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Scientific Data Documentation
Diabetes And OGTT Data, Ages 20 - 74 years (1982-1984)
DSN: CC37.HSPHANES.DIABETES ABSTRACT Introduction Hispanic Health and Nutrition Examination Survey Mexican Americans Cuban Americans Puerto Ricans Tape Number 6506 Ages 20 Years - 74 Years Version 1 August 1988 The Hispanic Health and Nutrition Examination Survey (HHANES) was conducted from July 1982 through December 1984. The following information shows the total number of persons ages 6 months to 74 years sampled, interviewed, and examined in each of the three portions of the survey. Mexican Americans Residing in selected counties of Texas, Colorado, New Mexico, Arizona, and California Surveyed from July 1982 through November 1983 9,894 persons sampled; 8,554 interviewed; 7,462 examined Cuban Americans Residing in Dade County (Miami), Florida Surveyed from January 1984 through April 1984 2,244 persons sampled; 1,766 interviewed; 1,357 examined Puerto Ricans Residing in the New York City area, including parts of New Jersey and Connecticut Surveyed from May 1984 through December 1984 3,786 persons sampled; 3,369 interviewed; 2,834 examined The data on the tape documented here are for all examined persons ages 20 years to 74 years. Caution Notice CAUTION BEFORE USING THIS DATA TAPE, PLEASE READ THIS PAGE * Read the accompanying description of the survey, "The Plan and Operation of the Hispanic Health and Nutrition Examination Survey", DHHS Publication No. (PHS) 85-1321 before conducting analyses of the data on this tape. * Two aspects of HHANES, especially, should be taken into account when conducting any analyses: the sample weights and the complex survey design. * Analyses should not be conducted on data combined from the three portions of the survey (Mexican-American, Cuban-American, Puerto Rican). * HHANES is a survey of Hispanic households and some of the sample persons included on this tape are not of Hispanic origin. A detailed description of the data codes dealing with national origin or ancestry appears in the NOTES section of this document. * Examine the range and frequency of values of a variable before conducting an analysis of data. The range may include unusual or unexpected values. The frequency counts may be useful to determine which analyses may be worthwhile. * Language of interview, which may appear several places on this tape, can vary depending on the questionnaire (several used in the survey) and on whether the response was provided by the sample person or by a proxy. * For some data items, reference is made to a note. The notes (in a separate section of this document) may be very important in data analyses. Attention to them is strongly urged. * For some data items, the number of sample persons with a positive response is very small. In these instances, it may not be possible to produce a reliable population estimate. Because the response rates to the glucose tolerance component were under 50 percent, attention to Section B regarding nonresponse bias is strongly urged. This Public Use Data Tape has been edited very carefully. Numerous consistency and other checks were also performed. Nevertheless, due especially to the large number of data items, some errors may have gone undetected. Please bring to the attention of NCHS any errors in the data tape or the documentation. Errata sheets will be sent to people who have purchased the data tapes and corrections will be made to subsequently released data tapes. In publications, please acknowledge NCHS as the original data source. The acknowledgement should include a disclaimer crediting the authors for analyses, interpretations, and conclusions; NCHS should be cited as being responsible for only the collection and processing of the data. In addition, NCHS requests that the acronym HHANES be placed in the abstracts of journal articles and other publications based on data from this survey in order to facilitate the retrieval of such materials through automated bibliographic searches. Please send reprints of journal articles and other publications that include data from this tape to NCHS. Division of Health Examination Statistics National Center for Health Statistics Center Building, Room 2-58 3700 East-West Highway Hyattsville, MD 20782 Public Use Data Tapes for the Hispanic Health and Nutrition Examination Survey will be released through the National Technical Information Service (NTIS) as soon as the data have been edited, validated, and documented. A list of NCHS Public Use Data Tapes that can be purchased from NTIS may be obtained by writing the Scientific and Technical Information Branch, NCHS. Scientific and Technical Information Branch National Center for Health Statistics Center Building, Room 1-57 3700 East-West Highway Hyattsville, MD 20782 301-436-8500BACKGROUND Introduction The National Center for Health Statistics (NCHS) collects, analyzes, and disseminates data on the health status of Americans. The results of surveys, analyses, and studies are made known primarily through publications and the release of computer data tapes. This document contains details required to guide programmers, statistical analysts, and research scientists in the use of a Public Use Data Tape. From 1960 through 1980 NCHS conducted five population-based, national health examination surveys. Each survey involved collecting data by direct physical examination, the taking of a medical history, and laboratory and clinical tests and measurements. Questionnaires and examination components have been designed to obtain and support analyses of data on certain targeted conditions such as diabetes, hypertension, and anemia. Beginning with the first National Health and Nutrition Examination Survey (NHANES I) a nutrition component was added to obtain information on nutritional status and dietary practices. The numbers of Hispanics in these samples were, however, insufficient to enable adequate estimation of their health conditions. From 1982 through 1984 a Hispanic Health and Nutrition Examination Survey (HHANES) was conducted to obtain data on the health and nutritional status of three Hispanic groups: Mexican Americans from Texas, Colorado, New Mexico, Arizona, and California; Cuban Americans from Dade County, Florida; and Puerto Ricans from the New York City area, including parts of New Jersey and Connecticut. The general structure of the HHANES sample design was similar to that of the previous National Health and Nutrition Examination Surveys. All of these studies have used complex, multistage, stratified, clustered samples of defined populations. The major difference between HHANES and the previous surveys is that HHANES was a survey of three special subgroups of the population in selected areas of the United States rather than a national probability sample. A detailed presentation of the design specifications is found in Chapter 5 of "Plan and Operation of the Hispanic Health and Nutrition Examination Survey, 1982-84" (Ref. No. 1). Data collection began with a household interview. Several questionnaires were administered: * A Household Screener Questionnaire (HSQ), administered at each selected address, for determining household eligibility and for selecting sample persons. * A Family Questionnaire (FQ), administered once for each family containing sample persons, which included sections on family relationships, basic demographic inforation for sample persons and head of family, Medicare and health insurance coverage, participation in income assistance programs, and housing characteristics. * An Adult Sample Person Questionnaire (ASPQ), for persons 12 through 74 years which, depending on age, included sections on health status measures, health services utilization, smoking (20 through 74 years), meal program participation, and acculturation. Information on the use of medicines and vitamins in the past two weeks was also obtained. * A Child Sample Person Questionnaire (CSPQ), for sample persons 6 months through 11 years, which included sections on a number of health status issues, health care utilization, infant feeding practices, participation in meal programs, school attendance, and language use. Information on the use of medicines and vitamins in the past two weeks was also obtained. At the Mobile Examination Center two questionnaires were administered and an examination performed: * An Adult Sample Person Supplement (ASPS), for sample persons 12 through 74 years, which included sections on alcohol consumption, drug abuse, depression, smoking (12 through 19 years), pesticide exposure, and reproductive history. * A Dietary Questionnaire (DQ), for persons 6 months through 74 years, by which trained dietary interviewers collected information about "usual" consumption habits and dietary practices, and recorded foods consumed 24 hours prior to midnight on the day before the interview. * An examination which included a variety of tests and procedures. Age at interview and other factors determined which procedures were administered to which examinees. A dentist performed a dental examination and a vision test. Technicians took blood and urine specimens and administered a glucose tolerance test, X-rays, electrocardiograms, and ultrasonographs of the gallbladder. Technicians also performed hearing tests and took a variety of body measurements. A physician performed a medical examination focusing especially on the cardiovascular, gastrointestinal, neurological, and musculoskeletal systems. The physician's impression of overall health, nutritional and weight status, and health care needs were also recorded. Some blood and urine specimen analyses were performed by technicians in the examination center; others were conducted under contract at various laboratories. Because the HHANES sample is not a simple random one, it is necessary to incorporate sample weights for proper analysis of the data. These sample weights are a composite of individual selection probabilities, adjustments for noncoverage and nonresponse, and poststratification adjustments. The HHANES sample weights, which are necessary for the calculation of point estimates, are located on all data tapes in positions 184-213. Because of the complex sample design and the ratio adjustments used to produce the sample weights, commonly used methods of point and variance estimation and hypothesis testing which assume simple random sampling may give misleading results. In order to provide users with the capability of estimating the complex sample variances in the HHANES data, Strata and Pseudo Primary Sampling Unit (PSU) codes have been provided on all data tapes in positions 214-217. These codes and the sample weights are necessary for the calculation of variances. There are computer programs available designed for variance estimation for complex sample designs. The balanced repeated replication approach (Ref. No. 2) is used in &REPERR and a linearization approach is used in &PSALMS to calculate variance-covariance matrixes. Both routines are available within the OSIRIS IV library (Ref. No. 3). SURREGR (Ref. No. 4) and SUPERCARP (Ref. No. 5) are programs that calculate variance-covariance matrixes using a linearization approach (Ref. No. 6) (Taylor series expansion). Another program, SESUDAAN (Ref. No. 7) calculates standard errors, variances, and design effects. (Note: This version of SESUDAAN should not be used to obtain variances for totals.) SURREGR and SESUDAAN are special procedures which run data under the SAS system (Ref. No. 8). Even though the total number of examined persons in this survey is quite large, subclass analyses can lead to estimates that are unstable, particularly estimates of variances. Consequently, analyses of subclasses require that the user pay particular attention to the number of sample persons in the subclass and the number of PSU's that contain at least one sample person in the subclass. Small sample sizes, or a small number of PSU's used in the variance calculations, may produce unstable estimates of the variances. A more complete discussion of these issues and possible analytic strategies for examining various hypotheses is presented in Chapter 11 of "Plan and Operation of the Hispanic Health and Nutrition Examination Survey, 1982-84" (Ref. No. 1) and in an earlier NCHS methodology (Series 2) publication (Ref. No. 9). Some users, however, may not have access to the computer programs for estimating complex sample variances or may want to do their preliminary analyses without using them. In addition, variance estimates calculated from HHANES data through use of the programs described previously are likely to be unstable because there were so few sample areas for each portion of HHANES. This instability is not due to there being too few people in the sample but may be due to the fact that the sample was selected from relatively few areas. Therefore, the following discussion is designed to provide an alternative approach to deal with the unavailability of software and the small number of