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The National Health and Nutrition Examination Survey
The National Health and Nutrition Examination Survey
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICESCenters for Disease Control and PreventionNational Center for Health Statistics
anesanes
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National Health and Nutrition Examination Surveys
National Health and Nutrition Examination Surveys
NHES I 1960-62 18-79 yearsNHES II 1963-65 6-11 yearsNHES III 1966-70 12-17 yearsNHANES I 1971-75 1-74 yearsNHANES II 1976-80 6 mo.-74 yearsHHANES 1982-84 6 mo.-74 yearsNHANES III 1988-94 2 mo. +NHANES 1999- All ages
Survey Dates Ages
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•Estimate the prevalence of selected health conditions and risk factors
•Describe awareness, treatment and control of selected diseases
•Monitor trends over time
Goals of NHANESGoals of NHANES
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•Study the relationship of diet and health
•Explore emerging public health issues
•Establish and maintain a repository of stored biologic specimens for future research
Goals of NHANESGoals of NHANES
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• Multi-agency process
• Content solicitation posted on web site
• Proposals evaluated by a set of criteria
• NHANES Forum
• CDC/NCHS Leadership
• Institutional Review Board
• Office of Management and Budget
Planning NHANESPlanning NHANES
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• CDC (7 Centers)
• NIH (12 Institutes)
• USDA (2 Research Services)
• EPA
• FDA
• HUD
CollaboratorsCollaborators
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NHANES 1999-2004NHANES 1999-2004
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TopicsTopics
• Bone density, osteoporosis
• Cardiovascular disease
• Diabetes
• Dietary intake, nutritional status
• Environmental exposures
• Fitness, strength, activity
• Hearing and balance
• Infectious diseases, immunization
• Kidney disease
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TopicsTopics
• Mental health
• Obesity, body composition
• Oral health
• Reproductive health
• Respiratory disease
• Risk behaviors
• Skin diseases
• Vision
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Data CollectionData Collection
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SampleSample
• Civilian, non-institutionalized household population
• Residents of all states and the District of Columbia
• All ages
• A nationally representative sample of about 5,000 individuals a year
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OversampleOversample
• African Americans
• Mexican Americans
• Adolescents aged 12-19
• Older persons aged 60+
• Low income whites
• Pregnant women
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Stage 4SPs
Stage 1Counties Stage 2
Segments
Stage 3Households
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NHANES information flowNHANES information flow
Participant
Advanceletter
Informed consent
NCHS
Exams
Biologic specimens, DXA scans, dermatology
images
Screening In-home interview
s
Labs, Grader
s
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OP96S033
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OP96S034
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NHANES Mobile Examination Centers
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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Quality Assurance/Quality Control
Quality Assurance/Quality Control
•Outreach to assure high response rates
•Instruments calibrated
•Edit checks
•Direct observations
•Gold standard examiners
•Continual data review
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Information Technology Architecture
Information Technology Architecture
h i
Household interviews Westat
home office
T1T1
NCHS
Labs&
graders
T1
MEC
64kb
Fieldoffic
e
NationalFrame Relay
Network
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Survey data release scheduleSurvey data release schedule
•2-year datasets
•Website data release
•1999-2000 NHANES available
•2001-2002 NHANES release in 2004
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What About the Future? What About the Future?
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Future DirectionsFuture Directions
National HANES
•Disclosure risk
•Content
•Special populations
•Sample design
Community Health and Nutrition Examination Surveys