Vital and

Health Statistics

Advance Data

From Vital and

Health Statistics:

Numbers 191–200

Series 16:

Compilations of Advance Data

From Vital and Health Statistics

No. 20

Data in this report from health surveys present statistics by age and other variables on

national hospital discharge; selected medical device implants; fecundity and infertility;

AIDS knowledge and attitudes; cohabitation, marriage, marriage dissolution, and

remarriage; office visits by adolescents; and characterktics of persons by limitation of

activity, The reports were originally published in 1990 and 1991,

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Public Health Service

Centers for Disease Control and Prevention

National Center for Health Statistics

Hyattsvllle, Maryland

May 1995

DHHS Publication No, (PHS) 95-1879
Copyright information

All material appearing in this report ia in the public domain and may be

reproduced or copied without permission; citation as to source, however, is

appreciated.

Suggested citation

National Center for Health Statistics. Advance data from vital and health

statistics: numbers 191–200. National Center for Health statistics. Vital Health

Stat 16(20). 1995.
National Center for Health Statistics

Jack R. Anderson, Acting Director

Jennifer H. Madans, Ph.D., Acting Deputy Director

Jacob J. Feldman, Ph.D., Associate Director for Analysis,

Epidemiology, and Health Promotion

Gail F. Fisher, Ph.D., Associate Director for Planning and

Extramural Programs

Peter L. Hurley, Associate Director for Wtal and Health

Statistics Systems

Robert A. Israel, Associate Director for International

Statistics

Stephen E. Nieberding, Associate Director for

Management

Charles J. Rothwell, Associate Director for Data

Processing and Services

Monroe G. Sirken, Ph.D., Associate Director for Research

and Methodology
Use of Selected Medical Device Implants in the United States, 1988.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Fecundity and Infertility in the United States, 1965-88 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

MDS Ihowledge and Attitudes for January-March 1990 Provisional Data From the National Health Interview

Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Cohabitation, Marriage, Marital Dissolution, and Remarriage: United States, 1988 Data From the National Survey

of Family Growth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

AIDS Knowledge and Attitudes for April-June 1990 Provisional Data From the National Health Interview Survey . . .

Office Vkits by Adolescents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Disability and Healti Chmactefistim of Pemonsby Limitation of Activi& ad&essed Health Shtis, Ufited States,

1984-88 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

AIDS Knowledge and Attitudes for July-September 1990 Provisional Data From the National Health Interview

Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1989 Summary: National Hospital Discharge Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

AIDS-Related Knowledge and Behavior Among Women 15-44 Years of Age: United States, 1988. . . . . . . . . . . . . . . . .

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Ill
Number 191 ● February 26, 1991

Advance

Data

From Vital and Health Statistics of the National Center for Health Statistics

Use of Selected Medical Device Implants in the

United States, 1988

by Abigail J. Moss, Division of Health Interview Statistics, National Center for Health Statistics; Stanford Hamburger,

D.D.S., M. P.H., Roscoe M. Moore, Jr., D.V.M., M. P.H., Ph.D., and Lana L. Jeng, M. D., M. P. H., Food and Drug

Administration; and L. Jean Howie, Division of Health Interview Statistics, National Center for Health Statistics

Introduction

During the past few decades,

there have been great increases in the

numbers of manmade materials and

devices introduced to the medical

profession for implantation into

humans. The search for replacement

of natural body parts began in ancient

times. Dental implants are traceable to

early Egyptians and to Central and

South American cultures (l). The first

pacemaker was invented in the 1950’s,

the first artificial heart valve was

implanted by Hufnagel in 1952, and in

1954 Charnley performed the first

artificial hip replacement (2).

Despite the many advances made

to date in research and development

of medical device implants, it remains

unclear whether there is or ever will

be an implant device suitable for every

clinical situation. In addition, the longterm effectiveness and safety of the

most widely used implants have yet to

be definitively established.

All medical device implants are

complex in design, materials, and

implementation procedures. The

biocompatibility, durabili~, and

efficacy of medical device implants are

a continuing concern of the Food and

Drug Administration (FDA), the

medical profession, the device

manufacturers, and, most importantly,

the patients (3–12). Unfortunately,

sufficient scientific documentation and

literature presently are not available to

assess the success of many of these

medical device implants. This report

presents previously unavailable

baseline estimates of medical device

implants in an attempt to address

some of these concerns.

Included are estimates from the

National Center for Health Statistic’s

National Health Interview Survey

(NHIS) of the percent of persons in

the United States with one medicd

device implant or more. Estimates of

the total number of artificial joints,

fixation devices, intraoctdar lens

implants, pacemakers, artificial heart

valves, and ear vent tubes are also

presented. The technical notes to this

report include definitions of these

medical devices.

The report also includes estimates

for several details about these devices,

such as length of time the current

implant has been in use, implant

replacement, implant problems, and

reason(s) for the origimd implant. All

estimates are shown by the following

sociodemo&aphic and health status

indicators: age, sex, race, Hispanic

origin, famiIy income, poverty status,

education, geographic region, place of

residence, activity limitation, and

respondent-assessed health status.

Background

Under the Federal Food, Drug,

and Cosmetic Act, as amended, FDA

is responsible for the approval and

regtdation of new and existing medical

devices (13). This act defines a

mediczd device, inciuding any

component part, as any article

(a) intended for use in the diagnosis

of disease or other conditions;

(b) intended for use in the cure,

mitigation, treatmen~ and prevention

of diseasq or (c) intended to affect

the structure and/or function of the

,uncz*.o @“+ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVK%B **Q

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Public Health Sem”ce

s

‘%.> Manning

National

Centers

Feinleib,

Center

for

M.

Disease

for

D.,

Health

Dr.

Control

P.

Statistics

H., Director

cm
2 Advance Data No. 191 ● February 26, 1991

human body, Implants are classified as

medical devices under this act.

FDA’s Center for Devices and

Radiological Health (CDRH)

currently utilizes several sources of

medical device implant data to assess

the use, safety, and effectiveness of

specific classes of implanted medical

devices. Some of the sources used by

CDRH to monitor medical device

implants provide a count of the

number of implant procedures

performed in any given year but do

not provide any accompanying

historical information on the patients

who received the implants (14). Other

sources provide information that is

generated from either mandatory

reports of device-related deaths and

serious injuries or voluntary and

anecdotal reports of device utilization

experience (15). Manufacturer data on

medical device implants are primarily

sales data (16).

These information sources lack

denominator data needed for proper

cIinical evaluations. Furthermore, they

have limitations that restrict their use

for future epidemiologic studies.

Prevalence estimates generated from

these combined data are based on

mathematical models rather than

actual population dat~ reliance on

these sources alone may lead to biased

estimates.

In 1988, the National Center for

Health Statistics, in collaboration with

FDA’s CDRH and as part of its

ongoing NHIS, collected information

to produce the first nationally

representative, population-based

estimates of the prevalence and

utilization experience associated with

implanted medical devices. The

Medical Device Implant (MDI) Survey

had two major objectives: (a) to

generate reliable estimates of the total

number of medical devices implanted

in the U.S. population and (b) to

provide specific, detailed information

on selected generic classes of devices.

The MDI Survey was designed

primarily to provide supportive data

for CDRHS postmarketing

surveillance programs, regulatory

functions, and related public health

decisions relative to medical device

implants. Other organizations,

agencies, and individuals, however,

should also benefit from data

generated from the MDI Survey. For

example, the medical device industry

could use the estimates for marketing,

research, and development of new and

improved medical device implant

products. Other Government agencies,

such as the Centers for Disease

Control, the National Institutes of

Health, the Health Resources and

Services Administration, and the

Health Care Financing

Administration, may also utilize these

data for ongoing research, for

developing program objectives for

health personnel and health service

delivexy to populations or subgroups

of populations, for aiding in activities

concerning complications related to

special devices, and for developing

programs and policies for standards

and quality.

Data and methods

NHIS is a continuous,

cross-sectional survey representing the

household population of the United

States. Each year in NHIS basic health

and demographic information is

collected by face-to-face interviews

with a sample of about 122,000 family

members in about 47,000 households.

These interviews are conducted by

personnel empIoyed by the U.S.

Bureau of the Census.

In addition to the basic NHIS

questionnaire, questions on one or

more selected topics are included each

year. Through the 198S MDI Survey

questionnaire, information was

obtained about five generic types of

medical device implants —artificial

joints, f~ation devices, artificial heart

valves, intraocular lens implants, and

pacemakers– and a residual class of

all other devices. These classes of

medical device implants were selected

based on two criteria: The specific

generic class of device had to be

(a) implanted frequently enough for

national projections to be made and/or

(b) reported to have associated

adverse effects that result in significant

morbidity or mortality.

The MDI Survey questionnaire

contained a common set of questions

for each type of medical device

implant: the number, type, and body

location of each device reported; the

dates of the original and most recent

replacement implantation; the

frequency of replacement and reasons

for the most recent replacement; the

length of time in use of the implant;

and the types and onset of adverse

effects or complications that occurred

with each implant, such as healing

problems, pain, infection, or

mechanical failure. A limited number

of other questions unique to each

specific implant type were also

included. A facsimile of the MDI

Survey questionnaire is provided in

Current Estimates from the National

Health Interview SurvqY: United States,

1988 (17).

Persons with a medical device

implant were first identified through a

series of “screener” questions

administered to the NHIS adult

household respondent(s). The detailed

questions about medical devices asked

in response to the screener replies,

however, were administered directly to

those adult family members with the

actual medical device implant. If the

person with the medical device was

physically or mentally incapable of

answering the questions or was

temporarily away from home during

the intexview period, a related family

member who was knowledgeable

about the person’s implant was

interviewed. Information about

medical devices reported for children

was obtained from a knowledgeable

adult family member, usually a parent.

The overall response rate,

combining the response rates for the

household questionnaire and the MDI

questionnaire, was about 92 percent.

In the survey, 5,592 sample pelrsons

reported having one medical device

implant or more. A total of ablout

7,600 devices were reported.

The technical notes to this report

contain a brief description of the

sample design and data collection

procedure employed and the terms

used. The definition given for a

medical device implant is similar to

that used by the International

Standards Organization (18). Methods

are also provided for deriving
Advance Data No. 191 ● February 26, 1991 3

approximate sampling errors for the

estimated numbers and percents

presented in this report.

Tables 1 and 2 show the number

and percent of persons with medical

device implants according to the type

and total number of implants

reported. The number and percent

distributions of the medical device

implant population are shown by

sociodemographic characteristics in

table 3. Prevalence estimates by age,

sex, and race for several kinds of

devices not included elsewhere in this

report are given in table 4. Estimates

are presented in tables 5–10 of specific

types of implants by length of time in

use. Table 11 contains percent

estimates of implants never replaced

by sociodemographic characteristics.

In table 12 similar figures are

presented for implants with one

problem or more reported. Table 13

shows estimates of devices by

reason(s) for the original implant.

Estimates of all persons and the

medical device implant population are

shown in table 14 according to NO

NHIS health status measures.

Table 15 contains population

denominators needed to derive various

estimated frequencies for the percent

estimates presented in this report. The

estimates presented in the tables in

this report are weighted to produce

representative national estimates of

the U.S. civilian noninstitutionalized

population.

Results

Persons with implants

In 1988, an estimated 11 milIion

Americans (4.6 percent of the civilian

noninstitutionalized population of the

United States) had at least one

medical device implant (tables 1 and

2). Fixation devices were reported with

the greatest frequency. About

40 percent of persons with implants

reported their use, followed by lens

implants (23 percent) and artificial

joints (12 percent).

The percent of persons with an

implant, as expected, varied by age

and type of device reported. For most

types of medical devices, older persons

were most likely to have an implant.

Of persons 65 years of age and over,

about 7 percent had a lens implant,

3.5 percent reported a fixation device,

and about 3 percent had an artificial

joint. &nong those 75 years of age

and over, about 1 out of 10 individuals

had a lens implant. About 2 percent

of children 5 years of age and under

used an ear vent tube.

Although the majority of persons

with medical device implants reported

only one implant, over 30 percent (3.4

million persons) reported multiple

implants. Few persons, however (less

than 4 percent of the implant

population), reported more than two

implants. The Likelihood of having

more than one implant depended

somewhat upon the type of implant

obtained. For example, over one-half

of children with ear vent tubes were

reported to have two implants of this

type and about 45 percent of persons

with a lens implant reported implants

in both eyes.

Separate figures are not

specifically shown in this report on the

proportion of persons in the

population with several different kinds

of medicaI device implants. However,

estimates from this data base show

that about 6 percent of persons with

implants reported more than one type

of implant.

In table 3, estimates of persons

with specific types of medical device

implants are shown by a number of

sociodemographic characteristics.

About one-half of all persons with ear

vent tubes were 5 years of age and

under (472,000 children). The risk of

having an ear vent tube was lM times

as great for maIes (60 percent) as it

was for females (40 percent), as

shown in figure 1. The vast majority

of persons with ear vent tube implants

were white (93 percent), had an

annual family income of at least

$15,000 (72 percent), and had at least

a high school education (90 percent).

(For children, the highest educational

level for a family member was used.)

As previously mentioned, more

persons reported having a fiiation

device than any other kind of medical

device implant (about 4.4 million

individuals). Men were somewhat

more at risk of having a fixation device

than were women (58 percent

compared with 42 percent). This

finding probably reflects generally

higher rates of injuries found among

males. About equal numbers of

persons under 45 years of age and

persons 45 years and over reported a

fwation device.

About 2% million individuals,

almost one-half of whom were 75

years of age and over, had a lens

implant. Proportionately more females

than maIes had a lens implant, 12.9

per 1,000 women compared with 8.4

per 1,000 men. The inverse

relationship found between lens

impIants and family income and

education is at least partly because of

the disproportionate number of elderly

persons in the lower income and

education categories.

Of the 1.3 million persons with an

artificial joint, 62 percent were 65

years of age and over and 58 percent

were women. Again, differentials by

income and education probably reflect

the larger proportion of older

individuals, who are at greater risk of

having an artificial joint, in the lower

income and education groups.

Pacemakers were implanted in an

estimated 460,000 persons. Unlike

other types of medical device implants,

pacemakers were used by about equal

numbers of men and women. About

86 percent of those individuals were

at Ieast 65 years of age, and

94 percent were white.

In 1988, there were an estimated

253,000 art~lcial heart valves in use.

Although it appears that artificial

heart wolves were implanted somewhat

more frequently in men than in

women, the difference between these

estimates was not statistically

significant. Similarly, the data appear

to show that persons living in

metropolitan statistical areas (MSA’S)

were somewhat more likely to have an

implant of this type than persons living

outside these areas (about 111 per

100,000 persons in MSA’S compared

with 88 per 100,000 individuals not in

MSA’S). The difference may reflect

greater access to this medical

procedure in urbanized areas but also

may be due to sampling variation.
4 Advance Data No. 191 ● February 26, 1991

3,000

2,750

2,500

2,250

2,000

1,750

1,500

1,250

1,000

750

500

250

0

❑ Male

2,543 ❑ Female

Fixation device Lens tmplant Artificial joint Ear vent tube Pacemaker Artificial hearl valve

Figure 1. Number of persons with selected medical device implants, by sex United States, 1988

Prevalence by age, sex, and race

In table 4, number and percent

estimates are shown for several

additional medical device implants,

some by specified body site, that are

not included in the other tables of this

report. These data are distributed

according to age, sex, and race. This

table, as weII as tables 5–13, differ

from tables 2 and 3 in that the

estimates are based on the number of

implants reported rather than on the

number of persons with implants.

About one-half of aII reported

artificial joints were hip joint

replacements (816,000 implants) and

another third (521,000) involved the

knee. Similarly, over one-half of all

fixation devices (about 2.7 million

implants) were located in the lower

extremities. The distributions of the

estimates shown in table 4 according

to age, sex, and race closely parallel

the patterns found in table 3 for

persons with these types of implants.

Women were the primary

recipients of silicone implants, with

breast implants leading the list of sites

reported most frequently. Of the

estimated 620,000 siIicone implants,

almost 90 percent were breast

implants, with about three-fourths of

them implanted in women ages

18-44 years. Estimated numbers of

silicone breast implants from other

sources suggest that the MD1 Survey

figure may be an underestimate of the

actual number of devices of this type.

Dental implants represented less

than 2 percent of all medical devices

in use in 1988. Based on estimates

derived from the MDI Survey

questionnaire, a somewhat higher

proportion of dental implants was

found in males and about 60 percent

of dental implants were for persons

under 45 years of age.

Length of time in use

Tables 5-10 present estimates that

pertain to the interval of time different

types of medical devices currently in

use have been implanted. About

270,000 of the 1.6 million artificial

joints currently in use were obtained

within the past year, and about

one-half of aIl artificial joints were

implanted 5 years ago or more

(table 5). A somewhat higher

proportion of artificial joints in

persons 65 years and over were

implanted within the past 12

months —19 percent compared with

12 percent of all joints implanted in

younger individuals (0.10 level of

significance).

Almost two-thirds of all reported

fixation devices (62 percent) were

implanted at least 5 years prior to the

interview (table 6). Among the

estimated 193,000 devices of this type

reported among children, however,

about 30 percent were implanted

within the year. With fixation clevices,

men were somewhat more likely to

have had their impIant for a minimum

of 5 years than were women,

66 percent compared with 57 percent.

The relatively small number of

artificial heart vaIves and pacemakers

upon which the estimates in tables 7

and 8 are based limits the type of

comparisons that can be made. Of the

estimated 279,000 heart valve implants

currently in use, over one-half were

implanted 5 years ago or more and

90 percent were in use for at least

1 year. Of the estimated 460,000
Advance Data No. 191 ● February 26, 1991 5

pacemakers reported, about 75,000

were implanted during the 12-month

period preceding the interview.

About one-fifth of all reported

intraocular lens implants, an estimated

840,000 devices, were obtained within

the past year (table 9). Among white

persons, about 22 percent of all lens

implants were obtained during the

past 12 months. In contrast, about

44 percent of lens implants obtained

by black persons were implanted

during the same period. This finding

may reflect a different usage pattern

for intraocular lens implants between

these two population groups. Similar

distributions, however, were found for

most of the other sociodemographic

characteristics shown in this table.

Unlike most other medical device

implants, ear vent tubes are commonly

implanted for temporary conditions

and are usually removed once the

problem is corrected. Consequently,

percent estimates of the length of time

this type of device has been in use,

shown in table 10, vary considerably

from similar figures for the other

types of implants described in this

report.

About 45 percent of all ear vent

tubes, 670,000 devices, were implanted

within the past year. Only 9 percent of

all such devices were implanted 5

years ago or more, and the vast

majority of these were for adult users.

Specifically, about one out of three ear

vent tubes for persons 18 years of age

and over (38.5 percent) were

implanted this length of time.

Estimates of the overall length of

time ear vent tubes were in use were

similar (or within sampling variation)

for most of the other

sociodemographic groups shown in

table 10. Note, however, that about

one-half of the ear vent tubes

impIanted in persons from the South

were in use for less than 1 year, a

somewhat higher proportion than

estimated for the other geographic

regions (0,10 level of significance).

Implant replacement

The MDI Survey questionnaire

contained a number of items about

the replacement esTerience associated

\vith different types of medical device

implants. For each implant reported,

questions were asked to determine

whether the device had ever been

replaced and, if so, the total number

of replacements obtained. Data on the

reason(s) for replacement and the

length of time implanted before

replacement were also collected about

the most recent replacement. Reliable

estimates cannot, however, be

produced for many of these items

because of the relatively small number

of replacements reported for some

types of medical devices.

Overall, of an estimated 15 million

medical device implants in use during

1988, about 8.8 percent (1.3 million)

were replaced at least one time. Given

the diversity of medical device

implants and their unique uses, all

estimates about replacements

presented in this report are shown by

type of implant. Specifically, table 11

shows percent estimates of implants

that were never replaced by selected

sociodemographic variables for the

following types of medical device

implants: ear vent tubes, fixation

devices, artificial joints, artificial heart

valves, pacemakers, and lens implants.

These data demonstrate that the

vast majori~ of medical device

implants in use have never been

replaced —from 69 percent of ear vent

tubes to 99 percent of lens implants.

Although a greater proportion of ear

vent tubes than other types of devices

were replaced, these replacements are

often the result of a recurrence of a

specflc heahh problem. In contrast,

replacements involving other types of

implants are usually because of some

problem with the device itself. Most

likely to have had an ear vent tube

replacement were non-Hispanic white

children 6-17 years of age living in the

Northeast and Midwest Regions of the

country. (Age and geographic region

differences tested at the 0.10 level of

si=~ificance.)

About 95 percent of all f~ation

device implants were never replaced

or repaired. The risk of replacement

or repair for this type of device was

inversely related to the person’s age,

with 93 percent of implants for

persons under 45 years of age not

replaced, compared with 97 percent

not replaced among persons 65 years

of age and over. Although specific

estimates of replacement reasons are

not provided in this analysis, the most

frequently reported reasons for

replacement or repair of fixation

devices reported by respondents

included breakage, loosening, and

defects.

Ninety-two percent of artificial

joints were never replaced. The

Northeast Region had a greater

proportion of joint replacements than

elsewhere, with 85 percent not

requiring replacement versus

94 percent for the other regions of the

country (O.10 level of significance).

The likelihood of replacement was

somewhat greater for pacemakers than

for most of the other types of medical

device implants identified in this table.

About 16 percent of all pacemakers

(72,000 devices) were replaced at least

one time. AIthough not specifically

shown in table 11, about 60 percent

of them lasted for 5 years or more

before they were replaced. Risk of

pacemaker replacement was about the

same regardless of age, sex, or race.

Problems with implants

The MDI Survey questionnaire

also included an extensive set of

questions about various kinds of

problems sometimes experienced with

medical device implants. In addition to

questions to identify the kinds of

problems encountered with each

device, it also contained questions to

identi& when the problem was first

noticed (that is, less than 30 days,

30-90 days, or more than 90 days

from the date of implantation).

A different set of problems was

used for each type of medical device

implant listed on the questionnaire.

Even though the problems varied

somewhat depending upon the

implant, there were similarities in the

kinds of problems specified for all

devices, such as pain (other than

discomfort generally associated with

surgery and heaIing), healing

problems, defects or failure, infection,

bleeding, or blood clots. One openended question about other problems

or complications was also included for

each type of device.
6 Advance Data No. 191 ● February 26, 1991

Because the kinds of problems

reported among the respondents

varied greatly in severity, the estimates

of the percent of implants with one

problem or more presented in this

report reflect a wide range of

experience. Furthermore, as with all

information obtained in NHIS, the

types of problems reported were only

those known and identified by the

respondent. These estimates,

therefore, may be higher than

estimates from other data sources.

Table 12 presents percent

estimates of selected types of implants

with one problem or more for a

number of sociodemographic

characteristics. Based on respondent

reports from NHIS, it appears that

problems occur with a significant

number of implants. Depending upon

the type of implant, 20-50 percent of

all devices resulted in one problem or

more. Problems were reported for

about one-third of all ear vent tubes,

fixation devices, and artificial joints.

One out of five artificial heart valves,

one out of four pacemakers, and one

out of two lens implants also had

complications associated with them.

For most &pes of implants, the

most frequently reported problem

related to pain. With lens implants,

clouding or blurred vision was most

often cited. The most common

problem for persons with pacemakers

was an irregular heartbeat.

A somewhat larger proportion of

ear vent tubes (40 percent) caused

problems in very young children

(under 3 years of age) than among

older individuals (0.10 level of

significance). With fmation devices, in

contrast, proportionately fewer

problems were reported for persons in

the youngest age group – 22 percent

under 18 years of age (0.10 level of

significance). Among respondents with

fixation devices, problems were

reported most often by those with the

least family income (43 percent) and

least completed years of education

(38 percent).

Problems were experienced with

almost one-half of all artificial joints

implanted in persons ages 18-44 years,

compared with about one-third of

similar implants for other persons.

Artificial joints were also more likely

to result in probIems among men

(37 percent) than women

(28 percent). Lens implants were

somewhat more likely to cause

problems for persons under 65 years

of age than for older individuals (0.10

level of significance), but no percent

differences in reporting problems were

found by sex or race for this type of

device.

Reason for original implant

Table 13 contains estimates of the

original reason(s) for implantation of

five kinds of medical devices: artificial

joints, fwation devices, intraocular lens

implants, ear vent tubes, and dental

implants. The specific reason

categories shown in this table

appeared on the questionnaire and

were used by the interviewers to

record the respondent’s responses to

the question “Why did you need to get

the (type of implant) in the first

place?” This questionnaire procedure

should be considered when assessing

the responses. In addition, some

device categories such as dental

implants show a large proportion of

“other” reasons for the original

implant. Interviewers appear to have

recorded some responses in the

“other” reason category when, in fact,

the reason may have been one of the

specific categories listed on the

questionnaire.

According to respondent reports,

almost one-half of all artificial joints

were implanted because of arthritis.

The second leading cause of joint

replacements, about one-quarter of all

such implants, related to injuries.

Injuries also accounted for the

majority of fixation devices that were

reported. About 70 percent of all

fixation devices, 3.4 million implants,

resulted from injuries. Injuries were

also reported as the cause of about

one-fourth of all dental implants.

Almost all lens implants were

attributed to the presence of cataracts.

Of the estimated 3.8 million lens

implants in use during 1988,

94 percent were said to be caused by

this condition. Infection was cited as

the leading cause of ear vent tube

implants, with 71 percent (about 1

million devices) the result of this

reported reason.

Health status of persons with

implants

Two NHIS health measures are

included in this report to assess the

overall health of persons with medical

device implants: limitation of activity

because of chronic conditions and

respondent-assessed health status.

The limitation-of-activity

categories are used to classify persons

by their ability to perform the major

activity most often associated with

healthy persons their age and their

ability to participate in other activities.

Major activities include normal play

activities for young children, attending

regular school for older children,

working and/or keeping house :for

adults, and performing daily activities

associated with independent living for

senior citizens. Assessed healthl status

is determined by the respondent’s

opinion of each family member’s

overall health as reported when asked

the question “Would you

say ‘s health is excellent, very

good, good, fair, or poor?”

Table 14 shows estimates of all

persons and persons with selected

types of medical device implants

according to the two NHIS health

measures described. Data are

aggregated according to two broad age

groups because measures of overall

health and medical device implants are

highly correlated with age.

Compared with the general

population, persons with implants are

more likely to be limited in their

ability to perform their major and

other activities and to be assessed in

fair or poor health. Specifically,, about

44 percent of persons with one

medical device implant or more were

limited, compared with about

14 percent of the U.S. population.

When estimates are further compared

by age, persons with implants who

were under 65 years of age wer(e

almost four times as likely to report

an activity limitation as other persons

of similar age. Among the age group

65 years and over, the implant
Advance Data No. 191 ● February 26, 1991 7

population was about 172 times as

likely to be limited, 52 compared with

37 percent. Similar ratios between the

estimates for these two population

groups were also found for the two

separate activity-limitation categories

shown in table 14.

The percent of the implant

population reporting an activity

limitation also differed according to

the type of medical device. Of persons

under 65 years of age with a medical

device implant, proportionately about

twice as many persons with an

artificial heart valve as persons with a

fixation device reported an activity

limitation (74 compared with

39 percent). Among older persons

with medical device implants, those

with lens implants were the least likely

to report an activity limitation.

The likelihood of being assessed

in fair or poor health was almost three

times greater for persons with a

medical device implant as it was for

the U.S. population. An estimated

10 percent of all persons in the

United States were in fair or poor

health, compared with about

27 percent of the implant population.

Among older persons, differences in

the percent of persons in fair or poor

health for these two populations were

not as great (29 and 37 percent in fair

or poor heaIth, respectively). SimiIarIy,

whereas about 71 percent of all U.S.

persons 65 years of age and over were

reported in exceIIent to good health,

61 to 65 percent of persons with

various types of implants specified

(except for the pacemaker population)

were also assessed in this way.

Accordingly, based on these two

health status measures, the relative

overall health of persons with impIants

under the age of 65 years appears to

be poorer (when compared with all

persons of similar age) than for the

older implant population.

Conclusion

Medical device implants are

expected to become one of the most

promising areas of medicine in the

next decade (19). Although there has

been great progress in medical device

implant technology, some devices are

so new that no baseline data exist to

evaIuate them, and their effectiveness

in future years is unknown. The data

collected through the 1988 MIX

Survey will serve as a valuable source

of information for conducting cliniczd

epidemiologic studies desiamed to

identify risk factors associated with the

implantation and replacement of

medical devices in humans and for

evaluating the long-term safety and

effectiveness of these devices.

References

1. Balkin BE. Implant dentistry Historical

overview with current perspectives. J Dent

Ed 52(12):683-5. 1988.

2. Madison A. Transplanted and artificial

body organs. New York Beaufort Books,

Inc. 1981.

3. Freeman R, Gould F. Infection and

prostheses. Clin Mater 3(4):265-71. 1988.

4. Haggag Y. Late complications of

cardiac valve prostheses. J Clin Eng

14(1):69-76. 19S9.

5. Greenspan A, Kay H, Berger B, et al.

Incidence of unwarranted implantation of

permanent cardiac pacemakers in a large

medical population. N Engl J Med

318(3):158-63. 1988.

6. Cooney W, Beckenbaugh R,

Linscheid R. Total wrist arthroplasty

Problems with implant failures. CIin

Orthop (1S7):121-8. 1984.

7. National Institutes of Health.

Intraocular lens implantation consensus

development conference. Bethesda,

Maryland: Sept 10-11, 1979.

8. National Institutes of Health. Dental

implants consensus development

conference. Bethesda, Maryland:

June 13-15, 1988.

9. Kossovsky N, Snow R.

Clinical-pathological analysis of failed

central nervous system fluid shunts. J

Biomed Mater Res 23(A1):73-86. 1989.

10. Finnegan M. The tissue response to

internal fiiation devices. Crit Rev

Biocompat 5(1):1-10. 1989.

11. Hanker J, Giamrnara BL. Biomaterials

and biomedical devices. Science

242(4880):885-92. 1988.

12 Gristina A. Biomaterial-centered

infection: Microbial adhesion versus tissue

integration. Science 237(4822):1588-95.

1987.

13. Code of Federal Regulations. Federal

Food, Drug, and Cosmetic Act. Title 21,

part 800.1981.

14. Health Resources and Services

Administration. Inventory of U.S. Health

Care Data Bases, 1976-1987. Abstract

Nos. 121 and 180. Washington: 1988.

15. Code of Federal Regulations. An

overview of the medical device reporting

regulation. Title 21, part 803.1984.

16. Frost & Sullivan, Ltd. Medical

prosthetic implants. Monograph 236.1980.

17. Adams PF, Hardy AM. Current

estimates from the National Health

Interview Survey United States, 1988.

National Center for Health Statistics. Vital

Health Stat 10(173). 1989.

18. B1och B. The International

Organization for Standardization technical

committee on implants for surgery. J Med

Eng Technol 8(4)170-6. 1984.

19. Louis Harris and Associates, Inc. The

Bristol-Myers Report Medicine in the next

century. Study no 861018:183. New York.

1987.

20. Moss AJ, Parsons VL. Current

estimates from the National HeaIth

Interview Survey United States, 1985.

National Center for Health Statistics. V]tal

Health Stat 10(160). 1986.

21. Kovar MG, Poe GS. The National

Health Interview Survey design, 1973-84,

and procedures, 1975-83. National Center

for Health Statistics. Vhal Health Stat

1(18). 1985.

22. Massey JT, Moore TF, Parsons VL,

Tadros W. Design and estimation for the

National Health Interview Survey,

1985-94. National Center for Health

Statistics. Vhal Health Stat 2(110). 1989.
8 Advance Data No. 191 ● February 26, 1991

Table 1. Percent of persons with 1 medical

device implant or more, by selected types

of implants and age: United States, 1988

Percent of

Type of imp)ant and age persons

All per~ons with 1 Implant or

more . . . . . . . . . . . . . . . . 4.6

Artificial joint

Alleges . . . . . . . . . . . . . . . . . 0.5

65 years And over . . . . . . . . . . 2.8

Fixation device

Alleges . . . . . . . . . . . . . . . . 1.8

65 years And over . . . . . . . . . . 3.5

Lens implant

Alleges . . . . . . . . . . . . . . . . . 1.1

65 years Andover.......,.. 7.3

75 years And over . . . . . . . . . . 11.3

Pacemaker

Alleges . . . . . . . . . . . . . . . . . 0.2

65 years And over . . . . . . . . . . 1.4

75 years And over . . . . . . . . . . 2.6

Arfificlal heart valve

Alleges . . . . . . . . . . . . . . . . . 0,1

65yeare And over . . . . . . . . . . 0.5

Ear vent tube

Alleges . . . . . . . . . . . . . . . . . 0.4

Under 3 years . . . . . . . . . . . . . 2.0

3-5 years . . . . . . . . . . . . . . . . 2.3

‘Includesall types of implants reported, such as artificial

joints, flxatmn devices, artificial heart valves, intraocular lens

implants, pacemakers, ear vent tubes, infusion pumps, dental

implants, sihcone implants, and artificial arteries, ligaments,

and veins.

Table 2. Number and percent distribution of persons with 1 medical device implant or more by number of implants person now has of

each type, according to selected types of Implants: United States, 1988

Typeof implant

All persons w“ttr Artificial Lens Artificial Fixation Ear Silicone

Number of implants f imp/ant or more’ heart valve implant joint device2 vent tube implant

Number of persons in thousands

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11,051 253 2,582 1,294 4,382 953 3al

l implant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,659 230 1,399 1,013 3,933 411 144

2!mplants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,982 *22 1,183 251 398 542 235

3tmplanta or more . . . . . . . . . . . . . . . . . . . . . . . . . . . 409 ‘1 ●3O 61 *2

Percent distribution

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Implant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69.3 90.9 54.2 78.3 89.8 43.1 37.8

2 implants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27.0 ‘8.7 45.8 19.4 9.1 56.9 61.7

3implants ormore . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.7 ‘0.4 *2.3 1.2 *0.5

'includes all~pes oflmpknts re~fled, such asafl!ftc4al joints, fixation dewces, ati8ficlal heanvabea, intraocular lens implanE, pacemakers, ear vent tubas, infusion pumps, dentslimplants, s!l!.

cone implants, andartdioalarfenes, Ihgamenta,andvems.

2Number of f8xaion dewcefmplants refers tothenumMr of bdysltes conti8n8ng lhedW[ces, suti=p!ns, screws, plates, wires, orrods, thatwere8mplanted. It!snot theactual number of such

devrces !mplanted m a parhcular body part.
Advance Data No. 191 ● February 26, 1991 9

Table 3. Number and percent distribution of persons with selected types of medical device implants by selected sociodemogrephic

characteristics: United States, 1988

Artificial Artificial

Ear Fixation ArLir7cial heart Lens Ear Fmtion Artificial heart

Characteristic

Lens

vent tube device joint valve Pacemaker implant vent tube device joint wlve Pacemaker implant

Number of persons in thousands Percent distribution

All persons’ . . . . . . . . . . . .

Age

Under 3years . . . . . . . . . .

3-5 years . . . . . . . . . . . . .

6-17years . . . . . . . . . . . .

18 years And over . . . . . . . .

Under 18 years . . . . . . . . . .

16-44 years . . . . . . . . . . . .

4.E-64 years . . . . . . . . . . . .

65years And over . . . . . . . .

Under 45years . . . . . . . . . .

45-64 years. . . . . . . . . . . .

65 years and over . . . . . . . .

Under 65years . . . . . . . . . .

65-74 years . . . . . . . . . . . .

75 years And over . . . . . . . .

Sex

Male . . . . . . . . . . . . . . . .

Female . . . . . . . . . . . . . . .

Race

white. . . . . . . . . . . . . . . .

Black . . . . . . . . . . . . . . . .

Hispanic origin

Non-Hispanic. . . . . . . . . . .

Hispanic . . . . . . . . . . . . . .

Family income

Less than $15,000 . . . . . . . .

$15,000-$34,699 . . . . . . . .

635,0000r more . . . . . . . . .

Poverly status

Inpoverly . . . . . . . . . . . . .

Notinpoverly . . . . . . . . . .

Education

Less than 12 years . . . . . . .

12 years . . . . . . . . . . . . . .

13yeare ormore . . . . . . . .

Geographic region

Northeast . . . . . . . . . . . . .

Midwest . . . . . . . . . . . . . .

South . . . . . . . . . . . . . . . .

West . . . . . . . . . . . . . . . .

Place of residence

MA. . . . . . . . . . . . . . . .

Central icy. . . . . . . . . . .

Outside central c”@. . . . . .

Not MSA . . . . . . . . . . . . . .

953

222

250

328

152

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

566

385

890

48

49

167

345

345

132

764

66

370

465

128

353

142

694

249

445

259

4,382

. . .

. . .

. . .

. . .

173

1,932

1,264

1,013

. . .

. . .

. . .

. . .

. . .

. . .

2,543

I ,a39

4,015

295

4,194

I a7

1,073

1,664

1,126

434

3,647

1,080

1,733

1,541

663

1,193

1,528

977

3,165

1,225

1,940

1,217

1,294

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

180

311

804

. . .

. . .

. . .

546

749

1,193

82

1,256

●39

452

406

225

114

1,052

504

433

356

250

372

443

229

909

354

555

386

253

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

● 33

88

132

. . .

. . .

. . .

138

115

231

*2O

262

*2

48

98

57

*15

leg

71

117

61

47

64

81

41

206

100

106

48

460

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

62

113

286

232

228

431

“24

447

●13

187

121

4a

51

327

233

141

63

92

128

156

64

350

159

191

110

2,582

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

502

a19

1,261

963

1,599

2,457

102

2,526

56

975

800

339

206

2,046

1,106

793

667

466

709

918

489

1,636

800

1,036

746

100.0

23.3

26.2

34.4

15.9

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

59.6

40.4

93.4

5.0

94.8

5.1

17.5

36.2

36.2

13.9

82.3

10.1

3a.8

50.9

13.4

34.5

37.0

14.9

72.8

26.1

46.7

27.2

100.0

...

...

...

...

3.9

44.1

28.8

23.1

. . .

. . .

. . .

. . .

. . .

. . .

58.0

42.0

91.6

6.7

95.7

4.3

24.5

38.0

25.7

9.9

63.2

24.6

39.5

35.2

15.6

27.2

24.9

22.3

72.2

28.0

44.3

27.8

lW.O

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

13.9

24.0

62.1

. . .

. . .

. . .

42.2

57.9

92.2

6.3

97.1

●3.O

34.9

31.4

17.4

a.a

81.3

38.9

33.5

27.5

19.3

28.7

34.2

17.7

70.2

27.4

42.9

29.8

100.0

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

*I 3.0

34.8

52.2

. . .

. . .

. . .

54.5

45.5

91.3

*7.9

99.6

●0.8

19.0

38.7

22.5

●5.9

78.7

2a.1

46.2

24.1

18.6

33.2

32.0

16.2

81.4

39.5

41.9

19.0

100.0

...

...

...

...

...

...

...

...

...

...

...

13.5

24.6

62.2

50.4

49.6

93.7

*5.2

97.2

*2.8

40.7

26.3

10.0

11.1

71.1

50.7

30.7

18.0

20.0

27.8

33.9

18.3

76.1

34.6

41.5

23.9

100.0

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

19.4

31.7

48.8

38.1

61.9

95.2

4.0

97.8

2.2

37.8

31.0

13.7

8.1

79.3

42.8

30.7

25.8

16.0

27.5

35.6

78.9

71.1

31.0

%

‘Includes all Olhsr races, unknown family income, unknown paveny status, end unknmw adu@rOn.

NOTES: Poverty status IS determmed in the Nat,onal Health lnterwew Survey by femily sue, number of ch!ldren, and family irmnre using 19B7 poverty Ieve!s definer! by the U.S. aureau of the

Census. MSA is metropolitan statiswal area.
10 Advance Data No. 191 ● February 26, 1991

Table 4. Number of selected types of medical device impiants and percent distribution by age, sex, and race, according to type and

location of implant: United States, 1988

Age Sex

Number of

Race

implants in Under 18 1844 45-84 65 yeara

Type and bcation of imptant thousands Tots? yeara yaara years and over Male Female White Blach

All artificial joints2. . .

Hip joint . . . . . . .

Knee joint . . . . . .

All fixation devices2’3.

Head ...,.....

Torso . . . . . . . . .

Upper extremity . .

Lower extremity . .

Other site . . . . . .

All silicone implants2.

Breast implant . . .

Shunt or catheter. . .

Dental implant. . . . .

. . . . . . . .

. . . . . . . .

. . . . . . . .

1,625

816

521

100.0

100.0

100.0

●0.6

*0.5

13.0 24.6

6.5 26.3

10.9 20.5

61.7 39.9 60.1 92.3 6.2

66.7 37.5 62.4 93.5 5.5

68.5 41.8 58.2 88.1 10.0

4,890

351

563

646

2,690

622

100.0

100.0

100.0

100.0

I m.o

100.0

3.9

+4.3

●5.3

“3.7

3.0

●6.4

44.3 28.4

67.8 22.6

49.6 31.8

55.9 25.4

39.6 27.9

34.4 341

23.4 57.2 42.8 91.7 6.6

‘5.4 57.3 42.7 93.2 ●4.8

13.3 62.7 37.5 92.2 *6.9

15.0 70.4 29.7 91.6 *5.6

29.4 52.8 47.2 91.1

25.1 57.9 42.1 93.6 ‘z

. . . . . . .

. . . . . . .

. . . . . . .

. . . . . . . .

. . . . . . . .

. . . . . . . .

620

544

100.0

100.0

●0.5

‘0.6

73.1 23.7

73.0 24.1

●2.9 8.2 91.8 97.6 ●0.8

●2.6 ‘2.0 96.0 96.5

29.3 SO.5 49.2 65.7 ●12.5

. . . . . . . .

. . . . . . . .

. . . . . . . . 321 100.0 24.3 24.3 22.1

. . . . . . . . 275 100.0 ●2.2 57.8 27.3 ●12.7 !%.4 43.6 93.8 *4.O

‘Includes allotherraces.

21ncludesall and unknownsites.

3Eachfixationdevce representsa singlebodysite,regardlaesofthe numberof pine,WM. plates,wires,rods,d!ps, or nailsthatwereusedto holdorfastenh in a fixedfxwition.
Advance Data No. 191 ● February 26, 1991 11

Table 5. Number of artificial joints and percent distribution by length of time in use of current joint according to selected

sociodemographic characteristics: United States, 1988

Number of Length of time in use

pints in Less than 1-4

Characteristic thousands

5 years

Total’ 1year years or more

Percent di~bution

Alljointsz . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,625 100.0 16.6 34a 43.6

Age

Under 45yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65years and over . . . . . . . . . . . . . . . . . . . . . . . . . . .

222

400

1,003

100.0

100.0

100.0

●5.6

15.8

19.3

31.0

40.6

33.3

63.5

43.3

47.4

Sex

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 649 100.0 15.6 34.9

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

49.5

976 100.0 17.3 34.8 46.0

Race

Whfie . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1,500

100

100.0

100.0

16.8

*1 5.0

34.7 48.5

“40.0 ●46.3

Hispanic origin

Non-fiispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,566

Hispanic.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

100.0 16.7

56

34.6 48.5

100.0 ●12.6 ●34.O %3.2

Family inmme

Lessthan$15,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . 562 100.0 13.5 35.6

$15,00-$34,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SO.7

513 100.0 19.1

$35,0000rmore . . . . . . . . . . . . . . . . . . . . . . . . . . . .

32.1 48.5

261 100.0 18.5 37.0 44.5

Pwerlystetus

In povedy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140 100.0 ●7.4

Notin poverty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

34.7 57.9

1,320 100.0 172 35.2 47.7

Lessthan 12yeare . . . . . . . . . . . . . . . . . . . . . . . . . .

12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13yeareormore . . . . . . . . . . . . . . . . . . . . . . . . . . . .

645 100.0 19.6 31.2 49.2

100.0 16.0 36.8 47.1

444 100.0 13.3 37.0 49.8

Geographic region

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 308 100.0 ●11.5 35.1

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

53.5

467 1(ULO 18.2 32.9

south . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

49.0

556 100.0 21.1 33.6

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45.3

293 100.0 *1O.9 40.1 48.6

Place of residence

MA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,150 1W.o 14.1 34.1

Centrslcity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

51.6

421 100.0 11.8 33.1

Outsidecentralc”ty . . . . . . . . . . . . . . . . . . . . . . . . .

54.8

730 100.0 15.2 34.7

NotMSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

50.2

474 100.0 22.8 36.5 40.7

‘Escludes artificial jomls with unknown length of time is use.

21~ude~a110ther ra~s,unknownfsmily inoame,unkrawn PoWtystatu%and unkn~edu=~.

NOTES: Poverty status isdeterminedinthe Nat]onal Healthlnterview Survey byfamilysize, numberofchildrers, andfamifywxxxne uaing1987poverty Iave!sdeiinedtsy theU.S.8ureauof the

Census. MSA IS metropolnan stat]swel aree.
12 Advance Data No. 191 ● February 26, 1991

Table 6. Number of fixation devices and percent distribution by length of time in use of current device, according to seiected

sociodemographic characteristics: United States, 1988

Number of

Length of time in use

devices in Less than 14

Characteristic

5 years

thousands Tots+ 1 year yeara or more

Percent distribution

Alldevices2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,890 100.0 12.9 24.9 62.2

Age

Under 18 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193 100.0

16-44years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

30.8

2,166

43.4

100.0

25.3

45-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12.6 23.6

1,388

63.8

100.0

65years Andover . . . . . . . . . . . . . . . . . . . . . . . . . . .

10.3 21.8

1,142

67.8

100.0 13.4 27.9 58.T

Sex

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Race

White . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,799

2,092

4,466

322

100.0

100.0

100.0

100.0

11.3

15.0

13.1

●1O.8

22.7

27.8

25.0

21.2

66.0

57.2

62.0

68.1

Hispanic origin

Non-Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,683 100.0

Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12.9 25.3

206 100.0

61.8

●13.2 *16.3 70.5

Familymcome

Lessthan $15,000. . . . . . . . . . . . . . . . . . . . . . . . . . . 1,220 100.0

$15,000--s34,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12.1 25.7

1,870

62.3

100.0

$35,0000rmore . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12.6 23.6

1,208 100.0

63.5

10.8 27.1 62.1

Poverty status

In poverly, ..,,.....,.. . . . . . . . . . . . . . . . . . . . 487 100,0

Not in poverty, . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13.6 28.9

4,057

57.5

100.0 12.2 24.7 63.0

Education

Lessthan 12years . . . . . . . . . . . . . . . . . . . . . . . . . . 1,206 100.0

12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

14.7

1,942

23.9

100.0

61.4

13years ormore. .,..... . . . . . . . . . . . . . . . . . . . .

13.6 25.3

1,710

61.1

100.0 10.9 25.4 63.T

Geographic region

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77T 100.0

Midwest, .,, . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16.3 26.2

1,340

55.5

100.0

South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

10.5 27.2

1,660

62.3

100,0

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13.7 22.1

1,093

64.3

100.0 10.8 25.7 63.5

Place of residence

MA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,534 100.0 13.0

Central icy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25.3

1,387

61.7

Outside central city . . . . . . . . . . . . . . . . . . . . . . . . .

100.0 12.8 25.9

2,148 100.0

61.4

NotMSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13.2 24.9

1.356

61.9

100.0 12.7 24.0 63.4

‘Excludes fixat!on devices wmhunknown length of bme in use,

‘jncf~de~all~therra~es, “nk”own femily income, unknmmpoveq aralus. andunkn~edu~t!on.

NOTES: Number of ftxaltondev!cesr eferstothen umberof body s(tescontarntng medwlces, such aapins, screM, plates, wires, orrods, tiatwere imp&nted. hisnottie atiualnumber of such

deviceamplanledma part!cularbody pari. Poverty status mdetenmned in the National Heailhlntervlew Suwey by fsmilyaize, number ofchildren, and famiiy income using 19a7p0ve!ty levels

de freed by the US. Bureau of the Census MSAismetropolnan Sat@!calarea.
Advance Data No. 191 ● February 26, 1994.. 13

Table 7. Number of artificial heart valves and percent distribution by length of time in use of current valve, according to selected

sociodemographic characteristics: United States, 1988

Number of

Length of time in use

valves in Less than 14

Characteristic

5 years

thousands Total’ 1 year yeara or more

Percent distribution

Allvalves2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279 100.0 ●1O.3 36.0 53.6

Age

Under 45 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 100.0 ●I a.9 %4.1

45-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

*27.O

89 100.0 *4.O *39.4

65years and over . . . . . . . . . . . . . . . . . . . . . . . . . . .

56.6

139 100.0 *1 2.8 26.0 59.2

Sex

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

146

133

100.0

100.0

*5.9

●16.0

39.7

●32.8

55.1

52.0

Race

White . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249 100.0 ●9.1 35.5

Black . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55.4

●28 1Oil.o ●25.O ●35.7 *42.9

Hispanic origin

Non-Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277 100.0 ●I 0.4 35.6

Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . “2

53.8

100.0 *1 00.0

Family income

LessthanS15,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 100.0 ‘11.8 ●33.3

S15,00LM-34,999. . . . . . . . . . . . . . . . . . . . . . . . . . . .

●56.9

102 100.0 “7.0 937.0

$35rOOOormore . . . . . . . . . . . . . . . . . . . . . . . . . . . .

56.0

66 100.0 “40.0 ●60.O

Poverty status

lnpoverly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . *21 100.0 *1O.5

NotinpoveRy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

●26.3 ●83.2

215 100.0 ●5.9 36.9 56.7

Lessthan 12years . . . . . . . . . . . . . . . . . . . . . . . . . . 86 100.0 ●I 2.2 ●35.4

12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

52.4

123 100.0 ●12.O ●29.1

13yearsormore . . . . . . . . . . . . . . . . . . . . . . . . . . . .

59.6

67 100.0 ●3.4 ●50.O ●46.6

Geographic region

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Place of residence

MA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Centrality. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Outside centralcity . . . . . . . . . . . . . . . . . . . . . . . . .

NotMSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

49

ee

87

48

228

109

119

51

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

●1O.6

●6.5

*16.O

●9.5

●10.4

●10.1

●9.7

●12.2

●25.5

●36.O

●42.O

●33.3

36.2

“40.4

36.3

*26.5

“63.8

55.4

●42.O

*57.1

51.4

48.5

54.0

*63.3

‘Excludes arfficial heart valves with unknown length of time in use.

‘Includes all other races, unknown farmfy incnme, unknown poverty status, and unknown educatmrr.

NOTES Poverty status IS determined in the National Heaiih Intenww Survey by fsmiiy sue, number of children, and family income using 1987 poverly fevels defined by the U.S. aureau of !he

Census. MSA m metropolitan atahatlcal area.
14 Advance Data No. 191 ● February 26, 1991

Table 8. Number of pacemakers and percent distribution by length of time in use of current pacemaker, according to selected

sociodemographlc characteristics: United States, 1988

Number of

Length of time h use

pacemakeffi Less fhan 14 5 yesrs

CfrarecteriW in thousands Tote? 1year years or more

Percent distribution

Allpacemakers2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 460 100.0 16.3 45.9 38.0

Age

Under 65 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 100.0 *14.5 *41 .9 ●4I .9

65-74years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 100.0 *20.2 49.5 ●30.3

75yearsand over . . . . . . . . . . . . . . . . . . . . . . . . . . . 286 100.0 14.9 44.9 39.9

Sex

Male, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

232

228

100.0 18.7

100.0 *1 3.5

48.9 32.4

42.8 43.7

Race

Whtie . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 431 100.0 15.6 46.2 38.5

Black . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ●24 100.0 %4.8 *34.8 ‘30.4

Hispanic origin

Non-Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 447 100.0 16.9 45.0 38.3

Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ●13 100.0 ●71 .2 ●26.8

Family income

Lessthan S15,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . 187 100.0 *1 8.0 47.5 34.4

$15,000-s34,999 . . . . . ...<.... . . . . . . . . . . . . . . . 121 100.0 ●12.7 42.4 44.1

$35,0000rmore . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 100.0 %7.4 *47.8 *34.8

Poverlystatus

In poverty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 100.0 ●29.4 ●82.7 ●7.8

Not in poverty . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327 100.0 13.2 43.8 42.9

Education

Lessthan 12years . . . . . . . . . . . . . . . . . . . . . . . . . .

12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13yearsormore . . . . . . . . . . . . . . . . . . . . . . . . . . . .

233

141

83

100.0

100.0

100.0

*11 .4

●20.4

●22.8

44.3

46.7

*46. 1

43.9

33.6

“30.4

Geographic region

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 100.0 ●10.3 ●46.O ●43 .7

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128 100.0 *21 .4 43.7 34.9

South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156 100.0 ●16.3 47.1 36.6

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64 100.0 814.8 ●46.9 ●38.3

Place of residence

MSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 350 100.0 14.0 47.4 38.3

Central icy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159 100.0 *13.8 46.4

Outside c=ntralcw . . . . . . . . . . . . . . . . . . . . . . . . .

37.7

191 100.0 “142 46.4 39.3

NotMSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110 100.0 *22.9 40.0 *36.2

‘ExcludespacemakersWithunknownlengthOftimainuse.

21n~lude~d]~er races,unkn~farni~ inmme,unknownpweriystetwsnd unkn~eduf=tim,

NOTES: Pove!ly siatus m detenmmedin w National Health Intew?w Survey by femiiy size, number of children, and family inrmme using1987 pcwertylevelsdefinedby the U.S. ❑ureauof the

Census. M3A IS metropolitan stattslical area.
Advance Data No. 191 ● February 26, 1991 15

Table 9. Number of intraocular lens implants and percent distribution by length of time in use of current implant, according to selected

sociodemographic characteristics: United States, 1988

Number d

Length of time in use

lens implants Leas than 14

Characteristic

5 yeara

in thousands Totat 1 year yeara or more

Percent distribution

Alllens implants2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,765 100.0 22.3 54.8 22.9

Age

Under 65 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 25.6 54.2

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,;:

20.0

100.0 24.4 50.1

7Syears And over . . . . . . . . . . . . . . . . . . . . . . . . . . .

25.5

1,889 100.0 19.8 58.0 22.3

Sex

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,415 100.0 21.6 53.6

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

24.8

2,349 100.0 22.7 55.5 21.8

Race

Whtie . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3.596

131

100.0

100.0

21.6

44.0

55.1

42.4

23.3

●12.8

Htspanic origin

Non-Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,675 100.0 22.4 54.9

Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

22.7

90 1OQ.o 918.5 51.9 *29.6

Family income

Lessthan$15,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,432 100.0 20.0 56.6

$15,00cM34,89a. . . . . . . . . . . . . . . . . . . . . . . . . . . .

23.4

1,157 100.0 24.7 53.2

$35,0000rmore . . . . . . . . . . . . . . . . . . . . . . . . . . . .

22.1

436 100.0 22.9 57.0 20.0

Poverty status

Inpoverly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 302 100.0 20.2 54.6

Notinpoverly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2S.5

2,987 100.0 22.8 55.2 22.2

Education

Lessthan 12years . . . . . . . . . . . . . . . . . . . . . . . . . . 1,621 100.0 21.4 55.9

12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

22.8

1,164 100.0 21.1 53.1

13yearsormore . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25.8

957 100.0 24.6 55.6 19.6

Geograph*region

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

646 100.0 22.4 57.9 19.5

1,049 100.0 22.5 51.2

south . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

26.3

1,334 100.0 24.4 54.8 20.8

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 736 100.0 18.0 57.2 24.6

Place of residence

MS/L . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,667 100.0 21.8 56.4

Centraicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

21.8

1,185 100.0 21.1 55.1 23.8

Outsidecentral c-~ . . . . . . . . . . . . . . . . . . . . . . . . . 1,501 100.0 22.3 57.4

NotMSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

20.3

1,078 100.0 23.5 51.0 25.5

‘Excludeslens implants wilh unknowt length of tmw in use.

‘Insfudesaflothar racas, unknomfamity mcome,unknovm pwertyslatus,and unknovmeducatctl.

NOTES Povertystatusisdaterminecfinihe NationaIHealthlnterviewSurveybyfamiiysize, numberofshildren, andkmilyiwerne mirg19S7pov@ Ievekdefinedby thaU.S. Bureauof the

Census.M3Aismstrop.diin statistdarea
16 Advance Data No. 191. February 26,1991

Table 10. Number of ear vent tubes and percent distribution by length of time in use of current implant, according to selected

sociodemographic characteristics: United States, 1988

Number of ear

Length of time in use

vent tubes in Less than 14

Characteristic

5 years

thousands Tota~ 1 year yeara or more

Percent distribution

Aflearvent tubesz . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,494 100.0 44.9 46.0 9.0

Age

Under 3 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3-5 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18 years and over . . . . . . . . . . . . . . . . . . . . . . . . . . .

385

404

517

188

100.0 65.9 33.8

100.0 45.6 54.4

100.0 35.6 53.1 11.4

100.0 28.0 33.0 38.5

Sex

Male. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

896

599

100.0 47.0 45.2 7.8

100.0 42.0 47.3 10.9

Race

White . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1.400

69

100.0 45.0 46.7 8.3

100.0 ‘47.5 ●24.4 *18.O

Hispanic origin

Non-Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1,413

82

100.0 45.2 46.3 6.5

100.0 ‘40.0 ●41 .3 ●17.5

Family income

Lessthan $15,000 . . . . . . . . . . . . . . . . . . . . . . . . . .

$15,00&$34,999 . . . . . . . . . . . . . . . . . . . . . . . . . . .

S35,0000rmore . . . . . . . . . . . . . . . . . . . . . . . . . . . .

267

528

556

100.0 44.2 42.1 ●13.6

100.0 44.2 48.1 9.8

100.0 45.3 50.6 ●4.3

Poverty status

lnpove~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Not m poverty . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

211

1,231

100.0 41.3 41.6 ●17.3

100.0 45.5 46.9 7.5

Education

Lessthan 12years . . . . . . . . . . . . . . . . . . . . . . . . . .

12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13yearsormore . . . . . . . . . . . . . . . . . . . . . . . . . . . .

151

566

775

100.0 35.2 50.0 ●14.8

100.0 44.3 45.3 10.6

100.0 47.2 45.8 6.9

Geographic region

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

196

505

568

226

100.0 34.1 58.1 *9.8

100.0 44.7 43.5 11.8

100.0 51.4 42.8 *6.O

100.0 37.9 51.7 ●10.3

Place of residence

MA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Central cify . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Outsidecentral cay . . . . . . . . . . . . . . . . . . . . . . . . .

Not MSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1 ,oa7

387

700

408

100.0 44.0 47.0 8.9

100.0 45.8 43.0 *11 .2

100.0 42.9 49.4 7.7

100.0 47.3 43.5 ●9.5

‘Excludes earvent tube !mplantawithunknow Iengthoft!me muse.

‘Includes all other races, unknown fam!ly mwme, unknown poveWsfelus, and unknown educahon,

NOTES: Poverty staws tsdetermmed mthe Nat!onal Health interview Suweybyfamtyslze, number ofchkken,andfamilyincomeusmg lSS7poverty levels defined bythe U.S. Bureau of the

Census. MSA is metropohtan stahshcal Srea.
Advance Data No. 191 ● February 26, 1991 17

Table 11. Percent of selected types of medical device implants never replaced, by selected sociodemographic characteristics:

United States, 1988

ArMcial

Ear venf Fixation Artificial hearl Lens

Characteristic tube derice joint valve Pacemaker implant

Percent of implants never replaced

Afl implants’ . . . . . . . . . . . . . . . . . . . . . . .

Age

Under3years . . . . . . . . . . . . . . . . . . . . . .

%5yeare . . . . . . . . . . . . . . . . . . . . . . . . .

G17years . . . . . . . . . . . . . . . . . . . . . . . .

18yearsand over . . . . . . . . . . . . . . . . . . . .

Under18years . . . . . . . . . . . . . . . . . . . . . .

18-44years . . . . . . . . . . . . . . . . . . . . . . . .

45-64years . . . . . . . . . . . . . . . . . . . . . . . .

65years Andover . . . . . . . . . . . . . . . . . . . .

Under45years . . . . . . . . . . . . . . . . . . . . . .

45-64years . . . . . . . . . . . . . . . . . . . . . . . .

65yearsandover . . . . . . . . . . . . . . . . . . . .

Under65years . . . . . . . . . . . . . . . . . . . . . .

6%74years . . . . . . . . . . . . . . . . . . . . . . . .

75years Andover . . . . . . . . . . . . . . . . . . . .

sex

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Female . . . . . . . . . . . . . . . . . . . . . . . . . . .

Race

White . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Hispanic origin

Non-Hispanic . . . . . . . . . . . . . . . . . . . . . .

Hispanic . . . . . . . . . . . . . . . . . . . . . . . . .

Family income

Lessthan $15,000 . . . . . . . . . . . . . . . . . . . .

$15,00G$34,999 . . . . . . . . . . . . . . . . . . . .

335,0000rm0re . . . . . . . . . . . . . . . . . . . . .

Poverly status

In poverty . . . . . . . . . . . . . . . . . . . . . . . . .

Notin poverty . . . . . . . . . . . . . . . . . . . . . .

Education

Lessthan 12years . . . . . . . . . . . . . . . . . . .

12years . . . . . . . . . . . . . . . . . . . . . . . . . .

13yearsormore . . . . . . . . . . . . . . . . . . . .

Geographic region

Northeast . . . . . . . . . . . . . . . . . . . . . . . . .

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . .

South . . . . . . . . . . . . . . . . . . . . . . . . . . . .

West . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Place of residence

MA. . . . . . . . . . . . . . . . . . . . . . . . . . . .

Central c.~ . . . . . . . . . . . . . . . . . . . . . . .

Outsidecentralcity . . . . . . . . . . . . . . . . . .

Not MSA . . . . . . . . . . . . . . . . . . . . . . . . . .

ea.?

90.6

67.7

54.7

64.7

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

66.2

72.6

67.3

87.7

67.3

92.4

65.3

72.0

67.6

67.3

68.7

74.5

67.6

63.3

60.0

64.3

73.6

73.5

68.4

73.6

65.4

69.5

94.6

. . .

. . .

. . .

. . .

90.6

93.3

e4.9

97.2

. . .

. . .

. . .

. . .

. . .

. . .

93.7

95.7

84.6

95.6

94.5

95.9

64.9

S3.6

ea.o

93.9

94.8

95.3

95.2

93.4

e’1.l

84.7

94.1

95.6

94.4

95.2

93.9

es.o

92.2

. . .

. . .

. . .

. . .

*1 00.0

93.1

90.9

92.5

. . .

. . .

. . .

. . .

. . .

. . .

90.6

93.3

92.6

84.7

92.3

88.5

91.0

93.5

92.3

91,4

92.1

91.9

92.6

92.3

85.4

95.2

93.9

91.1

91.8

90.3

92.5

93.2

95.3

. . .

. . .

. . .

. .

. . .

. . .

. . .

. . .

●92.7

94.9

96.4

. . .

. . .

. . .

97.9

92.5

95.1

W8.4

95.3

*1OO.O

94.3

97.1

98.5

●69.5

95.8

e6.5

94.3

96.9

91.5

92.7

96.6

100.0

95.6

93.5

97.5

94.1

84.3

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

87.1

83.2

83.9

84.5

84.6

84.7

*83.3

84.3

●92.3

80.2

87.6

89.1

●76.5

84.1

85.4

89.4

73.5

76.1

86.7

87.2

84.5

84.0

82.4

85.3

86.4

99.1

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

99.1

99.3

98.8

96.7

99.3

99.2

95.9

99.0

100.0

96.5

99.8

99.0

98.6

99.1

99.0

99.0

99.3

99.2

98.4

99.6

98.6

98.9

99.0

98.9

99.4

‘includes all other races, unknown family income, unknown pwerty status, and unknown education.

NOTES Percents exclude implants with unknown number of times replaced. Poferty status is delerrmned in the National HealthInterviewSuweybyfam!lysize, numberofchildren,andfamily income

using 1987poveq lwelsdefined bytie U. S. Bureau of the Census. MSAis~Wltin *ti*al area.
18 Advance Data No. 191 ● February 26, 1991

Table 12. Percent of selected types of medical device implants with 1 problem or more, by selected sociodemographic characteristics:

United States, 1988

Twe of imnlan~

Ear vent Fwtion AnMciaf Lens

Characteristic tube denca joint implant Pacemaker

Allimplantsz . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Age

Under3 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3-5years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-17years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18years Andover . . . . . . . . . . . . . . . . . . . . . . . . . . .

Under 18years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-44years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-64years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65yearsand over . . . . . . . . . . . . . . . . . . . . . . . . . . .

Under65 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65–74years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

75years Andover . . . . . . . . . . . . . . . . . . . . . . . . . . .

Sex

Ma[e. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Race

w’hft~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Hispanic origin

Non-Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Family income

Lessthan $15,000 . . . . . . . . . . . . . . . . . . . . . . . . . . .

$15,000-$34,989 . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$35,0000rmore . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Poverty status

In poverty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Not in poverty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Education

Lessthan 12years . . . . . . . . . . . . . . . . . . . . . . . . . .

12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13yearsormore . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Geographic region

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Place of residence

MA, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Central icy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Outside central city . . . . . . . . . . . . . . . . . . . . . . . . .

NotMSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Percent ofimplarrfswithl problem or more

31.4

40.2

29.6

25.9

32.6

. .

. . .

. . .

. . .

. . .

. . .

. . .

31.9

30.5

31.2

*43 .1

31.6

*28.O

33.6

31.7

28.7

34.1

30.0

38.9

27.4

32.8

29.5

35.1

26.6

32.1

29.5

27.9

30.1

36.6

33.2

. . .

. . .

. . .

. . .

22.3

36.1

33.7

28.1

.

. . .

. . .

32.9

33.7

32.9

34.9

23.2

33.7

42.7

31.6

27.1

47.6

31.8

37.9

32.3

31.3

32.1

33.1

34.5

32.3

32.8

34.6

31.7

34.3

31.6

. . .

. . .

. . .

. . .

●33.3

46.6

32.4

28.2

. . .

. . .

. . .

37.4

27.7

SO.6

“40.8

31.6

●32.7

32.9

26.1

38.6

43.9

30.2

31.0

32.4

31.7

26.1

28.3

35.5

32.4

30.4

31.4

29.9

34.5

49.3 26.9

. . .

.. .

. . .

. . .

. . .

. . .

. . .

. . .

56.0

46.1

46.8

. . .

.. .

. . .

. . .

. . .

. . .

. ..

. . .

●20.7

●24.3

29.7

48.8 21.6

49.7 32.5

49.4 26.4

48.1 *1 9.0

49.3 27.3

*52a *1 5.4

51.1 30.3

45.3 *21 .9

50.6 *28.2

51.7 “22.0

48.3 27.4

54.3 25.7

44.5 33.1

46.6 ●21 .1

52.4 *25.3

45.5 *24.8

46.6 ●27. 1

57.1 “30.0

48.4 28.0

47.7 27.0

49.0 29.1

51.5 ‘24.0

'Detailed estimates forafl!fic!al heativalves arenotshom b~usedab area@titi!mlly unreliable ~aresuh ofdl~ll ske. ~e~ment tiallenificial heWmMeimpbn&whhl problem or

more is 195,

2Excludea Implants wtth unknown problems experienced. tncludes all other rams, unknown family income, unknown poverly status, and unknown education.

NOTES: Poverlyatatus tsdetennmed inthe National Health lnterv!e.v Survey by fsmily size, number ofchildren, and famifyinwrneuaing 1987 p@erlylavels defined bythe U.S, Bureau of the

WTSUS. MSAlsme!ropOlftan slabstc-e!Brea,
Advance Data No. 191 ● February 26, 1991 19

Table 13. Number and percent distribution of selected types of medical device implants by

reason for original implanti United States, 1988

Number of Percent

Tjfpe of implant and reason implants distribti”on

for o.@ins/ implant in thousands of implants

Artiriciel joird

Total implants’ . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,625 100.0

Arthritis? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 776 47.9

Osteoatihriis . . . . . . . . . . . . . . . . . . . . . . . . . . . . 246 15.1

Rheumatoidarthritis . . . . . . . . . . . . . . . . . . . . . . . Ieo 11.7

Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 460 28.3

Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135 8.3

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 373 23.0

Fixation device

Total implants’ . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,880 100.0

Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,362 6S.8

Deformity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275 5.6

Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ●39 ●0.8

Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ●21 90.4

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,140 23.3

intraocular lens implant

Total implants’ . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,7&5 100.0

Cataract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,552 94.3

Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ●26 ●0.7

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166 4.4

Ear vent tube

Totalimplants’ . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,484 100.0

Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,057 70.7

Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ●4 ●0.3

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 474 31.7

Dental implant

Total implants’ . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275 100.0

Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 24.4

Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ●15 ●5.5

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1s4 70.5

‘Includes unknwn reason.

2\~udSS~lltih~S, spcirtedandm.specifted

NOT&Percsnkrrrey totslrnwethan100.0 becsusescmedevkes sreimplaniedfor multiplereasorrs.
20 Advance Data No. 191 ● February 26, 1991

Table 14. Total number of persons and number of persons with 1 medical device implant or more, and percent distribution by activity

limitation and respondent-assessed health status, according to type of implant and age: United States, 1988

Type of implant

Persons

Age, activity /irnitat/err, and

Artificial

All w“th 1 impk?nt Fixation Lens Artificia/ heart

respondent-assessed health status persons or more’ device irnp/anf joint Pacemaker valve

Number in thousands

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Under 65 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65 years And over . . . . . . . . . . . . . . . . . . . . . . . . . . .

All ages

Activity limtation:

All persons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

No limitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

bmitatlon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Majoractwity . . . . . . . . . . . . . . . . . . . . . . . . . . .

Otheractivittes . . . . . . . . . . . . . . . . . . . . . . . . . .

Respondent-assessed health status:

All persons2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Excellenttogood . . . . . . . . . . . . . . . . . . . . . . . . . .

Fairorpoor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Under 65 years

Activity Iimltatjon:

All persons.,,,......,,. . . . . . . . . . . . . . . . . .

No limtation . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Limitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Majoractivity . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other activities . . . . . . . . . . . . . . . . . . . . . . . . . .

Respondent-assessed health status:

All persons2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Excellenttogood . . . . . . . . . . . . . . . . . . . . . . . . . .

Fair or poor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65 years and over

Activity limitation:

All persons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

No limitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Limitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Majoractivity . . . . . . . . . . . . . . . . . . . . . . . . . . .

Otheractivitles . . . . . . . . . . . . . . . . . . . . . . . . . .

Respondent-assessed health status:

All persons2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Excellenttogood . . . . . . . . . . . . . . . . . . . . . . . . . .

