Data from the

NATIONAL HEALTH SURVEY

BasicDataon

DepressiveSymptomatology

UnitedStates,1974-75

This report presents basic data on depressive symptomatology as

determined by the Center for Epidemiologic Studies Depression

Scale (CES-D).

DHEW Publication No. (PHS) 80-1666

Series 11

Number 216

U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

Public Health Service

Office of Health Research, Statistics, and Technology

National Center for Health Statistics

Hyattsville, Md. April 1980
;

NATIONAL CENTER FOR HEALTH STATISTICS

DOROTHY P. RICE, Director

ROBERT A. ISFL4EL,Deputy Director

JACOB J. FELDMAN, Ph.D., Associate Director for Analysis

GAIL F. FISHER, Ph.D., Associate Director for the Cooperative HeulthStatistics System

ROBERT A. ISRAEL, Acting Associate Director for Data Systems

ROBERT M. THORNER, SC.D.,Associate Director for International Statistics

“ROBERTC. HUBER, Associate Director for Management

MONROE G. SIRKEN, Ph.D,, Associate Director for MathematicalStatistics

PETER L. HURLEY, Associate Director for Operations

JAMES M. ROBEY, Ph.D., Associate Director for ProgramDevelopment

GEORGE A. SCHNACK,Acting Associate Director for Research

ALICE HAYWOOD,Information Officer

DIVISION OF HEALTH IEXAMINATION STATISTICS

ROBERT S. MURPHY, Director

HAROLD J. DUPUY,Ph.D., Psycho/o#.calAdvisor

COOPERATION OF THE U.S. BUREAU OF THE CENSUS

In accordance with specifications established by the Nationsl Center for Health Statistics, the

Bureau of the Census, under a contractual agreement, participated in the design and selection of

the sample, aud carried out the first stage of the field interviewing and certain parts of the

statistical processing.

Vital and Health Statistics-Series 11-No. 216

DHEW Publication No. (PHS) 80-1666

Library of CongressCatalog CardNumber 79-607176
Library of Congress Cataloging in Publication Data

Sayetta, Rena Beth.

Basic data on depressive symptornatology, United States, 1974-75.

(Vital and health statistics : Series 11, Data from the National Health Survey ; no. 216)

(DHEW publication; (PHS) 80-1666)

Includes bibliographical references.

Supt. of Dots. no.: HE 20.6209:11/216

1. Depression, Mental–United States–Statistics. 2. United States–Statistics, Medical].

I. Johnson, David P., joint author. II. Title. III. Series: United States. National Center for

Health Statistics. Vital and health statistics : Series 11, Data from the National Health Survey ; no. 216. IV. Series: United States. Dept. of Health, Education, and Welfare. DHEIW

publication ; (PHS) 80-1666.

RA407.3.A347 no. 216 [RC537] 312’0973s 79-607176

ISBN 0-8406 -0182-4 [312’.38527’00973]

—.

For sale by the Superintendent of Documents, U.S. Government Printing Office, Washington, D.C. 20402
PREFACE

The National Center for Health Statistics has as its mission the collection,

analysis, and dissemination of data on the health of the population of the United

States. One of the major programs is the Health Examination Survey, in which are

conducted extensive examinations of a sample of the U.S. population. Data from

this survey have been published periodically in Series 11 reports of Vital and

Health Stat@tics.

Historically the published documents in Series 11 present only a small fraction of the available data. In order to make additional data available for users, the

Center has for many years had a policy of preparing public use tapes for purchase

by persons interested in more detailed analysis or analysis of additional variables

not published in Series 11 reports. These data, however, are only easily accessible

to persons with computers and support staff who can read, interpret, and ardyze

the data. In order to make these data more generalIy accessible to many users and,

in particular, to persons not able to directly use data tapes, the Division of Health

Examination Statistics, in the autumn of 1977, initiated a program to release,

along with the data tapes, basic descriptive summary tables of data contained in

those tapes. These tabular summaries have been termed “basic data publications.”

These basic data publications present findings of the Health and Nutrition Examination Survey of 1971-75. For each of the data sets, these publications include information on the methods used to collect the data, a descriptive summary

of the tables included, an index to the tables, and the tables themselves. An appendix describes the basic format of the associated data tape. More detailed

information on use of the data for additional analysis is available on request from

the staff of the Division of Health Examination Statistics.

...

Ill
ACKNOWLEDGEMENTS

The authors wish to express their gratitude to Lenore Radloff, National Institute of Mental Health (NIMH), for consultation on scoring and interpreting the

CES-D.
CONTENTS

Preface .................................................................................................................................. .................