PSU's. The approach is based on using average design effects (Ref. No. 10). The design effect, defined as the ratio of the variance of a statistic from a complex sample to the variance of the same statistic from a simple random sample of the same size, that is, COMPLEX SAMPLE VARIANCE DESIGN EFFECT (DEFF) = ----------------------------- SIMPLE RANDOM SAMPLE VARIANCE is often used to show the impact of the complex sample design on variances. If the design effect is near 1, the complex sample design has little effect on the variances and the user could consider assuming simple random sampling for the analysis. Some illustrative design effects for HHANES data on this tape are given in the following tables. The design effects in the tables are the average for the age groups usually presented in NCHS Series 11 publications. If the average design effect for a subgroup was less than 1.0 (implying an improvement over simple random sampling), it was coded as 1.0. The following guidelines were used in the calculation of the average design effects: 1. Exclude all persons of non-Hispanic origin, 2. Exclude all estimates for large age ranges, such as all ages combined or 'all adults', and 3. Exclude all estimates where the proportion of the subpopulation with the specific characteristic or condition was zero percent or one hundred percent. Design effects tend to be larger when age groups are combined, just as they are when the sexes are combined, as shown in the tables. The data in the tables give the user an idea of the range in design effects for selected response variables from this data tape. If a response variable is not one shown in the tables, take the range into account; it is possible that a user could have one of the higher, rather than one of the lower, design effects. Suppose, for example, that of the 177 Puerto Rican females ages 45-54 years, 11.7 percent reported that they have diabetes or sugar diabetes. Suppose, also, for example, that their mean plasma glucose value at third venipuncture was 134.5. Assuming simple random sampling, the variance for the percent is calculated by converting the percent to a proportion and using the standard formula for the variance of a proportion, V = pq -- n This variance (V) multiplied by the design effect (DEFF) provides an estimate of the variance from a complex sample of the same sample size (n). In the example above, V = (.117) (.883) 177 = .00058 = variance for a simple random sample Then, multiplying by the design effect, = (.00058) (1.2) = .0007 = estimated variance for the complex sample In a similar way, the complex sample variance of the mean plasma glucose at the third venipuncture is determined by multiplying the simple random sample variance of the mean by the appropriate design effect -- in this example, 1.3. The user can then proceed with estimating confidence intervals and testing hypotheses in the usual manner. The user should recognize that this approach does not incorporate the variance-covariance matrix. In most cases, this leads to a slight overestimate of the variance because the covariance terms, which are subtracted in the variance of a ratio, in general, are positive. Thus, in a borderline case, the null hypothesis would be less likely to be rejected (Ref. No. 11). Alternative or better approaches may exist or be developed. Users who want to suggest such approaches, or who want the latest information should contact the Scientific and Technical Information Branch (address given in the beginning of this documentation). Table 1 DIABETES AND OGTT DATA Average Design Effects, by Sex, for Selected Variables -- Mexican-American Portion Mean or Tape Both Variable Proportion Positions Sexes Male Female Do you have diabetes or sugar diabetes? p 405 1.0 1.0 1.0 Have you been told by a doctor or health pro- fessional that you have borderline diabetes? p 412 1.1 1.1 1.0 Have you been told by a doctor or health pro- fessional that you have potential diabetes? p 415 1.0 1.0 1.0 Have you ever taken insulin injections? p 430 1.1 1.0 1.0 Have you ever taken diabetes pills? p 438 1.0 1.0 1.0 Plasma glucose value from first venipuncture x 517-519 1.5 1.3 1.6 Plasma glucose value from third venipuncture x 523-525 2.0 1.4 1.7 Interval between last food or drink and first venipuncture x 526-529 1.2 1.1 1.0 Source: NCHS, HHANES, 1982-84, Tape Number 6506, Version 1.Table 2 Average Design Effects, by Sex, for Selected Variables -- Cuban-American Portion Mean or Tape Both Variable Proportion Positions Sexes Male Female Do you have diabetes or sugar diabetes? p 405 1.1 1.0 1.1 Have you been told by a doctor or health pro- fessional that you have borderline diabetes? p 412 1.1 1.2 * Have you been told by a doctor or health pro- fessional that you have potential diabetes? p 415 1.1 1.2 1.1 Have you ever taken insulin injections? p 430 1.0 * * Have you ever taken diabetes pills? p 438 1.0 * * Plasma glucose value from first venipuncture x 517-519 1.0 1.1 1.0 Plasma glucose value from third venipuncture x 523-525 1.1 1.3 1.0 Interval between last food or drink and first venipuncture x 526-529 1.0 1.0 1.0 Source: NCHS, HHANES, 1982-84, Tape Number 6506, Version 1. *These are samples of variables where the number of sample persons with a positive response was too small to calculate reliable age-sex specific population estimates, variances of those estimates, and average design effects. For this data tape, there may be many variables (e.g., questions asked only of diabetics) where this is the case.Table 3 Average Design Effects, by Sex, for Selected Variables Puerto Rican Portion Mean or Tape Both Variable Proportion Positions Sexes Male Female Do you have diabetes or sugar diabetes? p 405 1.0 1.3 1.2 Have you been told by a doctor or health pro- fessional that you have borderline diabetes? p 412 1.1 * 1.2 Have you been told by a doctor or health pro- fessional that you have potential diabetes? p 415 1.5 1.8 1.0 Have you ever taken insulin injections? p 430 1.0 * * Have you ever taken diabetes pills? p 438 1.0 * * Plasma glucose value from first venipuncture x 517-519 1.1 1.1 1.0 Plasma glucose value from third venipuncture x 523-525 1.5 1.3 1.3 Interval between last food or drink and first venipuncture x 526-529 1.2 1.2 1.0 Source: NCHS, HHANES, 1982-84, Tape Number 6506, Version 1. *These are samples of variables where the number of sample persons with a positive response was too small to calculate reliable age-sex specific population estimates, variances of those estimates, and average design effects. For this data tape, there may be many variables (e.g., questions asked only of diabetics) where this is the case.METHODS General Procedures, data collection and processing procedures Data presented in Sections E through H and the family relationships data in Section J were collected on the Household Screener and Family Questionnaires. Data presented in Section K were collected on the Adult Sample Person Questionnaire. These interview schedules were administered in sample persons' households. Data presented in Sections L and M were collected in the mobile examination center. Completed interview schedules were reviewed in the Survey's field offices and again at the data processing center of NCHS by clerical editors. The editors checked the forms for completeness, clarity, and compliance with skip patterns, and they coded items such as industry and occupation. At the data processing center the questionnaires were keyed and verified on key-to-disk data entry equipment under the control of programs that checked for valid codes and ranges, compliance with skip patterns, and consistency. After being keyed, data were reedited by analysts for reasonableness and consistency and for compliance with instructions for sampling and questionnaire administration. The general tape description format is Tape Position X Item X Counts. The item (field) may be a tape descriptor (e.g., Version Number), a sample person descriptor (e.g., Age at Interview), or a question (e.g., Is sample person covered by Medicare?). Where appropriate, data entries are presented by codes. Frequency counts are given for each code. The counts are included to help the user in planning analyses and in verifying that programs account for all data. The data source is given also (e.g., from Family Questionnaire). In some cases, a note is referenced. The notes contain explanations of the item (e.g., how Poverty Index is calculated). The questionnaire data have undergone many quality control and editing procedures. The responses of sample persons to some questions may appear extreme or illogical. Self-reported data, especially, are subject to a number of sources of variability, including recall and other reporting errors. In the data clean-up process, responses that varied considerably from expected were verified through direct review of the collection form or a copy of it. Such responses may not represent fact, but they are included as recorded in the field. The user must determine if these responses should be included in analyses. Responses to "other" and "specify" were recoded to existing categories, if possible. For responses that could not be recoded, new code categories were created if the information was deemed analytically useful. Caution should be used in interpreting the data from these new categories because there is no way of knowing which other respondents would have selected one of the new categories if given the option. For the adult sample person questionnaires there are three codes for missing information: 7's, 8's, and blanks. In a few questions, 7's were used when the question was not applicable. A code "8", which is labeled as "blank but applicable", is used to indicate that a sample person should have a data value for a particular item but for varying reasons that value is unavailable. Blanks were used to follow skip patterns, i.e., when a question was not supposed to be asked or was not applicable. The "don't know" codes (9, 99, 999) were used only when given as a printed response on the original questionnaire. Copies of the questionnaires and examination forms, both in English and Spanish, can be found in the plan and operation report for HHANES (Ref. No. 1). Detailed information on interviewing procedures is contained in the household interviewer's manual (Ref. No. 12) and the mobile examination center interviewer's manual (Ref. No. 13). These manuals are available upon request from: Division of Health Examination Statistics National Center for Health Statistics Center Building, Room 2-58 3700 East-West Highway Hyattsville, MD 20782 301-436-7080 OGTT Procedures and Bias Analysis Description The oral glucose tolerance test (OGTT) was administered to a subsample of adults aged 20-74 years who are referred to as the fasting subsample. This subsample was selected by assigning alternative sample persons aged 20-74 years to a one-half subsample who were asked to fast overnight, to attend the examination center in the morning, and, with the exception of diabetics using insulin, to submit to an OGTT. There were 2554 Mexican-Americans, 782 Cuban-Americans, and 979 Puerto Ricans aged 20-74 years in the fasting subsamples. Oral glucose tolerance tests were administered to this subsample according to the National Diabetes Data Group's (NDDG) recommendations (Ref. No. 14), which require the following: subjects must fast overnight for 10-16 hours; OGTT's are performed in the morning; a fasting blood sample is taken; subjects drink flavored water containing 75 grams of glucose or carbohydrate equivalent; additional blood samples are taken after one hour and two hours. This procedure was utilized in the second National Health and Nutrition Examination Survey (NHANES II), 1976-1980, and has been described in more detail in Ref. No. 15. In that survey, OGTT's that conformed to the NDDG's requirements were obtainable from only 43 percent of persons in the OGTT subsample. As shown in Table A, the response rates to the OGTT in the HHANES were also low: 39.6 percent for Mexican-American adults, 27.1 percent for Cuban-American adults, and 27.8 for Puerto Rican adults in the adult fasting subsample. A large proportion of the non-response occurred from refusals for the overall interview and examination and not the OGTT per se. One should also examine the response rates among the adults in the fasting subsample who were eligible for the OGTT (interviewed, examined, and not a diabetic on insulin). Using the latter as the denominator, the response rates to the OGTT were 58.1 percent (1012/1741), 47.4 percent (212/447), and 42.0 percent (272/647) in the Mexican-American, Cuban-American, and Puerto Rican samples, respectively. The low response rates were primarily explained by failure to meet the examination requirements to fast before the exam and failure to attend the examination center in the morning hours. Although the initial fasting requirements were between 10 and 16 hours before the exam, we extended those limits to 9 and 17 hours for analysis purposes. In the previous analysis of the non-response to the OGTT in NHANES II, several checks were made to detect non-response bias in the OGTT results (Ref. No. 14). Using the previous approach as a model, we took the following steps to evaluate potential bias from the high non-response to the OGTT: 1. Convened a distinguished panel of experts to advise the Center on the acceptability of the OGTT data, the NCHS Diabetes Working Group. See Table B for names and affiliations. 