Access to health care among Hispanic or Latino women: United States, 2000-2002

OBJECTIVE: This report presents national estimates on access to health care for the following five subgroups of Hispanic or Latino women aged 18 years and over in the United States: Mexican, Puerto Rican, Cuban, Central or South American, and other Hispanic. For comparison, estimates are also presented for non-Hispanic white women and non-Hispanic black women. METHODS: Data for persons of all ages in the U.S. civilian noninstitutionalized population are collected each year in the National Health Interview Survey (NHIS), which is conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics. Each year, data are collected for approximately 100,000 persons in 40,000 households. In the 2000-2002 surveys combined, data were collected for 54,763 women aged 18 years and over (9,082 Hispanic or Latino women), with an overall response rate of 73.4%. Estimates in this report are presented as annual estimates, averaged over the 3 survey years. Estimates were age adjusted to the 2000 U.S. standard population to permit comparison among the various race and ethnic subgroups. RESULTS: Among the 33.4 million Hispanic or Latino women in the United States, 31% lacked health insurance coverage at the time of interview, 20% had no usual place to go for medical care during the past year, and 22% experienced unmet health care needs during the past year due to cost. Of the five subgroups of Hispanic or Latino women, Mexican women (35%) and Central or South American women (36%) were more likely than Puerto Rican women (14%) and Cuban women (23%) to lack health insurance coverage. Mexican women (78%) and Central or South American women (78%) were less likely to have a usual place to go for health care compared with Puerto Rican women (90%), Cuban women (82%), and other Hispanic women (90%). The percentage of Hispanic or Latino women who had an unmet medical need due to cost was highest among Mexican women (24%) and lowest among Cuban women (14%). Lack of access to health care was most prevalent among Hispanic or Latino women who had poor or near poor poverty status, had less than a high school diploma, or were foreign born. CONCLUSION: Access to health care varied among subgroups of Hispanic or Latino women. Understanding these subgroup differences may help community-based programs improve access to care among Hispanic or Latino women.     

Climate conditions and physical activity in the United States

OBJECTIVE: To identify the influence season and climate have on physical activity among US adults. METHODS: Seven weather classifications from 255 weather stations were linked with 355 counties covered by the 2003 BRFSS. RESULTS: The percentage meeting the recommendations for physical activity ranged from 30.9% in Puerto Rico to 60.9% in Montana and significantly varied across seasons: 44.6% in winter, 46.2% in spring, 48.4% in summer, and 45.8% in fall. Counties in the top 25% meeting the recommendations for physical activity had the highest percentage of days with dry moderate conditions. Counties in the bottom 25% had the highest percentage of days with moist tropical conditions. CONCLUSION: Season and climate significantly influence physical activity in the United States.     

Contribution of occupational physical activity toward meeting recommended physical activity guidelines: United States, 2007

Regular physical activity helps maintain healthy weight and reduces the likelihood of developing chronic diseases. The 2008 Physical Activity Guidelines for Americans (1) are derived from the most recent scientific review of physical activity health benefits and do not differentiate among physical activity for leisure, transportation, work, or other purposes. To examine the potential influence of occupational physical activity on meeting minimum weekly aerobic physical activity guidelines, the Washington State Department of Health (WADOH) analyzed demographic patterns in physical activity levels with and without consideration of occupational physical activity using 2007 Behavioral Risk Factor Surveillance System (BRFSS) data. This report describes the results of that analysis, which indicated that, approximately two thirds (64.3%) of U.S. adults met minimum physical activity guidelines through nonoccupational physical activity. When occupational physical activity (defined as reported work activity of mostly walking or heavy labor) was considered, an additional 6.5% of adults likely met the guidelines. The increase was greatest for Hispanic men (14.4%) and men with less than a high school education (15.9%). Public health agencies conducting surveillance of population physical activity levels also should consider including occupational physical activity, which will help to identify demographic groups for targeted programs that increase physical activity.     