Acknowledgements ................................................................................................................................

Introduction ...........................................................................................................................................

Source and Ultations of the Data .........................................................................................................

Findings .................................................................................................................................................

Dkcussion ..............................................................................................................................................

Summary ................................................................................................................................................

References ..............................................................................................................................................

Lut of Detailed Tables ...........................................................................................................................

Appendixes

I. Statistical Notes ........................................................................................................................

II. Definitions of Demographic and Socioeconomic Terms ............................................................

III. HANES I Data Tape Summary Catalog Number 4171: General Well-Being and

CES-D Scaks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . .....

IV. Description of the CES-D Scale.................................................................................................

SYMBOLS

I

Data not available————— .——.—- . -- I

Category not applicable—-- . . .

I

Quantity zero--—--–———--— ------ I

I

Quantity more than O but less than 0.05— 0.0 I

...

u

iv

1

1

2

4

4

6

7

21

2.5

29

31

Figure does not meet standards of

reliability or precision (more than

25 percent relative standard error)—------- *

v
BASIC DATA ON DEPRESSIVE

SYMPTOMATOLOGY

Rona Beth Sayetta and David P.Johnson, Division of Health Examination Statistics

INTRODUCTION

This report summarizes the basic findings on

depressive symptomatology for the civilian noninstitutionalized U.S. population 25-74 years of

age. Data were collected as part of Cycle I of the

Health and Nutrition Examination Survey conducted in 1971-75. The findings are based on

the responses of examinees who were given the

Center for Epidemiologic Studies-Depression

Scale (CES-D) in 1974-75, as an addendum to

the General WeII-Being Questionnaire.

Approximately 18.5 million people, or 17.3

percent of the U.S. population, aged 25-74 years

had relatively high levels. of endorsement of

depressive symptomatology on the CES-D Scale.

This figure is somewhat arbitrary, depending on

the amount of symptom endorsement considered to be “high.” Depression has been recog

nized as a ranking national health problem and

one that may contribute to premature death by

suicide.1

This report focuses on segments of the

noninstitutionalized U,S. population whose selfreported depression scores indicate that they

may be at relatively greater risk of becoming

clinical cases of depression. These groups may

deserve attention in evaluations of the usefulness

of treatment and prevention techniques.

It should be noted, though, that these data

do not show whether poor or black persons or

persons with low educational levels, for instance,

aBoth authors were formerly with the Psychological

Statistics Branch.

really have a greater number of depressive

symptoms than their respective complementary

segments or whether they simply tend to respond to questionnaires differently and endorse

these items more frequently thzm the other ‘

population segments found to have lower scores.

SOURCE AND LIMITATIONS OF

THE DATA

The Health and Nutrition Examination Survey (HANES I) was the first conducted by the

National Center for Health Statistics through

which the nutritional as well as the general

health status of the civilian noninstitutionalized

population 1-74 years of age in the coterminous

United States was measured, Detailed information on the health status and medical care needs

of a subsample of persons 25-74 years of age was

also obtained, The plan and operation of the

survey are described elsewhere.z~s Questions on

depression were asked in the latter portion of

the HANES I data collection (stands 66-100),

referred to as the Augmentation Survey (July

1974-September 1975).3

Appendix I gives statistical notes for the

HANES I survey and presents the age, sex, and

race distributions of sample persons and of the

total noninstitutionalized U.S, population at the

midpoint of the survey. In addition, the statistical design of the survey and the methods used to

generate population estimates from the sample

data are discussed. The reliability of the survey

estimates is indicated by standard errors of the

mean shown .in the detailed tables and explained

1
in appendix I. To test the statistical significance

of the differences in mean depression scores fcm

any two population groups of interest, a z

statistic may be computed and interpreted as

described in the appendix. This method is used

throughout the report in comparisons between

groups with a 95-percent level of confidence

supporting inferences about the significance bf

findings.

Appendix II provides definitions of the

demographic and socioeconomic terms used in

this report.

The data used to prepare this report are

derived from HANES I tape catalog number

4171. Appendix III summarizes the contents of

this microdata tape.