2. Compared frequently distributions on several demographic, socioeconomic, and medical variables from the completed OGTT sample persons with the entire interviewed sample, the entire examined sample, and the non-completed OGTT sample. These variables are shown in Table C. 3. Computed statistical tests for differences between the completed OGTT sample and the non-completed OGTT sample for the variables examined in Table C. 4. Evaluated some possible effects of non-response on the prevalence estimates of diabetes in the OGTT examined group by computing and comparing observed and expected rates of diabetes and impaired glucose tolerance. The criteria for these diagnoses are shown in Table D. The expected rates were the rates one would expect in the entire OGTT sample if all eligible persons had taken the test. These were computed, using the direct method of standardization, by multiplying the prevalence rates of diabetes for each group of demographic or medical variables in the completed OGTT sample times the population distribution of the entire OGTT sample in each subgroup of the variables examined. Expected rates of diabetes were then computed by adding the rates for each subgroup. An example is shown below: For the Mexican-American sample, the prevalence rates of the World Health Organization (WHO) diabetes by age times proportion of each age group in entire OGTT sample is: 20 - 44 years .0215 (prev. rate) X .628 (proportion in OGTT sample = .0135 45 - 74 years .1404 (prev. rate) X .372 (proportion in OGTT sample = +.0522 .0657 Expected rate of diabetes taking age of or 6.57% OGTT sample into account 6.57% is similar to the observed rate of diabetes in the OGTT-completed sample (6.79%). (Note: This is not the true rate of diabetes (diagnosed and undiagnosed) in the Mexican-American sample since self-reported diabetics on insulin were not included in the OGTT sample. 5. The observed rates of diabetes were divided by the expected rates of diabetes (O/E) for each demographic and medical variable noted above. If O/E was 1.1 or .9, the variable was said to be biased. In other words, bias was said to be detected if the rates observed in the completed OGTT sample were 10 percent higher or lower relative to the expected rates based on the entire OGTT sample. The results of the above analyses were unremarkable. For the Mexican-American sample, there were no significant differences on any of the variables shown in Table C between the completed OGTT and non-completed OGTT sample persons. Likewise, the O/E ratios for WHO diabetes and WHO IGT were all within the limits of acceptability set by the NCHS Diabetes Working Group. In the Cuban-American analyses, there was only one variable with a significant difference. The completed OGTT sample was more likely to have non-smokers (56.5%) than the non-completed sample (45.3%). Because this effect could have resulted from age, the analyses were rerun controlling for age (45+) and the variables noted in Table C. No significant differences were observed between the completed and non-completed OGTT samples, and all O/E ratios for WHO diabetes and WHO IGT were within the acceptable limits. For the Puerto Rican analyses, the completed OGTT sample was older (50.0 vs 38.8% over age 45 responding) and in fair or poor self-reported health (54.8 vs 47.8%, respectively) than the non-completed sample. Since there were only two persons with diabetes in the 20-44 age group, the analyses were rerun for persons 45-74 years, wherein the health status difference disappeared. One additional variable appeared as different in this age group when examining O/E ratios; wearing glasses or contacts (greater proportion in completed OGTT sample). However, the statistical test was deemed invalid because of a zero cell. All the diagnosed diabetics in the completed education became important for IGT in the O/E analysis because all the sample persons diagnosed with IGT were lower educated (less than high school). In summary, there was no discernible bias in the observed rates of WHO diabetes or WHO IGT in the Puerto Rican sample, after taking age and small sample sizes into account. We should note one final word of caution. There may have been some other variable, not collected in HHANES, that affected the completion rate for the OGTT and that could bias the diabetes rates. For example, in the NHANES II survey (Ref. No. 15), participation in the OGTT was higher among persons with a parent who had had diabetes as compared to those persons who had no parental history of diabetes. Since this question was not asked in HHANES, we cannot say whether or not this factor caused selection bias. We do know, however, that this variable was found to cause a difference of only .4% in the diabetes prevalence estimates for the persons in NHANES II - making it unlikely to affect estimates computed for HHANES (Ref. No. 15) in a major way. Researchers should carefully evaluate the potential nonresponse bias for any analyses they perform with these data.Table A Response Rates for OGTT Mexican-Americans Cuban-Americans Puerto Ricans Response % of % of % of Category Number Total Number Total Number Total Total Adult Fasting Sample 2554 100.0 782 100.0 979 100.0 Interviewed Sample 2120 83.0 595 76.1 842 86.0 Examined Sample 1777 69.6 449 57.4 667 68.1 Examined but ineligible for OGTT because of current insulin use 22 2 20 Three plasma glucose values obtained 1012 39.6 212 27.1 27.2 27.8Table B Names and affiliations of NCHS panel convened to evaluate HHANES OGTT data: Name Affiliation Maureen I. Harris, Ph.D. National Diabetes Data Group NIDDK, National Institutes of Health Bethesda, Maryland Rumaldo Juarez, Ph.D. Department of Sociology and Social Work Pan American University Edinburg, Texas William C. Knowler, M.D., Dr. P.H. Epidemiology and Field Studies Branch NIDDK, National Institutes of Health Phoenix, Arizona Eliseo J. Perez-Stable, M.D. Division of General Internal Medicine Department of Medicine University of California San Francisco, California Michael P. Stern, M.D. Division of Clinical Epidemiology Department of Medicine University of Texas Health Science Center San Antonio, Texas National Center for Health Statistics Staff from the Division of Health Examination Statistics Trena M. Ezzati, M.S. Survey Planning and Development Branch Katherine M. Flegal, Ph.D. Medical Statistics Branch Marilyn Miles McMillen, Ph.D. Medical Statistics Branch Suzanne G. Haynes, Ph.D. Medical Statistics BranchTable C Variables Examined in the HHANES OGTT Bias Analysis Type of Variable Variable Name Questionnaire or Examination* Sociodemographic Age HSQ Sex FQ Generation ASPQ Marital Status FQ Education FQ Poverty Index FQ Literacy ASPQ Acculturation (for ASPQ Mexican-Americans only) Life-Style Characteristics Overweight Anthropometric Exam Current Smoker ASPQ Ever Smoked ASPQ Health Care Ever had Routine Exam ASPQ Have a Usual Place of ASPQ Health Care Had Health Care in ASPQ Previous Years Has Health Insurance ASPQ Last Visit to Usual ASPQ Place of Care Last Visit to Any ASPQ Place of Care Wears Glasses or Contacts ASPQ Health Status or Self-reported Health Status ASPQ Conditions Doctor or Health Professional ASPQ Diagnosed Borderline, Potential, or Pre-diabetes Doctor or Health Professional ASPQ Diagnosed Hypertension On Medication for Hypertension ASPQTable D Variables Examined in the HHANES OGTT Bias Analysis (CONTINUED) Type of Variable Variable Name Questionnaire or Examination* Health Status or Doctor every told: Conditions, Cont. Rheumatic Fever ASPQ Rheumatic Heart Disease ASPQ Heart Murmur ASPQ Heart Failure ASPQ Heart Attack ASPQ Kidney Problems ASPQ Glaucoma ASPQ Cataracts ASPQ *HSQ = Household Screener Questionnaire FQ = Family Questionnaire ASPQ = Adult Sample Person QuestionnaireTable E World Health Organization criteria used to define diabetes or impaired glucose tolerance using results from the OGTT Fasting and 2-hour Plasma Glucose Concentrations Diagnosis Fasting, 140 mg/dl or more Diabetes Fasting, less than 140 mg/dl: 2 hour, 200 mg/dl or more Diabetes 2 hour, 140-199 mg/dl Impaired Glucose Tolerance 2 hour, less than 140 mg/dl Normal TAPE POSITION INDEX TAPE POSITIONS 1-400 contain data categories common to all data tapes: sociodemographic data, family composition, family income, residence and household. Sample weights are also in this set of data. TAPE POSITIONS 401+ contain data categories unique to this data tape. SOCIODEMOGRAPHIC DATA - SAMPLE PERSON (E) 1-5 Sample Person Sequence Number 6-15 Survey and Tape Identifiers 16 Examination Status 17 Language of Interview 18-21 Date of Interview 22-25 Date of Examination 26-29 Date of Birth 30-32 Age at Interview 33-38 Age at Examination 39-43 Family Number 44-45 Relationship to Head of Family 46 Sex 47 Race 48-49 National Origin or Ancestry 50-52 Birth Place 53 National Origin Recode 54-56 Education 57 Marital Status 58 Service in Armed Forces 59-69 Work/Occupation/Employment 70-95 Health Insurance/Health Care Support 96-99 Income Assistance/Public Compensation or Support SOCIODEMOGRAPHIC DATA - HEAD OF FAMILY (F) 100 Interview and Examination Status 102-105 Date of Birth 106-108 Age at Interview 109 Sex 110 Race 111-112 National Origin or Ancestry 113-115 Birth Place 116-118 Education 119 Marital Status 120 Service in Armed Forces 121-131 Work/Occupation/Employment FAMILY COMPOSITION AND INCOME DATA (G) 132-133 Number of People in Family 134-135 Number of Sample People in Family 136-138 Combined Family Income 139-143 Per Capita Income 144-146 Poverty Index 147-162 Income, Food Stamps RESIDENCE AND HOUSEHOLD DATA (H) 163 Size of Place 164 Standard Metropolitan Statistical Area 165-166 Number of People in Household 167-168 Number of Sample People in Household 169-170 Number of Rooms 171 Kitchen Facilities Access 172-183 Heating/Cooling Equipment SAMPLE WEIGHTS (I) 184-189 Examination Final Weight 190-195 Interview Final Weight 196-201 GTT/Ultrasound Weight 202-207 Audiometry/Vision Weight 208-213 Pesticide Weight 214-215 Strata Code 216-217 Pseudo PSU Code FAMILY RELATIONSHIPS (J) 218-400 Data not yet available ADULT HISTORY DATA (DIABETES) (K) 405 Self-Reported Diabetes 406-407 Source of Diabetes Diagnosis 408-411 Age of Diabetes Onset 412-420 Self-reported Borderline, Potential, and Prediabetes 422-424 Tests for Diabetes 425-426 Hospitalization for Diabetes 427-429 Weight at Diagnosis 430-437 Insulin Treatment 438-443 Diabetes Pills 444-445 Diet for Diabetes 446 Identification 447-448 Last and Annual Health Visits GLUCOSE CHALLENGE QUESTIONNAIRE DATA (L) 450-453 Tape Number 454 In Fasting Subsample 455 OGTT Completion Status 456-457 Reason for Incomplete OGTT 458 Second Visit Status 459-460 Reason for Second Visit 461-462 On Diabetes Medication 463-467 Last Meal 468-473 Last Anything to Eat 474-479 Last Anything to Drink 480-496 Second Visit Information PLASMA GLUCOSE VALUES AND COMPUTED TIME INTERVALS (M) 500-503 Time of First Venipuncture 504-507 Time Glucola Given 508-511 Time of Second Venipuncture 512-515 Time of Third Venipuncture 516 Time Generated 517-525 Plasma Glucose Values 526-569 Computed Time IntervalsRECORD LAYOUT Sociodemographic Data - Sample Person Positions 1-21 COUNTS SOURCE POSITION ITEM DESCRIPTION AND CODE M C P AND NOTES E. SOCIODEMOGRAPHIC DATA - SAMPLE PERSON (POS 1-99) Source: Family Questionnaire (FQ) Household Screener Questionnaire (HSQ) 1-5 Sample Person Sequence Number 00001-09894 Mexican Americans 3555 - 10002-12238 Cuban Americans - 907 - 13001-16785 Puerto Ricans - - 1353 6-12 Blank 13 Portion of Survey 1 Mexican-American (M) 3555 - - 2 Cuban-American (C) - 907 - 3 Puerto Rican (P) - - 1353 14 Family Questionnaire Missing 1 Yes 10 4 5 See Note 1 2 No 3545 903 1348 15 Version Number 1 3555 907 1353 16 Examination Status 1 Examined 3555 907 1353 See Note 2 2 Not examined 0 0 0 17 Language of interview (Pos. 1-400) FQ 1 English 2127 157 561 2 Spanish 1418 746 787 Blank 10 4 5 Date of Interview HSQ 4 18-19 01-12 Month 3555 907 1353 20-21 82-84 Year 3555 907 1353 Date of Examination From survey control record Positions 22-43 COUNTS SOURCE POSITION ITEM DESCRIPTION AND CODE M C P AND NOTES 22-23 01-12 Month 3555 907 1353 24-25 82-84 Year 3555 907 1353 Date of Birth HSQ 2e 26-27 01-12 Month 3555 907 1353 88 Blank but applicable 0 0 0 28-29 08-64 Year 3555 907 1353 88 Blank but applicable 0 0 0 30-31 Age at Interview (computed) 20-74 (See next column for units) 3555 907 1353 32 Age at Interview Units HSQ 2f 1 Years 3555 907 1353 Age at Examination (computed) Positions 33-38 are all 0 for non-examined persons 33-34 