Fair orpoor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

240,S90

212,207

28,633

100.0

a6.3

13.7

9.4

4,3

100.0

90.0

10.0

100.0

S9.4

10.6

7.7

2.9

100.0

92.7

7,3

100.0

63.0

37.0

22.6

14.4

100.0

70.6

29.4

11,051

6,617

4,434

100.0

56.4

43.6

30.2

13.3

100.0

72.6

27.2

100.0

61.6

38.2

29.2

9.0

100.0

79.6

20.4

100.0

46.4

51.6

31.9

19.7

100.0

62.7

37.3

4,382 2,582

3,369 502

1,013 2,080

Percent distribution

100.0

56.5

43.4

31.7

11.7

100.0

77.0

23.0

100.0

61.2

36.8

29.0

9.8

100.0

81.0

19.0

100.0

41.1

58.9

40.7

16.3

100.0

63.7

36.3

100,0

56.3

43.7

25.6

18.1

100.0

66.5

&3.6

100.0

58.6

41.2

33.5

*7.8

100.0

73.5

26.7

100.0

55.6

44.2

23.6

20.6

100.0

84.6

35.2

1,294

490

804

100.0

39.6

60.5

42.0

16.5

100.0

63.0

37.0

100.0

38.8

61.4

49.4

12.0

100.0

66.2

34.0

100.0

40.0

60.0

37.6

22.4

100.0

61.2

3s.9

460

62

398

100,0

36.0

62.0

40.0

21.7

100.0

49.2

50.8

100.0

●35.5

*64.5

●50.O

●14.5

100.0

*5 I .6

*48.4

100.0

38.4

61.6

36.7

22.9

100,0

46.9

51.1

253

121

132

100,0

34.0

66.0

47.6

16.2

100.0

59.7

40.3

100,0

●25.6

74.4

61.2

*1 3.2

100.0

58.7

41.3

100.0

40.9

59.1

35.6

*23.5

100,0

61.4

39.4

‘ includes all types 01implants reported, such as artificialjo!nts, fixation devices, artificial heart vatves, !ntramuler lens implants, pacemaker, ear vent tubes, infusion pumps, dental implants, silicone !mplanta, and artlhc!al arteriea, ligaments, and veins.

‘Excludes persons with unknown respondent-assessed health status.
Advance Data No. 191 ● February 26, 1991 21

Table 15. Number of persons by selected sociodemographic characteristics:

United States, 1988

Number of persons

Characteristic in thousands

Total’ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 240,890

Age

Under18years . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Under3yasrs . . . . . . . . . . . . . . . . . . . . . . . . . . .

3-5yaara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-17years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1844years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-64years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65yearsand over . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74years . . . . . . . . . . . . . . . . . . . . . . . . . . . .

75yearsand over.... . . . . . . . . . . . . . . . . . . . .

18yearsand over . . . . . . . . . . . . . . . . . . . . . . . . . .

Under45years . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Under65years . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Sex

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Female. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

63,569

11,122

10,826

41,621

103,066

45,573

26,6S3

17,565

11,118

177,320

166,635

212,207

116,657

124,232

Race

White . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203,256

Black . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29,382

Hispanic origin

Non-Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221,366

Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19,504

Family income

Lessthan$15.000 . . . . . . . . . . . . . . . . . . . . . . . . . .

S15,000-$34,999 . . . . . . . . . . . . . . . . . . . . . . . . . .

47,514

82,664

S35,0000rmore . . . . . . . . . . . . . . . . . . . . . . . . . . . 74,869

Poveriy status

In poverly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26,017

Notinpoverty . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195,466

Education*

Lessthan 12years . . . . . . . . . . . . . . . . . . . . . . . . . 39,502

12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66,301

13yearsormore . . . . . . . . . . . . . . . . . . . . . . . . . . 67,872

Geographic region

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49,271

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59,543

South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82,278

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49,797

Place of residence

MA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166,222

Centralcily . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74,860

Outsidecentralcity . . . . . . . . . . . . . . . . . . . . . . . . 111,362

Not MSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54,6S8

‘Includes all other races, unknown family income, unknown pverly status, and unknown educatton.

2Persons 18 years and over,

NOTES: Poverty status is determined in the Netionaf Heaf!h Interview Survey by fsrrsi~ size, number of children, and family Income

using 1987 poverly levels defined by the U.S. Bureau of the Census. MSA is rnetrqmhtsn Statsbcal area
22 Advance Data No. 191 ● February 26, 1991

Technical notes

Source and description of data

This report contains data from the

1988 National Health Interview Survey

(NHIS). NHIS is a continuing

cross-sectional nationwide survey of

the civilian noninstitutionalized

population. Each week a probability

sample of households in the United

States is interviewed by personnel of

the L’.S. Bureau of the Census.

Interviewers obtain information about

the health and other characteristics of

each household member included in

the NHIS sample.

NHIS consists of two pans: (a) a

basic health questionnaire that

remains the same each year and is

completed for every household

member and (b) special topics

questionnaires that va~ from year to

year, some of which maybe completed

only for selected persons in each

family. In 1988, the special topics

included medicaI device implants,

alcohol, occupational health, child

health, and acquired

immunodeficiency syndrome (AIDS)

knowledge and attitudes. These data

sets can be linked to provide

additional sources for analysis.

The total interviewed sample for

1988 for the basic health questionnaire

consisted of 47,485 households

containing 122,310 individuals. The

total response rate for the basic

questionnaire was 95 percent, or

5-percent nonresponse. Although all

households in the NHIS sample were

eligible to receive the Medical Device

Implant (MDI) Survey questionnaire,

an additional 3 percent of interviewed

households did not complete the MDI

Survey questionnaire.

The MDI Survey family-style

questions were administered to the

NHIS household respondent, and, in

most cases, the person with the

medical device responded to the

detailed questions about each reported

implant. The family-style questions on

medical device implants were used to

identify whether any family members

had any of the following implants:

artificial joints; surgically inserted pins,

screws, nails, wires, rods, or plates;

artificial heart valves; intraocular

lenses; silicone implants; pacemaker

ear vent tubes; infusion pumps; brain

or spinal column shunts; any other

type of surgically inserted shunt or

cathete~ or any other kind of

surgically inserted medical device,

such as artificial arteries and veins,

ligaments, and dental impIants.

For each device reported,

additional information was obtained,

including (but not limited to) date of

implantation, reason for implant,

status as an original or replacement

implant, number of replacements, and

any problems or complications

experienced with the current implant,

such as infection or pain.

The MDI Survey questionnaire

underwent a number of major

modifications during its development.

One of the changes was based on

findings from the pretest of the

proposed 1988 NHIS questionnaire,

conducted in Seattle, Washington, in

June 1987. Pretest results showed that

a disproportionately large number of

fiiation devices were being reported

for the family-style question about

“other” types of medical devices.

Although a specific set of questions

had not been planned for this type of

medical device, following the pretest a

separate section for f~ation devices

was developed.

These and subsequent changes

affected the date that the MDI Survey

questionnaire was implemented by

NHIS. Only the initial MDI Survey

family-style questions were finalized in

time for their use at the beginning of

calendar year 1988. As a result,

detailed information about specific

medical devices reported in NHIS in

January and February was

subsequently obtained by followup

telephone interview. The complete

MDI Survey questionnaire was

implemented in March 1988 and

remained a part of NHIS throughout

the year.

Sampling errors

Because estimates shown in this

report are based on a sample of the

population rather than on the entire

population, they are subject to

sampling error. When an estimate or

the numerator or denominator of a

percent is smrdI, the sampling error

may be relatively high. In addition,

the complex sample design of NHIS

has the effect of making the sampling

errors Iarger than they would be had

a simple random sample of equal size

been used.

Approximate standard errors of

the estimated percents in table 1 of

this report may be calculated by using

the formula

SE(p) =P ~0.00 00307 + 3,640/x

where p is the estimated percent and

x =py/100 withy = the population

denominator.

Approximate standard errors of

the estimated numbers (x) in tables 2,

3, 14, and 15 (except for age, sex, and

race for all persons when the

standard error is assumed to be 0.0)

may be calculated using the formula

SE(X)= ~0.0000307( X)Z+ 3,m

Approximate standard errors of

the estimated percents in tables 2,3,

and 14 may be calculated using the

formula

where p is the estimated percent and

y is the population denominator.

Approximate standard errc]rs of

the estimated numbers (X) in tables

4-10 and 13 maybe calculated by

using the formula

where X is the number of implants

and x is the number of persons with

the specific type of implant, as found

in table 3 (not the actual numlber of

implants, as shown in these tables).

For example, it is estimated that

1,625,000 artificial joints have been

implanted (table 5). Using this

formula, the standard error for the

estimated number is

1,625,000

v

3,640

0“0000307 + 1,294,000

= 87,000
Advance Data No. 191 ● February 26, 1991 23

(NOT7Z The number of implants may

be used as the population

denominator (x) for those few types

of implants for which the estimated

number of persons with a device is

not provided in this report-for

example, dental implants.)

Approximate standard errors of

the estimated percents (P) of

implants in tables 4-13 may be

calculated by using the formula

SE(P) =

v

,64O(P)(1OO–P)

Y

where P is the estimated percent and

y is the population denominator,

which in this case is the total number

of persons with that particular type of

implant (as found in table 3). For

example, it is estimated that

48,6 percent of all artificial joints

have been implanted for 5 years or

more (table 5). Using this formula,

the standard error for the estimated

percent is

,640(48.6)(100-48.6)=2 65

.

1,294,000

(NOTE The number of implants may

be used as the population

denominator (j) for those few types

of implants for which the estimated

number of persons with a device is

not provided in this report —for

example, dental implants.)

Ifxl and Xzare two estimates, then

the approximate standard error of the

difference (xl –x) can be computed

as follows

v~) xl +

X2 — % X2

where SE(XJ and SE(X2) are

computed using the appropriate

formulas previously presented in this

section and r is the correlation

coefilcient between xl and Xy

Assuming r = 0.0 will result in an

accurate standard error if the two

estimates are actually uncorrelated

and will result in an overestimate of

the standard error if the correlation is

positive or an underestimate if the

correlation is negative.

In this report, unless otherwise

noted, a difference was considered

statistically significant at the 5-percent

level if the difference (xl –xJ was at

least twice as large as its standard

error.

Definitions of terms

Medical device implant –Defined

for the MDI Survey questionnaire as a

device that is surgically implanted in

the body by a physician or other

health care provider to replace a body

part or function and cannot be

removed by the recipient. Excluded

were removable limb protheses;

silicone injections; organ transplants,

such as comeal transplants; natural

bone, artery, and vein transplants;

intrauterine devices (IUD’s); and

regular dentures, bridges, fillings,

sealants, and other forms of dental

work.

Artificial joint –A mechanical

substitute for a diseased or painful

joint in the body.

Fixation device-A medical device

that is surgically placed in the body to

hold or fasten a body part in a fwed

position, such as screws, pins, nails,

plates, cIips, or wires.

Intraocular lens implant –An

artificial lens that is surgically

implanted in the eye.

Pacemaker-A medicaI device that

is implanted in the body to regulate

heart rhythm.

Artificial heart valve –A substitute

valve that controls the flow of blood

through the heart and/or aorta.

Ear vent tube–A tube that is

placed in the ear drum (tympanic

membrane) to create a passageway

between the middle and outer ear.

Silicone implant –An implant of

material used to enhance form or

function of selected body sites; for

example, breast or chin enlargements.

Silicone injections are not included.

Catheter or shzmt–A flexible tube

implanted in the body for the

introduction or withdrawal of fluids.

Dental implant –An artificial

device or material used to promote

bone regeneration around the teeth

and jaws or to support a dental

prosthesis. Root canals, sealants,

fillings, crowns, and bridges are not

considered dental implants.

Other types of medical

devices-Include artificial blood

vessels (manmade tubes or ducts used

to carry blood in the body), artificial

ligaments (substitutes used to connect

bones and strengthen joints), artificial

urinary sphincters (substitutes that aid

the control of urine flow), and infusion

pumps (mechanical pumps, fully or

partizdly implanted, that introduce

chemotherapeutic fluids into the

body).

Related documentation

More detailed discussion of the

sample design, estimating procedures,

procedures for estimating standard

errors, nonsampling errors, and

definitions of other sociodemographic

terms used in this report have been

published in V7tal and Health Statistics,

Series 10, nos. 160 and 173; Series 1,

no. 18; and Series 2, no. 110 (20, 17,

21, and 22, respectively).

A public use data file based on

the 1988 MDI Survey questionnaire

was released in April 1990.

Information regarding the purchase of

the public use tape may be obtained

by writing the Division of Health

Interview Statistics, National Center

for Health Statistics, 6525 Belcrest

Road, Hyattsville, Maryland 20782,
Number 192 . December 4, 1990

Advance

Data

From Vital and Health Statistics of the National Center for Health Statistics

Fecundity and infertilityin the UnitedStates, 1965-88

by William D. Mosher, Ph. D., and William F. Pratt, Ph. D., Division of Vital Statistics

Introduction

In 1988, about 4.9 million women

15-44 years of age had an impaired

ability to have children. These women

comprised 8.4 percent, or about 1 in

12, of the 57.9 million women 1544

years of age. Of the 4.9 million, about

2.2 million had no births; the other

2.7 million had one birth or more

before their fecundity impairment.

The percent of women with impaired

fecundity in 1982 was the

same —8.4 percent, or 1 in 12.

However, the number of childless

women 25-44 years of age with

impaired fecundity has increased

because of delayed childbearing and

the ent~ of the Baby Boom cohorts

into the age range 2544 years.

Physicians providing infertility

services define infertili~ as the

inability to conceive after 12 months

or more of intercourse without

contraception. Using this definition,

infertili~ can be measured for

married couples since 1965. About

2.3 million married couples with

wives ages 15-44 years were infertile

in 1988– 7.9 percent, or sIightIy less

than 1 in 12. These figures were not

significantly different from the

findings in 1982; however, there

appears to have been an increase in

the number of women who used

infertility semices in the 12 months

before the survey.

In some popular descriptions of

infertility, it has been suggested that

there are 9 or 10 million infertile

couples, that 1 in 6 couples is

infertile, that infertility is increasing

rapidly, or that there is an

“epidemic” of infertility in the United

States. (See, for example, (l-4).) The

findings of this report indicate that

these perceptions are inaccurate, but

the increased use of infertility

services, the increased number of

childless older women with impaired

fecundity, and other factors (cited

later) may help to account for the

perception that infertility is increasing

or that it is more common than it

actuaIly is.

These are some of the highlights

of this report, which presents the first

national estimates of trends in the

fecundity status of all women of

reproductive age in the United States,

regardless of marital status, and

trends in the use of infertility

services. This report also updates

earlier publications describing trends

in fecundity and infertility among

married couples (5-7). The data for

1976, 1982, and 1988 are from Cycles

II, III, and IV of the National Survey

of FamiIy Growth (NSFG), conducted

by the National Center for Health

Statistics. The data for 1965 are from

the National Fertility Study,

conducted by Princeton University.

The 1988 NSFG was based on

personal interviews with a national

sample of 8,450 women 15-44 years

of age in the civilian noninstitutionalized population of the United

States. From January through August

1988, interviews were conducted with

8,450 women–2,771 black, 5,354

white, and 325 of other races. The

interview focused on the respondent’s

fecundi~ (or physical ability to have

children); past and current use of

contraception, dates and outcomes of

pregnancies, if any marriages; use of

family planning and infertility

sexvice~ and a wide range of social,

economic, and demographic

characteristics.

The concept of fecundity status

The respondent’s physical ability

to have children was measured by her

answers to a series of questions, not

by a medical examination. The

purpose of this series of questions

@-.mr.ti% &

-g

U.S. DEPARTMENT OF HEALTHAND HUMAN SERVICES *

~= Public Health Service

a Centers for Disease Control $%*+

>

National Center for Health Statistics

Jwaa Manning Feinleib, M.D., Dr. P.H., Director
2 Advance Data

was to classify women or couples into

three major groups: surgically sterile

(unable to have a baby because of

surgery); having impaired fecundity

(sterile for reasons other than

surgery, or difficult or dangerous to

have a baby); and fecund (no known

physical problem). The questions

included the following

●

●

●

●

●

Have you (or your husband . . .)

had an operation . . . that would

prevent you from conceiving

a(nother) baby. . .?

Some women find it physical~

impossible to have (more)

children. As far as you know, is it

physically possible or impossible

for you . . . to conceive a(nother)

baby, that is, to get pregnant

(again)?

What about your husband. . .?

Is it physically possible or

impossible for him to father

a(nother) child?

Some people are able to have a

baby, but have difficulty getting

pregnant or holding onto the

baby. As far as you know, is there

any problem or difficulty for you

(and your husband. ..) to

conceive or deliver a(nother)

baby?

Does your husband have any

diffic&y fathering a child?

In these questions, the words “as far

as you know” are important. Many

women who have never tried to

become pregnant do not know

whether they have a fecundity

impairment. Some women who

reported that they did not know of

any physical problems nonetheless

had long periods of time in which

they did not conceive although they

did not use any contraception. A few

women may be classified as having

fecundity problems because of

underreporting of either

contraceptive use or pregnancies, but

there is no evidence that this

underreporting has a significant effect

on any of the estimates presented

here. (See (6,7).) Finally, although

some women with fecundity problems

subsequently may have a child, their

reduced capacity for childbearing may

have an impact on the Nation’s birth

rate and on the estimates of couples

needing medical services to improve

their chances of childbearing.

The category “surgically sterile”

is divided into two parts:

“contraceptively sterile” and

“noncontraceptively sterile.” The

category “noncontraceptively sterile”

includes women who had surgery to

correct medical problems with their

reproductive organs, such as

hysterectomies for fibroid tumors or

endometriosis. The category

“contraceptively sterile” includes

women with all other sterilizing

operations, including most tubal

operations (and vasectomies

performed on their husbands, if they

are married), that were performed to

prevent pregnancy. The motives for

preventing pregnancy may have been

to control family size, to reduce the

health risks of pregnancy or other

contraceptive methods, or a

combination of these (8).

This classification of sterilization

operations differs from that used in

reports based on the 1976 and 1982

surveys. Therefore, the 1982 data for

the categories “contraceptively

sterile” and “surgically steriIe for

noncmtraceptive reasons” presented

here differ from 1982 data presented

in previous reports, but they are

intended to be as comparable as

possible with the 1988 data. In 1988,

23 percent of all women 15-44 years

of age (or their husbands, if they

were married) were contraceptively

sterile, including 3 percent of

childIess women and 39 percent of

women with one birth or more

(table 1). Another 5 percent of

women had been surgically sterilized

for noncontraceptive reasons,

including about 2 percent of childless

women and 7 percent of women with

one birth or more (table 1).

Women with “impaired

fecundity” include (a) those who said

that it was impossible to have a baby

for some reason other than a

sterilization operation —such as

accident, illness, or unexplained

inability to conceive; (b) those who

said that it was physically difficult for

them to conceive or deliver a baby, or

that a doctor had told them never to

become pregnant again because a

pregnancy would pose a danger to the

woman, the baby, or both; and

(c) women or couples who were

continuously married, did not use

contraception, and did not became

pregnant for 36 months or more.

Each of these subcategories suggests

that the woman or couple has a

reduced, or “impaired,” capacity for

childbearing. Such conditions may be

treatable, however, and do not imply

that the woman or couple is

necessarily sterile.

About 4.9 million women had

impaired fecundity in 1988; this was

8.4 percent, as in 1982, or about 1 in

12 women. About 2.2 million childless

women had impaired fecundi~y. in

1988, aIong with about 2.7 mdhon

women with one birth or more. In

1982, these figures were 1.9 million

and 2.6 million, respectively.

“Fecund” is a residual category

consisting of women who were not

surgically sterile and did not have

impaired fecundity, and whose

husbands were not surgically sterile

and did not have impaired fecundity.

As shown in table 1, about

64 percent, or nearly two out of

three, women were classified as

fecund, including 87 percent of

childless women and only 46 ]?ercent

of those with one birth or more.

There are two main reasons for this

large difference between childless

women and those with one birth or

more: Childless women are younger

on average than women with one

birth or more, and many childless

women have never tried to become

pregnant. J% a result, childless

women are much less likely to be

surgically sterilized than women with

children and have had fewer chances

to discover or develop any fecundity

problems.

The percent with impaired

fecundity did not change significantly

from 1982 to 1988 in any of the 12

categories shown in table 1. The

percent contraceptively sterilized did

increase significantly overall (from 19

to 23 percent) and among women

with children (from 31 to

39 percent). The percent sterilized

for noncontraceptive reasons showed
Advance Data 3

Table 1. Number of women 15+4 years of age and percent distribution by fecundm status, according to parity and age: United States,

1982 and 1988

[Statistics are baaed on samples of the female population of the Untied States. See technical notes for estimates of sampling vanabilii and definitions of terms]

Surgically sterile

Impaired

Aft wvmen Contraceptive Noncuntraceptim fecundity Fecund

Pa@ and age 1988 7982 Totaf f988 1882 1988 1982 1988 1982 1988 1982

AIl pefltes Number in thousands Percent dktribufion

15-f4yeara . . . . . . . . . . . . . . . . 57,900 54,099 100.0 23.3 18.6 4.7 6.6 8.4 8.4 63.6 66.3

15-24 yeara . . . . . . . . . . . . . . . . 18,592 20,150 100.0 2.0 2.1 ●0.2 ●O2 4.8

2H4yeats . . . . . . . . . . . . . . . .

4.3 93.0 93<4

21,726 19,644 109.0 22.9 21.0 2.7 4.9

3%44years . . . . . . . . . . . . . . . .

9.6 10.0 64.7 64.2

17,582 14,305 100.0 46.3 38.7 12.0 18.3 10.6 12.1 31.0 31.0

Parity O

15-54 yeara . . . . . . . . . . . . . . . . 25,129 22,941 100.0 2.6 1.7 1.5 1.4 8.8 8.4 86.9 86.6

15-24 years . . . . . . . . . . . . . . . . 14,978 15,547 100.0 *0.2 +0.1 0.0 0.0 4.1

25-34 yeara . . . . . . . . . . . . . . . .

4.1

7,252 5,626 100.0

95.7

3.1

95.6

*3.3 ●1.6 ●1.8

35-44 years . . . . . . . . . . . . . . . . 2,888

13.4 14.7

1,766 100.0

82.0

15.8

60.2

*1O.3 9.2 12.7 21.4 25.7 53.6 51.3

Parity 1 or more

l!%klyears . . . . . . . . . . . . . . . . 32,771 31,158 100.0 39.0 31.2 7.1 10.5 8.1 8.5 45.8 49.9

15-24 yeara . . . . . . . . . . . . . . . . 3,614 4,603 100.0 9.8 9.0 ●0.7 ‘0.6

25-34 years . . . . . . . . . . . . . . . .

7.7 5.2

14,474 14,016 100.0 32.8

81.8

28.1

85.2

3.3 6.1

3.5-14 yeara . . . . . . . . . . . . . . . .

7.6 8.1 56.1 57.8

14,6S3 12,539 100.0 52.3 42.7 12.5 19.0 8.5 10.1 26.7 26.1

NOTE Eecause ofroundingof estimates, figures may not add to totals.

a small but significant decrease, from

7 to 5 percent. The percent fecund

decreased significantly overall, from

66 to 64 percent, and among women

with children, from 50 to 46 percent.

However, none of the other changes

in the percent fecund shown in

table 1 was statistically s@ificant.

Looking at the data in table 1 by

age and parity, it can be seem that in

1988 the percent with impaired

fecundity increased with age among

childless women, from 4 percent at

ages 15-24 years to 21 percent at

ages 3544 years. This increase with

age among childless women ako

occurred in 1982. However, among

women with children in 1988, there

was no significant rise in the percent

with impaired fecundity as age

increased.

The data in tabIe 1 for childless

women shed some Iight on the issue

of delayed childbearing. The number

of women who were 35-44 years of

age and still childless was 1.766

million in 1982 this group increased

to 2.899 miIlion by 1988, an increase

of over 1 miIIion. Multiplying these

numbers by the percent with impaired

fecundity in 1982 and 1988, it can be

seen that about 454,000 women ages

3544 years were childless and had

impaired fecundity in 1982, compared

with about 620,000 in 1988, an

increase of 166,000, or more than

one-third. As a fraction of the 57.9

million women of reproductive age,

this is not a large increase. However,

as a percent increase (166,000/454,000

is about a 37-percent increase), it is

large.

A similar situation exists at ages

25-34 years: The number of childless

women increased from 5.628 miIIion

to 7.252 miIlion. There~ore, the

number with impaired fecundity

increased from about 827,000 to

972;000, even though the percent with

impaired fecundity did not increase.

These increases in the number of

childIess women with impaired

fecundi~ at oIder ages may help to

exTIain the popular perception that

impaired fecundity is increasing

rapidly (2-4), despite the lack of

increase in the overaIl percent with

impaired fecundity.

Note that the number of women

15–24 years of age decreased from

20.2 million in 1982 to about 18.6

miIlion in 1988, but the number ages

25-34 years increased by about 2

million, and the number ages

35-44 years increased by more than 3

million. In sum, a look at tabIe 1

shows seyeral important facts about

deIayed childbearing and impaired

fecundity. Firs4 the number of

women ages 25-44 years who have

had no births is increasing, partly

because the Baby Boom generation

(born 1946-64) is in that age range.

Seeond, the percent with impaired

fecundity dropped among childless

women ages 25-34 and 3544 years.

Third, the increasing number of

childless women in the age range

25-44 years has increased the number

of childless women who have

impaired fecundity, despite the

decIine in the percent who have

impaired fecundity. Thus, two of the

causes of the popuIar perception that

infertility is increasing are the delay

in childbearing and the aging of the

Baby Boom generation –not any

increase in the percents with

impaired fecundiq at given ages. This

perception that infertili~ is increasing

is also due in part to a number of

sociaI and medical changes, which will

be discussed later in this report.

Trends among married

couples, 1978-88

Data on fecundity status for

married coupIes \vith wives 154.4

years of age are availabIe from the

1976 NSFG and have been published

previously (5,9). However, the 1976
4 Advance Data

data on whether sterilization

operations were for contraceptive or

noncontraceptive reasons are not

comparable to the data for 1982 and

1988, so they are shown as a

combined “surgically sterile” catego~

in table 2. This combined “surgically

steriIe” category is comparable over

time. A married couple is classified as

surgically sterile if either the husband

or wife is surgically sterile as a result

of a vasectomy, hysterectomy, tubal

sterilization, or other sterilization

operation, regardless of the reasons

for the operation.

In 1988, as in 1976 and 1982, the

percent of couples surgically sterilized

increased with age and was greater

among couples with children (parity 1

or more) than among childless

couples (parity O). In 1988, one-half

(50 percent) of all married couples

with one child or more were

surgically sterilized; among couples

with one child or more in which the

wife was 35-44 years of age, the

proportion sterilized was about

two-thirds (68 percent).

In 1988, about 1.1 million

currently married coupIes were

childless and had impaired

fecundiq–about 21 percent of the

5.5 million childless married couples

in 1988 (table 2) but only about

3.9 percent of the 29.1 million

married couples with wives 15-44

years of age in 1988. This figure was

about the same as in 1982 In that

year about 1.1 million couples were

childless and had impaired

fecundity– about 22 percent of the

childless coupIes but only about

3.9 percent of all married couples

(table 2).

In 1988 as well as in 1976 and

1982, the percent of married couples

with impaired fecundity was higher

among childless women (21 percent

for parity O) than among women with

one birth or more (8 percent for

parity 1 or more). The percent with

impaired fecundity ako increased

with age, especially among childless

couplex In 1988, the percent of

childless couples with impaired

fecundity increased from 8 percent at

ages 15–24 years to 36 percent at

ages 35-44 years.

In 1982 and 1988, the proportion

of all couples with impaired fecundity

was about the same (11 percent in

both years). There was no significant

change in the percent of childless

couples who had impaired fecundity

(22 percent in 1982 and 21 percent

in 1988). Similarly, there was no

change from 1982 to 1988 in the

percent of couples with children

(parity 1 or more) who had impaired

fecundity– 8 percent in both years.

In fact, none of the changes in the

percent with impaired fecundity from

1982 to 1988 in any of the 12

age-parity categories in table 2 was

significant.

From 1976 to 1988, there were

some significant decreases in the

percent with impaired fecundity,

especially among couples with

children. In contrast, the percent of

childless couples with impaired!

fecundity did not change significantly

from 1976 to 1988 (21 percent in

both years). However, the percent of

childless couples with impairedl

fecundity did drop significantly at

ages 25–34 years, from 27 percent in

1976 to 20 percent in 1988, and at

ages 35-44 years, from 54 percent in

1976 to 36 percent in 1988.

One category in table 2 is

noteworthy Childless (parity O)

couples with wives ages 35-44 years.

The number of women in that

category increased from 565,000 in

1976 to 1,149,000 in 1988, a finding

that supports the perception that

delayed childbearing has increased

among married couples. Note,

however, that the percent of that

group having impaired fecundi~

decreased sharply, from 54 percent in

1976 to 36 percent in 1988. Finally,

multipIy the number of childless

women 35-44 years of age by the

Table 2. Number of currently married women 15-44years of age and percent distribution by fecundity status, according to parity and

age: United States, 1976, 1982, and 1988

[Statistics are based on samples of the female population of the United States. See technioel notes for eafimstes of sampling variabilii and definitions of terms]

Ail married women Surgically sterile lmpaked fmundity Fecund

Parify and age 1988 1982 1978 Toial 1988 1982 1976 1988 1982 1978 1988 198:? 1976

All parites Number in thousands Percent distribution

1.5-M yeare . . . . . . . . . 29,147 28,231 27,488 100.0 42.4 38.9 28.1 10.7 10.8 15.7 46.9 50.3 56.1

15-24 yeare . . . . . . . . . 3,337 4,741 6,020 100.0 6.0 “7.2 3.9 7.6 8.8 10.8 86.4 84.0 65,3

25-34 years . . . . . . . . . 13,646 12,924 12,179 100.0 31.1 31.6 25.9 10.9 9.7 15.5 58.0 58.6 58.6

35-44 years . . . . . . . . . 12,163 10.566 9,268 100.0 65.1 62.0 47.0 11.4 13.1 19.1 23.5 24.9 33.9

Parity O

15-44 years . . . . . . . . . 5,533 5,096 5,23-5 100.0 11.s 9.9 5.6 20.5 21.7 21.4 68.0 68.4 73.0

15-24 years . . . . . . . . . 1,404 1,989 2,738 100.0 0.0 *0.1 ●0.2 8.4 ●11.1 10.6 91.6 86.8 89.3

2%34yeara . . . . . . . . . 2,979 2,256 1,931 100.0 8.0 ●9.7 6.3 20.0 21.1 27.3 72.0 69.2 66.4

35-44 yeara . . . . . . . . . 1,149 653 565 100.0 34.5 ●33.3 26.6 36.4 47.8 53.9 29.1 ●I 8.9 17.2

Parity 1 or more

15-44 years . . . . . . . . . 23,614 23,134 22,254 100.0 49.7 45.3 33.6 6.4 6.4 14.3 41.9 46.3 52.2

15-24 years . . . . . . . . . 1,932 2,752 3,282 100.0 10.3 ●12.3 7.0 7.1 ‘7.2 11.1 82.6 60.6 62.0

25-34 years . . . . . . . . . 10,668 10,688 10,248 100.0 37.6 36.3 29.5 6.3 7.3 13.2 64.1 56.4 57.3

35--44 year n . . . . . . . . 11,014 9,713 6,723 100.0 68.3 64.5 48.2 8.8 10.0 16.6 22.9 25.5 34.9

NOIE Because of rounding of eeUmates, figures may not add to mtals.
Advance Data 5

percent with impaired fecundity to

obtain the number with impaired

fecundity: 305,000 in 1976,408,000 in

1982, and 418,000 in 1988. As a

percent of the 57.9 million women

ages 15-44 years, or even as a percent

of all 29.1 million married coupIes,

this increase of 0.1 million is not a

large increase. However, as a percent

of childless women ages 35-44 years

with impaired fecundi~ in 1976 (0.3

million), it is a large increase, and it

is this increase that people involved

in infertility services perceive.

Infertility among married

couples

Many physicians define infertility

as an inability to conceive after 12

months or more of intercourse

without use of contraception. This

concept is used as a screening device

to decide when couples should begin

to receive treatment, not to

determine sterility (5-7). This

measure has been criticized on the

grounds that some couples may take

longer than 12 months to conceive

but nevertheless will conceive without

medical treatment (10). However, it is

used here for two reasons. First, data

on this measure are widely used and

frequently requested. Second, because

data are available (for married

couples onIy) since 1965, this concept

can be used to measure trends over

this 23-year period – a much Ionger

time trend than for the impaired

fecundity measure.

Infertility differs from impaired

fecundity in two ways: First, infertili~

is a measure of difficulty in

conceiving only; impaired fecundity is

a measure of both difficulty in

conceiving and difficulty (or danger)

in carrying to term. Therefore, the

percents of married couples who are

infertile are usuaIly lower than the

percent with impaired fecundity.

Second, infertility was measured in

these nationaI surveys onIy for

married couples, because the concept

assumes continuous exposure to

intercourse and no underreporting of

pregnancies, which can be assumed

only of currently married women (7).

Impaired fecundity could be

determined for both married couples

and for unmarried women (11,12).

Table 3 contains data on married

couples with wives 15+4 years of age

by whether they had no births (parity

O) or one birth or more in 1965, 1982,

and 1988. (Data on infertili~ in 1976

have been published previously (13).)

From 1965 to 1982, the percent

surgically steriIe more than doubled,

from 16 to 42 percent. Among

couples with children, it nearIy

tripled, from 17 to 50 percent. But

among childless couples, the increase

was only about 4 percentage

points –from 7.3 to 11.5 percent.

The overall percent infertile

decreased from 11.2 percent in 1965

to 8.5 percent in 1982 and

7.9 percent in 1988. The percent

infertile did not change significantly

from 1982 to 1988, either overzdl or

among childless couples and those

with one birth or more (table 3).

However, the trends since 1965 were

different for childless couples

(primary infertility) than for coupIes

with one birth or more (secondary

infertility). Multiplying the percents

infertile by the population (tabIe 3)

to obtain the numbers infertile

produces the results shown in table 4.

Table 4. Number of currently married

women 15-44 years of age who were

infertile, by parity United States, 1965,

1982, and 1988

PanYy 1936 1982 1965

Number of women in millions

AJlparities. . . . . . 2.3 2.4 3.0

Parii O....... 1.0 1.0 0.5

Parifyl or more. . 1.3 1.4 2.5

SOURC& Calculatedfromtable 3.

Thus, the number of couples with

seconda~ infertili~ has declined

since 1965, from 2.5 miIIion in 1965

to 1.4 miIIion in 1982 and 1.3 million

in 1988. The number with primary

infertility increased from 0.5 miIlion

in 1965 to 1.0 million in 1982 and

remained at about 1.0 million in 1988.

Overall, from 1982 to 1988, there was

virtuaIIy no change in the number of

couples who were infertile (2.4

million in 1982 and 2.3 million in

1988).

Use of infertility services

As shown in the first three tables

of this report, the percents of aIl

women with infertility and impaired

fecundity are not increasing. The

perception of increasing infertility has

been discussed in detail elsewhere

(10,12,14). Briefly, however, this

perception is the result of the

foIlowing changes (10,12,14):

. Delayed childbearing and the

aging of the Baby Boom

generation, which has increased

the number of childIess women

25-44 years of age (as discussed

previously and shown in tables 1

and 2).

Table 3. Number of currently married women 15-44 years of age and percent distribution by infertility status, according to parity:

United States, 1965, 1982, and 1988

[Statistics are based on samples of the femala population of the United States. See technical notes for estimates of sampling friability and definitions of terms]

All married women Surgiaily sterile Inferfile Fecund

Parffy 1988 1982 1965 Tofel 1988 1982 19s5 7988 1982 1965 1988 1982 1965

All parities Number in thousands Percent distribution

Afl parities . . . . . . . . . . 29,147 28,231 26,454 100.0 42.4 38.9 15.8 7.9 8.5 11.2 49.7 52.6 73.0

Parity O . . . . . . . . . . . . . 5,533 5,098

Parityl or more. . . . . . .

3,492 100.0 11.5 9.9 7.3 16.5 19.6

23,614 23,134

14.5 70.0

22,962

70.5

100.0 49.7

78.2

45.3 16.9 5.4 6.0 10.8 45.0 48.7 72.3

NOTE Becauseofrounding of estimates, figures may not add 10totals.
6 Advance Data

●

●

●

The many new drugs and

techniques for treating infertility,

including the new reproductive

technologies of in vitro

fertilization, artificial

insemination, and surrogate

motherhood, and news coverage

of those techniques.

An increase in the number of

physicians trained to treat

infertility.

An increase in the number of

visits to physicians for infertility.

There are some data from the

1982 and 1988 surveys on use of

medical services for infertility. In

both sumeys women were asked –

. Have you (or your husband) ever

been to a doctor or clinic to talk

about ways to help you become

pregnant?

. (Not counting routine care or

advice about a pregnancy), have

you (or your husband) ever been

to a doctor or clinic to talk about

ways to help you prevent a

miscarriage?

Women who answered “yes” to either

of these questions were classified as

having used infertili~ services. These

women were asked the date (month

and year) of their most recent visit

for these medical services. From this

date it was possible to determine the

number of women who used services

in the 12 months, 3 years, or 5 years

before they were interviewed. These

statistics are shown in table 5. Note

that the number who used services in

the 12 months before the survey

increased from 1.08 million in 1982 to

1.35 million in 1988, an increase of

about one-quarter of a million

women, An increase of about the

same magnitude is shown in the

number who had one visit or more in

Table 5. Number and percent of women who had 1 visit or more to a doctor or cilnic for

advice or treatment to heip them become pregnant or carry a pregnancy to term, by when

the most recent visit occurred: United States, 1982 and 1988

Date of most

recent h7fertiMyw“sit 1988 7982 Increase 1988 1982

Number in thousands Percent

Inthe lastyear . . . . . . . . . . 1,346 1,062 264 2.3 2.0

lnthelsst 3years . . . . . . . . 2,392 2,056 336 4.1 3.6

lntAelsst 5years . . . . . . . . 3,123 2,867 256 5.4 5.3

NOTE Because of rounding of etismates, figures may not add 10 totals.

the last 3 or 5 years. Note that only

about 2 percent of women of

reproductive age had one visit or

more for infertility in the last 12

months. The percent of women who

had one infertility visit or more in the

last 12 months, 3 years, and 5 years

appeared to increase from 1982 to

1988, but none of the increases was

statistically significant.

It is also possible that the

number of visits per woman (or

couple) increased because more drugs

and procedures can be offered for

infertility than in past years.

However, data were not collected on

the number of visits each woman

made for infertility. Data on the

number of visits for infertili~ in the

past year would be a worthwhile

addition to future surveys.

References

1.

2.

3.

4.

5.

Silber S. How to get pregnant. New

York Warner Books. 1980.

Mann P. New help for the childless.

Readers Digest 13540. Jan 1986.

Lord L. Desperately seeking baby.

U.S. News and Worid Report 58-65.

Ott 5, 1987.

Friedrich O. The new origins of life.

Time 46-56. Sept 10, 1984.

Mosher WD, Pratt WF. Fecundity

and infertility in the United States,

1965-82. Advance data from vital and

health statistics; no 104. Hyattsviile,

6.

7.

8.

9.

10.

11.

12.

13.

14.

Ma~iand: National Center for Health

Statistics. 1985.

Mosher WD, Pratt %$’F.Fecundity,

infertility, and reproductive health in

the United States, 1982. National

Center for Health Statistics. Vhai

Heaith Stat 23(14). 1987.

Mosher WD. Reproductive

impairments in the United States,

1965-1982. Demography 22(3):415-30.

1985.

Pratt W. The motivation for surgical

sterilization. Paper presented at the

1984 annual meeting of the American

Public Health Association. Anaheim,

California 1984.

Mosher WD, Pratt WF. Reprod~ctive

impairments among married couples

United States. National center for

Health Statistics. Vhal Health Stat

23(11). 1982.

Menken J, Trusscll J, Larsen U. Age

and infertili~. Science

233(4771):1389-94. 1986.

Mosher W. Fecundity and infertility

in the United States. Am J Public

Health 78(2):181-2. 1988.

Mosher W. Fertility and family

planning in the United States:

Insights from the National Survey of

Family Growth. Family Plann

Perspect 20(5): 207–17. 1988.

Mosher W. Infertility trends among

U.S. couples: 1965-1976. Family

Plann Perspect 14(1):22-7. 1982.

OffIce of Technology Assessment.

Infertility: Medical and social choices.

Publication no OTA- BA-358.

Washington: U.S. Congress. 1988.
Advance Data 7

Technical notes

The National Survey of Family

Growth (NSFG) is a periodic survey

conducted by the National Center for

Health Statistics (NCHS) to collect

data on factors affecting childbearing,

contraception, infertility, and related

aspects of maternal and infant health.

The survey is jointly planned and

funded by NCHS, the National

Institute of Child Health and Human

Development, and the Office of

Population Affairs, all of the U.S.

Department of Health and Human

Services. Fieldwork was conducted

under contract by Westat, Inc., in

1982 and 1988.

For the 1988 suwey (Cycle IV),

personal interviews were conducted

with a national sample of women who

were 1544 years of age on March 15,

1988. In 1982, the population cxwered

was women 15-44 years of age living

in the civilian noninstitutionalized

population of the conterminous

United States. In 1988, Alaska and

Hawaii were included, so the

popr.dation covered was the citiian

noninstitutionalized population of the

entire United States. Interviews were

completed with 7,969 women in 1982

and 8,450 women in 1988. Further

details on the sample design and

procedures of the 1982 survey have

been published (6).

Interviews for Cycle IV of the

survey were conducted from January

through August 1988 for households

that had been interviewed in the

National Health Interview Survey

from October 1985 through March

1987. The National Health Interview

Survey is also conducted by NCHS.

As in previous cycles of the NSFG,

bIack women were oversampled.

Interviews were conducted in person

in the respondent women’s homes by

trained female interviewers and lasted

an average of about 70 minutes. The

interview focused on the woman’s

pregnancy history past and current

use of contraception; ability to bear

children (fecundi~ and infertility);

use of medical services for family

planning, infertility, and prenatal

care; marital histo~, occupation and

labor force participation; and a wide

range of social, economic, and

demographic characteristics.

Reliability of estimates

Because the statistics presented

in this report are based on a sample,

they may differ from the statistics

that would result if all 57.9 million

women represented by the NSFG had

been interviewed. The standard error

of an estimate is a measure of such

differences. The standard error of an

estimated number or percent is

calculated by using the appropriate

values of A and B from table I in the

equations,

SE(N) = V(A + B/N) N

and

‘E(p)=m

where N = the number of women

P = the percent

X = the number of women in

the denominator of the

percent.

The parameters shown in table I

were used to generate table II, which

shows preliminary estimates of

standard errors for percents of total

or white women. A similar table for

Table L Preliminary estimates of

parameters A and B for estimating standard

errors for women, by race

Parameter

Race A B

Total or white. . . . -0.00018 10,738

Black . . . . . . . . . -0.000626 5,181

the Cycle 111(1982) survey has been

published (6).

The chances are about 68 in 100

(about 2 in 3) that a sample estimate

would fzdl within one standard error

of a statistic based on a complete

count of the population represented

by the NSFG. The chances are about

95 in 100 that a sample estimate

would fall within two standard errors

of the same measure obtained if all

people in the population were

intervieii’ed. Differences between

percents discussed in this report were

found to be statistically significant at

the 5-percent level using a two-tailed

normal deviate test. This means that

in repeated samples of the same me

and size, a difference as large as the

one observed would occur in only

5 percent of samples if there were, in

fact, no difference between the

percents in the population.

In the text, terms such as

“greater:’ “less:’ “increase,” or

“decrease” indicate that the observed

differences were statistically

signiilcant at the 0.05 level using a

two-tailed normal deviate test.

Statements using the phrase “the

data suggest” indicate that the

difference was significant at the 0.10

(lO-percent) level but not the 0.05

(5-percent) level. Lack of comment in

the text about any two statistics does

not mean that the difference was

tested and found not to be significant.

The relative standard error (or

coefficient of variation) of a statistic

is the ratio of the standard error to

the statistic and usually is expressed

as a percent of the estimate. In this

report, statistics with a relative

standard error of 30 percent or more

Table Il. Prelimhra~ estimates of standard errors for estimated percents of total womem

1988 National Survey of Family Growth

Estimated percent

2 or 5 or 10 or 20 or 30 or 40 or

Base ofpercerrt 98 95 90 80 70 60 50

Standard error in percentage points

loo,ooo . . . . . . . . . . . . ..~. . . 4.8 7.1 9.8 13.1 15.0 16.1 16.4

500,000 . . . . . . . . . . . . . . . . . 2.1 3.2 4.4 5.9 6.7 7.2 7.3

1,000,000 . . . . . . . . . . . . . . . 1.5 2.3 3.1 4.1 4.7 5.1 5.2

5,000.000 . . . . . . . . . . . . . . . 0.6 1.0 1.4 1.9 2.1 2.3 2.3

10.000,000 . . . . . . . . . . . . . . . 0.5 0.7 1.3 1.5 1.6

30,000,000 . . . . . . . . . . . . . . . 0.3 0.4 u 0.8 0.9 (H 0.9

50,000,000 . . . . . . . . . . . . . . . 0.2 0.3 0.4 0.6 0.7 0.7 0.7

58,000,000 . . . . . . . . . . . . . . . 0.2 0.3 0.4 0.5 0.6 0.7 0.7
8 Advance Data

are indicated w-ith an asterisk(”).

These estimates may be viewed as

unreliable by themselves, but they

may be combined with other

estimates to make comparisons of

greater precision.

Statistics in this report also may

be subject to nonsampling error, that

is, errors or omissions in responding

to the interview, recording answers,

and processing data. The data have

been adjusted for nonresponse by

means of adjustments to the sample

weights assigned to each case. Other

types of nonsampling error were

minimized by a series of quality

control measures described in reports

on Cycle III (such as (6)).

The 1965 National Fertility

Study

The figures on infertili~ status

for 1965 were computed from the

1965 National Fertility Study. Some

were published previously (5,7,9,13).

Descriptions of the 1965 survey

design and procedures have been

published (9,13).

Unlike the NSFG, the 1965

National Fertility Study did not

include procedures to obtain

weighted numbers; therefore,

approximate numbers of currently

married women for 1965 were

obtained from population estimates

published by the U.S. Bureau of the

Census. The weighted numbers shown

in table 3 differ from those shown for

1982 and 1988 in the following ways:

Alaska and Hawaii are included in

1965 and 1988, but not in 1982, and

the age range in 1965 includes

currently married women 14 years of

age. The sources of the population

estimates have been published (5).

Definitions of terms

Fecundiy status –Fecundity is the

physical ability of a woman or couple

to presently have children and refers

to women or couples with any

number of children (unless classified

by parity). It is determined by

responses to questions asked in the

NSFG interview, not by a medical

examination. Fecundity status, as

shown in tables 1 and 2 of this report,

has three main categories: surgically

sterilized, impaired fecundity, and

fecund. Women were classified as

surgically sterile if they (or their

current husband or partner) had had

a sterilizing operation (for example, a

vasectomy, hysterectomy, or tubal

ligation). Surgically sterile is divided

(in table 1) into two subcategories:

contraceptive and noncontraceptive.

Impaired fecundity includes women

who reported that (a) it was

impossible for them to have a baby

for any reason other than a sterilizing

operation, (b) it was difficult to

conceive or difficult or dangerous to

carry a pregnancy to term, or (c) they

had been continuously married or

cohabiting, had not used

contraception, and had not had a

pregnancy for 3 years or more. In

tables 1 and 2, “fecund” is a residual

category and means that the woman

(or couple) was not surgically sterile

and did not have impaired fecundity.

The percent of currently married

couples with impaired fecundity is

higher than the percent infertile

because impaired fecundity includes

difficulty or danger carrying to term

as well as difficulty conceiving,

whereas infertility includes only

difficulty in conceiving. For a more

detailed discussion of the concept of

fecundity status, see the text of this

report and a previously published

report (6).

Infertility status –Infertility is a

medical concept; it is used by

physicians to identify couples who

may need to be evaluated to see

whether they need medical services to

help them have a baby. It is

computed for married couples only in

the NSFG. When neither spouse is

surgically sterilized, a couple is

considered infertile if, during the

previous 12 months or longer, they

were continuously married, had not

used contraception, and had not

conceived. Infertility status, as shown

in table 3, refers to the categories

surgically sterile, infertile, and

fecund, where fecund means “not

surgically sterile and not infertile.”

Use of infertilin’ services – A

woman was classified as having used

infertility services if she answered

“yes” to either of the following two

questions:

. Have you (or your husband) ever

been to a doctor or clinic to talk

about ways to help you become

pregnant?

. (Not counting routine care or

advice about a pregnancy), have

you (or your husband) ever been

to a doctor or clinic to talk about

ways to help you prevent a

miscarriage?

Women or couples who have had

infertili~ services may not be

currently infertile if the treatment or

advice was successful.

Age –Age was classified by the

age of the respondent in completed

years as of March 15, 1988, the

approximate midpoint of interviewing.

Marital status – Women were

classified as currently married,

widowed, divorced, separated, or

never married. In Cycles III (1982)

and IV (1988), to improve the

comparability of NSFG data on

marital status over time and with

other sources of data, informally

married, or cohabiting, women (who

reported that they were not married

but were living with their sexual

partner) were classified by their legal

marital status. In all NSFG surveys, a

woman who was married but

separated from her spouse was

classified as separated if the reason

for the separation was marital discord

and as currently married otherwise.

Parity –Parity refers to the

number of live births the woman has

had. For example, a woman classified

as “parity O“ has never had a live

birth. “Parity 1 or more” means that

she has had one live birth or nnore.

Cooperating agencies

Cycle IV of the National Survey

of Family Growth was supported in

part by the National Institute of

Child Health and Human

Development, National Institutes of

Health, and the Office of Population

Affairs, Office of the Assistant

Secretary of Health. These agencies

also participated in the design of the

questionnaire.
Number 193 . September 26, 1990

Advance

Data

From Vital and Health Statistics of the Natignal Center for Health Statistics

AIDS KnowledgeandAttitudesforJanuary-March1990

Provisional Data From the National Health Interview Survey

by Deborah A. Dawson, Ph. D., Division of Health Interview Statistics

Introduction

The National Center for Health

Statistics has included questions

about acquired immunodeficiency

syndrome (AIDS) in the National

Health Interview Survey (NHIS) since

1987, Data concerning the adult

population’s knowledge and attitudes

about AIDS and transmission of the

human immunodeficiency virus (HIV)

are collected to assist in the planning

of educational programs. Since the

initiation of the NHIS AIDS suwey,

its scope has widened to include

many questions on HIV testing and

blood donation experience. In

addition to assessing self-perceived

risk of becoming infected with HIV,

the survey incIudes a general risk

behavior question similar to that

asked by the Red Cross of potential

blood donors. At various points in its

history, the AIDS survey also has

been used as a tool for evaluating

public awareness campaigns and for

assessing the public’s willingness to

participate in a national

seroprevalence survey. Information on

the NHIS AIDS sumey sample is

contained in the technical notes at

the end of this report.

The first AIDS Knowledge and

Attitudes suwey was in the field from

August–December 1987. Provisional

results of that smvey were published

monthly in Advance Data From Vital

and Health Statistics (Nos. 146, 148,

150, 151, and 153). During the first 4

months of 1988, the NHIS

questionnaire was revised to meet

program needs at that time. The

revised AIDS Knowledge and

Attitudes Survey entered the field in

May 1988. Provisional findings for

the remainder of 1988 were published

periodically (Advance Data From Vital

and Health Statistics Nos. 160, 161,

163, 164, 167, and 175); in addition,

two special reports with a focus on

minority populations were published

from the 1988 data (Advance Data

From Ktal and Health Statistics Nos.

165 and 166).

The 1988 AIDS questionnaire

was used without modification

throughout 1989, and results were

published on a quarterly basis

(Advance Data From JZtal and Health

Statistics Nos. 176, 179, 183, and 186).

For 1990, the AIDS questionnaire

was revised again, with added

emphasis on HIV testing procedures

and on the distinction between testing

in connection with blood donation

and for other reasons. Provisional

survey findings will continue to be

published on a quarterly basis for the

1990 data.

The NHIS AIDS questionnaires

were developed by the National

Center for Health Statistics and

interagency working groups

established by the Information,

Education, and Risk Factor

Reduction Subcommittee of the

Public Health Service Executive Task

Force on AIDS. The working groups

included representatives from the

Centers for Disease Control; the

National Institutes of Health; the

Alcohol, Drug Abuse and Mental

Health Administration; and the

Health Resources and Semites

Administration.

The Advance Data reports

describing the NHIS AIDS data have

been restricted to simple descriptive

statistics to facilitate their timely

release. Thus, these reports do not

attempt to explain or interpret

differences among population

subgroups or to examine relationships

among various measures of

%xtwcIt.o #“+ *+4

@

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

g Public Health Sewice

~ Centers for Disease Control

‘%.>

National Center for Health Statistics

Manning Feinleib, M.D., Dr. P.H., Director
2 Advance Data

knowledgs and behavior. The hXIS estimates, but responses of “don’t Selected findings

AIDS data bases permit more

complex analyses than those

presented in this series of Advarzce

Data reports, and further exploration

of the data is encouraged. Public use

data tapes of the 1987 and 1988

AIDS Knowledge and Attitudes

Surveys are available at this time, and

the data tape for 1989 will be

released by the end of this year.

This report presents provisional

data for Janua~-}larch 1990 for

most items included in the NHIS

.41DS questionnaire. Table 1 displays

percent distributions of persons 18

years of age and over by response

categories, according to age, sex,

race~ethnicity, and education. In most

cases, the actual questions asked of

the respondents are reproduced

verbatim in table 1 along with the

coded response categories, In a few

cases, questions or response

categories have been rephrased or

combined for clearer or more concise

presentation or results. Refusals and

other nonresponse categories

(generally less than 1 percent of total

responses) are excluded from the

denominator in the calculation of

know” are included. The NHIS AIDS

questionnaire uses the phrase “the

AIDS virus” rather than “HIV,”

because it is felt to be more widely

recognized and understood. In this

report the two terms are used

synonymously.

The population subgroups used in

presenting the 1990 NHIS AIDS data

differ from those used in previous

reports. In reports based on the

1987–89 surveys, NO racial

categories were shown: white and

black. The 1990 reports show three

categories that reflect both race and

ethnic origin: non-Hispanic white,

non-Hispanic black, and Hispanic.

This change, which reflects the

increasing demand for information

about the Hispanic population, means

that estimates by race cannot be

compared directly between the 1990

and earlier NHIS AIDS Advance

Data reports. In addition, the

revisions in the questionnaire,

whether in actual wording or in

context and location of questions,

must be considered when interpreting

trend data.

The following highlights describe

survey results of the NHIS AIDS

Knowlege and Attitudes Survey for

the period January-March 1990.

Unless otherwise noted in the text, all

measures described remained stable

over the 3-month period. All

differences cited in the text are

statistically significant at the .05 leveI.

Table II shows provisional estimates

of the standard errors associated with

these results.

General AIDS knowledge –

General knowledge about AIDS and

HIV was ascertained through a series

of statements about the general

characteristics of the disease and how

it is transmitted. Respondents were

asked to classify each statement as

definitely true, probably true,

probably false, or definitely false. As

shown in figure 1, most measures of

general knowledge about AIDS and

HIV improved between the last

quarter of 1989 and the first quarter

of 1990. For the most part, the

changes observed between these two

quarters were larger than those

occurring throughout the entire year

of 1989.

Any person with the AIDS virus can pass it on to someone else during

sexual mtercourae.

87

There IS no cure for AIDS at present.

A pregnant woman wtIo has the AIDS tints can give it to her baby.

AIDS can reduce the body’s natural protection against disease.

79

A person can be infected with the AIDS virus and not have the

d~ease AIDS.

65

,::;::::,::,::.::.:.:.: Y:,:;,.,.::::::: ;,..,,:,..., x :,:;,y:~:y,y, <,;:,;.:,.::. ,,:,,.

:.y ::::f.::.:,, ,. :,,..,,:: :,,.,,;,.,:,:,:,:,,,::,,,,:,:.,;,::,::,, ,,::,,:,,,:

AIDS can damage the brian.

43

January-March 1990

Figure 1. Provisional estimates of percent of adults reporting that selected statements are definitely true: United States, January-March

1990
Advance Data 3

The largest increases were in the

areas where generaI knowledge was

lowest. For example, the percent of

adults who stated that it is definitely

true that AIDS can damage the brain

rose from 27 to 43 percent, and the

percent who thought it definitely true

that a person can be infected with the

AIDS virus and not have AIDS rose

from 58 to 65 percent. Knowledge

about the main modes of HIV

transmission improved as well,

despite a high baseiine level. The

proportions of adults who thought it

definitely true that HIV can be

transmitted via sexual intercourse and

from a pregnant woman to her child

each increased by 4 percentage

points to 87 and 86 percent,

respectively. The proportion of adults

who thought it veV likely that HIV

can be transmitted by sharing needles

for drug use remained stable at

96 percent. (Knowledge about HIV

transmission via needle sharing was

asked in a separate series of

questions with different response

categories.)

Despite the overall improvement

in knowledge, there was a decrease in

one area. In October-December

1989, 75 percent of U.S. adults 18

years of age and over realized that it

is definitely false that there is a

vaccine for the AIDS virus; for

January-March 1990, this proportion

was 68 percent. This change may

reflect failure to distinguish between

a vaccine and drugs that are used in

treatment of AIDS/HIV, e.g.,

zidovudane (AZT), or it may result

from publicity concerning progress

towards development of a vaccine.

Although most objective

measures of general AIDS knowledge

registered gains between the last

quarter of 1989 and the first quarter

of 1990, self-assessed knowledge

about AIDS decreased. In OctoberDecember 1989, 24 percent of adults

stated that they knew a lot about

AIDS; in January-March 1990, this

proportion declined to 18 percent.

Between the same two periods, the

proportion of adults claiming to know

nothing about AIDS increased from 7

to 11 percent. It is impossible to

determine whether this shift in selfassessed knowledge reflects a sense of

information overload associated with

the constantly increasing amount of

information available about

development of a vaccine for HIV,

modes of transmission, and forms of

treatment, or if it is solely an effect of

questionnaire design changes.

Although this question is worded the

same in 1990 as in preceding years,

its location has changed so that it is

now the first question asked.

During the first quarter of 1990,

as in all previous quarters, general

knowledge about AIDS varied by

demographic and socioeconomic

characteristics. Persons aged 50 ye?rs

and over were less knowledgeable than

younger persons. Knowlege increased

directly with number of years of

school completed. For 5 out of the 9

measures of general AIDS knowledge

examined, non-Hispanic white adults

were more likely than non-Hispanic

black or Hispanic adults to respond

correctly. For 3 of the remaining 4

measures, knowledge did not vary by

race/ethnicity for one measure

(awareness that AIDS can damage

the brain), non-Hispanic black adults

were the most knowledgeable. There

was no consistent difference by

gender in general AIDS knowledge.

These differentials in objective

measures of knowledge were

generally consistent with those in selfassessed knowledge about AIDS. The

population subgroups most likely to

state that they know a lot about

AIDS were persons below 50 years of

age and those with more than 12

years of school.

Two new items regarding general

AIDS knowledge were added to the

1990 NHIS AIDS survey. One of

these is a question asking whether the

respondent had ever heard the AIDS

virus referred to as “HIV.”

Two-thirds of adults were familiar

with this term as of January-March

1990, but this proportion was much

lower for p~rsons 50 years of age and

over (54 percent), with less than 12

years of school (42 percent), or who

were of Hispanic origin (48 percent).

The second new item was a statement

that there are drugs available to

extend the life of a person infected

with HIV. Slightly less than half of all

adults (46 percent) categorized this

statement as definitely true; an

additional 27 percent stated that it is

probably true.

Msinfonnation about HIV

h-cznwnission –The NHIS AIDS

questionnaire asked respondents to

estimate the risk of HIV transmission

associated with several forms of

casual contact with infected or

potentially infected individuals, e.g.,

working with someone with AIDS,

using public toilets, and so forth.

Respondents were offered fi~’e

response options for the Likelihood of

transmission: very likely, somewhat

likely, somewhat unlikely, very

unlikely, and definitely not possible.

Both “very unlikely” and “definitely

not possible” were interpreted as

correct responses, even for forms of

contact where our current

understanding of the virus indicates

that there definitely is no possibility

of transmission. The decision to

accept “very urdikely” as correct was

based on the large numbers of

respondents who chose that option,

seemingly unwilling to commit

themselves to the concept of a zero

probability.

As has been true since 1987, the

results for January-March 1990

indicated that many misperceptions

about HIV transmission remain. The

proportion of adults who assessed the

risk of transmission as “very unlikely”

or “definitely not possible” varied

from less than half for transmission

via insect bites or contact with the

saliva of an infected individual

(sharing eating utensils, being

sneezed/coughed on) to about threefourths for working near or attending

school with someone with HIV. Most

of these measures did not change

between October-December 1989 and

January-March 1990, but the

proportion of adults who thought it

very unlikely or definitely not possible

to become infected by working with

an infected individual rose from 71 to

76 percent. In contrast, the

proportion who thought it unlikely or

definitely not possible to transmit

HIV by sharing eating utensils

decreased from 49 to 46 percent.

As with general AIDS knowledge,

there were demographic and
4 Advance Data

socioeconomic differentials in

misperceptions, about HIV

transmission. Adults 50 years of age

and over were more likely than

younger adults to be misinformed,

and non-Hispanic black and Hispanic

individuals generally had more

misperceptions than did non-Hispanic

white individuals. The level of

misinformation decreased with

increasing educational attainment.

Again, there was no consistent

differential by gender.

Information and communication

about AIDS —From OctoberDecember 1989 to January-March

1990, the proportion of adults who

reported discussing AIDS with their

children aged 10-17 years rose from

62 to 68 percent, and the proportion

who reported that their children had

received instruction in school about

AIDS rose from 63 to 73 percent.

N-inety-one percent of adults stated

that they had received information

about AIDYHIV in the month

preceding the NHIS AIDS survey.

The most commonly reported sources

of information were television (cited

b} 80 percent of adults), newspapers

and magazines (57 and 46 percent,

respectively), and radio (34 percent).

Sources of AIDS information

differed by race and ethnicity. Radio

was cited more frequently by

Hispanic and non-Hospanic black

adults than by non-Hispanic white

adults; the opposite was tme for

newspapers which were reported most

often by non-Hispanic white

individuals. There were three sources

of information that were reported

more often by Hispanic than nonHispanic individuals: street signs and

billboards, store displays, and mass

transit displays (signs in buses and

subways).

Blood donation and testing-There

was no change in blood donation

experience between October–

December 1989 and January-March

1990. Data for the first quarter of

1990 indicated that 39 percent of

adults had ever donated blood,

16 percent had donated blood since

March 1985 (when blood donations

were first routinely tested for HIV),

and 7 percent had donated blood in

the preceding year. Multiple

donations were common among those

who had donated blood. Of the

16 percent of adults who had

donated blood since March 1985, half

(8 percent) donated blood 3 or more

times. In the year preceding

interview, 4 percent of adults had

donated blood once, 1 percent had

donated blood twice, and 2 percent

had donated blood 3 or more times.

Seventy-eight percent of U.S.

adults had heard of the blood test to

detect HIV antibodies, up from

74 percent in the last quarter of

1989, Sixty-eight percent, seveneighths of those familiar with the

blood test, knew blood donations are

routinely tested for HIV. Three

percent of the persons who had

donated blood since March 1985– an

estimated 700,000 individuals —

reportedly did so at least in part to

be tested for HIV. Use of blood

donation as a means of being tested

for HIV was reported more often by

men than women and was far more

common for non-Hispanic black

adults than other adults.

Not counting testing performed in

conjunction with blood donation,

10 percent of U.S. adults are

reported to have had their blood

tested for HIV antibodies, including

7 percent tested only once and

3 percent with multiple tests.

Including the 16 percent of adults

who were tested as a part of blood

donation since 1985, an estimated

26 percent of the adult population

has been tested. This is a substantial

increase over the estimate of

21 percent from October-December

1989, but the difference may partly

reflect questionnaire changes. In

1988-89, the NHIS AIDS

questionnaire asked if respondents

had had the AIDS blood test if they

did not respond positively but had

donated blood since March 1985, they

were included in the estimate of

persons tested. In this year’s survey,

respondents are asked separately

about blood donations and testing

exclusive of blood donations; then the

two estimates are summed.

The proportion of adults who had

been tested exclusive of blood

donations declined sharply with age,

from 16 percent of persons 18-29

years of age to 12 and 3 percent,

respectively, of those 30-49 years of

age and 50 years of age and over.

Men were slightly more likely than

women to have been tested exclusive

of blood donations, 12 compared with

9 percent. Hispanic and non-Hispanic

black adults were more likely than

non-Hispanic white adults to have

been tested outside of blood

donations, 15 and 14 percent

compared with 9 percent. The

probability of having been tested also

increased with education, from

7 percent of persons with less than

12 years of school to 13 percent of

those with more than 12 years of

school.

Of persons tested exclusive of

blood donations, 51 percent stated

that all their tests were required, i.e.,

conducted as a part of an activity that

includes mandatory blood testing. For

45 percent their tests were voluntary.

Three percent had both required and

voluntary tests. The most commonly

cited reasons for required tests were

hospitalization or surgery (reported

by 12 percent of persons tested

outside of blood donations) and

militaxy induction or sem-ice

(11 percent). In addition, 9 percent

were tested as a requirement of

employment, 6 percent for life

insurance, 5 percent for immigration

(cited by 35 percent of Hispanic

adults who were tested exclusive of

blood donations), 3 percent for

health insurance, and 12 percent for

other reasons. Individuals may lhave

cited more than one reason for a

single test (e.g., for both employment

and health insurance) or may have

had more than one required test;

thus, the sum of the individual

reasons exceeds the proportion of

persons with at least one required

blood test.

One-third of persons tested for

HIV antibodies exclusive of blood

donations – including both voluntary

and required testing —had their last

blood test at a doctor’s office or

HMO, and about one-fourth

(26 percent) were tested at a hospital

clinic or emergency room. Eleven

percent were tested at military

induction or service sites. Only

3 percent were tested at designated
Advance Data 5

AIDS clinic, counseling, or testing

sites. Just 38 percent were counseled

about AIDS and HIV before the test

was administered. Three-fourths

(77 percent) received their test

results; of those that did not, onethird reportedly wanted the results of

their tests. Of those persons who

received their test results, 27 percent

were given counseling about

prevention of HIV transmission at the

time the results were provided. SixtyWO percent got their test results in

person, compared with smaIler

proportions who received their test

results by mail (17 percent),

telephone (15 percent), or in some

other way (5 percent). The vast

majority (92 percent) of persons

tested for HIV felt that their tests

were handled properly in terms of

confidentiality of test results.

Seven percent of U.S. adults

reportedly plan to be tested for HIV

antibodies in the next 12 months,

according to the NHIS AIDS data for

January-March 1990. The proportion

of these persons who had been tested

previously has not yet been

determined, but it is Iikely that some

are repeaters. This figure, which has

remained fairly stable over the past

year, was two to three times higher

for minorities than for non-Hispanic

white adults. Sixteen percent of nonHispanic bIack adults reported plans

to be tested, compared with

11 percent of Hispanic adults and

5 percent of non-Hispanic white

adults.

Of persons who plan to be tested,

tsvo-thirds stated that they would be

tested voIuntanIy, because they

personally wanted to know if they are

infected. Twent@x percent plan to

be tested as part of blood donation,

and 16 percent cited the need for

testing as a requirement for a job.

Some individuals reported more than

one reason for anticipated testing.

l%e locations at which persons plan

to be tested are similar to those

reported for tests already conducted,

with private doctors or HMO’s, and

hospital emergency rooms or clinics

accounting for over half (36 and

22 percent, respectively).

R&k of HIV infection– The firstquarter 1990 NHIS AIDS survey

results indicated that 5 percent of

L1.S. adults, an estimated 9 million

persons, received blood transfusions

between 1977 and 1985. This is the

period when HIV is thought to have

entered the United States and when

routine screening of blood donations

began. HaIf of the nation’s adults

think the blood suppIy is now safe for

transfusions.

The 1990 AIDS survey reveaIed

increasing uncertain~ about the

efficacy of condom use in preventing

HIV transmission. The proportion of

adults who think condoms are very

effective in preventing transmission of

the virus declined from 33 percent in

October-December 1989 to

27 percent in January-March 1990,

while the proportion who did not

know rose from 7 to 12 percent.

Although these shifts occurred in all

population subgroups, the increase in

uncertainty was especially evident

among non-Hispanic black adults. For

this group, the proportion who did

not know how effective condoms are

in preventing HIV transmission rose

from 10 percent in the last quarter of

1989 to 20 percent in January-March

1990.

Eighty-one percent of adults felt

there was no chance of their having

been infected with HIV, and

15 percent said there was a low

chance. The proportions who thought

there was a medium or high chance

of already being infected were

2 percent and less than 1 percent,

respectively. Between the last quarter

of 1989 and the first quarter of 1990,

the proportion of persons who

thought there was no chance of their

becoming infected with HIV in the

future dropped from 77 to

73 percent, reversing a long-term

increase in this area. As of

January-March 1990, 21 percent

believed that they had a low chance

of becoming infected; three and less

than 1 percent, respectively, cited a

medium or high chance. Only

2 percent of adults reported being in

any of the categories associated with

a high risk of HIV infection. This

proportion has remained stable since

the risk behavior question was added

to the NHIS AIDS questionnaire in

1988.

As of January-March 1990, one

out of every seven adt.dts (14 percent)

knew someone with AIDS or HIV,

the same figure as in the last quarter

of 1989. This proportion was higher

for persons under 50 years of age

than for those age 50 years and over

but did not vary by sex or

race/ethnicity. The proportion of

adults who reported knowing

someone with AIDS or HIV

increased sharpIy with number of

years of school, from 7 percent of

persons with less than 12 years of

school to 21 percent of those with

more than 12 years of school.

Suggested citation

Dawson DA, AIDS knowledge and attitudes

for January-March 1990; Provision~ data

from the National Health Intewiew Survey.