The 2 O-item self-reported Center for

Epidemiologic Studies-Depression (CES-D) Scale

on which the depression findings in this repcxt

are based was developed by the Center for

Epidemiologic Studies, National Institute of

Mental Health, in Rockville, Maryland, to measure depressive symptomatology in the general

population. Items cover depressed mood, inclu~ding feelings of guilt, worthlessness, helplessness,

and hopelessness; and psychophysiologic manifestations such as psychomotor retardation, loss

of appetite, and sleep disturbance.4 The utility

of this psychometric instrument and its reliabilityy and validity are described elsewhere .4~s The

20 CES-D items, scoring instructions, and miissing-data rules that were followed for this report

are described in appendix IV. This” report presents only mean depression scores, standard

deviations, and the smallest and largest scores

for selected segments of the population. The

higher the CES-D score, the greater the respondent’s endorsement of depressive symptomatolOgy .

The reader is cautioned not to draw unwarranted conclusions from the data. Please note

that CES-D scores reflect depressive symptoms

only and should not be equated with a clinical

diagnosis of depression. While groups whose

members have high average CES-D scores pro,bably include many clinically depressed persons, a

similar interpretation of high scores for individuals cannot be made because respondents with

diagnoses other than clinical depression may also

endorse depressive symptomatology. In addition, the cross-classification of depression scores

by selected demographic and socioeconomic

characteristics does not necessarily imply that

either factor causes the other; alternatively, both

may be effects of some other, unnamed cause.

FINDINGS

The average CES-D score for noninstitutionalized adults aged 25-74 years was 8.7 (table

1), which represents a low-moderate level of

depressive symptomatology. Women had significantly higher scores indicating higher levels of

depressive symptomatology, on the average,

than men had. Black persons had a significantly

higher mean score than white persons and those

of other races. There were no significant differences in terms of age categories.

Table 2 shows that formerly married persons

had a significantly higher mean depresflon score

than that for the remaining population. Currently married persons, by contrast, had a

significantly lower mean score. The average

depression score for never-married persons was

statistically indistinguishable from thdt for the

remaining population. Among marital status

groups of both sexes all ages, formerly married

persons had the highest observed mean depression score, followed by those never married and

then those currently married.

The mean depression score for women was

higher than that for men of the same marital

status (table 2). Among women, ~he highmoderate scores of those ever married were not

statistically different from the scores of those

never married.

Among persons 35-44 and 65-74 years of

age, marital status groups deviated from this

overall pattern (table 3). In both age groups,

formerly married persons had the highest observed mean depression score, followed by those

currently married and those never married. The

mean scores of never married persons in both

age groups were, however, statistically indistinguishable from the scores of the ‘remaining

individuals in their respective age groups. Formerly married persons 35-44 years of age had a

significantly higher mean depression score than

did currently married persons in thl~ same age

category.

2
Table 4 shows that the rank order of

depression scores for marital status groups in the

total population—from highest to lowest scores,

the formerly married, the never married, and the

currently married-heId for all racial segments

except bIack persons. There were no significant

differences in mean depression scores among

marital status groups of black persons.

The mean depression score varied significantly with number of household members

(table 5). Persons in households with one member and those in large households with seven or

more members had the highest mean scores, but

Bonferroni tests on these two groups show that

their mean scores were statistically indistinguishable from the mean depression scores for their

respective remaining population sefynents. Persons in households with two or four members

had scores significantly below those of all other

persons. Among sole household members, females had somewhat higher depression scores

than did males @ < 0.10).

The depression scores of adult children and

other relatives (except wives) living in households of which a male was the head were almost

as high as the scores of female heads of household. Only male heads of household had scores

significantly below all others in the population.

Significant differences in average depression

scores were not associated with the language

spoken in the household (table 5).

Table 6 shows that persons who did not

complete their high school education had the

highest mean depression scores–significantly

above the scores of persons with more education. Most persons whose schooling went beyond the high schooI leveI had mean depression

scores slightly but insignificantly below the

remainder of the population. In general, for

persons with a postsecondary school education,

depression scores declined at successively higher

IeveIs of educational attainment (except for

those who had completed their second year of

college). Persons with a 4-year college degree or

graduate work had significantly lower depression

scores than persons with less education.

Depressive symptomatology was inversely

related to income Ievel. Persons with a low totaI

annual family income had high average depression scores.

successively

Mean depression ‘scores d;opp;d at

higher income levels. Persons with

incomes of $15,000 or more had mean scores

that were significantly lower than the scores of

persons with Iower incomes.