20-75 Years 3555 907 1353 35-36 00-11 Months 3555 907 1353 37-38 00-30 Days 3555 907 1353 39-43 Family Number See Note 3 00002-03527 3555 - - 04005-04922 - 907 - 07003-08584 - - 1353 Positions 44-60 COUNTS SOURCE POSITION ITEM DESCRIPTION AND CODE M C P AND NOTES 44-45 What is sample person's HSQ 2b relationship to head of family? See Note 4 Sample person is: 01 Head of family living alone (1 family with only 1 member) 143 56 113 02 Head of family, with no related persons in house- hold (2+ persons in household) 70 23 23 03 Head of family, with related persons in household 1566 368 674 04 Wife of head (husband living at home and not in Armed Forces) 1264 297 290 05 Wife of head (husband living at home and is in Armed Forces) 5 0 0 06 Husband of head (wife living at home and not in Armed Forces) 35 12 37 07 Husband of head (wife living at home and is in Armed Forces) 0 0 0 08 Child of head or head's spouse 277 76 126 09 Grandchild of head or head's spouse 7 0 3 10 Parent of head or head's spouse 57 35 33 11 Other relative (includes ex- spouse, daughter-in-law, etc.) 131 40 54 12 Foster child 0 0 0 46 Sex FQ B-4 1 Male 1572 393 498 2 Female 1983 514 855 47 Observed Race FQ B-5 1 White 3446 870 1220 See Note 5 2 Black 30 13 62 3 Other 6 2 27 8 Blank but applicable 41 12 28 9 Not observed 22 6 11 Blank 10 4 5 48-49 Sample person's national origin HSQ 2c or ancestry See Note 6 01 Mexican/Mexicano 940 1 1 02 Mexican-American 2230 0 0 03 Chicano 46 0 0 04 Puerto Rican 7 3 1202 05 Boricuan 0 0 15 06 Cuban 3 796 14 07 Cuban-American 0 69 0 08 Hispano - specify 61 10 20 09 Other Latin-American or other Spanish - specify 25 16 25 00 Other - specify 217 12 76 10 Spanish-American 13 0 0 11 Spanish (Spain) 13 0 0 50-52 In what state or foreign country FQ B-6 was sample person born? 001-115 State/country code 3528 900 1324 888 Blank but applicable 17 3 24 Blank 10 4 5 53 National origin recode See Note 8 "Hispanic" = Mexican-American in Southwest, Cuban-American in Florida and Puerto Rican in New York City area 1 "Hispanic" 3326 865 1220 2 Not "Hispanic" 229 42 133 54-55 What is the highest grade or year FQ B-7 of regular school sample person has ever attended? 00 Never attended or kinder- garten only 141 6 23 01-08 Elementary grade 1312 342 435 09-12 High school grade 1442 292 666 13-16 College 536 228 195 17 Graduate school 69 30 14 88 Blank but applicable 45 5 15 Blank 10 4 5 56 Did sample person finish that FQ B-8 grade/year? 1 Yes 2779 779 1055 2 No 580 108 236 8 Blank but applicable 45 10 34 Blank 151 10 28 57 Is sample person now married, FQ B-9 widowed, divorced, separated or has he or she never been married? 1 Married - spouse in household 2539 622 647 2 Married - spouse not in household 68 17 53 3 Widowed 161 50 66 4 Divorced 209 92 154 5 Separated 149 21 147 6 Never married 403 100 275 8 Blank but applicable 16 1 6 Blank 10 4 5 58 Did sample person ever serve in FQ B-11 the Armed Forces of the United States? 1 Yes 413 27 141 2 No 3125 874 1198 8 Blank but applicable 7 2 9 Blank 10 4 5 59 During the past 2 weeks, did FQ B-12 sample person work at any time at a job or business, not counting work around the house? 1 Yes 2028 581 566 2 No 1507 317 767 8 Blank but applicable 10 5 15 Blank 10 4 5 60 Even though sample person did not FQ B-13 work during those 2 weeks, did he or she have a job or business? 1 Yes 44 12 21 2 No 1462 303 743 8 Blank but applicable 11 7 18 Blank 2038 585 571 Positions 61-80 COUNTS SOURCE POSITION ITEM DESCRIPTION AND CODE M C P AND NOTES 61 Was sample person looking for FQ B-14 work or on layoff from a job? 1 Yes 200 39 51 2 No 1306 276 713 8 Blank but applicable 11 7 18 Blank 2038 585 571 62 Which, looking for work or on FQ B-15 layoff from a job or both? 1 Looking 131 30 35 2 Layoff 45 6 8 3 Both 22 2 7 Blank but applicable 13 8 19 Blank 3344 861 1284 63-65 What kind of business or industry FQ B-19 does sample person work for? See Note 9 010-932 Industry code 2238 621 628 990 Blank but applicable 31 10 21 Blank 1286 276 704 66-68 What kind of work was sample FQ B-20 person doing? See Note 9 003-889 Occupation code 2240 622 628 999 Blank but applicable 29 9 21 Blank 1286 276 704 69 Class of Worker FQ B-22 1 An employee of a private com- pany, business or individual for wages, salary or commission 1742 502 501 2 A Federal government employee 72 6 18 3 A State government employee 119 18 17 4 A Local government employee 163 16 56 5 Self-employed in own incorporated business or professional practice 17 12 7 6 Self-employed in own unin- corporated business, profes- sional practice, or farm 125 66 26 7 Working without pay in family business or farm 1 0 0 8 Blank but applicable 29 10 23 0 Never worked or never worked at a full-time civilian job lasting 2 weeks or more 1 1 1 Blank 1286 276 704 70 Is sample person now covered by FQ C-2 Medicare? 1 Covered 258 103 109 2 Not covered 3279 796 1234 8 Blank but applicable 5 3 5 9 Don't know 3 1 0 Blank 10 4 5 71 Is sample now covered by the part FQ C-3 of Social Security Medicare which pays for hospital bills? 1 Yes 230 6 100 2 No 13 4 4 8 Blank but applicable 14 3 10 9 Don't know 6 3 0 Blank 3292 801 1239 72 Is sample now covered by that part FQ C-4 of Medicare which pays for doctor's bills? This is the Medicare plan for which he or she or some agency must pay a certain amount each month. 1 Yes 227 98 92 2 No 14 3 11 8 Blank but applicable 14 3 10 9 Don't know 8 2 1 Blank 3292 801 1239 73 Type of Medicare coverage FQ C-5 As shown on Medicare card 2 Medical 2 0 0 3 Card not available 3 0 1 4 Hospital and medical 5 3 0 8 Blank but applicable 14 3 10 Blank 3531 901 1342 HEALTH INSURANCE See Note 10 74 Is sample person covered by FQ C-11 any health insurance plan which pays any part of a hospital, doctor's, or surgeon's bill? 1 Yes 2009 556 560 2 No 1526 343 779 8 Blank but applicable 6 4 9 9 Don't know 4 0 0 Blank 10 4 5 75 Is sample person covered by a FQ C-9 plan that pays any part of hospital expenses? 1 Yes 1979 550 525 2 No 3 3 4 8 Blank but applicable 27 7 35 9 Don't know 6 0 5 Blank 1540 347 784 76 Is sample person covered by a FQ C-10 plan that pays any part of a doctor's or surgeon's bills for operations? 1 Yes 1982 546 523 2 No 9 7 17 8 Blank but applicable 15 7 20 9 Don't know 9 0 9 Blank 1540 347 784 Many people do not carry health FQ C-13/15 insurance for various reasons. See Note 10 Which of these statements describes why sample person is not covered by any health insurance (or Medicare)? (Positions 77-80) 77-78 Main reason 01 Care received through Medicaid or welfare 79 14 289 02 Unemployed, or reasons related to unemployment 180 29 68 03 Can't obtain insurance because of poor health, illness, or age 17 2 9 04 Too expensive, can't afford health insurance 756 163 226 05 Dissatisfied with previous insurance 23 2 2 06 Don't believe in insurance 14 3 4 07 Have been healthy, not much sickness in the family, haven't needed health insurance 94 15 13 08 Military dependent, (CHAMPUS), Veteran's benefits 20 1 11 09 Some other reason - not specified 1 0 2 10 Some other reason - specified 112 19 37 88 Blank but applicable 49 23 29 Blank 2210 636 663 79-80 Second reason 00 No second reason reported 1102 199 564 01 Care received through Medicaid or welfare 25 10 23 02 Unemployed, or reasons related to unemployment 46 16 12 03 Can't obtain insurance because of poor health, illness, or age 3 1 2 04 Too expensive, can't afford health insurance 81 14 56 05 Dissatisfied with previous insurance 8 1 2 06 Don't believe in insurance 7 1 1 07 Have been healthy, not much sickness in the family, haven't needed health insurance 21 4 3 08 Military dependent, (CHAMPUS), Veteran's benefits 0 0 0 09 Some other reason - not specified 0 0 0 10 Some other reason - specified 13 6 2 88 Blank but applicable 39 19 25 Blank 2210 636 663 Positions 81-99 COUNTS SOURCE POSITION ITEM DESCRIPTION AND CODE M C P AND NOTES 81-87 Blank 88 During the last 12 months, has FQ D-6 sample person received health care which has been or will be paid for by Medicaid? 1 Yes 195 66 385 2 No 3328 832 949 8 Blank but applicable 22 5 14 9 Don't know 0 0 0 Blank 10 4 5 89 Does sample person have a FQ D-8 Medicaid card? 1 Yes 198 67 403 2 No 3329 825 931 8 Blank but applicable 18 11 14 9 Don't know 0 0 0 Blank 10 4 5 90 Status of sample person's FQ D-9 Medicaid card? 1 Medicaid card seen - current 148 52 285 2 Medicaid card seen - expired 2 0 5 3 No card seen 43 13 103 4 Other card seen 0 0 0 5 Other card seen (specify) 3 0 1 8 Blank but applicable 20 13 23 Blank 3339 829 936 91 Is sample person now covered by FQ D-11 any other public assistance program that pays for health care? 1 Yes 12 2 12 2 No 3527 900 1331 8 Blank but applicable 6 1 5 9 Don't know 0 0 0 Blank 10 4 5 92 Does sample person now receive FQ D-13 military retirement payments from any branch of the Armed Forces or a pension from the Veteran's Administration? Do not include VA disability compensation. 1 Yes 45 2 9 2 No 3492 900 1335 8 Blank but applicable 8 1 4 9 Don't know 0 0 0 Blank 10 4 5 93 Which does sample person receive: FQ D-14 the Armed Forces retirement, the VA pension, or both? 1 Armed Forces 12 0 2 2 Veteran's Administration 24 0 5 3 Both 4 2 1 8 Blank but applicable 13 1 5 Blank 3502 904 1340 94 Is sample person now covered by FQ D-16 CHAMP-VA, which is medical insurance for dependents or survivors of disabled veterans? 1 Yes 20 2 6 2 No 3520 900 1340 8 Blank but applicable 5 1 2 9 Don't know 0 0 0 Blank 10 4 5 95 Is sample person now covered by FQ D-18 any other program that provides health care for military dependents or survivors of military persons? 1 Yes 20 1 5 2 No 3518 901 1336 8 Blank but applicable 7 1 7 9 Don't know 0 0 0 Blank 10 4 5 96 Is sample person included in the FQ D-2 AFDC "Aid to Families with Dependent Children" assistance payment? 1 Yes 87 15 182 2 No 3448 885 1153 8 Blank but applicable 10 2 12 9 Don't know 0 1 1 Blank 10 4 5 97 Does sample person now receive the FQ D-4 "Supplemental Security Income" or "SSI" gold-colored check? 1 Yes 92 43 91 2 No 3441 852 1247 8 Blank but applicable 12 8 10 9 Don't know 0 0 0 Blank 10 4 5 98 Does sample person have a FQ D-20 disability related to his or her service in the Armed Forces of the United States? 1 Yes 48 2 14 2 No 343 20 106 8 Blank but applicable 29 7 30 Blank 3135 878 1203 99 Does sample person now receive FQ D-21 compensation for this disability from the Veteran's Administration? 1 Yes 31 1 9 2 No 17 1 4 8 Blank but applicable 29 7 31 Blank 3478 898 1309 Sociodemographic Data - Head of Family COUNTS SOURCE POSITION ITEM DESCRIPTION AND CODE M C P AND NOTES F. SOCIODEMOGRAPHIC DATA - HEAD OF FAMILY (POS 100-131) Source: Family Questionnaire (FQ) Household Screener Questionnaire (HSQ) 100 Interview and examination status See Note 4 of head of family 1 Selected as sample person, interviewed on Adult Sample Person Questionnaire, and examined 3158 764 1266 2 Selected as sample person, interviewed on Adult Sample Person Questionnaire, but not examined 120 32 30 3 Selected as sample person, not interviewed, and not examined 98 21 5 4 Not selected as sample person 169 86 47 Blank 10 4 5 101 Blank Date of Birth HSQ 2e 102-103 01-12 Month 3535 902 1352 88 Blank but applicable 20 5 1 104-105 00-86, 89-99 Year 3545 904 1352 88 Blank but applicable 10 3 1 106-107 Age at Interview 18-95 Years 3555 907 1353 108 Blank 109 Sex FQ B-4 1 Male 2939 719 768 2 Female 606 184 580 Blank 10 4 5 110 Observed Race FQ B-5 1 White 3417 862 1218 See Note 5 2 Black 35 17 67 3 Other 4 2 22 8 Blank but applicable 54 18 29 9 Not observed 35 4 12 Blank 10 4 5 111-112 Head of family's national origin HSQ 2c or ancestry See Note 6 01 Mexican/Mexicano 948 0 2 02 Mexican-American 2180 0 0 03 Chicano 46 0 0 04 Puerto Rican 9 5 1198 05 Boricuan 0 0 14 06 Cuban 4 801 22 07 Cuban-American 0 58 0 08 Hispano - specify 65 14 16 09 Other Latin-American or other Spanish - specify 24 11 16 00 Other - specify 254 18 85 10 Spanish-American 11 0 0 11 Spanish (Spain) 14 0 0 113-115 In what state or foreign country FQ B-6 was head of family born? See Note 7 001-118 State/country code 3509 893 1320 888 Blank but applicable 36 10 28 Blank 10 4 5 116-117 What is the highest grade or year FQ B-7 of regular school head of family has ever attended? 00 Never attended or kinder- garten only 138 4 17 01-08 Elementary grade 1406 350 482 09-12 High school grade 1323 256 630 13-16 College 515 236 175 17 Graduate school 88 41 24 88 Blank but applicable 75 16 20 Blank 10 4 5 118 Did head of family finish that FQ B-8 grade/year? 1 Yes 2733 788 1083 2 No 603 90 216 8 Blank but applicable 71 21 32 Blank 148 8 22 119 Is the head of family now married, FQ B-9 widowed, divorced, separated or has he or she never been married? 1 Married - spouse in household 2741 694 710 2 Married - spouse not in household 56 7 48 3 Widowed 179 41 70 4 Divorced 198 94 156 5 Separated 143 14 178 6 Never married 189 46 183 8 Blank but applicable 39 7 3 Blank 10 4 5 120 Did head of family ever serve in FQ B-11 the Armed Forces of the United States? 