011–2012 influenza season, we conducted a nationwide survey with randomly stratified samples and collected 1400 self-reported questionnaires from respondents aged 15 years and above using the computer-aided telephone interviewing software in Taiwan.

Results

One-third of the respondents intended to receive the seasonal influenza vaccine. Knowledge of protective behaviors against influenza was the most common predictor of perceived changes in different protective behaviors and the intent to receive the seasonal influenza vaccine. Older respondents were significantly more inclined to perceive changes in protective behaviors than younger respondents (adjusted odds ratio [AOR] ranging from 1.7 to 2.5). Female respondents were significantly more likely to change their behavior in wearing a face mask (AOR = 1.5; 95% CI, 1.09 to 2.07) and buying antimicrobial products (AOR = 1.45; 95% CI, 1.09 to 1.92) compared with males. Furthermore, recipients of past H1N1 (AOR = 4.45; 95% CI, 3.03 to 6.53) and seasonal influenza vaccines (AOR = 6.1; 95% CI, 3.31 to 11.23) were more likely to obtain the seasonal influenza vaccine. In contrast, individuals aged 30–49 (AOR = 0.53; 95% CI, 0.38 to 0.74) and females (AOR = 0.65; 95% CI, 0.48 to 0.87) were significantly less likely to intend to receive the seasonal influenza vaccine.

Conclusions

The findings suggest that the predictors of perceived changes in protective behaviors and intent to receive the seasonal influenza vaccine differ. We provide perspectives and suggestions for overcoming the perceived barriers and for developing targeted risk-communication campaigns.     

Influence of neighborhood deprivation, gender and ethno-racial origin on smoking behavior of Canadian youth

Objective

Deprived neighborhoods play an important role in adult smoking behavior, but little research exists about youth on this topic. This study explored the relationship between deprivation and youth smoking to examine whether this association differs by gender and ethno-racial origin.

Methods

Individual-level data from the Canadian Community Health Survey (2000-2005) were combined with neighborhood-level data from the 2001 Canada Census to assess smoking among youth aged 12-18 (n = 15,615).

Results

Youth who were female (OR = 1.27, 95%CI:1.16-1.38), White (OR = 1.95, 95%CI:1.71-2.21) and living in deprived neighborhoods (OR = 1.22, 95%CI:1.16-1.28) were more likely to smoke. In multilevel models, White females were more likely to smoke relative to non-White females and males (OR = 1.42, 95%CI:1.06-1.89). Youth with a strong sense of community belonging and living in deprived neighborhoods were at increased risk of smoking (OR = 1.18, 95%CI:1.06-1.32). The individual-level risk factor, household smoker, contributed substantially to youth smoking reducing the bivariate association between material deprivation and smoking by 33%.

Conclusion

White females, youth cohabiting with other smokers and youth living in poor neighborhoods with a strong sense of community belonging, are at an increased risk of smoking. Future anti-smoking efforts might have greater impact if they target at-risk youth as well as household members who cohabit with youth.     

Does a smoking prevention program in elementary schools prepare children for secondary school?

Introduction

A smoking prevention program was developed to prepare children in elementary school for secondary school. This study assessed the effects on smoking in secondary school.

Methods

In 2002, 121 schools in The Netherlands were randomly assigned to the intervention or control group. The intervention group received 3 lessons in 5th grade of elementary school and a second 3 lessons in 6th grade. The control group received “usual care”. Students completed 5 questionnaires: before and after the lessons in 5th and 6th grade and in the first class of secondary school. At baseline, 3173 students completed the questionnaire; 57% completed all questionnaires.

Results

The program had limited effect at the end of elementary school. One year later in secondary school significant effects on behavioral determinants and smoking were found. The intervention group had a higher intention not to smoke (β = 0.13, 95% confidence interval = 0.01-0.24) and started to smoke less often than the control group (odds ratio = 0.59, 95% confidence interval = 0.35-0.99): smoking increased from 2.5% to 3.6% in the intervention group and from 3.2% to 6.5% in the control group. Girls showed the largest differences in smoking between intervention and control condition.

Conclusions

A prevention program in elementary school seems to be effective in preventing smoking.     

Associations between anxious-depressed symptoms and cardiovascular risk factors in a longitudinal childhood study

Objective

To examine the influence of anxious/depressed scores on cardiovascular risk factors throughout childhood.

Methods

Data from the Western Australian Pregnancy Cohort (Raine) Study, a study of 2900 pregnancies recruited between 1989 and 1991, were used. Anxious-depressed scores (derived from the Childhood Behavior Checklist), body mass index (BMI) and blood pressure were measured at 5 (n = 1681), 8 (n = 1697), 10 (n = 1575) and 14 (n = 1386) years. At age 14 depressive symptom scores (Beck Depression Inventory for Youth), anxious-depressed scores (Youth Self-Report (YSR) and Teacher Report Form (TRF)) and fasting lipid, glucose and insulin were also available. Cross sectional and longitudinal analyses were conducted.