Bonferroni tests applied to data in table 7

show that residents of central cities of 3 million

persons or more had insignificantly higher mean

depression scores, but residents of rural areas

within standard metropolitan statistical areas

(SMSA’S) had significantly lower scores than did

the rest of the population within SMSA’S. Persons in urban and rural areas outside SMSA’S

generaUy had higher average depression scores

than did those in urban and rural areas within

SMSA’S, but the differences were not statistically significant. Among persons living in rural

areas outside SMSA’S, the depression scores of

farm dwellers and nonfarm dwellers were statistically indistinguishable. Regional variation in

depression scores was also insignificant.

Examining average depression scores by class

of worker (table 8) shows that government

workers (of whom State and local workers were

the most numerous) had scores significantly

lower than those in the remaining population.

Persons who had never worked had the highest

depression scores, and unpaid workers had moderately high scores, but these differences were

not statistically significant.

In terms of the usual activity of persons in

the population during the 3 months prior to

interview, depression scores of those whose

usual activity was working were lower than

those of all others in the general population

(tabIes 8-1O). People who were unable to work

due to illness or disability or who were keeping

house had significantly higher mean depression

scores than others in the general population.

This pattern was essentially the same for aII

races (table 10) and both sexes (table 8), with

two exceptions: The mean depression scores for

women keeping house and for bIack persons

unable to work did not differ signi~lcantIy from

scores for the remaining women and for the

remaining black persons, respectively. Table 9

shows that depressive symptomatology was significantly related to inability to work and to

keeping house for all age groups.

Table 11 shows depression scores by the

business or industry in which respondents were

working during the 2 weeks prior to the date of

the interview. Persons in many types of business

3
or industry had lower average depression scores

than their respective complements in the population had. The most notable exceptions were the

high-moderate depression scores of people working in the entertainment industry, in public administration, and in personal service businesses.

Among men, those with the highest depression scores were engaged in mining, entertainment, public administration, and agriculture.

Men who provided professional services had the

lowest mean depression scores. Among wome:n,

those working in manufacturing, agriculture, and

retail trade had the highest scores. The mean

depression scores of women in the transportation and professional services were not significantly lower than those of the remaining female

population.

Table 12 shows mean depression scores by

occupation. According to specific occupatiorls,

household workers (mostly women) and farm

laborers and foremen (mostly men) had tlhe

highest average depression scores. Professiorlal

and technical workers and managers and administrators had the lowest scores both in the total

population and for men and women considered

separately. The scores of members of each

occupational group mentioned, except farm

laborers and foremen, differed significantly from

the average scores for each of the remaining

population segments.

DISCUSSION

The standard (U.S. Bureau of the Census)

classifications of size and urbanization of place6

used here do not translate exactly into the lay

concepts of urban, suburban, and rural modes of

living. Perhaps these concepts or other classifications of the data would enable more meaningful

interpretations of the psychology associated

with Iifest yle and crowdedness.

The standard (U.S. Bureau of the Census)

classification of industries and occupations’

used here may also be of limited value for

psychological interpretation. The occupational

categories bear scant relation to personal job

requirements or interests, and their relation to

skills and training is somewhat irregular.g Other

axes of classification may be more ulseful for

psychological interpretation, but there is little

agreement among investigators as to what defini- -

tions or categories should. be used. Examples of

other axes of classification include the primary

focus of the job activity, occupational status,

ease of entry, level of skill, level of responsibility

at work, and earnings level.

Sociodemographic factors of the individual

that are associated with the endorsement of

depressive symptomatology may be in.+olved in

the genesis of psychopathology, in the’ person’s

response to psychological disorder, and in interactions with his milieu both before &d after

experiencing symptoms. The precise nature of

these interactions has been the focus of a great

deal of contemporary research.g The basic statistics presented in this report are generally consistent with the findings of others, but tlheir interpretation can form the grist for much additional

work. This is particularly true because, the findings presented here have not been disaggregated ‘

finely (e.g., by examining depression scores of

the formerly married separately by widowed

versus divorced status) or adjusted for the influence of confounding variables (e g., the known

lower average income levels for previously married women than for men).

SUMMARY

The 1974-75 findings presented here reveal

relatively higher levels of endorsement, of depressive symptomatology in each of the’ foHowing

segments of the U.S. population 25-’74 years of

age when compared against their respective

remaining population segments:

● Women

● Black persons

. Formerly married persons

. Female heads of household

. All adult relatives except wives living in

male-headed households

. People with less than a high school

education

4
. persons whose total family income is While the basic descriptive statistics in this

below $5,000 per year report generally corroborate the earlier findings

of others,] S9 the precise nature of the reIation--

. Persons unable to work ships observed and the interactions among various sociodemographic, socioeconomic, and

● Persons engaged in keeping house other factors remain to be elucidated.