1 Yes 780 38 239 2 No 2730 854 1096 8 Blank but applicable 35 11 13 Blank 10 4 5 121 During the past 2 weeks, did head FQ B-12 of family work at any time at a job or business, not counting work around the house? 1 Yes 2529 661 699 2 No 986 230 638 8 Blank but applicable 30 12 11 Blank 10 4 5 122 Even though head of family did not FQ B-13 work during those 2 weeks, did he or she have a job or business? 1 Yes 52 14 15 2 No 934 216 623 8 Blank but applicable 30 12 11 Blank 2539 665 704 123 Was head of family looking for FQ B-14 work or on layoff from a job? 1 Yes 220 46 54 2 No 766 184 583 8 Blank but applicable 30 12 12 Blank 2539 665 704 124 Which, looking for work or on FQ B-15 layoff from a job or both? 1 Looking 115 31 32 2 Layoff 63 9 10 3 Both 40 3 9 8 Blank but applicable 32 15 15 Blank 3305 849 1287 125-127 What kind of business or industry FQ B-19 does head of family work for? See Note 9 010-932 Industry code 2769 705 752 990 Blank but applicable 49 15 22 Blank 737 187 579 128-130 What kind of work was head FQ B-20 of family doing? See Note 9 003-889 Occupation code 2771 705 750 999 Blank but applicable 47 15 24 Blank 737 187 579 131 Class of Worker FQ B-22 1 Employee of a private company, business or individual for wages, salary or commission 2155 543 567 2 A Federal government employee 98 3 24 3 A State government employee 118 11 29 4 A Local government employee 180 19 90 5 Self-employed in own incorpora- ted business or professional practice 26 19 10 6 Self-employed in own unin- corporated business, profes- sional practice, or farm 201 108 32 7 Working without pay in family business or farm 0 0 0 8 Blank but applicable 39 17 21 0 Never worked or never worked at a full-time civilian job lasting 2 weeks or more 1 0 1 Blank 737 187 579 Family Composition and Income Data COUNTS SOURCE POSITION ITEM DESCRIPTION AND CODE M C P AND NOTES G. FAMILY COMPOSITION AND INCOME DATA (POS 132-162) Source: Family Questionnaire (FQ) 132-133 Number of Persons in Family (computed) 01-18 Persons 3555 907 1353 134-135 Number of Sample Persons in Family (computed) 01-13 Persons 3555 907 1353 136 Was the total combined family FQ E-10 income during the past 12 months more or less than $20,000? Include money from jobs, Social Security, retirement income, unemployment payments, public assistance, and so forth. Also include income from interest, dividends, net income from business, farm or rent, and any other money income received. 1 $20,000 or more 1195 361 326 2 Less than $20,000 2233 526 1000 7 Refused information 18 1 5 8 Blank but applicable 99 15 17 Blank 10 4 5 137-138 Of those income groups, which best FQ E-11 represents the total combined family income during the past 12 months? Include wages, salaries, and other items we just talked about (in dollars). 01 Less than 1,000 22 7 4 02 1,000 - 1,999 46 6 15 03 2,000 - 2,999 51 14 34 04 3,000 - 3,999 82 20 55 05 4,000 - 4,999 97 21 126 06 5,000 - 5,999 117 32 75 07 6,000 - 6,999 143 26 82 08 7,000 - 7,999 146 31 68 09 8,000 - 8,999 118 26 45 10 9,000 - 9,999 126 33 56 11 10,000 - 10,999 132 46 59 12 11,000 - 11,999 109 31 33 13 12,000 - 12,999 143 39 53 14 13,000 - 13,999 90 21 29 15 14,000 - 14,999 111 17 32 16 15,000 - 15,999 99 23 41 17 16,000 - 16,999 95 22 31 18 17,000 - 17,999 104 21 32 19 18,000 - 18,999 147 20 45 20 19,000 - 19,999 116 34 46 21 20,000 - 24,999 336 101 79 22 25,000 - 29,999 293 61 68 23 30,000 - 34,999 163 44 51 24 35,000 - 39,999 145 48 31 25 40,000 - 44,999 107 32 22 26 45,000 - 49,999 52 27 21 27 50,000 and over 54 34 31 77 Refused information 41 9 25 88 Blank but applicable 160 57 59 Blank 10 4 5 139-143 Per Capita Income (computed) See Note 11 00083-50000 Dollrs 3244 837 1264 88888 Blank but applicable 301 66 84 Blank 10 4 5 144-146 Poverty Index (computed) See Note 12 Decimal not shown on tape 0.04-9.78 3244 837 1264 999 Blank but applicable 301 66 84 Blank 10 4 5 147 Did any member of this family FQ E-12 receive any Government food stamps in any of the past 12 months? 1 Yes 619 149 506 2 No 2921 752 840 8 Blank but applicable 5 2 2 Blank 10 4 5 148-149 In how many months of the past 12 FQ E-13 months did any member of this family receive food stamps? 01-12 months 613 149 504 88 Blank but applicable 11 2 4 Blank 2931 756 845 150 Did this family receive any FQ E-14 government food stamps last month? 1 Yes 502 120 481 2 No 116 29 25 8 Blank but applicable 6 2 2 Blank 2931 756 845 151-152 In which month did any member of FQ E-15 this family last receive any food stamps? 01-12 Month 114 29 25 88 Blank but applicable 8 2 2 Blank 3433 876 1326 153-154 For how many persons were those FQ E-16 food stamps authorized? 01-13 Persons 614 149 505 88 Blank but applicable 10 2 3 Blank 2931 756 845 155-157 What was the total face value of FQ E-17 those food stamps received by this family in that month? 010-520 Dollars 585 147 499 888 Blank but applicable 39 4 9 Blank 2931 756 845 158 Did this family spend more for FQ E-18 food in that month than the value of your food stamps? 1 Yes 539 128 492 2 No 74 21 14 8 Blank but applicable 11 2 2 Blank 2931 756 845 159-161 How much more? FQ E-19 003-880 Dollars 501 120 482 888 Blank but applicable 49 10 12 Blank 3005 777 859 162 Is your family receiving food FQ E-20 stamps at the present time? 1 Yes 474 116 473 2 No 3061 783 869 8 Blank but applicable 10 4 6 Blank 10 4 5 Residence and Household Data COUNTS SOURCE POSITION ITEM DESCRIPTION AND CODE M C P AND NOTES H. RESIDENCE AND HOUSEHOLD DATA (POS 163-183) Source: Family Questionnaire (FQ) Household Screener Questionnaire (HSQ) 163 Size of Place See Note 13 1 1 million or more 484 0 1009 2 500,000 - 999,999 423 0 0 3 250,000 - 499,999 450 334 0 4 100,000 - 249,999 91 235 155 5 50,000 - 99,999 568 49 32 6 25,000 - 49,999 386 131 98 7 10,000 - 24,999 352 76 46 8 200 - 9,999 491 52 13 9 Not in a place 310 30 0 164 Standard Metropolitan Statistical See Note 13 Area 1 In SMSA, in central city 1771 334 1173 2 In SMSA, not in central city 1332 573 180 4 Not in SMSA 452 0 0 165-166 Number of Persons in Household HSQ 1a 01-18 persons 3555 907 1353 167-168 Number of Sample Persons in Household (computed) 01-13 Persons 3555 907 1353 169-170 How many rooms are in this home? FQ E-1 Count the kitchen, but not the bathroom. 01-14 Rooms 3541 902 1346 88 Blank but applicable 4 1 2 Blank 10 4 5 171 Do you have access to complete FQ E-2 kitchen facilities in this home; that is, kitchen sink with piped water, a refrigerator and a range or cookstove? 1 Yes 3397 879 1213 2 No 40 7 8 8 Blank but applicable 108 17 127 Blank 10 4 5 172-173 What is the main fuel used for FQ E-3 heating this home? See Note 14 00 No fuel used 214 164 5 01 Oil 2 0 940 02 Natural gas 2888 45 362 03 Electricity 277 682 15 04 Bottled gas (propane) 85 2 0 05 Kerosene 7 2 0 06 Wood 45 3 0 07 Coal 0 0 6 08 Other, not specified 0 0 1 09 Other, specified 6 0 2 88 Blank but applicable 21 5 17 Blank 10 4 5 174-175 What is the main heating equipment FQ E-4 for this home? See Note 14 00 No heating equipment used 214 164 6 01 Steam or hot water with radiators or convectors 19 4 686 02 Central warm air furnace with ducts to individual rooms, or central heat pump 1296 340 96 03 Built-in electric units (per- manently installed in wall, ceiling, or baseboard) 219 219 32 04 Floor, wall or pipeless furnace 783 30 12 05 Room heaters with flue or vent, burning oil, gas, or kerosene 403 12 301 06 Room heaters without flue or vent, burning oil, gas, or kerosene 406 4 189 07 Heating stove burning wood, coal or coke 37 0 2 08 Fireplace(s) 37 4 0 09 Portable electric heater(s) 68 95 2 10 Other, not specified 0 0 0 11 Other, specified 53 26 7 88 Blank but applicable 1 5 8 99 Don't know 9 0 7 Blank 10 4 5 176-177 Are any other types of equipment FQ E-5 used for heating this home? See Note 14 00 No other heating equipment used 2877 707 1132 01 Steam or hot water with radiators or convectors 0 0 3 02 Central warm air furnace with ducts to individual rooms, or central heat pump 5 9 5 03 Built-in electric units (per- manently installed in wall, ceiling, or baseboard) 16 0 1 04 Floor, wall or pipeless furnace 5 0 0 05 Room heaters with flue or vent, burning oil, gas, or kerosene 12 0 0 06 Room heaters without flue or vent, burning oil, gas, or kerosene 15 1 16 07 Heating stove burning wood, coal or coke 42 0 5 08 Fireplace(s) 239 5 4 09 Portable electric heater(s) 95 14 166 10 Other, not specified 4 1 0 11 Other, specified 10 1 1 88 Blank but applicable 15 1 9 Blank 224 168 11 178-179 What is the main fuel used by this FQ E-6 additional equipment? See Note 14 00 No fuel used 1 0 1 01 Oil 0 0 9 02 Natural gas 51 1 10 03 Electricity 116 24 162 04 Bottled gas (propane) 6 0 1 05 Kerosene 2 0 14 06 Wood 250 5 6 07 Coal 2 0 0 08 Other, not specified 0 0 0 09 Other, specified 5 0 0 88 Blank but applicable 21 2 7 Blank 3101 875 1143 180-181 What is the main fuel used for FQ E-7 cooking in this home? 00 No fuel used 10 4 2 01 Oil 5 0 9 02 Natural gas 2789 163 1236 03 Electricity 639 726 78 04 Bottled gas (propane) 85 7 7 05 Kerosene 0 0 3 06 Wood 0 0 0 07 Coal 0 0 0 08 Other, not specified 0 0 0 09 Other, specified 8 1 0 88 Blank but applicable 9 2 13 Blank 10 4 5 182 Do you have air-conditioning - FQ E-8 either individual room units, a central system or evaporative cooling? 1 Yes 1733 829 347 2 No 1806 73 995 8 Blank but applicable 6 1 6 Blank 10 4 5 183 Which do you have? FQ E-9 1 Individual room unit 779 411 328 2 Central air-conditioning 603 410 10 3 Evaporative cooling 349 3 4 8 Blank but applicable 8 6 11 Blank 1816 77 1000 Sample Weights COUNTS SOURCE POSITION ITEM DESCRIPTION AND CODE M C P AND NOTES I. SAMPLE WEIGHTS (POS 184-217) 184-189 Examined Final Weight 000439-002711 3555 - - 000248-000891 - 907 - 000177-002000 - - 1353 190-195 Interview Final Weight 000447-002096 3555 - - 000207-000578 - 907 - 000175-001220 - - 1353 GTT/ULTRASOUND, AUDIOMETRY/VISION, PESTICIDE WEIGHTS By design, only some of the persons in the sample were included in the GTT/ultrasound, audiometry/vision, and pesticide components of the survey. Tape positions for those persons not part of these subsamples are BLANK. 196-201 GTT/Ultrasound Weight 000843-005302 1777 - - 000469-001685 - 449 - 000349-003110 - - 667 Blank 1778 458 686 202-207 Audiometry/Vision Weight 000870-006283 1778 - - 000454-001600 - 458 - 000343-003123 - - 686 Blank 1777 449 667 208-213 Pesticide Weight 000872-005584 1778 - - 000454-001600 - 458 - 000343-003117 - - 686 Blank 1777 449 667 214-215 Strata Code 01-08 3555 907 1353 216-217 Pseudo PSU Code 01-02 3555 907 1353 Family Relationships COUNTS SOURCE POSITION ITEM DESCRIPTION AND CODE M C P AND NOTES J. FAMILY RELATIONSHIPS (POS 218-400) Source: Adult Sample Person Questionnaire Family Questionnaire 218-400 Blank Data not yet available. Adult History Data (Diabetes) Position Item description Counts Source and code M C P and notes K. ADULT HISTORY DATA (DIABETES) (POS 401-448) Source: Adult Sample Person Questionnaire (ASPQ) 401-404 Blank Positions 405-448 contain selected interview data for adults 20-74 years. These data are also found on HHANES data tape number 6521 (Adolescent and Adult History Questionnaire). 405 Do you have diabetes or sugar diabetes? ASPQ C-1 1 Yes 233 40 104 2 No 3321 867 1248 8 Blank but applicable 1 0 0 Blank 0 0 1 406 Did a doctor tell you that you have it? ASPQ C-2 1 Yes 230 39 102 2 No 3 1 1 8 Blank but applicable 1 0 1 Blank 3321 867 1249 407 Did any other health professional, such as ASPQ C-3 a nurse or physician's assistant, tell you that you have it? 1 Yes 0 0 0 2 No 3 1 1 8 Blank but applicable 1 0 1 Blank 3551 906 1351 408-409 How long ago did the (doctor/health ASPQ C-4 professional) first tell you that you See Note 15 had diabetes? 00 Less than 1 year ago 20 7 9 01-36 Years 210 32 92 88 Blank but applicable 1 0 2 Blank 3324 868 1250 410-411 How old were you then? ASPQ C-5 07-73 Years of age 230 39 101See Note 15 88 Blank but applicable 1 0 2 Blank 3324 868 1250 412 Have you ever been told by a doctor or ASPQ C-6 other health professional that you have borderline diabetes? 1 Yes 109 11 25 2 No 3438 892 1319 8 Blank but applicable 8 4 8 Blank 0 0 1 413-414 How old were you then? ASPQ C-7 11-69 Years 90 8 24 See Note 15 88 Blank but applicable 27 7 9 Blank 3438 892 1320 415 Have you ever been told by a doctor or ASPQ C-6 other health professional that you have potential diabetes? 1 Yes 53 11 17 2 No 3493 894 1325 8 Blank but applicable 9 2 10 Blank 0 0 1 416-417 How old were you then? ASPQ C-7 13-71 Years of age 46 7 14 See Note 15 88 Blank but applicable 16 6 13 Blank 3493 894 1326 418 Have you ever been told by a doctor or ASPQ C-6 other health professional that you have prediabetes? 1 Yes 20 14 10 2 No 3526 890 1332 8 Blank but applicable 9 3 10 Blank 0 0 1 419-420 How old were you then? ASPQ C-7 15-71 Years of age 17 11 8 See Note 15 88 Blank but applicable 12 6 12 Blank 3526 890 1333 421 Blank When you were first told by a (doctor/health ASPQ C-9 professional) that you had (diabetes/...), were any of the following tests done? (Pos. 422-424) 422 The oral glucose tolerance test, in which you drink a sweet drink and samples of your blood are taken from your arm for a few hours afterwards? 