Self-reported age-related eye diseases and visual impairment in the United States: results of the 2002 national health interview survey

Objectives. We sought to establish national data on the prevalence of visual impairment, blindness, and selected eye conditions (cataract, diabetic retinopathy, glaucoma, and macular degeneration) and to characterize these conditions within sociodemographic subgroups.Methods. Information on self-reported visual impairment and diagnosed eye diseases was collected from 31 044 adults. We calculated weighted prevalence estimates and odds ratios with logistic regression using SUDAAN.Results. Among noninstitutionalized US adults 18 years and older, the estimated prevalence for visual impairment was 9.3% (19.1 million Americans), including 0.3% (0.7 million) with blindness. Lifetime prevalence of diagnosed diseases was as follows: cataract, 8.6% (17 million); glaucoma, 2.0% (4 million); macular degeneration, 1.1% (2 million); and diabetic retinopathy, 0.7% (1.3 million). The prevalence of diabetic retinopathy among persons with diagnosed diabetes was 9.9%.Conclusions. We present the most recently available national data on self-reported visual impairment and selected eye diseases in the United States. The results of this study provide a baseline for future public health initiatives relating to visual impairment.Visual impairment is defined as low vision not correctable by glasses or contact lenses; it may have different causes. Visual impairment is recognized as a global public health problem.1^,2 Worldwide, an estimated 37 million people were blind in 2002, and an additional 124 million were visually impaired.1 The leading causes of blindness and visual impairment, determined on the basis of a composite analysis of several population-based studies conducted in developed and developing countries, are primarily age-related eye diseases: cataracts, glaucoma, macular degeneration, and diabetic retinopathy.1^,2Healthy People 2010 established national vision objectives to improve visual health through prevention, early detection, treatment, and rehabilitation.3^,4 When the Healthy People 2010 vision objectives were published in 2000, all but 1 lacked national baseline data.3 Because of cost and logistical difficulty, nationwide studies concerning the prevalence of visual impairment and eye diseases in the United States have been limited. Most US data come from population-based studies of visual impairment in specific demographic groups5^–7 or locations.8^–10 Prevalence estimates may be obtained through self-reports in interview surveys or through surveys that include eye and vision examinations. The most recent national data on measured visual impairment are from the National Health and Nutrition Examination Survey (NHANES); these data were used to estimate that 6.4% of persons 12 years and older had visual acuity of 20/50 or worse in the better-seeing eye in 1999 to 2002.11 NHANES 1999 to 2002 did not collect data on eye diseases.For our study, we sought to (1) provide national data for adults on the prevalence of self-reported visual impairment, blindness, and 4 diagnosed eye conditions (cataract, diabetic retinopathy, glaucoma, and macular degeneration) and (2) characterize these conditions within sociodemographic subgroups. Self-reported data from the 2002 National Health Interview Survey (NHIS) provide the most recent national estimates for these 4 eye conditions.     

Reproduction rates for 1990-2002 and intrinsic rates for 2000-2001: United States.

OBJECTIVE: This report presents revised rates of reproduction for 1990-93, reproduction rates for 1994-2002, and intrinsic rates for 2000-2001. The revised rates for 1991-93 are based on populations consistent with the April 1, 2000, census, as are the rates for 1994-2002. METHODS: Tabular and graphic data on the reproduction and intrinsic rates by race and Hispanic origin of mother are presented and described. RESULTS: Rates of reproduction (total fertility, gross reproduction, and net reproduction rates), the intrinsic rate of natural increase, and the intrinsic birth rate were lower in 2001 (and 2002) than 1990. Among the race and Hispanic subgroups, the reproduction rates were lower for all groups except Cubans and whites (total). The overall intrinsic death rate increased between 1990 and 2001 with the rate declining for whites (total) but increasing for blacks (total).     

Widespread West Nile virus activity, eastern United States, 2000

In 1999, the U.S. West Nile (WN) virus epidemic was preceded by widespread reports of avian deaths. In 2000, ArboNET, a cooperative WN virus surveillance system, was implemented to monitor the sentinel epizootic that precedes human infection. This report summarizes 2000 surveillance data, documents widespread virus activity in 2000, and demonstrates the utility of monitoring virus activity in animals to identify human risk for infection.     