000

5
REFERENCES

lThe President’s Commission on Mental Health:

Vols. Iand II, Report tothe President. Washington. U.S.

Government Printing Office, Feb. 15, 1978, p. 5.

2National Center for Health Statistics: Plan znd

operation of the Health and Nutrition Examination

Survey, United States, 1971-1973, by H. Miller. Vital

and Health Statistics. Series 1-Nos. 10a and 10b. DHEiW

Pub. No. (HSM) 73-1310. Health Services and Mental

Health Administration. Washington. U.S. Government

Printing Office, Feb. 1973.

3National Center for Health Statistics: Plan and

operation of the HANES I Augmentation Survey of

adults 25-74 years: United States, 1974-1975, by A.

Engel, R. Murphy, K. Maurer, and E. Col~ms. Vital and

Health Statistics. Series l-No. 14. DHEW Pub. No. (PHS)

78-1314. Public Health Service. Washington. U.S. Government Printing Office, June 1978.

4Radloff, L. S.: The CES-D Scale: A self-report

depression scale for research in the general population.

Appl. Psychol. Measur. 1:385-401, p. 386, 1977.

5Weissman, M. M. et al.: Assessing depressive symptoms in five psychiatric populations: A validation

study. Am. J. Epidemiol. 106:203-214, 1977.

6U.S. Bureau of the Census: U.S. Census of Population: 1960, Vol. 1. Washington. U.S. Government

Printing Office, 1961.

7U.S. Bureau of the Census: 1970 Census of Population Alphabetical Index of Industries and Occupations.

Washington. U.S. Government Printing Office, 1971.

8Roe, A.: The Psychology of Occupations. New

York. John Wiley and Sons, 1956. p. 144.

‘Jackson, J. J., ed. Special Issue: Recent developments in the sociology of mental illness. j. Health Sot.

Behav. 16:342-429, 1975.

1‘National Center for Health Statistics: Replication:

An approach to the analysis of data from complex

surveys, by P. J. McCarthy. Vital and Health Statistics.

Series 2-No. 14. DHEW Pub. No. (HSM) 73-1269. Health

Services and Mental Health Administration. Washington.

U.S. Government Printing Office, Apr. 1966.

11National Center for Health Statistics: Pseudoreplication: Further evaluation and application of de balanced

half-sample technique, by P. J. McCarthy. Vital and

Health Statistics. PHS Pub. No. 1000-Series 2-No. 31.

Public Health Service. Washington. U.S. Government

Printing Office, Jan. 1969.

12Dufi, O. J. and Clark, V. A.: Applied Statistics:

Analysis of Variance and Regression. New York. John

Wiley and Sons, 1974. p. 80.

13 us. Office of Management and Budget) Statistical

Policy Division Standard Metropolitan Statistical Areas. ‘

Washington. U.S. Government Printing Office, 1967.

14Comstock, G. W, and Helsing, K. J.: S’$mPtoms of.

depression in two communities. Psychol. Med. 6:551-

564, 1976.

15Hus~~, B. A. and Neff, J. A.; Depression in Rural

Communities: Establishing CES-D Cutting Points. Final

report of work performed under NIMH con~act number

278-77-0044 (DBE), Mental Health Report, Tennessee

State University, Nashville. Feb. 1979, pp. 33 ff.
LIST OF DETAILED TABLES

1. CES-D Depression Scale scores, standard deviations, standard errors of means, and percent distribution of adults 25-74 years

of age by sex, age, and rece: United States, 1974-75 .................................................................................................................

2. CES-D Depression Scale scores, standard deviations, stendard errors of means, and percent distribution of adults 25-74 years

of aga by sex and marital status: United States, 1974-75 ..........................................................................................................

3. CES-D Depression Scale scores, standard deviations, standard errors of means, and percent distribution of adults 25-74 years

of age by age and merital status: United States, 1974-75 ..........................................................................................................

4. CES-D Depression Scale scores, standard deviations, standard errors of means, and percent distribution of adults 25-74 years

of age by race and marital status: United States, 1974-75 .........................................................................................................

5. CES-D Depression Scale scores, standerd deviations, standerd errors of means, and percent distribution of adults 25-74 years

of age by number of household members, relationship to head of household, and language spoken in household: United

States, 1974-75 .........................................................................................................................................................................

6. CES-D Depression Scale scores, stendard deviations, standard errors of means, and percent distribution of edults 25-74 years

of age by education completed end total annual family income: United Stetes, 1974-75 .........................................................