1 Yes 172 42 71 2 No 130 16 36 8 Blank but applicable 2 2 6 9 Don't know 15 0 7 Blank 3236 847 1233 423 A test for sugar or glucose in your urine? 1 Yes 284 51 101 2 No 23 8 11 8 Blank but applicable 3 1 6 9 Don't know 9 0 2 Blank 3236 847 1233 424 A test for sugar or glucose in your blood? 1 Yes 287 55 105 2 No 18 3 6 8 Blank but applicable 3 2 6 9 Don't know 11 0 3 Blank 3236 847 1233 425 Were you a patient in a hospital at the ASPQ C-10 time a (doctor/health professional) first told you that you had (diabetes/...)? 1 Yes 75 13 35 2 No 241 45 79 8 Blank but applicable 3 2 6 Blank 3236 847 1233 426 (Not counting that first time) Have you ASPQ C-11 ever been hospitalized because of your diabetes/...)? 1 Yes 47 7 19 2 No 270 51 95 8 Blank but applicable 2 2 6 Blank 3236 847 1233 427-429 About how much did you weigh when you ASPQ C-12 were first told you had (diabetes/...)? 028-350 Pounds 297 54 103 888 Blank but applicable 22 6 17 Blank 3236 847 1233 430 Have you ever taken insulin injections? ASPQ C-13 1 Yes 89 14 35 2 No 229 44 82 8 Blank but applicable 1 2 3 Blank 3236 847 1233 431 Have you been taking insulin injections ASPQ C-14 for most of the past 12 months? 1 Yes 62 6 25 2 No 27 8 10 8 Blank but applicable 1 2 3 Blank 3465 891 1315 432 Are you now taking insulin injections? ASPQ C-15 1 Yes 56 5 27 2 No 33 9 8 8 Blank but applicable 1 2 3 Blank 3465 891 1315 433-435 About how many units per day do you take? ASPQ C-16 010-120 Units per day 56 4 27 888 Blank but applicable 1 3 3 Blank 3498 900 1323 436-437 How many years (have you been taking/did ASPQ C-17 you take) insulin injections? See Note 15 00 Less than 1 year 27 9 9 01-36 Years 62 5 25 88 Blank but applicable 1 2 4 Blank 3465 891 1315 438 Have you ever taken diabetes pills? ASPQ C-18 1 Yes 183 28 65 2 No 135 30 52 8 Blank but applicable 1 2 3 Blank 3236 847 1233 439 Have you been taking them most of the past ASPQ C-19 12 months? 1 Yes 93 16 31 2 No 90 12 34 8 Blank but applicable 1 2 3 Blank 3371 877 1285 440 Are you now taking diabetes pills? ASPQ C-20 1 Yes 88 18 29 2 No 95 10 36 8 Blank but applicable 1 2 3 Blank 3371 877 1285 441 What is the name of the medicine you are ASPQ C-21 taking? See Note 16 1 Diabinese 57 14 19 2 Dymelor 2 0 1 3 Orinase (Tolbutamide) 10 1 2 4 Tolinase 8 1 2 5 Mellitron 1 0 0 6 Diabeta/Micronase 1 0 1 7 Other specified, non-diabetes medication 2 0 1 8 Blank but applicable 8 4 6 Blank 3466 887 1321 442-443 How many years (have you been taking/did ASPQ C-22 you take) diabetes pills? See Note 15 00 Less than 1 year 51 7 17 01-26 years 129 20 47 88 Blank but applicable 3 3 4 Blank 3372 877 1285 444 Has a doctor, nurse, or other health ASPQ C-23 professional ever given you a diet or instructions on what foods to eat for your (diabetes/...)? 1 Yes 254 46 88 2 No 63 12 26 8 Blank but applicable 2 2 6 Blank 3236 847 1233 445 Do you now follow the diet or instructions? ASPQ C-24 1 Yes 123 25 48 2 No 131 21 40 8 Blank but applicable 2 2 6 Blank 3299 859 1259 446 Do you carry or wear anything which ASPQ C-25 identifies you as having (diabetes/...)? 1 Yes 38 4 23 2 No 279 54 90 8 Blank but applicable 2 2 7 Blank 3236 847 1233 447 When did you last see or talk to a doctor ASPQ C-26 or other health professional about your (diabetes/...)? 1 During the past 2 weeks 49 7 38 2 Over 2 weeks through 6 months136 25 39 3 Over 6 months through 12 months 30 6 13 4 Over 12 months through 2 years 40 4 5 5 Over 2 years through 5 years 29 11 13 6 Over 5 years ago 31 5 5 8 Blank but applicable 4 2 7 Blank 3236 847 1233 448 About how many times a year do you see a ASPQ C-27 doctor or other health professional about your (diabetes/...)? 1 Less than once a year 4 1 4 2 Once 15 1 7 3 Twice 22 3 3 4 3-4 times 32 6 17 5 5 or more times 61 14 39 6 No regular schedule 67 11 17 8 Blank but applicable 18 4 10 Blank 3336 867 1256 449 Blank Glucose Challenge Questionnaire Data Position Item description Counts Source and code M C P and notes L. GLUCOSE CHALLENGE QUESTIONNAIRE (POS 450-499) 450-453 Tape Number 6506 3555 907 1353 454 Assigned to fasting subsample, designated to take oral glucose tolerance test? (see p. 10) 1 Yes 1777 449 667 2 No 1778 458 686 455 Complete oral glucose See Note 17 tolerance test (3 plasma glucose values) 1 Complete 1012 212 272 2 Not complete 765 237 395 3 Not in fasting subsample 1778 458 686 456-457 Reason for incomplete oral glucose See Notes 18,19 tolerance test 01 Not in fasting subsample 1778 458 686 02 Examined in afternoon or evening 508 170 254 03 Diabetic currently taking insulin 15 1 9 04 Arrived late 11 0 2 05 Ill 1 4 4 06 Technical error 18 4 9 07 Fasted fewer than 10 hours 97 29 59 08 Fasted more than 16 hours 21 3 6 09 Refused interview 0 2 0 10 Refused Glucola 11 8 25 11 Refused venipuncture 10 2 8 12 Venipuncture unsuccessful 9 3 3 13 Became ill during test 10 1 4 14 Glucose in urine/ glucosuria 2+ 12 2 2 15 Abnormal EKG 9 1 0 16 Refused test because of known diabetes 4 5 4 17 Left early/ran out of time 11 2 3 18 Plasma specimens thawed 6 0 0 19 Specimen not collected 5 0 0 20 Other 7 0 3 Blank 1012 212 272 458 Returned for second visit? See Notes 18,19 1 Yes 21 6 5 2 No 1756 443 662 Blank 1778 458 686 459-460 Reason for second visit See Notes 18,19 (reason that test was not completed on first visit) 01 Not in fasting subsample 0 0 0 02 Examined in afternoon or evening 1 0 0 03 Diabetic currently taking insulin 0 0 0 04 Arrived late 0 0 0 05 Ill 0 0 0 06 Technical error 0 0 0 07 Fasted fewer than 10 hours 17 4 3 08 Fasted more than 16 hours 3 1 0 09 Refused interview 0 0 0 10 Refused Glucola 0 0 1 11 Refused venipuncture 0 0 0 12 Venipuncture unsuccessful 0 1 0 13 Became ill during test 0 0 0 14 Glucose in urine/ glucosuria 2+ 0 0 0 15 Abnormal EKG 0 0 0 16 Refused test because of known diabetes 0 0 0 17 Left early/ran out of time 0 0 0 18 Plasma specimens thawed 0 0 0 19 Specimen not collected 0 0 0 20 Other 0 0 1 Blank 3534 901 1348 461 Are you currently taking insulin? 1 Yes 15 1 9 2 No 1254 278 404 Blank 2286 628 940 462 Are you currently taking diabetes pills? 1 Yes 25 9 13 2 No 1229 269 391 Blank 2301 629 949 463-466 At what time did you finish your last See Note 20 meal? 0030-2400 (hours:minutes) 1252 278 404 8888 Blank but applicable 2 0 0 Blank 2301 629 949 467 Yesterday/today of last meal? 1 Yesterday 1192 259 388 2 Today 60 19 16 8 Blank but applicable 2 0 0 Blank 2301 629 949 468 Have you had anything to eat since your last meal? 1 Yes 280 48 116 2 No 971 229 288 8 Blank but applicable 1 1 0 Blank 2303 629 949 469-472 At what time did you have anything See Note 20 to eat since your last meal? (Colon not shown on tape) 0030-2400 (hours:minutes) 280 48 116 8888 Blank but applicable 0 0 0 Blank 3275 859 1237 473 Yesterday/today for last eat anything at all? 1 Yesterday 259 47 104 2 Today 21 1 12 8 Blank but applicable 0 0 0 Blank 3275 859 1237 474 Have you had anything to drink, other than water, since the last time you had anything to eat? (latest time in Positions 463-466 or 469-472) 1 Yes 296 83 110 2 No 955 194 294 8 Blank but applicable 1 1 0 Blank 2303 629 949 475-478 At what time did you last have anything See Note 20 at all to drink? (Colon not shown on tape) 0010-2400 (hours:minutes) 296 83 108 8888 Blank but applicable 0 0 2 Blank 3259 824 1243 479 Yesterday/today for last anything at all to drink? 1 Yesterday 256 67 67 2 Today 40 16 41 8 Blank but applicable 0 0 2 Blank 3259 824 1243 SECOND VISIT INFORMATION Persons in this section failed to See Note 19 complete the first OGTT and were given the opportunity to take the OGTT a second time. 480-483 At what time did you finish your last meal? See Note 20 1200-2300 (hours:minutes) 21 6 5 Blank 3534 901 1348 484 Yesterday/today of last meal? 1 Yesterday 21 6 5 2 Today 0 0 0 Blank 3534 901 1348 485 Have you had anything to eat since your last meal? 1 Yes 6 0 1 2 No 15 6 4 Blank 3534 901 1348 486-489 At what time did you have anything See Note 20 to eat since your last meal? (Colon not shown on tape) 1800-2245 (hours:minutes) 6 0 1 Blank 3549 907 1352 490 Yesterday/today for last eat anything 1 Yesterday 6 0 1 2 Today 0 0 0 Blank 3549 907 1352 491 Have you had anything to drink other than water, since the last time you had anything to eat (latest time in Positions 480-483 or 486-489) 1 Yes 6 0 0 2 No 15 6 5 Blank 3534 901 1348 492-495 At what time did you last have anything See Note 20 to drink? (Colon not shown on tape) 1700-2330 (hours:minutes) 6 0 0 Blank 3549 907 1353 496 Yesterday/today for last anything to drink? 1 Yesterday 6 0 0 2 Today 0 0 0 Blank 3549 907 1353 497-499 Blank Plasma Glucose Values and Computed Time Intervals Position Item description Counts Source and code M C P and notes M. PLASMA GLUCOSE VALUES AND COMPUTED TIME INTERVALS (POS 500-600) ATTENTION: The colon is not shown on the tape. (Positions 500-515) 500-503 Time of first venipuncture (fasting See Note 20 specimen) 0800-1107 (hours:minutes) 1083 227 329 8888 Blank but applicable 171 51 75 Blank 2301 629 949 504-507 Time Glucola given See Note 20 0805-1110 (hours:minutes) 1059 216 283 8888 Blank but applicable 195 62 121 Blank 2301 629 949 508-511 Time of second venipuncture See Note 20 (one-hour specimen) 0905-1205 (hours:minutes) 1055 215 276 8888 Blank but applicable 199 63 128 Blank 2301 629 949 512-515 Time of third venipuncture See Note 20 (two-hour specimen) 1000-1245 (hours:minutes) 1031 212 274 8888 Blank but applicable 223 66 130 Blank 2301 629 949 516 Code indicating imputed time generated for the second venipuncture 1 Yes 8 0 1 2 No 1047 215 275 Blank 2500 692 1077 Reasons for blank or missing (888) plasma gluose values are given in Positions 456-457 517-519 Plasma glucose value (mg/dl) from first venipuncture See Note 21 051-407 1068 227 328 888 Blank but applicable 186 51 76 Blank 2301 629 949 520-522 Plasma glucose value (mg/dl) See Note 21 from second venipuncture 037-639 1040 215 275 888 Blank but applicable 214 63 129 Blank 2301 629 949 523-525 Plasma glucose value (mg/dl) See Note 21 from third venipuncture 026-707 1016 212 272 888 Blank but applicable 238 66 132 Blank 2301 629 949 ATTENTION: The colon is not shown on the tape. (Positions 526-569) 526-529 Interval betwen last food or drink and first venipuncture (smallest of three times in Positions 530-541). 00:50-24:15 (hours:minutes) 1083 227 329 8888 Blank but applicable171 51 75 Blank 2301 629 949 530-533 Interval between last meal and first venipuncture 01:20-24:15 (hours:minutes) 1083 227 329 8888 Blank but applicable171 51 75 Blank 2301 629 949 534-537 Interval between last snack and first venipuncture 00:50-17:47 (hours:minutes) 250 44 88 8888 Blank but applicable 36 2 28 Blank 3269 861 1237 538-541 Interval between last drink and first venipuncture 02:05-16:35 (hours:minutes) 248 58 70 8888 Blank but applicable 51 22 37 Blank 3256 827 1246 542-545 Interval between first venipuncture and Glucola ingestion 00:00-01:25 (hours:minutes) 1059 216 283 8888 Blank but applicable 195 62 121 Blank 2301 629 949 546-549 Interval between Glucola ingestion and second venipuncture 00:50-01:15 (hours:minutes) 1055 215 276 8888 Blank but applicable 199 63 128 Blank 2301 629 949 550-553 Interval beween second venipuncture and third venipuncture 00:40-01:26 (hours:minutes) 1031 212 274 8888 Blank but applicable 223 66 130 Blank 2301 629 949 554-557 Interval between first venipuncture and second venipuncture 00:54-02:24 (hours:minutes) 1055 215 276 8888 Blank but applicable 199 63 128 Blank 2301 629 949 558-561 Interval between first venipuncture and third venipuncture 01:49-03:22 (hours:minutes) 1031 212 274 8888 Blank but applicable 223 66 130 Blank 2301 629 949 562-565 Interval between Glucola ingestion and third venipuncture 01:41-02:24 (hours:minutes) 1031 212 274 8888 Blank but applicable 223 66 130 Blank 2301 629 949 566-569 Interval between last food or drink and Glucola ingestion 02:10-19:20 (hours:minutes) 1059 216 283 8888 Blank but applicable 195 62 121 Blank 2301 629 949 570-600 Blank GENERAL NOTES, SOCIODEMOGRAPHIC AND DIABETES DATA Family Questionnaire Missing A Family Questionnaire was to be completed for each eligible family in a household with sample persons. However, a few Family Questionnaires are missing. Data records for sample persons in families with missing questionnaires are flagged with a code = 1, and all family data are blank. Data records for sample persons in families wit a Family Questionnaire are flagged with a code = 2. During the Mexican-American portion of the HHANES survey, a Family Questionnaire continuation booklet containing sample person information was lost for one sample person. Therefore, the sociodemographic data for this sample person are missing. The reference person, family composition, income, residence, and household data for this person were obtained from another person in the household. Examination Status Not all sample persons consented to come to a Mobile Examination Center to