Advance data from vital and health statistics;

no 193. Hyattsville, Maryland: National Center

for Health Statistics. 1990,

Copyright Information

Symbols

Quantity zero

o Quantity more than zero but less

than 0.05

This report may be reprinted without further

permission.
6 Advance Data

Table 1. Provisional estimates of the percent of persons 18 years of age and over with seleoted AIDS knowledge and attitudes from the

199o National Health Interview Sumey, by selected characteristics: United States, January-March 1990

[Data are based on household Interviews of the cMIian noninatitufionallzed population. The survey design, general quafmsations, and information on the reliabilii of

the estimates are given in technltxd notes]

Race/ethnlcify

Age Sex Non-Hispanic Education

1%29 30-4s 50 yeara Laas than More ttran

AIDS knowledge or attitude Tofal years years and over Male Female White Black Hispanic 12 years 12 years 12 yeara

Percent distribution

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1.

2.

3.

4a.

4b.

4C.

4d.

4e.

4f.

How much would you say you know about AIDS?

A lit . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Some . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Aiiile . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Nothing . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

In the past month, have you received information

about AIDS from any of these aourcea?l

Television . . . . . . . . . . . . . . . . . . . . . . . . .

Radi o . . . . . . . . . . . . . . . . . . . . . . . . . . .

Magazines . . . . . . . . . . . . . . . . . . . . . . . . .

Newspapers . . . . . . . . . . . . . . . . . . . . . . . .

Streetsigns/billboards. . . . . . . . . . . . . . . . . .

Store displaysktoredlstrlbutedb rochures . . . . .

Bus/streetoer/subweydlsplays.... . . . . . . . . .

Heaithdepartment brochures . . . . . . . . . . . . .

Workplacedtibuted brochures. . . . . . . . . . .

School distributed brochures . . . . . . . . . . . . .

Church distributed brochurea . . . . . . . . . . . . .

Communityorganization . . . . . . . . . . . . . . . .

Friend/acquaintance . . . . . . . . . . . . . . . . . . .

Gathe r . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

Recehfed noAIDSinformation inpaat month. . . .

Have you heard the AIDS virus called HIV?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

AIDS can reduce the body’s natural protection

against disease.

Dafinitelytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablytme . . . . . . . . . . . . . . . . . . . . . . .

Probablyfalse . . . . . . . . . . . . . . . . . . . . . . .

Definitalyfelse . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

AIDS can damage the brain.

Definhelytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablyfdse . . . . . . . . . . . . . . . . . . . . . . .

Defmitelyfalse . . . . . . . . . . . . . . . . . . . . . . .

Don’tknmv . . . . . . . . . . . . . . . . . . . . . . . . .

AIDSlsaninfectloua dlseasecausedby avlrus.

Deflnltelytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablytrua . . . . . . . . . . . . . . . . . . . . . . .

Probabiyfake. . . . . . . . . . . . . . . . . . . . . . .

Definifeiyfelae . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

Apersoncanbeinfected withtheAIDSvlms and

not have the disease AIDS.

Definitetytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablyfalse . . . . . . . . . . . . . . . . . . . . . . .

Definitelyfalae . . . . . . . . . . . . . . . . . . . . . . .

Don’tkncw . . . . . . . . . . . . . . . . . . . . . . . . .

ANYpersonv@trthe AIDSvlruscanpass Itonto

someone else through sexual Intercourse.

Definitelytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablyfslse . . . . . . . . . . . . . . . . . . . . . . .

Definitelyfalse . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

ADreanantwomen whohsstheAIDS viruscangive

it to h;r baby.

Definitelytrue . . . . . . . . . . . . . . . . . . . . . . .

Probabiytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablyfalse . . . . . . . . . . . . . . . . . . . . . . .

Definitelyfalse . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

Seefootnotes at snd oftable.

100

18

z

11

0

80

34

46

57

13

a

5

19

13

9

:

13

4

1

9

67

31

2

78

9

:

9

4s

2e

7

4

20

70

14

:

11

66

16

3

3

13

e7

9

1

0

3

e6

10

0

0

4

100

21

56

20,

2

0

SI

41

51

53

21

13

:

13

16

5

6

20

5

0

7

73

26

1

62

9

:

5

40

27

10

e

16

80

11

2

2

4

71

13

3

5

e

92

6

1

1

1

80

7

0

0

2

100

21

52

21

5

0

80

36

49

60

14

a

5

20

17

11

5

6

14

4

1

%

74

25

2

65

7

1

:

45

25

6

5

17

76

13

1

3

7

72

15

2

3

9

69

e

1

0

2

88

9

0

0

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100

12

33

31

25

0

7e

25

39

55

7

4

3

11

7

3

5

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7

3

1

11

54

42

4

66

11

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42

26

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56

la

2

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53

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22

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11

:

6

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38

44

59

15

9

6

17

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5

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65

33

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8

;

9

44

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5

19

74

13

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17

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86

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3

84

11

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100

18

47

24

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79

29

46

54

12

7

5

21

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11

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66

29

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78

9

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41

26

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2:

67

15

;

12

66

16

2

3

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86

6

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68

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0

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19

48

24

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81

33

46

5a

12

7

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18

12

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69

26

2

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1

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42

27

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70

14

2

3

10

88

16

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8

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:

87

10

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100

;

27

19

0

7e

35

44

48

21

14

13

24

15

12

:

18

3

1

10

64

33

4

65

10

4

5

17

47

25

:

22

71

12

2

1:

58

16

3

5

18

65

9

1

0

5

85

8

0

;

100

17

41

28

13

1

77

38

2

18

9

8

21

13

13

:

13

2

0

11

46

49

3

66

14

3

2

16

4s

23

10

1;

71

17

1

2

10

55

16

4

4

86

9

:

3

64

9

1

1

5

100

8

z

30

0

76

25

28

41

10

7

4

14

5

8

:

11

2

1

14

42

54

4

55

14

3

4

24

40

27

4

3

26

56

17

2

2

46

19

4

4

28

82

10

1

0

7

78

13

0

0

9

100

14

49

28

8

0

80

32

45

55

13

9

5

19

12

8

5

1;

3

1

9

65

32

3

80

9

1

2

7

44

27

6

2:

70

15

:

10

64

16

3

4

13

e9

6

0

0

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87

10

0

:

100

28

54

16

3

0

82

40

57

67

16

8

6

22

17

12

6

7

15

5

0

6

82

16

1

91

5

1

1

2

44

25

70

6

16

78

12

:

6

77

14

2

2

6

69

s

1

1

1

90

8

0

ii
Advance Data 7

Table 1. Provisional estimates of the percent of persons 18 years of age and over with selected AIDS knowledge and attitudes from the

1990 National Health Interview Survey, by selected characteristics: United States, January-March 1990-Con.

[Data are based on householdinterviewsof the oMllan nonlnafltutionalkadpopulation.The surveydesign, generalqualifications,and infcwrnationon the reliabilityof

the estimatesare given in taohnicalnotes]

Race/ethnfcity

Age sex Non-Hispanic Eduoafion

16-29 30-49 50 Year?r Less than More than

AIDS knowfadge or aftltude Total yaars years ad over Male Female White Black Hispanic 12 years 12 years 12 years

4(J.

4h.

41.

5.

5a

5b.

5C.

5d.

5e.

St.

There era drugsavaSlableto treatAIDS orthe AIDS

viruswhichcan lengthenthe Iiie of an infected

person.

Definitelytrue . . . . . . . . . . . . . . . . . . . . . . . 46

Probabtytfue . . . . . . . . . . . . . . . . . . . . . . . 27

Probablyfslse. . . . . . . . . . . . . . . . . . . . . . . 6

Deflniteiyfalse. . . . . . . . . . . . . . . . . . . . . . . 6

Don’tkncw. . . . . . . . . . . . . . . . . . . . . . . . . 16

There is a vaccineavaMble to the publicthat

protectsa personfrom gettktgthe AfDS virus.

Definitelytrue . . . . . . . . . . . . . . . . . . . . . . . 3

Probabiytme . . . . . . . . . . . . . . . . . . . . . . . 4

Probablyfalse. . . . . . . . . . . . . . . . . . . . . . . 11

Definitelyfalse. . . . . . . . . . . . . . . . . . . . . . . 66

Don’tknow. . . . . . . . . . . . . . . . . . . . . . . . . 15

There Is no curefor AIDS at present.

Definitelytrue . . . . . . . . . . . . . . . . . . . . . . . 86

Probabtyfrue . . . . . . . . . . . . . . . . . . . . . . . 6

Probsblyfase . . . . . . . . . . . . . . . . . . . . . . .

Definitelyfslsa. . . . . . . . . . . . . . . . . . . . . . . 1

Don’tknow. . . . . . . . . . . . . . . . . . . . . . . . . 5

How llke~ do you think it la that a personvhllget

AIDS orthe AIDS virusinfectionfromWorkingnear someonewiththe AIDS virus?

Verylikely . . . . . . . . . . . . . . . . . . . . . . . . . 3

Somewhatllkeiy . . . . . . . . . . . . . . . . . . . . . 6

Somewtmtunlikely. . . . . . . . . . . . . . . . . . . . 9

Veryunfikely. . . . . . . . . . . . . . . . . . . . . . . . 40

Definitelynotposaible . . . . . . . . . . . . . . . . . . 33

Don’tknmv. . . . . . . . . . . . . . . . . . . . . . . . . 6

Eatingin a restaurantwhere the cook hasthe AIDS

tirus?

Vetyllkety . . . . . . . . . . . . . . . . . . . . . . . . . 6

Somewhatlikety . . . . . . . . . . . . . . . . . . . . . 18

Somewhstunlikely. . . . . . . . . . . . . . . . . . . . 13

Vetyunlikeiy. . . . . . . . . . . . . . . . . . . . . . . . 32

Definitelynotpossible. . . . . . . . . . . . . . . . . . 21

Don’t know. . . . . . . . . . . . . . . . . . . . . . . . . 10

Sharingplates,forks, or glasseswith someonewho

hasthe AIDS virus?

Very iikely . . . . . . . . . . . . . . . . . . . . . . . . . 11

Somewhatllkefy . . . . . . . . . . . . . . . . . . . . . 21

Somawhatunlikety. . . . . . . . . . . . . . . . . . . . 14

Varyunlikely. . . . . . . . . . . . . . . . . . . . . . . . 26

Definitelynotpcealble . . . . . . . . . . . . . . . . . . 18

Don’tknow. . . ... . . . . . . . . . . . . . . . . . . . . 9

Usingpublictoltets?

Verylikefy . . . . . . . . . . . . . . . . . . . . . . . . . 6

Somewhatlikely . . . . . . . . . . . . . . . . . . . . . 14

Somewhatunlikely. . . . . . . . . . . . . . . . . . . . 12

Veryunlikely. . . . . . . . . . . . . . . . . . . . . . . . 35

Definitelynotposslble. . . . . . . . . . . . . . . . . . 25

Don’tknow. . . . . . . . . . . . . . . . . . . . . . . . . 9

Sharing needlesfor drug use withsomeonewho

has the AIDS virus?

Very likely, . . . . . . . . . . . . . . . . . . . . . . . . ~

Somewhatlikety . . . . . . . . . . . . . . . . . . . . .

Somewhatunlikely. . . . . . . . . . . . . . . . . . . . 0

VeryunlikeIy. . . . . . . . . . . . . . . . . . . . . . . . 0

Definitelynotposslble. . . . . . . . . . . . . . . . . . 0

Don’tknow. . . . . . . . . . . . . . . . . . . . . . . . . 2

Being coughedor sneezed on by someone who has

the AIDS virus?

Verylikety . . . . . . . . . . . . . . . . . . . . . . . . . 8

Somewhetlikely . . . . . . . . . . . . . . . . . . . . . 19

Somewhatunlikely. . . . . . . . . . . . . . . . . . . . 15

Veryunlikeiy. . . . . . . . . . . . . . . . . . . . . . . . 30

Definitelynotpossible. . . . . . . . . . . . . . . . . . 17

Don’tknow. . . . . . . . . . . . . . . . . . . . . . . . . 11

See foatnotes at end of table.

46

27

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9

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42

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4

5

13

13

35

28

5

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0

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1

5

17

:

21

6

52

25

6

5

11

3

3

10

74

10

6a

5

:

3

3

6

:

36

4

5

17

H

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7

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15

28

18

7

6

12

13

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26

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18

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2

0

0

0

1

9

21

14

29

17

11

56

26

5

5

8

2

2

10

78

8

90

5

:

2

2

5

10

42

39

2

3

15

14

36

24

5

8

19

E

20

4

3

10

13

40

30

4

98

:

0

0

0

6

17

18

36

16

5
8 Advance Data

Table 1. Provisional esthetes of the percent of persons 18 years of age and over with selected AIDS knowledge and attitudes from the

199o National Health Interview Suwey, by eelected characteristics: United States, January-March 1990-Con.

[Data are baaed on household interviews of the ch41ii noninatitufionafized population. The survey design, general qualifications, and information on the reliability of

the estimates are given In technical notea]

Race/ethnicity

Age Sex Non-Hiapenic Eduoation

16-26 3&49 50 years Less fhan

AIDS knowledge or attitude

Mora than

Total years years and over Male Female Whife Black Hispanic 12 yaats 12 years 12 years

5g. Attending schcd with a child who has the AIDS virus?

Very likely . . . . . . . . . . . . . . . . . . . . . . . . . 2

Somewhat likely . . . . . . . . . . . . . . . . . . . . . 6

Somawhat unlikeiy . . . . . . . . . . . . . . . . . . . . 10

Very unllkely . . . . . . . . . . . . . . . . . . . . . . . . 41

Der!niteFynot possible . . . . . . . . . . . . . . . . . . 35

Don’t know, . . . . . . . . . . . . . . . . . . . . . . . . 7

5h. Mosquitoes or other Insects?

VeVlikety . . . . . . . . . . . . . . . . . . . . . . . . . 11

Somewhat likely, . . . . . . . . . . . . . . . . . . . . 20

Somewhat unlikely . . . . . . . . . . . . . . . . . . . . 9

Very unlikely . . . . . . . . . . . . . . . . . . . . . . . . 24

Definitely nctpossible . . . . . . . . . . . . . . . . . . 19

Don’tkncw . . . . . . . . . . . . . . . . . . . . . . . . . la

6. Have you ever discussed AIDS w“ti any of your

children aged 10-17?2

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68

No. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . 32

Don’tkncw . . . . . . . . . . . . . . . . . . . . . . . . . -0

9. Have anyorall ofyourchlldren aged 10-17 had

instruction at school about AfDS?2

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . la

10. Haveyou werdonatedblcod?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 0

11a. Have you donated blood since March 1965?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 1

11b. Have you donated blood in the past 12 months?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 1

12. Howmanytimes have youdonated blocdsinca

March 1985?

Once . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Twice . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Threetimesormore . . . . . . . . . . . . . . . . . . . 8

Don’tknmv . . . . . . . . . . . . . . . . . . . . . . . . . 0

Didnotdonate blood since March 1985s. . . . . . 64

13. Howmany times haveyou donated blood inthe paat

12 months?

Once . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Twice . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Threetimesormore . . . . . . . . . . . . . . . . . . . 2

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 0

Dldnotdonate blcodinthepsst12 months4 . . . 93

14, Have youever heard ofablccsj teatthatcsn detect

the AIDS virus infection?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Don’tknow. . . . . . . . . . . . . . . . . . . . . . . . . 9

15. Tothebeat ofyourknowledge, are blood donations

routinely tested fortheAIDSvkus infection?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Don’t know. . . . . . . . . . . . . . . . . . . . . . . . . 8

Neverheard obtests . . . . . . . . . . . . . . . . . . . 22

16. Wasoneof ycurreaaons fordonafing blood because

youwantedtobetested fortheAIDSvirus infection?e

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 0

Neverheard ofte@ . . . . . . . . . . . . . . . . . . . 9

17. Exceptforblood donationasinoe 1865, haveyouhad

your blood tested for the AIDS virus infection?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

No, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65

Don’tknow. . . . . . . . . . . . . . . . . . . . . . . . . 2

Neverheardoftes~ . . . . . . . . . . . . . . . . . . . 22

See fmtnotes at end of teble.

;

9

40

42

2

13

23

10

24

18

12

58

42

51

20

29

34

86

0

23

77

0

9:

0

9

5

9

0

77

6

;

o

91

64

15

1

76

3

5

16

2

i

16

66

2

16

2

6

10

44

35

4

11

18

10

25

21

16

69

31

0

73

9

16

41

59

0

18

62

1

6

91

1

;

10

0

62

4

2

2

0

92

85

13

2

76

4

5

15

2

85

0

7

12

71

2

15

3

7

9

39

28

13

10

19

7

23

17

25

56

42

76

4

la

42

58

0

6

92

1

:

1

2

1

4

9:

2

1

1

0

97

64

31

5

54

3

6

36

1

77

17

3

59

2

36

2

7

10

41

34

6

12

20

8

25

la

17

56

44

0

71

2

51

49

0

20

80

1

9:

1

5

1:

:

4

2

2

0

91

79

19

2

69

4

6

21

4

00

9

12

66

2

21

Percerrtdiibution

2

5

10

41

35

7

10

19

9

24

20

19

78

21

0

75

11

15

29

71

0

12

66

0

:

0

4

2

5

8:

3

1

1

0

95

76

21

3

67

3

6

24

1

86

0

8

9

65

2

24

2

5

10

43

35

6

10

19

9

25

19

18

68

32

0

73

8

16

42

56

0

17

63

1

9;

1

5

3

9

8:

4

2

2

0

93

80

17

3

72

3

5

20

8:

0

8

9

69

2

20

4

7

9

39

31

10

E

7

20

16

20

72

28

0

69

2

33

66

0

12

87

1

9:

1

4

4

4

6:

3

1

1

96

65

33

2

53

5

a

35

;

13

14

49

1

35

2

6

9

34

39

8

::

8

20

18

19

59

41

73

11

17

24

78

0

11

89

0

9:

1

5

2

4

89

3

0

1

0

95

K

2

57

4

7

33

3

76

10

15

48

3

33

4

6

9

35

28

15

15

21

6

19

14

25

z

66

9

24

27

72

1

7

92

1

:

1

3

:

93

2

0

1

0

97

69

37

4

49

3

7

41

3

77

18

7

50

2

41

2

8

10

41

35

6

11

22

a

22

16

19

65

34

0

73

1:

37

63

0

14

86

0

6

94

1

4

3

7

8:

3

:

0

94

7a

20

3

6a

4

6

22

7:

1;

9

67

2

22

1

4

9

45

37

2

a

17

11

30

22

13

76

24

0

76

9

15

49

51

0

22

77

0

10

90

1

6

4

11

0

78

5

2

2

0

so

68

10

2

79

4

5

12

2

86

0

5

13

73

2

12
Advance Data 9

Table 1. Provisional esttmates of the percent of parsons 18 years of age and over with selected AIDS knowledge and attitudes from the

1990 National Health Interview Survey, by selected charecterktlcs: United States, January-March 1990-Con.

[Dats are baaed on household interviews of the cMllan nonb@ituUotiaed population. The survey design, general queliioatiorra, and information on the reliability of

the estimates are given in technical notes]

Age Sex Non-Hispanic Education

18-2S 30+9 50 pars Less fhan &fore than

AIDS knowledge or ai?itude Total yeera years and over Male Female White BIack Hispanic 12 years 12years 12 years

18.

19.

How many times have you had your blocd testad for

the AIDS virus infection, not Including bkxd

donations?

Once . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Twice . . . . . . . . . . . . . . . . . ..- . . . . . . . . 2

Three times or more . . . . . . . . ..-. . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . :

Never heard of/had teat7 . . . . . . . . . . . . . . . . ~

How many times in the peat 12 months txve you

had vour blood tested for the AJDS vims brfaction,

not ificludmg blood donations?

None . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Once, . . . . . . . . . . . . . . . . ..-. . . . . . . .

Twice . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Three times ormore . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . ..-. . . . . . . .

Never heard of/had teat7 . . . . . . . . . . . . . . . .

20a. Were the blood teats, including those you had

before the peat 12 months, required or U you go

forthem voluntarily,or were there some of asch?s

Allrequired . . . . . . . . . . . . . . . . . . . . . . . .

Allvolunteered . . . . . . . . . . . . . . . . . . . . . .

Someofeach . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

20b.Wereanyofthe bloodteeterequifad fod

Hosp.tiionora surgicel procedure?. . . . . . .

Healthinsurerrce? . . . . . . . . . . . . . . . . . . . .

Lifeinsurance? . . . . . . . . . . . . . . . . . . . . . .

Employment? . . . . . . . . . . . . . . . . . . . . . . .

Militaryinductionor mllltaryservice?. . . . . . . . .

Immigration? . . . . . . . . . . . . . . . . . . . . . . . .

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow. . . . . . . . . . . . . . . . . . . . . . . . .

21. ~enw=ymr~b~tetititie~=tiws

infections

1860, . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1989 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1988 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1987 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1986 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1985 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Oon’tknow. . . . . . . . . . . . . . . . . . . . . . . . .

22a. Was your last teat required or did you go for It

Voluntarfly?t

Required . . . . . . . . . . . . . . . . . . . . . . . . . .

voluntary . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

22b. Was the teat required fore

Hospitalization ora surgicsl procedura?. . . . . . .

Heatthinsuranoe? . . . . . . . . . . . . . . . . . . . .

Lifeinsuranca? . . . . . . . . . . . . . . . . . . . . . .

Employment? . . . . . . . . . . . . . . . . . . . . . . .

Militaryinductionor mllite~service?. . . . . . . . .

immigration? . . . . . . . . . . . . . . . . . . . . . . . .

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow. . . . . . . . . . . . . . . . . . . . . . . . .

23, Notincludingablooddonation, where wasyOurb3St

bloodtest forthe AIOSvirusdone?a

AIDS ciinic/counseling/testlngsite. . . . . . . . . .

Clinicrurrbyemployer . . . . . . . . . . . . . . . . .

Doctor/HMO. . . . . . . . . . . . . . . . . . . . . . . .

Publicheatthdepsrfment. . . . . . . . . . . . . . . .

Hospital/emergencyroom/outpatientdtnlc. . . . .

STDclinic . . . . . . . . . . . . . . . . . . . . . . . . .

Familyplanningcllnlc. . . . . . . . . . . . . . . . . .

Prenatalclinic. . . . . . . . . . . . . . . . . . . . . . .

Tuberculosiaclinic. . . . . . . . . . . . . . . . . . . .

Otherclinic. . . . . . . . . . . . . . . . . . . . . . . . .

Drugtreatrnentfacility. . . . . . . . . . . . . . . . . .

Militaryinduotion/sefvirxsite.. . . . . . . . . . . . .

Immigrafionsite. . . . . . . . . . . . . . . . . . . . . .

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow. . . . . . . . . . . . . . . . . . . . . . . . .

Seefootnotesat andoftile.

51

45

3

1

12

3

6

9

11

5

12

8

53

19

10

;

3

52

47

1

12

3

6

7

10

1;

3

4

33

6

26

0

0

1

6

1:

1

9

10

3

3

0

84

6

a

1

:

84

55

41

4

1

12

2

4

9

18

6

74

6

57

18

9

4

;

57

43

0

12

2

4

7

16

6

12

2

3

30

7

24

1

1

1

i

1!

1

6

8

2

2

8:

6

6

:

0

68

49

46

4

1

10

5

9

9

8

6

9

:

20

10

3

:

50

48

1

9

4

6

6

7

:

5

5

w

2:

:

0

i

6

1

9

2

:

9;

:

0

0

0

97

43

54

1

1

19

2

4

8

2

14

:

17

8

4

:

47

53

1

20

2

3

6

2

14

1

5

36

3;

4

;

10

7

E

8:

5

6

:

0

86

52

44

4

0

7

4

6

8

19

6

6

9

55

16

11

3

3

2

53

4a

1

6

4

8

7

17

6

7

3

4

32

;

o

0

0

i

1:

1

10

Percentdistribution

6

1

1

0

91

4

4

0

0

0

91

50

48

2

1

16

2

4

9

2

5

17

a

52

22

;

:

51

47

1

18

2

4

6

1

5

14

3

4

34

:

1

1

1

7

2

1

6

6

1

:

91

4

4

;

o

91

50

45

4

1

15

4

8

6

12

1

11

6

52

19

10

4

:

52

47

1

14

4

6

7

10

:

3

4

31

2:

0

0

1

5

0

11

0

11

10

2

2

0

86

5

7

1

;

86

46

50

2

0

6

;

11

15

1

15

9

67

19

9

3

:

47

52

0

8

0

2

10

14

1

14

5

2

2?

o

0

1

5

13

7

11

2

2

s;

6

6

1

0

65

64

34

2

3

3

1:

6

35

12

4

13

7

4

6

82

37

2

4

2

8

6

35

11

4

5

47

1;

2

1

5

9

5

1

5

1

:

93

3

3

;

o

93

59

40

1

19

1

;

2

16

17

8

55

16

9

3

2

3

57

42

18

1

1

5

2

16

16

1

2

39

6

31

1

2

7

2

2

6

6

1

2

0

91

4

4

0

:

91

54

40

5

1

13

2

4

9

16

6

14

9

52

16

10

6

1

1

57

42

1

13

3

4

8

15

6

11

3

4

26

2:

:

1

4

15

1

7

9

2

2

0

87

6

6

:

0

87

46

49

4

1

9

5

9

9

11

2

9

8

5s

20

9

2

;

48

50

1

6

4

9

8

10

2

6

4

4

35

2

0

0

6

0

10

0

12
10 Advance Data

Table 1. Provisional estimates of the percent of persons 18 years of age and over with selected AIDS knowledge and attitudes from the

1990 National Health Interview Survey, by selected characteristic= United States, January-March 1990-Con.

[Dats are based on household interviews of the cMfii nonlnsfituffonatlzad population. The sufvey design, general quafiioations, and inform~on on the reliability of

the estimates are given in technical notes]

Race/ethnlcffy

Age Sex Non-Hispanic Education

18-29 30-49 50 yeara

AIDS knowfedge or atf/tude

Less than More than

Total years years and over Male Female White Black Hisparrlc 12 yeara 12 years 12 yeans

24.

25.

26.

27,

28.

29.

30.

31.

32.

Before your lest blood test for the AIDS virus

Infetilon, were you counseled about the AIDS virus

and the meaning of the test?a

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

Don’t know . . . . . . . . . . . . . . . . . . . . . . . . . 0

Did you get the results of your last test?a

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . I

DidyouwanttheresuRa ofyourlaatteat?g

Yea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 5

When you received the rasufta of your last test, did

you receiva counseling or talk with a health

professional about how to lower your chances of

becoming infected withtheAIDSvirue orhowto

avoid paasing Itontoanother person?lo

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 0

Were the results given in person} by telephone, by

mailorinsome otherwa@o

In peraon . . . . . . . . . . . . . . . . . . . . . . . . . . 62

Sytelephone . . . . . . . . . . . . . . . . . . . . . . . 15

Bymail . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 1

Do you feel your last test for the AtDS virus Infection

was handled properly in terms of the confidentialii

ofyourtestresufts?s

Yea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 4

Do you expect to have a blood test for the AfDS

virusinfectionin thenext12months?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 3

Neverheardofte#’ . . . . . . . . . . . . . . . . . . . 22

Tell me which of these statements explaln why you

will have the blood teatll

Voluntarily, becauae you personally want to

knowifyouarelnfected . . . . . . . . . . . . . . . . 66

As partofablood donation ..,. . . . . . . . . . . 26

As part of a hospitaliition or surgical

procedure . . . . . . . . . . . . . . . . . . . . . . . . 10

Asarequirementforheafth insurance. . . . . . . . 11

Asarequlrementforiiie insurance. . . . . . . . . . 9

Asarequirement forajob, other than military. . . 16

Aaarequlrementforthe military . . . . . . . . . . . 10

Asarequirementforimmigrafion. . . . . . . . . . . 4

As a required part of some other acthdty that

includes a blood sample and automatic AfDS

testing. . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Where will you go to have a blood test for the AIDS

virus infection?ll

AIDSclinic/counseling/testingsfte . . . , . . . . . . 2

Clinicrun byemployer . . . . . . . . . . . . . . . . . 4

Doctor/HMO . . . . . . . . . . . . . . . . . . . . . . . . 36

Hospital/emergency rcmm/outpatient ciinic. . . . . 22

Otherclinic . . . . . . . . . . . . . . . . . . . . . . . . . 7

Pubficheatthdepartment . . . . . . . . . . . . . . . . 8

RedCross/bloodbank . . . . . . . . . . . . . . . . . 9

Other . ., . . . . . . . . . . . . . . . . . . . . . . . . . 8

Don’tknow. . . . . . . . . . . . . . . . . . . . . . . . . 3

See footnotes at end of table,

39

w

o

78

22

0

33

60

7

30

70

65

12

17

7

95

2

3

:

5

16

70

24

9

12

10

16

13

3

18

2

4

37

22

8

8

1:

4

39

60

0

76

22

1

37

59

4

25

75

0

59

18

19

3

0

so

4

5

7;

4

15

64

28

9

11

5

17

9

4

12

2

4

35

21

7

6

12

6

3

28

72

1

77

22

2

21

79

22

78

65

15

11

5

4

93

3

4

6;

2

36

50

26

14

10

13

14

2

2

11

8

42

24

1

4

14

4

2

42

57

0

77

22

0

33

62

5

26

74

0

63

13

16

6

1

92

4

4

;

4

21

63

26

6

11

9

16

15

3

15

2

4

37

22

4

7

9

11

3

Percent distribution

32

67

0

76

22

1

34

61

5

27

73

0

61

18

16

3

0

93

3

3

6:

3

24

69

24

12

11

8

16

4

4

15

1

5

36

23

10

9

7

5

4

35

54

0

75

24

1

32

64

4

21

79

0

59

18

16

5

1

93

3

3

7:

3

20

60

32

9

6

7

14

10

2

15

1

3

38

22

5

7

12

9

4

54

44

0

82

16

1

48

37

15

41

59

62

10

23

5

90

4

5

16

44

6

33

80

16

12

15

14

19

15

5

16

3

6

32

22

9

12

1

11

3

36

64

60

17

2

26

74

40

60

67

7

5

1

90

5

5

::

7

33

71

23

12

19

6

29

6

9

10

2

10

43

15

17

4

3

6

0

35

64

0

60

17

2

26

72

2

30

70

80

9

:

1

89

6

5

6

49

3

41

74

24

1:

11

18

7

6

15

2

42

25

10

11

2

2

4

35

64

0

z

1

2!5

66

7

z

o

65

13

17

4

1

93

3

3

6;

3

22

67

26

13

11

6

17

12

4

13

3

3:

22

5

7

7

9

3

40

59

0

76

23

1

39

56

5

24

75

0

55

19

20

6

1

93

3

4

7;

1:

60

28

6

9

6

14

11

2

16

1

3

33

21

8

7

13

12

3
Advance Data 11

Table 1. Provisional estimates of the percent of persons 18 years of age and over with selected AIDS knowledge and attitudes from the

199o National Haalth Interview Survey, by selected characteristics: United States, January-March 1990-Con.

[Date are based on household intewiaws of the civilian noninstitti~onakzed population. The survey design, general qualifications, and information on the reliability of

the estimates are given in technical notes]

Race/ethnicify

Age Sex Norr-h’isparrlc Education

l&29 30+9 50 yeara Less than More than

AIDS knowfedge or aftitude Total years yeara and over Male Female White Blaok Hispanic 12 years 12 years 12 yeara

33. Did you have a blood transfusion at any time

between 1977 and 1935?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

No, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84

Don’t know. . . . . . . . . . . . . . . . . . . . . . . . . 1

34. Doyouthink thepresent supply of blood is safe for

tranfuslons?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 22

35. Howeffective doyouthink theuseofa condom is

to prevent getting the AIDS virus through sexual

activity?

Veryeffecfiie . . . . . . . . . . . . . . . . . . . . . . . 27

SomewhateffectMe. . . . . . . . . . . . . . . . . . . 53

NOtatalleffedNe . . . . . . . . . . . . . . . . . . . . 4

Don’tknowhoweffective . . . . . . . . . . . . . . . . 12

Don’tknowmethcd . . . . . . . . . . . . . . . . . . . 4

36. Whatare your chances ofhaving the AIDS virus?

High . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0

Medium. . . . . . . . . . . 2

Low......::::::::::::: : ::.,..... 15

None . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 2

37. Whatare your chances ofgettlng the AIDSvirus?

High . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0

Medium . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Low . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

None . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 2

N/A– High chance of already having the AIDS

virus . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0

38. Haveyou ever personally known anyone w”fi AIDS

or the AIDS virus?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 1

39. Isanyofthese statemente true foryou?

a. Youhave hemophilia andhave received clotting

factor concentrates since 1977.

b. You are a native of Hati or Central or East Africa

who has entered the United States since 1977.

c. Youarea manwhohas hadsex with another

man atsometimesince 197T’,even 1 time.

d. You have taken illegal drugs by needle at any

time since 1977.

e. Since 1977, youareor have been thesexpartrter

of any pemon who would answer yes to any of

the items above (39 a-d).

f. Youhave hadsexfor money ordrugs at anytime

since 1977.

Yestoatleastl statement . . . . . . . . . . . . . . . 2

Notoall statements . . . . . . . . . . . . . . . . . . . 97

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 0

2

97

1

58

28

16

32

54

4

8

2

1

3

22

73

1

1

2:

85

2

1

2

1

4

96

0

5

84

1

52

28

19

30

55

4

8

2

1

2

17

78

2

1

2:

70

2

1

18

80

1

3

97

0

7

91

2

42

30

29

21

48

4

21

8

0

1

7

89

2

0

1:

84

3

0

:

1

A

o

4

95

1

56

24

20

31

52

3

10

3

1

3

18

79

2

1

4

71

2

1

13

8s

1

3

97

0

Percent distribution

6

93

1

44

32

23

24

53

5

14

4

0

1

14

82

2

0

2

19

76

2

0

15

83

1

2

96

0

5

94

1

53

26

21

28

54

4

11

3

0

2

16

81

1

:

22

73

2

0

14

84

1

2

98

0

5

94

1

37

36

26

30

41

5

20

5

1

3

16

77

4

1

1:

72

4

1

16

83

2

4

96

1

3

96

1

39

38

23

24

53

4

12

7

1

3

10

81

4

0

1:

77

4

1

15

84

1

3

97

0

6

es

2

36

34

30

20

44

6

22

8

0

3

8

64

5

0

4

11

80

5

0

7

92

1

2

97

1

5

94

1

50

29

21

26

54

4

12

3

1

1

14

83

1

:

18

76

2

1

12

87

1

2

96

0

5

94

1

57

25

16

33

56

3

7

2

0

2

20

77

1

1

2;

67

1

0

21

78

2

3

97

0

1Mutiple responses may sum 10 mOIe than 100.

29=W on pemonS ~Swering ~eS to quest(on 6, ‘-Do you have any children aged 10 through 17? Quetion 7 w3S “HOW manY do W have?

3perSonS ~nswering no or don’t know 10 question 10 or 1la.

4Pereon$ answering no or don’t know to question 10, 1 la, or 1lb.

5persons enewenng no or don? know 10 quest!on 14.

%ased on persons answering yes 10 quest!on 1la.

7PefSOIW anawermg no or don’t know to quest!ons 14 or 17.

Saased on persons answering yes 10 question17.

9Peraons answering no or don’t know to quest!on 25.

lo~sed on persons answeringyesto question25.

11Basedon persons enswwmg yes to question 30.
12 Advance Data

Technical notes

The National Health Interview

Survey (NHIS) is a continuous,

cross-sectional household interview

survey. Each week, a probability

sample of the civilian

noninstitutionalized population is

intemiewed by personnel of the U.S.

Bureau of the Census to obtain

information on the health and other

characteristics of each member of the

household. Information on special

health topics is collected for all or a

sample of household members. The

1990 National Health Interview

Survey of AIDS Knowledge and

Attitudes is asked of one randomly

chosen adult 18 years of age or over

in each family. The estimates in this

report are based on completed

interviews with 9,379 persons, or

about 87 percent of eligible

respondents.

Table I contains the estimated

population size of each of the

demographic subgroups included in

table 1 to allow readers to derive

provisional estimates of the number

of people in the United States with a

given characteristic, for example, the

number of men who have had their

blood tested for HIV. The population

figures in table I are based on 1989

data from the NHIS; they are not

official population estimates. Table 11

shows approximate standard errors of

estimates presented in table 1. Both

the estimates in table 1 and the

standard errors in table II are

provisionaL They may differ from

estimates made using the final data

file because they were calculated

using a simplified weighting

procedure that does not adjust for all

the factors used in weighting the final

data file. A final data file covering

the entire data collection period for

1990 will be available at the end of

1991.

Table 1. Sample sizes for the 1989 National

Health Interview Survey of AIDS

Knowledge and Attitudes and estimated

adult population 18 years of age and over,

by selected characterlstlc~ United States,

January-March 1990

Estimated

Sample

Characteristics

population

size [r?thousands

Alladuits . . . . . . . . . . .

Age

18-29 years ...,.....

30+9years . . . . . . . . .

50 yeara and over . . . . .

Sex

Male . . . . . . . . . . . . . .

Female . . . . . . . . . . . .

Race/ethnicily

Non-Hispanic white. . . , .

Non-Hispanic black. . . . .

Hispanic . . . . . . . . . . .

Education

Less than 12 years . . . . .

12years . . . . . . . . . . .

More than 12 yeara. . . . .

9,379 179,518

2,238 46,512

3,751 71,074

3,390 61,932

3,887 85,252

5,492 94,266

7,372 140,49s

1,150 19,438

520 14,162

2,074 39,807

3,434 68,559

3,778 69,365

Table IL Standard errors, expressed In percentage points, of estimated percents from the National Health Intenrlew Survey of AIDS

Knowledge and Attitudes, by selected characteristics: United States, January-March 1990

Age Sex Race/ethnicity Education

1&29 30+9 50 yeara Less than More than

Estimated percent Tots4 years yeara and over Male Female White B/ack Hispanic 12 years 12 yeara 12 years

5or95 . . . . . . . . . . . . . . . . . . . . 0.3 0.6 0.5 0.5 0.4 0.4 0.3 0.s

100r 90 . . . . . . . . . . . . . . . . . . . 0.4 0.8

1.2 0.6

0.6 0.7

0.5 0.5

0.5 0.4 1.1 1.7

150r 85.........,......,.. 0.5 1.0 :; 0.6 0.5 1.4

0.8

o.a 0.8

0.7 0.6

2.0

200r 80 . . . . . . . . . . . . . . . . . . . 0.5 1.1

1.0

0.s

0.8

0.9

0.7

0.s 0.7 0.s 1.5 2.3 1.1 0.9 0.8

250r75. . . . . . . . . . . . . . . . . . . 0.6 1.2 0.9 1.0 0.9 0.8 0.6 1.6 2.4 1.2

300r70 . . . . . . . . . . . . . . . . . . . 0.6 1.2

1.0

1.0 1.0

0.9

0.9 0.8 0.7 1.7 2.6

350r65 . . . . . . . . . . . . . . . . . . . 0.6 1.3

1.3

1.0

1.0

1.1

1.0

1.0 0.6 0.7 1.8 2.7

400r60. . . . . . . . . . . . . . . . . . . 0.7 1.3

1.3

1.0

1.0

1.1

1.0

1.0 0.9 0.7 1.9 2.8 1.4 1.1

450r 55 . . . . . . . . . . . . . . . . . . . 0.7 1.4 1.0

1.0

1.1 1.0 0.9 0.7 1.9 2.6

50 . . . . . . . . . . . . . . . . . . . . . . . 0.7 1.4

1.4

1.1

1.1

1.1

1.0

1.0 0.9 0.7 1.9 2.8 1,4 1.1 1.0
Number 194 ● January 4, 1991

Advance

Data

From Vital and Health Statistics of the National Center for Health Statistics

Cohabitation, Marriage, Marital Dissolution, and Remarriage:

United States, 1988

Data from the National Survey of Family Growth

by Kathryn A. London, Ph. D., Division of Vital Statistics

Introduction

The living arrangements of

women of chiklbearing age in the

United States have been changing

dramatically: Cohabitation has

become more widely practiced; men

and women have been deferring

marriage; the U.S. divorce rate,

despite having declined in recent

years, remains at a very high level;

and the rate at which peopie remarry

after divorce or widowhood has

falien.

Data from a recent survey of

American women, conducted by the

National Center for Health Statistics

(NCHS), illustrate these changes.

More than a third of women 15-44

years of age in 19SS had Iived with a

boyfriend or partner at some time

without being married to him. Only

about 40 percent of women under

age 30 years had married. More than

a third of first marriages among

women 15-44 years of age had

already ended in separation, divorce,

or widowhood, and among women

who had been married for the first

time in 1974 or earlier, the

proportion of disrupted first

marriages approached half. Only

16 percent of women whose first

marriages ended in widowhood or

divorce in 1980-84 had remarried

within a year, compared with more

than 33 percent of women whose first

marriages ended in 1965-69. These

findings are based on data from the

1988 National Survey of FamiIy

Growth (NSFG).

The National Survey of Family

Growth is conducted periodically by

NCHS on topics related to

childbearing, contraceptive practice,

and other aspects of matemaI and

chiId heaIth. Previous cycles of the

survey were conducted in 1973, 1976,

and 1982. In CycIe IV of the XSFG,

conducted in 1988, interviews were

completed with 8,450 women 15J44

years of age in the noninstitutionalized population of the United

States. Women of alI marital statuses

were interviewed. At the time of the

survey, 50.3 percent were married,

5.2 percent were not married but

Iiving with a partner, 2.8 percent

were separated, 7.8 percent were

divorced, 0.7 percent were widowed,

and 33.3 percent had never been

married. Further details about the

sample design and reIiabili~ of the

data presented in this report are

given in the technical notes.

The changes in family patterns

described above, aIong with the

growing proportion of births

occurring outside of marriage (1),

mean that, compared with earIier

decades, aduits and chiIdren spend

more of their lives outside of

married-couple households. Both men

and women can now expect to spend

more than half of their lives

unmarned (2,3). Recent estimates of

the proportion of children expected

to live in a single-parent household at

some time before reaching adulthood

range from about half to more than

70 percent (4,5). Because these

changes in family patterns affect the

health and well-being of aduIts and

children, it is important to document

SWlcrs,b #

*+ ●+

%

-@

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Public Health Service

$‘%> National

Centers

Center

for Disease

for Health

Control

Statistics Cx

Manning Feinleib, M. D., Dr. P.H., Director
2 Advance Data No. 194 ● January 4, 1991

the trends in cohabitation, marriage,

divorce, and remarriage.

Cohabitation

Until recently, U.S. data on

cohabitation —sharing living quarters

with a sexual partner without a

formal marriage –were largely

unavailable or limited in scope. The

NTSFG is one of only a few nationally

representative sumeys to include

information on cohabitation. The

1982 h-SFG produced some

information on cohabitation, and the

1988 NSFG added questions about

the respondent’s first cohabiting

union and up to two additional

cohabiting unions that were followed

by marriage. See the technical notes

for a discussion of the cohabitation

questions asked in the 1988 NSFG.

Only about 5 percent of women

15-44 years of age were cohabiting at

the time of the NSFG, as noted

earlier, but many more women had

cohabited at some time. A quarter of

the NSFG respondents reported that

they had cohabited before first

marriage, including women who had

cohabited but had not been married

(table 1). Women who were 25-29

years of age at the time of the survey

were more likely to report that they

had cohabited before first marriage

than were either younger or older

women. That older women were Iess

likely to have cohabited than women

25–29 vears of age suggests that

.

cohabitation has become more

common over time. Lower rates of

cohabitation among the youngest

}vomen are to be expected because

they have had less time to establish

cohabiting relationships.

Some women had not cohabited

before first marriage but did cohabit

sometime after their first marriage

ended, bringing the total of women

\vho had ever cohabited to more than

a third (33.5 percent). Of women

25–34 vears of age, nearly half had

cohabited at some time. The majority

of women who had cohabited (except

\vomen 40–44 years of age) had done

so before marriage. Almost all of the

younger w’ornen who had cohabited

had done so before marriage. More

Table 1. Number of women 15-44 years of age and percent who cohabited before

marriage, ever cohabited, and ever married, by race, age, and Hispanic origin:

United States, 1988

[Based on a sample of the nonmstiiutionalized population. See technical notes for discussion of the survey

design and estimstes of sampling variability]

Cohabited

Number before firs? Ever Ever

Race, age, and Hispamc origin in thousands marriage’ cohabited married

Tots? Percent

Aliases . . . . . . . . . . . . . . . . . . . . . . . .

15-19 years, . . . . . . . . . . . . . . . . . . . .

2&24 years . . . . . . . . . . . . . . . . . . . . .

25-29 years . . . . . . . . . . . . . . . . . . . . .

30-34 years . . . . . . . . . . . . . . . . . . . . .

3&39years . . . . . . . . . . . . . . . . . . . . .

4CM4years . . . . . . . . . . . . . . . . . . . . .

White

Alleges . . . . . . . . . . . . . . . . . . . . . . . .

15-19 years, . . . . . . . . . . . . . . . . . . . .

20-24 years . . . . . . . . . . . . . . . . . . . . .

2E-29years . . . . . . . . . . . . . . . . . . . . .

3&34years . . . . . . . . . . . . . . . . . . . . .

35-39 years . . . . . . . . . . . . . . . . . . . . .

40+4yeam . . . . . . . . . . . . . . . . . . . . .

Black

Alleges . . . . . . . . . . . . . . . . . . . . . . . .

15-19 years . . . . . . . . . . . . . . . . . . . . .

20-24 years . . . . . . . . . . . . . . . . . . . . .

25-29 years . . . . . . . . . . . . . . . . . . . . .

30-34 years . . . . . . . . . . . . . . . . . . . . .

35-39 years . . . . . . . . . . . . . . . . . . . . .

40-44 years . . . . . . . . . . . . . . . . . . . . .

Hispanic origin

Hispanic . . . . . . . . . . . . . . . . . . . . . . .

Non-Htspanic . . . . . . . . . . . . . . . . . . . .

57,900

9,179

9,413

10,796

10,930

9,583

7,999

47,077

7,313

7,401

8,672

9,010

7,936

6,745

7,679

1,403

1,364

1,459

1,406

1,170

872

5,557

52,343

25.4

6,2

30.3

39.1

33.3

23.9

12.3

25.0

9.2

31.6

37.9

32.6

22.4

11.0

29.3

*3.7

28.6

44.3

42.0

34.3

19.4

25.5

25.4

33.5

&4

32.4

45.1

44.9

38.4

26.3

33.6

9.3

34.2

44.7

44.9

37.7

25.3

35.0

●3.7

29.0

47.8

52.1

45.0

32.6

32.9

33.5

63.6

3.7

38.6

71.0

84.4

69.5

92.5

66.8

4.4

42.9

75.5

86.6

91.7

93.7

47.1

●1.5

23.6

47.7

69.0

75.1

63.5

62.1

63.8

‘Includeswomenwho had mhabded buthad notmarried.

ztndudesMtie, bkk, and other r==.

NOTES For Oefimtions of terms sea tecilnical notes. Because of rounding of estlmstes, figures may not add to totals

of the older women had cohabited

later. This is to be expected, because

many of the younger women had not

yet married in the first place, and

most had not yet dissolved a

marriage.

When all first cohabiting unions

are considered (either before first

marriage or sometime later), the data

show that slightly more than half

resuIted in marriages (some of which

subsequently dissolved), 37.2 percent

dissolved without marriage, and

10.0 percent were ongoing at the

time of the survey (figure 1).

Cohabitation was less Iikely to

progress to marriage among black

than among white women. More than

half (54.4 percent) of white women’s

first cohabiting unions were foHowed

by marriage, compared with

42.1 percent of black women’s.

When only women who had ever

been married are considered, it can

be seen that more than a quarter of

first marriages were preceded by

cohabitation (table 2). Broken down

by race, about a quarter of white

women and nearly a third of black

women lived with their first (or only)

husband before marriage. A

comparison of tabIes 1 and 2 shows

that in general the subset of evermarried women were more likely than

average to have ever cohabited,

although this was not true for women

ages 35 years and over.

Marriage

Although it is possible that

cohabitation is a substitute for

marriage for some women, most

women still marry eventually. Nearly

two-thirds of women 15-44 years of

age in 1988 had been married at least

once (tabIe 1). Naturally, a much

smaller proportion of the younger
Advance Data No. 194 ● January 4, 1991 3

50

r Total’ m Al 7

40

30

F

8

8

n

20

10

0

48.7

m

15.6

Intact Intact Dissolved Dissolved

cohabitation maniage marriage cohabitation

. .. ..

Fkfure 1. Percent distribution of first cohabltations of women 1S-44 years of age by outcome of cohabitation, according to race:

l.l~ted States, 1988

Table 2. Number of ever-married women 16-44 years of age, percent who cohabited with

their first husbands before marriage, and percent who ever cohabited, by race, age, and

Hispanic origin: United States, 1988

[Based on a sample of the noninstitutionalized population. See technical notes for discussion of the survey

design and estimates of sampling variability]

Cohabited

with rirst

Number in husband Ever

Race, age, and Hispanic origin thousands before marriage cuhabited

Total’ Percent

Allages . . . . . . . . . . . . . . . . . . . . . . . .

15-19 yeas E. . . . . . . . . . . . . . . . . . . .

20-24 yeare . . . . . . . . . . . . . . . . . . . . .

25-29 yeaE . . . . . . . . . . . . . . . . . . . . .

3M4 yeara . . . . . . . . . . . . . . . . . . . . .

35=39 year n . . . . . . . . . . . . . . . . . . . .

4044 years . . . . . . . . . . . . . . . . . . . . .

White

Alleges . . . . . . . . . . . . . . . . . . . . . . . .

15-19 years . . . . . . . . . . . . . . . . . . . . .

2C-24years . . . . . . . . . . . . . . . . . . . . .

25-29 yeare . . . . . . . . . . . . . . . . . . . . .

30-34 years . . . . . . . . . . . . . . . . . . . . .

35-39years . . . . . . . . . . . . . . . . . . . . .

4044years . . . . . . . . . . . . . . . . . . . . .

Black

Alleges . . . . . . . . . . . . . . . . . . . . . . . .

15-19yeare . . . . . . . . . . . . . . . . . . . . .

20-24years . . . . . . . . . . . . . . . . . . . . .

25-29years . . . . . . . . . . . . . . . . . . . . .

30-34years . . . . . . . . . . . . . . . . . . . . .

3S39yeam . . . . . . . . . . . . . . . . . . . . .

40-14yeara . . . . . . . . . . . . . . . . . . . . .

36,642

340

3,631

7,669

9,220

8,581

7,401

31,465

319

3,176

6,546

7,824

7,277

6.322

3,614

21

322

695

970

678

726

Hispanic origin

Hispanic . . . . . . . . . . . . . . . . . . . . . . . 3,452

Non-Hispanic . . . . . . . . . . . . . . . . . . . . 33,390

25.7

●23.3

36.5

36.7

29.5

20.0

10.7

24.9

●28.3

36.2

35.5

29.0

19.1

9.7

31.7

*44.6

44.0

42.5

36.5

25.9

15.7

24.0

25.9

39.9

●34.3

44.0

47.3

45.4

37.9

26.1

39.5

“33.6

44.1

4s.9

45.2

37.6

25.1

45.6

%4.6

46,4

52.2

53.9

41.0

33.2

37.1

40.2

‘Irkdudeswhte, black,and other races.

~T!3Forde fmit!onsof lermsae etechmcalnofes. Because ofroundtng ofesttmates, figur-may notaddtoto:a!s.

women had been married (Iess than

halfofthe women ages 20-24years

and almost none ofthe youngest

women), and four-fifths or moreof

women in the age groups30 and over

hadbeenmarried.

However, the trend over the last

two decades has been toward

postponing marriage. U.S. vital

statistics data show that the marriage

rate fornever-marned women has

fa11enbymorethan25 percent since

1970. Further, the average age at first

marriage has risen steadily since the

mid-1970’s (6). The NSFG data also

reflect the postponement of marriage;

only about 40 percent of respondents

underage 30 years had ever been

married.

The NSFG data show that black

women were much Iess Iikely than

white women to have married

(table l). Two-thirds ofwhite women

had married at least once, but fewer

than half of black women had. W’ithin

each age group, black women were

less likely to have married than white

women. Looking at women ages

40-44 years gives some indication of

the proportion of women who will

ever marry, because the majority of

women in this age group who wiIl
4 Advance Data No. 194 ● January 4, 1991

ever mar~ already have done so. By

this age, 93.7 percent of white

women had married, compared with

only 83.5 percent of black women.

Hispanic and non-Hispanic

women differed very little in the

proportion who had married. Slightly

more than 60 percent of both

Hispanic and non-Hispanic

respondents had been married at

least once.

Dissolution of first marriage

Marital dissolution was common;

more than a third of first marriages

had already ended in separation,

divorce, or widowhood (table 3), and

of course marriages that were intact

at the time of the survey will dissolve

eventually. Among women who had

been married in 1974 or earlier, the

proportion of marriages that already

had ended approached half.

Note that the proportions of

marriages that were dissolved are

biased downward in some cohorts

(italicized in table 3) because not all

of the women in the cohort had

completed the indicated number of

years since first marriage by the time

of the survey. For instance, all women

who married for the first time in

1980-84 had been married at least

3 years before the survey date, but

the remaining cells are biased

downward because only some of the

women had been married 4 or 5 years

before the sumey date.

The longer a marriage had

sumived, the less likely it was to

dissolve. The data for women who

were married in 1965-69 illustrate

this pattern. All of these women had

married at least 18 years before the

survey and thus had been exposed to

the risk of marital dissolution for the

full range of durations shown in

table 3. Some 5.9 percent of these

marriages ended within a year. An

additional 3.9 percent ended in the

following year, bringing the total to

9.8 percent dissolved within 2 years.

For the most part, the number of

additional dissolutions declined with

each year after marriage. Yet, even

after 15 years, marriages continued to

dissoIve in substantial numbers. Of

course, at very long maritaI durations,

marital dissolution rates should

increase rather than decrease over

time, because more of the

dissolutions are due to widowhood

and fewer are due to separation or

divorce. However, for women 15-44

years of age, dissolution by

widowhood is relatively uncommon

(figure 2).

BIack women’s marriages were

more Iikely to have dissolved than

white women’s at each duration since

first marriage. Anong black women,

more than half of all first marriages

already had ended by the survey date,

except among those most recently

married (1980–84). However,

dissolution was common among white

women, too, approaching 50 percent

among white women who had

married in the periods 1965-69 and

1970-74.

Black women and white women

15-44 years of age were about equally

IikeIy to have been widowed in their

Table 3. Number of ever-married women 15-44 years of age and cumulative percent whose first marriage was dissolved by separation,

divorce, or death, by years since first marriage, race, year of first marriage, and Hispanic origin: United States, 1988

[Based on a sample of the noninstifutionalized population. See technical notes for discussion of the sutvey design and estimates of sampling variability]

Years since first marriage

Race, year of first Number in ,4//

marriage, and Hispanic origin thousands years 1 2 3 4 5 10 15

Tota~’ Cumulative Dercent dissolved at time of interview

Allyearsz . . . . . . . . . . . . . . . . . . . . . . .

1980-84 . . . . . . . . . . . . . . . . . . . . . . .

1975-79 . . . . . . . . . . . . . . . . . . . . . . .

1970-74 . . . . . . . . . . . . . . . . . . . . . . .

1985-69 . . . . . . . . . . . . . . . . . . . . . . .

White

Allyears2 . . . . . . . . . . . . . . . . . . . . . . .

1980-84 . . . . . . . . . . . . . . . . . . . . . . .

1975-79 . . . . . . . . . . . . . . . . . . . . . . .

1970-74 . . . . . . . . . . . . . . . . . . . . . . .

1965-89 . . . . . . . . . . . . . . . . . . . . . . .

Black

Allyears2 . . . . . . . . . . . . . . . . . . . . . . .

1980-84 . . . . . . . . . . . . . . . . . . . . . . .

1975-79 . . . . . . . . . . . . . . . . . . . . . . .

1970-74 . . . . . . . . . . . . . . . . . . . . . . .

1965-69 . . . . . . . . . . . . . . . . . . . . . . .

Hispanic origin

Hispanic . . . . . . . . . . . . . . . . . . . . . . .

Non-Hispanic . . . . . . . . . . . . . . . . . . .

36,842

8,043

7,777

7,575

6,561

31,465

6,B09

6,659

6,523

5.714

3,614

768

674

766

598

3,452

33,390

35.6 4.9 9.1 13.1

23.6 4.9 9.6 73.9

35.6 4.3 9.0 14,7

46.7 4.7 8.1 13.1

48.1 5.9 9.8 12.8

35,0 4.8 8.9 13.0

22,9 5.2 9.9 14.1

34.6 4.2 8.9 15.1

48.2 4.4 7.7 12.7

47.0 6.1 9.8 12.6

46,9 7.0 12.6 17.5

38,1 “5.2 11.9 17.0

50.4 *6.8 13.6 16.1

558 ‘5.8 11.5 17.3

61.7 ‘6.3 10.5 16.5

37.0 4.7 8.0 14.0

35,5 4.9 9.2 13.1

16.8

18.0

18.1

19.4

15.9

16,8

18.2

J8,2

19.4

15.8

22.1

24.0

24.3

21.9

19.5

18.5

16.7

20.0 28.8

20.7 . . .

22.1 33.8

23.7 36.7

18.5 31.9

19.7 28.3

20.2 . . .

22.1 32.9

23.8 36.9

18.3 30.9

26.8 38.6

31.2 . . .

31.1 47.3

27.0 42.1

23.1 40.8

21.4 28.5

19.8 28.9

33.0

. . .

.,.

44.6

41.7

32.3

. . .

. . .

43.8

40.5

44.8

. . .

. . .

54.7

64.8

33.7

32.9

1

Includes whfle. black, and other races.

‘Includes first marriages begmnmg before 1965 and between 1985 and !rxerwew.

NOTES: For defmmons of terms see techmcsl mztes, Becauae of rounding of W,mates, flgwes may not add to totals, F!gures m Italtcs reflect incomplete experiences of all or some women In the

marriage cohorl
.-Advance —-—-. —-—Data ---—--- No.—---—194 ● Januarv 4.1991 !5 -,.-–.

Widowhood Widowhood

5.yA 5.y)L

.5@i

8

White Black

Figure 2. Percent distribution of dissolved first marriages of women 15-44 years of age by type of dissolution, according to race:

United States, 1988

first marriages, but black women were

much more likely than white women

to have been separated rather than

divorced (figure 2). Eight percent of

white women, compared with nearly

33 percent of bIack women, reported

being separated from their first

husbands.

Remarriage

After their first marriages

dissolved, most women remarried,

and remarried fairly quickly (tabIe 4).

NearIy half of all women whose first

marriages ended in widowhood or

divorce had remarried within 5 years.

In table 4, women whose first

marriages were dissolved by divorce

or death of a spouse are grouped in

dissolution cohorts according to the

years in which the marriages were

dissolved. Women in earlier

dissolution cohorts were more Iikely

to have remarried. More than

80 percent of women whose

marriages ended during the periods

1965-69 and 1970-74 had remarried

by the interview date. One reason

that these women were more likely

have remarried is simply that they

to

had more time in which to remarry.

Women whose marriages ended in

1965 had more than 20 years in which

to remarry, compared with only

4 years for women whose marriages

ended in 1984.

Nevertheless, the probability of

remarriage seems to have decIined

over time. Nearly a third of the

women in the dissolution cohort of

1965-69 had remarried within a year,

compared with only 16 percent of

those in the dissolution cohort of

1980-84. This pattern was consistent

across all race categories, taking into

account the amount of time the

women were eligible to remarry: For

each racial group, an increasingly

small proportion of each subsequent

dissolution cohort had remarried

within each of the first 5 years after

the marriage ended. As in table 3,

the percents having remarried are

biased downward in some of the cells,

because the cohort had not

completed the indicated number of

years since dissolution of first

marriage at the time of the survey.

The affected percents appear in

itaIics in tabIe 4.

Black women were less likely

than white women to remarry. Nearly

60 percent of white women had

remarried after their first marriage

ended, but only 34 percent of black

women had remarried. This pattern

was evident at every duration after

dissolution. Note that table 4 is

restricted to women whose first

marriages ended in divorce or

widowhood. Thus, if all marital

dissolutions including separations

were considered, then black women

would have an even lower remarriage

rate compared with white women.

Hispanic women were less likely

than non-Hispanic women to remarry.

Some 57.9 percent of non-Hispanic

women remarried after their first

marriage, compared with 44.7 percent

of Hispanic women. Within each

category of duration since dissolution

of the first marriage, Hispanic women

were much less likely to have

remarried. A larger percentage of

Hispanic than of bIack women had

remarried, both within each

dissolution catego~ and overall, but

the differences between Hispanic and

bIack women were not statistically

significant.
6 Advance Data No. 194 ● January 4, 1991

Table 4. Number of women 1644 years of age whose first marriage was dissolved by divorce or death of a spouse and cumulative

percent who remarried, by years since dissolution, race, year of dissolution, and Hispanic origin: United States, 1988

[Based on a sample of the noninstitutlonalized population. See technical notes for dk,cusston of the sutvey design and estimates of sampling variability]

Years since dissolution of first marriage

Race, year of dissolution, Number h Aft

and Hispanic origin thousands years 1 2 3 4 5

Total’ Cumulative percenf remarried at time of interview

Allyears2, . . . . . . . . . . . . . . . 11,577 56.8 20.6 32.8 40.7 46.2 49.7

1980-S4 . . . . . . . . . . . . . . . . 3,504 47.5 16.3 28.1

1975-79 . . . . . . . . . . . . . . . . 3,235 65.3

36.4 41.1

21.9

45.4

36.0

1s70-74 . . . . . . . . . . . . . . . . 1.687

44.7

63.2

52.7

24,9

55.4

36.6

1966-69 . . . . . . . . . . . . . . . . 1,013

47.9

89.9

56.4

32.6

61.2

48.7 60.2 65.0 72.8

White

A.iyears2 . . . . . . . . . . . . . . . . 10,103 59.9 21.9 35.2 43.5 49.4 53.0

lQ8&&$ . . . . . . . . . . . . . . . . 3,030 51.4 18.2 31.1

197>79 . . . . . . . . . . . . . . . . 2,839

40.3

69.5

45.2

23.2

49.8

38.5

1570-74 . . . . . . . . . . . . . . . . 1,622

46.9

67.5

55.6

24.9

58.4

39.8

196S69 . . . . . . . . . . . . . . . . 693

49.8

91.0

59.3

34.7

64.3

52.3 64.9 69.3 76.9

Black

AJlyeara2 . . . . . . . . . . . . . . . . 1,166 34.0 10,9 16.5 19.6 22.7 25.0

1960+4 . . . . . . . . . . . . . . . . 380 19.7 ●4.7 ●10.6 *12.9

1975-79 . . . . . . . . . . . . . . . . 301 32.3

14.8

*1 1.4

14.8

●15.6

1970-74 . . . . . . . . . . . . . . . . 227

18.5

59.0

22.2

22.3

24.9

29.4

1965-6e . . . . . . . . . . . . . . . . 98

35.3

81.2

38.7

“20.9

42.3

●27.3 *31 .3 40.8 52.1

Hispanic origin

Hispamc. . . . . . . . . . . . . . . . 942 44.7 12.5

Non-Hispanic . . . . . . . . . . . . .

16.6 22.7 27.8 29.9

10,635 57.9 21.3 34.3 42.3 47.8 51.5

llncludes white.black,and otherraces.

‘)ncludes hrsl marriages dss+afvedb%fore1965 and between 1985 and mterww.

NOTES: For definitions of terms seetechnicel notes. Secauseof rounding olastimataa, figures maynotaddmtorals. Figures initalwer aflacti ncomDletee xDOrienceO fellOrsOmew men In the

marriage whom.

References

1

2,

3.

4.

5.

6.

National Center for Health Statistics. Advance report, final natality

statistics, 1988. Monthly vital statistics repor~ vol 39 no 4, suppl.

Hyattsville, Maryland: Public

Health Service. 1990.

Schoen R. The continuing retreat

from marriage: figures from 1983

U.S. marital status Iife tables.

SocioIogy Social Res 71(2):108-9.

1986.

Schoen R, Urton W, Woodrow K,

Baj J. Marriage and divorce in

twentieth century American

cohorts. Demography

22(1):101-14. 1985.

Bumpass L. Children and marital

disruption: a replication and

update. Demography 21(1):71–82.

1984.

Hofferth S, Updating children’s

life course. J Marriage Fam

47(1):93-115. 1985.

National Center for Health

Statistics. Advance report, final

marriage statistics, 1987. Monthly

7.

8.

9.

vital statistics report; vol 38 no

12, suppl. Hyattsville, Maryland:

Public Health Service. 1990.

French DK. National Survey of

Family Growth, Cycle I: sample

design, estimation procedures,

and variance estimation. National

Center for Health Statistics. Vital

Health Stat 2(76). 1978.

Grady WR. National Survey of

Family Growth, Cycle 11:sample

design, estimation procedures,

and variance estimation. National

Center for Health Statistics. Vital

Health Stat 2(87). 1981.

Bachrach CA, Horn MC, Mosher

WD, Shimizu I. National Survey

of Family Growth, Cycle III:

sample design, weighting, and

variance estimation. National

Center for Health Statistics. Vital

Health Stat 2(98). 1985.

Symbols

.-. Data not available

. . . Categofy not applicable

Quantity zero

0.0 Quantity more than zero but less

than 0.05

* Figure does not meet standard of

reliability or precision

Suggested citation

London KA. Cohabtiation, marriage, mariial

dissolution, and remarriage: United States,

1988. Advance data from vital and health

statistics; no 194. Hyattsville, Maryland:

National Center for Health Statistics. 1990.

Copyright information

This report may be reprinted without further

permission.
Advance Data No. 194 ● January 4, 1991 7

Technical notes

Survey design

The National Survey of Family

Growth (NSFG) is a periodic survey

conducted by the National Center for

Health Statistics (NCHS) to collect

data on fertility and infertility, family

planning, and related aspects of

maternal and infant health. Fieldwork

for Cycle I was conducted in 1973 by

the National Opinion Research

Center. Fieldwork for Cycles 11, III,

and IV was conducted by Westat,

Inc., in 1976, 1982, and 1988.

For Cycle IV of the NSFG,

personal interviews were conducted

from January through August 1988

with a national sample of 8.450

women who were 15-44 years of age

as of March 15, 1988. Data have been

weighted to be representative of the

noninstitutionalized population of the

United States, and black women were

oversampled in order to yield reIiable

estimates by race. Further details on

the sample design of Cycles I–III of

the NSFG are given in (7–9).

Interviews for Cycle IV were

conducted in households that had

participated in another NCHS sumey,

the National Health Interview Survey,

from 1985 through 1987. Respondents

were interviewed in person in their

own homes by trained femaIe

interviewers. The interviews covered

the respondent’s pregnancy history

past and current use of contraception;

ability to bear children; use of

medical services for family planning,

infertility, and prenatal care; marital

history and associated cohabiting

unions: occupation and labor force

participation; and a wide range of

social, economic, and demographic

characteristics.

Reliability of estimates

Because the statistics presented

in this report are based on a sample,

they may differ from the statistics

that would have resulted if all

5S milIion women represented by the

NSFG had been interviewed. The

standard error of an estimate is a

measure of such differences. The

standard error of an estimated

number or percent is calculated by

substituting in the following equations

the appropriate values of A and B

from table I:

SE(N) = V(A + B/N) N

and

‘E(p)=vT-

\vhere N =

P=

x=

the number of women

the percent

the number of women in

the denominator of the

percent.

The parameters shown in table I

were used to generate table II, which

shows preliminary estimates of

standard errors for percents of total

or white women, and table III, which

shows preliminary estimates of

standard errors for percents of black

women.

Table L Preliminary estimates of the

parameters A and B for estimating standard

errors for women, by race

Parameter

Race A B

Total or whiie. . . . -0.00018 10,738

Black . . . . . . . . . -0.000626 5,181

The chances are about 68 in 100

that a sample estimate would fall

within one standard error and about

95 in 100 that it would falI within two

standard errors of a statistic based on

a complete count of the population

represented by the NSFG.

Differences among percents discussed

in this report were found to be

statistically significant at the

95-percent confidence level using a

two-tailed f-test with 39 degrees of

freedom. This means that, in

repeated samples of the same type

and size, a difference as large as the

one observed would occur in only

5 percent of the samples if there

were, in fact, no difference between

the percents in the population.

In the text, terms such as

“greater,” “less,” “increase,” and

“decrease” indicate that the observed

differences were statistically

significant at the 0.05 level using a

two-tailed normal deviate test.

Statements using the phrase “the

data suggest” indicate that the

difference was significant at the 0.10

(lO-percent) leveI but not at the 0.05

(5-percent) leveL Lack of comment in

the text about any two statistics does

not mean that the difference was

tested and found not to be significant.

Table Il. Preliminary estimates of standard errors for percents of total or white women:

1988 National Suwey of Family Growth

Estimated percent

2 or 5 or 10or 20 or 30 or 40 or

Base of percent 98 95 90 80 70 60 50

Standard error in percentage points

100,000. . . . . . . . . . . . . . . . . 4.6 7.1 9.8 13.1 15.0 16.1 16,4

500,000. . . . . . . . . . . . . . . . . 2.1 3.2 4.4 5.9 6.7 7.2 7.3

1,000,000 . . . . . . . . . . . . . . . 1.5 2.3 3.1 4.1 4.7 5.1 5.2

5,000,000 . . . . . . . . . . . . . . . 06 1.0 1.4 1.9 2,1 2.3 2.3

10.000,000. . . . . . . . . . . . . . . 0.5 0.7 1.3 1.5 1.6 1.6

30,000,000. . . . . . . . . . . . . . . 0.3 0.4 ::: 0.8 0.9 0.9 0.9

50,000,000. . . . . . . . . . . . . . . 0.2 0,4 0.6 0.7 0.7 0.7

58,000,000. . . . . . . . . . . . . . . 0.2 F3 0.4 0.5 0.6 0.7 0,7

Table 111.Preliminary estimates of standard errors for estimated percents of black women:

1988 National Survey of Family Growth

Estimated percent

2 or 5 or 10 or 20 or 30 or 40 or

Base of percent 98 95 90 80 70 60 50

Standard error m percentage points

100,000. . . . . . . . . . . . . . . . . 3.2 5.0 6,8 9.1 10.4 11.2 11,4

500.000. . . . . . . . . . . . . . . . . 1.4 2.2 3.1 4.1 4.7 5.0 5.1

1000.000 . . . . . . . . . . . . . . . 1.0 1.6 2.2 2.9 3.3 3.5 3.6

5.000,000 . . . . . . . . . . . . . . . 0,5 0.7 1.0 1.3 1.5 1.6 1.6

7,500,000 . . . . . . . . . . . . . . . 04 0.6 0,8 1.1 1.2 1.3 1.3
8 Advance Data No. 194 ● January 4, 1991

The relative standard error (or

coefficient of variation) of a statistic

is the ratio of the standard error to

the statistic and usually is expressed

as a percent of the estimate. In this

report, statistics with relative

standard errors of 30 percent or

larger are indicated with an asterisk

(*). These estimates may be viewed

as unreliable by themselves, but they

may be combined with other

estimates to make comparisons of

greater precision.