7. CES.D Depression Scale scores, standard deviations, stendard errors of maans, end percent distribution of adults 25-74 years

of age by geographic region end size and urbanization of placa of residance: Unitad States, 1974-75 ....................,,,.,,.............

8, CES-D Depression Scale scores, standard tlaviations, standard errors of means, and percent distribution of adults 25-74 years

of age by classof worker, usual activity, and sax: United States, 1974-75 ...........................................................................4....

9. CES-D Depression Scale scores, standard deviations, standard errors of means, and parcent distribution of adults 25-74 years

of ega by age and usual activity: United States, 1974-75 ..........................................................................................................

10. CES.D Depression Scala scoras, standard deviations, stendard errors of maans, and parcent distribution of edults 25-74 years

of ege by race end usual activity: Unitad Statas, 1974-75 .........................................................................................................

11. CES-D Depression Scala scores, stendard deviations, standard errors of maens, and percent distribution of adults 25-74 yeers

of ege by sex and businassor industry: United States, 1974-75 ....................,...........................................................................

12. CES-D Depression Scale scoras, standard deviations, standard errors of means, end percent distribution of adults 25-74 years

of age by sex and occupation: United States, 1974-75 ..............................................................................................................

8

9

10

11

12

13

14

15

16

17

18

19

7
Table 1, CES-D Depression Scale scores, standard deviations, standard errors of means, and percent distribution of adults 25.74 years of

age by sex, age, and race: United States, 1974-75

Sex, age, and race

Total population aged 25-74 years ..............................

Sex .

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

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

—Age

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

~5-44 years ...................... ..............................!..... ....................... .

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

5$64 years ............................................................................... ...

65.74 years ................................................ .. ...... .. ...................... ..

Race

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

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

Othqr ........................................ .............................................. .....

—

1106,956,216 adults 25-74 years of age.

Mean

score

8.7

7.1

10.0

8.5

8.8

8.7

8.8

8.4

8.4

11,1

7.9

Smallest

score

o

0

0

0

0

0

0

0

0

0

0

Lergast

score

60

60

56

48

60

41

60

41

60

36

25

Standard

deviation

8.4

7.2

9.1

8.3

8.8

8.0

9.0

7.7

8.3

8.7

6.9

Standard

error of

mean

0,18

0.20

0.25

0.27

0.33

0,32

0.46

0.40

0.18

0.57

1.71

Percent

distribution of

population

1100.0

47.5

52.5

27,3

20.6

21.7

18.1

12.3

89.1

9.5

1.4
Table 2. CES-D Depression Scale scores, standard deviations, standard errors of means, and percent distribution of adults 25-74 years Of

age by sex and marital status: United Statas. 1974-75

Sex and marital status

Both sexas...................................................................

Never marriad ..............................................................................

Evar married ................................................................................

Currently marriad ...................................................................

Formerly marriad ...................................................................

Unknown ....................................................................................

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

Never married ..............................................................................

Ever marriad ................................................................................

Currently marriad ...................................................................

Formarly mar~ed ...................................................................

Unknown ....................................................................................

Famala ..............................................................................

Never married ..............................................................................

Ever married ................................................................................

Currently marriad ...................................................................

Formerly marriad ...................................................................

Unknown ...................................................................................,

Mean Smallest Largest Standard

score soore soore deviation

8.7 0 60 8.4

9.6 0 60 9.2

8.6 0 60 8.3

8.0 0 60 8.0

11.3 0 50 9.3

●6.5. 4 10 2.7

7.1 [ 01 60 ] 7.2

I I

8.7 0 60 8.3

7.0 0 60 7.1

6.8 0 60 6.8

9.4 0 45 8.6

●7.6 .5 10 2.5

10.0 I o 56 9.1

I I I

WiLu!

Standard Parcent

arror of distribumean

tion of

population

0.18 ] 1100.0

0.80 6.9

0.18 93.0

0.18 77.5

0.57 15.5

2.82 0.1

=-l---

0.85 3.5

0.23 43.9

0.23 40.0

0.93 4.0

4.20 0.1

0.25 I 52.5

I

1.36 3.4

0.23 49.1

0.29 37.5

0.69 11.5

2.83 0.0

1106,9S6,216 adults 25-74 years of age.

9
Table 3. CES-D Depression Scale scores, standard deviations, standard errors of maans, and parcent distribution of adults 25-74 yaars of

aaa bv aae and marital status: United States, 1974-75

Age and marital status

All ages25-74 yaars.....................................................