participate in the examination phase of the survey. In certain rare instances (less than 0.1%), sample persons who came to the Mobile Examination Centers did not participate in sufficient components of the examination to be considered as "examined." This data field contains code = 1 for those persons who participated fully in the examination phase, and code = 2 for those who did not come to the examination center or who did not satisfactorily complete the examination. Family Number In HHANES, all household members who were related by blood, marriage, or adoption were considered to be one "family." All sample persons in the same family unit have the same computer-generated family unit code. Head of Family Relationship of Sample Person to Head of family (Pos. 44-45) Each family containing sample persons has a designated "head of family," and the relationship of each sample person to the head of his or her family is coded in tape positions 44-45. The first three categories of this variable describe the "head" of three different kinds of families. * Code '01' identifies sample persons who lived alone (i.e., "head" of one-person families, no unrelated individuals living in the household). * Code '02' identifies sample persons who lived only with unrelated persons. * Code '03' identifies sample persons who were "heads" of families containing at least one other person (whether or not the household included additional families unrelated to the sample person). Sociodemographic Data (Pos. 100-131) This data tape includes some sociodemographic data about the head of each sample person's family (Section F). Because there can only be one "head" per family, the data in this section (positions 100-131) are the same for all sample persons in the same family (i.e., with the same family number codes in positions 39-43). If the sample person is head of his or her family, the data in positions 100-131 are the same as in the corresponding positions in Section E. Observed Race "Race" was observed by the interviewer for all sample persons actually seen. Rules for classification of observed race were consistent with those used in the NHANES II and the National Health Interview Survey at that time. The categories were coded as follows: White Includes Spanish origin persons unless they are definitely Black, Indian or other nonwhite. Black Black or negro. Other Race other than White or Black, including Japanese, Chinese, American Indian, Korean, Eskimo. National Origin or Ancestry The value for national origin or ancestry is based on Item 2c in the Household Screener Questionnaire and was reported by the household respondent for all household members. In the Mexican-American portion of the survey, if "other Latin-American or other Spanish" (code 9) or "Other" (code 0) was recorded and the specified origin was "Spanish-American" or "Spanish (Spain)", a code of 10 or 11, respectively, was assigned. In all three portions of the survey, if more than one category was reported, the first appropriate "Hispanic" code, if any, was assigned (codes 1, 2, 3, 8, 10, or 11 in the Mexican-American portion; codes 6 or 7 in the Cuban-American portion; codes 4 or 5 in the Puerto Rican portion). If none of these codes was recorded, the first category entered was coded. Codes for States and Foreign Countries Code State or Foreign Country 001 Alabama 002 Alaska 004 Arizona 005 Arkansas 006 California 008 Colorado 009 Connecticut 010 Delaware 011 District of Columbia 012 Florida 013 Georgia 015 Hawaii 016 Idaho 017 Illinois 018 Indiana 019 Iowa 020 Kansas 021 Kentucky 022 Louisiana 023 Maine 024 Maryland 025 Massachusetts 026 Michigan 027 Minnesota 028 Mississippi 029 Missouri 030 Montana 031 Nebraska 032 Nevada 033 New Hampshire 034 New Jersey 035 New Mexico 036 New York 037 North Carolina 038 North Dakota 039 Ohio 040 Oklahoma 041 Oregon 042 Pennsylvania 044 Rhode Island 045 South Carolina 046 South Dakota 047 Tennessee 048 Texas 049 Utah 050 Vermont 051 Virginia Codes for States and Foreign Countries (continued) Code State or Foreign Coutry 053 Washington 054 West Virginia 055 Wisconsin 056 Wyoming 060 American Samoa 093 Canada 061 Canal Zone 062 Canton and Enderbury Islands 091 Central America 095 Costa Rica 063 Cuba 064 Dominican Republic 065 El Salvador 062 Enderbury Islands 087 Germany 066 Guam 068 Guatemala 069 Haiti 088 Honduras 070 Jamaica 090 Japan 067 Johnston Atoll 080 Mexico 071 Midway Islands 081 Nicaragua 096 Palestine 097 Austria 098 Lebanon 099 Chile 100 Philippines 101 Brazil 102 Holland 103 Colombia 082 Panama 072 Puerto Rico 092 Saudi Arabia 083 Spain 094 Taiwan 089 Turkey 084 Uruguay 085 Venezuela 073 Ryukyu Islands, Southern 074 Swan Islands 075 Trust Territories of the Pacific Islands (includes Caroline, Mariana and Marshall Island groups) 076 U.S. miscellaneous Caribbean Islands (includes Navassa Islands, Quito Sueno Bank, Roncador Cay, Serrana Bank and Serranilla Bank) 077 U.S. miscellaneous Pacific Islands (includes Kingman Reef, Howland, Baker & Jarvis Islands, and Palmyra Atoll) 086 United States 078 Virgin Islands 079 Wake Island 104 Azores 105 Peru 106 England 107 Vietnam 108 Italy 109 Ecuador 110 North America 111 Surinam 112 Argentina 113 Portugal 114 Trinidad 115 Egypt 116 Sudan 117 British Honduras 118 China 888 Blank but applicable National Origin Recode In the HHANES, if any household member was identified as "Hispanic" (as defined below), all household members, regardless of origin, were eligible to be selected as sample persons. The national origin recode specifies whether a sample person is considered to be "Hispanic" or "not Hispanic" for purposes of analysis. "Hispanic" is defined as: Mexican-American, residing in selected counties of Texas, Colorado, New Mexico, Arizona, and California; Cuban-American, residing in Dade County (Miami), Florida; or Puerto Rican, residing in the New York City area, including parts of New Jersey and Connecticut. The recode was assigned as follows: A. Southwest portion 1) If the original national origin or ancestry code on the Household Screener Questionnaire was 1, 2, 3, 8, 10, or 11, then National origin recode = 1; 2) If national origin or ancestry was 4, 5, 6, 7, 9, or 0 but the person specified Mexican/Mexicano, Chicano, or Mexican-American self-identification on the Adult Sample Person Questionnaire (question M10), or the person was the biological child of a household member with Recode equal to 1 (as determined by questions A-1-A-11 on the Family Questionnaire), then National origin recode = 1; 3) In all other cases, National origin recode = 2. B. Dade County, Florida portion 1) If the original national origin or ancestry code was 6 or 7, then National origin recode = 1; 2) In all other cases, National origin recode = 2. C. New York City area portion 1) If the original national origin or ancestry code was 4 or 5, then National origin recode = 1; 2) If national origin or ancestry was 1, 2, 3, 6, 7, 8, 9, or 0 but the person specified Boricuan or Puerto Rican self-identification on the Adult Sample Person Questionnaire (question M-10), or the person was the biological child of a household member with Recode equal to 1 (as determined by questions A-1-A-11 on the Family Questionnaire), then National origin recode = 1; 3) In all other cases, National origin recode = 2. The national origin recode may be used in analysis in one of two ways: a. Selecting on Recode = 1 will restrict analysis to "Hispanics" only. In this case, in the Southwest portion of the survey, the weighted estimates by age and sex will approximately equal U.S. Bureau of Census population estimates of the number of Mexican Americans and a small proportion of other Hispanics assumed to be Hispano in the five Southwest States (Arizona, California, Colorado, New Mexico, and Texas) at the midpoint of the Mexican-American portion of HHANES - March 1983. The weighted estimates of Cuban Americans represents an independent estimate of the number of Cuban Americans in Dade County at the midpoint, February 1984. The weighted estimates of Puerto Ricans represents an independent estimate of the number of Puerto Ricans in the sample counties in New York, New Jersey, and Connecticut at the midpoint of the Puerto Rican portion - September 1984. b. Using Recode greater than 0, that is, all sample persons, will include "Hispanic" and "not Hispanic" persons and the Southwest weighted estimates by age and sex will overestimate the U.S. Bureau of the Census population estimates of Mexican Americans and other Hispanics by about 4.5 percent. In Dade County, using recode greater than 0 will increase the weighted estimates by about 5.3 percent over that for Cuban Americans only, using recode greater than 0 for the New York area will increase the weighted estimates by about 9.2 percent over that for Puerto Ricans only. Industry and Occupation Code Family Questionnaire questions B-12 through B-15 (see page 117 or 139 of Ref. No. 1 in Section C) identified sample persons 17 years old or older who were in the labor force working for pay at a job or business or who worked without pay in a family business or farm operated by a related member of the household without receiving wages or salary for work performed. Questions B-17 through B-22 provided a full description of sample persons' current or most recent job or business. The detail asked for in these questions was necessary to properly and accurately code each occupation and industry. Interviewers were trained to define a job as a definite arrangement for regular work for pay every week or every month. This included arrangements for either regular part-time or regular full-time work. If a sample person was absent from his or her regular job, worked at more than one job, was on layoff from a job, or was looking for work during the two week reference period, interviewers were trained to use the following criteria to determine the job described: a. If a sample person worked at more than one job during the two week reference period or operated a farm or business and also worked for someone else, the job at which he or she worked the most hours was described. If the sample person worked the same number of hours at all jobs, the job at which he or she had been employed the longest was entered. If the sample person was employed at all the same length of time, the job the sample person considered the main job was entered. b. If a sample person was absent from his or her regular job all of the two week reference period, but worked temporarily at another job, the job at which the sample person actually worked was described, not the job from which he or she was absent. c. If a sample person had a job but did not work at all during the two week reference period, the job he or she held was described. d. If a sample person was on layoff during the two week reference period, the job from which he or she was laid off, regardless of whether a full-time or part-time job, was described. e. If a sample person was looking for work or waiting to begin a new job within 30 days of the interview, the last full-time civilian job which lasted two consecutive weeks or more was described. The 1980 census of population Alphabetical Index of Industries and Occupations was used in the coding of both industry and occupation. This book has Library of Congress Number 80-18360, and is for sale by the Superintendent of Documents, U.S. Government Printing Office, Washington, D.C. 20402 for $3.00. Its Stock Number is 003024049-2. Health Insurance a. In the Health Insurance section of the Family Questionnaire, up to three separate health insurance plans could be reported for a family. Each sample person could have been covered by any combination of the three, or by none at all. In order to simplify the health insurance coverage data, the information on all reported plans was combined to a single variable for each sample person, i.e., whether or not the person is covered by any plan (position 74). For all persons covered by at least one plan, information on the type of coverage is then indicated; position 75 specifies whether any of the sample person's plans pays hospital expenses and position 76 specifies whether any of the sample person's plans pays doctor's or surgeon's bills. b. For all sample persons who were not covered by Medicare or any health insurance plan, the reasons for not being covered were ascertained. Positions 77-78 contain the main or only reason reported. For persons with one or more additional reasons, the first (lowest) code entered on the questionnaire was coded in positions 79-80. Per Capita Income Per capita income was computed by dividing the total combined family income by the number of people in the family. Poverty Index The poverty index is a ratio of two components. The numerator is the midpoint of the income bracket reported for each family in the Family Questionnaire (E-11). Respondents were asked to report total combined family income during the 12 months preceding the interview. The denominator is a poverty threshold which varied