Statistics in this report also may

be subject to nonsampling error, that

is, errors or omissions in responding

to the interview, recording answers,

and processing data. The data have

been adjusted for nonresponse by

means of adjustment to the sample

weights assigned to each case. Other

types of nonsampling error were

minimized by a series of quality

control measures.

Definition of terms

Cohabitation – Women were

classified as currently cohabiting if

they reported that their maritaI status

was “not married but living with a

partner or boyfriend.” Women were

classified as having cohabited before

their first marriage and as ever having

cohabited based on a series of

questions on whether they had lived

with their husbands before they got

married and whether they had ever

lived with a partner or boyfriend

without being married to him.

Women who asked for clarification

were told, “By living together, we

mean both of you having the same

usual address.”

Hispanic origin – In the 1988

NSFG, a respondent was classified as

being of Hispanic origin if she

reported that her only or principal

national origin was Puerto Rican,

Cuban, Mexican American, Central

or South American, or other Spanish.

For 3 percent of respondents, origin

was not ascertained, so values were

imputed. In tables where data are

presented for women according to

race and Hispanic origin, women of

Hispanic origin are included in the

statistics for white and black women

if they were classified as such by race.

Marital dissolution – Dissolution of

formal marriage includes death of the

spouse, separation because of marital

discord, and divorce. In the case of

divorce, the date that a woman and

her husband separated is used to

compute the number of years

bemeen first marriage and

dissolution.

Marital status – Respondents were

classified by marital status as married,

widowed, divorced, separated, or

never married. In Cycles I and II,

informally married women—women

who volunteered that they were

sharing living quarters with their

sexual part ner – were classified as

currently married. These women

constituted about 2 percent of

currently married respondents in

Cycle I and 3 percent in Cycle II. In

CycIes III and IV, such women were

classified according to their Iegal

marital status. In all cycIes, women

who were married but separated from

their spouses were classified as

separated if the reason for the

separation was marital discord;

otherwise, they were classified as

current[y married. Formal marital

status is used throughout this report.

Thus, for example, the number of

years between first marriage and

dissolution refers to the time elapsed

between the date of the first formal

marriage and the date of dissolution;

remarriage is entry into a second

formal marriage.

Race – Race refers to the race of

the woman interviewed and is,

reported as black, white, or other. In

the 1988 NSFG, race was classified

according to the woman’s own report

of the race that best described her.

Cooperating agencies

Cycle IV of the National Survey

of Family Growth was supported in

part by the National Institute of

Child Health and Human

Development, National Institutes of

Health, and the Office of Population

Affairs, Office of the Assistant

Secretary of Health. These agencies

aIso participated in the design of the

questionnaire.
Number 195 . December 18, 1990

Advance

Data

From Vital and Health Statistics of the National Center for Health Statistics

AIDS Knowledge and Attitudes for April-June 1990

Provisional Data From the National Health Interview Survey

by Joseph E. Fitti, M.S.P,H., and Marcie Cynamon, M.A., Division of Health Interview Statistics

Introduction

The National Center for Health

Statistics has included questions

about acquired immunodeficiency

syndrome (AIDS) in the National

Health Interview Survey (NHIS) since

1987, Data concerning the adult

population’s knowledge and attitudes

about AIDS and transmission of the

human immunodeficiency virus (HIV)

are collected to assist in planning

educational programs. Since the

initiation of the NHIS AIDS

Knowledge and Attitudes Survey, its

scope has widened to include

questions on HIV testing and blood

donation experience. In addition,

questions assessing self-perceived risk

of becoming infected with HIV and a

general risk behavior question similar

to that asked by the Red Cross of

potential blood donors have been

included. At various points in its

history, the AIDS surwey has also

been used as a tool for evaluating

public awareness campaigns and for

assessing the public’s willingness to

participate in a national

seroprevalence sumey. Information on

the NHIS AIDS Knowledge and

Attitudes Survey sample is contained

in the technical notes at the end of

this report.

The first AIDS Knowledge and

Attitudes Survey was in the field fkom

August-December 1987. Provisional

results of that survey were published

monthly in Advance Data From J%al

and Health Statistics (Nos. 146, 148,

150, 151, and 153). During the

beginning of 1988, the NHIS

questionnaire was revised to meet

program needs at that time. The

revised AIDS Knowledge and

Attitudes Survey entered the field in

May 1988. Provisional findings for the

remainder of 1988 were published

periodically (Advance Data From P7tal

and Health Sta&ics Nos. 160, 161,

163, 164, 167, 175, and 193); in

addition, two special reports with a

focus on minority populations were

published from the 1988 data

(Advance Data From Wtal and Health

Statistics Nos. 165 and 166).

The 1988 AIDS questionnaire

was used without modification

throughout 1989, and results were

published on a quarterly basis

(Advance Data From P7tal and Heallh

Statistics Nos. 176, 179, 183, and 186).

For 1990, the AIDS questionnaire

was revised again, with added

emphasis on HIV testing and on the

distinction between testing in

connection with blood donation and

for other reasons. Provisional survey

findings will continue to be published

on a quarterly basis for the 1990 data.

The NHIS AIDS questionnaires

are deveIoped by the National Center

for Health Statistics and an

interagency Task Force createdlby

the Public Health Service Health

Data Policy Committee. The Task

Force included representatives from

the Centers for Disease Control; the

Office of the Assistant Secretary for

Health; the National Institutes of

Health; the AIcohol, Drug Abuse and

Mental Health Administration; the

Food and Drug Administration; and

the Health Resources and Services

Administration.

The Advance Data reports

describing the NHIS AIDS data have

been restricted to simple descriptive

statistics to facilitate their timely

release. Thus, these reports do not

attempt to explain or interpret

differences among population

subgroups or to examine relationships

* mlct*.ti

# -%

-g

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES ●*

g

Public Health Service

s. Centers for Disease Control

3%

>%,,a Manning

National

Feinleib,

Center

M.

for

D.,

Health

Dr. P.

Statistics

H., Director

CDC
2 Advance Data No. 195. December 18, 1990

Lrnong various measures of

knowledge and behavior. The NHIS

.\ IDS data bases permit more

complex analyses than those

presented in this series of Advance

Data reports, and further exploration

of the data is encouraged. Public use

data tapes of the 1987 and 1988

.\ IDS Knowledge and Attitudes

Surveys are available at this time, and

:he data tape for 1989 will be

released by the end of this year.

This report presents provisional

data for April–June 1990 for most

items included in the 1990 NHIS

.MDS Knowledge and Attitudes

questionnaire. Table 1 displays

percent distributions of persons 18

years of age and over by response

categories, according to age, sex,

race/ethnicity, and education. In most

cases, the actual questions asked of

the respondents are reproduced

verbatim in table 1 along with the

coded response categories. In a few

cases, questions or response

categories have been rephrased or

combined for clearer or more concise

presentation or results. Refusals and

other nonresponse categories

(generally less than 1 percent of total

responses) are excluded from the

denominator in the calculation of

estimates, but responses of “don’t

know” are included. The NHIS AIDS

questionnaire uses the phrase “the

AIDS virus” rather than “HIV,”

because it is felt to be more widely

recognized and understood. However,

this recognition is changing, as is

noted later that over 70 percent of

adults said they had heard AIDS

called by the term “HIV”. In this

report the two terms are used

synonymously.

The population subgroups used in

presentirig ~he 1990 NH~S fiDS

Knowledge and Attitudes data differ

from those used in previous reports.

In reports based on the 1987-89

surveys, two racial categories were

shown: white and black. The 1990

reports show three categories that

reflect both race and ethnic origin:

non-Hispanic white, non-Hispanic

black, and Hispanic. This change,

which reflects the increasing demand

for information about the Hispanic

population, means that estimates by

race cannot be compared directly

between the 1990 and earlier NHIS

AIDS Advance Data reports. In

Any person with the AIDS virus can

pass it on to someone else during

sexual intercourse.

AIDS is an infectious disease caused by

a virus.

I There isnocureforAIDS at present.

87

87

I

A person can be infected with the AIDS

virus and not have the disease AIDS.

A pregnant woman who has the AIDS

virus can give it to her baby.

AIDS can reduce the body’s natural

protection against disease.

78

79

P’”

AIDS can damage the brain.

m Apriklune 1990

Janua~-March 1990

addition, the revisions in the

questionnaire, whether in actual

wording or in context and location of

questions, must be considered when

interpreting trend data.

Selected findings

The following highlights describe

survey results of the NHIS AIDS

Knowledge and Attitudes Survey for

the period April–June 1990. Unless

otherwise noted in the text, all

measures described remained stable

over the 3-month period. All

differences cited in the text are

statistically significant at the .05 level.

Table 11 shows provisional estimates

of the standard errors associated with

these results.

General AIDS knowledge –

Knowledge about AIDS and HIV was

ascertained through a series of

statements about the general

characteristics of the disease and how

it is transmitted. Respondents ‘were

asked to classify each statement as

definitely true, probably true,

probably false, or definitely false. As

shown in figure 1, the level of

general knowledge about AIDS and

HIV in the second quarter of 1.990

was unchanged for most measures

from the first quarter.

Gains noted during the first

quarter of 1990 in areas where

knowledge levels were low in 1989

continued at the elevated level during

the second quarter. For example, the

increase in the percent of adults who

stated that it is definitely true that

AIDS can damage the brain

(27 percent in the last quarter of

1989 to 43 percent in the first quarter

of 1990) remained in the second

quarter of 1990 (42 percent). The

percent who thought it definitely true

that a person can be infected with the

AIDS virus and not have AIDS rose

from 58 percent in 1989 to

65 percent in the first quarter of 1990

and 64 percent in the second quarter.

The high baseline level of

knowledge about the main modes of

HIV transmission remained at the

improved level reached in the first

auarter of 1990. The proportions of Figure 1, Provisional estimates of percent of adults reporting that selected statements are

definitely trua: United States, April-June 1990 . -.
Advance Data No. 195 @December 18, 1990 3

adults who thought it definitely true

that HIV can be transmitted via

sexual intercourse and from a

pregnant woman to her child each

increased from the level in the last

quarter of 1989 by 4 percentage

points to 87 and 86 percent,

respectively in the first quarter of

1990, and remained at 87 percent

and 85 percent in the second quarter.

The proportion of aduIts who thought

it vexy likely that HIV can be

transmitted by sharing needles for

drug use remained at the Januaryhlarch 1990 level of 95 percent.

Knowledge about HIV transmission

via needIe sharing was asked in a

separate series of questions.

Despite the overaII improvement

in knowledge shown in the first

quarter of 1990, there was a decrease

in one area. In October-December

1989, 75 percent of U.S. adults 18

years of age and over realized that it

is definitely false that there is a

vaccine for the AIDS virus. ~is

decreased to 68 percent for

January-March 1990 and remained at

the lower level for the period,

April-June 1990. This change from

the 1989 level may reflect confusion

between a vaccine and drugs that are

used in treatment of AIDWHIV, e.g.,

zidovudine (AZT), or it may result

from publicity concerning progress

towards development of a vaccine.

Although knowledge levels have

increased since 19S9, self-assessed

knowledge about AIDS declined. In

October-December 1989, 24 percent

of adults stated that they knew a lot

about AIDS; in January-March 1990,

this proportion declined to

1S percent. Similarly, in April-June

1990, 19 percent of adults stated they

knew a lot about AIDS. The

proportion of adults claiming to know

nothing about AIDS increased from 7

to 11 percent by the first quarter of

1990 and held constant through the

second quarter. It is impossible to

determine whether the decline in selfassessed level of knowledge from

1989 reflects a sense of information

overload associated with the

increasing amount of information

available about development of a

vaccine for HIV, modes of

transmission, and forms of treatment.

or if it is solely an effect of

questionnaire design changes.

Although this question is worded the

same in 1990 as in preceding years,

its location in the intemiew has

changed so that it is now the first

question asked.

General knowledge about AIDS

continues to vary by demographic and

socioeconomic characteristics. Persons

aged 50 years and over were Iess

knowledgeable than younger persons.

Knowledge increased directly with

number of years of school completed.

For 8 out of the 9 measures of

general AIDS knowledge examined,

non-Hispanic white adults were more

likely than non-Hispanic black or

Hispanic adults to respond correctly.

For one measure (awareness that

AIDS can damage the brain),

non-Hispanic black adults were the

most knowledgeable. There was no

consistent difference by gender in

general AIDS knowledge, These

differentials in objective measures of

knowledge were generally consistent

\vith those in self-assessed knowledge

about AIDS. The population

subgroups most likely to state that

they know a lot about AIDS were

persons below 50 years of age and

those with more than 12 years of

school.

Two new items regarding general

AIDS knowledge were added to the

1990 NHIS AIDS survey. One of

these is a question asking whether or

not the respondent had ever heard

the AIDS virus referred to as “HIV.”

Two-thirds of adults were familiar

with the “HIV” term as of

January-March 1990; by April-June

1990, 71 percent reported recognizing

this term. However, familiarity with

the term is lower among adults 50

years of age or over and among

adults with less than 12 years of

school. In January-March 1990, these

percentages were only 54 percent and

42 percent, respectively. In

April-June 1990, they were

58 percent and 44 percent,

respectively, The percent of persons

of Hispanic origin who said they were

familiar with this term decreased

substantially between the first quarter

and the second quarter 1990, from

48 Dercent to 39 mrcent. The .

possibility that this difference may be

related to a translation problem is

being investigated.

The proportion of adults who

categorized the second new item, a

statement regarding the availability of

drugs to extend the life of a person

infected with HIV, as true or

probably true remained at the same

level in the second quarter as in the

first quarter 1990, [46 and 27 percent

and 45 and 27 percent, respectively).

Misinformation about HIV

transmission —Respondents were

asked to estimate the risk of HIV

transmission associated with several

forms of casual contact with infected

or potentially infected individuals,

e.g., working with someone with

AIDS, usin~ public toilets, and so

forth. Five response options were

offered for the likelihood of

transmission: very Iikely, somewhat

likely, somewhat unlikely, very

unlikely, and definitely not possible.

Both “very unlikely” and “definitely

not possible” were interpreted as

correct responses, even for forms of

contact where our current

understanding of the virus indicates

that there definitely is no possibility

of transmission. The decision to

accept “very unlikely” as correct was

based on the large numbers of

respondents who chose that option,

seemingly unwilling to commit

themselves to the concept of a zero

probability.

As has been true since 1987 when

the suwey was begun, the results for

ApnI-June 1990 indicated that many

misperceptions about HIV

transmission exist. The proportion of

adults who assessed the risk of

transmission as “very unlikely” or

“definitely not possible” varied from

less than half for transmission via

insect bites or contact with the saliva

of an infected individual (sharing

eating utensils, being

sneezed/coughed on) to about threefourths for working near or attending

school with someone with HIV. The

level of misinformation, as indicated

by these measures, has remained

constant in 1990.

As with general AIDS knowledge,

there were demographic and

socioeconomic differentials in
4 Advance Data No. 195. December 18, 1990

misperceptions about HIV

transmission. Adults 50 years of age

and over were more likely than

younger adults to be misinformed,

and non-Hispanic black and Hispanic

individuals generally had more

misperceptions than did non-Hispanic

white individuals. The level of

misinformation decreased with

increasing educational attainment.

Again, there was no consistent

differential by gender.

Information and communication

about AIDS —The proportion of

adults who reported discussing AIDS

with their children aged 10-17 years

during April-June 1990 was

68 percent, and the proportion who

reported that their children had

received instruction in school about

AIDS was 75 percent. Ninety percent

of adults stated that they had

received information about

AIDS;’HIVin the month preceding

the NHIS AIDS survey. The most

commonly reported sources of

information were television (cited by

80 percent of adults), newspapers

and magazines (57 and 45 percent,

respectively), and radio (33 percent).

Source? of AIDS information

differed somewhat by race and

ethnicity. Newspapers were reported

more frequently by non-Hispanic

white individuals (59 percent) than

by Hispanic or non-Hispanic black

individuals (42 percent and

47 percent, respectively). There were

7 sources of information that were

reported more often by non-Hispanic

black than by Hispanic or

non-Hispanic white individuals: street

signs and billboards, store displays,

mass transit displays (signs in buses

and subways), health department

brochures, work place brochures, and

friends and relatives. Mention of

these sources by non-Hispanic black

individuals ranged from 11 percent to

26 percent.

Blood donation and testing– There

was no change in blood donation

experience between January-March

1990 and April–June 1990. Data for

the first two quarters of 1990

indicated that 39 and 40 percent of

adults, respectively, had ever donated

blood, 16 and 15 percent had

donated blood since March 1985

(when blood donations were first

routinely tested for HIV), and 7 and

6 percent had donated blood in the

preceding year. Multiple donations

were common among those who had

donated blood. Of the 15 percent of

adults who had donated blood since

%larch 1985, as reported in

April-June 1990, about half

(7 percent) donated blood 3 or more

times.

Seventy-nine percent of U.S.

adults had heard of the blood test to

detect HIV antibodies. Sixty-eight

percent knew blood donations are

routinely tested for HIV, i.e., seveneighths of those familiar with the

blood test. Two percent of the

persons who had donated blood since

March 1985– an estimated 500,000

individuals – reportedly did so at least

in part to be tested for HIV. Use of

blood donation as a means of being

tested for HIV was reported more

often by men than women and was

far more common for non-Hispanic

black than other adults.

Ten percent of U.S. adults

reported in January-March 1990

having had their blood tested for HIV

antibodies (not counting testing

performed in conjunction with bIood

donation), including 7 percent tested

once and 3 percent with multiple

tests. In April-June 1990, these

percentages remained the same.

Including the 15 percent of adults

who were tested as a part of blood

donation since 1985, an estimated

25 percent of the adult population

has been tested. This is a substantial

increase over the estimate of

21 percent from October-December

1989, but the difference may partly

reflect questionnaire changes. In

1988-89, the NHIS AIDS

questionnaire asked if respondents

had the AIDS blood test; if they did

not respond positively but had

donated blood since March 1985, they

were included in the estimate of

persons tested. In this year’s survey

respondents are asked separately

about blood donation and testing

exclusive of blood donation; then the

two estimates are summed.

The proportion of adults who had

been tested exclusive of blood

donation declined sharply with age,

from 16 percent of persons 18-29

years of age to 12 and 3 percent,

respectively, of those 30-49 years of

age and 50 years of age and over.

Men were slightly more likely than

women to have been tested exclusive

of blood donation, 11 percent

compared with 9 percent. Hispanic

adults and non-Hispanic black adults

were more likely than non-Hispanic

white adults to have been tested

outside of blood donations,

14 percent each compared with

9 percent. Having been tested also

increased with education, from

8 percent of persons with less than

12 years of school to 12 percent of

those with more than 12 years of

schooI.

Of persons tested exclusive of

blood donation, 52 percent stated

that aIl their tests were required, i.e.,

conducted as a part of an activity that

includes mandatory blood testing. For

43 percent all their tests were

voluntary. Three percent had both

required and voluntary tests. The

most commonly cited reasons for

required tests were hospitalization or

surgery and militaV induction or

service (each reported by 10 percent

of persons tested outside of blood

donation). In addition, 7 percent

were tested as a requirement clf

employment, 6 percent for life

insurance, 7 percent for immigration

(cited by 47 percent of Hispanic

adults who were tested exclusive of

blood donation), 4 percent for health

insurance, and 14 percent for other

reasons. Individuals may have cited

more than one reason for a single test

(e.g., for both employment and health

insurance) or may have had more

than one required test; thus, the sum

of the individual reasons exceeds the

proportion of persons with at least

one required blood test. The only

difference reported between the first

and second quarters of 1990 was

Hispanic adults reporting immigration

as a reason for testing, 35 percent in

the first quarter and 47 percent in

the second quarter.

Twenty-nine percent of persons

tested for HIV antibodies exclusive of

blood donations -including both

voluntary and required testing —had

their last blood test at a doctor’s
Advance Data No. 195. December 18, 1990 5

office or HMO, and22 percent were

tested at a hospital clinic or

emergency room. Forty-three percent

and 9 percent of Hispanic adults

tested for HIV antibodies, other than

in bIood donations, were tested at

these locations, respectively. Eleven

percent of all aduIts tested were

tested at military induction/service

sites. Only 3 percent of persons

tested for HIV exclusive of blood

donations were tested at designated

AIDS clinic/counseling/testing sites.

Thirty-nine percent of persons tested

received counseling about AIDS and

HIV before the test was

administered.

Three-fourths of the persons

tested (74 percent) received their test

results; of those who did not,

one-third reportedly wanted the

results of their tests. Of those persons

who received their test results, only

29 percent were given counseling

about prevention of HIV transmission

at the time the results were provided.

Sixty-six percent of persons who

received results got their test results

in person, compared with smaller

proportions who received their test

results by mail (13 percent),

telephone (15 percent), or in some

other way (5 percent). The vast

majority (91 percent) of persons

tested for HIV felt that their tests

were handled properly in terms of

confidentiality of test results.

Six percent of U.S. adults

reportedly plan to be tested for HIV

antibodies in the next 12 months,

according to the NHIS AIDS data for

April-June 1990. This figure, which

has remained fairly stable since 1989,

was 2 times higher for minorities than

for non-Hispanic white adults.

Thirteen percent of non-Hispanic

black adults reported plans to be

tested, compared with 11 percent of

Hispanic adults and 5 percent of

non-Hispanic white adults.

Suggested citation

Fitti JE, Cynamon M. AIDS knowledge and

attitudes for Apri14une 1990; Provisional data

from the National Health Interview Survey.

Advance data from vital and health statistics;

no 195, Hyattsville, Maryland: National Center

for Health Statistics. 1990.

Of persons who plan to be tested,

two-thirds stated that they would be

tested voluntarily, because they

personally wanted to know if they are

infected. Twenty-four percent plan to

be tested as part of blood donation,

and 16 percent cited the need for

testing as a requirement for a job

other than military. Some individuals

reported more than one reason for

anticipated testing. The locations at

which persons plan to be tested are

similar to those reported for tests

already conducted, with private

doctors/HMOs and hospital

emergency rooms/clinics accounting

for over half (38 and 17 percent,

respectively).

Rkk of HIV infection –The

second-quarter 1990 NHIS AIDS

survey results indicated that

5 percent of U.S. adults, an

estimated 9 million persons, received

blood transfusions between 1977 and

1985. This is the period when HIV is

thought to have entered the United

States and when routine screening of

blood donations began. The level

reported in the second quarter agrees

with that reported in the first quarter.

About half of the nation’s aduks

think the blood supply is now safe for

transfusions.

The 1990 AIDS survey revealed

increasing uncertainty about the

efficacy of condom use in preventing

HIV transmission. The proportion of

adults who think condoms are very

effective in preventing transmission of

the virus decIined from 33 percent in

October-December 1989 to

27 percent in both January-March

1990 and April-June 1990, while the

proportion who did not know rose

from 7 to 14 percent. Although these

shifts occurred in all population

subgroups, the increase in uncertainty

was especially evident among adults

age 50 years and over. For this group,

the proportion who did not know how

Copyright Inforrnatlon

This report may be reprinted without further

permission.

effective condoms are in preventing

HIV transmission rose from 13

percent in the last quarter of 1989 to

23 percent in January-March 1990.

These differences between 1989 and

1990 may be due to the change in the

format of the question.

Eighty percent of adults felt there

was no chance of their having been

infected with HIV, and 15 percent

said there was a Iow chance. The

proportions who thought there was a

medium or high chance of already

being infected were 2 and less than 1

percent, respectively. Between the

last quarter of 1989 and the second

quarter of 1990, the proportion of

persons who thought there was no

chance of their becoming infected

with HIV in the future dropped from

77 to 73 percent, reversing a longterm increase in this area. As of

April-June 1990, 21 percent believed

that they had a low chance of

becoming infected; three and less

than 1 percent, respectively, cited a

medium or high chance. Only 2

percent of aduIts reported being in

any of the categories associated with

a high risk of HIV infection. This

proportion has remained stable since

the risk behavior question was added

to the NHIS AIDS questionnaire in

1988.

As of April-June 1990, 15 percent

of adults knew someone with AIDS

or HIV, about the same figure as in

the last quarter of 1989. This

proportion remains higher for persons

under 50 years of age than for those

age 50 years and over and higher for

black non-Hispanic adults than for

Hispanic or non-Hispanic white

adults. The proportion of adults who

reported knowing someone with

AIDS or HIV increased sharply with

number of years of school, from

8 percent of persons with less than 12

years of school to 21 percent of those

with more than 12 years of school.

Symbols

Quantity zero

o Quantity more than zero but less

than 0.05
6 Advance Data No. 195. December 18, 1990

Table 1. Provisional estimates of the percent of persons 18 years of age and over with selected AIDS knowledge and attitudes from the

1990 National Health Interview Survey, by selected characteristics: United States, April-June 1990

[Data are based on household interviews of the ciwhan noninstiiutionalizad population. The survey design, general qualifications, and information on the reliability of

the estimates are gtien in technical notes]

Race/ethnicify

Age Sex Non-Hispanic Education

16-29 30-49 50 yeare Less than

ALE knowfedge or attitude

More than

Tofa/ yeara yeara and over Male Female White Black Hispanic 12 years 12 years 12 years

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...100

1.

2.

3.

4a.

4b.

4C.

4d

4e.

4f.

How much would you say you know about AIDS?

A lit. . . . . . . . . . . . . . . . . . . . . . . . . . . .

Some . . . . . . . . . . . . . )........ . . . . .

A little . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Nothing . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

In the past month, have youreceived information

about AIDS from any of these sources?l

Television . . . . . . . . . . . . . . . . . . . . . . . . .

Radio . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Magazines . . . . . . . . . . . . . . . . . . . . . . . .

Newspapers . . . . . . . . . . . . . . . . . . . . . . . .

Streetsigns/billboards. . . . . . . . . . . . . . . . .

Store displays/store distributed brochures -----

Bus/streetcar/subwaydisplays. . . . . . . . . . . . .

Health department brochures . . . . . . . . . . .

Workplacedistributed brochures. . . . . . . . . . .

School distributed brochures . . . . . . . . . . . .

Church distributed brochures . . , . . . . . . . . . .

Communityorganization . . . . . . . . . . . . . . . .

Friend/acquaintance . . . . . . . . . . . . . . . . . . .

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

Received no AIDS information in past month. . . .

Have you heard the AIDS virus called HIV?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’lknow . . . . . . . . . . . . . . . . . . . . . . . . .

AIDS can reduce the body’s natural protection

against dtsease.

Definitelytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablyfalse . . . . . . . . . . . . . . . . . . . . . . .

Definitelyfalse . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

AIDS can damage the brain.

Definitelytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablyfalse . . . . . . . . . . . . . . . . . . . . . . .

Definitelyfdse . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

AIDS isaninfectious diseasecausedby avirus.

Definitelytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablyfalse . . . . . . . . . . . . . . . . . . . . . . .

Definitelyfalse . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . .

A person can be infected wth the AIDS virus and

not have the disease AIDS.

Dafinitelytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablyfalse . . . . . . . . . . . . . . . . . . . . . . .

Definitelyfalse . . . . . . . . . . . . . . . . . . . . . . .

Don’t know, . . . . . . . . . . . . . . . . . . . . . . .

ANY person with the AIDS virus can pass t on to

someone else through sexual

intercourse.

Definitelytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablyfalse . . . . . . . . . . . . . . . . . . . . . . .

Defimtelyfalse . . . . . . . . . . . . . . . . . . . . . . .

Don’t know . . . . . . . . . . . . . . . . . . . . . . .

A meanant women who has the AIDS virus can give

it to h&baby.

Definitelytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablyfalse . . . . . . . . . . . . . . . . . . . . . . .

Deflmtelyfalse . . . . . . . . . . . . . . . . . . . . . . .

Don’t know, . . . . . . . . . . . . . . .

See fOOtnOteS al end of table.

19

47

24

11

0

80

33

45

57

12

7

4

18

12

10

4

5

13

3

1

10

71

27

2

78

11

1

2

a

42

25

9

4

19

69

16

2

3

10

64

17

3

3

12

87

9

1

0

3

85

11

0

0

4

100

22

53

21

4

81

36

50

53

1.9

10

7

25

11

16

4

6

18

4

0

9

75

24

2

81

11

1

2

5

40

26

12

6

17

76

15

2

2

5

67

16

4

4

9

92

6

1

0

1

89

9

0

0

2

100

22

54

20

4

0

61

36

49

60

13

8

4

20

17

11

5

6

16

3

0

8

79

20

1

65

8

1

2

4

44

25

10

5

16

77

13

2

3

5

72

15

2

3

7

90

7

1

0

1

89

9

0

0

2

100

12

35

30

23

0

78

25

37

55

7

4

2

11

6

3

4

4

7

2

1

13

56

36

4

6a

13

1

2

15

42

26

6

2

25

56

19

3

3

19

53

21

3

2

21

81

12

0

0

6

78

14

0

0

7

Percent distribution

100 100 100

18

46

25

11

0

81

36

43

56

14

7

5

16

12

8

4

5

13

2

1

10

70

28

2

79

11

1

2

8

42

26

9

4

18

71

15

2

3

9

64

17

3

4

13

86

10

0

0

3

83

13

0

0

4

19

49

22

10

0

79

30

47

56

10

7

3

20

12

11

4

6

13

3

1

10

71

26

2

78

11

1

2

8

42

25

8

2:

6a

16

2

3

11

65

18

3

3

12

89

7

1

0

3

87

9

0

0

4

19

50

22

9

0

80

34

46

59

11

6

3

17

11

8

4

4

12

3

1

10

74

24

2

82

10

1

1

6

41

26

9

2:

70

15

2

3

10

67

17

3

2

11

88

9

0

0

3

86

10

0

0

4

t00

:

27

17

0

77

30

42

47

17

11

10

26

16

13

7

9

16

3

1;

71

27

3

65

13

3

5

15

50

22

6

4

17

70

16

2

3

10

59

17

2

6

18

68

7

1

0

4

85

10

0

0

4

100

:

26

16

79

34

37

42

14

9

7

18

10

11

7

6

15

4

1

12

39

56

4

63

19

1

4

14

45

24

7

5

18

65

20

1

2

12

49

20

5

5

21

82

12

1

1

5

81

13

0

6

100

9

29

31

30

0

75

26

30

40

8

5

3

12

5

7

4

3

10

1

2

17

44

51

5

54

18

3

3

22

40

27

5

2

26

55

19

3

2

20

43

20

4

4

29

81

11

0

0

7

76

15

0

0

9

100

15

50

27

8

0

61

31

43

55

10

7

3

18

10

9

4

4

12

2

0

10

70

27

2

78

12

:

6

42

27

8

4

19

68

17

2

3

10

62

20

3

3

11

89

8

1

0

2

86

11

0

0

3

100

27

54

17

3

0

81

40

56

67

16

8

5

21

17

12

5

7

16

4

0

6

85

14

1

91

6

0

1

2

43

23

12

6

16

76

12

2

3

4

78

14

2

2

5

90

8

0

0

1

90

8

0

0

2
Advance Data No. 195. December 18, 1990 7

Table 1. Provisional estimates of the percent of persons 18 years of age and over with sefected AIDS knowledge and attitudes from the

1990 National Health Interview Survey, by selected characteristics: United States, April-June 1990-Con.

[Data are based on household interviews of the civifian noninstitutionafized population. The survey design, general qualifications, and information on the rehability of

the estimates are given in technical notes]

Race/ethnicity

Age Sex IVon-h’ispanic Education

1S-29 30-49 50 years Less than More than

A/DS knowledge or aftitude Totil years years and over Male Female White Black Hispanic 12 years 12 yeara 12 yeara

4g,

4h.

4i.

5.

5a.

5b.

5C.

.5d.

5e.

Sf.

There are drugs available to treat AIDS or the AIDS

virus which can lengthen the life of an infected

person,

Definlely true . . . . . . . . . . . . . . . . . . . . . . . 45

Probably true, . . . . . . . . . . . . . . . . . . . . . . 27

Probably false . . . . . . . . . . . . . . . . . . . . . . . 6

Definitely false . . . . . . . . . . . . . . . . . . . . . . . 6

Don’t know. . . . . . . . . . . . . . . . . . . . . . . . . 16

There is a vaccine available to the public that

protects a person from getting the AIDS virus.

Definitely true . . . . . . . . . . . . . . . . . . . . . . . 2

Probably true . . . . . . . . . . . . . . . . . . . . . . . 4

Probably false . . . . . . . . . . . . . . . . . . . . . . . 9

Definitely false . . . . . . . . . . . . . . . . . . . . . . . 69

Don’t know . . . . . . . . . . . . . . . . . . . . . . . . . 15

There is no cure for AIDS at present.

Definitely true . . . . . . . . . . . . . . . . . . . . . . . 85

Probablytrue . . . . . . . . . . . . . . . . . . . . . . . 7

Probablyfalse . . . . . . . . . . . . . . . . . . . . . . . 1

Defimtelyfalse. . . . . . . . . . . . . . . . . . . . . . . 2

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 5

How likely do you think it is that a person will get

AIDS or the AIDS virus infection from–

Working near someona with the AIDS virus?

Veiyl,kely . . . . . . . . . . . . . . . . . . . . . . . . . 2

Somewhathkely . . . . . . . . . . . . . . . . . . . . . 6

Somewhatunlikely . . . . . . . . . . . . . . . . . . . . 9

Veryunlikely . . . . . . . . . . . . . . . . . . . . . . . . 40

Definitelynotpossible . . . . . . . . . . . . . . . . . . 36

Don’t know. . . . . . . . . . . . . . . . . . . . . . . . . 6

Eating in a re.9aurant where the cook has the AIDS

virus?

Verylikely . . . . . . . . . . . . . . . . . . . . . . . . . 5

Somewhatlikely . . . . . . . . . . . . . . . . . . . . . 17

Somewhatunlikely . . . . . . . . . . . . . . . . . . . . 13

Veryunlikely . . . . . . . . . . . . . . . . . . . . . . . . 34

Definitelynotpossible . . . . . . . . . . . . . . . . . . 21

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 10

Sharing plates, forks, or glasses with someone who

has the AIDS virus?

Verylikaly . . . . . . . . . . . . . . . . . . . . . . . . . 10

Somewhatlikely . . . . . . . . . . . . . . . . . . . . . 22

Somewhatunlikely . . . . . . . . . . . . . . . . . . . . 13

Veryunlikely . . . . . . . . . . . . . . . . . . . . . . . . 29

Definitelynotpossible . . . . . . . . . . . . . . . . . . 18

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 9

Using public toilets?

Verylikely . . . . . . . . . . . . . . . . . . . . . . . . . 5

Somewhatlikeiy . . . . . . . . . . . . . . . . . . . . . 14

Somewhatunlikely . . . . . . . . . . . . . . . . . . . . 11

Very urrlikely. . . . . . . . . . . . . . . . . . . . . . . . 36

Defmitelynotposeible . . . . . . . . . . . . . . . . . . 25

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 8

Sharing needles for drug use w“M someone who has

the AIDS virus?

Veryhkely. . . . . . . . . . . . . . . . . . . . . . . . . 95

Somewhatlikely . . . . . . . . . . . . . . . . . . . . . 2

Somewhatunlikely . . . . . . . . . . . . . . . . . . . . 0

Veryunlikely . . . . . . . . . . . . . . . . . . . . . . . . 0

Defmftelynotpossible . . . . . . . . . . . . . . . . . . 0

Don’t know. . . . . . . . . . . . . . . . . . . . . . . . . 2

Being coughed or sneezed on by someone who has

the AIDS virus?

Verylikely . . . . . . . . . . . . . . . . . . . . . . . . . 8

Somewhatlikely . . . . . . . . . . . . . . . . . . . . . 20

Somewhatunlikely . . . . . . . . . . . . . . . . . . . . 15

Vetyunlikely . . . . . . . . . . . . . . . . . . . . . . . . 30

Defmitelynotpossible . . . . . . . . . . . . . . . . . . 17

Donlknow, . . . . . . . . . . . . . . . . . . . . . . . . 10

See fm!ro!es al eq$ of table.

46

27

7

7

12

3

4

10

71

12

86

8

2

2

3

2

7

10

40

40

2

4

17

15

3s

25

6

8

20

$

22

5

6

13

::

29

5

97

1

0

0

0

1

1:

:

22

5

51

27

5

7

11

:

9

76

10

89

6

1

1

3

2

:

40

39

4

5

17

13

37

22

6

9

22

:

19

6

1:

::

28

5

97

1

0

0

0

1

2:

:

18

7

38

28

5

4

24

3

4

10

60

24

81

6

1

2

8

3

:

40

31

11

7

17

11

32

16

16

11

z?

2

13

15

6

16

11

35

18

14

92

3

0

0

0

4

1:

13

26

12

17

46

27

6

6

15

3

4

9

71

13

85

7

1

2

5

2

7

10

40

3s

6

6

18

13

34

20

9

10

23

13

29

16

6

5

15

11

37

25

7

95

2

0

0

0

2

2:

15

32

16

10

Percent distribution

45

28

5

6

16

2

4

10

67

17

86

7

1

2

5

2

6

:

38

6

5

16

13

34

23

10

9

20

13

29

19

9

6

13

12

36

25

9

95

2

0

0

0

2

8

20

14

29

18

11

47

28

6

5

14

2

3

9

73

14

87

6

1

1

4

2

5

9

42

37

5

5

17

13

36

21

9

9

21

14

31

17

8

5

12

::

25

8

96

2

0

0

0

1

7

20

15

32

18

10

41

23

6

10

20

6

6

10

58

20

81

6

2

3

7

4

:

37

34

8

8

16

14

28

21

14

E

12

24

17

11

8

15

13

31

24

10

94

3

0

1

0

2

10

20

14

25

17

14

35

26

6

9

24

4

10

10

52

24

77

7

2

3

11

3

11

11

29

36

9

6

17

13

25

27

11

9

24

11

21

24

11

6

24

9

22

27

10

91

3

1

1

:

9

21

12

24

22

12

31

24

6

7

31

5

6

11

48

29

74

8

:

12

4

9

E

31

14

8

18

12

25

18

19

2

;;

15

17

9

20

10

26

18

16

90

4

0

1

0

5

10

23

l?

23

14

19

43

30

6

7

15

2

4

10

69

15

86

8

1

1

4

2

1:

41

36

5

6

18

12

34

21

10

10

21

14

28

18

9

6

14

13

36

25

7

96

2

0

0

0

1

8

20

15

30

17

10

55

27

6

5

8

2

2

8

60

8

91

5

1

1

2

2

:

43

40

2

4

15

14

39

24

5

8

20

14

34

19

5

3

10

11

43

29

4

97

1

0

1

0

1

6

16

:;

16

6
8 Advance Data No. 195. December 18, 1990

Table 1. Provisional estimates of the percent of persons 18 years of age and over with selected AIDS knowledge and attitudes from the

199o National Health interview Survey, by selected characteristics: United States, April-June 1990-Con.

[Data are based on household intewiews of the civilian noninstitutionalized population. The survey design, general qualifications, and information on the reliability of

the estimates are given m technical notes]

Fface/ethrriclty

Age Sex Non-Hispanic Education

18-29 30-49 50 years Less than More than

AIDS knowfedge or attitude Total years years and over Male Female White Black Hispanic 12 years 12 yeare 12 years

5g.

5h.

8.

9.

10.

Attending school with a child who has the AIDS virus?

Very likely . . . . . . . . . . . . . . . . . . . . . . . . .

Somewhat likely . . . . . . . . . . . . . . . . . . . . .

Somewhat unlikely . . . . . . . . . . . . . . . . . . . .

Very unlikely . . . . . . . . . . . . . . . . . . . . . . . .

Definitely notpossible . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

Mosquitoes or other inaecte?

Very likely . . . . . . . . . . . . . . . . . . . . . . . . .

Somewhat likely . . . . . . . . . . . . . . . . . . . . .

Somewhatunlikely . . . . . . . . . . . . . . . . . . . .

Very unlikely . . . . . . . . . . . . . . . . . . . . . . . .

Definitelynotpossible . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

Have you ever discussed AIDS with any of your

children aged 10-17?2

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

Have any or all of your children aged 10-17 had

instruction atachool about AlDS?2

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

Have you ever donated blood?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

11a, Have you donated blood since March 1985?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

11b. Have you donated blood in the past 12 months?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

12. Howmany timeshare youdonated bbodsince

March 1985?

Once . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Twice . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Threetimesormore . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

Didnotdonate blood since March 19B53. . . . . .

13. Howmanytimes have youdonated blood in the past

12months?

Once . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Twice . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Threetimesormore . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

Didnotdonate blood inthepast12months4 . . .

14. Have youever heard ofablood teat fhat can detect

the AIDS virus Infection?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

15, Tothebest ofyourknowledge, are blood donations

routinely tested fortheAIDSvirus infection?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’t know . . . . . . . . . . . . . . . . . . . . . . . . .

Neverheardoftest5 . . . . . . . . . . . . . . . . . . .

16. Was one of your reasons fordonating blood because

you wanted to be tested for the AIDS virus infe~lon?e

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Donlknow.. . . . . . . . . . . . . . . . . . . . . . . .

Neverheardoftest5 . . . . . . . . . . . . . . . . . . .

17. Except for blood donations since 19B5, have you had

your blood tested for the AIDS virus infection?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’t know . . . . . . . . . . . . . . . . . . . . . . . . .

Neverheardoftest5 . . . . . . . . . . . . . . . . . . .

1

5

9

41

37

6

10

19

8

24

19

20

66

32

0

75

9

15

40

60

0

15

85

0

6

94

0

5

3

7

0

65

3

1

1

J’

79

19

2

68

4

6

21

2

82

0

11

10

66

2

21

1

4

8

40

44

2

11

22

9

23

20

15

56

44

87

13

20

31

69

0

21

79

0

6

92

0

9

4

8

0

79

5

2

1

;

82

17

1

72

4

6

18

3

80

12

16

64

2

18

1

5

10

42

39

4

9

19

9

25

22

17

69

31

0

77

9

14

44

56

0

19

81

1

7

92

1

5

3

10

0

81

4

2

1

0

93

87

11

1

77

4

6

13

2

85

0

8

12

73

2

13

2

6

9

41

31

11

9

17

7

24

17

27

62

36

69

9

22

41

56

0

6

93

0

3

97

0

2

1

4

0

94

1

1

1

0

97

66

30

4

54

4

8

34

1

74

19

3

60

3:

1

6

9

42

35

6

11

20

8

25

19

17

55

45

71

9

20

50

50

0

18

81

1

7

92

1

5

4

9

0

62

4

2

2

0

93

79

19

2

68

4

2:

3

82

0

10

11

65

3

21

Percent distrib~lon

1

4

8

40

40

6

8

la

8

24

20

22

78

22

0

79

9

12

30

69

0

:

0

4

95

0

4

2

:

86

3

1

1

0

95

78

19

3

68

4

$

1

81

12

9

67

2

22

1

4

9

44

37

5

6

17

9

26

20

20

68

32

74

9

17

43

57

0

16

83

0

7

93

1

5

3

8

0

84

4

2

1

9:

81

17

2

72

4

6

19

1

64

0

10

9

70

2

19

2

6

10

36

36

9

15

21

7

20

17

20

72

26

81

7

12

32

67

0

12

66

1

4

95

1

4

3

4

0

86

3

1

0

96

68

30

2

54

6

8

32

7

68

18

14

52

1

32

2

6

8

28

45

9

15

25

6

14

21

19

58

42

73

12

15

27

73

9

91

0

2

98

0

4

2

3

0

91

2

0

0

98

68

30

2

53

5

10

32

3

66

22

14

51

3:

3

8

8

34

33

15

13

21

6

19

14

27

51

49

66

14

18

26

73

0

5

95

0

2

98

0

2

1

2

0

95

1

0

0

0

98

60

36

4

47

4

9

40

1

67

2;

8

50

2

40

1

5

9

42

38

5

10

20

9

23

18

20

67

33

77

8

15

37

63

0

14

86

0

5

95

0

5

2

:

86

3

1

:

95

78

20

2

66

4

2;

3

76

0

16

6;

2

22

1

4

9

44

40

3

8

17

9

28

23

15

75

24

0

76

9

15

50

50

0

21

76

1

9

90

1

5

4

12

0

79

5

2

2

0

91

89

10

1

61

4

5

11

1

87

0

7

12

74

3

11

See footnotes at end O! table.
Advance Data No. 195. December 18, 1990 9

Tablel. Provisional estimates of the percent of persons 18years ofageand over with selected AIDS knowledge andaRitudes from the

1990 National Health Interview Survey, by selected characteristic= United States, April-June 1990-Con.

[Data are based on household intewiewe of the civilian noninstiiufionalized population. The survey design, general qualifications, and information on the reliabilii of

the estimates are given in technical notes]

Race/ethnicly

Age sex Non-Hispanic Education

16-W 30-49 50 years Leaa than More ffran

AIDS knowfedge or attitude ToW years yeare and over Male Female Wtrlte Black Hispanic 12 years 12 years 12 years

18. How many times have you had your bfcocf teated for

the AIDS virus infection, not including blood

donations?

Once . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Twice . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Three times or more . . . . . . . . . . . . . . . . . . .

Don’t know . . . . . . . . . . . . . . . . . . . . . . . . .

Never heard of/had test7 . . . . . . . . . . . . . . . .

19. Howmany times inthepast 12monthshave you had

your bleed tested for the AIDS virus infedon, not

including blood donations?

None . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Once . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Twice . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Threetimesormore . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

Neverheardof/hadtest7 . . . . . . . . . . . . . . . .

20a. Were the blcod tests, including those you had before

thepest12months, requiredordidyou goforthem

voluntarily, or were there some of each@

A!lrequired . . . . . . . . . . . . . . . . . . . . . . . .

Allvolunteered . . . . . . . . . . . . . . . . . . . . . .

Someofeach . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

20b. Were any of the b!cmd tests required foes

l-lospitalizatlo norasurgice lprccedum?. . . . . . .

Healthmsurence? . . . . . . . . . . . . . . . . . . . .

Lfeimurance? . . . . . . . . . . . . . . . . . . . . . .

Employment?. . . . . . . . . . . . . . . . . . . . . . .

Mi!tiry reduction ormiliiaryservice?. . . . . . . . .

Immigration? . . . . . . . . . . . . . . . . . . . . . . . .

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

7

2

1

0

80

5

5

0

0

0

90

52

43

3

2

10

4

6

7

10

7

14

21. When wasyourkrstbloodteatforffseAfDSvims

infetion?s

1990 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

1969 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

1988 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

1987 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

1986 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

1985 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 2

22a. Was your last test required or did you go for it

volunterily?a

Required . . . . . . . . . . . . . . . . . . . . . . . . . . a

Voluntary . . . . . . . . . . . . . . . . . . . . . . . . . . 44

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 2

22b. Wae the test required for?

Iiospitelizetion orasurgical procedure?. . . . . . . 9

Health insurance? . . . . . . . . . . . . . . . . . . . . 3

Lffeinsurance? . . . . . . . . . . . . . . . . . . . . . . 6

Employment? . . . . . . . . . . . . . . . . . . . . . . . 7

Miliiry induction ormiliiarysewice?. . . . . . . . . 9

Immigration? . . . . . . . . . . . . . . . . . . . . . . . . 7

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . -

23. Notincluding ablooddorration, where waeyourl~

blood test for the AIDS virus done?8

AIDS clinic/counseling/tes!ingsife . . . . . . . . . . 3

Clinicrun byemployer . . . . . . . . . . . . . . . . . 4

Doctor/HMO . . . . . . . . . . . . . . . . . . . . . . . . 2g

Publicheatthdepartment . . . . . . . . . . . . . . . . 8

Hospital~emergency rmm/outpatient clinic . . . . . 22

STDcllnic . . . . . . . . . . . . . . . . . . . . . . . . . 0

Familyplanning clinic . . . . . . . . . . . . . . . . . . 1

Prenatelclinic . . . . . . . . . . . . . . . . . . . . . . . 1

Tuberculosisclmic . . . . . . . . . . . . . . . . . . . . -

Otherclinic . . . . . . . . . . . . . . . . . . . . . . . . . 5

Drugtreatmentfacilii . . . . . . . . . . . . . . . . . . 0

Militaryinductlon/sewicesite. . . . . . . . . . . . . . 11

Immigratronste . . . . . . . . . . . . . . . . . . . . . .

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1:

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 0

11

3

2

:

7

8

1

0

G

57

39

2

1

:

3

8

16

6

17

23

45

16

:

2

1

5s

40

1

7

3

3

7

15

6

16

4

4

26

10

20

0

1

1

4

1!

1

8

0

8

2

2

8:

6

5

0

0

0

88

50

46

3

1

9

4

10

8

6

7

12

24

40

16

10

3

3

2

51

47

2

:

9

7

5

6

10

2

5

31

7

21

0

2

0

6

;

1

15

2

0

0

0

97

2

1

0

;

97

47

45

3

5

22

3

:

4

5

10

$

15

6

8

2

7

47

46

5

19

3

3

2

4

5

10

5

2

33

6

36

4

6

1

6

7

2

2

:

5

5

:

0

89

55

39

4

1

7

4

9

7

17

8

10

27

39

13

9

4

2

2

57

41

1

7

4

8

7

16

8

8

3

5

24

8

17

0

1

i

1:

1

15

0

Percent distribution

7

T

1

9?

4

4

0

:

91

49

47

:

13

3

4

7

2

5

18

21

42

18

8

4

;

50

47

3

11

3

4

7

2

5

18

4

4

35

9

26

0

1

1

4

:

1

7

6

1

1

0

91

4

4

0

0

0

91

54

42

3

1

12

4

9

7

11

2

14

z

15

10

:

2

z

1

11

4

8

7

11

2

13

3

4

27

6

25

7

1

4

0

13

1

14

9

3

2

8:

6

7

1

:

a6

43

53

3

1

10

2

1

10

10

1

14

26

42

12

11

2

2

3

44

55

1

:

1

10

10

1

13

3

8

30

16

20

1

1

1

4

10

1

4

1

10

3

1

8;

6

8

0

0

86

80

35

3

2

2

2

1

47

11

;

24

5

:

2

?7

2

2

2

1

46

10

3

4

43

11

9

6

13

2

7

2

6

1

1

9:

4

4

0

0

9;

57

40

2

1

11

2

2

;

28

12

z

19

:

2

4

56

41

1

11

2

2

3

z

12

3

5

25

14

24

4

3

7

3

4

8

6

1

1

9:

4

4

:

9:

48

47

2

2

9

4

4

8

12

3

14

%

12

9

4

4

2

49

49

2

:

3

8

11

3

13

2

5

28

8

23

0

1

4

0

14

1

10

:

2

8:

6

5

;

o

88

54

41

3

2

11

4

9

8

10

3

T4

22

41

~7

11

4

;

55

42

2

9

4

9

7

10

3

13

4

4

31

7

21

0

1

0

5

1!

1

14

0
10 Advance Data No. 195 ● December 18, 1990

Table 1. Provisional estimates of the percent of persons 18 years of age and over with selected AIDS knowledge and attitudes from the

1990 National Health Interview Survey, by selected characteristics: United States, April-June 1990-Con.

[Data are based on household interviewa of the civilian noninstiitilonallzed population. The survey design, general qualifications, and information on the reliability of

the estimatee are given m technid notes]

Race/ethnlclly

Age Sex Non-Hispanic Education

18–29 3&49 50 year3 Less than

AIDS knowledge or attitude

More than

Total yeara yeara and over Male Female White Black Hispanic 12 years 12 yeara 12 years

24,

25.

26.

27.

28.

29.

30.

31.

32

Before your last blood test for the AIDS virus

infectlon, were you counseled about the AIDS wrus

and the meaning of the test?e

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

Don’t know . . . . . . . . . . . . . . . . . . . . . . . . . 1

Did you get the results of your last test?a

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

Don’t know . . . . . . . . . . . . . . . . . . . . . . . . . 0

Did you want the results of your last test?g

yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

Don’tknow., . . . . . . . . . . . . . . . . . . . . . . . . 4

When you recetved the results of your last test, did

you receive counseling or talk with a health

professional about how to lower your chances of

becoming infected with the AIDS virus or how to

avoid passing fiontoanother personal”

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 0

Were the results given in person, by telephone, by

mail or in some other way?l”

Unperson . . . . . . . . . . . . . . . . . . . . . . . . . . 66

Bytelephone . . . . . . . . . . . . . . . . . . . . . . . 15

Bymail . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 0

Do you feel your last test for the AIDS virus infection

was handled properly in terms of the confidentially

of your test results?a

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 5

Do you expect to have a blood teat for the AIDS virus

infection in the next 12 months?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6S

Don’t know . . . . . . . . . . . . . . . . . . . . . . . . . 4

Neverheardoftests . . . . . . . . . . . . . . . . . 21

Tell me which of these statements explain why you

will have the blood testll

Voluntarily, because you personally want to know

ifyouareinfecfed . . . . . . . . . . . . . . . . . . . . 67

As panofablood donation . . . . . . . . . . . . . . 24

As part of a hospitalization or surgical

rxocedure . . . . . . . . . . . . . . . . . . . . . . . . 11

As arequlrementfor heaffhinsurance. . . . . . . 11

As arequirementforliie insurance . . . . . . . 9

As arequirementfor ajob, other than mihtary. . . 16

As arequirementforthe mllita~ . . . . . . . . . 12

Aearequirementforimmigration. . . . . . . . . . . 3

Asarequiredparf ofsomeotheractivify that

Includes a blood sample and automatic AIDS

testing . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Where will you go to have a blood test for the AIDS

wrus infect(on?li

AIDS clinic/counseling/testingslte . . . 2

Clmicrun byemployer . . . . . . . . . . . . . . . . . 3

DoctorlWvfO.. . . . . . . . . . . . . . . . . . . . . . 38

Hospitaliemergencyroom/outpatient clinic. . 17

rXherclinic . . . . . . . . . . . . . . . . . . . . . . . . . 9

Publicheafthdepartment . . . . . . . . . . . . . . . . 10

RedCross/bloodbank . . . . . . . . . . . . . . . . . 6

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Don’t know . . . . . . . . . . . . . . . . . . . . . . . . . 3

See footnoles a! end of !sble.

40

59

0

76

23

0

32

60

6

32

68

0

66

15

12

6

0

92

1

6

::

5

16

69

25

10

14

10

16

18

3

16

2

2

39

15

9

12

6

11

4

40

58

1

72

27

0

27

71

2

29

71

0

64

16

15

5

0

91

3

5

7

77

4

13

67

22

9

9

10

17

6

3

13

2

5

36

20

10

6

9

s

2

28

71

0

76

23

1

23

74

4

E

1

71

15

10

2

1

91

4

5

6;

3

34

57

31

21

11

7

13

9

1

10

3

43

15

4

6

13

13

2

41

57

0

73

26

0

30

67

3

31

69

0

67

13

14

6

1

91

3

6

6

67

4

21

83

26

10

13

11

17

17

3

13

2

4

36

15

a

6

10

14

4

Percent distribution

36

62

1

75

24

0

27

67

6

26

74

0

64

18

13

5

0

92

2

5

5

69

4

22

72

23

12

10

7

15

6

2

16

1

3

40

21

10

12

6

4

2

37

61

1

71

28

1

2a

66

4

23

77

0

59

19

15

7

0

91

3

6

5

73

3

19

57

27

12

10

8

17

13

2

14

1

3

41

17

5

7

11

12

3

41

59

0

80

20

26

65

9

45

54

1

77

12

9

1

1

96

2

2

13

46

7

32

83

21

9

16

13

20

11

3

16

3

3

32

20

12

17

4

6

2

45

54

1

86

14

25

75

37

63

87

4

4

4

90

4

6

11

48

6

32

83

23

7

13

10

9

12

6

12

4

6

37

15

16

10

3

3

4

38

61

79

19

55

45

39

60

1

74

25

1

23

72

5

39

59

1

72

26

0

26

69

5

27 28 30

73 72 70

0 0 0

64 65 59

9 16 18

4 15 16

3 4 7

0 1

92 91 92

3 2 3

4 7 4

7 7

49 6: 79

4 4 4

40 22 11

86

19

12

14

13

16

13

5

13

2

4

35

23

6

16

3

5

3

68

25

10

12

8

14

11

2

15

2

4

41

18

6

7

8

6

4

55

26

10

10

9

17

12

2

14

1

3

37

14

10

7

12

15

2
Advance Data No. 195. December 18,1990 11

Table 1. Provisional estimates of the percent of persons 18 years of age and over with selected AIDS knowledge and attitudes from the

1990 National Health Interview Survey, by selected characteristic= United States, April-June 1990-Con.

[Data are based on household interviews of the civilian noninstiiutionaliied population. The survey design, general qualiicetions, and information on the reliabihty of

the estimates are given in technical notes]

Race/ethnicify

Age Sex Non-Hispanic Education

18-28 3&f9 50 years Less than More than

AIDS knowdedge or attitude Total yeara years and over Male Female White Black Hispanic 12 years 12 yeara 12 years

33. Did you have a blood transfusion at any time

between 1977 and 1985?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’t know . . . . . . . . . . . . . . . . . . . . . . . . .

34. Do you think the present supply of blood is safe for

transfusions?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

35. Howeffective doyouthink thauseof acondom is to

prevent getting the AIDS virus through sexual

activity?

Veryeffective . . . . . . . . . . . . . . . . . . . . . . .

Somewhateffective . . . . . . . . . . . . . . . . . . .

Notatall effectwe . . . . . . . . . . . . . . . . . . . .

Don’tknowhoweffective . . . . . . . . . . . . . . . .

Don’tknowmethod . . . . . . . . . . . . . . . . . . .

36. What areyour chances ofhaving the AIDS virus?

High. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Medium . . . . . . . . . . . . . . . . . . . . . . . . . . .

Low . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

None . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

37. What areyour chances ofgetting the AIDS virus?

High . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Medium . . . . . . . . . . . . . . . . . . . . . . . . . . .

Low . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

None . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’t know . . . . . . . . . . . . . . . . . . . . . . . . .

N/A - High chance of already having the AIDS

virus . . . . . . . . . . . . . . . . . . 4 . . . . . . . . .

3S. Have youever personally known anyone with AIDS or

the AIDS virus?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

No... . . . . . . . . . . . . . . . .

Don’tknow : : : : ::::..... . . . . . . . . . . .

39. Isanyof these statements true foryou?

a. Youhave hemophilia and have received clotthg

factor concentrates since 1977.

b. You are a native of Haiti or Central or East Africa

whohasentered the United States since 1977.

c. You area man who has hadsexwlth another

manatsome time since 1977, even 1 time.

d. You have taken illegal drugs by needle at any

time since 1977.

e. 6ince 1977, youareor have been the sex partner

of any person who would answer yes to any of

the items above (39 a-d).

f. Youhave hadsexfor money ordrugsatanytlme

since 1977.

Yestoatleast l statement . . . . . . . . . . . . . . .

Notoall statements . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

9:

1

46

31

23

27

52

4

14

3

0

3

21

73

2

0

15

84

1

2

98

0

2

97

0

51

31

18

33

54

5

7

2

1

2:

74

2

0

3

27

66

2

1

;

1

3

97

0

5

94

1

49

31

20

30

55

4

10

1

:

16

78

1

:

25

70

2

0

19

80

1

3

97

0

8

91

2

39

32

29

20

47

5

23

5

0

2

8;

2

:

12

82

3

0

11

88

1

1

99

0

2

1

51

28

21

31

52

3

11

3

0

3

17

78

2

:

24

70

2

0

z

1

3

97

0

Percent distribution

6

93

1

42

34

24

24

52

5

16

3

0

2

14

62

2

0

2

la

76

2

0

15

64

1

2

98

0

9:

1

2

23

27

54

4

13

2

0

1:

81

1

0

2

22

74

2

0

14

85

1

2

98

0

5

94

1

z

24

29

47

5

16

4

1

5

18

75

3

1

4

19

70

5

1

18

80

2

9;

o

9:

1

32

41

27

26

46

7

16

6

:

13

79

4

:

18

73

5

1

15

63

2

2

98

0

6

92

1

33

35

32

19

42

2;

7

1

2

9

64

4

0

2

12

80

5

1

8

91

2

2

9a

o

5

94

1

43

34

23

26

54

5

13

2

0

2

E

1

0

3

19

75

2

0

11

88

1

9:

0

5

94

1

56

26

18

32

55

3

8

1

:

20

77

1

:

27

66

1

0

21

78

1

2

98

0

1Mull!ple responses may sum 10 more than 100.

2Based on persons an.swenng yes 10 questton 6, “DO You have any children aged 10 through 177” Question 7 was “’How many do you have?

3Persons answering no or don’t know to question 10 or 1la.

4Pereons answering no or don’t know to question 10, 11a, or 11 b.

spersons answering no or don? know to qUeStiOn 14

‘Based on persons answering yes to question 1la.

7persons snswarmg no or oon’t know to questions 14 Or 17.

8Bss@d on persons aaswermg yes to questfon 171

9perSo”S ~“swer(ng no or don? know to Westlon 25,

lcaa~ed on persons answenng yes to qUeSriOn 25,

11Based on pwsons answenng yes to question 30.
12 Advance Data No. 195 ● December 18, 1990

Technical notes

The National Health Interview

Sumey (NHIS) is a continuous, crosssectional household interview survey.

Each week a probability sample of

the civilian noninstitutionalized

population is interviewed by

personnel of the U.S. Bureau of the

Census to obtain infom’ation on the

health and other characteristics of

each member of the household.

Information on special health topics

is collected for alI or a sample of

household members. The 1990

National Health Interview Survey of

AIDS Knowledge and Attitudes is

asked of one randomly chosen adult

18 years of age or over in each family.

The estimates in this report are based

on completed intemiews with 10,261

persons, or about 86 percent of

e~igible respondents.

Table I contains the estimated

population size of each of the

demographic subgroups included in

table 1 to allow readers to derive

provisional estimates of the number

of people in the United States with a

given characteristic, for example, the

number of men who have had their

blood tested for HIV. The population

figures in table I are based on 1990

data from the NHIS; they are not

official population estimates. Table 11

shows approximate standard errors of

estimates presented in table 1. Both

the estimates in tab[e 1 and the

standard errors in table II are

provisional. They may differ from

estimates made using the final data

file because they were calculated

using a simplified weighting

procedure that does not adjust for all

the factors used in weighting the final

data file. A final data file covering

the entire data collection period for

1990 will be available at the end of

1991.

Table L Sample sizes for the 1989 National

Health Interview Survey of AIDS

Knowledge and Attitudes and estimated

adult population 18 years of age and over,

by selected characteristics: United States,

April-June 1990

Estimated

Sampla population

Characteristics size In tiousands

All adults . . . . . . . . . . . 10,261 160,270

Age

l&29years . . . . . . . . . 2,286 46,262

30-49 years . . . . . . . . . 4,123 71,831

50 years and over . . . . . 3,852 82,157

Sex

Male. . . . . . . . . . . . . . 4,312 65,S32

Female . . . . . . . . . . . . 5,949 S4,636

Race/ethnicity

Non-Hispanic whtie. . . . . 7,616 140,293

Non-Hispanic black. . . . . 1,464 19,735

Hispanic . . . . . . . . . . . 645 13,635

Education

Lass than 12 years. . . . . 2,204 36,901

12yeara . . . . . . . . . . . 3,897 69,945

More than 12 years. . . . . 4,090 72,130

Table Il. Standard errors, expressed in percentage points, of estimated percents from the Nat[onal Health Intewlew Survey of AIDS

Knowledge and Attitudes, by selected characterlstlc= United States, April-June 1990

Age Sex Race/ethnicUy Education

18-2S 3&49 S3 yeara Less than More than

Estimated percent Total years years and over Male Female Write Black Hispanic 12years 12yeara 12 years

5or95 . . . . . . . . . . . . . . . . . . . . 0,3 0.6 0.4 0.4 0.4 0.3 0.7 1.1 0.4 0.4

100r90 . . . . . . . . . . . . . . . . . . . 0,4 0.6 0.6 ::: 0.6 0.5 0.4 1.0 1.5 ::: 0.6 0.6

150r65 . . . . . . . . . . . . . . . . . . . 0.5 1.0 0.7 0.7 0.7 0.6 0.5 1.2 1.6 1.0 0.7 0.7

200r60 . . . . . . . . . . . . . . . . . . . 0.5 1.1 0.6 0.6 0.8 0.7 0.6 1.3 2.0 1.1 0.6 0.8

250r75 . . . . . . . . . . . . . . . . . . . 0.6 1.2 0.9 0.9 0.6 1.4 2.2 1.2 0.9 0.9

300r70 . . . . . . . . . . . . . . . . . . . 0.6 1,2 0.9 1.0 :: ::: 0.7 1.5 2.3 1.3 0.9 0.9

350r65 . . . . . . . . . . . . . . . . . . . 0.6 1.3 1.0 1.0 0.9 0.8 0.7 1.6 2.4 1.3 1.0 1.0

400r 60 . . . . . . . . . . . . . . . . . . . 0.6 1.3 1.0 1.0 1.0 0.6 0.7 1.6 2.5 1.3 1.0 1.0

450r55 . . . . . . . . . . . . . . . . . . . 0.6 1.0 1.0 1.0 0.6 0.7 1.7 1.4 1.0

50 . . . . . . . . . . . . . . . . . . . . . . . 0.6 U 1.0 1.0 1.0 0.6 0.7 1.7 ::: 1.4 ::: 1.0
Number 196 ● April 11, 1991

Advance

Data

From Vital and Health Statistics of the National Center for Health Statistics

Office Visits by Adolescents

by Cheryl Nelson, M.S.P.H., Division of Health Care Statistics

Introduction

This report examines 1985

statistics from the United States on

the health care provided to

adolescents by office-based

physicians. The data are colIected by

means of the National Ambulatory

Medical Care Survey (NAMCS), a

year-long probability sample survey of

private office-based physicians. This

survey was conducted annually from

1978 through 1981 and again in 1985

by the Division of HeaIth Care

Statistics of the National Center for

Health Statistics. NAMCS resumed as

an annual survey in 1989. For

purposes of this report, an adolescent

visit is defined as a visit by a patient

11-20 vears of age. Older adolescents

are de;ined as patients 15-20 years of

age and younger adolescents as

patients 11-14 years of age,

In 19S5 in the United States, 58

million visits (9 percent of all patient

visits) to office-based physicians were

made by adolescent patients. Visits by

adolescents were reflective of the

demographic profile of aIl patient

visits to private, office-based

physicians: primarily non-Hispanic,

white, and female (tabIe 1). Health

Table 1. Number of office visits made by persons of aii ages and by adolescents

11-20 years of age and percent distribution by patient’s sex, race, and ethnicity,

according to age: United States, 1985

AII 11-20 11-14 16-20

Sex, race, and e!hrricity ages yeara years years

Number of visits in thousands . . . . . . . . . . 536,386 58,996 19,360 39,637

Percent distribution

Allvisits . . . . . . . . . . . . . . . . . . . . . . . . 100.00 100.00 1Oo.oa 100.00

Sex

Female . . . . . . . . . . . . . . . . . . . . . . . . 60.89 57.39 S0.07 60.96

Male . . . . . . . . . . . . . . . . . . . . . . . . . . 39.11 42.61 49.93 39.04

Race

White . . . . . . . . . . . . . . . . . . . . . . . . . 89.96 89.29 90.78 88.57

Black . . . . . . . . . . . . . . . . . . . . . . . . . 8.19 8,76 7.47 9.39

Other races.............,.. . . . . . 1.84 1.95 1.74 2.05

Ethnicity

Hispanic . . . . . . . . . . . . . . . . . . . . . . . 6.36 7.52 0.15

Non-Hispanic . . . . . . . . . . . . . . . . . . . . 93.62 92.46 9:% 91.85

care visits by patients 11-14 years of

age were Iike those of children, and

health care visits by patients 15-20

years of age were like those of young

adults.

Physician specialty and visit

status

Younger adolescents primarily

sought medical care from

pediatricians and general and/or

family practitioners (table 2). The

eider adolescent patient generally

sought care not only from

pediatricians and general andlor

family practitioners but also from

physicians specializing in obstetrics

and gynecology and dermatology.

Sixty-six percent of the visits by the

older adolescent patient were to these

four types of specialists. An almost

equal percent of visits by the younger

##* -=’”(+

+

U.S. DEPARTMENT OF HEALTH AND HUMAN SEWlCE!3

.

2* Pubiic Heaith Service

s

Centers for Disease Control

;

>

~%..a,a

Manning

National

Feinleib,

Center

M.

for

D.,

Health

Dr. P.

Statistics

H., Director

CDC
2 Advance Data No. 196 ● April 11, 1991

Table 2. Number of office visits made by persons of all ages and by adolescents

11-20 years of age and percent distribution by physician specialty, according to age:

Urifted States, 1985

Al! 11-20

Specia/fy

11–14 15-20

ages yeara years yeara

humber of visits in thousands . . . . . . . . 636,386 58,996 19,360 39,637

Percent distribution

Ail visits . . . . . . . . . . . . . . . .. . . . . . . . . 103.00 100,00 100.00 100.00

General and/or family practice. . . . . . . . . 30.46 3540 30.79 37.65

In!ernal medicine . . . . . . . . . . . . . . . . . . 11.59 5,14 4.01 5.70

Pediatrics . . . . . . . . . . . . . . . . . . . . . . . 11.42 17,60 33.33 9.91

Cxletrics and gynecology. . . . . . . . . 8.90 8.05 1.27 11.36

O~hthalmology . . . . . . . . . . . . . . . . . . . 6.30 4.62 4.91 4,48

C?hopedlc surgery . . . . . . . . . . . . . . . . . 4.95 7.32 8.03 6.98

General surgery . . . . . . . . . . . . . . . . . . . 4.69 3.70 2.09 4,49

D~rmato[ogy. . . . . . . . . . . . . . . . . . . . . 3.79 6,46 3.69 7.84

Psychiahy . . . . . . . . . . . . . . . . . . . . . . 2.63 2.00 1.85 2.07

OWhinolaryngology . . . . . . . . . . . . . . . . 2.53 2.56 2.88 2.40

LJ-dogical surgery . . . . . . . . . . . . . . . . 1.84 0.59 0.48 0.64

Cardiovascular disease . . . . . . . . . . . . . 1.67 0.13 0.00 0.19

Neurology . . . . . . . . . . . . . . . . . . . . . 0.78 0.63 0.69 0.59

A,! otherspecialties. . . . . . . . . . . . . . . . . 8.24 5.76 5.98 5.68

adolescent patient (64 percent) were

to physicians specializing in pediatrics

and general and/or family practice.