Navar marriad .............................................................................

Ever married ...............................................................................

Currently marriad ..................................................................

Formerly married ...................................................................

Unknown ....................................................................................

25-34 yaars .......................................................................

Never married ..............................................................................

Ever married ................................................................................

Currantly marriad .......................................................l...........

Formerly married ...................................................................

Unknown ....................................................................................

35-44 years ...).........c.......d..........................................c.c...

Naver married .............................................................................

Ever marriad ............................................................................>...

Currently married ...................................................................

Formerly marriad ...................................................................

Unknown ....................................................................................

45-54 years .......................................................................

Never married ..............................................................................

Evar married ................................................................................

Currently marriad ...................................................................

Formarly marri#d ...................................................................

Unknown ....................................................................................

55-64 years .....c.........................l .........i............................

Never marriad ..............................................................................

Ever married ................................................................................

Currently marriad ...................................................................

Formarly marriad ...................................................................

Unknown ....................................................................................

65-74 yaars .......................................................................

Nevar married ..............................................................................

Ever married ................................................................................

Currently marriad ...................................................................

Formerly married ...................................................................

Unknown ................................................................................... —

1106,956,216 adults 2S-74 years Of age.

--1-1

Mean Smallest

scora scora

9.6 0

6.6 0

8.0 0

11.3 o

6.5 4

8.5 I o

10.5

8.2

7.8

10,9

*7.2

8.8

7.1

8.9

8.1

13.8

. . .

8.7

0

0

0

0

4

0

0

0

0

0

. . .

0

::;

8.0

12,5

0

0

0

0

. . .

I

...

10.5

8.8

8.2

11.3

*5.O

o

0

0

0

5

8.4 I o

6.9

8.4

8.2

9.0

. . .

0

0

0

0

. . .

Largest Standard

Standard

score deviation error of

mean

I

60 8.4 0.18

60 9.2 0.80

60 8.3 0.18

60 8.0 0.18

50 9.3 0.57

10 2.7 2.82

48 8.3 0.27

36

48

48

45

10

60

9.0

8.1

7.8

9.3

3.0

8.8

1.08

0.32

0.40

1.18

4.21

0,33

60 1,18

56 :: 0.34

56 8.3 0.35

50 10.6 1.34

. . . . . . . . .

41 8.0 0.32

34 8.7 2,24

41 8.0 0,33

41 7.6 0.36

38 9.2 1.47

. . . . . . . . .

60 9.0 0.46

43 11.8 2.44

60 8.8 0.44

60 8.5 0.47

49 9.4 1,28

5 3.54

41 7,7 0.40

20 6.8 1,54

41 7.7 0.41

41 7.7 0.37

38 7.7 0.81

. . . . . . . . .

Percent

distribution of

population

1100.0

6.9

93.0

77.5

15.5

0.1

27.3

3.7

23.5

20.3

3.2

0.1

20.6

0.9

19.7

17.1

2,5

. . .

21.7

0.9

20.8

17.8

3.0

. . .

18,1

0.9

17.2

14.0

3.1

0.0

12.3

0.4

11.8

8.2

3.6

. . .

10
Table4. CES-DDepression Scale scores, standard deviations, standard errors of means, andpercent distribution ofadults 25-74 yearsof

age byrace and marital status: United States, 1974-75

Race and marital status

Al I races......................................................................

Never marriad ..............................................................................

Ever married ................................................................................

Currently married ...................................................................

Formerly marriad ...................................................................

Unknown ....................................................................................

Whita ................................................................................

Nevar marriad ..............................................................................

Ever marriad ................................................................................

Currently marriad ...................................................................

Formarly marriad ...................................................................

Unknown ....................................................................................

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

Navar married ..............................................................................

Ever married ................................................................................

Currently married ...................................................................

Formerly marriad .,..,,.,,,,..,,.,,.. ,.,,..,,,,,.,,,.,., ............................

Unknown ....................................................................................

Other ................................................................................

Never marriad ..............................................................................

Ever marriad ................................................................................

Currently married ...................................................................

Formarly married ...................................................................

Unknown ....................................................................................

Mean

scora

*

8.7

9.6

8.6

8.0

11.3

*6.5

8,4

8.8

8.4

7.9

11,1

●4.5

11.1

12.5

10.9

10.3

12.2

+10.0

7.9

*I 5.2

6.9

6.5

“20.0

. . .