Leisure-time physical activity disparities among Hispanic subgroups in the United States

Studies of leisure-time physical activity disparities for Hispanic individuals have not adjusted for sociodemographic confounds or accounted for variation by country of origin. We used the National Health Interview Survey to compare leisure-time physical activity among Hispanic and non-Hispanic White persons. All Hispanic subgroups were less active than were non-Hispanic White people, yet significant heterogeneity existed among Hispanic persons. Sociodemographic factors partly accounted for disparities among men; disparities among women persisted despite multivariate adjustments. Interventions must attend to these under-served yet varied sub-communities.     

Self-reported physical activity and aerobic fitness are differently related to mental health

BackgroundA relevant, but overlooked question is if self-reported physical activity and aerobic fitness are differently related to mental health.PurposeTo examine the relation between mental health and level of self-reported physical activity (SRPA) and aerobic fitness (AF), and whether AF mediates the relation between SRPA and mental health.MethodsParticipating in the study were 177 voluntary subjects (49% men, 51% women) with a mean age of 39 years. Symptoms of depression and anxiety were measured through the Hospital Anxiety and Depression (HAD) scale, and the Shirom-Melamed Burnout Questionnaire (SMBQ) was used to evaluate self-reported symptoms of burnout. Leisure time SRPA during the last three months were measured using a single item. AF was measured by using the Åstrand bicycle test.ResultsSelf-reported physical activity, but not AF, was significantly related to self-reported symptoms of depression, anxiety, and burnout. Light to moderate physical activity that is performed regularly seems to be associated with more favorable mental health pattern compared with physical inactivity. No support was found for the mediating effect of AF of the physical activity–mental health relationship.ConclusionsSelf-reported behavior of regular physical activity seems to be more important to monitor than measures of AF when considering the potential preventive effects of physical activity on mental health.     

Outbreak of listeriosis--northeastern United States, 2002

A multistate outbreak of Listeria monocytogenes infections with 46 culture-confirmed cases, seven deaths, and three stillbirths or miscarriages in eight states has been linked to eating sliceable turkey deli meat. Cases have been reported from Pennsylvania (14 cases), New York (11 in New York City and seven in other locations), New Jersey (five), Delaware (four), Maryland (two), Connecticut (one), Massachusetts (one), and Michigan (one). Culture dates ranged from July 18 to September 30, 2002; case-finding is ongoing. Outbreak isolates share a relatively uncommon pulsed-field gel electrophoresis (PFGE) pattern.     

United States life tables, 2002.

This report presents period life tables for the United States based on age-specific death rates in 2002. Data used to prepare these life tables are 2002 final mortality statistics; July 1, 2002, population estimates based on the 2000 decennial census and data from the Medicare program. Presented are complete life tables by age, race, and sex. In 2002 the overall expectation of life at birth was 77.3 years, representing an increase of 0.1 years from life expectancy in 2001. Between 2001 and 2002, life expectancy increased for both males and females. Life expectancy increased by 0.2 years for black males (from 68.6 to 68.8). It increased by 0.1 year for white males (from 75.0 to 75.1), for white females (from 80.2 to 80.3), and for black females (from 75.5 to 75.6).     