There was a significant difference

between the percent of visits by

younger adolescents and the percent

by older adolescents to physicians

specializing in pediatrics and

obstetrics and gynecology. As

expected, younger adolescent patients

were more Iikelyto seek medical care

from pediatricians, and older

adolescent patients were more likely

to seek medical care from

obstetricians and gynecologists.

Thirty-three percent of the visits by

the younger adolescent patient were

to physicians specializing in

pediatrics, and only 1 percent were to

physicians specializing in obstetrics

and gynecology. Eleven percent of the

visits by older adolescent patients

\vere to obstetricians and

~necologists, and only 9 percent

\vere to pediatricians.

The percents of visits to

dermatologists by the younger

adolescent patient and by the older

adolescent patient were 3 percent and

7 percent, respectively. Thirty percent

of the visits by younger adolescents

\vere to general and/or family

practitioners, compared with

57 percent bv older adolescents.

Twenty-~hree percent of the visits

by adolescents were classified as

“first-time” visits, or as “new-patient”

visits. Assuming all new-patient visits

presented the physician with a new

medical problem, at least 50 percent

of the visits by adolescents were for

care of a new medical problem (table

3). New problem visits for patients of

all ages accounted for 39 percent of

the total number of visits.

Patient’s reason for visit

General medical or physical

examination was the major reason

adolescents visited a physician’s office

(table 4), accounting for 5.4 million

visits. This ranked as the principal

reason for visit for all adolescent

patients, especially younger

adolescent patients.

Routine prenatal examination

was the reason given most often~

among older adolescent patients for

visiting a physician, accounting :for

3.3 million visits. There were a total

of 3.4 million adolescent visits in

which a routine prenatal examination

was given as the principal reason for

visit; and 98 percent of these were by

older adolescents. Symptoms

referable to throat ranked as the

second most frequent reason given by

older adolescents for visiting a

physician – 4.2 million adolescent

visits, or 7 percent.

Another major reason for visit by

the older adolescent was for acne or

pimples. Of the 2.4 million visits

made by adolescents for this reason,

2.1 milIion (or 86 percent) were made

by older adolescents.

Visits by younger adolescents in

which general medical or physical

examination was the principal reason

totaled 2.5 million. About half,

1,1 milIion, of these visits were

specifically for physical examination:

836,000 visits were for physicaI

examinations for extracurricular

activities and 273,000 were for

physical examinations required for

school. OIder adolescents made

2.8 million visits in which the reason

for visit was specifically for a physical

examination: 421,000 were for

physical examinations for

extracurricular activities, 378,000 were

for physical examinations required for

Table 3. Number of office visits made by persons of all ages and by adolescents

11-20 years of age and percent distribution by patient’s referral status and prior visit

status, according to age United States, 1985

All 11-20 11-14 75-20

Referra/ status and prior visit status ages yeara years years

Number of visits in thousands . . . . . . . . . 636,386 56,996 19,360 3.9,637

Percent dlatribtilon

All visits . . . . . . . . . . . . . . . . . . . . . . . . 100.00 100.00 100.00 100.00

Referral status

Referred by another physician. . . . . . . . . 5.62 5.56 5.73 5.48

Not refened by another physician. . . . . 94.38 94.44 94.27 94.52

Prtor visil status

New patient . . . . . . . . . . . . . . . . . . . . . 16.91 23.01 22.54 23.24

Old pabent. . . . . . . . . . . . . . . . . . . . . . 83.09 76.99 77,46 76.76

New problem . . . . . . . . . . . . . . . . . . . 22.73 29.42 34.45 26.96

Old problem . . . . . . . . . . . . . . . . . . . . 60.36 47.58 43,01 49.81

Newproblerns . . . . . . . . . . . . . . . . 39.64 52.42 56.99 50.19

Old!xoblems . . . . . . . . . . . . . . . . . . . . 60.36 47.58 43.01 49.81
Advance Data No. 196 ● Amil 11.1991 3

Table 4. Number and percent distribution of office visits made by adolescents 11-20 years

of age by most frequent principal reason for visit, according to age: United States, 1985

Number of

n“sitsin Percent

Age, principal reason for visit, and RVC code’ thousands distribution

11-20 years

All visits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

General medical and physical examination . . .X1 00,2A100-A140

Symptoms referable to throat . . . . . . . . . . . . . . . . . . .S455

Prenatal examination, routine . . . . . . . . . . . . . . . . . . .X205

Acne orpimples . . . . . . . . . . . . . . . . . . . . . . . . . ..S830

Cough . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..S440

Earache orear infection. . . . . . . . . . . . . . . . . . . . . ..S355

Skin rash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..s860

Knee symptoms . . . . . . . . . . . . . . . . . . . . . . . . . ..S925

Allergymedication . . . . . . . . . . . . . . . . . . . . . . . . ..TIOO

Headache, painmhead . . . . . . . . . . . . . . . . . . . . ..S210

Waris, nototherwise specified. . . . . . . . . . . . . . . . . ..S850

Abdominal pain, cramps,spasms. . . . , . ., . . . . . . . ..S550

Allergy, nototherwisespecified. . . . . . . . . . . . . . . . . .S090

Post-operativeVisit . . . . . . . . . . . . . . . . . . . . . . . . ..T205

Eyeexammation . . . . . . . . . . . . . . . . . . . . . . . . . ..X230

Head cold, upper respiratory infection (CORYZ4). . . . . . .S445

Vkondysfuncfions . . . . . . . . . . . . . . . . . . . . . . . ..S305

Suture- insertion, removal. . . . . . . . . . . . . . . . . . . . .T555

Fever . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..S010

13acksymptoms . . . . . . . . . . . . . . . . . . . . . . . . . . ..S905

Altotherreasons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11-14 years

Allvisits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

General medical and physical examination . . .X100,2A100-A140

Symptoms referabletothroat . . . . . . . . . . . . . . . . . ..S455

Cough . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..S440

Skm rash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..S880

Earache orearinfection . . . . . . . . . . . . . . . . . . . . . ..S355

Al!ergy, notothewise specified. . . . . . . . . . . . . . . . ..S090

Kneesymptoms, . . . . . . . . . . . . . . . . . . . . . . . . ..S925

Allergymedication, . . . . . . . . ... . . . . . . . . . . . . ..TIOO

Acneorpimples . . . . . . . . . . . ., . . .. S830 . . . . ..S83O

Vls[on dysfunctions . . . . . . . . . . . . . . . . . . . . . . . ..S305

Warts. nototherwise specified. . . . . . . . . . . . . . . . . .S850

Headache, pain inhead . . . . . . . . . . . . . . . . . . . . ..S210

Nasal congestion . . . . . . . . . . . . . . . . . . . . . . . . . ..S400

Head cold, upper respiratory infection (CORYZ,4). . . . . . ,S445

Abdommal pain, cramps,spasms. . . . . . . . . . . . . . . . .S550

Suture-insertion, removal. , . . . . . . . . . . . . . . . . . ..T555

Footandtoesymptoms . . . . . . . . . . . . . . . . . . . . . ..S935

Post-operativevisit . . . . . . . . . . . . . . . . . . . . . . . . ..T205

Eye examination . . . . . . . . . . . . . . . . . . . . . . . . . ..X23J

Backsymptoms . . . . . . . . . . . . . . . . . . . . . . . . . . . ..S905

All otherreasons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15-20 years

Allwsits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Prenatal examination, routine . . . . . . . . . , . . . . . . . ,X205

General medical and physical examination . . .X100,2A100.A140

Symptoms referabletothroat . . . . . . . . . . . . . . . . .s455

Acne orpimples . . . . . . . . . . . . . . . . . . . . . . . . . ..S830

Earache orearmfectlon. ,... . . . . . . . . . . . . . . . . ..s355

Skm rash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..sS60

Allergymedication . . . . . . . . . . . . . . . . . . . . . . . . ..TIf)O

Cough . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..sJMo

Headache, pain inhead . . . . . . . . . . . . . . . . . . . . ..S21O

Warts, not otherwise specified.. . . . . . . . . . . . . . . . . .S850

Knee symptoms . . . . . . . . . . . . . . . . . . . . . . . . . ..Sg25

Abdommal pain, cramps, spasms. . . , . . , . . . . . . . . .S550

Post-operatwevistt, . . . . . . . . . . . . . . . . . . . . . . . ..T2r35

Eye examination . . . . . . . . . . . . . . . . . . . . . . . . . ..x230

Head cold, upper respiratory infection (CORYZA). . . . . . .S445

Fever, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..so1o

Suture-inserfion, removal, . . . . . . . . . . . . . . . . . . ..T555

Visron dysfunctions . . . . . . . , . . . . . . . . . . . . . . . ..s3o5

Back symptoms . . . . . . . . . . . . . . . . . . . . . . . . . . ..sgo5

Allergy, nototherwses peclfied. . . . . . . . . . . . . . . . ..S090

All ctherreasons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

58.996

5,440

4,277

3,435

2,455

1,460

1,359

1,2S6

1,076

1,065

949

945

859

812

772

725

720

671

606

571

565

28,934

19,360

2.562

1,622

758

557

526

470

436

360

339

308

304

296

288

266

250

234

224

214

210

209

8.930

39,637

3,391

2,878

2,655

2,117

833

742

705

702

653

641

640

609

559

515

%

372

363

357

343

19,734

100.00

9.22

7.25

5.82

4.16

2.47

2.30

2.20

1.82

1.81

1.61

1.60

1.46

1.38

1.31

1.23

1.22

1.14

1.03

0.97

0.96

49.04

100.00

13.23

8.38

3.91

2.88

2.72

2.43

2.25

1.86

1.75

1.59

1.57

1.53

1.49

1.37

1.29

1.21

1.16

1.10

1.09

1.08

46.12

100.00

8.55

7.26

6.70

5.34

2.10

1.67

1.78

1.77

1.65

1.62

1.61

1.54

1.41

1.30

1.15

0.95

0.94

0.92

0.90

0.86

49.79

‘Based on .%hnelder D, Ac.ple!on A, and McLemore T. A reason for VISIt class.f,cat!onfor ambulatory care. Na:c-al Cen!ar for

Hea’!h Slat@tcs.VitalandHealthSat2( 78). 1979.

‘Reason forvml dass,f:cat,on (RVCI coae X1OO IS general medical exammatton and c.cdes AI OO.A140 are;hys -~! examination

recL,ed foremployment. iorschoo!, foretiracuw!cular ati[v!tiea, fordrlver,s ticenae exam! nat!on, ford. sab,l)tye~- nawm, and for

prerartal exammat] on,

schooI, and 345,000 were for physical

examinations required for

employment.

Cough was another complaint

that characterized visits by younger

adolescents. Cough, as a principal

reason for visit, accounted for 758,000

(3 percent) visits by younger

adolescents and for 702,000

(1 percent) visits by older

adolescents.

Diagnostic services and

physician’s diagnosis

No diagnostic services were

ordered or provided by the physician

in 42 percent of alI adolescent visits.

In addition, no diagnostic services

were orderedor providedin

48percentofthe visits byyounger

adolescents and in39 percentof the

visits by older adolescents (table 5).

The diagnostic services most

often orderedor provided were blood

pressure check and urinalysis.The

older adolescent patient, however,

wasmorelikeIy to receive ablood

pressure check than the younger

adolescent patient. BIood pressure

checks were given in34percentcf

the visits byoIder adolescents and in

19percent of the visits byyounger

adolescents. As expected, older

adolescents were also more likeIy to

receive some type of gynecological

examination. In 12 percent of the

visits byoider adolescents, patients

received diagnostic services of a

peIvic examination; and in 6 percent,

abreast examination. OnIy in

1 percent of the visits by younger

adolescents did they receive

diagnostic services of a breast

examination or a pelvic examination.

Normal pregnancy was the

principal diagnosis made by the

physician during 3.4 million

adolescent visits (5 percent) (table 6).

Normal pregnancy ranked as the .

principaI diagnosis made during \tisits

by alI adolescent patients, especially

the older adolescent patient, for

whom 3.3 million such diagnoses (or

8 percent) were made.

Aside from normaI pregnanq,

other diagnoses that were rendered

more often during visits byoIder

adolescents than during visits by
4 Advance Data No. 196 ● April 11, 1991

Table 5. Number of office visits made by people of all ages and by adolescents

11-20 years of age and percent distribution by diagnostic services ordered or provided,

according to age: United States, 1985

All 1 7–20 11-14 T5-20

Diagnostic services’ ages years years years

Number of viste in thousands . . . . . . . . .

Allvisits . . . . . . . . . . . . . . . . . . . . . . . .

None . . . . . . . . . . . . . . . . . . . . . . . . . .

Breast exam . . . . . . . . . . . . . . . . . . . . .

Pelwcexam. . . . . . . . . . . . . . . . . . . . .

Rectal exam. . . . . . . . . . . . . . . . . . .

Visual acvw . . . . . . . . . . . . . . . . . . . . .

Urmalysls . . . . . . . . . . . . . . . . . . . . . . .

Hemato@y. . . . . . . . . . . . . . . . . . . . .

Blood chem@ry. . . . . . . . . . . . . . .

Paptest . . . . . . . . . . . . . . . . . . . . . . . .

Otherlaatest . . . . . . . . . . . . . . . . . . . .

Blood pressurecheck . . . . . . . . . . . . . . .

EKG . . . . . . . . . . . . . . . . . . . . . . . . .

Chestx ray . . . . . . . . . . . . . . . . . . . . . .

Otherrao!ology . . . . . . . . . . . . . . . . . . .

Ultrasound . . . . . . . . . . . . . . . . . . . . . .

Other . . . . . . . . . . . . . . . . . . . . . . . .

636.386

100.00

36.14

6.78

6.62

5.37

6.43

13.63

9.27

6.90

4.49

8.41

38.64

3,19

2.76

5.94

0,94

10,65

58,996 19,360

Percent distribtiton

100.00 100.00

42.15 46.17

5,16 1.63

6.83 1.81

2.67 1.00

7,10 9.02

15,61 13.92

9.87 10.74

3.99 3.00

4.00 0.63

11,29 11.81

29,43 19.97

0.49 0.37

1.11 1.10

6.67 8.41

0.74 0.40

8.23 5.95

39.637

100.0+3

39.21

6.89

12.26

3.46

6.17

16.44

9.44

4.47

5.64

11.03

34.06

0.55

1.12

6.11

0.90

9.34

‘May nota:d to 100.00 becausemorethanone diagnosticservicewas poss!bleduringthe patlenlvisit.

younger adolescents were diseasesof

the sebaceous glands; disordersof

urethra and urinary tract;

contraceptive management; special

investigation and examination

(principally gynecological); and

inflammato~ disease of cervix,

vagina, and vulva.

General medical examination was

the principal diagnosis rendered in

3.3 milIion adolescent visits

(5 percent). General medical

examination accounted for 1.4mi11ion

younger adolescent visits (7 percent)

and ranked asthe number one

diagnosis during visits byyounger

adolescents. There were 1.9 million

visits (6 percent) by older adolescents

for general medicaI examination.

Nonmedication therapy

h’onmedication therapy was

ordered or provided in only

31 percent of the adolescent visits.

The nonmedication therapy services

given most often were ambulatory

surge~and other counseling

(table 7).

The nonmedication therapies

family planning and diet counseling

\vere each ordered or provided in

3-percent of the visits by adolescents.

NineV-five percent and 79 percent,

respect it$ely.of the adolescent visits

for family planning service or diet

counseling services were by older

adolescent patients.

Disposition and duration of

visit

The mean durations of visit for

adolescent patients and aII patients

were 14 minutes and 16 minutes,

respectively. Approximately

62 percent of the visits by adolescents

had a duration of 6 to 15 minutes. A

“return” disposition was given in

78 percent of the visits by adolescents.

The disposition “Return at a

specified time” was given to

adolescent patients in 49 percent of

the office visits (table 8).

Medication therapy

Medication was ordered or

provided in more than 50 percent of

the 58 million visits made by

adolescents (table 9). These

31 million drug visits produced

46 million drug mentions,

representing a drug visit rate of 1.4

drugs per drug visit. The 46 million

drug mentions associated \vith

adolescent visits represented

6 percent of all drugs mentioned in

all visits by patients of all a~es.

The drugs ordered or provided to

adolescent patients were generally

characterized as antibiotics (table 10).

However, drug mentions of tuberculin

tine test (a tuberculin skin test) and

diphtheria tetanus toxoids (an

immunization) were more likely

associated with younger adolescents.

Drug mentions of Ortho-novum (a

contraceptive) and Retin-A (an acne

treatment) were more likely

associated with older adolescents.

The antibiotics mentioned most

frequently during visits by adolescents

were tetracycline, amoxicillin,

ampiciI1in, amoxil, Pen-Vee K, E.E.S.

(erythromycin ethylsuccinate),

erythromycin, and Keflex.

Summary

The profile of visits by older

adolescents was quite different from

that by younger adolescents. Older

adolescents differed with respect to

the male-to-female ratio (40:60), the

specialists from whom they sought

medicaI care (obstetricians), their

reasons for visiting the physician

(prenatal care, acne), the diagnoses

rendered (pregnancy), the

nonmedication services provided

(famiIy planning, diet counseling),

and the medications prescribed

(antibiotics, Ortho-novum, Retin-A).

Comparatively, younger adolescents

sought medical care primarily from

pediatricians, the male-to-female ratio

was 50:50, the principal reasons for

visiting the physician were for a

general medical or physical

examination or a cough, and

antibiotics and immunizations were

frequently ordered or provided..
Advance Data No. 196 ● April 11,1991 5

Table 6. Number and percent distribution of office visits made by people of all ages and

by adolescents 11-20 years of age by the 15 most frequent principal diagnoses,

according to age: United States, 1985

Number of

wits in Percent

Age, principal d!agnosis, and CD-9-CM code’ thousands distribution

11-20 years

Allvisits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Normal pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . ..V22

General medical examination . . . . . . . . . . . . . . . . . . . .V70

Diseases of sebaceous glands . . . . . . . . . . . . . . ...706

Acute pharyngitis . . . . . . . . . . . . . . . . . . . . . . . . . ...462

Acute upper respiratory infections of rnuwle or

unspecified sales . . . . . . . . . . . . . . . . . . . . . . . . ...465

Otnerdiseases due!ovtrtises anochlamydlae. . . . . . . . .78

AIlerg!c rhmi!is . . . . . . . . . . . . . . . . . . . . . . . . . . ...477

D!sordersof refraction andaccommoaat!on . . . . . . . . ...367

Suptmratwe andunspecifted otrkmedia. . . . . . . . . . . .382

Certamadverse eflects, not elsewhere classified . . . . ...9952

Contact dermatitis andothereczerna . . . . . . . . . . . . . .692

Acute tonsillitis . . . . . . . . . . . . . . . . . . . . . . . . . . ...483

Health supervision ofinfantorchdd . . . . . . . . . . . . . .V20

Other disordefe ofurethra andunnarytract . . . . . . . . ...599

Disorder of external ear . . . . . . . . . . . . . . . . . . . . . ...380

All other diagnoses . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11-14 years

Allvisfts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

General medical examination . . . . . . . . . . . . . . . . . . . .V70

Acute pharyngitis . . . . . . . . . . . . . . . . . . . . . . . . . ...462

Acute upper respiratory infections of m~ ‘“,ple or

unspecified sites, . . . . . . . . . . . . . . . . . . . . . . ...465

Cedsin adverse effects, notelsewhere c.=ssifled . . . . . . .9952

Allergic rhmitis . . . . . . . . . . . . . . . . . . . . . . . . . . ...477

Health supervision ofinfantorchild . . . . . . . . . . . . . . .V20

Contact dermatitis and other eczema . . . . . . . . . . . . ...692

Suppuratwe andunspectfled ofitismed!a. . . . . . . . . . ...382

other diseases duetoviruses andchlamydiae. . . . . . . . . .78

Disorders ofrefraction andaccammodat]on . . . . . . . . . . .367

Diseases of sebaceous glands . . . . . . . . . . . . . . . . ...706

Curvature of spine . . . . . . . . . . . . . . . . . . . . . . . . ...737

Acute tonsillitis . . . . . . . . . . . . . . . . . . . . . . . . . . ...463

Streptococcal sorethroat and scarlet fever. . . . . . . . . . ...34

Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...493

Allotherdiagnoses . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15-20 yeare

Aflvisita . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Norma[pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . ..V22

Diseases ofsebaceousglands . . . . . . . . . . . . . . . . . ..706

General medlcel examination . . . . . . . . . . . . . . . . . . . .V70

Acute upper respiratory mfed!ons of mult!ple or

unspecified sties . . . . . . . . . . . . . . . . . . . . . . . . . ..465

Acute pha~ngitis . . . . . . . . . . . . . . . . . . . . . . . . . ...462

Otherdiseasesduetovirusesand chlamydiae. . . . . . . . . .78

Allergicrhinitis . . . . . . . . . . . . . . . . . . . . . . . . . . ...477

Disorders ofrefraction and accommodation . . . . . . . . . ..367

Suppurative andunspecif!ed otitls media. . . . . . . . . . ...382

Acutetonsillitis . . . . . . . . . . . . . . . . . . . . . . . . . . ...463

Other disorders ofurethra and urinary tract . . . . . . . . ...599

Contsctdermatiis andothereczema . . . . . . . . . . . ...692

Contraceptive management . . . . . . . . . . . . . . . . . . . ..V25

Ceftamadverse effacts, notelsewhere classified . . . . ...9952

Special investigations andexammations. . . . . . . . . . . . .V723

Allotherdiagnoses . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

58,996

3,424

3,375

2.888

1.8t4

1.606

1.424

1,356

1,231

1.141

1,038

1,011

893

853

678

657

35,408

19,360

1,433

709

637

555

553

527

475

473

459

458

401

311

308

3crfl

297

11,464

39,637

3,391

2,487

1,942

1,169

1,105

%

772

668

585

547

535

510

483

464

23.208

100.00

5.80

5.72

4.90

3.07

3.06

2.41

2.30

2.03

1.93

1.76

1.71

1.51

1.45

1.15

1.11

60.02

100.00

7.40

3.66

3.2e

2.87

2.86

2.72

2.46

2.44

2.37

2.37

2.07

1.61

1.59

1.55

1.53

59.21

100.00

8.56

6.27

4.eo

2.95

2.73

%

1.95

1.88

1.48

1.38

1.35

1.2e

1.22

1.17

58.55

18=edon Public Heakh Sewiceand Heakh Care Flnanctng Adm1n]stmtton. lntemational C!sss!fication of Dt@ses.Sth

Revision, ClmtCel mCd.flCalmI(’ CD-9-CfJ). Was7,a~orc PubIic Health Serv!ce, 1980.

‘Pnmardyal lergy,unspeclfied (995.3).

3p~mar,Iy gynecolog!cel exermrsaion w.3).
6 Advance Data No., 196 ● April 11, 1991

Table 7. Number of office visits made by persons of all ages and by adolescents

11-20 years of age and percent distribution by the nonmedication therapy ordered or

provided, according to age: United States, 1985

All 11–20 11-14

fVorrrrredicafion therapy’

1.5-20

ages years yeara yeara

Number of visits in thousands . . . . . . . 636,3a6 58,996 19,360 39,637

Percent distribution

All visits . . . . . . . . . . . . . . . . . . . .,, ,. 100.00 100.00 100.00 100.00

None, . . . . . . . . . . . . . . . . . . . . . . . . . 66.69 69.33

Physiotherapy . . . . . . . . . . . . . . . . . . . .

75.05 66,53

4.16 4.10 3.53 4,39

Ambulatorysurgery. .,...,. . . . . . . . . 6.59 6.93 7.96

Radiatlontherapy. .,,....,., . . . . . .

9.40

0.10 0.09 0,13 0,07

Psychotherapy . . . . . . . . . . . . . . . . . . 3.35 2.23 1,71 2.48

Familyplanning . . . . . . . . . . . . . . . . . . . 1.91 342

Dietcounseling . . . . . . . . . . . . . . . . . . .

0.49 4.85

6.49 3.69 2.28 4.3a

Othercounseling . . . . . . . . . . . . . . . . . . 9.29 6.62 6.39 9.03

Corrective lenses . . . . . . . . . . . . . . . . . . 1.71 1.60 1.57 1.62

Other . . . . . . . . . . . . . . . . . . . . . . . . . 1.22 1.33 1.73 1.13

‘May not add to 100.00 bewusemore than Onenonmedlcat,on thempywas possible duflngthe patlenttisit.

Table 8. Number of office visits made by persons of all ages and by adolescents

11-20 years of age by duration and disposition of the visit, according to age:

UnitedStates,1985

,4// 17-20 11-14 15-20

Duration and disposition of visit ages years years years

Number ofvisits inthousands. . . . . . . . . . 636,366 58,996 19,360 39,637

Percent distribution

Allvisits . . . . . . . . . . . . . . . . . . . . . . . . 100.00 100,00 100.00 100.00

Duration

Zerominutes’ . . . . . . . . . . . . . . . . . . .

l-5minutes . . . . . . . . . . . . . . . . . . . . .

6-10minutes . . . . . . . . . . . . . . . . . . . .

11-15 minutes . . . . . . . . . . . . . . . . . . . .

16-30minutes . . . . . . . . . . . . . . . . . . . .

31 minutesormore . . . . . . . . . . . . . . . .

Dispositionz

Nofollowup . . . . . . . . . . . . . . . . . . . . .

Return atspecified time . . . . . . . . . . . . . .

Return ifneeded . . . . . . . . . . . . . . . . . .

Telephonefollowup . . . . . . . . . . . . . . . . .

Refer toanother physician . . . . . . . . . . .

Returnto referring physician. . . . , . , . . . .

Admittohospltaf . . . . . . . . . . . . . . . . . .

Other . . . . . . . . . . . . . . . . . . . . . . . . .

2.27

10.25

28.47

30.01

22.66

6.34

9.76

61.46

22.87

3.96

3.15

0.78

1.62

0,54

3.12

13.64

31.95

29.64

17.76

3.88

16.45

49.65

28.68

3.94

2.oa

0.31

0.96

0.30

3.98

13.67

31.62

30.56

16.68

3.50

21.30

42.92

29.77

4.66

2.36

0.45

0.80

0.19

2.70

13.62

32.12

29.19

18.29

4.07

14.07

52.93

28.14

3.58

1.94

0.25

1.07

0.36

‘Represents OffICe vistis m which there was no feca-ro-face comact between the pat!ent and Ihe physician.

2May not add to I 00,00 beceu~e more than one disposition was poaslble during the Petient ~s~

Table 9. Number of office visits made by persons of all ages and by adolescents

11-20 years of age by number of medications ordered or provided, according to age:

United States, 19B5

All 11-20 11-14 15-20

Number of medications ages yeara yeara yeara

Number ofwsitsm thousands. . . . 636,388 58,996 19,360 39,637

Percent distribution

Allvisits . . . . . . . . . . . . . . . . . . . . . . . . 100.00 100.00 100.00 100.00

0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3861 45,96 50.65 43.67

1 .,..,,,,,........,........ 33.45 3585 33.33

2

37.08

15.99

30;rno;e::::::::::::::: ::::::::

13,16 11.39 14.06

11.75 5,00 4.63 5.18
Advance Data No. 196 ● April 11,1991 7

Table 10. Number, percent distribution, and therapeutic use of drug mentions, by age and

the most frequent drug entry for adolescents ~1-20 years of ag= United States, 1985

Number of

nrerrt;ons in Percent

Age and entry name’ of drug thousands distribution Therapeuffc use

11-20 years

All drug entries . . . . . . . . . . . . . . . . . . .

Tetracycline . . . . . . . . . . . . . . . . . . . . .

Amoxicilfin . . . . . . . . . . . . . . . . . . . . . .

Ampicillin . . . . . . . . . . . . . . . . . . . . . . .

Ortho-novum . . . . . . . . . . . . . . . . . . . . .

Amoxil . . . . . . . . . . . . . . . . . . . . . . . . .

Pen-Vee K . . . . . . . . . . . . . . . . . . . . . .

E,E.S.(erythromycin ethylsuccinate) . . . . . .

Erythromycin . . . . . . . . . . . . . . . . . . . . .

Reflex . . . . . . . . . . . . . . . . . . . . . . . . .

Retin-A . . . . . . . . . . . . . . . . . . . . . . . .

Afl othermentions . . . . . . . . . . . . . . . . .

11-14 years

Alldrug entries . . . . . . . . . . . . . . . . . . .

Amoxil, . . . . . . . . . . . . . . . . . . . . . . . .

Amoxicillin . . . . . . . . . . . . . . . . . . . . . .

E.E.S.(e~hromycin ethylsuccinate) . . . . . .

Tuberculmtinetest . . . . . . . . . . . . . . . . .

Keflex . . . . . . . . . . . . . . . . . . . . . . . . .

Ampicillin . . . . . . . . . . . . . . . . . . . . . . .

Cortisporin . . . . . . . . . . . . . . . . . . . . . .

Diphtheriatetanustoxoids . . . . . . . . . . . .

House duatconcentrate bulktreatment . . . .

Benadryl . . . . . . . . . . . . . . . . . . . . . . .

Allothermentions . . . . . . . . . . . . . . . . .

15-20 years

All drug entries . . . . . . . . . . . . . . . . . . .

Tetracycline . . . . . . . . . . . . . . . . . . . . .

Ortho-novum . . . . . . . . . . . . . . . . . . . . .

Amoxicillin . . . . . . . . . . . . . . . . . . . . . .

A@cilhn. . . . . . . . . . . . . . . . . . . . . . .

Pen-VeeK . . . . . . . . . . . . . . . . . . . . . .

Erythromycin . . . . . . . . . . . . . . . . . . . . .

Reflex, . . . . . . . . . . . . . . . . . . . . . . . .

E.E.S.(e@romycin ethylsuccinate) . . . . . .

Retm-A . . . . . . . . . . . . . . . . . . . . . . . .

Amoxil . . . . . . . . . . . . . . . . . . . . . . . . .

All othermentions . . . . . . . . . . . . . . . . .

46,705

1,229

I,lla

877

859

839

790

743

742

721

619

38,168

13,976

405

381

271

255

236

226

223

215

209

209

11,554

32,729

1,022

789

737

651

610

548

485

472

454

434

26,961

100.00

2.63

2.39

1.86

1.84

1.80

1.69

1.59

1.59

1.54

1.39

81.72

100.00

2.90

2.73

1.94

1.83

1.69

1.62

1.60

1.54

1.50

1.49

82.87

109.00

3.12

2.41

2.25

1.99

1.87

1.67

1.48

1.44

1.39

1.33

82.38

. . .

Antibiotic

Antibiotic

Antibiotic

Oral contraceptive

Antibiotic

Antibiotic

An:lbiot!c

Antibiotic

Antibiotic

Acne treatment

. . .

. ..

Antibiotic

Antibiotic

Antibiotic

Tuberculosis skin test

Antibiotic

Antibiotic

Anti-inflammatory and antibacterial agent

Immunization

Allergenic extract, immunotherapy

Antihistsminic

. . .

. . .

Antibiotic

Oral contraceptive

Antibiotic

Antibiotic

Antibiotic

Antibiotic

Antibiotic

Antibiotic

Acne treatment

Antibiotic

,..

‘The trade or genenc name used by the physicmn on the prescription or other medcel records. The use of trade names is for

identlfimllon on~anddoes notimply endorsement bythe Publlc Hea~SeN~@orlhe U.S. Department of Heafthand Hwnsn

Serwces. Because of its nonapecrfic nature, the enwy “Allergy relief or shots” wrh 1,459.000 mentions ia omfled

(655,000 menttons for persons 11-14 years of age and 603,000 mentmna for those 15-20 years of age).
Advance Data No. 196 ● Awil 11.1991 9

Technical notes employed physicians who are master files maintained by the

principally engaged in office practice American Medical ksociation and

Source of data and sample but not in the specialties of the American Osteopathic

design anesthesiology, pathology, or Association. The physician response

radiology. Telephone contacts and rate for the 1985 NAMCS was

The information presented in this nonoffice visits are excIuded. 70.2 percent. Sample physicians were

report is based on data coIlected by

means of the National Ambulatory

Medical Care Survey (NAMCS) from

March 1985 through February 1986.

The target universe of NAMCS

includes office visits made within the

coterminous United States by

ambulatory patients to nonfederally

A multistage probability sample

design is used in NAMCS, involving

sampIes of primary sampling units

(PSU’S), physician practices within

PSU’S, and patient visits within

physician practices. For 1985, a

sample of 5,032 non-Federal, officebased physicians was selected from

asked to complete patient records

(see figure) for a systematic random

sample of office visits occurring

during a randomly assigned l-week

reporting period. Responding

physicians completed 71,594 patient

records. Characteristics of the

physician’s practice, such as primary

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Figure. 1985 National Ambulatory Medical Care Survey Patient Record
10 Advance Data No. 196 ● Acxil 11.1991

specialty and type of practice, were

obtained during an induction

interview, The National Opinion

Research Center, under contract to

NCHS, was responsible for the

survey’s data collection and

processing.

Adjustments for nonresponse

Estimates from NAMCS data

t~ere adjusted to account for sample

physicians who \vere in scope but did

not participate in the study. This

adjustment was calculated to

minimize the impact of response on

final estimates by imputing to

nonresponding physicians the practice

characteristics of similar responding

physicians. For this purpose,

physicians were judged similar if they

had the same specialty designation

and practiced in the same PSU.

Sampling errors

The standard error is primarily a

measure of the sampling variability

that occurs by chance when only a

sample rather than an entire universe

is surveyed. The relative standard

error of an estimate is obtained by

dividing the standard error by the

estimate itselfi the result is then

expressed as a percent of the

estimate. These measurements are

applied to office visits in table I; in

table 11they are applied to drug

mentions.

Table L Relative standard errors of

estimated numbers of office visits based

on all physician specialties: National

Ambulatory Medical Care Survey, 1985

Estimated number

of ofr7cevisits Relative stsndard

m thousands error in percent

200 . . . . . . . . . . . . . . . . . 37.8

500. . . . . . . . . . . . . . . . . 24.1

1,000. . . . . . . . . . . . . . . . 17.2

2,000,. . . . . . . . . . . . . . . 12.5

5,000,. . . . . . . . . . . . . . . 8,5

10,000. . . . . . . . . . . . . . . 6.6

20,000. . . . . . . . . . . . . . . 5.4

50.000. . . . . . . . . . . . . . . 4,5

100,000. . . . . . . . . . . . . . 4.2

600,000 . . . . . . . . . . . . . . 3.9

Example of use of table, An aggregate estimate of

15,000,000 vIsIis has a relatwe standard error of 60 percent,

0< a standard error of 900,0CU visrts (6,0 percent of

15,000,000 Vlslts),

Table Il. Relative standard errors of

estimated numbers of drug mentions based

on all physician specialties: National

Ambulatory Medical Care Survey, 1985

Est/mated number

of drug mentions f?e/ative standard

m thousands error in percent

300, . . . . . . . . . . . . . . . . 39.8

500. . . . . . . . . . . . . . . . . 30.9

1,000. . . . . . . . . . . . . . . . 22.1

2,000. . . . . . . . . . . . . . . . 15.9

5,000. . . . . . . . . . . . . . . . 10.6

10,000. . . . . . . . . . . . . . . 81

20,000.. . 6.5

50,000.,, ,. .,... . . 5,3

100,000. . . . . . . . . . . . . . 4.9

600,000,. . . . . . . . . . . . . 4,4

Example of use of Iable: An aggregate eetlmate of

15.000, OOOdrugmentcms hasarelalive standard evorof 7.3

percent, or a standard error of 1,0S5,000 drug ment[ons (7.3

percent of 15,000,000 drug ment!ons).

Test of significance and

rounding

In this report, the determination

of statistical significance is based on a

two-sided t-test with a critical value of

1.96 (0.05 level of confidence). Terms

relating to difference, such as

“greater than” or “less than,”

indicate that the difference is

statistically significant. In the tables,

estimates of office visits have been

rounded to the nearest thousand.

Consequently, estimates will not

always add to totals. Rates and

percent were calculated from original

unrounded figures and do not

necessarily agree with percents

calculated from rounded data.

Definition of terms

An ambulatory patient is an

individual seeking personal health

services who is not currently admitted

to any health care institution.

A physician is a duly licensed

doctor of medicine (M. D.) or doctor

of osteopathy (D. O.) who is currently

in office-based practice, and who

spends some time caring for

ambulatory patients. Excluded from

NAMCS are physicians who are

hospital based; who specialize in

anesthesiology, pathology, or

radiology; who are federally

employed; who treat only

institutionalized patients; who are

employed full time by an institution;

and who spend no time seeing

ambulatory patients.

An office is a place that

physicians identify as a locatio:n for

their ambulatory practice; these

customarily include consultaticm,

examination, or treatment spaces the

patient associates with the particular

physician. Responsibility for patient

care and professional services

rendered in an office resides with the

individual physician rather tha:n with

an institution.

A visit is a direct personal

exchange between an ambulatory

patient and a physician or a staff

member working under the

physician’s supervision for the

purpose of seeking care and

rendering personal health services.

A drug mention is the physician’s

entry of a pharmaceutical agenlt – by

any route of administration —for

prevention, diagnosis, or treatment.

Generic as weI1 as brand name drugs

are included, as are nonprescription

and prescription drugs. Along ‘with all

new drugs, the physician also records

continued medications if the patient

was specifically instructed duri:ng the

visit to continue the medication.

A drug visit is a visit in which

medication was prescribed or

provided by the physician.
Number 197 ● May 21, 1991

Advance

Data

From Vital and Health Statistics of the National Center for Health Statistics

Disability and Health: Characteristics of Persons by

Limitation of Activity and Assessed Health Status,

by Peter

Introduction

United States, 1984-88

Ries, Division of Health Interview Statistics, and Scott Brown, Ph. D., Gallaudet University

Health status and disability status

are conceptually distinct but

empirically interrelated. For instance,

a person maybe disabled by

blindness and yet be in excellent

health, and a person with a chronic

heart condition may have adequate

capacities to function in an average

way in relation to his or her social

roles and therefore not be disabled.

However, in practice a large

proportion of persons who are in bad

health have some disability, and a

large proportion of persons who are

disabled are in bad health. This

report gives estimates of the number

of persons in the civilian

noninstitutionalized population of the

United States, combining measures of

both disability and health status, and

describes the resulting groups in

relation to sociodemographic and

other health characteristics.

Each year the National Center

for Health Statistics publishes

estimates from the National Health

Interview Suxvey (NHIS) of the

number of persons by disability status

and health status (l). There are many

ways to define “disability,” and the

concept of limitation of activity due

to chronic conditions is used in

NHIS. Limitation of activity is

defined in terms of level of ability to

perform certain major activities

associated with specific age ranges

(for instance, the ability to attend a

regular school, for children 5–17 years

of age). The NHIS concept of heaIth

status is based on responses to the

question, “Would you say _‘s

health in general is excellent, very

good, good, fair, or poor?” Because

responsible adult family members

respond for their children and for

other adult members of the family

who are not present at the interview

or are incapable of responding, the

estimates associated with this concept

are most properly referred to as

“respondent-assessed health status.”

For convenience of expression, the

briefer term “health status” is often

used in this publication.

The published annual estimates

from NHIS are shown separately for

each of these characteristics.

Occasionally special reports are

released showing detailed estimates

for each characteristic for many

subgroups within the population (2,3).

However, rare)y do estimates appear

showing these two characteristics

cross-classified in terms of, for

instance, the health status of persons

limited in activily or the limitation

status of persons in poor health. This

is because disabled people and

people with chronic illness, who

ordinarily constitute the subgroups of

major interest in health statistics, are

relatively small proportions of the

total population. Thus, crossclassifying persons by these

characteristics produces many

estimates with very high sampling

errors.

To overcome this limitation, this

report shows these types of estimates

on the basis of accumulating all of

the individuals included in the N’HIS

sample from 1984 to 1988, amounting

to an overall population sample of

about 504,000 persons. However, even

with a sample this large, some of the

estimates to be shown in this report

would be statistically unreliable if the

two health-related characteristics

were to be cross-classified in all

**,Slwcc,.

& %,

4g

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

;+ Public Health Service

s Centers for Disease Control

‘%.>

Manning

National

Feinleib,

Center

M.

for

D.,

Health

Dr. P.

Statistics

H., Director

CDC
2 Advance Data No. 197 ● May 21,1991

possible deiail. For this reason, the

estimates are shown in terms of only

two categories for each of the

characteristics. Persons are classified

as Iimited or not limited in activity

(their degree of limitation being

disregarded) and as in fair or poor

health (combined) or in good, very

good, or excellent health (combined).

The presentation of the results

focuses on the sociodemographic and

health differences of the four

subgroups produced by this simple

cross-classification.

Results

Table 1 shows that most persons

in the population (82.1 percent) were

not limited in activity and were in

good to excellent health. Among the

other 17.9 percent of the population,

6.1 percent were both limited in

activity and in fair or poor health,

7.7 percent were limited in activity

but in good to excellent health, and

4.1 percent were in only fair or poor

health but were not limited in

activity.

Figure 1 shows the distribution of

the population of these four

subgroups according to age, sex,

family income, and race. The relative

proportion of each of the groups

associated with limitation and/or fair

or poor health increases with age. For

instance, only about 7.0 percent of

persons under 18 years of age were

limited in activity, in fair or poor

health, or both, but about

48.1 percent of persons 65 years of

age and o~’erfeI1 into one of these

three groups.

The reIative proportions of

persons who are both limited and in

fair or poor health increase with age

in relation to the percents of persons

who are either limited or in fair or

poor health but not both. For

instance, although for persons under

18 years of age only 12.9 percent

(0.9 percent divided by 7.0 percent)

of those who were limited and/or in

fair or poor health were both limited

and in fair or poor health, the

corresponding estimate for persons 65

years of age and over is 43.9 percent

Table 1. Average annual percent distribution and number of persons by limitation of

activity due to chronic conditions and respondent-assessed health statust United States,

1964-88

Limited in Not Ilmifed

Health status Total activity in activity

Percent distribution

All health statuses . . . . . . . . . . . . . . . . . ‘1OO.O 13.8 86.2

Fairer poor . . . . . . . . . . . . . . . . . . . . . 10.2 6.1 4.1

Good to excellent . . . . . . . . . . . . . . . . . . 89.8 7.7 82.1

Number of pereons in thousands

All health statuses . . . . . . . . . . . . . . . . . 2236,122 32,411 202,514

Fair or poor . . . . . . . . . . . . . . . . . . . . 24,070 14,365 9,665

Goodto excellent . . . . . . . . . . . . . . . . . . 210,655 16,026 192,629

‘Excludespersonsforwhomhealthstatuswas notdetermmed.

‘Includes personsforwhomhealthstatuswas notdetermmed.

Limitedin activity Not limited in actkity

_ Fairor poor health _ Fairor poor health

= Gd to excellent health ~ Good to excellent health

100

80

~ 60

al

v

5

Q

40

20

0

Under 18 18-44 45-64 85 years Male Female

years years ye!ars and over

m sexLeas than Black

$10,OOQ $19;99e ti4:9e9 or more

.

Family income Race

?+07’5UnknownhearersmtuaInexcludedinCskulstlngpercsncs

Figure 1. Average annual percent distribution of persons by limitation of activity due to

chronic conditions and reamondent-assessed health status, according to selected

characteristics: United Stat’es, 1984-B8
Advance Data No. 197 ● May 21,1991 3

(21.1 percent divided by

48.1 percent).

The relative differences according

to sex are minor compared with the

differences shown for the other

characteristics in figure 1. About

83.0 percent of males were not

limited in activity and in good to

excellent health; for females, the

corresponding estimate is

81.2 percent.

About 1 of 3 persons

(32.6 percent) in families with an

annual income of less than $10,000

was limited in activity, in fair or poor

heaIth, or both; the corresponding

proportion for persons in families

with an annual income of $35,000 or

more was 1 in 10 persons

(10.0 percent). Also, the ratio of

persons limited rind in fair or poor

health to those either limited or in

fair or poor health (but not both)

increases as family income decreases.

The ratio of persons with both

characteristics to those with at least

one characteristic is 45.4 percent

(14.8 percent divided by

32.6 percent) for incomes of less than

$10,000; the corresponding estimate

for per:ons in families with an annual

family income of S35,000 or more is

20.0 percent (2.0 percent divided by

10.0 percent).

Figure 1 also shows the results

for white and black persons. About

82.4 percent of white persons were

not Iimited in activity and in good to

excellent health. The corresponding

estimate for black persons is

78.8 percent. The major difference

among those who were limited and/or

in fair or poor health is that, in

contrast to white persons (and unlike

the comparisons in figure 1 for age,

sex, and family income), the

proportion of black persons who were

in fair or poor health but not limited

in activity (6.7 percent) was larger

than the proportion who were limited

but not in fair or poor health

(5.8 percent). The corresponding

estimates for white persons were

3.7 percent and 8.0 percent,

respectively. However, the proportion

who were both Iimited and in fair or

poor health among black persons

(8.7 percent) was larger than the

proportion for white persons

(5.8 percent).

Table 2 shows the estimates in

figure 1 for sex and race by age. It

a!so includes estimates for the four

limitation and health status groups by

family income, region, and place of

residence. The estimates by

geographic region are similar, except

that a lower proportion of persons in

the South were in good to exceIlent

health and not limited in activity

(80.2 percent). In regard to place of

residence, the lowest proportion of

persons in good to excellent health

and not limited in activity was among

those persons living outside of

metropolitan statistical areas

(79.3 percent).

Regarding other health

characteristics of the four groups of

persons distinguished in terms of

limitation of activity and assessed

health status, figure 2 shows the

results for restricted-activity days,

physician contacts, and short-stay

hospital days. These data are shown

by age, sex, race, family income,

geographic region, and place of

residence in tables 3-5.

A restricted-activity day is a day

on which a person stays in bed,

misses work or school, or cuts down

on his or her usuaI activi~ because of

illness, impairment, or injury. As may

be noted, the estimates for the four

groups range from 7.4 days per

person per year for those not limited

and in good to excellent health to

88.2 days per person per year for

persons limited and in fair or poor

health. Persons in this latter group

experience some form of activity

restriction on about one out of e~rery

four days (24.2 percent) in a year.

Figure 2 also shows the results

for physician contacts. A physician

contact is defined as a contact with a

physician or a medical assistant

working under the supervision of a

physician for purposes of treatment,

diagnosis, or consultation. Contacts of

this nature over the telephone are

included, but contacts with medical

personnel while an overnight patient

in a hospitaI are not. However, visits

to a hospital clinic or emergency

room are included. The estimates for

physician contacts range from 3.8 per

person per year for those not limited

in activity and in good to excellent

health to 17.1 per person per year for

persons who were limited and in fair

or poor health.

The range of the estimates is

greatest for the third measure shown

in figure 2—hospital days, a measure

of the number of nights a person

spent as an admitted patient in a

short-stay hospital. Persons not

limited in activity who were in good

to excellent health had 33.2 hospital

days per 100 persons per year, but

those who were limited and in fair to

poor health had a corresponding rate

of 530.2.

It maybe noted from the

relationships among the rates shown

for each of the health measures in

figure 2 that the rates for mixed

groups (limited but not in fair or poor

health, in fair or poor health but not

limited) show Iittle variation. This

suggests, at Ieast in terms of these

three measures of morbidi~, that

health status and disabili~ status

when considered alone have similar

effects with regard to morbidity

measures.

Aside from comparing morbidity

rates for the four subgroups described

in this report, one may examine the

proportion of the total morbidity for

selected measures associated with

each subgroup. Table 6 shows that

although during an average year from

1984 to 1988, persons who were

limited in activity and in fair or poor

health constituted only 6.1 percent of

the population, they accounted for

36.6 percent of restricted-activi~

days, 19.8 percent of physician

contacts, and 40.5 percent of shortstay hospital days.

It remains to consider the types

of conditions associated with the four

limitation and health status groups

that to this point have been described

only in terms of sociodemographic

and health-impact measures. Both

Imitation of activity and assessed

health status are measures of the

impact of chronic conditions. Indeed,

table. 7 shows smaI1 differences for

the four groups in the incidence rates

of acute conditions. Acute conditions
4 Advance Data No. 197 ● May 21, 1991

Table 2. Average annual percent distribution and number of persons by limitation of activity due to chronic conditions and

respondent-assessed health status, according to selected sociodemographic characterlatics United States, 1984-88

Limited ht activify Not /irnited in actlvify Limited in acthity Not limited in activity

Fair or Good to Fair or Good to Fair or Good to Fair or Good tO

poor exce//errt poor exce//ent poor exce//ent excellent

Characteristic Total’ health

poor

health health heaffh Tots? health health health health

Percent distribution Number In thousands

Allpersons3 . . . . . . . . . . . . . . . . . . . . .

Age

Under 18 years . . . . . . . . . . . . . . . . . . .

Under 5 years...........,.. . . . .

5-17 years. . . . . . . . . . . . . . . . . . . .

lS-44 years . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . .

25-44 years . . . . . . . . . . . . . . . . . . . .

45-64 years . . . . . . . . . . . . . . . . . . . . .

65 years and over . . . . . . . . . . . . . . . . .

65-89 years . . . . . . . . . . . . . . . . . . . .

70-74years . . . . . . . . . . . . . . . . . . . .

75 years Andover, . . . . . . . . . . . . . . .

Sex and age

Male, all ages . . . . . . . . . . . . . . . . . . . .

Under5years . . . . . . . . . . . . . . . . . . .

5-17years . . . . . . . . . . . . . . . . . . . . . .

16-24 years . . . . . . . . . . . . . . . . . . . . .

25-44years . . . . . . . . . . . . . . . . . . . . .

45-84 years.......,,.. . . . . . . . . . .

65yearsand over . . . . . . . . . . . . . . . . .

Female, alleges . . . . . . . . . . . . . . . . . . .

Under5 years, . . . . . . . . . . . . . . . . . . .

5-17years . . . . . . . . . . . . . . . . . . . . . .

18-24years . . . . . . . . . . . . . . . . . . . . .

25-44years . . . . . . . . . . . . . . . . . . . .

45-64years . . . . . . . . . . . . . . . . . . . .

65years Andover . . . . . . . . . . . . . . . .

Race and age

White, allages . . . . . . . . . . . . . . . . . . . .

Under5years . . . . . . . . . . . . . . . . . . . .

5-17years . . . . . . . . . . . . . . . . . . . . . .

18-24years . . . . . . . . . . . . . . . . . . . . .

25+4years . . . . . . . . . . . . . . . . . . . . .

45-84years . . . . . . . . . . . . . . . . . . . . .

65years Andover . . . . . . . . . . . . . . . . .

Black, allages . . . . . . . . . . . . . . . . . . . .

Under5yeara . . . . . . . . . . . . . . . . . . .

5-17years . . . . . . . . . . . . . . . . . . . . . .

18-24years . . . . . . . . . . . . . . . . . . . . .

25-44years . . . . . . . . . . . . . . . . . . . .

45-64years . . . . . . . . . . . . . . . . . . . . .

65yearsand over . . . . . . . . . . . . . . . . .

Family income

Lessthan SIO,OOO . . . . . . . . . . . . .

$10,000-s19,999 . . . . . . . . . . . . . .

$20,000-S34,999 . . . . . . . . . . . . . . .

$35,0000rmore . . . . . . . . . . . . . . . . .

Geographic region

Northeast . . . . . . . . . . . . . . . . . . . . . . .

Midwest. . . . . . . . . . . . . . . . . . . . . . . .

South . . . . . . . . . . . . . . . . . . . . . . . . .

West . . . . . . . . . . . . . . . . . . . . . . . . .

Place of residence

MA.. .,.......,...,,,. . . . . . . .

Central c~ . . . . . . . . . . . . . . . . . . .

Noncentral city . . . . . . . . . . . . . . . . . .

Not MSA, .,.....,....,,,

100.0

100.0

103.0

10s.0

100,0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100,0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

1000

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100,0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

1000

100.0

100.0

6.1

0.9

0.7

1.0

2,6

1.2

3.1

12.3

21.1

20.5

16.4

23.5

5.6

0.7

1.1

1.1

2.8

11.8

21.0

6.6

0.6

0.9

1.3

3.3

12.7

21.1

5.6

0.6

0.9

1.1

2.7

11.2

20.1

6.7

1.1

1.6

:::

22.1

32.9

14.8

8.0

3.7

2.0

5.5

5.6

7.5

4,9

5.6

6.7

4.9

7.7

7.7

4.2

1.6

5.3

5.9

4.5

6.4

10.6

17.3

17.5

13.9

19,4

7.7

1.8

6.2

5.0

6.9

10,2

16.7

7.6

1.5

4.2

4.1

6.0

11.0

17.7

8.0

1.6

5.4

4.7

6.7

10.9

17.6

5.8

2.1

4,9

3.6

4.9

6.6

14.2

10,6

6.7

7.0

6.1

7.3

6.0

7.4

6.2

7.5

7.6

7.4

8.2

4.1

1.9

2.3

1.7

3.2

2.9

3.4

5.9

9.7

6.9

11.7

10.7

3.7

2.5

1.5

2.2

2.8

5.7

10.0

4.5

2.0

1.9

3.6

3.9

6.1

9.4

3.7

2.0

1.4

2.5

2.9

5.2

9.2

6.7

3.8

3.4

5.1

6.7

11.1

14.3

7.2

5.5

3.2

1.9

3.6

3.8

4.9

3.6

3.9

4.7

3.4

4.8

62.1

93.0

95.5

92.0

88.3

91.4

87.2

71.2

52.0

55.1

56.0

46.4

83.0

95.0

91.2

91.7

87.6

72.4

52.4

81.2

95.9

92.9

91.0

66.8

70.2

51.8

82.4

95.9

92.3

91.7

67.6

72.6

53.2

76.8

93.0

90.0

89.4

82.2

58.2

38.6

67.4

77.8

86.1

90.0

63.4

82.6

80.2

83.2

63.0

81.0

84.3

79.3

236,122

63,035

18,154

44,882

100,740

26,790

73,950

44,788

27,558

9,477

7,485

10,597

114,181

9,290

22,936

13,082

36,172

21,347

11,354

121,941

6,684

21,946

13,708

37,778

23,441

16,204

200,424

14,742

36,562

22,155

62,923

39,184

24,859

26,543

2,771

6,874

3,68e

8,438

4,474

2,297

33,392

45,832

62,655

62,867

49,963

56,544

80,320

47,296

177,599

71,194

106,405

58,523

14,385

568

118

450

2,584

323

2,262

5,484

5,769

1,933

1,367

2,469

6,343

65

244

147

1,020

2,496

2,371

6,042

53

206

175

1,242

2,988

3,398

11,661

84

324

246

1,671

4,379

4,956

2,472

1%

69

527

963

750

4,913

3,652

2,333

1,254

2,754

3,290

6,017

2,324

9,8a3

4,748

5,136

4,501

18,026

2,632

295

2,338

5,922

1,206

4,716

4,743

4,726

1,650

1,035

2,044

8,756

166

1,422

847

2,471

2,168

1,a83

9,268

129

916

559

2,245

2,575

2,845

18,035

229

1,960

1,033

4,204

4,265

434

1,644

58

335

133

412

383

324

3,516

3,991

4,366

3,788

3,627

4,646

5,892

3,861

13,278

5,403

7,876

4,748

9,685

1,160

406

754

3,258

779

2,479

2,624

2,644

651

868

1,126

4,183

226

340

289

995

1,207

1,126

5,502

180

414

490

1,464

1,416

1,518

7,437

286

493

548

1,808

2,040

2,263

1,904

103

231

189

559

494

327

2,391

2,510

1,970

1,196

1,664

2,194

3,923

1,705

6,660

3,301

3,559

2,825

192,829

58,170

17,181

40,969

88,650

24,363

64,267

31,752

14,257

5,201

4,169

4,887

94,303

8,755

20,750

11,943

31,566

15,370

5,917

98,526

6,426

20,240

12,439

32,699

16,362

6,341

164,321

14,027

33,512

20,247

55,059

28,324

13,153

22,336

2,548

6,131

3,282

6,904

2,589

882

22,361

35,487

53,778

56,197

41,429

48,160

64,035

39,205

146,651

57,340

89,311

46,176

‘Excludes persons whose heatm stalus was not assessed.

2

Includes persons whose health status was not assessed,

31ncIude5 ~erSon5 of races other than whrte or black and persons with unknOwn famW Inmme.

NOTE: MSA!smetropol!tan stallshcal area.
Advance Data No. 197 ● May 21,1991 5

100r

I

Restricted-activity days

Limited in activity Not limited in activity

_ Fairer poor health =Fair or poor health

- Good to excellent health ~~~Goodto excellent health

Physician contacts Hospital days

I NOTE: Unknown health statuslsexduded in cdc.latlng rates.

1

Figure 2. Average annual rates for respondent-assessed health status and limitation of activity due to chronic conditions for

restricted-activity days, physician contacts, and short-stay hospital days: United States, 1984-88

play a relatively insignificant role in

explaining the large differences

among the four groups in the rates

shown earlier for restricted-activity

days, physician contacts, and hospital

days,

Showing the prevalence rates for

each of the four Imitation and health

groups of all of the chronic conditions

for which NHIS collects data would

be beyond the scope of this report.

However, as su~:ested earlier in the

example of blindness, an impairment

differs from other types of chronic

conditions in that it does not

necessarily imply a health problem.

Thus the interaction of impairments

with disability and health status is of

special interest.

In NHIS, a condition is

considered chronic if (a) the

respondent indicates it was first noted

3 months or more before the

reference date of the interview or

(b) it is a type of condition that

ordinarily has a duration of more

than 3 months. An impairment is a

chronic or permanent defect, usually

static in nature, that results from

disease, injury, or congenital

malformation.

AS expected, considerably lower

percentages of persons with

impairments than persons in the

general population were not limited

in activity and \vere in good to

excellent health. As shown in table 8,

these percents were lower for persons

with an impairment than for all

persons for every impairment

measured. There is, however, some

variation by impairment in the

proportions of peopIe not Iimited in

activity and in good to excellent

health. At one exlreme is color

blindness, with roughly three-quarters

of persons reported as not limited

and in good health. At the other

extreme is paralysis of extremities,

w’ith only about 1 out of 10 persons

so reported.

Estimates for the other

impairments range from about 40 to

55 percent. Persons with reported

cataracts and those with glaucoma

were among the least likely to

indicate good health and no

Imitation; those in the categories of

hearing impairment and deformity or

orthopedic impairment of the back

and lower extremities were most

Iikely.

The relationship of the percents

for the two health categories among

the population with an activity

limitation also differs by impairment.

For instance, like the population in

general, persons with speech

impairments and those with deformity

or orthopedic impairments were more

likely to be limited but in good to

excellent health than to be limited

and in fair or poor health. This was

not true for the other impairments.

In interpreting the speech

impairment data, it is useful to

remember that this is one impairment

for which children are likely to have

higher prevalence rates than adults.

In 1988, of an estimated 2,640,000

persons with reported speech

impairments, 1,151,000 (43.6 percent)

were under the age of 18 years. That

children in general are in good health

and that so many of the persons with

reported speech impairments are

children could help to explain why

the percent who were limited in

activity but in good to excellent

health was relatively high for this

group.

Also important is the fact that

the reported impairments may differ

in severity. For example, the overall

prevalence rate reported for hearing

impairment over the period 1984-88

was relatively high, 89.8 per 1,000

persons. Past studies (4,5) have

documented that this catego~

includes various leveIs of hearing

impairment. The rate for paralysis of

extremities was much lower, 5.8 per

1,000 persons. There may not be

much variation in severity for this

condition, however. Almost one-half

of the population with paralysis of

extremities indicated that they \vere

limited in activity and in fair to poor

health.

To discern whether the observed

patterns are a function of the
6 Advance Data No. 197 ● May 21, 1991

Table 3. Average annual number per person per year and number of restricted-activity days, by limitation of activity due to chronic

conditions, respondent-assessed health status, and selected sociodemographic characteristics: United States, 1984-88

Lirmted in actrvity Not /irr7ifed In acMy Limited in activity Not limited in activity

Fair or Good to Fair or Good to Fair or Good to Fair or Good to

poor excelent poor excellent poor excellent exce//ent

Characteristic Tots?

poor

health health health health Totai health health health health

Number per person per year Number in thousands

Allpersonsz . . . . . . . . . . . . . . . . . . . . .

Age

Under 5years . . . . . . . . . . . . . . . . . . .

5-17 years... . . . . . . . . . . . . . . . . . .

18–24 years . .,, . . . . . . . . . . .

25–44 yeara . . . . . . . . . . . . . . . .: ::::

45-64 years . .,, . . . . . . . . . . . . . . . . .

65 years and over . . . . . . . . . . . . . . . . .

Sex and age

Male, all ages, . . . . . . . . . . . . . . . . . .

Under 5 years . . . . . . . . . . . . . . . . . .

5-17 years . . . . . . . . . . . . . . . . . . . . .

18-24 years, . . . . . . . . . . . . . . ... ,,.

25-44years . . . . . . . . . . . . . . . . . . . . .

45-64years . . . . . . . . . . . . . . . . . . . . .

65years Andover.....,,.. . . . . . . . .

Female, alleges........,.. . . . . . . . .

Under5years . . . . . . . . . . . . . . . . . . . .

5-17years . . . . . . . . . . . . . . . . . . . . . .

18–24years . . . . . . . . . . . . . . . . . . . . .

25-44years . . . . . . . . . . . . . . . . . . . .

45-64years . . . . . . . . . . . . . . . . . . . . .

65yearsand over . . . . . . . . . . . . . . . . .

Race and age

White, alleges. . . . . . . . . . . . . . . . . .

Under5 years. . . . . . . . . . . . . . . . . . .

5-17years . . . . . . . . . . . . . . . . . . . . . .

18-24years . . . . . . . . . . . . . . . . . . . . .

25-44years, . . . . . . . . . . . . . . . . . . . .

45-64years . . . . . . . . . . . . . . . . . . . . .

65years Andover . . . . . . . . . . . . . . . . .

Black, allages . . . . . . . . . . . . . . . . . . . .

Under5years . . . . . . . . . . . . . . . . . . .

5–17years . . . . . . . . . . . . . . . . . . . . . .

18-24years . . . . . . . . . . . . . . . . . . . . .

25A4 years . . . . . . . . . . . . . . . . . . . . .

45-64years . . . . . . . . . . . . . . . . . . .

65yearsand over ...,.., . . . . . . . . . .

Family income

Lessthan$lO,OOO . . . . . . . . . . . . . . . . .

$10,000-$19,999 . . . . . . . . . . . . . . . . . .

S20,000-$34,999 . . . . . . . . . . . . . . . . . .

$35,0000r more . . . . . . . . . . . . . . . . . .

Geographic region

Northeast. . . . . . . . . . . . . . . . . . . . . .

Midwest. . . . . . . . . . . . . . . . . . . . . . .

South . . . . . . . . . . . . . . . . . . . . ...,,

West, .,,...........,,. . . . . .

Place of residence

MA. . . . . . . . . . . . . . . . . . . . . . . . .

Central icy. . . . . . . . . . . . . . . . . . .

Noncentral cay.......,.. . . . . . . . .

Not MSA . . . . . . . . . . . . . . . . . . . . .

14.8

10.2

8.8

9.6

12,1

19.8

31.6

12,9

10,3

8,2

7.7

10.4

18.2

28.1

16.6

10.1

9.5

11.5

13.7

21.2

34.0

14.7

10.6

9.2

9,9

11.7

18.8

30.5

16.7

8.8

7.0

8.8

16,4

29.9

43.5

25.2

16.9

12.4

10.0

13.8

13.3

16,0

15,7

14.7

16.2

13.7

15.2

88.2

84.4

56.9

714

91.5

88.6

90.1

83.2

81.4

52.3

67.1

90,4

85,1

82.3

92.2

87.9

62.4

75.3

92.5

91.5

95.5

87.7

89.9

60.9

73.5

91.2

87.3

69.5

89,8

67.0

41,1

64,6

91.4

946

92.6

94.7

65.1

83.6

82.8

85.0

60.5

89,1

100.8

91.6

948

88,5

81,3

2&5

24.9

18.0

250

31,3

297

30.7

25.6

25.9

16.4

22.4

28.3

29.3

25.9

31.2

23.7

20.6

28,0

34.6

30,1

33.9

28.1

26.9

18.6

25.4

30.2

29.4

29.9

32.6

*17.9

15.9

26.0

41.1

33.5

43.0

31,7

28,9

26.6

26.8

29.6

25.6

28.7

30.6

29.9

31.2

26.9

24.9

26.3

34.6

22.2

26.9

27.7

21.4

29.7

23.2

33,8

21,0

21,2

21.9

19.9

26.9

28.8

35.5

23.1

30.2

31.7

22.7

31.8

27.3

38.9

26.0

28.8

27.3

22.3

30.1

24.3

25.8

15.0

24.1

30.5

19.2

27.7

28.7

25.8

24.1

25.5

262

25.9

24.9

30,4

27.3

26.7

27.6

24.7

7.4

8.8

7.5

7.5

7.3

6.3

8.4

6,5

8.8

6.9

5.6

6.1

5.8

7.0

8.3

8.8

8.2

9.1

8.5

6.9

9.4

7.6

9.2

7.9

7.8

7.4

6.3

8.5

6.6

7.3

5.6

6.0

6.0

6.9

6.6

8.5

7.9

7.7

6.9

7.1

6,9

7,4

8.5

7.6

7.7

7.5

7.1

3,492,089

184,942

395,341

256,194

697,053

686,192

670,369

1,468,806

95,678

166,961

100,399

377,990

389,108

318,651

2,023,263

69,263

206,360

157,795

519,063

497,084

551,716

2,943,152

155,836

338,095

218,374

735,836

735,675

759,133

477,113

24,466

46,246

32,454

138,467

133,567

99,891

841,379

772,558

776,856

627,806

687,757

779,020

1,282,756

742,556

2,615,601

1,154,269

1,461,331

838,109

1,269,206

9,955

25,618

23,047

207,040

464,011

519,536

527,574

5,294

12,754

9,666

92,206

212,330

195,122

741,634

4,661

12,863

13,179

114,834

271,661

324.415

1,023,2’-

7,5:

19,721

18,084

152,336

382,183

443,336

221,919

2,076

4,602

4,454

48,191

92,985

69,609

465,201

310,647

194,969

103,666

234,127

264,702

536,215

234,164

905,042

450,253

454,789

348,903

513,288

7,360

42,137

30,142

147,544

140,939

145,167

224,165

4,303

23,291

14,484

69,931

63,424

46,733

269,123

3,056

16,646

15,658

77,6!4

77,515

96,433

451,239

6,167

36,437

26,215

126,946

125,455

130,019

53,515

1,039

5,328

3,452

16,929

12,849

13,921

111,477

115,144

116,335

101,598

107,449

118,772

168,884

118,163

396,531

168,711

227,820

111,910

255,175

14,035

16,723

20,934

68,730

56,211

78,544

96,960

7,644

7,146

6,124

21,764

24,013

30,267

158,215

6,391

9,575

14,810

46,966

32,198

48,276

202,779

11,138

12,804

15,790

49,398

45,480

66,169

46,239

2,655

3,473

4,557

17,032

9,465

9,057

68,719

64,737

47,436

30,557

48,849

56,801

97,624

51,902

187,021

86,030

96,991

65,874

1,433,153

151,905

307,667

183,369

470,660

199,513

120,039

610,565

77,410

142,390

69,666

192,987

86,683

41,428

822,588

74,495

165,277

113,703

277,673

112,829

78,611

1,248,494

129,631

268,231

157,649

405,134

177,656

111,992

151,879

18,491

34,635

19,726

55,265

17,902

5,859

190,870

278,565

415,369

368,500

293,123

333,446

471,466

335,115

1,110,397

439,963

670,434

307,416

‘ Includes persons whose health status was not assessed,

21ncludes persons of racea other than whie or black and persons with unknown famij income.

NOTE MSAlsmetropolflan statwtlcel area,
Advance Data No. 197 ● May 21,1991 7

Table 4. Average annual number per person per year and number of physician contacts, by limitation of activity due to chronic

conditions, respondent-assessed health status, and selected sociodemographic characteristics: United States, 1984-68

timited in activity Not Iim;ted in activity Limited in activity Not limited in activity

Fair or Good to Fair or Good to Fair or Good to Fair or Good to

poor exce//errt poor excellent poor excellent

Characteristic

poor excellent

Total’ health health health health Tots? health health health health

Number Der person per year Number in thousands

Allpersons2 . . . . . . . . . . . . . . . . . . . . .

Age

Under 5years . . . . . . . . . . . . . . . . . . . .

5-17 years . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . .

25-44 years . . . . . . . . . . . . . . . . . . . . .

45-84 yeare . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . .

75years and over . . . . . . . . . . . . . . . . .

Sex and age

Male, all ages . . . . . . . . . . . . . . . . . . . .

Under 18 years . . . . . . . . . . . . . . . . . . .

18-14 years . . . . . . . . . . . . . . . . . . . . .

45-84 yeara . . . . . . . . . . . . . . . . . . . . .

65years and over . . . . . . . . . . . . . . . . .

Female, all ages . . . . . . . . . . . . . . . . . . .

Under 18years . . . . . . . . . . . . . . . . . . .

18-14 yeare . . . . . . . . . . . . . . . . . . . . .

45-84years . . . . . . . . . . . . . . . . . . . . .

65yearsandover . . . . . . . . . . . . . . . . .

Race and age

Whlte,allages . . . . . . . . . . . . . . . . . . . .

Under18years . . . . . . . . . . . . . . . . . . .

18-44years . . . . . .. c...... . . . . . . .

45-84years . . . . .. d...... . . . . . . . .

65yearsand over . . . . . . . . . . . . . . . . .

Black,allages . . . . . . . . . . . . . . . . . . . .

Under18yaars . . . . . . . . . . . . . . . . . . .

18+4years . . . . . . . . . . . . . . . . . . . . .

45-84years . . . . . . . . . . . . . . . . . . . . .

65yearsandover . . . . . . . . . . . . . . . . .

Family income

Lessthan$lO,OOO . . . . . . . . . . . . . . . . .

$10,00C-$19,999, . . . . . . . . . . . . . . . . .

$20,001H34,999 . . . . . . . . . . . . . . . . . .

$35,0000rmore . . . . . . . . . . . . . . . . . .

Gmgraphicregion

Northeast . . . . . . . . . . . . . . . . . . . . . . .

Midwest . . . . . . . . . . . . . . . . . . . . . . . .

South . . . . . . . . . . . . . . . . . . . . . . . . .

West . . . . . . . . . . . . . . . . . . . . . . . . . .

Place of residence

MA. . . . . . . . . . . . . . . . . . . . . . . . . .