Results

At age 14, girls with higher anxious-depressed scores had higher BMI (p ≤ 0.005) and homeostasis model assessment-estimated insulin resistance (p ≤ 0.0001). This equated to a difference of 0.6 kg/m² and 0.3 units in predicted BMI and HOMA-IR respectively (top 5% vs. score of zero). Boys with higher anxious-depressed scores had lower systolic blood pressure trajectories (p = 0.024).

Conclusion

Depressive scores appear to have differing influences on BMI, homeostasis model assessment-estimated insulin resistance and systolic blood pressure in boys and girls. Paradoxically boys with higher anxious-depressed scores had lower blood pressure throughout childhood.     

Does the use of standing 'hot' desks change sedentary work time in an open plan office?

Objective

This study assessed the use of standing ‘hot’ desks in an open plan office and their impact on sedentary work time.

Method

Australian employees (n = 11; 46.9 [9.8] years; BMI 25.9 [3.5 kg/m²]) wore an armband accelerometer for two consecutive working weeks (November-December 2010). In the second week, employees were encouraged to use a pod of four standing ‘hot’ desks to stand and work as often as possible. Desk use was recorded using time logs. The percentages of daily work time spent in sedentary (< 1.6 METs), light (1.6-3.0 METs) and moderate + (> 3 METs) intensity categories were calculated for each week, relative to the total daily time at work. Paired sample t tests were used to compare weekly differences.

Results

Employees spent 8:09 ± 0:31 h/day at work and ‘hot’ desk use ranged from zero to 9:35 h for the week. There were no significant changes in mean time spent in sedentary (difference of − 0.1%), light (difference of 0.8%) and moderate + (− 0.7%) intensity categories. However, individual changes in sedentary work time ranged from − 5.9 to 6.4%.

Conclusions

Volitional use of standing ‘hot’ desks varied and while individual changes were apparent, desk use did not alter overall sedentary work time in this sample.     

Association between childhood and adolescent television viewing and unemployment in adulthood

Objective

To assess the long-term association between childhood television viewing and adult unemployment, and if this association is mediated by educational achievement.

Method

Study members were a general-population birth cohort of 1037 participants born in New Zealand in 1972/1973. Hours of weekday television viewing were reported at ages 5-15. Since age 18, unemployment was assessed retrospectively using life-history calendars to age 32. Information on educational qualifications was collected at age 32.

Results

Childhood and adolescent television viewing predicted adult unemployment. This association was significant for male Study members only (β = 0.20, p < 0.0001). The association for male Study members remained after further controlling for socioeconomic status, cognitive ability, and early indications of behaviour problems (p < 0.0007). The association was only partially mediated by educational achievement and television viewing remained a predictor of unemployment after adjusting for this (p = 0.0035). By logistic regression, each additional hour of daily television viewing was associated with an increased likelihood of spending at least 6 months in unemployment between ages 18 and 32 years (OR = 1.36, 95%, CI = 1.06, 1.76, p = 0.0157).

Conclusion

Childhood and adolescent television viewing may have long-lasting consequences for adult unemployment for boys. This association is only partially explained by the association between television viewing and educational achievement.     

A comparison of prevalence estimates for selected health indicators and chronic diseases or conditions from the Behavioral Risk Factor Surveillance System, the National Health Interview Survey, and the National Health and Nutrition Examination Survey, 2007-2008

Objective

To compare the prevalence estimates of selected health indicators and chronic diseases or conditions among three national health surveys in the United States.

Methods

Data from adults aged 18 years or older who participated in the Behavioral Risk Factor Surveillance System (BRFSS) in 2007 and 2008 (n = 807,524), the National Health Interview Survey (NHIS) in 2007 and 2008 (n = 44,262), and the National Health and Nutrition Examination Survey (NHANES) during 2007 and 2008 (n = 5871) were analyzed.

Results

The prevalence estimates of current smoking, obesity, hypertension, and no health insurance were similar across the three surveys, with absolute differences ranging from 0.7% to 3.9% (relative differences: 2.3% to 20.2%). The prevalence estimate of poor or fair health from BRFSS was similar to that from NHANES, but higher than that from NHIS. The prevalence estimates of diabetes, coronary heart disease, and stroke were similar across the three surveys, with absolute differences ranging from 0.0% to 0.8% (relative differences: 0.2% to 17.1%).

Conclusion

While the BRFSS continues to provide invaluable health information at state and local level, it is reassuring to observe consistency in the prevalence estimates of key health indicators of similar caliber between BRFSS and other national surveys.