with the number of persons in the family, the adult/child composition of the family, the age of the reference person, and the month and the year in which the family was interviewed. Poverty thresholds published in Bureau of the Census reports* are based on calendar years and were adjusted to reflect differences caused by inflation between calendar years and 12 month income reference periods to which question E-11 referred. Average Consumer Price Indexes for all Urban consumers (CPI-U) for the calendar year for which the poverty thresholds were published (see table below) and for the 12 months representing the income reference period for the respondent were calculated. The percentage difference between these two numbers represents the inflation between these two periods and was applied to the poverty threshold appropriate for the family (based on the characteristics listed above). For example, for a family interviewed in November, 1983, the 1982 poverty threshold was updated to reflect inflation by multiplying by the percent change in the average CPI-U for the 12 month reference period, which would have been November, 1982 through October, 1983, over the calendar year January through December, 1982, in this example. To compute poverty indexes, the midpoint of the total combined family income bracket was divided by the updated poverty threshold. Average Consumer Price Index, all Urban Consumers (CPI-U), U.S. City Average, 1981-84 Month Year 1981 1982 1983 1984 January 260.5 282.5 293.1 305.2 February 263.2 283.4 293.2 306.6 March 265.1 283.1 293.4 307.3 April 266.8 284.3 295.5 308.8 May 269.0 287.1 297.1 309.7 June 271.3 290.6 298.1 310.7 July 274.4 292.2 299.3 311.7 August 276.5 292.8 300.3 313.0 September 279.3 293.3 301.8 October 279.9 294.1 302.6 November 280.7 293.6 303.1 December 281.5 292.4 303.5 Average 272.4 289.1 298.4 Source: U.S. Department of Labor, Bureau of Labor Statistics. * U.S. Bureau of the Census, Current Population Reports, Series P-60, No. 138, "Characteristics of the Population Below the Poverty Level: 1981", U.S. Government Printing Office, Washington, D.C., March 1983. U.S. Bureau of the Census, Current Population Reports, Series P-60, No. 144, "Characteristics of the Population Below the Poverty Level: 1982", U.S. Government Printing Office, Washington, D.C., March 1984. Members of families with incomes equal to or greater than poverty thresholds have poverty indexes equal to or greater than 1.0 and can be described as "at or above poverty"; those with incomes less than the poverty threshold have indexes less than 1.0 and can be described as "below poverty". Poverty thresholds used were computed on a national basis only. No attempt was made to adjust these thresholds for regional, State, or other variations in the cost of living. None of the noncash public welfare benefits such as food stamp bonuses were included in the income of the low income families receiving these benefits. Size of Place and SMSA Codes for size of place and SMSA were obtained from Bureau of Census summary tape files (STF1B). A place is a concentration of population. Most places are incorporated as cities, towns, villages, or boroughs, but others are defined by the Bureau of the Census around definite residential nuclei with dense, city-type street patterns, with, ideally, at least 1,000 persons per square mile. The boundaries of Census defined places may not coincide with civil divisions. A Standard Metropolitan Statistical Area (SMSA) is a large population nucleus and nearby communities which have a high degree of economic and social integration with that nucleus. Generally, an SMSA includes one or more central cities, all urbanized areas around the city or cities, and the remainder of the county or counties in which the urbanized areas are located. SMSAs are designed by the Office of Management and Budget. The same place size and SMSA codes were assigned to all persons in the same segment (for the definition of segments see Ref. No. 1 in Section C). In a few cases segments were divided by place boundaries. In these cases codes were assigned after inspecting segment maps. If the segment was predominantly in one place, then the place code for that place was used. If the segment was approximately evenly divided, the code for the larger place was used. Home Heating Questions E3 through E6, pertaining to the main fuel and equipment used for heating the home, appear to have codes which are inconsistent. It has been verified that these are the codes that were recorded on the original document; that is, codes that appear inconsistent were not incorrectly keyed. Illogical or Extreme Values The responses for some sample persons for this variable may appear extreme, illogical, or inconsistent with responses in other variables. The data entry was verified through direct review of the collection form or a copy of it. These responses may not represent fact but they are included as they were recorded. The user must determine if these responses should be included in analyses. Responses specified in open-ended response categories Some of the "other" or "specify" responses to this question were recoded to existing categories, if possible. For responses that could not be recoded, new code categories were created if the information was deemed analytically useful. Caution should be used in interpreting the data from these new categories because there is no way of knowing which other respondents would have selected one of the new categories if given the option. Complete glucose tolerance test For this data item, persons for whom three plasma glucose values were available are considered to have a complete glucose tolerance test, regardless of the conditions under which these values were obtained (such as length of fast or elapsed time between venipunctures). However, users may wish to take such conditions into account for analyses of these data. Reasons for incomplete test Codes 01-03 were supplied in the editing process. Persons not assigned to the fasting subsample (code 01) were not designated to take the glucose tolerance test nor to complete the Glucose Challenge Questionnaire (GCQ). Persons assigned to the fasting subsample who were unable or unwilling to be examined in the morning (Code 02) did not complete the GCQ or receive the test, because the test was only administered in the morning. Persons currently using insulin who were in the fasting subsample and who were examined in the morning (Code 03) were not asked to fast and were not administered the test, per the study protocol. This exclusion was made because it was not considered medically advisable for a person using insulin to fast. Persons in the fasting subsample who were examined in the morning may have failed to complete the test for reasons noted in GCQ 6A-6J, corresponding to codes 04-13. Codes 14-19 are recodes of notations on the questionnaire or other information from survey records. Some persons were inappropriately eliminate from the glucose tolerance test by one physician examiner because of glucosuria (code 14), an abnormal EKG (code 15) or known diabetes in a person not taking insulin (code 16). In addition, some persons refused the test because of known diabetes (code 16). Second visit Persons who did not complete the OGTT at the initial examination were given the opportunity to return for a second visit to take the OGTT on a different day. If the person returned for a second visit, the reason for not completing the OGTT on the first visit is coded in positions 459-460; otherwise positions 459-460 are blank. If the persons did not return for a second visit, the reason for not completing the OGTT on the first visit is coded in positions 456-457. If the person completed the OGTT on the second visit, positions 456-457 are blank; if the person returned for a second visit but did not complete the OGTT, the reason for not completing the OGTT on the second visit is coded in positions 456-457. Data from the second visit on times of last food and drink are entered in positions 480-496. Time using 24-hour clock These times are presented using the 24-hour clock system (military time) in which 0100 corresponds to 1 a.m., 1200 corresponds to 12 noon, 1300 corresponds to 1 p.m., and 2400 corresponds to 12 midnight. Plasma glucose determinations Glucose values were determined at the Centers for Disease Control, Division of Environmental Health Laboratories. Glucose was measured by a micro-adaptation of the National Glucose Reference method (1) on a Gilford System 3500 Computer-Directed Analyzer (2). The determination is based on the enzymatic coupling of hexokinase and glucose-6-phosphate dehydrogenase (G-6-PD), and it has been optimized for D-Glucose. See the Laboratory Procedures for the Hispanic Health and Nutrition Examination Survey (HHANES) 1982-1984 (3) pages 21-24 for exact details of the plasma glucose calculation. References 1. Neese, J.W., Duncan, P., Bayse, D., Robinson, M., Cooper, T., Steward, C.: Development and evaluation of a hexokinase/ glucose-6-phosphate dehydrogenase procedures for use as a national glucose reference method. Atlanta: Centers for Disease Control, 1976. DHEW Publication No. (CDC) 77-8330. 2. Gilford Laboratories, Inc. Instruction manual for the Gilford System 3500 Computer-directed Analyzer. Oberlin, Ohio: Gilford Laboratories, Inc. June 1978. 3. Gunter, E.W. and Miller, D.T.: Laboratory procedures used by the Division of Environmental Health, Laboratory Sciences Center for Environmental Health, Centers for Disease Control for the Hispanic Health and Nutrition Examination Survey (HHANES) 1982-84. Atlanta: Centers for Disease Control, 1986. REFERENCES 1. National Center for Health Statistics: Maurer, K. R. and others: Plan and Operation of the Hispanic Health and Nutrition Examination Survey, 1982-84. Vital and Health Statistics. Series 1, No. 19. DHHS Pub. No. (PHS) 85-1321. Public Health Service. Washington. U.S. Government Printing Office. Sept., 1985. 2. National Center for Health Statistics: McCarthy, P.J.: Replication: An Approach to the Analysis of Data from Complex Surveys. Vital and Health Statistics. Series 2, No. 14. PHS Pub. No. 1000. Public Health Service. Washington. U.S. Government Printing Office. Apr., 1966. 3. Survey Research Center Computer Support Group: OSIRIS IV User's Manual, Institute for Social Research, University of Michigan, Ann Arbor, MI, 1979. 4. Holt, M. M.: SURREGR: Standard Errors of Regression Coefficients from Sample Survey Data. Research Triangle Institute, Research Triangle Park, NC, 1977. (Revised Apr., 1982 by B. V. Shah). 5. Hidiroglou, M. A., Fuller, W. A., and Hickman, R. D.: SUPERCARP. Sixth Edition. Survey Section, Statistical Laboratory, Iowa State University, Ames, IA. Oct., 1980. 6. Woodruff, R. S.: A Simple Method for Approximating the Variance of a Complicated Estimate. Journal of the American Statistical Association, 66:411-414, 1971. 7. Shah, B. V.: SESUDAAN: Standard Errors Program for Computing of Standardized Rates from Sample Survey Data. RTI/5250/00-01S. Research Triangle Institute, Research Triangle Park, NC. Apr., 1981. 8. SAS Institute Inc. SAS Users' Guide: Basics, Version 5 Edition. SAS Institute, Inc., Cary, NC. 1982. 9. National Center for Health Statistics: Landis, J. R., Lepkowski, J. M., Eklund, S. A., and Stehouwer, S. A. A Statistical Methodology for Analyzing Data from a Complex Survey: The First National Health and Nutrition Examination Survey. Vital and Health Statistics. Series 2, No. 92. DHHS Pub. No. (PHS) 82-1366. Public Health Service. Washington. U.S. Government Printing Office. Sept., 1982. 10. Kovar, M. G. and Johnson, C.: Design Effects from the Mexican-American Portion of the Hispanic Health and Nutrition Examination Survey: A Strategy for Analysts. Proceedings of the Social Statistics Section, American Statistical Association, 1986. 11. Freeman, D. H. and Brock, D. B.: The Role of Covariance Matrix Estimation in the Analysis of Complex Sample Survey Data. In N. Krishnan Namboodiri, ed., Survey Sampling and Measurement. Symposium on Survey Sampling, 2d, University of North Carolina. New York, Academic Press, 1978. 12. National Center for Health Statistics: Instruction Manual Part 15h, Household Interviewer's Manual for the Hispanic Health and Nutrition Examination Survey, 1982-84. Hyattsville, MD, 986. 13. National Center for Health Statistics: Instruction Manual Part 15g, Mobile Examination Center Interviewer's Manual for the Hispanic Health and Nutrition Examination Survey, 1982-84. Hyattsville, MD, 1986. 14. National Diabetes Data Group: Classification and Diagnosis of Diabetes Mellitus and Other Categories of Glucose Intolerance. Diabetes 28:1039-1059, 1979. 15. National Center for Health Statistics: Hadden, W.C. and Harris, M.I.: Prevalence of Diagnosed Diabetes, Undiagnosed Diabetes, and Impaired Glucose Tolerance in Adults. Vital and Health Statistics. Series II, No. 237. DHHS Pub. No. (PHS) 87-1687. Public Health Service. Washington, U. S. Government Printing Office, Feb. 1987.