Centrality. . . . . . . . . . . . . . . . . . . .

Notcentralclt y . . . . . . . . . . . . . . . . .

NotMSA . . . . . . . . . . . . . . . . . . . . . . .

5.3

6.6

3.3

4.2

4.8

6.1

8.0

9.5

4.4

4.2

3.3

5.3

8.0

6.1

4.2

5.9

6.9

9.0

5.4

4.5

4.7

6.1

8.6

4.6

2.9

4.4

6.9

8.9

6.5

5.3

5.1

5.1

5.1

5.4

5.1

5.6

5.4

5.5

5.3

4,9

17.1

26.2

16.4

17.2

20.1

16.9

15.8

16.2

15.6

19.4

17.0

15.4

14.7

18.3

16.3

22,0

18.1

16.8

17.6

22.3

21.0

17.2

16.2

15.0

10.0

15.8

15.5

14.6

16.0

15.9

19.0

22.9

18.2

17.8

15.0

20.1

18.1

18.2

18.0

14.6

9.5

14.3

7.7

8.5

9.9

9.6

9.7

10.1

8.1

8.1

7.5

8.2

9.1

10.8

8.9

12.0

10.8

10.4

9.6

8.9

z

9.9

8.7

F5

9.4

9.6

8.9

9.2

10.1

10.3

10.2

9.6

1%

10.1

10.4

10.0

7.8

8.6

14.6

6.6

9.2

9.6

7.5

8.7

9.4

7.7

9.5

7.2

6.6

8.7

9.8

9.4

11.0

8.2

9.2

9.4

11.7

10.3

7.8

9.1

6.9

4.7

7.4

6.7

8.5

6.2

8.2

9.5

12.0

9.5

9.3

7.6

10.4

9.4

9.5

9.3

7.5

3.8

6.1

2.6

3.6

3.7

3.7

4.7

5.9

3.2

3.8

2.5

3.1

4.9

4.4

3.8

4.8

4.1

5.2

4.0

4.1

3.8

3.7

5.2

3.0

2.5

3.2

3.2

4.0

3.8

3.6

3.9

4.2

3.6

4.0

3.7

4.1

3.9

3.8

4.0

3.5

1,244,439

119,876

146,154

111,521

355,082

275,332

135,885

100,788

503,891

136,841

162,419

113,256

91,374

740,546

128,989

304,185

162,075

145,288

1,085,630

232,040

401,120

238,961

213,510

132,190

27,696

53,255

30,714

20,524

216,542

245,068

318,026

321,016

254,529

317,520

407,151

265,23a

956,458

393,452

583,008

267.981

245,779

3,328

7,363

5,551

45,462

92,166

51,983

39,927

98,957

5,984

19,852

38,342

34,798

146,822

4,727

31,160

53,824

57,111

204,776

9,105

40,352

75,195

80,124

37,016

1,426

9,411

15,217

1o,a63

78,803

58,201

44,328

28,712

50,047

58,579

90,502

46,651

179,117

86,426

92,691

66.662

171,595

4,220

17,975

10,213

46,784

45,682

26,027

20,713

71,164

12,862

23,385

17,794

17,162

100,411

9,334

33,612

27,868

29,578

154,154

19,428

50,727

40,952

43,046

14,300

2,413

5,756

3,612

3,117

31,315

36,837

43,956

39,084

36,978

44,620

49,642

40,355

134,690

56,300

78,389

36,908

85,361

5,996

4,989

7,186

23,712

19,682

13,175

10,619

32,359

5,391

9,209

8,004

9,756

53,002

5,597

21,689

11,678

14,038

89,894

9,077

24,321

15,859

20,637

13,223

1,569

5,540

3,333

2,781

19,595

20,489

16,745

14,387

17,844

20,313

29,741

17,664

84,261

31,247

33,034

21,080

735,521

105,327

114,940

86,265

236,214

116,230

43,658

28,888

296,235

111,630

109,447

48,264

26,894

437,286

108,637

217,032

67,966

43,652

651,568

192,928

264,798

105,659

68,182

66,861

22,122

32,849

8,344

3,546

85,420

128,559

209,825

237,819

146,404

192,726

234,937

159,454

573,545

217,373

356,172

161,976

‘Includes persons whose heslth status was not ssssssed.

‘+nclude$ ~emns of ~aceS other than Ate or black and persons wth unk- ffeW income.

NOTE MSA is metropolitan statistical area.
8 Advance Data No. 197 ● May 21, 1991

Table 5. Average annual number per 100 persons per year and number of short-stay hospital days, by limitation of activity due to chronic

conditions, respondent-assessed health status, and selected soclodemographic characteristics United States, 1984-88

Limited in activity Not /inrMecfIn acthfity Limited in activity Not /irnifed’in 8ctivi/y

Fair or Good to Fair or Good to Fair or Good to Fair or Good to

poor exce//ent poor exce//ent poor exce//ent

Characteristic Tots?

poor exca//ent

health health health health Tots! heatth heafth health health

Allpersons2 . . . . . . . . . . . . . . . . . . . . .

Age

Under 5 years . . . . . . . . . . . . . . . . . . . .

5-17 years....,..,.,...,.. . . . . . .

18-24 years..,,,,.,....,.. . . .

25-44 years . . . . . . . . . . . . . . . . . . . . .

45-64 years . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . .

75 years and over . . . . . . . . . . . . . . . . .

Sex and age

Male, all ages . . . . . . . . . . . . . . . . . . . .

Under 18years . . . . . . . . . . . . . . . . . .

16-44 years . . . . . . . . . . . . . . . . . . . . .

45-64 years...,.......,.. . . . . . . .

65 years And over . . . . . . . . . . . . . . . .

Female, all ages, ,,, . . . . . . . . . . . . . . .

Under 18 years . . . . . . . . . . . . . . . . . . .

l&-44 years . . . . . . . . . . . . . . . . . . . . .

45-64 years . . . . . . . . . . . . . . . . . . . . .

65 years and over . . . . . . . . . . . . . . . .

Race and age

White, all ages . . . . . . . . . . . . . . . . . . . .

Under 16years . . . . . . . . . . . . . . . . . . .

16-44years . . . . . . . . . . . . . . . . . . . . .

45-64yeara . . . . . . . . . . . . . . . . . . . . .

65years Andover.....,.. . . . . . . . .

Black, all ages . . . . . . . . . . . . . . . . . . . .

Under 18years . . . . . . . . . . . . . . . . . . .

16-44years . . . . . . . . . . . . . . . . . . . . .

45-64years . . . . . . . . . . . . . . . . . . . . .

65yearsand over . . . . . . . . . . . . . . . . .

Family income

Lessthan $10,000 . . . . . . . . . . . . . . . . .

$10,000-$19,999 . . . . . . . . . . . . . . . . . .

$20,00&$34,999 . . . . . . . . . . . . . . . . . .

$35,0000rmore . . . . . . . . . . . . . . . . . .

Northeast. .

Midwest. . .

South . . . .

West. . . . .

Geographic region

. . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . .

Place of residence

MA, . . . . . . . . . . . . . . . . . . . . . . . . .

Central icy. . . . . . . . . . . . . . . . . . .

Noncentral cay. . . . . . . . . . . . . . . . .

Not MSA, . . . . . . . . . . . . . . . . . . . . .

Number per 100 persons per year Number in thousands

80.2

51.7

20.2

47.2

58.4

110.7

207,6

285.5

75,5

28,0

41.4

128.6

257.7

84.5

30.5

68.8

94.3

223.4

79.4

27.6

53.0

105.8

234.5

95.7

39.5

78.8

168.8

278.4

136.4

98.9

63.7

45.9

85.8

83,4

89.0

55.2

77.8

67.9

71.0

87.4

530.2

1,582.2

3456

476,8

466,5

469.8

570.6

613.9

600.5

378.2

522.9

612.0

655.7

474.7

871.4

422.7

387.1

542.7

529.1

596.1

456.6

465.9

569.8

549,5

655.9

527.7

535.5

564.9

495.1

540.1

570.4

531.4

841.1

542.6

523.2

399.1

544.0

555.2

533.5

500.0

t 75.9

220.0

88.5

1468

149.9

166.8

219.1

306.1

171.3

96.5

144.8

203.6

241.1

180.2

113.4

154.3

139.5

267.2

174.6

103.4

142.0

163.2

261.1

205.4

111.7

238.7

237.1

224.7

213.4

179.2

150.0

126.0

194.8

186.7

168.8

125.4

183.9

210.2

165.8

153.5

167.0

321.7

65.3

134.3

136.4

130.0

242,4

253.6

178.8

137.3

107.2

163.3

297.7

156.1

171.9

154.5

101.8

209.9

178.7

160.2

142.1

138.2

259.6

136.7

147.6

129.1

113.2

178.9

163,1

183.1

155.1

145.0

189.1

206.4

151.7

124.7

168,4

155.9

180.1

163.6

33.2

31.9

11.8

33.9

34.3

34.9

69.9

119.1

26.4

18.4

19.1

36.5

93.1

39.8

17.0

48.7

33.3

82.3

33.6

17.3

33.7

35.8

87.1

34.0

21.7

40.4

30.5

91.6

43.0

36.5

31.4

27.4

34.9

36.1

35.1

24.9

32.5

33.9

31.5

35.6

189,252

9,387

9,045

12,648

43,153

49,558

35,211

30,251

86,161

9,036

20,339

27,461

103,091

9,394

35,402

22,096

36,200

159,105

14,279

45,065

41,466

58,295

27,316

3,812

9,556

7,554

6,395

45,530

45,337

39,939

26,757

42,855

48,820

71,471

28,105

138,091

62,578

75,515

51,162

76,265

1,867

1,555

1,540

10,552

26,764

18,831

15,157

38,087

1,165

6,102

15,275

15,546

38,176

2,257

5,990

11,490

18,442

61,685

2,432

8,753

21,278

29,232

13,584

938

3,145

5,264

4,237

24,326

19,726

13,308

6,664

17,657

17,851

31,483

9,275

53,760

26,361

27,399

22,505

31,706

649

2,069

1,771

7,070

8,007

5,862

6,257

15,002

1,533

4,515

4,415

4,539

16,704

1,185

4,326

3,593

7,601

28,002

2,264

7,436

6,959

11,342

3,377

439

1,301

906

72a

7,504

7,151

6,549

4,848

7,067

8,674

11,124

4,842

24,417

11,355

13,062

7,269

16,176

1,306

492

1,046

3,382

3,412

3,682

2,856

7,476

77

1,377

1,971

3,352

8,699

1,021

3,050

1,441

3,187

13,290

1,248

3,349

2,819

5,874

2,603

493

966

559

665

3,900

4,602

3,056

1,734

3,524

4,573

5,953

2,126

11,554

5,145

6,409

4,623

64,042

5,481

4,826

6,262

22,026

11,073

6,553

5,618

24,853

5,422

8,311

5,612

5,507

39,189

4,866

21,979

5,481

6,863

55,221

8,215

25,401

10,144

11,460

7,600

1,664

4,120

789

808

9,619

13,670

16,664

15,395

14,464

17,372

22,452

9,754

47,602

19,446

28,155

16,441

‘Includes persons whose heailh status was not assessed.

zfn~,ude~ ~er~on~ of raceS other than wh!!e or bleck and persons wllh unkno~ famify inmme.

NOTE. MSAmmetropolllan stat!stcslarea.
Advance Data No. 197 ● Mav 21.1991 9

Table 6. Average annual percent distribution of persons with restricted-activity days,

physician contacts, and hospital days by limitation of activity and respondent-assessed

health status: United States, 1984-88

Lim!ted in actiw”fy Not /imited in activity

Fair or Good to Fair or Good to

poor excellent poor exce//ent

Event Tota$ health health health health

Percentdistribution

Population. . . . . . . . . . . . . 100.0 6.1 7.7 4.1 62.1

Restricted-activitydays. . . . . 100.0 36.6 14.6 7.4 41.3

Physiciancontacts. . . . . . . . 100.0 19.8 13.9 6.9 59.4

Hospitaldays. ., . . . . . . . . 100.0 40.5 16.6 8.6 34.0

‘Excludespersonswhosehealrhstatuswas notassessed.

Table 7. Average annual number of acute conditions per 100 persons per year, by

imitation of activity due to chronic conditions and respondent-assessed health status:

United States, 1984-88

Number per 100

Limitation of activify and assessed health status persons per year

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178.0

Limited,fairer poorhealth . . . . . . . . . . . . . . . . . . . . . . 190.5

Limited,good to excellenthealth... . . . . . . . . . . . . . . . 1S4.6

Notlimited, fairorpoor health. . . . . . . . . . . . . . . . . . . . 216.3

Notlimited, goodto excellenthealth. . . . . . . . . . . . . . . . 174.6

particular age distribution for each

pattern, the data were adjusted for

age. The distributions for four age

groups (under 45 years, 45-64 years,

65-74 years, and 75 years and over)

were calculated using the total

population in each age group as the

base, rather than the population in

each age group with the particular

impairment. The resulting

populations in each age group are

summed and divided by the total

population to obtain an age-adjusted

percent distribution of activity

limitation for each impairment.

The patterns observed in the

actual data generally hold in the

age-adjusted distributions. Because,

with one exception, impairments are

positively associated with age, the

age-adjusted percents in good health

with no activity limitation are higher

than the actual ones. The exception is

speech impairments, for which the

Tabie 8. Unadjusted and age-adjusted average annual percent distribution of selected chronic impairments by imitation of activity and

respondent-assessed health status, according to impairment United States, 1984-88

Limited in acfwity Not I/m/ted in activity

Fair or Good to Fair or Good tO

p.cor excellent poor excellent

Impairment Totai health heallfr healti health

Totdpopulation. . . . . . . . . . . . . . . . . . . . . . . . . . . .

Visualimpairment . . . . . . . . . . . . . . . . . . . . . . . . . . .

Color blindness. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Cataracts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Glaucoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Hearing impakment. . . . . . . . . . . . . . . . . . . . . . . . . .

Tinnitus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Speech impairment. . . . . . . . . . . . . . . . . . . . . . . . . .

Absence ofextremitles . . . . . . . . . . . . . . . . . . . . . . . .

Paralysisof extremities . . . . . . . . . . . . . . . . . . . . . . . .

Deform”~ or orthopedic impairment . . . . . . . . . . . . . . . .

Back . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Upper extremities. . . . . . . . . . . . . . . . . . . . . . . . . .

Lowerextremities. . . . . . . . . . . . . . . . . . . . . . . . . .

Visual impairment . . . . . . . . . . . . . . . . . . . . . . . . . . .

Color blindness, . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Cataracts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Glaucoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Heanngimpairment . . . . . . . . . . . . . . . . . . . . . . . . . .

Tinnitus ..................................

Speach impairment . . . . . . . . . . . . . . . . . . . . . . . . . .

Absence of extremities . . . . . . . . . . . . . . . . . . . . . . . .

Paralysis of extremities . . . . . . . . . . . . . . . . . . . . . . . .

Deformity ororthopedic impairment . . . . . . . . . . . . . . . .

Back . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Upper extremities . . . . . . . . . . . . . . . . . . . . . . . . . .

Lowerextremifies . . . . . . . . . . . . . . . . . . . . . . . . . .

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

1W.o

100.0

100.0

100.0

100.0

100.0

100.0

6.1

25.2

9.5

29.4

26.1

19.1

23.7

20.1

24.3

48.3

17.6

18.6

22.2

18.6

17.8

8.0

19.5

18.2

12.5

16.3

21.1

17.1

37.4

14.9

16.4

17.3

15.6

Unadjusted percent distribution

7.7 4.1

17.6 5.2

9.1 3.5

21.5 9.0

22.4 8.8

la.o 7.1

18.3 7.1

30.0 4.9

20.0 5.3

39.2 1.9

22.2 5.5

20.0 6.1

27.6 4.8

25.4 4.9

Age-adjusted percent distribution

14.9 4.4

a.7 3.3

20.6 4.9

17.0 7.5

16.5 5.9

16.7 6.4

29.5 4.9

20.1 3.6

48.4 2.0

21.6 5.1

19.3 5.8

29.2 4.0

24.6 4.5

82.1

52.0

77.9

40.1

42.7

55.8

50.9

44.9

50.3

10.6

54.7

55.2

45.2

51.1

62,9

ao.o

55.0

57.3

65.1

60.6

44.5

59.2

12.2

58.4

58.6

49.6

55.1

‘Escluo’esmrsonswtmaeheelthstatuswasnoressessad
10 Advance Data No. 197 ● May 21, 1991

Table 9. Unadjusted and age-adjusted average annual number of selected chronic impairments per 1,000 persons, by limitation of activity

and respondent-assessed health status: United States, 1984-68

Limited in actfvlfy Not /imited in activify

Fair or Good tO Fair or Good tO

poor exce//errt poor

/mpa/rment Tots?

exceJ/ent

health health health health

Vwuallmparment, ., . . . . . . . . . . . . . . . . . . . . . . .

Color bhndness . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Cataracts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Glaucoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

l+ea~ln gtmpairmen t,,,.... . . . . . . . . . . . . . .

TIm_ws, . . . . . . . . . . . . . . . . . . . . .

SDeech!mpairment ..,... . . . . . . . . . . . .

Absence ofextremities . . . . . . . . .

Pa:alysls of extremities . . . . . . . . . . . . . . . . . . . . . . . .

Deformity ororthopedic impairment . . . . . . . . . . . . . .

Back . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Upper extremities . . . . . . . . . . . . . . . . . . . . . . . . . .

Lowerextremlties, .,...... . . . . . . . . . . . . . . . . .

Visual impairment . . . . . . . . . . . . . . . . . . . . . . . . . . .

Co!orbhndness . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Cataracts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Glaucoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Hearing impairment .,...... . . . . . . . . . . . . . . . . . .

TmnWs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Speech impairment, . . . . . . . . . . . . . . . . . . . . . . . . .

Absence ofextremihes . . . . . . . . . . . . . . . . . . . . . . .

Para’yslsofextremlties . . . . . . . . . . . . . . . . . . . . . . .

Deformity ororthopedlc impairment . . . . . . . . . . .

Back . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Upaerextremities . . . . . . . . . . . . . . . . . . . . . . . .

Lower extremities . . . . . . . . . . . . . . . . . . . . . . .

34.9

11.3

23.4

7.9

89.8

261

10.6

7.0

5.8

113.1

64.2

13.3

48.3

34.8

11.3

23.4

7.9

89.8

26.1

10.6

7.0

5.8

113.1

84.2

13.3

48,4

143.5

17.5

112.3

33.9

280.2

101.1

34.8

27.9

45.6

325.5

196.6

48.1

146.7

Unadjusted number per 1,000 persons

80.0 44.1

13.4 9.5

65.5 51.1

23.1 16.9

210,1 155.7

624 44.8

4f .5 12.7

16.4 9.1

29.6 2.7

327.2 150.4

166.9 94.9

48.0 15.6

160.2 57.5

Age-adjusted number per 1,000 persons

123.3 66.5 36.5

14.6 12.8 9.2

43.7 33.2 23.4

17.2 13.2 9.8

200.9 166.0 115.0

75.7 46.7 34.2

45.0 53.1 15.8

22.6 15.7 6.2

42.8 29.6 2.4

360.2 341.8 148.6

252.9 173.0 96.7

49.0 51.3 12.9

173.7 166.7 54.7

22.1

10.7

11.4

4.1

61.0

16.2

5.8

4.3

0.7

75.3

43.1

7.3

30.1

23.7

10.9

17.0

5.7

73.1

19.2

5.6

5.0

0.9

77.5

44.1

7.9

30.9

‘Exc!udes persons whose heakh status wasnc; assessed.

percent is unchanged. At the same

time, the adjusted percents for

persons in good health and withno

Iimitation are virtually unchanged for

colorblindness and paralysisof

extremities. After age adjustment,

almost one-half of the persons with

paralysis of extremities are seen to

have had inactivity Iimitation butto

have been ingood health. In the

actual distribution one-half are

limited and in fair or poor health.

Like\vise, the percents ofpersons

limited but ingood health are higher

than the percents limited and in fair

or poor health for those who have

hearing impairments and absenceof

extremitiesin the adjusted

distributions but not in the

unadjusted distributions.

As might be expected, the

prevalence rates for reported

impairments tend tobe highest

among persons limitedin activity and

in fair or poor health. They are

Io\vest among those not limited and

in good health, as demonstrated in

table 9,There are a few exceptions

tothispattem. The prevalence rates

per 1,000 persons of reported

impairments of speech and of the

lower extremities were higher for

persons limited in activity and in good

health than for those limited and in

less than good health.

For persons limited in activity

and in fair topoorhealth, the

prevalence rates per 1,000 persons for

reported visual impairments,

cataracts, glaucoma, and absence or

paralysis of extremities were very high

compared with those for all persons.

In sharp contrast, color blindness did

not show much variation in reported

rates.

Rates of impairments were

generally higher for those limited but

in good health than for those not

limited but in fair to poor health.

Among those not limited but in fair

to poor health, reported rates for

cataracts and glaucoma were

relatively high.

As with the percent distrilbutions,

the prevalence rates were adjusted

for age. Rates for four age groups

(under 45 years, 45-64 years, 65-74

years, and 75 years of age andl over)

were calculated using the total

population in each age group as the

base, rather than the population in

each age group with a particular

activity limitation and health status

configuration. The resulting

populations in each age group are

summed and divided by the tc~tal

population to obtain an age-adjusted

rate for each configuration.

In general, the patterns fcmnd in

the unadjusted data hold. The

adjusted rates tend to be lower for

persons either with an activity

limitation or in fair or poor health,

because these populations tend to be

older than the population with no

limitations and in good health. The

adjusted rate for deformi~ or

orthopedic impairment of lower

extremities among persons limited

and in fair or poor health is higher
Advance Data No. 197

● May 21,1991 11

than among those limited but in good

to excellent health. This is not true

for the unadjusted rate.

To summarize, there appear to be

particular patterns of association

among various impairment categories

and various configurations of activity

limitation and self-assessed health

status. Visual impairment, cataract,

glaucoma, and absence of extremities

are associated with fair to poor

health; reported speech impairment

and deformity or orthopedic

impairment are associated with

limited activity but good health. Color

blindness is associated with good

health and no activity Imitation, but

paralysis of extremities is associated

with activity Imitation and, toa lesser

extent, with less than good health.

References

1.

2.

3.

4.

5.

6.

Adams PF, Hardy AM. Current estimates from the National Health Interview Survey, 1988.National Center

for Health Statistics. Vital Health Stat

10(173). 1989.

Feller BA. Health characteristics of

persons with chronic activity

limitation, United States, 1979.

National Center for Health Statistics.

V]tal Health Stat 10(137). 1981.

Ries P. Americans assess their health

United States, 1987. National Center

for Health Statistics. Vital Health Stat

10(174). 1990.

Gentile A. Persons with impaired

hearing, United States, 1971. National

Center for Health Statistics. Vital

Health Stat 10(101). 1975.

Ries PW. Hearing ability of persons

by sociodemiographic and health

characteristics, United States.

h’ational Center for Health Statistics.

Vital Health Stat 10(140). 1982.

Adams PF, Benson V. Current

estimates from the National Health

Interview Survey, 1989. National

Center for Health Statistics. Vital

Health Stat 10(176). 1990.

Symbols

--– Data not available . . . Categoty not applicable

Quantity zero

0.0 Quant-@more than zero but less

than 0.05

* Figure does not meet standard of

reliability or precision
12 Advance Data No. 197 ● May 21,1991

Technical notes

The National Health Interview

Survey (NHIS) is a continuous,

cross-sectional, nationwide survey

conducted by household interview.

Each week a probability sample of

households in the civilian

noninstitutionalized population of the

United States is interviewed by

personnel of the U.S. Bureau of the

Census to obtain information on the

health and other characteristics of

each member of the household. A

description of the survey design,

methods used in estimation, and

general qualifications of the NHIS

data is provided in the Current

estimates report for 1989 (6).

The NHIS sample for the 5 years

1984-88 was composed of about

194,000 eligible households,

containing approximately 504,000

persons living at the time of

interview. The total nonintemiew rate

for NHIS was about 4.3 percent.

Estimates were produced by summing

the frequencies for the 5-year period

and dividing by 5. Thus, the

Table 1. Parameters used to compute estimated standard errors for the estimates shown

in this report

Parameter

Characteristic a b

Population group defined by characteristics

other than age, sex, or race . . . . . . . . . . . . . 0.00001028 10,901

Restricted-actiiity days . . . . . . . . . . . . . . . . . 0.000105 118,358

Physician contacts . . . . . . . . . . . . . . . . . . . . 0.0000156 36,892

Hospital discharge dada . . . . . . . . . . . . . . . . 0.0LX)55 22.224

frequencies, percents, and rates

represent average annual estimates

for this 5-year period and not

estimates for the whole period.

The sampling errors associated

with the estimates shown in this

report may be obtained by consulting

appendix I of the Current estimates

report for 1989 (6) and using the

appropriate forrnuIas and the

parameters for 5 years of data shown

in table I.

Population estimates restricted to

age, sex, or race categories are

adjusted to U.S. Bureau of the

Census estimates and therefore have

no sampling variation.

Suggested cltatlon

Ries P, Brown S. Disability and health:

Characteristics of persons by limitation of

activity and assessed health status, United

States, 1984-88. Advance data from vital and

health statistics; no 197. Hyattsville, Maryland:

National Center for Health Statistics. 1991.

Copyright information

This report may be reprinted without further

permission.
Number 198 ● April 1, 1991

Advance

Data

From Vital and Health Statistics of the National Center for Health Statistics

AIDS Knowledge and Attitudes for July-September

Provisional Data From the National Health Interview Survey

by Patricia F. Adams and Ann M. Hardy, Dr.P.H., Division of Health Interview Statistics

1990

Introduction

The National Center for Health

Statistics has included questions

about acquired immunodeficiency

syndrome (AIDS) in the National

Health Interview Survey (NHIS) since

1987. Data concerning the ~dult

population’s knowledge and attitudes

about AIDS and transmission of the

human immunodeficiency virus (HIV)

are collected to assist in planning

educational programs. Since the

initiation of the NHIS AIDS survey,

its scope has widened to include

many questions on HIV testing and

blood donation experience. In

addition to assessing self-perceived

risk of becoming infected with HIV,

the survey includes a general risk

behavior question similar to that

asked by the Red Cross of potential

blood donors. At various points in its

history, the AIDS survey has also

been used as a tool for evaluating

public awareness campaigns and for

assessing the public’s willingness to

participate in a national

seroprevalence survey. Information on

the NHIS AIDS survey sample is

contained in the Technical notes at

the end of this report.

The first AIDS Knowledge and

Attitudes survey was in the field from

August through December 1987.

Provisional results of that survey were

published monthly in Advance Data

From Ktal and Health Statistics (Nos.

146, 148, 150, 151, and 153). During

the first 4 months of 1988, the NHIS

questionnaire was revised to meet

program needs at that time. The

revised AIDS Knowledge and

Attitudes Survey entered the field

May 1988. Provisional findings for

remainder of 1988 were published

in

the

periodically (Advance Data From Vital

and Health Statistics, Nos. 160, 161,

163, 164, 167, and 175); in addition,

two special reports with a focus on

minority populations were published

from the 1988 data (Advance Data

From Etal and Health Statistics, Nos.

165 and 166).

The 1988 AIDS questionnaire

was used without modification

throughout 1989, and results were

published on a quarteriy basis

(Advance Data From Wal and Health

Statistics, Nos. 176, 179, 183, and

186). For 1990 the AIDS

questionnaire was revised again, with

added emphasis on HIV testing

procedures and on the distinction

between testing in connection with

blood donation and for other reasons.

Provisional survey findings have been

published on a quarterly basis in

Ad}’ante Data From IZtal and HcaIth

Statistics, Nos. 193 and 195, and will

continue to be published on a

quarterly basis for 1990.

The NHIS AIDS questionnaires

were developed by the National

Center for Health Statistics and an

interagency task force created by the

Public Health Service Health Data

Policy Committee. The task force

included representatives from the

Centers for Disease Control; Office

of the Assistant Secretary for Health;

National AIDS Program Office;

National Institutes of HeaIth;

Alcohol, Drug Abuse and hlental

Health Administration; Food and

Drug Administration; and the Health

Resources and Services

Administration.

The Advance Data reports

describing the NHIS AIDS data have

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2 Advance Data No. 198 ● April 1, 1991

been restricted to simple descriptive

statistics to facilitate their timely

release. Thus these reports do not

attempt to explain or interpret

differences among population

subgroups or to examine relationships

among various measures of

knowledge and behavior. The NHIS

AIDS data bases permit more

complex analyses than those

presented in this series of Advance

Data reports, and further exploration

of the data is encouraged. Public use

data tapes of the 1987, 1988, and

1989 AIDS Knowledge and Attitudes

surveys are available at this time.

This report presents provisional

data for July–September 1990 for

most items included in the NHIS

AIDS questionnaire. Table 1 displays

percent distributions of persons 18

years of age and over by response

categories, according to age, sex, race

and ethnicity, and education. In most

cases, the actual questions asked of

the respondents are reproduced

verbatim in table 1 along with the

coded response categories. In a few

cases, questions or response

categories have been rephrased or

combined for clearer or more concise

presentation or results. Refusals and

other nonresponse categories

(generally less than 1 percent of total

responses) are excluded from the

denominator in the calculation of

estimates, but responses of “don’t

know” are included. The NHIS AIDS

questionnaire uses the phrase “the

AIDS virus” rather than “HIV,”

because it is felt to be more widely

recognized and understood. In this

report the two terms are used

synonymously.

The population subgroups used in

presenting the 1990 NHIS AIDS data

differ from those used in previous

reports. In reports based on the

1987–89 surveys, two racial categories

were shown –white and black. The

1990 reports show three categories

that reflect both race and ethnic

origin —non-Hispanic white,

non-Hispanic black, and Hispanic.

This change, which reflects the

increasing demand for information

about the Hispanic population, means

that estimates by race cannot be

compared directly between the 1990

and earlier NHIS AIDS Advance

Data reports. In addition, the

revisions in the questionnaire,

whether in actual wording or in

context and location of questions,

must be considered when interpreting

trend data.

Selected findings

The following highlights describe

survey results of the NHIS AIDS

Knowledge and Attitudes Survey for

the period July-September 1990.

Unless otherwise noted in the text, all

measures described remained stable

over this period. M differences cited

in the text are statistically significant

at the .05 level. Table II shows

provisional estimates of the standard

errors associated with these results.

General AIDS knowledge –

General knowledge about AIDS and

HIV was ascertained through a series

of statements about the general

characteristics of the disease and how

it is transmitted. Respondents were

asked to classify each statement as

definitely true, probably true,

probably false, or definitely false,

overall the measures of general

knowledge about AIDS and HIV

were similar between the second and

third quarters of 1990. For example,

the percent of adults who stated that

it is definitely true that AIDS can

damage the brain remained steady at

42 percent compared to 43 percenc

and the percent who thought it is

definitely true that a person can be

infected with the AIDS virus and not

have AIDS was 64 compared to

65 percent.

Levels of knowledge about the

three major modes of HIV

transmission also remained high. For

the third quarter the proportions of

adults who thought it is definitely

true that HIV can be transmitted

through sexual intercourse

(86 percent) and from a pregnant

woman to her child (84 percent)

were similar to the second quarter

(87 percent and 85 percent,

respectively). The proportion of

adults who thought it very likely that

HIV can be transmitted by sharing

needles for drug use remained stable

at 95 percent. (Knowledge about

HIV transmission through needle

sharing was asked in a separate series

of questions with different response

categories.)

Despite the overall similarities in

knowledge, there was a slight

decrease in one area. For this

3-month period 67 percent of U.S.

adults 18 years of age and over

realized that it is definitely false that

there is a vaccine for the AIDS virus;

a decrease from 69 percent for the

previous 3-month period. Overall

there has been a decrease in 1990

compared with 1989 in proportions

with the definitive correct answer to

this question. This may reflect failure

to distinguish between a vaccine and

drugs that are used in treatment of

AIDS or HIV, for example,

zidovudine (AZT), or it may result

from pubIicity concerning progress

towards development of a vaccine.

During the third quarter of 1990,

as in all previous quarters, general

knowledge about AIDS varied by

demographic and socioeconomic

characteristics. Persons aged 5(0years

and over were less knowledgea~ble

than younger persons. Knowledge

increased directly with number of

years of school completed. For five of

the nine measures of general AIDS

knowledge examined, non-Hispanic

white adults were more likely than

non-Hispanic black or Hispanic adults

to respond correctly. For three of the

remaining four measures, knowledge

was lower among Hispanic adults; for

one measure (awareness that HIV

can damage the brain), non-Hkpanic

black adults (50 percent) were the

most knowledgeable compared with

non-Hispanic white (43 percent) and

Hispanic adults (44 percent). There

was no consistent difference by

gender in general AIDS knowledge.

Two new items regarding general

AIDS knowledge were added to the

1990 NHIS AIDS survey. One was a

question asking whether the

respondent had ever heard the AIDS

virus referred to as “HIV.” Almost

three-fourths of adults were familiar

with this term as of July-September

1990, but this proportion was much

lower for persons 50 years of age and

over (62 percent) and for persons

with less than 12 years of school
Advance Data No. 198 ● April 1, 1991 3

(48 percent). ALso,the proportion of

Hispanic adults who recognized this

term (51 percent) was much lower

than the proportion for non-Hispanic

white adults (77 percent) or

non-Hispanic black adults

(69 percent). Since approximately

25 percent of the Hispanic

households sampled in the first half

of 1990 required at least some

transition of the NHIS survey into

Spanish, this lower level of

recognition may be due, in part, to

unfamiliarity with the English term

“HIV” among Spanish-speaking

Hispanic adults. The second new item

in the survey was a statement that

there are drugs available to extend

the life of a person infected with

HIV. Slightly less than half of aIl

adults (45 percent) categorized this

statement as definitely true; an

additional 27 percent stated it as

probabIy true.

Self-assessed knowledge about

AIDS also remained stable for the

second and third quarters of 1990. In

the third quarter, 19 percent of

adults stated they knew a lot about

AIDS; in the second quarter, this

proportion was identical. The

proportion of adults who stated they

knew nothing about AIDS also

remained virtually unchanged

(10 percent), While these proportions

did not change in 1990, they

represent a decline from the previous

year. Although this question is

worded the same in 1990 as in

preceding years, its location was

changed in 1990 so that it is now the

first question asked in the survey. In

general the sociodemographic “

differentials in objective measures of

knowiedge were generally consistent

with those in self-assessed knowledge

about AIDS, The population

subgroups most likely to state that

they know a lot about AIDS were

persons under 50 years of age and

those with more than 12 years of

school.

Misinformation about HIV

transmission –The NHIS AIDS

questionnaire asked respondents to

estimate the risk of HIV transmission

associated with several forms of

casuaI contact with infected or

potentially infected individuals, for

example, working with someone with

AIDS, using public toilets, and so

forth. Respondents were offered five

response options for the likelihood of

transmission –very likely, somewhat

likely, somewhat unlikely, very

unlikely, and definitely not possible.

Both “very unlikely” and “definitely

not possible” were interpreted as

correct responses, even for forms of

contact where our current

understanding of the virus indicates

that there definitely is no possibility

of transmission. The decision to

accept “ve~ unlikely” as correct was

based on the large numbers of

respondents who chose that option,

seemingly unwilling to commit

themselves to the concept of a zero

probability. As has been true since

1987, the results for July–September

1990 indicated that many

misperceptions about HIV

transmission remain. The proportion

of adults who assessed the risk of

transmission as “very unlikely” or

“definitely not possible” varied from

less than half for transmission by

means of insect bites or contact with

the saliva of an infected individual

(sharing eating utensils or being

sneezed or coughed on) to almost

three-fourths for working near or

attending school with someone with

HIV. Most of these measures

remained similar between April-June

and July–September 1990.

As with generaI AIDS knowledge,

there were demographic and

socioeconomic differentials in

misperceptions about HIV

transmission. Adults 50 years of age

and over were more likely than

younger adults to be misinformed,

and non-Hispanic black and Hispanic

individuals generally had more

misperceptions than did non-Hispanic

white individuals. The level of

misinformation decreased with

increasing educational attainment.

Again, there was no consistent

differential by gender.

Information and communication

about AZLS —From April–June to

July-September 1990, the proportion

of adults who reported discussing

AIDS with their children aged 10-17

years was similar, 68 and 67 percent,

respectively. However, the proportion

who reported that their children had

received instruction in school about

AIDS decreased slightly, from 75 to

72 percent for the same time period.

Eighty-seven percent of adults stated

that they had received information

about AIDS or HIV in the month

preceding the NHIS AIDS survey.

The most commonly reported sources

of information were television (cited

by 75 percent of adults), newspapers

(51 percent), magazines (41 percent),

and radio (28 percent). Each of these

sources showed a decline from the

previous quarter – 80, 57,45, and

33 percent, respectively.

Sources of AIDS information did

not differ significantly in most areas

by race or ethnicity. Newspapers and

magazines were cited most often by

non-Hispanic white individuals than

minorities. There were three sources

of information that were reported

more often by non-Hispanic black

than by non-Hispanic white

individuals —mass transit displays

(signs in buses and subways), health

department brochures, and brochures

distributed at the workplace.

Blood donation and testing–There

was no change in blood donation

experience between the second and

third quarters of 1990. Data for the

third quarter indicated that

40 percent of adults had ever

donated blood, 16 percent had

donated blood since March 1985

(when blood donations were first

routinely tested for HIV), and

7 percent had donated blood in the

preceding year. Multiple donations

were common among those who had

donated blood. Of the 16 percent of

adults who had donated bIood since

March 1985, one-half, or 8 percent,

donated blood three times or more.

In the year preceding the interview,

4 percent of adults had donated

blood once, 2 percent had donated

blood twice, and 1 percent had

donated blood three times or more.

Seventy-nine percent of U.S.

adults had heard of the blood test to

detect HIV antibodies, the same

percent reported for the second

quarter of 1990. Simy-six percent, or

five-sixths of those familiar with the

blood test, knew blood donations are
4 Advance Data No. 198 ● April 1, 1991

routinely tested for HIV. This was a

slight decrease from 68 percent

reported during the previous quarter.

Two percent of the persons who had

donated blood since March 1985 (an

estimated 692,000 individuals)

reportedly did so at least in part to

be tested for HIV.

Not counting testing performed in

conjunction with blood donation,

10 percent of U.S. adults reported

having had their blood tested for HIV

antibodies. Testing as a result of

blood donation occurred in the

16 percent of adults who had

donated blood since March 1985.

These figures include 2 percent who

were tested because of blood

donation and for other means.

Overall an estimated 24 percent of

the adult population has been tested

for HIV antibodies, The total percent

tested in the first three quarters of

1990 (23-24 percent) represents a

slight increase over the estimate of

21 percent from the last quarter of

1989. (The revised estimated total

percent of adults tested for HIV for

the first and second quarters of 1990

is 23 percent for each.)

The proportion of adults who had

been tested exclusive of blood

donation declined sharply with age,

from 16 percent of persons 18-29

years of age to 13 and 4 percent,

respectively, of those 30-49 years and

50 years of age and over, There was

no statistically significant difference

between men and women in percent

tested. Hispanic adults were more

likely than non-Hispanic white adults

to have been tested outside of blood

donations, 17 percent compared to

9 percent. The probability of having

been tested showed no differences

with education.

Of persons tested exclusive of

blood donation, 49 percent stated

that all their tests were required, that

is, conducted as a part of an activity

that includes mandatory blood

testing. For 47 percent all their tests

were voluntary. Three percent had

both required and voluntary tests.

The most commonly cited reasons for

required tests were hospitalization or

surgery and militaxy induction or

service (reported by 9 percent of

persons tested outside of blood

donation). In addition, 8 percent

were tested as a requirement for life

insurance, 7 percent for immigration

(cited by 39 percent of Hispanic

adults who were tested exclusive of

blood donation), 6 percent for

employment, 3 percent for health

insurance, and 12 percent were

tested for other reasons. Individuals

may have cited more than one reason

for a single test (for example, for

both employment and health

insurance) or may have had more

than one required test; thus the sum

of the individual reasons exceeds the

proportion of persons with at least

one required bIood test.

One-third of persons tested for

HIV antibodies apart from blood

donations – including both voluntary

and required testing– had their last

blood test at a doctor’s office or a

Health Maintenance Organization

(HMO), and about one-fourth

(24 percent) were tested at a

hospital, outpatient clinic, or

emergency room. Eight percent were

tested at military induction or service

sites, and another 8 percent were

tested at public health departments.

Only 3 percent were tested at

designated AIDS clinics or counseling

and testing sites. Less than half,

43 percent, were counseled about

AIDS and HIV before the test was

administered. Almost four-fifths

(79 percent) received their test

results. Of those that did not receive

their results, nearly two-fifths

(38 percent) reportedly wanted them.

Of those who received their test

results, 29 percent were counseled

about prevention of HIV transmission

at the time the results were provided.

Sixty-three percent received their test

results in person compared to smaller

proportions who received their test

results by telephone (17 percent),

mail (13 percent), or by other means

(6 percent). The vast majority

(92 percent) of persons tested for

HIV felt that their tests were handled

properly in terms of confidentiality of

test results.

According to the NHIS AIDS

data for this quarter, 6 percent of

U.S. adults reportedly plan to be

tested for HIV antibodies in the next

12 months. The proportion of these

persons who had been tested

previously has not yet been anadyzed,

but it is likely that some are

repeaters. This figure, which has

remained fairly stable over the past

year, was more than two times higher

for non-Hispanic black than for

non-Hispanic white adults. Twelve

percent of non-Hispanic black adults

reported plans to be tested compared

to 5 percent of non-Hispanic white

adults.

Of persons who plan to be tested,

almost two-thirds stated that thley

would be tested voluntarily because

they personally wanted to know if

they are infected. Twenty-five percent

plan to be tested as part of blood

donation, 12 percent as part of a

hospital or surgical procedure, and

10 percent cited the need for testing

as a requirement for a job or the

military. Some individuals reported

more than one reason for anticipated

testing. In general the locations at

which persons plan to be tested are

somewhat similar to those reported

for tests already conducted, with

private doctors or HMOS and hospital

emergency rooms or clinics

accounting for over half of the

locations (38 and 18 percent,

respectively).

Risk of HIV infection – The thirdquarter 1990 NHIS AIDS survey

results indicated that 5 percerrt of

U.S. adults, an estimated 10 million

persons, received blood transfusions

between 1977 and 1985. This is the

period when HIV is thought to have

entered the United States and when

routine screening of blood donations

began. SlightIy less than half of the

Nation’s adults think the blood. supply

is now safe for transfusions.

During July–September 1990 the

proportion of adults who think

condoms are very effective in

preventing transmission of HIV was

26 percent, similar to figures alluring

the two previous quarters in 1990.

Perceptions about effectiveness varied

by race and ethnici~. Twenty-one

percent of Hispanic adults reported

condoms are very effective in

preventing transmission of HIV

compared to 27 percent for both

non-Hispanic black and non-Hispanic

white adults. The proportion who did
Advance Data No. 198 ● Am’il 1.1991 5

not know’ how effective condoms are

in preventing transmission of HIV

was higher for non-Hispanic black

(18 percent) than for non-Hispanic

white adults (13 percent).

Eighty percent of adults felt there

was no chance of their having been

infected with HIV, and 15 percent

said there was a low chance. The

proportion who thought there was a

medium or high chance of already

being infected wws 3 percent. The

prc?ortion of persons who thought

there was no chance of their

becoming infected with HIV in the

future was similar for the second and

third quarters of 1990 (73 and

72 percent, respectively). As of this

quarter, 21 percent of adults believed

that they had a low chance of

Suggested citation

Adams PF, Hardy AM. AIDS knowiedge and

attitudes for July-September 1990;

Provisional data from the Nationai Heaith

interview Survey. Advance data from vital and

health statistics: no 198. Hyattsvilie, Maryland:

National Center for Health Statistics. 1991.

becoming infected, and 4 percent

cited a medium or high chance. Only

2 percent of adults reported being in

any of the behavior categories

associated with a high risk of HIV

infection. This proportion has

remained stable since the risk

behavior question was added to the

NHIS AIDS questionnaire in 1988.

As of July–September 1990, about

one out of every seven adults

(15 percent) knew someone with

AIDS or HIV, the same figure as in

the second quarter of 1990. This

proportion was higher for persons

under 50 years of age than for those

aged 50 years and over but did not

vary by sex. However, the proportion

was higher among non-Hispanic black

(19 percent) than among

non-Hispanic white adults

(15 percent). The proportion of

adults who reported knowing

someone with AIDS or HIV

increased sharpIy with number of

years of school, from 9 percent of

persons with less than 12 years of

school to 21 percent of those with

more than 12 years of school.

Symbols

Quantity zero

o Quantity more than zero but less

than 0.05

Copyright information

This report may be reprinted without further

permission.
6 Advance Data No. 198 ● April 1, 1991

Table 1. Provisional estimates of the percent of persons 18 years of age and over with selected AIDS knowledge and attitudes from the

199o National Health Interview Survey, by seiected characteristics: United States, July-September 1990

[Data are based on household interviews of the civikan noninstitutionaiized population. The survey design, general qualifications, and information on the reliability of

the estimates are given in technical notes]

Race or efhnicify

Age Sex Non-Hispanic Education

18-29 30-49 50 years Less than More than

AIDS knowledge or atttude Total years years and over Male Female White Black Hispanic 12 yeara 12 years 12 years

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100

1.

2.

3.

4a.

4b.

4C.

4d.

4e.

4f.

How much would you say you know aboul AIDS?

A lit . . . . . . . . . . . . . . . . . . . . . . .

Some . . . . . . . . . . . . . . . . . . . . . . . . . . . .

AIRtle. . . . . . . . . . . . . . . . . . . . . . . . . . . .

Nothing . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’t know. . . . . . . . . . . . . . . . . . . . . . . . .

In the past month, have you received information

abed AIDS from any of these sources?l

Television . . . . . . . . . . . . . . . . . . . . . . . . .

Radio . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Magazines . . . . . . . . . . . . . . . . . . . . . . . . .

Newspapers. . . . . . . . . . . . . . . . . . . . . . . .

Street signsbillboards. . . . . . . . . . . . . . . . .

Store displays/store distributed brochurae . . . .

Buslstreetcarlsubway displays. . . . . . . . . . . .

Health department brochures . . . . . . . . . . . . .

Workplace clistribufed brochures . . . . . . . . . .

School distributed brochures . . . . . . . . . .

Church dWibutedbrochures . . . . . . . . . . . .

Communltyorganization . . . . . . . . . . . . . . . .

Friend/acquaintance . . . . . . . . . . . . . . . . . . .

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

Received no AIDS information inpastmonU’I. . . .

Have you heard the AIDS virus celled HIV?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’t know. . . . . . . . . . . . . . . . . . . . . . . . .

AIDS can reduce the body’s natural protection

against dkease.

Definitelytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablyfalse . . . . . . . . . . . . . . . . . . . . . . .

Definitelyfalse . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

AIDS can damage the brain.

Definitelytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablyfalse . . . . . . . . . . . . . . . . . . . . . . .

Definitelyfalse . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

AIDS is an infectious disease caused by a virus.

Definifelytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablyfalse . . . . . . . . . . . . . . . . . . . . . . .

Definitelyfalse . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

A person can be infected with the AIDS wrus and

not have the dkseeee AIDS.

Definitelytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablyfalse . . . . . . . . . . . . . . . . . . . . . . .

Definitelyfalse . . . . . . . . . . . . . . . . . . . . . . .

Don’t know. . . . . . . . . . . . . . . . . . . . . . . . .

ANY person with the AIDS virus can pass it on to

someone else through sexual

intercourse.

Definitelytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablytrue . . . . . . . . . . . . . . . . . . . . . . .

Probablyfalse . . . . . . . . . . . . . . . . . . . . . . .

Definitelyfalse . . . . . . . . . . . . . . . . . . . . . . .

Don’t know. . . . . . . . . . . . . . . . . . . . . . .

Aoreanantwomen whohasthe AIDS wruscangwe

19

46

24

10

0

75

28

41

51

10

6

4

17

11

7

4

4

12

3

1

13

73

24

2

77

12

1

2

8

43

26

7

4

19

70

15

2

3

11

65

16

3

3

13

66

10

0

0

3

it to h;rbaby.

Defmitelytrue . . . . . . . . . . . . . . . . . . . . . . . 84

Probablytrue . . . . . . . . . . . . . . . . . . . . . . . 11

Probablyfalse . . . . . . . . . . . . . . . . . . . . . 0

Definitelyfalse . . . . . . . . . . . . . . . . . . . . . . . 0

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . 4

See footnotesat ene oftable

100

22

52

21

5

0

75

32

44

46

15

10

6

24

11

13

4

5

19

4

1

11

77

22

2

80

9

1

3

7

42

27

9

5

17

77

13

1

2

6

68

15

3

5

9

89

8

1

0

2

87

to

o

0

3

100

23

53

21

3

0

76

32

44

54

11

6

4

17

16

8

5

5

12

3

0

12

81

18

2

83

10

1

2

4

46

24

8

5

17

76

13

1

3

6

72

15

2

3

8

69

9

0

0

2

87

10

0

0

3

100

13

35

30

22

0

74

21

35

51

5

4

2

11

5

2

3

3

7

2

1

16

62

34

4

66

15

2

2

15

42

27

5

2

24

56

20

3

3

19

54

19

3

2

22

80

12

0

0

6

78

14

0

0

7

100

18

45

25

11

0

76

32

39

53

12

6

4

15

10

6

4

4

12

3

1

13

72

25

2

77

12

1

2

8

44

26

7

4

18

70

16

1

2

10

63

18

3

4

13

84

11

0

1

4

81

14

0

0

5

Percent distribution

100

20

47

23

10

0

75

25

43

49

6

6

4

19

12

6

4

5

12

3

1

13

75

23

3

76

11

1

3

8

43

26

7

4

20

69

15

2

3

11

66

15

3

3

13

88

6

0

0

3

87

9

0

0

A

100

19

49

23

9

0

75

29

43

53

10

6

3

16

10

7

3

1;

3

1

13

77

21

2

81

10

1

1

7

43

26

8

4

20

70

15

2

3

10

66

16

2

3

11

88

9

0

0

3

86

10

0

0

4

100

18

38

29

15

0

75

27

34

43

13

9

7

20

14

8

6

6

13

2

1

15

69

27

4

62

14

1

8

15

50

25

4

3

19

71

15

1

3

11

61

14

2

5

17

86

8

1

0

4

83

12

0

1

5

100

21

35

28

15

0

76

28

34

42

11

7

1;

12

10

7

6

15

3

1

11

51

46

3

:

2

2

12

44

30

7

4

16

84

19

2

1

13

50

23

4

4

19

76

15

0

1

5

74

19

0

0

7

100

10

30

32

28

0

72

20

24

35

7

5

3

11

5

4

4

3

9

1

1

19

48

47

5

52

19

2

4

23

39

27

4

3

26

54

20

2

2

22

46

18

:

29

78

13

0

0

9

73

17

0

0

9

100

15

48

28

6

0

75

27

36

51

9

6

3

16

9

6

4

1:

2

1

13

73

25

2

77

13

1

3

7

42

28

7

3

20

69

17

2

3

10

63

16

3

4

12

87

10

0

1

3

85

11

0

0

4

100

28

53

16

3

0

z

53

60

13

7

5

20

16

10

4

5

14

5

0

10

86

11

1

90

6

0

1

2

47

23

9

5

15

79

12

1

3

5

76

14

1

2

6

90

6

1

0

1

88

9

0

2
Advance Data No. 198 ● April 1, 1991 7

Table 1. Provisional estimates of the percent of persons 18 years of age and over with seIected AIDS knowledge and attitudes from the

1990 National Health Interview Survey, by selected characteristics: United States, July-September 1990-Con.

[Data are based on household interviews of the civilian norsinsfiiutionahzed population. The survey design, general quafiications, and information on the reliabihty of

the estimates are gwen in technical notes]

Race or ethnicity

Age Sex Non-Hispanic Education

16-29 3049 50 years Less than

AIDS knowledge or attitude

More than

Total years yeara and over Male Female White Black Hispanic 12 years 12 years 12 years

4g.

4h.

4i.

5.

5a.

5b.

SC.

5d.

5e.

5f.

There are drugs available to treat AIDS or the AIDS

virus which can lengthen the life of an infected

person.

Definitely true . . . . . . . . . . . . . . . . . . . . . . . 45

Probably true . . . . . . . . . . . . . . . . . . . . . . . 27

Probably false . . . . . . . . . . . . . . . . . . . . . . . 5

Definitely false . . . . . . . . . . . . . . . . . . . . . . . 6

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 17

There is a vaccine available to the public that

protects a person from getting the AIDS virus.

Definitely true . . . . . . . . . . . . . . . . . . . . . . . 3

Probably true . . . . . . . . . . . . . . . . . . . . . . . 4

Probably false . . . . . . . . . . . . . . . . . . . . . . . 10

Definitely false . . . . . . . . . . . . . . . . . . . . . . . 67

Don’t know..............,.. . . . . . . . . 16

There is no cure for AIDS at present.

Defintely true . . . . . . . . . . . . . . . . . . . . . . . 85

Probably true . . . . . . . . . . . . . . . . . . . . . . . 7

Probably false . . . . . . . . . . . . . . . . . . . . . . . 1

Definitely false . . . . . . . . . . . . . . . . . . . . . . . 2

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 6

How likely do you think it is that a person will get

AIDS or the AIDS virus infection fromWorking near someone with the AIDS virus?

Very fikely . . . . . . . . . . . . . . . . . . . . . . . . . 2

Somewhatlikely . . . . . . . . . . . . . . . . . . . . . 6

Somewhatunlikely . . . . . . . . . . . . . . . . . . . . 9

Veryunllkely . . . . . . . . . . . . . . . . . . . . . . . . 40

Definitelynotpossible . . . . . . . . . . . . . . . . . . 37

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 6

Eating in a restaurant where the cook has the AIDS

virus?

Veryfikefy . . . . . . . . . . . . . . . . . . . . . . . . . 6

Somewhatfikely . . . . . . . . . . . . . . . . . . . . . 18

Somewhatunhkely . . . . . . . . . . . . . . . . . . . . 13

Veryunlikely . . . . . . . . . . . . . . . . . . . . . . . . 31

Definitelynotpossible . . . . . . . . . . . . . . . . . . 22

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 10

Sharing plates, forks, or glasses with someone who

has the AIDS virus?

Veryfikely . . . . . . . . . . . . . . . . . . . . . . . . . IO

Somewhatfikely . . . . . . . . . . . . . . . . . . . . . 21

Somewhatunhkely . . . . . . . . . . . . . . . . . . . . 13

Veryunfikely . . . . . . . . . . . . . . . . . . . . . . . . 27

Definitelynotpossible . . . . . . . . . . . . . . . . . . 20

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 9

Using pubfic toilets?

Verylikely . . . . . . . . . . . . . . . . . . . . . . . . . 6

Somewhatlikely . . . . . . . . . . . . . . . . . . . . . 13

Somewhatunlikely . . . . . . . . . . . . . . . . . . . . 12

Veryunhkely . . . . . . . . . . . . . . . . . . . . . . . . 34

Definiteiynotpossible . . . . . . . . . . . . . . . . . . 27

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 8

Sharing needles for drug use with someone who has

the AIDS virus?

Verylikely . . . . . . . . . . . . . . . . . . . . . . . . . 95

Somewhathkely . . . . . . . . . . . . . . . . . . . . 2

Somewhatunlikely . . . . . . . . . . . . . . . . . . . . 0

Very unlikely . . . . . . . . . . . . . . . . . . . . . . . . 0

Defmitelynotpossible . . . . . . . . . . . . . . . . . . 0

Don’tknow, . . . . . . . . . . . . . . . . . . . . . . . . 2

Being coughed or sneezed on by someone who has

the AIDS virus?

Very fikely . . . . . . . . . . . . . . . . . . . . . . . . . 6

Somewhatlikely . . . . . . . . . . . . . . . . . . . . . 20

Somewhatunhkely . . . . . . . . . . . . . . . . . . . . 14

Veryunlikely. ,,, . . . . . . . . . . . . . . . . . . . . 30

Defimtely notpossible . . . . . . . . . . . . . . . . . . 16

Don”tknow, . . . . . . . . . . . . . . . . . . . . . . . . 10

SeefoolnoiesaI endoftable,

46

25

:

14

3

5

11

69

13

65

6

2

2

5

2

5

10

38

42

4

5

17

16

31

26

5

9

20

15

28

24

6

5

12

13

32

32

6

96

2

0

0

0

1

6

16

15

31

24

6

50

27

5

6

12

3

3

8

74

11

66

6

1

1

4

2

6

9

41

39

4

5

17

13

35

23

7

10

20

13

30

21

6

4

12

11

36

30

5

97

1

0

0

1

8

18

15

33

19

7

38

28

4

5

25

3

4

10

57

25

60

8

1

2

9

3

7

9

40

30

12

7

20

12

28

16

17

11

24

12

24

15

15

8

16

11

31

21

14

92

3

0

0

0

5

10

23

12

25

13

17

45

27

5

1:

3

4

9

69

15

64

7

1

2

6

2

6

9

40

36

6

5

19

14

32

21

9

10

23

13

27

19

9

5

12

12

36

27

8

95

2

0

0

0

2

7

20

14

31

18

10

Percent distribution

45

26

5

5

18

3

4

10

66

18

65

6

1

2

6

2

6

3:

37

7

6

18

13

31

22

10

10

20

13

26

21

9

6

15

11

32

27

9

95

2

0

0

0

2

8

20

14

28

19

11

47

27

5

1:

2

3

10

71

14

87

6

1

1

4

2

6

9

41

37

5

5

18

13

38

21

9

10

21

13

28

20

8

5

12

11

36

28

8

96

2

0

0

0

2

7

20

14

31

16

10

42

21

5

2;

7

6

8

57

22

60

7

;

7

5

7

3:

35

9

2:

11

27

21

12

13

23

11

22

19

12

10

15

11

28

25

11

93

3

0

0

0

3

12

21

12

25

18

12

33

30

3

2:

5

8

11

49

26

74

7

1

2

16

4

6

14

z

8

6

18

16

23

26

12

10

22

14

21

22

11

10

19

12

23

26

10

93

2

0

1

1

3

7

17

12

27

26

12

29

24

5

:

4

6

10

46

32

74

8

2

1

14

4

8

3:

29

15

2:

11

23

18

19

13

24

11

20

16

77

10

18

10

26

20

16

90

3

0

0

0

6

12

21

11

23

15

19

43

29

5

1:

2

1:

67

16

65

7

2

2

5

3

6

10

40

36

6

6

20

14

30

20

10

11

23

E

19

9

8

14

13

33

25

8

96

2

0

0

0

1

8

22

14

2B

16

10

55

26

5

5

9

3

2

9

76

9

90

5

1

1

3

1

5

6

42

41

3

4

15

z

25

5

6

16

14

32

23

5

3

10

11

39

33

5

97

1

0

0

0

1

6

~8

15

34

21

6
8 Advance Data No. 198 ● April 1, 1991

Table 1. Provisional estimates of the percent of persons 18 years of age and over with selected AIDS knowledge and attitudes lrom the

199o National Health Interview Survey, by selected characteristics: United States, July-September 1990-Con.

[Data are based on household interviews of the civilian noninstiutionafized population. The survey design, general qualifications, and information on the reliabifii of

the estimates are given in technical notes]

Race or eflrnicity

Age Sex Non-Hispanic Education

16-29 30-49 50 years Less than More than

.A/DS knowledge or attitude Total yaars years and over Male Female White Black Hispanic 12 years 12 yeara 12 years

5g.

5h.

&

9.

10.

Ila.

Ilb,

12.

13.

14.

15.

16.

17,

Attending school with a child who has the AIDS virus?

Vefy likely . . . . . . . . . . . . . . . . . . . . . . . . . 2

Somewhat likely . . . . . . . . . . . . . . . . . . . . 5

Somewhat unlikely . . . . . . . . . . . . . . . . . . 8

Very unlikely . . . . . . . . . . . . . . . . . . . . . 41

Definitely notposeible . . . . . . . . . . . . . . . . . . 37

Don’t know......,......,.. . . . . . . . . . 7

Mosquitoes or other insects?

Ve~ likely . . . . . . . . . . . . . . . . . . . . . . . . . 9

Somewhat likely . . . . . . . . . . . . . . . . . . . . . 19

Somewhat unlikely . . . . . . . . . . . . . . . . . . . . 7

Very unlikely . . . . . . . . . . . . . . . . . . . 25

Definitely not possible . . . . . . . . . . . . . . . . . . 20

Don’t know . . . . . . . . . . . . . . . . . . . . . . . . . 19

Have you ever discussed AIDS with any of your

children aged 10-17?2

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

Don’t know . . . . . . . . . . . . . . . . . . . . . . . . 0

Have any or all of your children aged 10-17 had

instruction at school about AIDS?2

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 18

Have you ever donated blood?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

Don’t know . . . . . . . . . . . . . . . . . . . . . . . . . 0

Have you donated blood since March 1985?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83

Don’t know . . . . . . . . . . . . . . . . . . . . . . . . . 1

Have you donated blood in the past 12 months?

Ye. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93

Don’t know, . . . . . . . . . . . . . . . . . . . . . . . . 1

How many times have you donated blood since

March 1965?

Once . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Twice . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Threetimesormore . . . . . . . . . . . . . . . . . . . 8

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . 0

Didnotdonate blood since March 19653. . . . . 84

How many times have you donated blood in the past

12 months?

Once . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Twice . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Threetimesormore . . . . . . . . . . . . . . . . . . . 1

Don’tknow, . . . . . . . . . . . . . . . . . . . . . . 0

Didnotdonate blood inthepaat12months4 . . 93

Have you ever heard of a blood test that can detect

the AIDS virus infection?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 2

Tothe best of your knowledge, are blood donations

routinely tested forthe AIDS virus mfectton?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 7

Neverheard oftest5 . . . . . . . . . . . . . . . . . . . 21

Was one of your reasons for donating blood because

you wanted to be tested for the AIDS virus infectlon?6

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

No . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . 81

Don’t know . . . . . . . . . . . . . . . . . . . . . . . . . 0

Never heard oftes~ . . . . . . . . . . . . . . . . . 9

Exceot for blood donations since 1985, have You had

yourblood tested fortheAIDS virus infection?

Yes, . . . . . . . . . . . . . . . . . . . . . . . . . . 10

No, ,,,... . . . . . . . . . . . . . . . . . . . . . . 66

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . 2

Never heard oftest5 . . . . . . . . 21

See footnotes at end of table.

2

4

9

38

43

4

11

21

9

23

21

15

57

42

1

66

22

12

34

66

0

24

76

0

9

91

0

9

5

9

0

76

6

2

1

9!

81

17

1

71

4

6

19

3

79

0

9

16

64

2

19

1

5

6

42

39

4

6

19

8

28

22

16

68

32

73

9

18

43

56

0

20

80

1

8

92

1

5

4

10

0

80

4

2

2

0

92

86

13

1

74

6

7

14

2

64

7

13

7~

2

14

2

7

8

40

30

13

9

18

6

23

17

27

56

44

70

7

24

41

59

0

6

93

1

3

96

1

1

1

3

0

94

2

1

0

0

97

68

26

4

54

5

3:

0

76

15

4

61

3

32

2

5

9

43

36

6

9

20

6

26

19

16

54

46

67

7

26

52

48

0

20

80

1

8

91

1

5

5

10

0

60

5

2

2

0

92

79

16

2

66

6

6

21

2

79

0

10

12

65

2

21

Percent distribution

2

6

6

39

38

7

9

19

7

24

21

21

76

22

0

77

11

12

29

70

0

13

66

0

5

94

1

5

2

6

0

S7

3

1

1

0

95

76

19

3

66

5

7

22

2

83

0

8

9

67

2

22

1

5

8

43

37

6

8

18

8

27

21

19

70

30

0

73

9

18

43

57

0

17

82

1

7

92

1

5

3

9

0

83

4

2

1

0

93

62

16

2

70

5

7

16

2

84

7

9

70

2

J8

4

6

9

35

36

9

14

24

6

19

16

20

61

39

74

9

17

33

67

0

14

85

1

5

94

1

5

4

6

0

86

3

1

1

0

95

68

29

3

51

9

3:

6

59

22

13

53

2

32

3

6

7

29

43

10

13

24

6

20

20

18

57

43

70

9

21

27

73

0

12

68

0

4

95

0

4

3

5

66

3

1

1

0

95

67

30

3

54

5

9

33

1

77

2

15

17

46

2

33

4

6

6

34

30

16

13

23

6

19

13

27

52

48

65

13

22

29

71

0

7

93

1

2

96

1

2

2

2

0

93

1

0

0

98

60

35

5

45

5

10

40

4

59

24

9

49

2

40

2

5

9

41

37

6

10

21

7

24

19

20

65

35

0

71

11

18

37

63

0

15

65

0

6

93

0

5

3

7

0

85

4

1

1

0

94

76

20

2

65

5

7

22

2

77

0

12

10

66

2

22

1

4

7

44

41

3

6

16

6

30

25

15

75

25

77

6

17

49

50

0

23

76

1

9

90

1

6

5

12

0

77

5

3

2

0

91

89

10

1

76

5

6

11

2

67

0

5

12

75

3

11
Advance Data No. 198 ● April 1, 1991 9

Table 1. Provisional estimates of the percent of persons 18 years of age and over with selected AIDS knowledge and attitudes from the

1990 National Health Interview Survey, by selected characteristics: United States, Juiy-September 1990-Con.

[Data are based on household interviews of the civilian noninstitutionalized population. The survey design, general qualifications, and information on the reliability of

the estimates are given in technical notes]

Race or ethrriciiy

Age Sex Non-Hispanic Education

18-29 3-9 50 years Less than More than

AIDS knotiedge or attrtude Total years years and over Male Female White Black Hispanic 12 years 12 years 12 years

18.

19.

20a,

20b,

21,

22a.

22b.

23.

How many times have you had your blood tested for

the AIDS virus infection, not including blood

donatiorrs?

Once . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Twice . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Three times or more . . . . . . . . . . . . . . . . . . . 1

Don’tknow, . . . . . . . . . . . . . . . . . . . . . . . . 0

heverheard of/had test7 . . . . . . . . . . . . . . . . 90

How many times in the past 12 months have you had

your blood tested for the AIDS virus infection, not

mcludmg blood donations?

None . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Once . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Twice . . . . . . . . . . . . . . . . . . . . . . . . . . . . I

Threetimesormore . . . . . . . . . . . . . . . . . . . 0

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 0

Neverheardof/hadtest7 . . . . . . . . . . . . . . . . 90

Were the blood tests, including those you had before

the past 12 months, required or did you go for them

voluntarily, or were there some of each?8

Atl required . . . . . . . . . . . . . . . . . . . . . . . . 49

Allvolunteered . . . . . . . . . . . . . . . . . . . . . . 47

Someofeach . . . . . . . . . . . . . . . . . . . . . . . 3

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 1

Were any of the blood tests required foce

Hospitalization ora surgical procedure?. . . . . . . 9

Health insurance? . . . . . . . . . . . . . . . . . . . . 3

Lifeinsurance? . . . . . . . . . . . . . . . . . . . . . . 8

Employment?, . . . . . . . . . . . . . . . . . . . . . . 6

Mthtaryinductionormilitaryservice?. . . . . . . . . 9

Immigration? . . . . . . . . . . . . . . . . . . . . . . . . 7

CXher . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . -

When was your last blood test for the AIDS virus

infection?8

1990. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

1989. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

1988. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

1987. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

19a6. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

1985. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 2

Was your last test required or did you go for it

voluntanly?a

Required . . . . . . . . . . . . . . . . . . . . . . . . . . 50

Voluntary . . . . . . . . . . . . . . . . . . . . . . . . . . 48

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 1

Wasthetest required for$

Hospitafiiation orasurgical procedure?. . . . . . . 9

Health insurance? . . . . . . . . . . . . . . . . . . . . 3

bfeinsurance?. . . . . . . . . . . . . . . . . . . . . . 8

Employment? . . . . . . . . . . . . . . . . . . . . . . . 5

Mi:daryinducfion ormiktaryservice?. . . . . . . . . 8

Immigration?. . . . . . . . . . . . . . . . . . . . . . . . 7

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Don’tknow. . . . . . . . . . . . . . . . . . . . . . . . . -

Not including a blood donation, where was your last

blocU test for the AIDS virus done?s

AIDS clinic/counseling/testingsite . . . . . . . . . . 3

Clmicrun byemployer. ..~.. . . . . . . . . . . . 3

Doctor/HMO . . . . . . . . . . . . . . . . . . . . . . . . 33

Publichealthdepartment . . . . . . . . . . . . . . . . 8

Hospital/emergency room/outpatient clinic . . . . . 24

STDchni c . . . . . . . . . . . . . . . . . . . . . . . . 0

Farnilyplanning chnic . . . . . . . . . . . . . . . . . . 0

Prenatal clinic. . . . . . . . . . . . . . . . . . . . . . . 0

Tuberculosisclinic . . . . . . . . . . . . . . . . . . . -

Otnerclinic . . . . . . . . . . . . . . . . . . . . . . . . . 7

Drugtreatmentfacility . . . . . . . . . . . . . . . . . . 0

ML,laryinduction/servicesIte. . . . . . . . . . . . . . 8

Irsmlgrationsite . . . . . . . . . . . . . . . . . . . . . . 1

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 0

Seefoomotesa! end of table,

10

3

2

0

84

7

7

1

0

84

47

49

4

0

9

:

5

14

3

14

35

35

19

5

3

1

2

49

49

0

10

1

5

1:

3

12

2

3

31

z

o

1

0

6

1

11

1

10

1

9

2

1

0

87

6

6

1

0

87

51

45

2

1

7

4

11

6

7

11

11

35

2a

18

10

5

2

1

52

48

1

7

4

11

5

6

11

10

4

2

36

7

21

0

0

6

0

8

2

14

3

1

0

0

96

2

1

0

0

0

96

43

55

1

1

15

:

:

2

12

36

27

18

8

2

:

43

54

2

15

1

8

8

3

2

11

6

5

25

5

36

11

4

0

8

8

2

2

0

88

6

5

:

86

54

43

2

1

7

4

12

7

15

6

10

32

31

19

8

4

1

3

56

43

0

7

4

11

7

13

6

10

3

3

29

7

21

0

:

7

1

12

1

14

0

Percentdistfibution

7

1

1

0

91

4

4

1

;

91

42

53

3

1

12

;

5

2

7

15

38

29

17

8

3

;

43

55

1

12

1

4

4

2

7

13

4

2

37

2;

o

0

0

6

3

2

10

7

2

:

91

5

4

0

0

0

91

49

46

2

1

10

3

10

5

10

1

13

35

28

19

9

4

2

3

50

49

1

10

3

10

5

9

1

12

3

2

33

2:

0

;

5

0

9

13

0

9

2

1

0

87

5

7

1

0

67

36

57

4

1

8

1

1:

8

5

10

43

33

9

;

:

39

57

1

6

1

4

10

5

5

10

4

5

25

16

20

;

1

7

2

7

2

8

13

3

:

83

8

8

1

0

83

56

41

1

1

5

0

2

5

39

9

33

35

21

6

2

1

57

41

1

5

2

5

39

7

6

2

44

10

9

13

0

5

10

6

2

1

0

91

4

4

1

0

0

91

45

51

2

2

10

:

2

0

21

12

34

33

19

:

3

47

543

2

11

0

2

2

0

21

10

7

3

29

15

21

0

0

0

11

0

0

4

9

7

2

1

0

90

4

4

:

90

47

49

3

0

9

2

5

1:

5

13

38

28

17

9

3

:

4a

51

0

9

2

4

5

12

5

11

2

3

34

9

25

1

1

5

0

10

0

10

8

2

1

0

88

6

5

1

0

88

51

45

3

1

9

1:

7

10

3

11

34

31

19

8

5

2

2

53

46

1

9

4

13

7

6

3

11

3

2

34

4

24

0

0

6

1

9

1

14

0
10 Advance Data No. 198 ● April 1, 1991

Table 1. Provisional estimates of the percent of persons 18 years of age and over with selected AIDS knowledge and attitudes from the

1990 National Health Interview Survey, by selected characteristics: United States, July~~eptember 1990-Con.

[Data are based on household inteiviewa of the civilian noninstitutionalized population. The survey design, general qualifications, and information on the reliabiiii of

the estimates are g!ven m technical notes]

Race or ettrnicify

Age Sex Non-Hispanic Education

18–29 3&49 50 yeara Less than More than

A/DS know/edqe or afmude Tots/ years years and over Ma/e Fema/e White Black Hispanic 12 years 12 yeara 12 years

24.

