U.S. Survey Will Give County a Physical
What do unleaded gasoline, children’s growth charts and calcium supplements in foods have in common?
They all have roots in the nearly 30-year-old National Health and Nutrition Examination Survey, a project of the U.S. Department of Health and Human Services National Center for Health Statistics.
Since the early ‘60s, the survey’s researchers have interviewed and examined thousands of Americans, developing data on such factors as cholesterol, lead levels in the blood and hypertension.
It was the survey’s data that first showed high lead levels in the blood of many American children, prompting the U.S. Environmental Protection Agency to develop a plan to eliminate leaded gasoline.
The standard charts that doctors use worldwide to follow a child’s growth and development were also developed from the survey’s data, and the survey found that a substantial portion of American women do not receive enough calcium in their diets.
Now the survey has come to Orange County.
Last month National Health interviewers began talking to the first of 476 county residents selected randomly for the program. Interviews and examinations are scheduled to continue through March 15.
The current version of the survey, known as the National Health and Nutrition Examination Survey III, began in 1988 and will travel to 88 communities nationwide before it is finished in 1994. By then, about 40,000 people will have participated, according to Jan Warren, field coordinator for the team stationed in Orange County.
Those who are selected for the study and agree to participate receive a battery of free medical tests, plus $30 to $50 for their time.
“The cost of the exam itself would start at around $500 if they went to get testing on their own,” Warren says.
Although the tests vary, depending on the age of the subject, she says, they may include a physical exam, dental exam, ultrasound test for gallstones, diabetes test, hearing test, check of body weight and measurements, X-rays of the knees and hands (to check for arthritis), a lung-capacity test, blood test, allergy testing, cholesterol check, electrocardiogram and a specialized eye exam. The average adult test takes from 2 1/2 to three hours, she says.
The random selection process begins with addresses chosen from the 1980 census, Warren says. “The United States is broken down into regions, then smaller areas, then counties, and then to the neighborhood level within those counties. Particular addresses are selected before we get there.”
Notices are mailed out ahead of time to explain what the survey is and let people know that they may be asked to participate. Then researchers from a 25-member team begin visiting those addresses. All National Health researchers carry photo identification cards from the U.S. Public Health Service.
When a researcher visits a home, he takes along a form with a specific instruction attached. “That may say that we’re looking for a female between 35 and 55, and if there is such a person in that household, she will be asked to participate,” Warren explains. If not, that household is eliminated, even though other members may be willing to participate. At the next house, the researcher may be looking for a 2-month-old child or a 75-year-old male.
“Unfortunately, we can’t take volunteers, since that would introduce bias,” Warren says. Nor can the researcher replace a person chosen for the study if that person decides not to participate.
“It is voluntary, but we want the people who are chosen to understand how important this is,” she says. “Each person who takes part is representing 3,000 other people in the United States of the same age, sex and type of neighborhood. To accommodate the work, school or other schedules of participants, the survey conducts some examinations at night and on weekends. The testing center is in several mobile units in the parking lot of the Doubletree Hotel in Orange. If necessary, survey workers will provide transportation to those who have no other way of getting to the examination center.
This third national survey is the largest ever, and the first one with no age cutoff. “Before we had a cutoff age of 74 years,” Warren says. “But the older population is growing so rapidly, we particularly need information on that group.”
Results of tests conducted as part of the study can be sent to the individual tested or to that person’s doctor or clinic, Warren says.
This version of the study is looking specifically at heart disease, asthma, chronic bronchitis, emphysema, diabetes, kidney disease and urological disorders, gall bladder disease, osteoporosis, arthritis, infectious diseases, dental problems, allergies, depression, hearing loss, vision problems, iron deficiency, anemia and obesity.
The study will also examine such risk factors as smoking, alcohol consumption, physical activity, weight, diet and heredity. Its placing particular emphasis on the health of children and the elderly, as well as occupational and environmental health.
Eventually, all the data will be made available in scientific journals and to health-care providers and educators. Government agencies such as the U.S. Food and Drug Administration may make changes in some regulations as a result of the information gathered.
“The overall goal is to help improve the nation’s health in general,” Warren says.
From past Nation Health surveys, doctors have determined that on the whole, our cholesterol levels are going down and Americans are getting taller. They have concluded that many skin problems are linked to sun exposure and that iron pills may not be good for people who are not anemic.
Information from tests and interviews is kept confidential by law and is to be used only by researchers working on the survey. Personal information, such as names and addresses, are removed before the information is compiled permanently.