Self-reported physical activity compared with maximal oxygen uptake

Maximal oxygen uptake has been used as a measure of physical fitness. This measure increases by approximately 25% when sedentary individuals become more physically active. Oxygen uptake measurement in the laboratory or estimation in fieldwork is complex and costly with finite risk. For the present study, 36 men and 32 women completed the Paffenbarger Physical Activity Index Questionnaire, including a sweat-inducing physical activity frequency question, and had measurement of oxygen uptake during pedal ergometry. Using maximal oxygen uptake as the measure of fitness, the authors found that the Paffenbarger Physical Activity Index, although more detailed, may be less valid than the simpler sweat induction frequency question for estimating fitness. The correlations observed between the sweat question and oxygen uptake were 0.54 for males, 0.26 for females, and 0.46 for the total group. The correlations between the Physical Activity Index and oxygen uptake were 0.26 for males, 0.08 for females, and 0.29 for the total group. The regression relationship (oxygen uptake = 1.92 X (sweat days) + 23.76; standard error of estimate = 8.63 ml/kg/min) is significant for sweat versus oxygen uptake. While the confidence interval limits the practical ability to predict individual values, low cost, absence of risk, and population validity suggest that fitness can be assessed rapidly and simply for epidemiologic studies with a simple "sweat" question.     

Marital status and health: United States, 1999-2002

OBJECTIVE: This report presents prevalence estimates by marital status for selected health status and limitations, health conditions, and health risk behaviors among U.S. adults, using data from the 1999-2002 National Health Interview Surveys (NHIS). METHODS: Data for the U.S. civilian noninstitutionalized population were collected using computer-assisted personal interviews (CAPI). The household response rate for the NHIS was 88.7%. This report is based on a total of 127,545 interviews with sample adults aged 18 years and over, representing an overall response rate of 72.4% for the 4 years combined. Statistics were age-adjusted to the 2000 U.S. standard population. Marital status categories shown in this report are: married, widowed, divorced or separated, never married, and living with a partner. RESULTS: Regardless of population subgroup (age, sex, race, Hispanic origin, education, income, or nativity) or health indictor (fair or poor health, limitations in activities, low back pain, headaches, serious psychological distress, smoking, or leisure-time physical inactivity), married adults were generally found to be healthier than adults in other marital status categories. Marital status differences in health were found in each of the three age groups studied (18-44 years, 45-64 years, and 65 years and over), but were most striking among adults aged 18-44 years. The one negative health indicator for which married adults had a higher prevalence was overweight or obesity. Married adults, particularly men, had high rates of overweight or obesity relative to adults in other marital status groups across most population subgroups studied. Never married adults were among the least likely to be overweight or obese.     

Diet and physical activity counseling during ambulatory care visits in the United States

BACKGROUND: Research is limited regarding national patterns of behavioral counseling during ambulatory care. We examined time trends and independent correlates of diet and physical activity counseling for American adults with an elevated cardiovascular risk during their outpatient visits. METHODS: The National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) provided 1992-2000 national estimates of counseling practices in private physician offices and hospital outpatient departments. RESULTS: Rates of diet and physical activity counseling among visits by at-risk adults exhibited a modest ascending trend from 1992 to 2000, with the biggest growth found between 1996 and 1997. Throughout the 1990s, however, diet counseling was provided in <45% and physical activity counseling in < or = 30% of visits by adults with hyperlipidemia, hypertension, obesity, or diabetes mellitus. Lower likelihood of either counseling was significantly associated with patients who were > or = 75 years of age, seen by generalists, and those with fewer risk factors. Also, diet counseling was less frequently provided during visits by whites vs. ethnic minorities and by men vs. women. CONCLUSIONS: Despite available national guidelines, diet and physical activity counseling remain below expectations during outpatient visits by adults with an elevated cardiovascular risk. Given recent trends, immediate, satisfactory improvement is unlikely without future innovative interventions.     

Association between physical activity and mental disorders among adults in the United States

BACKGROUND: The objective of this study was to determine the association between regular physical activity and mental disorders among adults in the United States. METHODS: Multiple logistic regression analyses were used to compare the prevalence of mental disorders among those who did and did not report regular physical activity using data from the National Comorbidity Survey (n = 8098), a nationally representative sample of adults ages 15-54 in the United States. CONCLUSIONS: Slightly over one-half of adults reported regular physical activity (60.3%). Regular physical activity was associated with a significantly decreased prevalence of current major depression and anxiety disorders, but was not significantly associated with other affective, substance use, or psychotic disorders. The association between regular physical activity and lower prevalence of current major depression (OR = 0.75 (0.6,0.94)), panic attacks (OR = 0.73 (0.56, 0.96)), social phobia (OR = 0.65 (0.53, 0.8)), specific phobia (OR = 0.78 (0.63, 0.97)), and agoraphobia (OR = 0.64 (0.43, 0.94)) persisted after adjusting for differences in sociodemographic characteristics, self-reported physical disorders, and comorbid mental disorders. Self-reported frequency of physical activity also showed a dose-response relation with current mental disorders. DISCUSSION: These data document a negative association between regular physical activity and depressive and anxiety disorders among adults in the U.S. population. Future research that investigates the mechanism of this association using longitudinal data to examine the link between physical activity and incident and recurrent mental disorders across the lifespan is needed.     