25.

26.

27.

28.

29.

30.

31.

32.

Before your last blood test for the AIDS virus

Infection, were you counseled about the AICS virus

and the meamng of the test?s

Yes . . . . . . . . . . . . . . . . . . . . . .

No. . . . . . . . . . . . . . . . . . . . . .

Don’t know . . . . . . . . . . . . . . . . .

D!d you get the results of your last test?s

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

Did you want the results of your last test?g

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . .

When you received the resuits of your last teat, did

you receive counseling or talk with a health

professional about how to lower your chancas of

becommg infected with the AIDS virus or how to

avoid passing it onto another personal”

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tlmow . . . . . . . . . . . . . . . . . . . . . . . . .

Were the resuits given in person, by telephone, by

mail, orinsome other way?10

Unperson . . . . . . . . . . . . . . . . . . . . . . . . . .

Bytelephone . . . . . . . . . . . . . . . . . . . . . .

Bymail . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

Do you feel your last test for the AIDS virus infection

was handled properly interms of theconfldentially

of your test results?a

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

Do you expect to have a blood test for the AIDS virus

infection in the next 12 months?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

Neverheardoftest5 . . . . . . . . . . . . . . . . . . .

Tell me which of these statements explain why you

will have the blood teatll

Voluntarily, because you personally want to know

ifyouare infected . . . . . . . . . . . . . . . . . . . .

Aaparfofa blooddonation . . . . . . . . . . . . . .

As part of a hoaprtafization or surgicsl

procedure . . . . . . . . . . . . . . . . . . . . . . .

Asarequirement for health insurance. . . . . . . .

Asarequirementfor life insurance. . . . . . . . . .

Aearequirement forajob, other than military. . .

Asarequirementforthe military . . . . . . . . . . .

Asarequirementfor immigration . . . . . . . .

Aaarequiredpart ofsome other activity that

includes a blood sample and automatic AIDS

testing . . . . . . . . . . . . . . . . . . . . . . . . . .

Where will you go to have a blood test for the AIDS

43

56

1

79

20

1

38

58

3

29

70

1

63

17

13

6

1

92

2

5

6

69

4

21

64

25

12

6

6

10

10

3

15

virus infectlon?ll

AIDSclinic/counseling/testingsite . . . . . . . . . . 1

Clinfcrun by employer . . . . . . . . . . . . . . . . 3

Doctor/HMO . . . . . . . . . . . . . . . . . . . . . . . . 38

Hospital/emergency room/outpatient clinic . . . . 18

Otherclmic . . . . . . . . . . . . . . . . . . . . . . . . . 6

Pubhchealthd apartment . . . . . . . . . . . . . . . . 8

RedCross/bloodbank, . . . . . . . . . . . . . 11

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . . 5

Seefootnotesat endoftable.

52

47

1

60

19

1

4s

47

5

37

62

1

66

17

10

6

0

94

3

3

10

66

5

19

68

24

12

7

7

9

13

3

16

1

1

40

19

6

11

9

6

6

40

56

1

78

21

0

35

63

2

25

74

1

60

16

14

7

1

90

2

6

6

76

4

14

:

9

10

9

12

11

2

13

1

4

35

17

5

7

13

13

4

25

74

79

20

27

70

4

16

63

1

67

11

16

4

1

94

0

5

:

3

32

56

24

22

9

11

a

2

14

;

39

19

11

5

11

2

4

43

55

2

76

22

1

42

65

3

30

69

1

64

11

16

8

1

91

2

6

7

66

2:

60

28

10

9

9

11

14

2

16

1

4

34

15

5

8

14

13

6

Percent distribution

42

56

1

61

18

0

34

62

4

28

72

0

62

23

10

4

0

94

2

4

5

70

4

22

70

21

14

8

7

10

6

3

14

;

43

22

7

8

7

6

4

42

57

1

77

22

1

36

60

2

27

72

1

56

20

14

8

1

92

2

5

5

74

3

18

55

26

12

7

7

8

12

2

16

:

35

18

5

6

13

13

5

54

41

1

78

19

32

56

12

39

61

66

15

16

4

92

1

5

12

49

6

32

80

16

14

11

1:

7

2

13

:

41

21

5

12

6

4

A

33

65

1

65

14

1

46

54

26

74

66

4

6

3

1

93

4

2

8

51

9

33

67

34

7

8

11

13

7

7

16

2

1

45

12

12

11

9

1

8

37

62

1

85

14

1

43

49

8

31

67

2

72

10

13

4

1

90

3

6

6

50

5

40

77

24

16

10

1:

3

2

14

2

2

36

17

10

15

10

3

5

46

52

1

77

22

0

37

59

4

32

68

0

69

14

12

6

0

95

2

2

5

69

2;

68

22

13

10

7

10

14

3

14

1

4

42

78

3

10

7

10

6

42

56

1

76

21

1

36

60

2

24

75

1

54

23

15

8

1

91

2

6

6

79

4

11

55

28

9

7

8

11

11

2

16

1

32

19

7

4

14

13

4
Advance Data No. 198 ● April 1, 1991 11

Table 1. Provisional estimates of the percent of persons 18 years of age and over with selacted AIDS knowledge and attitudes from the

1990 National Health Interview Survey, by selected characteristics: United States, JulySeptember 1990-Con.

[Data are based on household inlerviaws of the civilian noninstiiutionalized population. The swvey design, general qualifications, and information on the reliability of

the estimates are given in technical notes]

Race or ethrricr”~

Age Sex Nor+HIspanic Education

18-29 30+9 50 yaara Less ffran More than

A/17SIrnowfedge or attitude Total years years and over Male Female White Black Hispanic 12 yeara 12 years 12 years

33.

34.

35.

36.

37.

38.

39.

Did you have a blood transfusion at any time

between 1977 and 1985?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don”t know . . . . . . . . . . . . . . . . . . . . . . . . .

Do you think the present supply of blood is safe for

tranfus!ons?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’t know . . . . . . . . . . . . . . . . . . . . . . . . .

How effediie do you think the use of a condom is to

prevent getting the AIDS virus through sexual

actiii~

Veryeffective . . . . . . . . . . . . . . . . . . . . . . .

SomewhateffeclNe . . . . . . . . . . . . . . . . . . .

Not atalleffective . . . . . . . . . . . . . . . . . . . .

Don’tknowhoweffective . . . . . . . . . . . . . . . .

Don’tknowmethcd . . . . . . . . . . . . . . . . . . .

What are your chances of having the AIDS virus?

High . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Medium . . . . . . . . . . . . . . . . . . . . .. . . . . . .

Low . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

None . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

What are your chances of getting the AIDS virus?

High . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Medium. . . . . . . . . . . . . . . . . . . . . . . . . . .

Low . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

None . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’t know . . . . . . . . . . . . . . . . . . . . . . . . .

N/A– High chance of already having the AIDS

virus . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Have you ever personally known anyone with AIDS or

the AIDS virus?

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Don’tknow . . . . . . . . . . . . . . . . . . . . . . . . .

Is any of these statements true for you?

a. Youhave hemophilia andhave received clotting

factor concentrates since 1977.

b. You are a natwe of Haiti or Central or Eeet Afri@

whohasentered the United States since 1977.

c. Youarea man who has had sex with another

manat sometime since 1977, even 1 time.

d. You have taken illegal drugs by needle at any

time since 1977.

e. Since 1977, youareor have been the sex partner

of any person who would answer yes to any of

theltemsabove(39 a-d).

L Youhave hadsexfor money ordrugs at anytime

since 1977,

Yestoatleast l statement . . . . . . . . . . . . . . .

Notoallstalemente . . . . . . . . . . . . . . . . . . .

Don’t know . . . . . . . . . . . . . . . . . . . . . . . . .

5

93

1

44

32

23

26

53

4

14

3

0

2

15

ao

2

:

21

72

2

0

15

83

2

2

97

0

3

97

1

51

31

18

31

53

4

10

2

0

4

21

73

2

1

5

28

63

2

0

16

82

2

5

95

0

5

94

1

47

33

20

29

56

3

:

1

2

17

79

2

0

3

25

69

2

1

19

79

2

3

97

0

8

90

2

36

33

31

19

49

5

23

4

0

1

9

88

2

0

2

12

63

3

0

11

87

2

1

9s

o

6

93

1

48

30

22

30

52

3

13

3

0

2

17

78

2

;

24

69

3

0

;

2

3

97

0

Percentdtibr.stion

5

94

1

41

35

24

23

54

5

15

3

:

13

e3

2

:

19

75

2

0

E

2

2

98

0

6

93

1

47

31

22

27

54

4

13

2

0

2

16

81

1

0

3

22

73

1

0

:

2

2

98

0

5

84

0

34

37

29

27

44

8

18

3

1

4

13

76

4

1

3

17

73

5

1

19

78

3

4

95

0

3

96

2

32

43

25

21

49

5

16

9

1

3

8:

5

2

3

19

68

6

1

15

63

2

3

97

0

7

92

2

31

37

32

17

43

6

26

7

1

2

9

83

5

:

12

78

6

1

9

86

3

3

97

0

5

94

1

43

34

23

25

S4

4

14

2

0

2

14

82

2

1

3

18

76

2

0

13

86

2

2

98

0

6

93

1

53

26

19

32

57

3

7

1

0

2

19

77

1

0

3

30

66

1

0

21

76

2

2

97

0

lMultiple responses maysumlomorelhan lCHJ.

2Besedon Per~o"~an$werlng yestoquetilon 6,-SDoyou have anychrldren aged lOtir0U9h 17?’’ Cauestion 7was”’FIow manydoyouheve?”

3perSmS anwermg no or don’t know to question 10 or 1la.

4Persons answenn gnoordon’ tknowtoquest!on lo, ha, orllb,

speEons enswenng no or don’t know to quest!on 14.

6Ba~ed On parSOnS anSWerlng Yes !0 quest[on 11&

7Persons enswe:ng noordon’t knowloqtiestlons 140r 17.

8Besed on persons answering yes to questmn 17.

Sperso”s answemg m or don’t know to question 25.

loBasecj on persOnS anSWeflng yes to QuestIon 25.

11B=ed on persons answenng yes tO questm 30.
12 Advance Data No. 198 ● April 1, 1991

Technical notes

The National Health Interview

Survey (NHIS) is a continuous, crosssectional household interview survey.

Each week, a probability sample of

the civilian noninstitutionalized

population is interviewed by

personnel of the U.S. Bureau of the

Census to obtain information on the

health and other characteristics of

each member of the household.

Information on special health topics

is collected for all or a sample of

household members. The 1990

National Health Interview Survey of

AIDS Knowledge and Attitudes is

asked of one randomly chosen adult

18 years of age or over in each family.

The estimates in this report are based

on completed interviews with 10,125

persons, or about 85 percent of

eligible respondents.

Table I contains the estimated

population size of each of the

demographic subgroups included in

table 1 to allow readers to derive

provisional estimates of the number

of people in the United States with a

given characteristic, for example, the

number of men who have had their

blood tested for HIV. The population

figures in table I are based on 1989

data from the NHIS; they are not

official population estimates. Table II

shows approximate standard errors

for most of the estimates presented in

table 1. The reader is cautioned

about comparing estimates when the

denominator is small (for example,

when Iooking only at people who plan

to have an HIV antibody test in the

next year). Both the estimates in

table 1 and the standard errors in

table II are provisional. They may

differ from estimates made using the

final data file because they were

calculated using a simplified

weighting procedure that does not

adjust for all the factors used in

weighting the final data file. A final

data file covering the entire data

collection period for 1990 will be

available at the end of 1991.

Table L Sample sizes for the 1990 National

Health Interview Survey of AIDS

Knowledge and Attitudes and estimated

adult population 18 years of age and over,

by selected characteristics: United States,

July-September 1990

Estimated

Sample jYopu/atiorl

Characteristics size in thousands

All adults . . . . . . . . . . . 10,125

Age

16-29 years .<....... 2,347

30-49 years .,....... 4,053

50 years and over . . . . . 3,725

Sex

Male . . . . . . . . . . . . . . 4.253

Female . . . . . . . . . . . . 5,872

Race or ethnicity

Non-Hispanic white. . . . . 7,795

Non-Hispanic black. . . . . 1,330

Hispanic . . . . . . . . . . . 682

Education

Less than 12 years. . . . . 2,163

12 yeare ., .,..,.... 3,941

More than 12 years. . . . . 3,968

‘180,271

46,282

71,831

62,157

85,632

94,838

‘139,440

19,585

14,116

36,782

72,418

70,036

Table Il. Standard errors, expressed In percentage points, of estimated percents from the 1990 National Health Interview Survey of AIDS

Knowledge and Attitudes, by selected characteristics: United States, July-September 1990

Age Sex Race or ethrr)city Education

18–29 30-49 50 yeara Less than 12 More than

Estimated percent Total yeara years and over Male Female White Black Hispanic 12 years years 12 yeara

050r95 . . . . . . . . . . . . . . . . . . . 0.3 0.6 0.4 0.5 0.4

100r90. . . . . . . . . . . . . . . . . . . 0.4 0.8 0.6 0.6 0.6

150r 65 . . . . . . . . . . . . . . . . . . . 0.5 0.9 0.7 0.6 0.7

200r 80, . . . . . . . . . . . . . . . . . . 0.5 1.1 0.8 o.a 0.6

250r75 . . . . . . . . . . . . . . . . . . . 0.6 1.2 0.9 0.9 0.9

300r 70 . . . . . . . . . . . . . . . . . . . 0.8 1.2 0.9 1.0 0.9

350r 65 . . . . . . . . . . . . . . . . . . . 0.8 1.3 1.0 1,0 0.9

400r60 . . . . . . . . . . . . . . . . . . . 0.8 1.3 1.0 1.0 1.0

450r 55 . . . . . . . . . . . . . . . . . . . 0.6 1.3 1.0 1.0 1.0

50 . . . . . . . . . . . . . . . . . . . . . . . 0.8 1.3 1.0 1.1 1.0

0.4

0.5

0.6

0.7

0.7

0.8

0.8

0.8

0.8

0.6

0.3 0.8 1.1

0.4 1.1 1.5

0.5 1.3 1.8

0.6 1.4 2.0

0.6 1.5 2.1

0.7 1.6 2.3

0.7 1.7 2.4

0.7 1.7 2.4

0.7 1.6 2.5

0.7 1.8 2.5

0.6 0.4

0.8 0.6

1.0 0.7

1.1 0.8

1.2 0.9

1.3 0,9

1.4 1.0

1.4 1.0

1.4 1.0

1.4 1.0

0.4

0.6

0.7

0.6

0.9

0.9

1.0

1.0

1.0

1.0
Number 199 ● April 9, 1991

Advance

Data

From Vital and Health Statistics of the National Center for Health Statistics

1989 Summary: National Hospital Discharge Survey

by Edmund J. Graves, Division of Health Care Statistics

Introduction

During 1989, an estimated 30.9

million inpatients, excluding newborn

infants, were dkcharged from

short-stay non-Federal hospitals in

the United States. These patients

used 200.8 million days of inpatient

hospital care. The discharge rate was

126 discharges per 1,000 civilian

population and the average length of

stay was 6.5 days.

These and other statistics

presented in this report are based on

data coIlected by means of the

National Hospital Discharge Survey

(NHDS), a continuous survey that has

been conducted by the National

Center for Health Statistics (NCHS)

since 1965. In 1989, data were

abstracted from the medical records

of approximately 233,000 patients

discharged from 408 short-stay

non-Federal hospitak. Beginning in

1988, a new three-stage stratified

sample design was put in operation.

A brief description of the new design,

data collection procedures, and

estimation process and definitions of

terms used in this report can be

found in the section entitled

“Technical notes.” A description of

the development and design of the

original NHDS, which was in

operation from 1965 to 1987, has

been published (1). Differences may

exist between data for 1988 and 1989

and earlier years because of the

redesign of the survey.

Medical data for hospitalized

patients are coded according to the

International Classification of Diseases,

9th Revision, Clinical Modification

(ICD-9-CM) (2). Up to seven

diagnoses and four procedures are

coded for each discharge. Although

diagnoses included in the ICD-9-CM

section entitled “Supplementary

classification of external causes of

injury and poisoning” (codes

E800–E999) are used in the NHDS,

these diagnoses are excluded from

this report. The conditions diagnosed

and procedures performed are

presented here by chapter of

ICD-9–CM. Whhin these chapters, a

few diagnoses and procedures or

groups thereof also are shown. These

specific categories were selected

primarily because of their large

estimates or because they are of

special interest. More detailed

analyses of NHDS data are published

in Series 13 of the NCHS ?4ral and

Health Sracistics reports.

Starting in 1985, some hospitals

participating in the NHDS have

submitted machine-readable data

tapes through commercial abstracting

services. In 1989, approximately 27

percent of the hospitals used this

method to submit data. Analysis

indicates that a greater number of

nonsurgical procedures per patient

are recorded from these hospitals

than from hospitak submitting data in

the traditional manual mode (see

“Technical notes”). A portion of the

increases from 1984 to 1989 in the

estimates for miscellaneous diagnostic

and therapeutic procedures and,

therefore, for total procedures may

be due to this change in data

collection methods.

@swct*.o>

*.+ -1

-@

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

.

5* Public Health Service

sS Centers for Disease Control

3%

-2

National Center for Health Statistics Cr)’c

%

+v,za

CENTEF?S F3R CISGAS$ CONWOL

Manning Feinleib, M.D., Dr. P.H., Director
2 Advance Data No. 199 ● April 9, 1991

Data highlights are shown by age, geographic region,

Utilization by patient and hospital

and sex in tables 1–3. The 30.9

characteristics

million patients discharged from

short-stay hospitals during 1989

The number, rate, and average comprised an ‘estimated 1–2.6million

length of stay of patients discharged males and 18.4 million females. The

from short-stay non-Federal hospitals rate per 1,000 population for females

Table 1. Number of inpatients discharged from short-stay hospitals, by age, geographic

region, and sex United States, 1989

[Discharges from nonfederal hospitals. Excludes newborn infants]

Both

Age and region sexes Male Female

Total . . . . . . . . . . . . . . . . . . . . . . . . . .

Age

Under 15 years . . . . . . . . . . . . . . . . . . .

15-44 years . . . . . . . . . . . . . . . . . . . . .

4S-64 years . . . . . . . . . . . . . . . . . . . . .

65 years And over . . . . . . . . . . . . . . . . .

Region

Northeast . . . . . . . . . . . . . . . . . . . . . . .

Midwest . . . . . . . . . . . . . . . . . . . . . . . .

South . . . . . . . . . . . . . . . . . . . . . .. . . .

West . . . . . . . . . . . . . . . . . . . . . . .. . . .

Number of patients discharged in thousands

30,947 12,563 16,364

2,597 1,521 1,077

11,848 3,405 8,443

6,271 3,179 3,092

10,230 4,478 5,752

7,044 2,976 4,066

7,676 3,182 4,493

10,960 4,309 6,650

5,268 2,115 3,152

Table 2. Rate of inpatients discharged from short-stay hospitals, by age, geographic

region) and sex: United States, 1989

[Discharges from non-Federal hospitals. Excludes newborn infants]

Both

Age and region sexes Male Female

Total . . . . . . . . . . . . . . . . . . . . . . . . . .

Age

Under 15 years . . . . . . . . . . . . . . . . . . .

15-44 years . . . . . . . . . . . . . . . . . . . . .

45-64 years . . . . . . . . . . . . . . . . . . . . .

65 years and over . . . . . . . . . . . . . . . . .

Region

Northeast . . . . . . . . . . . . . . . . . . . . . . .

Midwest . . . . . . . . . . . . . . . . . . . . . . . .

South . . . . . . . . . . . . . . . . . . . . . . . . .

West . . . . . . . . . . . . . . . . . . . . . . . . . .

Rate of patients discharged per 1,000 population

125.5 105.3 144.5

48.2 55.1 40.9

102.8 59a 144.9

135.0 142.8 127.9

330.2 354.4 313.5

139.1 122.8 154.0

127.9 109.1 145.7

129.5 105.6 151.7

102.8 83.8 121.3

Table 3. Average iength of stay for inpatients discharged from short-stay hospitals, by

age, geographic region, and sex: United States, 1989

[Discharges from non-Federal hospitals. Excludes newborn infants]

Both

Age and region sexes Male Female

Average length of stay in days

Total .,, . . . . . . . . . . . . . . . . . . . . 6.5 7,0 6.1

Age

Under 15 years . . . . . . . . . . . . . . . . . . 49 4.9 4.9

15+4 years, . . . . . . . . . . . . . . . . . . . 4.7 6.2 4.1

4.%64 years, . . . . . . . . . . . . . . . . . . . 6.7 6.7 6.6

65yearsand over . . . . . . . . . . . . . . . . . 8.9 8.8 9.1

Region

Northeast . . . . . . . . . . . . . . . . . . . 7.7 6.0 7.4

Midwest, . . . . . . . . . . . . . . . . . . . . 6.4 6.9 6.1

south, . . . . . . . . . . . . . . . . . . . . 63 6.9 5.9

West, .,..,. . . . . . . . . . . . . 54 6.2 4.9

was 145, which was 38 percent higher

than the rate of105 for males. The

number and rate of discharges are

higher for females than for males

because of the large numberof

womenin their childbearing years

(15-44 years of age) who are

hospitalized for deliveries and

pregnancy-related conditions.

The average length ofstay was

7.0 days for males and 6.1 days for

females during 1989. The average

length of stay of the 3,9 million

women who were hospitalized for

deliveries was 2.9 days. The average

length of stay was 4.9 days for

patients under 15 years of age, 4.7

days for patients 15-44 years of age,

6.7 days for patients 45-64 years of

age, and 8.9 days for patients 65 years

of age and over.

The number of discharges from

short-stay hospitals bygeographlic

region during 1989 ranged from 11.0

million in the South to 5.3 million in

the West. Regional differencesin the

number of discharges are accounted

for in part by variations in the

population sizes. The rates per 1,000

population ranged from 139 in the

Northeast Region to 103 in the West.

Average lengths of stay by geographic

region were 5.4 days in the West, 6.3

days in the South, 6.4 days in the

Midwest, and 7.7 days in the

Northeast.

Utilization by diagnosis

Diseases of the circulatoxy system

ranked first in 1989 of the

ICD–9-CM diagnostic chapters as a

principal or first-listed diagnosis for

patients discharged from non-Federal

short-stay hospitals. These conditions

accounted for an estimated 5.2

million discharges. Other leading

ICD-9-CM diagnostic chapters were

supplementary classifications

(including females with deliveries)

(4.4 million discharges) and diseases

of the digestive system (3.3 million

discharges). Approximately 42

percent of the patients discharged

from non-Federal short-stay hospitals

were included in these three

ICD–9-CM diagnostic chapters.

The diagnostic categories

presented in this report were selected
Advance Data No. 199 ● April 9,1991 3

either because they appear as

principaI or first-listed diagnoses with

high frequency or because the

conditions are of special interest.

hfany of these categories (such as

malignant neoplasms, psychoses, and

fractures) are groupings of more

detailed diagnoses.

The number and rate of

discharges and average length of stay

for each ICD-9–CM diagnostic

chapter and selected categories are

shown by sex and age in tables 4-6.

The most common diagnostic

categories for all patients were

deliveries and heart disease. Other

leading diagnostic categories were

malignant neoplasms, pneumonia, and

fractures. Excluding deliveries, these

last four diagnostic categories were

the most common first-listed

diagnoses for both males and females.

Some of the more common diagnoses

for patients under 15 years of age

\vere pneumonia, acute respiratory

infections, asthma, fractures, and

chronic diseases of tonsils and

adenoids. For patients 1544 years of

age, frequent diagnoses were

deliveries, psychoses, fractures,

abortions and ectopic pregnancies,

and heart disease. For patients 45-64

years of age and 65 years of age and

over, heart disease and malignant

neoplasms were major causes of

hospitalization. The average length of

stay for all patients ranged from 1.2

days for chronic disease of tonsils and

adenoids to 14.5 days for psychoses.

Utilization by procedures

One or more surgical or

nonsurgical procedures were

performed for an estimated 20.1

miI1ion of the 30.9 million inpatients

discharged from short-stay hospitals

during 1989. A total of 40.0 miilion

procedures, or an average of 2.0 per

patient who underwent at ieast one

procedure, were recorded in 1989.

Procedures are grouped in the

tables of this report by the

ICD–9-CM procedure chapters.

Selected procedures within these

chapters also are presented by

specific categories. Some of these

categories (such as extraction of lens

and hysterectomy) are presented as

singie categories even though they are

divided into more precise subgroups

in ICD–9–CM.

Three-fourths of all the surgicai

and nonsurgical procedures

performed during 1989 are listed in

just 5 of the 16 procedure chapters.

These were diagnostic and

therapeutic procedures (11.5 miI1ion),

obstetrical procedures (6.4 miliion),

operations on the digestive system

(5.4 miilion), operations on the

cardiovascular system (3.7 milIion),

and operations on the

musculoskeletal system (3.2 miilion).

The number and rate of ail-listed

procedures in 1989 for each

ICD-9-CM procedure chapter and

selected procedure categories are

siown by sex and age in tables 7 and

8, Of the 40.0 miliion procedures

performed during 1989, 16.1 million

were for males and 24.0 million were

for females. The corresponding rates

per 100,000 population were 16,241.1

for both sexes, 13,466.7 for males,

and 18,849.2 for females. Frequent

procedures for males were

arteriography and angiocardiography

and computerized axial tomography.

Procedures commonly performed on

females were episiotomy, cesarean

section, diagnostic ultrasound,

computerized axial tomography, and

repair of current obstetric laceration.

The rate of procedures by age

per 100,000 population ranged from

3,987.7 for patients under 15 years of

age to 42,677.0 for patients 65 years

of age and over. Commonly

performed procedures for patients

under 15 years of age were spinal tap

and tonsillectomy, with or without

adenoidectomy for patients 15-44

years of age, episiotomy and cesarean

section; for patients 45–64 years of

age, arteriography and

angiocardiography, cardiac

catheterization, diagnostic ultrasound,

and computerized axial tomography,

for patients 65 years of age and over,

computerized axial tomography,

arteriography and angiocardiography,

and diagnostic ultrasound.

References

1.

2.

3.

4.

Simmons WR. Development of the

design of the NCHS Hospital Discharge Survey. Nationai Center for

Health Statistics. Vital Health Stat

2(39). 1970.

Public Health Service and Health

Care Financing Administration.

International Classification of

Diseases, 9th Revision, Clinical

Modification. Washington: Public

Health Semite. 1980.

SMG Marketing Group, Inc. Hospital

Market Database. Chicago:

Healthcare Information Specialists.

1989.

Shah BV. SESUD.A4N: Standard

Errors Program for Computing of

Standardized Rates from Sample

Survey Data. Research Triangle Park,

North Carolina: Research Triangle

Institute. 1981.

Symbols

--- Data not available

. . . Category not applicable

Quantity zero

0.0 Quantity more than zero but less

than 0.05

z Quantity more than zero but less

than 500 where numbers are

rounded to thousands

* Figure does not meet standards of

reliability or precision (see

Technical notes)

# Figure suppressed to comply with

confidentiality requirements
4 Advance Data No. 199 ● April 9,1991

Table 4. Number of inpatients discharged from short-stay hospitals, by category of first-listed diagnosis, sex, and age: United Ststes,

1989

[Discharges from non-Federal hospkals. Excludes newborn infants. Diagnostic groupings and code number inclusions are based on the hrfermfiorrd C/as.si17cationof

Diseases, 9th Revision, Clinical fwfosflficet~on(lCD-g-CM)]

Sex Age

Under 15 1544

Category of first-listed diagnosis and/CD-9-CM code

45-64

Total Male

65 yaara

Female yeara yeara yeare and over

All conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Infectious and parasitic diseases . . . . . . . . . ...001-139

Neoplasm . . . . . . . . . . . . . . . . . . . . . . . ...140-239

Mahgnant neoplasms . . . . . . . . . . ..140-208.230-234

Malignant neoplasm of large intestine and

rectum . . . . . . . . . . . . . . . . . . ...153-154.197.5

Malignant neoplasm of trachea, bronchus,

and lung . . . . . . . . . . . . . . . .162,197.0,197.3

Malignant neoplasm of breaS. , . . . . .174-175 .198.81

Benign neoplasms and neoplasms of uncertain behavior

and unspecified nature. . . . . . . . . . .210-229,235-239

Endocrine. nutritional and metabolic diseases, and immunity

disorders . . . . . . . . . . . . . . . . . . . . . . . ...24&279

Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . ...250

Diseases of the blood and blood-forming organs ..280-289

Mental disorders . . . . . . . . . . . . . . . . . . . . ...290-319

Psychoses, . . . . . . . . . . . . . , . . . . . . . ...290-299

Alcohol dependence syndrome. . . . . . . . . . . . . ..303

Diseases of the nervous system and sense organs .32&389

Diseases of the central newous system .320-336,34&349

Cataract . . . . . . . . . . . . . . . . . . . . . . . . . . . ...366

Diseases of theearand mastoid process. . . . . .3ao-369

Diseases of thecirculatory ayetem . . . . . . . . ...390-459

Heartdlsease . . . . . . . . . .391 -392.0,393-398,402,404,

410-416,420429

Acuremyocardial infarction . . . . . . . . . . . . . . ..410

Atherosclerotic heart disease. . . . . . . . . . . . . .414.0

Other ischamic haart disease. . ..411-413.414.1414.9

Cardiac dysrhythmias. . . . . . . . . . . . . . . . . . ..427

Congestive heartfailure . . . . . . . . . . . . . . ...428.0

Cerabrovascular disease. . . . . . . . . . . . . ...430-438

Ilseases of the respiratory system . . . . . . . . . ..460-519

Acute respiratory infections, except irrfiuenze . . .460Ai66

Chronic disease oftonsils and adenoids . . . . . . ...474

Pneumonia, allforms . . . . . . . . . . . . . . . . ..4W-486

Asthma . . . . . . . . . . . . . . . . . .,.....,.....493

Diseases ofthedigestive syatem . . . . . . . . . ...520-579

Ulcers of thestomach and small intestine . . ...531-534

Gastritis and duodenitis. .,... . .,.,.......,.535

Appendicitis . . . . . . . . . . . . . . . . . . . . . ...540-543

Inguinal hernia . . . . . . . . . . . . . . . . . . . . . . ...550

Noninfectious enteritis andcoliiis. . . . . ...555-556.558

Cholellthiasls . . . . . . . . . . . . . . . . . . . . . . . ...574

Diseases of thegenifourinary system. . . . . . . . . .58W329

Calculus ofkidney and ureter.. . . . . . . . . . . . ...592

Hyperplasiaofprostate . . . . . . . . . . . . . . . . . . ..!300

Complications of pregnancy, childbirth, and the

puerperium’ . . . . . . . . . . . . . . . . . . . . ...63&876

Abortions andeotopic and molar pregnancies. . .630-S39

Dkeasesof theskinan dsubcutaneousti ssue, . . .680-70g

Dbeases of the musculoskeletal system and connective

Wsue. . . . . . . . . . . . . . . . . . . . . . . . . . ...710-739

Arthropathles and related disorders . . . . . . . .710-719

Intervertebral disc disorders . . . . . . . . . . . . . . ...722

Congemtal anomalies . . . . . . . . . . . . . . . . ...740-759

C;:;ind conditions originating In the perinatal

. . . . . . . . . . . . . . . . . . . . . . . . . . .760-779

Symptoms, signs, andill-defined conditions . . . . .760-799

lnJuryand po!sonmg. . . . . . . . . . . . . . . . . ...800-999

Fractures, allsites . . . . . . . . . . . . . . . . . ...800-829

Fracture ofneckoffemur . . . , .,..,.......,820

Spramsand strains of back (including neck). . ..648-847

Intracranial inpmes (excluding those with skull

fracture) . . . . . . . . . . . . . . . . . . . . . . . ...65&854

Laceratlona and open wounds . . . . . . . . . .Li7C-904

Surmlementary classifications . . . . . .VO1-V62

Females with deliveries . . . . . . . . . . . . . . . . . . ..V27

30,e47

726

2,001

1,606

167

239

163

392

1,097

438

316

1,514

773

218

819

341

65

177

5,197

3,534

695

407

893

487

843

785

2,996

475

134

1,033

475

3,295

256

143

227

213

351

482

2,191

276

249

756

229

460

1,569

431

396

207

152

381

2,606

1,021

265

79

186

224

4,444

3,937

12,583

362

842

770

64

147

●

72

453

197

154

778

351

165

364

156

20

67

2,670

1,892

421

282

471

220

304

344

1,507

244

56

544

204

1,501

134

58

135

193

139

132

651

180

249

. . .

. . .

238

745

193

219

112

88

191

1,514

480

61

39

114

171

214

. . .

Number of patients discharged in thousands

18,364

363

1,159

838

83

92

162

320

644

241

184

736

422

53

455

163

44

90

2,527

1,842

274

125

422

267

339

451

1,489

230

76

489

271

,794

122

65

92

2:

351

,340

98

. . .

756

229

242

625

237

177

95

63

190

1,292

541

204

41

73

53

4,230

3,937

2,597

200

45

31

●

●

14

93

22

59

47

12

*

181

60

*

91

27

16

●

●

*

*

●

*

764

214

94

220

168

264

*

*7

60

30

88

●

69

●

●

●

39

51

16

●

137

146

56

341

120

●

●

51

30

75

●9

11,848

242

370

187

‘6

11

18

163

235

107

89

937

414

149

211

121

2;

406

225

42

22

50

36

16

32

536

61

38

136

127

953

44

51

130

46

124

172

915

136

●

751

227

155

566

125

208

41

●

154

1,186

332

●9

42

93

152

4,078

3,926

6,271

102

643

512

44

101

67

131

283

142

49

291

175

55

166

67

●lo

25

1,552

1,116

245

187

339

109

116

152

505

62

●

145

68

858

76

36

26

56

63

151

473

94

55

*

●

120

465

103

147

18

●

115

486

157

25

23

15

27

143

●

10,230

182

942

878

117

127

77

64

466

166

121

239

i 73

14

260

93

53

31

3,212

2,177

408

197

503

338

505

607

1,190

138

532

93

1,220

135

48

11

61

76

157

734

44

193

. . .

. . .

165

467

164

40

11

●5

56

791

412

228

12

27

15

147

. . .

lFirst-lMed d!agnosls for females wth delwenes lscoded V27, shown under “supplemenlsryc lassificaliona.’”
Advance Data No. 199 ● April 9,1991 5

Table 5. Rate of inpatients discharged from short-stay hospitals, by category of first-listed diagnosis, sex, and age: United States, 1989

[Discharges from non-Federel hospitals. Excludes newborn infants. Diagnostic groupings and code number inclusions are baaed on the htematiorral C/asslr7catiorrof

Dseases, 9fh Revision, Clinical Modification (lCD-%CM)]

Sex Age

Under 15 45-64

Category of first-listed diagnosis and ICD-9-C?J code Total

65 years

Ma/e Female yeara ;’ years and over

Rate of inpatients discharged per 10,000 population

All conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

infectious and parasitic diseases . . . . . . . . . ...001-139

Neoplasm . . . . . . . . . . . . . . . . . . . . . . . . ..~4&239

Malignant neoplasms . . . . . . . . . . . .140-208 .23&234

Mahgnant neoplasm of large intestine and

rectum . . . . . . . . . . . . . . . . . . ...153-154.197.5

Mahgnant neoplasm of trachea, bronchus,

ano lung . . , . . . . . . . . . . . . . . . .162,197 .0,197.3

Mahgnant neoplasm of breast. . . . . . .174-175 .198.81

Bervgn neoplasms and neoplasms of uncertain

behavior and unspecified nature. . . . .210-229,23=239

Endocrine, nutritional and metabolic diseases, and immunity

disorders . . . . . . . . . . . . . . . . . . . . . . . ...240-279

Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . ..25o

Diseases of the blood and blood-forming organs ..280-289

Mental disordefa . . . . . . . . . . . . . . . . . . . . ...290-319

Psychoses . . . . . . . . . . . . . . . . . . . . . . ...290-299

Alcohol dependanca syndrome . . . . . . . . . . . . ...303

Diseases of the nervous system and sense organs .320-389

Diseaaas of the central nervous system .320-336,340+49

Cataract . . . . . . . . . . . . . . . . . . . . . . . . . . . ...366

Diseases of theearand mastoid process. . . ...380-389

Diseases of the circulatory system . . . . . . . . ...390459

Heart disease . . . . . . . . . .391 -392.0,393-398,402,404,

41 W16,42C-429

Acute myocardial infarction . . . . . . . . . . . . . ...410

Atherosclerotic heart dkseaee. . . . . . . . . . . . . .414.0

Other ischemic heart disease. . ..411413.414.1414.9

Cardiac dysrhythmias. . . . . . . . . . . . . . . . . ...427

Congestive heart failure . . . . . . . . . . . . . . ...426.0

Cerebrovsscular disease. . . . . . . . . . . . . . . .43W38

Oiseases of therespiratory system . . . . . . . . ...460-519

Acuferespkatoryi nfecbons,ex captinfluenza . ..460-466

Chronic disease oftonsils and adenoids . . . . . . ...474

Pneumonia, all forms. . . . . . . . . . . . . . . ...460486

Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . ...493

Diseases of thedigeatfwesyatem . . . . . . . . . ...520-579

Ulcers of fhestomach and small intestine . . ...531-534

Gastritis andduodenitls . . . . . . . . . . . . . . . . . ...535

Appandicifis . . . . . . . . . . . . . . . . . . . . . ...540-543

Inguinal hernia . . . . . . . . . . . . . . . . . . . . . . ...550

Noninfedlous enteritis and colitis. . . . . ...555-558.558

Cholelithiasls . . . . . . . . . . . . . . . . . . . . . . . ...574

Diseases of thegenifourinay system. . . . . . . ...580-829

Calculus ofkidneyand ureter . . . . . . . . . . . . . ...592

Hyperplasia of prostate . . . . . . . . . . . . . . . . . ...600

Complications of pregnancy, childbirth, and the

puerperluml . . . . . . . . . . . . . . . . . . . . . ...830-676

Abortions andectopic and molar pregnancies. ..630-839

Diseases of theskin and subcutaneous tissue. . ..860-709

Diseases of the musculoskeletal system and connective

tissue. . . . . . . . . . . . . . . . . . . . . . . . . . . . .710-739

Arthropathies and related disorders . . . . . . ...710-719

Intervertebral disc disorders . . . . . . . . . . . . . . . ..722

Congenital anomalies . . . . . . . . . . . . . . . . ...740-759

Certain conditions originating in the pennatal

period . . . . . . . . . . . . . . . . . . . . . . . . . ...760-779

Symptoms, signs, andilldefmed condtions . . ...780-799

Injury and poisoning . . . . . . . . . . . . . . . . . ...800-999

Fractures. allsfies . . . . . . . . . . . . . . . . . ...800-629

Fracture ofneckoffemur . . . . . . . . . . . . . . . ..82O

Sprains andafrains of back (including neck). . ..848-647

Intracranial injuries (excluding those with skull

fracture) . . . . . . . . . . . . . . . . . . . . . . . . ..850-S54

Lacerations and open wounds . . . . . . . . . . . .870-904

Suppiementa~ classifications . . . . . . . . . . . . . .VO1-V82

Females with deliveries....,,... . . . . . . . . . ..V27

1,255.2

29.4

81.1

65.2

6.6

9.7

6.6

15.9

44.5

17.8

12.9

61.4

31.3

8.8

33.2

13.8

2.6

7.2

21 o.a

143.3

26.2

16.5

36.2

19.7

26.1

32.3

121.5

19.3

5.4

41.9

19.3

133.6

10.4

5.8

9.2

8.6

14.2

19.6

86.9

11.3

10.1

30.7

9.3

19.5

53.6

17.5

16.1

8.4

6.1

15.4

113.8

41.4

10.8

3.2

7.5

9.1

160.2

159.7

1,053.3

30.3

70.5

84.5

7.0

12.3

●

6.0

37.9

16.5

12.9

85.1

28.3

13.8

30.5

13.2

1.7

7.3

223.5

156.4

35.2

23.6

39.4

16.4

25.4

28.8

126.2

20.5

4.9

45.8

17.1

125.6

11.2

4.8

11.3

16.1

11,6

11.0

71.2

15.1

20.8

. . .

. . .

19.9

62.3

16.2

18.4

9.4

7.4

16.0

126.7

40.2

:;

9.5

14.3

17.9

. . .

3,301.6

58.7

303.9

263.3

37.8

40.9

25.0

20.6

156.8

53.6

39.2

77.2

55.6

4.7

64.1

30.1

17.3

10.0

1,036.8

702.6

131.6

63.5

182.4

109.2

162.9

195.8

364.2

44.5

171,8

29.9

393.6

43.5

15.6

3.6

26.2

24.5

50.6

236.9

14.2

62.4

. . .

. . .

53.3

150.8

59.5

12.9

3.6

●1.5

18.1

255.1

133.0

73.4

3.9

6.7

4.9

47.6

. . .

1,445.0

28.6

91.2

66.0

6.5

7.3

12.7

25.2

50.7

18.9

12.9

57.9

33.2

4.2

35.8

14.4

3.5

7.1

196.8

129.2

21.6

9.8

33.2

21.0

26.7

35.5

1172

18.1

3::

21.3

141.1

9.6

E

1.6

16.7

27.6

105.4

7.7

. . .

59.5

18.0

19.1

64.9

18.7

13.9

7.5

5.0

15.0

101.7

42.6

16.0

32

5.7

4.2

332.8

308.8

461.8

37.0

8.4

5.7

. ---- -

1,350.1

22.0

138.5

110.3

1 ,udu.a

21.0

32.1

16,2

●0.5 9.4

●

●

1.0

1.6

21.8

14.5

2.6 15.9 28.2

17.2

4.1

10.9

8.7

2.2

●

33.5

11.1

●

16.9

5.0

2.9

●

●

●

●

●

*

141.8

39.6

17.4

40.9

31.2

48.9

●

●1.4

11.2

5.6

16.3

●

20.4

9.3

7.7

81.4

35.9

12.9

T8.3

10.5

●

2.5

35.2

19.6

3.6

1.9

4.3

3.1

1.6

2.6

46.6

5.3

3.3

11.8

11.0

61.0

30.6

10.5

62.6

37.6

11.7

35.7

14.4

●2.1

5.5

334<2

240.2

52.8

40.2

73.0

23.4

25.0

32.8

106.8

13.3

31.;

19!0

164.7

16.3

7.7

5.6

12.0

13.7

82.7

3.8

4.4

11.2

4.0

10.7

14.9

79.4

12.0

●

32.6

101.8

20.3

11.7

I 2.a

●

●

●

65.2

19.7

13.5

●

●

7.2 25.9

50.9

10.9

I a.1

3.6

100.0

22.3

31.7

3.8

27.2

10.4

63.3

22.3

*

*

* ●

13.3

103.2

28.8

●o.a

3.7

24.7

104.6

33.9

5.3

5.0

9.4

5.6

14.0

●1.6

8.1

13.2

354.0

340.8

3.3

5.6

30.8

●

1Fnst-lmted d!qnosis for femaIes wth delwenes is coded V27, shown under “supplementary ckss~
6 Advance Data No. 199 ● April 9,1991

Table 6. Average length of stay for inpatients discharged from short-stsy hospitals, by category of first-listed diagnosis, sex, and age:

United States, 1989

[Discharges from non-Federal hospitals. Excludes newborn infants. Diagnostic groupings and code number inclusions are based on the International C/assificaticm of

Dseases, 9fh Rev/sIon, C/irrica/ Modification (lCD-g.-CM)]

Sex Age

Category of first-listed diagnosis and ICLHWM cude

Under 75

Total Male Female

4-4 65 yeara

years ;= years and over

Average length of stay in days

All conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Infectious andparasitic cfiseases . . . . . . . . . . .001–139

Neoplasm. ,, . . . . . . . . . . . . . . . . . . . . ...140-239

Mallgnantneoplaams . . . . . . .14G208,230-234

Mal[gnant neoplasm of large intestine and

rectum . . . . . . . . . . . . . . . . . . ...153-154.197.5

Malignant neoplasm of trachea, bronchus,

and lung . . . . . . . . . . . . . . . .162,197,0,197.3

Malignant neoplasm of breast. . . . . . .174-175,19 &81

Benign neoplasms and neoplasms of uncertain

behavior and unspecified nature. . . . ,210-229,23&239

Endocrine, nutritional and metabolic diseases, and immunity

disorders . . . . . . . . . . . . . . . . . . . . . . . ...240-279

Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . ..25o

Diseases of the blood and blood-forming organs ..280-289

Mentaldisorders . . . . . . . . . . . . . . . . . .. . . . ..2g0-31g

Psychoses. . . . . . . . . . . . . . . . . . . . . . . ..2g&2gg

Alcohol dependence syndrome. . . . . . . . . . . . . . .303

Diseases of the nervous system snd sense organs ,320-389

Diseases of the central nervous system .320-338,340+49

Cataract . . . . . . . . . . . . . . . . . . . . . . . . . . . ...368

Diseaaes of theearand mastoid process. . . ...380-389

Oiseases ofthe circulatory system . . . . . . . . ...390-459

Heart disease , . . . . . . . . .391-392.0,393-398,402,404,

410416,42W29

Acute myocardial infarction . . . . . . . . . . . . . . ..410

Atherosclerotic heartdiseas.e. . . . . . . . . . . ..414.0

Other ischemic heart d&ease. . . .411 -413,414.1-414.9

Cardiac dysrhythmias. . . . . . . , . . . . . . ...427

Congestive heart failure . . . . . . . . . . . . . . ...428.0

Cerebrovascular diseaee. . . . . . . . . . . . . . . .430-438

Diseases ofthe respiratory system . . . . . . . . , .460-519

Acute respiratory infections, except influenza . ..460-466

Chronic disease oftonsils and adenoids . . . . . . ...474

Pneumonia, allforrns . . . . . . . . . . . . . . . . ..480-4e6

Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . ...493

Diseases ofthe digestive system . . . . . . . . . . .52c-579

Ulcers of thestomach and small intestine . . . ..531-634

Gastritis and duodenifts . . . . . . . . . . . . . . . . . . . .535

Appendicitis . . . . . . . . . . . . . . . . . . . . . . ..5.4Gw

Inguinal herni a . . . . . . . . . , . . . . . . . . . . . . ..55o

Noninfectious enteritis and coliiis , . . . . . . ,55$556)558

Cholelithiasis . . . . . . . . . . . . . . . . . . . . . . . ...574

Diseases of thegenifourina~ system, . . . . . . ...580-629

Calculus ofkidneyand ureter.. . . . . . . . . . . . ...592

Hyperplasiaofprostate . . . . . . . . . . . . . . . . . ...600

Complications of pregnancy, childbirth, and the

pUerperiUM1 . . . . . . . . . . . . . , . . . . . . . ...630-676

Abortions andectopic and molar pregnancies. ..630-639

~seases of thesfdn andsubcuteneous fissue. . . .680-709

Oiseases of the musculoskeletal system and connective

tissue . . . . . . . . . . . . . . . . . .71C-739

Arthropathies andrelated disord’e;s ::::::: . .710-719

Intervertebral disc disorders . . . . . . . . . . . . . . . . .722

Congenital anomalies . . . . . . . . . . . . . . . . . . ,740–759

C;w&nd conditions originating in the perinatal

. . . . . . . . . . . . . . . . . . . . . . . . . . . .76C-779

Symptoms, signs, and ill-defined ccmditions . . . .78C-799

Injuryand poisoning . . . . . . . . . . . . . . . . . ...800-999

Fractures, allsites . . . . . . . . . . . . . . . . . . ..60C-829

Fractureofneckoffemur . . . . . . . . . . . . . . . ..82o

Sprains andstrains of back (including neck). . ..648-647

Intracranial injuries (excuding those with skull

fracture), . . . . . . . . . . . . . . . . . . . . . . . ..65B54

L.ecerations and open wounds . . . . . . . . . . . .87C!-904

Supplementary classifmatlons . . . . . . . . . . .VO1-V82

Femaleswith deliveries . . . . . . . . . . . . . . . . . ..V27

6.5

7.7

8.3

9.2

14.0

8.6

5.4

4.7

6.8

7.6

6.0

12.7

14.5

10.6

5.5

6.6

1.5

2.6

7.6

7.0

8.6

6.2

5.2

5.8

8.4

10.2

6.7

4.9

1.2

6.1

4.5

8.3

7.3

4.6

4.9

2.6

5.1

6.3

5.2

3.0

5.2

2.8

2.3

8.0

6.5

7.7

5.4

5.9

11.3

3.3

6.8

6.5

13.2

4.5

7.0

3.7

3.2

2.9

7.0

8.1

8.8

9.2

13.1

8.5

●

4,6

6.9

7.7

5.9

12.5

14.0

10.5

5.5

8.7

1.3

2.3

7.4

6.8

8.1

6.0

5.2

5.7

7.9

10.3

6.6

4.5

1.2

7.6

3.8

6.0

6.8

4.1

4.5

2.6

5.8

7.5

5.5

2.7

5.2

. . .

. . .

7.8

5.9

6.9

5.0

5.2

10.3

3.2

6.3

7.5

13.8

4.1

8.2

3.7

5.9

. .

6.1

7.3

8.0

9.3

14.9

8.9

5.4

4.7

6.6

7.4

6.1

13.0

14.9

11.0

5.6

6.5

1.5

2.9

7.6

7.2

9.3

6.6

5.3

5.9

8.8

10.2

6.8

5.4

1.2

8.4

5.0

6.6

8.0

4.9

5.4

2.5

4.6

5.9

5.1

3.7

. . .

2.6

2.3

8.3

7.1

8.4

6.0

6.6

12.8

3.3

7.4

9.4

13.0

4.6

5.0

3.8

3.1

2.9

4.9

4.3

6.5

6.3

●

*

2.6

4.4

4.6

3.8

25.2

26.6

●

3.9

6.6

*

2.2

5.8

6.1

●

●

●

●

*

●

3.5

3.5

1.2

4.3

2.9

3.8

●

●2.7

4.9

:::

●

5.2

●

●

●

4.2

5.9

5.7

●

5.4

11.0

2.7

4.3

5.1

*

●

3.1

4.2

4.8

●3.3

4,7

7.2

5.9

7.6

●9.1

8.6

4.2

4.1

RI

5.7

12.1

13.9

11.2

5.6

6.9

2.;

5.6

5.3

5.9

4.0

3.9

3,7

6.3

10.0

4.8

4.2

1.2

7.0

4.2

4.7

4.8

3.6

4.1

2.0

4.0

4.8

3.9

2.6

●

2.6

2.3

5.6

4.8

3.8

5.0

5.1

●

2.6

5.1

6.0

●9.O

4.1

7.6

3.6

2.9

2.9

6.7

10.6

7.7

8.6

14.1

6.5

5.1

4.6

6.2

7.1

5.6

11.6

14.3

6.5

5.2

6.4

*1.1

2.8

6.3

6.0

7.5

5.0

4.7

4,4

7.6

9.2

7.5

5.8

*

9.2

5.2

6.1

6.7

4.6

5.9

2.5

5,0

5.7

4.6

2.9

4.3

*

●

8.4

6.1

7.6

5.4

10.6

*

3.4

7.1

8.3

12.5

4.7

6.9

3.6

4.5

*

6.9

10.3

9.8

10.0

14.2

6.8

5.9

7.2

6.5

9.5

7.5

13.9

15.4

11.9

6.8

12.3

1.5

3.5

8.4

7.7

9.5

7.5

5.7

6.4

87

10.5

9.3

7.1

9.6

7.2

6.2

6.6

5.9

11.4

3.4

9.0

8.7

7.2

4.7

5.5

. . .

. . .

10.7

9.2

10.6

7.6

7.2

●14.6

5.5

10.3

11.6

13.5

5.7

10.6

4.5

8.9

. . .

1 F!St-l! steddlagnosis for females wttidelwer!es tswded V27, shwnunder ''supplementa~ d~s6mtlom,,'
Advance Data No. 199 ● April 9,1991 7

Table 7. Number of all-llsted procedures for inpatients discharged from short-stay hospitals, by procedure category, sex, and age

United States, 1989

[Discharges frcfn non-Federal hospitals. Excludes newborn Infants. Procedure groupings and code number inclusions are beeed on the krterrratiorra/ Classification of

Diseases, %5 Rev/s/on, Clinical Modification (lCD-g-OM)]

Sex Age

Under 15 15-M 4s=64 65 years

Procedure category and ICO-9-CM wde Total Male Femefe yeara yeara years and over

Allprmadures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Operations on the nervous system . . . . . . . . . . . . . ...01-05

Spinal tap . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...03.31

Operations on the endocrine system . . . . . . . . . . . . ...06-07

Operations onthe eye . . . . . . . . . . . . . . . . . . . . . . ..0=16

Extraction of lens . . . . . . . . . . . . . . . . . . . . . ...13.1-13.6

Insertion of prosthetic lens (pseudophakos) . . . . . . . ...13.7

Operations ontheesr . . . . . . . . . . . . . . . . . . . . . . ..1*2O

Operations on the nose, mouth, and pharynx. . . . . . . ...21-29

Rhinoplasty andrepairofnose. . . . . . . . . . . . . . . . ...21.8

Tonsillectomy with or without adenoidectomy . . . . . .28.2–28.3

Operations on the respiratory system. . . . . . . . . . . . ...30-34

Bronchoscopy . . . . . . . . . . . . . . . . . . . . . . . .33.21 +3.23

Operations on the cardiovascular system . . . . . . . . . ...35-29

Removal of corona~ artery obstruction . . . . . . . . . . ...36.0

Direct heart revseculanzation. . . . . . . . . . . . . . . . . . . .36.1

Cardiac catheterization . . . . . . . . . . . . . . . . . .37.21 -37.23

Pacemaker insertion, replacement, removal, repair. . .37.7-37.8

Operations on the heroic and lymphatic system . . . . . ...40-41

Operations on the digestive system. . . . . . . . . . . . . ...42-54

Esophagoecopy and gastroscupy (natural orifice) . .42.23,44.13

Partial gastrectomy and resection of

intestine . . . . . . . . . . . . . . . . . . . . . .43.5-43.8,45.6-45.8

Colonoacopy and sigmoidoscopy. . . . . . . . . . . .45.23-15.24

Appendectomy, excludingincidental . . . . . . . . . . . . ...47.0

Hemorrhoidectomy . . . . . . . . . . . . . . . . . . . . .49.43-49.48

Cholecystactc+ny . . . . . . . . . . . . . . . . . . . . . . . . ...51.2

Repeirofingulnel hemla . . . . . . . . . . . . . . . . ...53.0-53.1

Dtvislon of peritoneal adhesions. , . . . . . . . . . . . . . ...54.5

Operations on fheutinary system . . . . . . . . . . . . . . ...55-59

Endoscoples (natural oriftca) . . .55.21 -55.22 .56.31 ,57.32,58.22

Operations onthernale genltstorgsns. . . . . . . . . . . ...60-64

Prostatectorny . . . . . . .. . . . . . . . . . . . . . . . . ...60.2-60.6

Operations on the female genita! organs. . . . . . . . . . ...65-71

Oophorecfomy and salpingmphorectomy. . . . . . .65 S-65.6

Bilateral destruction or occlusion of fallopian tubes. . .66.2+6.3

Hysterectomy . . . . . . . . . . . . . . . ..l. . . . . . ..63.3-S3.7

Dllatlon andcurettsge ofuterus . . . . . . . . . . . . . . . . ..W.O

Repair of cyetocele and rectocele. . . . . . . . . . . . . . ...70.5

Obstetrical procedures . . . . . . . . . . . . . . . . . . . . . ...72-75

Epislotomy with or whhout forceps or vacuum

extraction . . . . . . . . . . . . . . . .72.1,72.21,72.31,72.71,73.6

CesareansecUon . . . . . . . . . . . . . . . .74.0-74.2,74.4,74.98

Repsirofcurrent obstetric laceration . . . . . . . . . . .75.%75.6

Operations onthemusculoskeletal system . . . . . . . . ...76-84

Open reduction of fracture except Jaw. . . . . . . . . . ...76.79.

79.2-79.3,79 .5-79.6

Other raduction of fracture except jaw. . . . . . . . . . ...76.70.

76.78,79.G79.1,79.4

Exclslon m destruction of intervertebral disc and spinal

fusion . . . . . . . . . . . . . . . . . . . . . . . . . . . ...60.5.81.0

Arthroplssiy end replacement of knee’ . . . . . ...61.41-51.47.

81.54-81.55

Operations on muscles, tendons, fascia, and buraa. . .82-83.1,

83.3-53.9

Operations on the Integumentary system . . . . . . . . . ...85-86

Mastectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . ...85.4

Excision or destruction of lesion or tissue of skin or

subcutaneous tissue . . . . . . . . . . . . . . . . . . ...86.2-66.4

Sklngraft (axcapt llpor mouth) . . . . . . . . . . . . . ..86.GS6.7

Miecelianeous diagnostic snd therapeutic procedures . . . .87-99

Computerized axial tomography. . . . . . ...87.03.87.41,67.71,

68.01,88.38

Pyelogram . . . . . . . . . . . . . . . . . . . . . . . . . .87.73-87.75

Artenography and angiccardiography using contrast

material . . . . . . . . . . . . . . . . . . . . . . . . . . . ..88.4-S6.5

Dhgnoefic uftrssound . . . . . . . . . . . . . . . . . . . . . ...88.7

Clrculato~ monttorkrg . . . . . . . . . . . . . . . . . . . . . ...89.6

Radioisotope scan . . . . . . . . . . . . . . . . . . . . ...92.0-92.1

40,043

90s

377

113

448

79

72

166

734

90

155

1,051

137

3,722

259

366

958

275

385

5,35J3

91

294

409

253

75

504

243

329

1,594

530

84s

376

2,365

421

389

541

265

135

6,383

1,704

936

762

3,171

479

192

355

228

312

1.428

120

542

124

11,544

1,519

288

1,620

1,558

777

635

16,086

475

203

31

198

25

24

93

366

46

69

608

85

2,236

X

601

142

180

2,309

43

136

157

141

45

144

220

59

962

380

648

376

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

1,676

236

107

204

123

191

633

●

303

75

5,844

721

161

1,000

628

388

287

23,954

435

174

63

250

54

48

75

348

44

66

442

52

1,486

82

97

357

133

195

3,051

48

157

252

112

3::

24

270

633

150

. . .

. . .

2,385

421

389

541

265

135

6,383

1,704

936

762

1,495

243

85

151

106

120

795

118

239

49

5,900

798

127

620

930

390

347

2,1 W

226

172

*

28

●

98

181

‘5

103

81

20

150

●

●

23

●

20

226

●9

●

●

61

G

●

43

*8

49

. . .

●8

●

●

●

12

●5

●

●

215

34

49

●5

●

39

94

●

34

12

719

63

●9

30

82

32

20

15,805

286

97

42

99

●

●

39

313

59

48

194

24

436

19

12

95

●lo

82

1,546

20

35

65

149

28

179

50

184

384

93

48

●

1,583

228

386

317

208

38

6,36S

1,698

936

760

1.320

175

61

186

91

131

526

14

197

45

2,436

354

110

164

465

128

119

8,865

196

47

45

100

13

13

17

136

15

*

307

37

1,320

133

165

425

43

105

1,310

16

80

93

29

32

162

62

67

386

135

129

71

470

144

●

165

42

52

●

*

*

●

755

92

32

128

41

90

380

48

131

26

3,204

355

75

685

379

188

187

13,223

198

61

25

220

60

56

16

104

*1 o

●

470

56

1,815

107

191

414

221

178

2,278

44

176

247

15

15

160

98

95

781

284

421

304

225

48

.. .

58

13

46

. . .

. . .

. . .

881

50

36

93

52

427

56

160

39

5,166

727

93

721

633

429

310

~lncJudesaddendatothelCO-S-CM effectweOcroberl, 1989.
8 Advance Data No. 199 ● April 9, 1991

Table 8. Rate of all-llsted procedures for inpatients discharged from short-stay hospitals, by procedure category, sex, and age:

United States, 1989

[Discharges from non-Federal hosptials. Excludes newborn infants. Procedure groupings and code number inclusions are based on the /rrfemationa/ C/asairlwtion of

L%seases, 9fh Revkion, C/inica/ A.focfrketion (ICD-9-CM)]

Sex Age

Under 15 15-44

Procedure category and ICB9-CM code

45=64 65 years

Total Male Female yeara yeare yeara and over

Rate of all-listed procedures per 100,000 population

All procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Operations onthenervoua system . . . . . . . . . . . . . ...01-05

Spinaltap. . . . . . . . . . . . . . . . . . . . . . . . . . . . ...03.31

Operations ontheendocrine syatem . . . . . . . ., . ...06-37

Operations ontheeye, . . . . . , . . . . . . . . . . . . . . . ..08–16

Extraction oflens. . . . . . . . . . . . . . . . . . . . . ...13.1-13.6

Insertion ofprosthetic lens (pseudophakos) . . . . . . . ...13.7

Operations ontheear . . . . . . . . . . . . . . . . . . . . . . ..Is-20

Operations onthenose, mouth, and pharynx. . . . . . . .21-29

Rhinoplasty and repairofnose. . . . . . . . . . . . . . . . ...21.8

Tonsillectomy with orwithout adenoidecfomy. . . . . .28.2-28.3

Operations ontheresplratorysystem. . . . , , . . . . . . . , .30-34

Bronchoscopy . . . . . . . . . . . . . . . . . . . . . . . .33.21-33.23

Operations onthe cardiovascular system . . . . . . . . . .3s39

Removal ofcoronary artery obstruction . . . . . . . . ..36.0

D!rectheart revascularization. . . . . . . . . . . . . . . . ...36.1

cardiac ~theterlzation . . . . . . . . . . . . . . . , . .37.21-37,23

Pacemaker insertion, replacement, removal, repair. . .37.7-37.8

Operations onthehemic and lymphatic system ., . . . ...40-41

Operations onthe digestive system. . . . . . . . . . . . . ...42-54

Esophagoscopy andgastroscopy (natural orifice) . .42.23,44,13

Partial gastrectomy and resetilon of

inteStine, . . . , . . . . . . . . . . . . . . .43.5+ .8,45,6-45.8

Colonoscopy andslgmoidoscopy. . . . . . . . . . . .45.2H5.24

Appendectomy, excluding incidental . . . . . . . . . . . . . ..47.0

Hemorrhoidectomy. , . . . . . , . . . , , . . . . . . .4g.&3qg.46

Cholecystectomy . . . . . . . . . . . . . . . . . . . . . . . . . ..5I.2

Repairof inguinalhernia. , . . . . . . . . . . , . . . . . .53,0-53.I

Diwsiono fperitoneala dhesions. . . . , . . . . . . , . . . . .545

Operationa ontheurlnarysystem . . . . . . . . . . . . . . . . .5s59

Endoscopies (natural oriice) . . .55.21 -55.22,58,31,57.32,58 .22

Operations onthemale genital organs. . . . . . . . . . . ...60-64

Prostatectomy. . . . . . . . . . . . . . . . . . . . . . . ...60.2-60.8

Operations onthefemala genlfal organs. . . . . . . . . . . . .6&71

Oophorectomy andsalpingo-oophorectomy. . . . . .65.3-65.6

Bilateral destruction orocclusion of fallopian tubes, , .66.2-56,3

Hysterectomy . . . . . . . . . . . . . . . . . . . . . . . . ..6M6M7.7

Dilation andcurettage of uterus . . . . . . . . . . . . . . , . ..69.0

Repair ofcystoceie andrectocele. . . . . . . . . . . , . . . ..70.5

Obstetrical procedures . . . . . . . . . . . . . . . . . . . . . . ..72–75

Episiotomy with or without forceps or vacuum

extraction . . . . . . . . . . . . . . . .72.1,72 .21,72,31,72.71,73.6

CeSareana8CtiOn. . . . . . . . . . . . . . . .74.0-74 .2,74.4,74 .99

Repair occurrent obstetric laceration , . . . . . . . . . .75.5-75.8

Operations onthemusculoskeletal system . . . . . . . . . . .76-S4

Open reduction of fracture except jaw. . , , . . . . . . . ..76.79,

79.2-79 .3,79.5-79.6

Other reduction of fracture except jaw. . . . . . . . . . . .76,70,

76.78,79.0-79.1,79,4

Excision or destruction of intervertebral disc and spinal

fusion . . . . . . . . . . . . . . . . . . . . .,.......,80.5,81.0

Arthroplasty andreplacement of kneel . . . . . , . .61.41 -81.47,

81 .54-S1 .55

Operations onmuscles, tendons, faecla, and bursa. . .82-83.1,

S3.3-83.9

Operations ontheintegumentary system , . . . . . . . . ...85-66

Mastectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . ...85.4

Excision or destruction of lesion or tissue of skin or

subctineoustlssue. . . . . . . . . . . , . . . . . , . .66.2-86.4

Skin graft (except lipormouth), , . . . . . . . . . . ...66.6-66.7

Miscellaneous diagnostic andtherape~lc procedures . . .67-99

Computerized axial tomography .87.03,87 .41,87 .71,68 .01,66.38

Pyelogram . . . . . . . . . . . . . . . . . . . . . . . . ..67.73-S7.75

Arteriography and anglocardtography using contrast

material . . . . . . . . . . . . . . . . . . . . . . . . . . . ..88.4-S8.5

Diagnostic ultrasound . . . . . . . . . . . .,.’ . . . . . . . ...86.7

Circulatory monitormg, . . . . . . . . . . . . . . . . . . . . ...89.6

Radioisotope scan . . . . . . . . . . . . . . . . . . . . ...92.0-92.1

16,241.1

368.6

153.1

46,0

181.6

32.1

29.1

66.2

297.6

36.4

62.9

426.2

55.6

1,509.4

105.0

149.3

386.4

111.5

156.1

2,174.0

37.0

119.2

165.7

102.5

30.6

204.2

96.6

133.4

846.7

214.6

262.8

152.6

967.5

170.8

157.6

219.3

107.3

54,8

2,588.6

691.0

380.4

309.1

1,286.1

194.2

77,9

144.1

92.7

126.3

579.1

48.9

219.7

50.4

4,682,1

616.0

116.6

657.2

632.0

315.3

257.5

13,486,7

397.3

170.2

25.6

165.6

21.0

19.7

78.0

323.4

38.1

57.5

509.3

70.9

1,871.6

148.2

226.8

503.1

118.9

159.3

1,932.5

35,9

114.2

131.3

117.8

37.6

120.8

183.6

49.6

804.8

318.0

542.4

315.0

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

1,403.0

197.3

69.4

170.9

102.6

159.9

530.0

●

253.3

62.7

4,723,9

603,6

134.4

836.9

525.7

324.5

240.6

18,849.2

342.0

136.9

65,1

196,7

42.6

36.0

58.9

273.7

34.8

67.9

348.1

41.2

1,168.9

64.3

76.6

280.7

104.5

153.1

2,400.9

38.1

123.9

196.0

88.1

23.8

282.7

18.5

212.1

498.0

117.8

. . .

. . .

1,877.0

331.0

305.8

425.4

206.2

106.3

5,022.5

1,340.5

738.0

599.7

1,176.1

191.3

67.2

118.9

83.3

94.8

625.2

92.7

188,1

38.9

4,642.9

627.6

100.0

488.2

732.0

306.7

273.4

3,967.7

419.8

319.5

●

52.0

*

177.9

335.9

●8.7

190.5

149.7

37.2

278.6

*

41.;

*

37.0

419.2

●16.8

●

●

112.7

●

61.6

●

79.9

●14.2

91.5

. . .

●14.5

●

●

●

22.9

●9.3

●

●

396.1

62.7

91.4

*9.7

72.2

174.8

●

62.2

22.5

1,332.7

153.1

● 17.4

56.1

151.5

56.9

37.0

13,719.3

249.7

64.5

36,7

66,4

●

●

34.2

271.7

51.6

41,2

168.0

20.5

376.9

16.4

10.4

82.9

●8.9

71.4

1,341.6

17.4

30.1

56.2

129.1

24.1

155,6

43.1

142.0

333.7

81.0

41.9

*

1,460.6

197.8

335.3

275.2

181.7

32.6

5,527.6

1,474.0

812.3

659.7

1,!46.1

151.7

53.2

161.6

76.6

113.6

456.5

12.1

171.3

39.2

2,114.2

307.0

95.6

159.8

403.3

111.4

102.9

19,083.7

425.5

101.4

96,5

216,2

29.0

27.0

36.5

292.3

32.9

●

660.8

79.8

2,840.7

285.9

355,5

9f5.6

93.2

225.9

2,820.2

38.9

171.5

200.7

61.6

69.5

349,7

133.9

143.7

837.2

290.6

278.6

152.7

1,012.3

309.1

●

355.2

89.7

111.1

●

●

*

●

1,625.9

199.0

68.2

275.2

89.3

193.2

618.7

103.5

281.9

59.9

6,897,3

765,0

160.6

1,474.7

815.1

405.5

402.1

42,677.0

638.1

196.1

79.1

709.7

194.6

181.9

51.0

336.5

*33.5

●

1,515.7

181.9

5,856.6

345.5

615.2

1,337.4

7? 2,3

573.7

7,352.7

142.7

566.7

796.2

47.4

49.6

516.4

316.8

306.5

2,520,0

947.8

1,358.5

982.7

725.3

156.1

2,

. . .

88.3

42.3

48.3

. . .

. . .

. . .

,..

$1.8

573.8

161.2

116,1

299.9

167.0

1,379.2

188.3

580.3

126.6

16,737.2

2,346.6

301.6

2,326.7

2,044.4

1,384,5

999.1

llncludes addenda tothelCD-8-CM effect!ve October 1, 1989
Advance Data No. 199 ● April 9,1991 9

Technical notes

Survey methodology

Source of data

The National Hospital Discharge

Survey covers discharges from

noninstitutional hospitals, excIusive of

Federal, militaV, and Veterans

Administration hospitals, located in

the 50 States and the District of

Columbia. Only short-stay hospitals

(hospitals with an average length of

stay for all patients of less than 30

days) or those whose specialty is

general (medical or surgical) or

children’s general are included in the

survey. These hospitals must also

have six beds or more staffed for

patient use.

Beginning with 1988, the NHDS

sampling frame consists of hospitals

that were listed in the April 1987

SMG Hospital Market Tape (3), met

the above criteria, and began

accepting patients by August 1987.

For 1989, the sample consisted of 542

hospitals. Of the 542 hospitals, 16

were found to be out of scope

(ineligible) because they went out of

business or otherwise failed to meet

the criteria for the NHDS universe.

Of the 526 in-scope (eligible)

hospitals, 408 responded to the

survey.

Sample design and data collection

The NCHS has conducted the

NHDS continuously since 1965. The

original sample was selected in 1964

from a frame of short-stay hospitals

listed in the National Master Facility

Inventory. That sample was updated

periodically with samples of hospitals

that opened later. Sample hospitals

were selected with probabilities

ranging from certainty for the largest

hospitals to 1 in 40 for the smallest

hospitals. Within each sample

hospital, a systematic random sample

of discharges was selected. A report

on the design and development of the

original NHDS was published (l).

Beginning in 1988, the NHDS

sample includes with certain~ all

hospitals with 1,000 beds or more or

40,000 discharges or more annually.

The remaining sample of hospitals is

based on a stratified three-stage

design. The first stage consists of a

selection of 112 primary sampling

units (PSU’S) that comprise a

probability subsample of PSU’S to be

used in the 1985-94 National Health

Interview Sunfey. The second stage

consists of a selection of noncertainty

hospitals from the sample PSU’S. At

the third stage, a sample of

discharges was selected by a

systematic random sampling

technique.

Two data collection procedures

were used for the survey. The first

was a manual system of sample

selection and data abstraction. The

second was an automated method,

used for approximately 27 percent of

the respondent hospitals in 1989, that

involved the purchase of data tapes

from abstracting service organizations.

In the manual system, the sample

selection and the transcription of

information from the hospital records

to abstract forms were performed at

the hospitals. The completed forms,

along with sample selection control

sheets, were forwarded to NCHS for

coding, editing, and weighting. A few

of these hospitals submitted their

data via computer printout or tape.

Of the hospitals using the manual

system in 1989, about two-thirds had

the work performed by their own

medical records staff. In the

remaining hospitals using the manual

system, personnel of the U.S. Bureau

of the Census did the work on behaIf

of NCHS.

For the automated system, NCHS

purchased tapes containing machinereadable medical record data from

abstracting service organizations.

Records were systematically sampled

by NCHS.

The medical abstract form and

the abstract service data tapes contain

items relating to the personal

characteristics of the patient,

incIuding birth date, sex, race, and

marital status but not name and

address; administrative information,

including admission and discharge

dates, discharge status, and medical

record number; and medical

information, including diagnoses and

surgical and nonsurgical operations or

procedures. Since 1977, patient ZIP

Code, expected source of payment,

and dates of surgery have also been

collected. (The medical record

number and patient ZIP Code are

confidential information and are not

available to the public.)

Presentation of estimates

The relative standard error of the

estimate and the number of sample

records on which the estimate is

based (referred to as the sample size)

are used to identify estimates with

relatively low reliability. Based on

consideration of the complex sample

design of the NHDS, the following

guidelines are used for presenting the

NHDS estimates:

. If the relative standard error of

an estimate is larger than 30

percent, the estimate is not

shown. Only an asterisk (*)

appears in the tables.

. If the sample size is less than 60,

the value of the estimate should

not be assumed to be reliable.

The estimate is preceded by an

asterisk (*) in the tables,

Sampling errors and rounding of

numbers

The standard error is primarily a

measure of sampling variability that

occurs by chance because onIy a

sample rather than the entire

universe is surveyed. The relative

standard error of the estimate is

obtained by dividing the standard

error by the estimate itself and is

expressed as a percent of the

estimate. The resuhing value is

multiplied by 100, so the relative

standard error is expressed as a

percent of the estimate.

Estimates of sampling variability

were calculated with SESUDAAN

software, which computes standard

errors by using a first-order Taylor

approximation of the deviation of

estimates from their expected values.

A description of the software and the

approach it uses has been

published (4).
10 Advance Data No. 199 ● April 9, 1991

Table L Approximate relative standard

errorsof estimated numbers of discharges

and diagnoses United States, 1989

.4

Size of estimate ages

5,000 . ., . . . . . . ..!...... 31.4

10,000 . . . . . . . . . . . . . . . . . 22.5

50,000, . . . . . . . . . . . . . . . . 11.2

100,000. . . . . . . . . . . . . . . . . 8..9

500,000, . . . . . . . . . . . . . . . . 6.7

I,ooo,om . . . . . . . . . . . . . . . 5.6

3,000,0C0 . . . . . . . . . . . . . . . 5.5

5,000,000 . . ! . . . . . . . . . . . . 5.5

10,000,000 . . . . . . . . . . . . . . 5.4

20,000,000. . . . . . . . . . . . . . . 5.4

30,000,000 . . . . . . . . . . . . . . 5.4

40,000,000. . . . . . . . . . . . . . . 5.4

Table I provides the estimate of

sampling variability for discharges and

first-listed diagnoses. Table II

provides the estimates of sampling

variability byali-listed procedures for

patients under15 years ofage and all

other variables.

Estimates have been roundedto

the nearest thousand. For this reason,

figures within tables do not always

add to the totals. Rates and average

Iengths of stay were calculated from

original, unrounded figures and will

not necessarily agree precisely with

rates or average Iengths ofstay

calculated from rounded data.

Tests of significance

Inthisreport, statistical inference

is based on the two-sided test with a

critical value of 1.96 (0.051evel of

significance) . Terms such as’’higher”

and “less” indicate that differences

are statistically significant, Terms

such as “similar” or “no difference”

mean that no statistically significant

difference exists between the

estimates being compared. Alackof

comment on the difference between

any two estimates does not mean that

the difference was tested and found

not to be significant.

Terms relating to

hospitalization

Hospitals– AH hospitals with an

average length of stay for all patients

of less than 30 days or hospitals

whose specialty is general (medical or

surgical) or children’s general are

eligible for inclusion in the National

Hospital Discharge Survey, except

Federal hospitals, hospital units of

institutions, and hospitals with less

than six beds staffed for patients’ use.

Patient – A person who is formally

admitted to the inpatient service of a

short-stay hospital for observation,

care, diagnosis, or treatment. The

terms “patient” and “inpatient” are

used synonymously.

Newborn infant– A patient

admitted by birth to a hospital.

Discharge– The formal release of

a patient by a hospital; that is, the

termination of a period of

hospitalization by death or by

disposition to place of residence,

nursing home, or another hospital.

The terms “discharges” and “patients

discharged” are used synonymously.

Discharge rate– The ratio of the

number of hospital discharges during

a year to the number of persons in

the civilian population on July 1 of

that year.

Days of care– The number of

patient days accumulated at time of

discharge by a patient. A stay of less

Table Il. Approximate relative standard errors of estimated numbers of all-iisted

procedures: United States, 1989

Under 15 All

Size of esfmafe years of age other ages

5,000, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32.1 30.8

10,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25.0 22.3

50,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.2 11.6

100,000. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.7 9.4

500,000.,.......,,........,,,. . . . . . . 13.4 7.3

1,000,000 . . . . . . . . . . . . . . . . . . . . . . . . . . 13.3 7.0

3,000,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.1 6.7

5,000,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.7

10,000,000. . . . . . . . . . . . . . . . . . . . . . . . .

. . .

6.7

20,000,000. . . . . . . . . . . . . . . . . . . . . . . . . . .

. .

6.6

30,000,000. . . . . . . . . . . . . . . . . . . . . . ...,,

.

6.6

40,000,000, ...,,.,.....,.. .

. . .

6.6

than 1 day (patient admission and

discharge on the same day) is

counted as 1 day in the summation of

total days of care. For patients

admitted and discharged on different

days, the number of days of care is

computed by counting all days from

(and including) the date of admission

to (but not including) the date of

discharge.

Average length of stay – The

number of days of care accumulated

by patients discharged during the year

divided by the number of these

patients.

Terms relating to diagnoses

Diagnosis- A disease or injury (or

factor that influences health status

and contact with health services that

is not itself a current illness or inju~)

on the medical record of a patitint.

Principal diagnosis - The condition

established after study to be chiefly

responsible for occasioning the

admission of the patient to the

hospital for care.

First-listed diagnosis– The coded

diagnosis identified as the principal

diagnosis or listed first on the fiace

sheet or discharge summary of the

medical record if the principal

diagnosis cannot be identified. The

number of first-listed diagnoses is

equivalent to the number of

discharges.

Terms relating to procedures

Procedure– A surgical or

nonsurgical operation, diagnostic

procedure, or special treatment

reported on the medical record of a

patient. The following ICD-9-CM

procedure codes are not used in the

the NHDS:

08.19, 16.21, 18.01, 18.11, 18.19,21.21,

21.29,22.19,24.19,25.09, 25.91,26.19,

27.29, 27.91,29.19, 31.48-31.49,37.29,

41.38-41.39,42.29,44.19, 45.19,

45.28-45.29,48.23,48.29, 49.21,49.29,

49,41,58.29, 61.19, 64.19, 64.91,64.94,

69.92, 70.21,73.91-73.92, 75.35,85.19,

86.19, 86.92, 87.09437.12, 87.16-87.17,

87.22-87.29,87.36-87.37, 87.39,
Advance Data No. 199 ● April 9,1991 11

87.43-87.49,87,69, 87.79,87.85-87.89,

87.92,87.95-87.99, 88.09,88.16-88.31,

88.33,88.35,88.37,88.39,89.01-89.13,

89.15-89,16,89.26-89.31,3-89.39,

89.45-89.53,89.55-89.59,6689.7,

90.01-91.99,93.01-93.25,7-93.28,

93.31-93.39,93.42-93.44,61-93.91,

93.94,93.96,93.99-94.23,94.25,

94.29-95.03,95.05-95.11,4-95.15,

95.31-95.49,96.09-96.19,26-96.28,

96.34-97.04, 97.14-97.69,97.72-97.89,

99.02-99.24, 99.26-99.59,99.71-99.79,

Demographic terms

Population – The U.S resident

population excluding members of the

Armed Forces.

Age– Patient’s age at birthday

prior to admission to the hospital.

Geographic reg”on– Hospitals are

classified by location in one of the

four geographic regions of the United

States that correspond to those used

by the U.S. Bureau of the Census.

99.82-99.99, Region

All-listed procedures – The number Northeast. .

~f Procedures on the fare sheet of

the medical record, In the NHDS a

maximum of four procedures are

coded.

Rate of procedures-The ratio of

the number of procedures during a

year to the number of persons in the Midwest . . .

civilian population on July 1 of that

year determines the rate of

procedures.

States included

Maine, New Hampshire,

Vermont,

Massachusetts, Rhode

Island, Connecticut,

N’ew York, New Jersey,

and Pennsylvania

Michigan, Ohio, I1linois,

Indiana, Wisconsin,

Minnesota, Iowa,

Region

South . . . . .

States included– Con.

hfissouri, North

Dakota, South Dakota,

Nebraska, and Kansas

Delaware, Maryland,

District of Columbia,

Virginia, West Virginia,

North Carolina, South

Carolina, Georgia,

Florida, Kentucky,

Tennessee, AIabama,

Mississippi, &kansas,

Louisiana, Oklahoma,

and Texas

West . . . . . . . Montana, Idaho,

Wyoming, Colorado,

New Mexico, Arizona,

~Ttah, Nevada,

Washington, Oregon,

California, Hawaii, and

Alaska
Number 200 . May 14, 1991

Advance

Data

From Vital and Health Statistics of the National Center for Health Statistics

AIDS-Related Knowledge and Behavior Among Women

15–44 Years of Age: United States, 1988

by James W. McNally, M.A., and William D. Mosher, Ph.D., Division of Vital Statistics

Changes in sexual behavior in

response to acquired immunodeficiency syndrome (AIDS) were

quite common in 1988. About 6.8

milIion sexually experienced

unmarried women (31 percent) had

made one or more changes in their

sexual behavior since hearing of

AIDS. Misconceptions concerning

some of the means of HIV (human

immunodeficiency virus)

transmission were fairly common

among women of reproductive age in

1988: for example, 11 million women

thought that they could become

infected with HIV (the virus that

causes AIDS) by giving blood, For

most of the items discussed in this

report, low-income women and nonHispanic black women were more

likely to have misinformation

concerning the means of HIV

transmission, and to say they had a

greater chance of contracting the

disease. These groups were also the

most likely to have reported making

some change in their sexual behavior

since hearing of AIDS.

These findings are from Cycle IV

of the NationaI Survey of Family

Growth (NSFG), conducted in 1988

by the National Center for Health

Statistics (NCHS). The survey was

based on personal interviews

conducted between January and

August of 1988 with 8,450 women

15-44 years of age in the civilian

noninstitutionalized population of the

United States. The NSFG interview

included information on a number of

topics related to childbearing, family

planning, and maternal and infant

health. The design of the 1988 sumey

and estimates of sampling errors are

discussed further in the Technical

notes.

In response to requests from

public health agencies for more

information on knowledge and

behavior related to HIV, the NSFG

included a series of questions

concerning the woman’s knowledge of

the means of HIV transmission,

changes in sexual behavior to avoid

infection, and the woman’s own

estimate of her chance of becoming

infected. Including these questions in

Cycle IV was considered important

because the NSFG obtains

information concerning the woman’s

marital history, sexually transmitted

disease (STD) history, and number of

lifetime sexual partners. Because

these variables are not available from

any other nationally representative

source, the NSFG provides an

important means for analyzing the

level of knowledge and behavior

change among women in groups at

risk of HIV infection.

This report covers three topics

related to HIV: a) misinformation

about I+IV transmission, b) changes

made in sexual behavior since hearing

of HIV, and c) perceptions of the

chances of becoming infected with

the AIDS virus.

Prior research suggests that

knowledge and behavior related to

the transmission of HIV differs

between white and bIack women, and

the findings of this report are

consistent with that (l-4). The

number of Hispanics in the NSFG

sample (641) is much smaller than

the 2,771 black women or the 5,354

white women in the sample. This

smaller sample size makes it

impossible to look at the data for

Hispanic women in the same detail as

*,v.vlcr*.

# %,

W.Q

#

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVIC~~

$ Public Health Service

s

s Centers for Disease Control

‘$%> Manning

National

Feinleib,

Center

M.

for

D.,

Health

Dr. P.

Statistics

H., Director

cm
2 Advance Data No. 200. May 14, 1991

that for non-Hispanic black and white

women. Thus, detailed data are

shown here for white and black

women, and summary data for

Hispanic women are cited in the text.

Data on AIDS related knowledge and

attitudes have been collected in

another NCHS survey, the National

Health Interview Survey (NHIS). The

wording and purpose of the AIDS

related questions in the NHIS, and

the population covered by it, \vere

different than those in the NSFG.

These differences, and the

comparability of the results, are

discussed in more detail in the

Technical notes, under “Other

sources of data.”

The overall level of

misinformation is quite Iow for most

of the measures shown in this report;

more than 85 percent of women gave

correct answers on most items. With

one exception, which will be discussed

later, the number of women reporting

that they did not know whether a

means of transmission could spread

the virus was Iess than 1 percent.

This suggests that at least some of the

\vomen giving correct answers may

have been guessing, so the proportion

of women with correct information

may be lower than the percent giving

correct answers. The estimates in this

report may be viewed, then, as

minimum estimates of the percent

with misinformation in 1988.

Findings

In the 1988 NSFG, all women,

including both married and

unmarried women were asked

“\Vhich activities listed on card 25

are ways in which a person can get

the AIDS virus? Just read me the

letter for those activities in which you

think a person can get the AIDS

virus.” The card listed the following

possible means of transmission:

A. Shaking hands or hugging?

B. Sharing hypodermic needles?

C. Sharing an apartment, classroom,

or office?

D. Receiving a blood transfusion?

E. Sexual intercourse between men?

F. Sexual intercourse between a man

and a woman?

G. Giving a blood donation?

H. Being bitten by an insect that has

bitten someone \vith the AIDS

virus?

1. Sharing personal items like dishes,

toilets, etc?

For all of these means of

transmission a response of “Yes,”

“>-0,” or “1 don’t kno~v” was

recorded. If she reported that one of

the above activities could cause HIV

transmission but, in fact, it cannot, or

if she reported that an activity could

not cause infection when, in fact, it

could, she is classified as having

“misinformation.” Tables 1 and 2

show the percent of women who had

misinformation. Measures are not

included for item A, “shaking hands

or hugging” or item C, “sharing an

apartment, classroom, or office”

because the proportion of women

holding misinformation on these

items was less than 5 percent of the

population and most of the

differences in the subgroups were too

small to be statistically significant.

HIV cannot be contracted by

donating blood (item G, above) (5).

Almost 20 percent of aIl women

15+4 years of age reported in 1988

that they could contract HIV if they

donated blood. This misbelief was

especially common among

non-Hispanic black women

(32 percent, table 1) and Hispanic

women (32 percent, not shown in

tables) compared with 15 percent of

non-Hispanic white women. Lowincome women were also more likely

to believe that they could contract

HIV by donating blood: 29 percent

compared with 17 percent of highincome women. Among low-income

non-Hispanic black women this

misinformation was even more

common (36 percent). This mistaken

belief could have public health

consequences if it deters women from

donating blood.

HIV cannot be transmitted by the

bite of an insect (item H, above) (5).

Although holding the belief that HIV

can be transmitted in this manner

does not put women at increased risk

of HIV infection, it does illustrate the

range of uncertainty that often

existed in 1988 about how the virus is

spread. Almost 22 percent of women

15-44 years of age reported that the

AIDS virus could be spread by the

bite of an infected insect. Strong

differences were found by both race

and income: 30 percent of

non-Hispanic black women said HIV

could be spread in this way,

compared with 19 percent of

non-Hispanic whites. Similarly,

27 percent of low-income women and

20 percent of high-income women

had this misinformation.

HIV cannot be spread by casual

contact such as sharing dishes or

toilets (item I, above) (5) and over

94 percent of women reported this

knowledge, Less than 6 percent of all

women reported a belief that a

person could be infected by HIV

through this kind of contact. This

misinformation is important because

it increases unwarranted concerns

about the way in which the disease

can be passed from one person to

another and thus, can affect the way

a person deals with others. Reducing

the level of this misinformation is a

major aspect of public education

efforts on the virus, and these results

reflect substantial success in this

regard. Differences by race, income,

and marital status are small, and aIl

groups showed levels of misinformation at or below 8 percent,

Currently married women appear to

be more knowledgeable about blood

donations and insect bites than

women not currently married. These

differences are both statistically

significant for women of all races.

Table 2 shows the percents of

unmarried women with misinformation about behaviors that can

transmit HIV infection. Married

women were not included in tahIe 2

because their average risk of

contracting HIV is generally lower

than the risk for unmarried women,

and because the behavior change

items in table 3 are shown only for

unmarried women. AII unmarried

women are included in table 2

because most become sexually active

at young ages (6).
Advance Data No. 200. May 14, 1991 3

Table 1. Number of women 1544 years of age and percent with misinformation about selected means of HiV/AiDS transmission, by

maritai status, poverty ievel income, and selected characteristics: United States, 1988

[Statistcs are based on samples of the female population of the Conterminous United States. See Technical notes for estimates of sampling variabilii and definitions

of demographic terms]

Mantel stafus Poverty level income

Less than 150

All Currently Formerfy Never 150

C%racteristics and means of transmission

percent

women married married married percent or more

Number in thousands

A!lvmmen’ . . . . . . . . . . . . . . . . . . . . . . . .

Unmarried women . . . . . . . . . . . . . . . . . .

Race:

Nan-Hispanic white . . . . . . . . . . . . . . . . . .

Ncm-Hispani cblack . . . . . . . . . . . . . . . . .

57,900

28,753

29,147 7,695

7,695

21,058

21,056

13,561

9,661

44,339

16,692

42,575

7,406

23,367

2,102

5,212

1,355

13,996

3,951

7,274

3,501

35,301

3,907

Receiving a blood transfusion

Allwcmen’ . . . . . . . . . . . . . . . . . . . . . . . .

Unmarried women . . . . . . . . . . . . . . . . . .

Race:

Non. Hispanic white . . . . . . . . . . . . . . . . . .

Non-Hispanic black . . . . . . . . . . . . . . . . . .

Percent

9.3

9.3

8.1

8.9

7.3

. . .

6.1

11.1

7.8

7.8

11.6

11.9

7.1

7.4

6.5

12.7

6.4

10.8

7.1

14.2

●8.1

16.6

6.2

9.2

Giving a blood donation

Allwomen’ . . . . . . . . . . . . . . . . . . . . . . . .

Un.married women . . . . . . . . . . . . . . . . . .

16.9

. . .

13.8

28.3

21.6

21.6

22.3 28.8 16.7

22.3 28.8 18,6

17.3 23.6 13.7

34.4 35.9 26.6

19.5

22.1

Race

Non-Hispanic white . . . . . . . . . . . . . . . . . .

Non-Hispanic black . . . . . . . . . . . . . . . . . .

15.4

32.1

17.5

31.5

Being btien by an infected insect

Allwo.men’ . . . . . . . . . . . . . . . . . . . . . . . .

Unmarried women . . . . . . . . . . . . . . . . . .

Race:

Non-Hispanic white . . . . . . . . . . . . . . . . . .

Non-Hispanic black . . . . . . . . . . . . . . . . . .

22.7

22.7

21.6

24.6

18.6

. . .

17.3

26.9

25.3 27.3 19.8

25.3 28.4 22.6

22.1 22.9 18,4

31.5 32.6 27.3

19.2

29.6

19.9

29.5

Sharing dishes, toliet, food

Alfwomen’ . . . . . . . . . . . . . . . . . . . . . . . .

Unmarriedwomen . . . . . . . . . . . . . . . . . .

Race:

Non-Hhpanicwhite . . . . . . . . . . . . . . . . . .

Non-Hispanicblack . . . . . . . . . . . . . . . . . .

5.8

5.8

5.8

. . .

4.6

7.9

6.2

6.2

5.7 7.9 5.2

5.7 8.1 4.6

4.5 ●7.3 4.4

7.4 7.7 6.8

4.9

7.2

5.9

5.6

‘Includes non-Hspan!cwhite,non.H!spanicblack.Hspsnic, and otherraces Hispanicsand o!herracesnotshowmseparately.Alsoincludescurrers!lymarriedwomen,

NOTE:Becauseofroundingof estmates, figuresmaynotaddto totals.

The measure “number of lifetime

sexual partners” in table 2is derived

from the NSFG question “Thinking

back, with how many men have you

had intercourse in your Iife?”. The

number of lifetime sexual partners

has at least two analytic limitations:

first, it is not the same as the number

of current sexial partners. Only about

7 percent ofunmarried womenin

most subgroups had 2 sexwal partners

or more in the 3 months prior to the

sunfey. However, about 17 percent of

unmarried women with 10 lifetime

partners or more had more than one

partner in the last 3 months (not

shown in tables). The second

limitation of this measure of the

number of Iifetime partners is that it

does not reveal when women had

those partners. For example, a

woman with 10 lifetime partners or

more may have had all of them prior

to the introduction of HIV into the

United States; she may not be at high

risk.

Three means of transmission

account for most adult HIV cases: the

sharing or using of tainted hypodermic needles used to inject illegal

drugs, homosexual intercourse, and

heterosexual intercourse (1,5,7-9),

Data on misinformation about these

means of transmission are shown in

table 2. The use of contaminated

needles is a special public health

concern because HIV is transmitted

through both the needle itself and

through sexual activity with persons

infected by the needle (7). About

10 percent of unmarried women

reported the belief that the AIDS

virus cannot be spread through

sharing hypodermic needles (item B,

above), and differences by race and

income were large. Only 7 percent of

non-Hispanic white women reported

this misinformation compared with

16 percent of non-Hispanic black

women and 17 percent of Hispanic

women. About 8 percent of highincome women reported this belief

compared with 14 percent of

low-income women. The level of

misinformation about transmission by

needles varied little by number of

sexual partners for unmarried women

with 1-9 lifetime partners, but

unmarried women with 10 lifetime

partners or more were less likely to

be misinformed (5 percent compared

with 10-12 percent). This was true in

each race and income group (but the
4 Advance Data No. 200. May 14, 1991

Table 2. Number of unmarried women 1544 years of age and percent with misinformation about selected means of HIV/AIDS

transmission, by number of lifetime sexual partners and seiected characteristics: United States, 1988

[Statistics are based on samples of the female population of the conterrninous United States. See Technical notes for estimates of sampling variabllii and definitions

of demographic terms]

All 10

unmarriyd Never had 1 2-4 5-9

Characteristics and means of transmission

partners

women intercourse partner partnem partners or more

Number in thousands

Allunmarr!ed women2 .,...... . . . . .

Race:

Non-Hispanic white . . . . . . . . . . . . . . . . . .

Non-Hispanic black . . . . . . . . . . . . . . . . . .

Poverty level income:

Less !han150Dercent . . . . . . . . . . . . . . . .

150percent or more..,....,.. . . . . . . .

28,753 6,735 4,296 7,742 5,165 4,121

19,208

5,306

4,612

719

2,667

562

4,923

1,648

3,318

1,298

3,035

645

9,661

16,892

2,028

4,707

1,510

2,785

2,797

4,945

1.811

3,353

1,40s

2,713

Sharing hypodermic needles

Allunmarr!ed womenz . . . . . . . . . . . . . . . . .

Race:

Non-H!spanic white, . . . . . . . . . . . . . . . . .

Non-Hispanic black . . . . . . . . . . . . . . . . .

Poverty level income:

Lessthan 150 percent . .,,....., . . . . .

150percent or more . . . . . . . . . . . . . . . .

Percent

10.0 9.5 12.2 11.2 10.2 5.4

6.8

16.0

6.1

10.1

8.3

21.1

7.6

17.4

6.4

17.1

4.1

13.2

16.0

6.6

18.8

6.6

13.6

8.3

●6.1

5.0

14.1

7.9

14.1

9.6

Homosexual intercourse

Allunmarried women2 ...,,.. . . . . . . .

Race:

Non-Hispanic white . . . . . . . . . . . ,. ...,.

Non-Hispanic black . . . . . . . . . . . . . . . . .

Poverty level income:

Less than 150 percent . . . . . . . . . . . . . . . .

150percent or more . . . . . . . . . . . . . . . .

5.7 5.2 4.9 6.4 5.1 3.0

3.7

11.1

3.4

10.8

●2,6

11.2

6.2

12.7

3.6

9.7

●1.4

9.5

*5.9

●1.5

6.0

4.4

●5.5

5.0

7.8

●3.3

11.9

6.4

6.9

4.1

Heterosexual intercourse

Allunmarried womenz . . . . . . . . . . . . . . . .

Race:

Non-Hispanic white . . . . . . . . . . . . . . . . . .

Non-Hispanic black . . . . . . . . . . . . . . . . .

Poverty level income:

Lessthan 150 percent . . . . . . . . . . . . . . . .

150percent or more . . . . . . . . . . . . . . . .

6.9 5.4 9.2 9.0 5.7 4.7

5.4

12.0

3.6

10.2

6.6

18.3

0.1

12.3

4.1

10.6

3.9

9.4

6.5

6.1

7.5

4.5

11.1

8.1

10.4

8.3

●5.5

5.8

*6.8

*3.6

Getting AIDS from an HIV positive person

Allunmarried womenz . . . . . . . . . . . . . . . . .

Race:

Non-Hispanic white . . . . . . . . . . . . . . . . . .

Non-Htspanic black . . . . . . . . . . . . . . . . .

Poverty Iavel income:

Less than 150 percent . . . . . . . . . . . . . . . .

150percent or more . . . . . . . . . . . . . . . . .

29.0 27.5 30.8 31.7 30.2 22.6

25.2

39.6

18.7

30.4

24.5

37.8

24.6

42.0

24.0

40.0

27.6

37.3

36.6

24.9

36.6

23.6

42.8

24.4

38.1

26.1

36.6

26.7

26.1

19.8

‘Includes women whose number of hfetlmesexual partners was not ascertained, not shown separately.

21ncludes non-H! span] cwhile, non-Htspank2 black, Hispanic, andother races: Hispanic andother races notshownseparateQ.

NOTE: Because of rounding ofest!mates, figures maynotactd lo totals.

differences were not statistically

significant in each group). Thus,

unmarried \vomen who are at greatest

risk also seem to be more

knowledgeable about the dangers

associated with sharing hypodermic

needles.

Homosexual intercourse (item E,

above) can be a means of

transmitting HIV, and, as reflected in

table 2, about 9-! percent of

unmarried \vomen reported a correct

answer for this question; only

6 percent did not. Knowing that

sexual intercourse between men can

transmit the AIDS virus is important

for women because it points to the

importance of knowing their sexual

partners. Knowledge about this risk

was very high, but misinformation

concerning it varied significantly by

race and income. Only 4 percent of

unmarried non-Hispanic white women

thought that homosexual intercourse

could not result in HIV transmission,

but 11 percent of non-Hispanic black

and 8 percent of Hispanic women

thought that it could not spread the

virus. There is no clear pattern by

number of lifetime sexwal partners,

but misinformation about homosexual

transmission is rare among unmarried

white and high-income women with

10 partners or more.

HIV can also be transmitted by

heterosexual intercourse (item F)

(5,8) and this was reported correctIy

by 93 percent of unmarried women

(table 2). Only 7 percent reported

that a person could not be infected in

this way. Again, however, the

differences in misinformation by race

are notable: Only 5 percent of

non-Hispanic white women, 7 percent

of Hispanic women, and 12 percent
Advance Data No. 200. May 14, 1991 5

of non-Hispanic black women said

that heterosexual intercourse could

not spread HIV. The proportion with

misinformation was about 9 percent

for unmarried w’omen with one to

four Iifetime sexual partners and

5 percent for those women with 10

lifetime partners or more. Thus,

unmarried women at greatest risk of

HIV infection – those with the highest

number of sexual partners (10) —were

the least likely to be misinformed.

The most striking finding in

table 2 concerns the responses to the

question: “Can a person get AIDS

from someone who has only the

AIDS virus but does not have the

disease?”. This question is important

because the population of

HIV-positive individuals is much

larger than the population with

recognized symptoms of AIDS (11).

About 29 percent of unmarried

women either reported that HIV

could not be transmitted in this way,

or that they did not know whether it

could be transmitted in this way. This

represents more than 8 milIion

unmarried women.

The differences by race were

large: 25 percent of non-Hispanic

white women reported this misbelief,

compared with 38 percent of

non-Hispanic black women (tabIe 2)

and 44 percent of Hispanic women

(not shown in tables). The differences

by income were also Iarge: 25 percent

of those with high income compared

with 37 percent of low-income

women. For both race groups and

both income groups, the percent who

had misinformation or did not know

was lower for unmarried women with

10 partners or more than for women

with 1–9 partners: 30 percent of

women with 5–9 lifetime partners

reported that HIV could not be

contracted from an individual ~~ho

had only the HIV infection or did not

know, compared with 23 percent of

women with 10 partners or more.

Table 3 contains results from a

series of NSFG questions that

examined changes that women have

Table 3. Number of unmarried women 1S44 years of age who have ever had intercourse and percent who have made some change in

their sexual behavior since hearing of HIVI’AIDS, bv marital status. number of lifetime sexual Dartners. oovertv level income. and seiected

characteristics: United States, 1983

. . . . .

[Statistics are based on samplesof the female poy.dationof the conterminousUnitedStates.See Technicalnotes for estimates of sampling variability and definitions

of demographic terms]

Poverty

Marital status Number of /ifefime sexual partnera level income

All 10

unmarr;ed Former/y Never 1 24 5-9 partners Less than 150 percent

Characteristics and means of transmission women’ rnarned married partner partners partners or more 150 percent or more

All unmarriedwomen who have ever had intercoumez . . . .

Race:

Ncm-l-fispan icwhit e . . . . . . . . . . . . . . . . . . . . . . .

Non-l-fispan icblac k . . . . . . . . . . . . . . . . . . . . . . .

Stopped having intercourse?

Allunmarried women2 . . . . . . . . . . . . . . . . . . . . . . . .

Race

Non-Hispanic white . . . . . . . . . . . . . . . . . . . . . . . . .

Non-Hispantc black . . . . . . . . . . . . . . . . . . . . . . . . .

Reduced frequency of sex?

Allunmarried women2 . . . . . . . . . . . . . . . . . . . . . . . .

Race:

Non-Hispanic whhe . . . . . . . . . . . . . . . . . . . . . . . . .

Non-Hispanic black . . . . . . . . . . . . . . . . . . . . . . . . .

Restricted sexual partners to one man?

Allunmarried women2 . . . . . . . . . . . . . . . . . . . . . . . .

Race:

Non-Hwpanlc white . . . . . . . . . . . . . . . . . . . . . . . . .

Non-Hispanic black . . . . . . . . . . . . . . . . . . . . . . . . .

Restricted sex to men you know well?

Allunmarried women2 . . . . . . . . . . . . . . . . . . . . . . . .

Rac~

Non-Hispanic white . . . . . . . . . . . . . . . . . . . . . . . . .

Non-l-fispan lcblac k . . . . . . . . . . . . . . . . . . . . . . .

22,018

14,596

4,566

5.5

4.8

7.2

9.3

7.7

34.7

15.6

13,7

20.3

11.5

11.8

11.1

31.0

27.6

41.1

7,695

5,212

1,355

6.2

5.7

7.9

9.6

8.6

12.0

15.7

14.1

20.8

13.7

13.7

14.3

32.4

30.0

40.7

14,323

9,384

3,231

5.1

4.3

6.9

9.1

7.2

15.6

15,5

13.7

20.2

10.3

10.7

9.7

30.3

26.2

41.3

4,296

2,887

562

6.6

4.a

12.1

5.7

4.4

12.9

4.2

●1.6

10.2

●1.8

●1.1

●3.3

16.5

11.3

34.4

7,742 5,165

4,923 3,318

1,646 1,296

Percent

5.9

4.4

9.7

6.0

5.1

14.8

12.0

9.5

17.2

6.1

4.7

8.3

25.9

19.5

40.4

4.2

4.1

●4.O

9.2

7.0

16.1

1a.6

16.0

21.9

12.7

12.7

13.4

34.1

30,8

40,5

4,121

3,035

645

5.0

5.9

●2.3

16.2

16.3

14.6

29.1

26.7

33.1

29.1

306

22.0

504

51.0

49.6

7,633

3,770

2,717

5,4

5.9

5.7

13.7

12.3

16.1

16.5

16.5

21.5

12.6

13.5

13.0

37.3

34.4

43.4

14,185

10,826

1,869

5.5

4.4

9.3

6.9

6.1

12.5

13.9

12.7

18.7

10.9

11.2

8.3

Made one change or more3

Allunmarried womenz . . . . . . . . . . . . . . . . . . . . . . . .

Race:

Non. Hispanic while . . . . . . . . . . . . . . . . . . . . . . . . .

Non-Hispanic black . . . . . . . . . . . . . . . . . . . . . . . . .

‘Includes women whose number of I!fet[me sexusl partners was not ascerfamed, M! shown separately.

21ncludes Hmpenic, nomHzspanlcwhle, “oml+spamc blec~, and other races Hlspanm and other racea are not shown separately.

31ncludes women who made tha ~ha”ge~ $peclf,ga akve aS well as women who sto~ped having intercourse w!th bisexual men or with men who used Intravenous arugs, not shown Sepsralely.

NOTE Because of round!ng of eshmates, rlgures may no! acd 10 totals.

27.5

25.2

37.8
6 Advance Data No. 200. May 14, 1991

made in their sexual behavior to

avoid infection with HIV. All women

who had ever had intercourse were

asked the question, “To keep people

from catching diseases such as genital

herpes, chlamydia or AIDS, doctors

have suggested several changes

people can make in their sexual

behavior, In which of the ways shown

on card 27, if any, have you changed

your sexual behavior?”.

Women who reported that they

had made changes in their behavior

out of concern over these sexually

transmitted diseases were then asked

a followup question: “Which of these

changes, if any, have you made since

you first heard about AIDS?”. The

changes that these women could have

reported since hearing of AIDS were:

A. Stopped having sexualintercourse?

B. Stopped having other types of

sexual relations?

C. Don’t have sex as often?

D. Stopped having sex with more

than one man?

E. Stopped having sex with men I

don’t know well?

F. Stopped having sex with men who

are bisexual?

G. Stopped having sex with men who

use needles to take drugs?

(or) Have made no changes.

Table 3 contains the responses of

unmarried women who had ever had

intercourse to these questions. The

answers were tabulated to show the

proportion who made these changes

specifically since hearing of AIDS.

Women who reported no change in

their sexual behavior since hearing of

AIDS were not necessarily engaging

in any of the listed behaviors when

interviewed. All we know is that they

have not made changes in their sexual

behavior out of a concern about

AIDS.

Only 3 percent of married

women reported any changes in their

behavior, compared with 31 percent

of unmarried women, so table 3

includes only unmarried women. Less

than 2 percent of unmarried women

reported that they had stopped

engaging in “other types of sexual

relations” (other than heterosexual

intercourse), or had stopped having

intercourse with bisexual men or men

who used intravenous drugs, so these

categories are not shown separately in

table 3, although women who

changed these behaviors are included

in the percent who made one or more

changes.

The most frequent change

reported in table 3 was that of

unmarried women reducing their

number of sexual partners to one

man: 16 percent of unmarried women

15-44 years of age reported this

change; 6 percent reported that they

had stopped having sexual intercourse

entirely, 9 percent had reduced their

frequency of intercourse, and

12 percent stopped having intercourse with men they did not know

well. The percents of these women

add up to more than the percent of

women who made one or more

changes because some unmarried

women made more than one change.

About 20 percent of unmarried

non-Hispanic black women compared

with 14 percent of non-Hispanic

white women had stopped having

intercourse with more than one man

(table 3).

In table 3 there is a uniform

pattern of change by number of

sexual partners. With the exception of

women who reported that they had

stopped having sexual intercourse

entirely since hearing of AIDS, there

is a dramatic increase in the percent

of women changing their sexual

behavior as their number of lifetime

sexual partners increases. For

example, 12 percent of women with

2-4 lifetime partners reported that

they had stopped having sex with

more than one man, compared with

29 percent of women with 10

partners or more. This is also true for

women who reported that they had

restricted their sexual partners to

men whom they knew well: Only

6 percent of women with 2-4 lifetime

partners reported this change

compared with 29 percent of women

with 10 lifetime partners or more.

The percents of women with one

lifetime sexual partner who reported

that they had restricted their partners

to one man (4 percent) or restricted

intercourse to men they knew well

(2 percent) since hearing of AIDS

are low, but they may be interpreted

in one of two ways: (a) they may have

understood the question to ask what

they will do in the future or may have

decided to restrict their sexual activity

to their current and only partner, and

(b) they may have rejected

opportunities to engage in intercourse

with other men out of concern about

HIV infection. Although 31 percent

of unmarried women reported that

they had made one or more changes

in their sexual behavior since hearing

of AIDS, statistically significant

differences existed by number of

partners, income, and race.

Low-income women were more Iikely

to say they had made one or more

changes than high-income women

(37 percent compared with

28 percent). About 41 percent of

non-Hispanic black women and

28 percent of unmarried

non-Hispanic white women reported

making one or more changes siince

hearing of AIDS (table 3).

There is a striking increase in the

proportion of women reporting one

or more changes by number of

partners: 17 percent of unmarried

women with one lifetime partner

reported that they had made one or

more changes, compared with

50 percent of women with 10

partners or more. This pattern is also

found for non-Hispanic white women:

11 percent of those with one partner

had made one or more changes,

compared with 51 percent of tlnose

with 10 partners or more. Among

non-Hispanic black women this

pattern was less pronounced:

34 percent of those with one partner

versus 50 percent of those with 10

partners or more. As was seen in the

other measures of change for tlhose

women with one lifetime partner, the

percent of these women who report a

change may reflect actual change,

such as stopping sexual activi~

entirely, or reporting their

expectation to make a change in their

future behavior if they find

themselves with the choice of having
Advance Data No. 200. May 14, 1991 7

sex with a potentially high-risk

partner.

Table 4 contains the responses of

women of all marital statuses to the

question “What wouId you say are

the chances that you could get AIDS?

Would you say that you have. . .

A. A ve~ strong chance,

B. A strong chance,

C. Some chance,

D. Not much chance, or

E. No chance at all?”

Two of every five women 15-44

years of age (41 percent) said they

had “no chance at all” of contracting

AIDS, another two in five

(40 percent) said they had “not much

chance”, whereas 17 percent said

they had some chance and 2 percent

said they had a strong or very strong

chance. Women with one lifetime

sexual partner were most Iikely to

report that they had no chance at all

of contracting HIV (51 percent)

compared with 27 percent of women

with 10 lifetime sexual partners or

more. Non-Hispanic black women

were slightIy more likely than

non-Hispanic white women to report

that they had no chance of

contracting AIDS (44 percent

compared with 39 percent). This

perception is not, however, consistent

with available evidence that black

women are more Iikely to develop

AIDS than white women (1,7,8).

Low-income women and black

women were twice as likely as highincome women to say that they had a

“strong chance” of contracting the

AIDS virus, but the percents were

small. The percent of women who

had ever had intercourse who

reported “some chance” of

contracting the AIDS virus increased

as the number of lifetime sexual

partners increased (13 percent for

those with 1 lifetime partner to

23 percent for those with 10 or

more).

Currently married women were

the most likely of all marital statuses

to say that they had “no chance at

alI” of contracting AIDS (45 percent

compared with 36-37 percent of

never married or formerly married

women). Both categories of

unmarried women were more likely to

Table 4. Number of women 15-44 years of age who have ever heard of AIDS and percent distribution by perceived risk of contracting

the human Immunodeficiency virus (HIV/AIDS), according to selected characterlstic~ United States, 1988

[Statistics are based on samples of the female population of the conterminous United States. See Technical notes for estimates of sampling variabilii and definitions

of demographic terms]

Marital status Number of lifetime sexual partners Pover2y level income

Charactetisfics and 10 Less than

perceiw?d risk AIl

150

Current/y Formerly Never Never had 1 24 5-9 partners 150 percent

of cmntrscting A/DS wwmer+ mam”ed mam’ed married intercourse partner parfrrem partners or more percent or more

Aflwomen2 . . . . . . . . . . . .

Unmarried women . . . . . .

Race:

Non-Hispanic whie. . . . . .

Non-Htspanic black. . . . . .

Strong chance

Aflwomen2 . . . . . . . . . . . .

Unmarried women . . . . . .

Race:

Non-Hispanic whfte. . . . . .

Non-Hispanic black. . . . . .

Some chance

Aflwomen2 . . . . . . . . . . . .

Unmarried women . . . . . .

Race:

Non-Hwpanic whte. . . . . .

Non-Hispanic black. . . . . .

Not much chance

Aflwomen2 . . . . . . . . . . . .

Unmarried woman . . . . . .

Race

Non-Hispanic whtie. . . . . .

Non-Hispanic black. . . . . .

No chance at all

Allwomen2 . . . . . . . . . . . .

Unmarried women . . . . . .

Race:

Non-Hispanic whiie. . . . . .

Non-Hispanic black. . . . . .

57,567

26,589

42,426

7,336

2.3

3.4

1.7

5.3

17.4

20.6

17,5

19.5

39.6

39.6

41.9

31.5

40.7

36.4

38.8

43.7

28,978

. . .

23,297

2,066

1.2

. . .

0.9

3.3

14.2

. . .

14.3

18.1

39.7

. . .

41.6

31.6

44.9

. . .

43.2

47.1

7,63s

7,636

5,166

1,333

3.5

3.5

3.2

6.8

21.7

21.7

22.7

20.6

36.6

38.6

39.8

33.6

36.2

36.2

34.3

38.6

20,951

20,951

13,942

3,919

3.3

3.3

2.6

5.8

20.2

20.2

21.0

19.8

40.0

40.0

43.1

30.8

36.5

36.5

33.2

43.6

Number in thousands

6,691 16,417 17,069

6,691 4,263 7,676

4,575 12,215 12,517

714 1,162 2,728

Percent distribution

2.7 1.2 2.9

2.7 *2.2 3.7

●2.6 ●0.6 ●2.4

●3.9 5.3 4.8

17.6 12.5 17.1

17,6 14.2 19.5

16.7 12.8 17.8

14.6 12.8 18.4

37.7 35.6 39.8

37.7 35.6 39.6

41.3 38.1 41.5

24.4 27.9 32.6

42.0 50.7 40.3

42.0 48.0 37.2

37.4 48.6 36.2

57.0 54.0 44.3

9,367

5,157

6,855

1,682

2.3

3.6

*1.3

5.2

21.2

23.5

20.9

22.6

43.0

41.4

44.8

34.2

33.5

31.5

33.0

38.0

6,767

4,118

5,364

786

3.3

5.0

2.8

7.5

23.4

28.5

21.6

29.8

46.1

45.2

48.1

33.0

27.2

21.3

27.4

29.7

13,429

9,781

7,237

3,465

4.4

5.0

3.8

5.7

18.9

20.7

19.6

19.0

33.5

35,7

36.8

29.1

E

39.8

46.2

44,138

18,808

35,189

3,873

1.7

2.5

1.3

4.9

16.9

20.6

17.1

20.0

41.5

41.6

43.0

33.7

39.9

35.2

38.6

41.4

.

‘IncludeswomenMose numberof Itfet$mesexuslpartnerswss notescerlamed,notstw.m separately.

2

Includes non+ilspanic white, “on.l+spanic black, Fhspanlc, and other races: I+spanic and other races not ~hmn S.epwafe&. AISO in~udes c~rrentfy married wmen.

NOTE Because of rounding of estlmales, figures may not add to totals.
8 Advance Data No. 200 ● May 14, 1991

report that they had a strong chance

of contracting the AIDS virus than

married women (34 percent

compared with 1 percent), or some

chance (20-22 percent compared with

14 percent).

STD history

The number of women who

reported to the 1988 NSFG that they

had ever had a sexuaHy transmitted

disease (STD) was too small to

analyze by number of sexual partners

and other variables. However, a

woman’s STD history is an important

means of measuring her risk for HIV

infection, so summary tabulations

using STD history are shown in

table 5. A woman was classified as

ever having an STD if she responded

affirmatively to one of the following

questions:

“Has a doctor ever told you that

you have genital warts?”

“Has a doctor ever told you that

you have gonorrhea?”

Table 5. Number of women 1S44 years of age in seiected categories and percent with

misinformation about the means of HiV/AIDS transmission, percent who made changes in

sexual behavior since hearing of HIV/AIDS, and percent distribution by perceived risk of

acquiring AIDS, according to STD history and age: United States, 1988

[Statistics are based on samples of the female population of the conterrninous United States. See Technical

notes for estimates of samplmg variability and definitions of demographic terms]

Ever had Never had 15-19 20-44

Se/ected characteristba an STD’ an STD’ years yeara

.4!I women . . . . . . . . . . . . . . . . . . . . .

Misinformation

Receiving a blood transfusion?z. . . . . . .

Grving a blood oonation?z . . . . . . . . .

Being bitten by an infected insect?2 . .

Snaring dishes, toilets, and food?z . . . . . . .

Unmarried women . . . . . . . . . . . . . . . . .

Sharing hypodermic needles?3 . . . . . . . .

Homosexual mtercourse?3 . . . . . . . .

Heterosexual intercourse?3. . . . . . . . .

Getting AIDS from an HIV positive person?3’4

Unmarried, sexually experienced women . . .

Changes in behavior

Stopped having intercourse?5 . . . . . . . . . .

Reduced frequency of sex?5 . . . . . . . . . . .

Restricted sex to one man?5 . . . . . . . . . .

Restricted sex to men you know well?5 . . . .

Made one or more changes5. . . . . . . .

Women who have heard of AIDSa. . . . . . . .

Chances of getbng AIDS

Total . . . . . . . . . . . . . . . . . . . . . . . . . .

Strong orve~strong?2 . . . . . . . . . . . . . .

Some chance? z . . . . . . . . . . . . . . . . . . .

Notmuch chance?z . . . . . . . . . . . . . . . .

Nochance atall?2, . . . . . . . . . . . . . . . .

4,226

6.9

“16.0

21.6

‘3.3

2,224

*7. 1

*3.4

*4.O

23.8

2,224

*5.4

“12.8

25.5

21.7

42.9

2,687

100.0

*3.9

24.5

45,9

25,7

Number in thousands

53,674 9,179

Percent

8.2 10.3

19.6 24.3

21.6 28.3

6.0 6.1

Number in thousands

26,526 6.667

Percent

10.2 10.7

5.8 6.0

7.2 5.5

29.3 29.5

Number in thousands

19,776 4,544

Percent

5.5 5.6

8.9 11.9

14.5 13.3

10.4 8.4

29.7 31.7

Number in thousands

54,881 9,146

Percent distribtilon

100.0 100.0

2.2 3.8

16.8 18.5

39.1 39.5

41.9 36.2

48,721

7.7

18.6

20.3

5.8

19,886

9.7

5.5

7.5

28.6

17,456

5.4

e.6

16.2

12.3

30.8

48,421

100.0

2.0

17.2

39.7

41.2

1Sexually Iransm]zed disease, mcludlng gonorrhea, genital herpes, chlamydla, or genital warts

21nclude~ women Of all mamal statuses.

3

includes only un_carned women,

4“HIV posmve person” IS a person wtth the AIDS (HIVI vwus, but not the disease.

51ncludes only sexually experienced unmarned women.

%cludes women vmh m!ssmg data on whether they had heard of AIDS.

NOTE: Because c! rounding of estrmates, hgures may not add to totals.

“Has a doctor ever toId you that

you have genital herpes?”

“Has a doctor ever told you that

you have chlamydia?”

Women were classified as never

having had an STD if they responded

negatively to all four of these

questions.

A history of STD has a small but

consistent effect on the percent with

misinformation on the means olf HIV

transmission (table 5), Only two of

the differences are statistically

significant at the 5-percent level

(“sharing dishes, toilets, and food,”

and “Heterosexual intercourse, ”

table 5), but the pattern is consistent:

In every comparison but one, women

who had an STD appear to be less

likely to have misinformation about

HIV transmission. The data suggest

that women with no STD history were

more likely to be unaware that HIV

can be spread by a person who has

the virus but not AIDS (29 percent

versus 24 percent).

The differences by STD histo~ in

the proportion of unmarried women

who changed their sexual behavior

since hearing of AIDS are striking.

One-fourth of unmarried women with

an STD history (26 percent) had

“stopped having sex with more than

one man,” compared with 15 I~ercent

of unmarried women with no $f13

history. Women who had ever had an

STD were twice as likely as others to

report that they had stopped having

intercourse with men they did :not

know well. (22 percent compared

with 10 percent). This may be the

result of women with an STD history

having more need to make these

changes than women with no history.

Overall, 43 percent of unmarried

women with an STD history made

one or more changes in their slcxual

behavior since hearing of AIDS,

compared with 30 percent of

unmarried women with no STD

history.

Large differences were also seen

in a woman’s perceived risk of

contracting HIV when examined by

STD history. Women with a history of

STD were more likely to report that

they had “some chance” of
Advance Data No. 200. May 14, 1991 9

contracting the virus than women who

never had an STD (25 percent

compared with 17 percent).

Conversely, women with a history of

STD were also far less likely to report

that they had “no chance at all” of

contracting the virus compared with

women with no history of STD

(26 percent compared with

42 percent).

The results of table 5 maybe

affected by the other characteristics

of women with and without a history

of STD: These characteristics include

race, income, education, and number

of lifetime sexual partners. One other

factor may be affecting these

differences as well. Because the

measure of STD history used in this

table is based on a woman being told

by a doctor that she has an STD, she

may have received counseling along

with her treatment, If so, she might

know more about the means of HIV

transmission and the changes in

behavior needed to prevent it, and

may have a better understanding of

her risk of becoming infected with the

virus.

Teenage knowledge and

behavior

Table 5 also contains the

differences in knowledge and

behavior for women 15-19 years of

age compared with women 20-44

years of age. Preliminary analysis

found that differences between age

groups were not statistically

significant for most categories. As

they begin sexual activity, teenagers

may be exposed to HIV. Other

research has suggested that sexual

activity among teenagers is increasing

(6), so it is important to have a

measure of their awareness of the

means of HIV transmission and the

ways the risk of infection can be

avoided.

Women 15-19 years of age were

more likely than women 2044 years

of age to have the mistaken belief

that they could contract the AIDS

virus by donating blood (24 percent

compared with 19 percent). Teenage

women were also more likely to have

the mistaken belief that HIV can be

transmitted by the bite of an insect

(28 percent compared with

20 percent, tab~e 5).

Teens and women 20-44 years of

age did not differ significantly in the

percent with misinformation about

the actual means of HIV

transmission: sharing hypodermic

needles (11 percent versus

10 percent), homosexual intercourse

(6 percent in both groups),

heterosexual intercourse (6 percent

compared with 8 percent), and

contracting the AIDS virus from an

HIV positive person (30 percent

compared with 29 percent). These

numbers suggest that the leveI of

knowledge among teenage women

(15-19 years of age) is comparable to

that for women 20-44 regarding the

means by which one can contract the

HIV virus,

The proportions of unmarried

women who changed their sexual

behavior since hearing of AIDS are

shown by age in table 5. The

differences between teenagers and

women 20-44 years of age are

generally small. About 32 percent of

unmarried teenagers and 31 percent

of women 2044 years of age made

one or more changes. These

proportions must be interpreted

cautiously, however, as women 15-19

years of age have not had as many

years to engage in sexual activity as

women 20 years of age and older.

Differences by age in perceptions of

the chances of contracting the AIDS

virus were also small (table 5).

References

1,

2,

3.

Guinan ME, Hardy A. Epidemiology

of AIDS in women in the United

States: 19S1-86. JAMA 257(15):

2039-42.1987.

Dawson DA. AIDS knowledge and

attitudes for July 1988: Provisional

data from the National Health

Interview Survey. Advance data from

vital and health statistics; no 161.

Hyattsville, Maryland. National

Center for Health Statistics. 1988.

Dawson DA, Hardy AM. AIDS

kncwledge and attitudes of Black

Americans: Provisional data from the

National Health Interview Survey.

Advance data from vital and health

statistics; no 165. Hyattsville,

Maryland. National Center for Health

Statistics. 1989.

4. Dawson DA. AIDS knowledge and

attitudes for July-September 1989:

Provisional data from the National

Health Interview Survey. Advance

data from vital and health statistic

No 183. Hyattsville, Maryland.

National Center for Health Statistics.

1990.

5. U.S. Department of Health and

6.

7.

8.

9.

10.

11.

Human Services. Surgeon General’s

report on acquired immune deficiency

syndrome. U.S. Government Printing

Office.

Forrest JD, Singh S. The sexual and

reproductive behavior of American

women, 1982-88. Fam P1ann Perspect

22(5):206-14, 1990.

Schoenbaum EE, Hartel D, Selwyn

PA, et al. Risk factors for human

immunodeficiency virus infection in

intravenous drug users. N Engl J

Med. 321(13):874-79. 1989.

Holmes IQ& Karen JM, Kreiss J. The

increasing frequency of heterosexually

acquired AIDS in the United States,

1983-88. AJPH 80(7): 858-63.1990.

Gayle JL, SeIik RM, Chu SY.

Surveillance for AIDS and HIV

infection among black and Hispanic

children and women of childbearing

age, 1981-89. MMWR 39(SS-3):23-30.

1990.

Aral SO, Holmes KK. Epidemiology

of sexual behavior and sexually

transmitted diseases. In: Sexually

transmitted diseases. New York

hfcGraw Hill, 19-36.1990.

Division of STD/HIV Prevention

(Centers for Disease Control).

Am.d report 1989.
10 Advance Data No. 200. May 14, 1991

Technical notes

Survey design

The National Survey of Family

Growth (NSFG) is a periodic survey

conducted by the National Center for

Health Statistics (NCHS) to collect

data on fertiIity and infertility, family

planning, and related aspects of

maternal and infant health. Fieldwork

for Cycle I was conducted in 1973 by

the National Opinion Research

Center. Fieldwork for Cycles II, III,

and IV was conducted by Westat,

Inc., in 1976, 1982, and 1988.

For Cycle IV of the NSFG,

personal interviews were conducted

between January and August of 1988

with a national sample of women who

were 1544 years of age as of March

15, 1988. Interviews were completed

with 8,450 women. Data have been

weighted to be representative of the

civilian noninstitutionalized

population of the United States, and

black women were oversampled in

order to yield reliable estimates by

race.

Interviews for Cycle IV of the

NSFG were conducted in households

which had participated in another

NCHS survey, the National Health

Interview Survey (NHIS), sometime

between 1985 and 1987, Respondents

were interviewed in person in their

own homes by trained female

interviewers. The interviews covered

the woman’s pregnancy history; her

past and current use of contraception;

her ability to bear children; her use

of medical services for family

planning, infertility, and prenatal

care; her marital history and

associated cohabiting unions; her

occupation and labor force

participation; and a wide range of

social, economic, and demographic

characteristics.

Reliability of estimates

Because the statistics presented

in this report are based on a sample,

they may differ from the statistics

that would result if all 58 million

women represented by the NSFG had

been interviewed. The standard error

of an estimate is a measure of such

differences. The standard error of an

estimated number or percent is

calculated by substituting the

appropriate values of A and B from

table I in the following equations:

SE(W = V(A + B/N’).N’

and

SE(p) = ti (B. P’.(1OO - P’)/x’)

where N = the number of women

P’ = the percent

X = the number of women in

the denominator of the

percent

Table L Preliminary estimates of

parameters A and B for estimating standard

errors for women, by race

Race A B

Total or white. . . . -0.00018 10,738

Black . . . . . . . . . -0.000626 5,181

The chances are about 68 in 100

that a sample estimate would fall

within one standard error, and about

95 in 100 that it would fall within two

standard errors of a statistic based on

a complete count of the population

represented by the NSFG.

Unless otherwise specified,

differences between percents

discussed in this report were found to

be statistically significant at the 0.05

level using a tvvo-tailed normal

deviate test (z-test). This means that

in repeated samples of the same type

and size, a difference as large as the

one observed would occur in only

5 percent of the samples if there

were, in fact, no difference between

the percents in the population.

Statements using the phrase “the

data suggest” indicate that the

difference was significant at the 0.10

(lO-percent) level but not the 0.05

(5-percent) level. Lack of comment in

the text about any two statistics does

not mean that the difference was

tested and found not to be significant.

The relative standard error (or

coefficient of variation) of a statistic

is the ratio of the standard error to

the statistic, and usually is expressed

as a percent of the estimate. In this

report, statistics with relative

standard errors of 30 percent or

larger are indicated with an asterisk

(*). These estimates may be viewed

as unreliable by themselves, but they

may be combined with other

estimates to make comparisons of

greater precision.

Statistics in this report may also

be subject to nonsampling error, that

is, errors or omissions in responding

to the interview, recording answers,

and processing data. The data have

been adjusted for nonresponse and

adjusted to independent control totals

obtained from the U.S. Bureau of the

Census. These adjustments reduce

most types of nonsampling error.

Other types of nonsampling error

were minimized by a series of quality

control procedures.

Other sources of data

This section includes comparisons

of the NSFG results with the

information on HIV knowledge in the

NHIS. There are differences between

the two surveys in the way some of

the questions are asked, how answers

were recorded, and in the populations

covered. The NHIS data refer to

males and females 20-75 years of age;

the NSFG data are for women 15-44

years of age. In addition, the NHIS

asked two separate questions

concerning whether HIV can be

spread through sharing dishes and

glasses, and whether it can be spread

through the use of public toilets,

whereas the NSFG covers both of

these issues in a single question,

The questions concerning the

spread of HIV by contaminated

hypodermic needles also differ. The

NHIS asks, “How likely do you think

it is that a person will get AIDS or

the AIDS virus from sharing needles

for drug use with someone who has

the AIDS virus?” (reference 2, page

9), directly associating the spread of

the virus with the practice by some

drug users of sharing their

hypodermic needles with each other.

The NSFG asks a more general
Advance Data No. 200 ● May 14, 1991 11

question of whether or not HIV can

be spread by “sharing hypodermic

needles” (see text). These wording

differences may result in some

differences in levels of misinformation

reported by the two surveys.

The method of recording

responses also differed substantially

between the two surveys. The NHIS

respondents were asked whether the

means of transmission was: “Very

likely,” “Somewhat likely,”

“Somewhat unlikely,” “Very

unlikely,” “Definitely not possible,”

or “Don’t know.” In contrast, the

NSFG simply recorded whether or

not the suggested means of

transmission could spread the virus as

“Yes” or “No.” This makes it

difficult to compare the results from

the two surveys with each other as

the distribution> differ for some

questions and are quite close for

other questions.

The results in table 2, on

misinformation about contracting

HIV from a person who has the

AIDS virus but not the disease,

differed from those reported by the

NHIS, which found that less than

10 percent of females possessed this

misinformation (2). However, the

wording of the questions in the two

sumeys differed substantially. The

NHIS asked how likely it is that “Any

person with the AIDS virus can pass

it on to someone else during sexual

intercourse,” whereas the NSFG

asked: “Can a person get AIDS from

someone who has only the AIDS

virus but does not have the disease?”.

These wording differences are

probably the primaxy cause of the

differences in the results; but NHIS

restdts are for women 20-75 years of

age of all marital statuses, and the

NSFG results shown here are for

unmarried women 15-44 years of

age —a much younger and much

smaller group.

Because only a small proportion

(2 percent) of alI women reported

either a very strong or a strong

chance of contracting AIDS, these

two categories are combined into one

group in table 4. The question

analyzed in table 4 is similar to the

one found in NHIS reports on AIDS,

but differences exist between the two

that result in somewhat different

responses. In contrast to the NSFG

question quoted in the text, the NHIS

asks, “What are your chances of

getting the AIDS virus?”: “High,”

“Medium,” “Low,” “None,” “Don’t

know,” or “High chance of already

having the AIDS virus.”

Definition of terms

Race – Race refers to the race of

the woman interviewed and is

reported as black, white, or other. In

the 1988 NSFG, race was classified

according to the woman’s own report

of the race that best described her.

Hispanic origin–In the 1988

hTSFG, a respondent was classified as

being of Hispanic origin if she

reported that her only or principal

national origin was Puerto Rican,

Cuban, Mexican American, Central

or South American, or other Spanish.

For 3 percent of respondents, origin

was not ascertained, so values were

imputed.

Marital srutus-In the NSFG,

persons were classified by marital

status as married, widowed, divorced,

separated, or never married. In

Cycles I and II, informally married

women —women who volunteered

that they were sharing living quarters

with their sexmal partner —were

classified as currently married. These

women constituted about 2 percent

of currently married respondents in

Cycle I and 3 percent in CycIe II. In

Cycles III and IV, such women were

classified according to their legal

maritaI status. In all cycIes, women

who were married but separated from

their spouses were classified as

separated if the reason for the

separation was marital discord;

otherwise, they were classified as

currently married. Formal marital

status is used throughout this report.

In this report, “unmarried” means

not legally married —that is, never

Iegally married or formerly married,

where formerly married includes

widowed, divorced, or separated.

Sexually mperienced – This refers

to a woman who has had sexual

intercourse at least once. Intercourse

before the first menstrual period is

excluded.

Lifetime sexual partners – This

refers to the number of men with

whom the woman has had sexual

intercourse in her life, as of the date

of interview.

Symbols

-–– Data not available

. . . Category not applicable

Quantity zero

0.0 Quantity more than zero but less

than 0.05

* Figure does not meet standard of

reliability or precision

“U.S.Gowrrhnmt PfintlngOfllcw 1SSS—39S—W?r2Ca9
Vital and Health Statistics

series descriptions

SERIES 1.

SERIES 2.

SERIES 3.

SERIES 4.

SERIES 5.

SERIES 6.

SERIES 10.

SERIES 11.

SERIES 12.

SERIES 13.

Programs and Collection Procedures—These reports

describe the data collection programs of the National Center

for Health statistics. They include descriptionsof the methods

used to collect and process the data, definitions, and other

material necessary for understanding the data.

Data Evaluation and Methods Research—These reports

are studies of new statistical methods and include analytical

techniques, objective evaluations of reliability of collected

data, and contribti”onsto statisticaltheory.These studies also

include experimental tests of new survey methods and

comparisons of U.S. methodology with those of other

countries.

Analytical and Epidemiological Studies-These reports

present analytical or interpretive studies based on vital and

health statistics.These reports carry the analyses rlriher than

the expository types of reports in the other series.

Documents and Committee Reports-These are final

reports of major committees concerned with vital and heaith

SMktiCS and documents such as recommended model vhal

registration laws and revised birth and death certificates.

International Vital and Heaith Statistics Reports-These

reports are analytical or descriptive reports that compare U.S.

vital and heaith statistics with those of other countries or

. present other international data of relevance to the health

statistics system of the United States.

Cognition and Survey Measurement—These reports are

from the National Laboratory for Collaborative Research in

Cognition and Survey Measurement. They use methods of

cognitive science to design, evaluate, and test survey

instruments.

Data From the Nationai Heaith Interview Survey-These

reports contain statistics on illness; unintentional injuries;

disabilii use of hospital, medical, and other heaith servic~

and a wide range of speciai current health topics covering

many aspects of heaith behaviors, heaith status, and heaith

care utilization. They are based on data collected in a

continuing national household interview survey.

Data From the National Health Examination Survey, the

Nationai Health and Nutrition Examination Surveys, and

the Hispanic Heaith and Nutrition Examination Survey—

Data from direct examination, testing, and measurement on

representative samples of the civilian noninstitutionalized

population provide the basis for (1) medicaliy defined total

prevalence of specific diseases or condtions in the United

States and the dktribufions of the population with respect to

physicai, physiological,and psychologicalcharacteristics, and

(2) analyses of trends and relationships among various

measurements and between survey periods.

Data From the Institutionalized Population Surveys—

Discontinued in 1975. Reports from these surveys are

included in Series 13.

Data From the National Heaith Care Survey—These

reports contain statisticson health resources and the public’s

use of heaith care resources inciuding ambulatory, hospital,

and long-term care sewices based on data coliected directly

from heaith care providers and provider records.

SERiES 14.

SERiES 15.

SERIES 16.

SERiES 20.

SERIES 21.

SERIES 22.

SERIES 23.

SERiES 24.

Data on Health Resources: Manpower and Facilities—

Discontinued in 1990. Reports on the numbers, geographic

distribution, and ch=acteristics of health resources are now

included in Series 13.

Data From Speciai Surveys—These reports contain

statistics on heaith and health-reiated topics coiiected in

special surveys that are not part of the continuing data

systems of the National Center for Heaith statistics.

Compilations of Advance Data From Vital and Health

Statistics-Advance Data Reports provide early release of

information from the Nationai Center for Heaith Statistics’

heaith and demographic surveys. They are compiied in the

order in which they are published. Some of these releases

may be foliowed by detaiied reports in Series 1*13.

Data on Mortaiity-These reports contain statistics on

mortality that are not included in regular, annual, or monthiy

reports. Special anaiyses by cause of death, age, other

demographic variables, and geographic and trend analyses

are included.

Data on Natality, Marrisge, and Divorc&These reports

contain statistics on natality, marriage, and divorce that are

not included in regular, annual, or monthiy reports. Special

analyses by health and demographic variabies and

geographic and trend anaiyses are included.

Data From the National Mortality and Natslity SurveysDiscontinued in 1975. Reports horn these sample surveys,

based on vital records, are now published in Series 20 or 21.

Data From the National Survey of Family Growth—

These reports contain statistics on factors that affect birth

rates, inciuding contraception, infertility, cohabitation,

marriage, divorce, and remarriag~ adoptio~ use of medical

care for family pIanning and infertiii~ and related maternai

and infant heaith topics. These statistics are based on

national surveys of childbearing age.

Compilations of Data on Natality, Mortalitv. Marriar.ie.

Divorce, and Induced Termina~ons of P;egnanc~-

These include advance reports of births, deaths, marriages,

and divorces based on finai data from the Nationai Vital

Statistics System that were published as supplements to the

Monthly Viaf .SWistica Report (MVSR). These reports provide

highlights and summaries of detailed data subsequently

published in Vital Statistics of the United States. Other

supplements to the MVSR published here provide selected

finditIgS based on final data from the National v~~ sts~s~~

System and may be foiiowad by detailed reports in Series 20

or 21.

For answers to questions about this report or for a list of reporta published

in these series, contact

Data Dissemination Branch

National Center for Health statistics

Centers for Disease Control end Prevention

Public Heaith Service

6525 Belcrest Road, Room 1064

Hyattsville, MD 20762

(301) 436-6500

E-mail: nchsquery@nchlOa.em.cdc.gov

Internet http://www.cdc.gov/nchswww/nchshome.htm
DEPARTMENT OF

HEALTH AND HUMAN SERWCES

Public Health Service

Centers for Disease Control and Prevention

National Center for Health Statistics

6525 Belcrest Road

Hyattsville, Maryland 20782

OFFICIAL BUSINESS

PENALTY FOR PRIVATE USE, $300

PRESORTED SPECIAL

FOURTH CIJWS RATE

POSTAGE & FEES PAID

PHS/NCHS

PERMIT NO. G-281

DHHS Publication No. (PHS) 95-1879, Series 16, No. 20

5-1115 (5/95)