Association between active transport habits and physical activity levels in a diverse sample of college students in the United States

Journal of Public Health - A lack of physical activity (PA) contributes to poor health. Active travel (AT) can help to achieve recommended levels of PA, though participation varies across...     

Trends in characteristics of births by State: United States, 1990, 1995, and 2000-2002.

OBJECTIVE: This report presents U.S. and State-level data on births, birth rates, fertility rates, sex ratio, marital status, and educational attainment by race and Hispanic origin for 1990, 1995, and 2000-2002. METHODS: Data are presented in detailed tables, summary tables, maps, and graphs. RESULTS: In 2002 there were 4,021,726 live births in the United States, 136,486 fewer than in 1990. Despite a slight decline in the number of births nationwide, a few States witnessed significant increases in the number of live births with most of these States located in the western United States. Some of the westward shift in number of births is attributable to a growing population and some to the age and race composition of the individual States. However, real differences in fertility by State persist even when the effects of age structure and race and ethnic composition of the States' population are taken into account. This report also presents data on sex ratios, percentage unmarried, and educational attainment of mothers. Several observations from these data are noteworthy. The proportion of births to unmarried mothers increased nationally and in every State between 1990 and 2002. Nationally the percentage of mothers with fewer than 12 years of education fell, and the percentage with 16 or more years increased for all racial and ethnic groups. However, at the State level, the percentage of women with fewer than 12 years of education increased for nearly a quarter of the States, despite near universal increases in the percentage of women with 16 or more years of education.     

Patterns of physical activity in free-living adults in the Southern United States

OBJECTIVE: To examine the relationship between the amount and patterns of physical activity (PA), body fatness, and age in a heterogeneous adult population in the free living. DESIGN: Cross-sectional study of the amount of PA over a 1-week period. The amount of body movements during PA (PA counts*10(3)) and time spent on various PA intensity categories were calculated from a triaxial accelerometer and compared with subject characteristics, including body fat from hydrodensitometry. PARTICIPANTS: Adult healthy men (n=48) and women (n=72) were recruited from the Nashville, Tennessee area and their PA was monitored in their free-living environment. RESULTS: The average weekday PA counts (176.5+/-60.3, P=0.002, r(2)=0.294), PA counts day-to-day variability (47.3+/-32.7, P=0.002, r(2)=0.286), daily maximum PA counts (241.9+/-89.2, P=0.001, r(2)=0.327), minute-to-minute variability on weekdays (0.281+/-0.091, P=0.001, r(2)=0.362), and the difference between maximum and minimum daily PA counts (130.6+/-78.3, P=0.008, r(2)=0.243) were significantly and negatively correlated with body fatness. During awake time, both men and women spent 10-12 h on low intensity (1.0-2.9 metabolic equivalents (METs)) PA, approximately 1 h on moderate (3.0-5.9 MET), and less than 10 min on vigorous (>6.0 MET) PA each day. On weekends, men and women spent more time at rest (1 MET), less time on low-intensity PA, and men spent more time on moderate PA than on weekdays. CONCLUSIONS: In adults living in the Southern US the amount of free-living PA was negatively correlated with body fatness. Both men and women spent the majority of active time on low and moderate PA. PA patterns on weekends were different than on weekdays and were related to sex and age, but not to body fatness. SPONSORSHIP: National Institutes of Health, US.