Smallest Largest Standard Standard

score score daviation error of

mean

I ! 1

0 60 8,4 0,18

t 1 1

0

0

0

0

4

60 9.2 0.60

60 8.3 0.18

60 0.18

50 % 0.57

10 2.7 2.82

0 60 8.3 0.18

0

0

0

0

4

0

0

0

0

0

10

0

11

0

0

20

. . .

60 8.9 0.75

60 8.3 0.18

60 8.0 0,19

50 9.5 0.67

5 0.5 2.28

36 I 8.7 I 0,57

36 9.9 2.53

36 8.4 0.54

36 8.3 0.87

35 8.5 1.39

10 7.07

r

25 6.9 1.71

25 5.6 4.16

25 6.5 1.57

25 6,1 1.35

20 14.14

. . . . . . . . .

Parcant

distribution of

population

1100.0

6.9

93.0

77.5

15.5

0.1

89.1

5.4

83.6

70,8

12.9

0.1

9.5

::?

5.5

2.6

0.0

1.4

0.2

1.2

1.2

0.0

. . .

1106,956,216 adults 2S-74 years of age.

11
Table 5. CES-D Depression Scale scores, standard deviations, standard errors of means, and percent distribution of adults 25-74 years of

age by number of household members, relationship to head OF household, and language spoken in household: United State$, 1974-75

Selected demographic characteristic

Total population aged 25-74 years ..............................

Number of household members

1..................... ...................... .............................. ........................ .

2........... ........ .. ............................................ ............................... ..

3 .. ......................... ...................................... .................................

4 ................... .................. .... .................. ............ ................ .. .........

5 ... ........................ .... .................. .................................................

6 ................. ........ .. ....... ....... ...................................................... ...

7-10 ...... ........ ........ .................................... ..........!... .... .................

11 or more .................................. ..................................... .......<...

Relationship to head of household

Sole household member ............................................ ..................

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

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

Haad of household .. ......................................... ...........................

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

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

Wife .................. ...................... ........ ...................... .......................

Child ........................ ...... .. ........ .............................. .....................

Other relative ....................................................... .......................

Language spoken in household

English ................. .. ............... ............................................. .........

Other ............. ........ ...... .......... ........ ...................... ................ ........

French ....................................................................................

German ................... ........ .............................. .. .................... .. .

Italian ...... .............. .. ...................................................... ...... .. .

Spanish .......... .. ....... ............... ...... ..........................................

Polish ............................ .............................. ........ ...... .. ...... .....

1106,956,216 adults 25-74 years of age.

Mean

soora

8.7

10.0

7,8

9.5

7.4

9.0

9.6

11.0

*15.5

9,9

8.5

10.8

7.5

6.8

12.5

9.3

11.5

11.5

8.5

10.5

7.9

●8.5

9.5

11.4

*14.5

Smallest

scora

o

0

0

0

0

0

0

0

10

0

0

0

0

0

0

0

0

0

0

0

0

0

a

a

a

Largast

score

60

49

45

60

45

56

40

49

18

49

29

49

60

60

50

56

60

43

60

48

19

24

35

48

38

Standard

deviation

8.4

8.6

7.8

9.0

7.4

8.9

8.9

9.7

3.7

8.5

7,0

9.3

7.5

6.8

9,7

8.8

11.0

9.8

8.3

9.3

4,8

8.0

7.1

9.4

11.2

Standard

error of

mean

0.18

0.50

0.25

0.54

0.34

0.50

0.62

1.13

8.32

0.50

0.94

0.78

0.26

0.25

0.67

0.30

1.23

1.27

0.18

0.87

1.62

3.13

2.30

1.73

3.85

Percent

kfistribution of

population

1100.0

11.2

30.8

18.5

18.0

12.4

5.1

3.9

0.1

11.3

4.5

6.9

47.1

40.7

6.4

36.8

2.7

2.0

91.4

8.6

0.4

0.9

0.9

2.7

0.8

12
Table6. CES-D Depression Scale scores, standard deviations, standard errors ofmeans, andwrcent distrihtion ofdults2S74veatsdf

. ----

age byeducation completed andtotal annual family income: "United States, 1974-75

Education and annual family income

Total population aged 25-74 years ..............................

Education comoleted

Grades l.8 ...................................................................................

Grades 9-11 .................................................................................

High school .................................................................................

College:

1st year ..................................................................................

2d year ...................................................................................

3d year ...................................................................................

4th year...................................................................................

Graduate school ..........................................................................

Unknown ....................................................................................

Total annual family income

Lessthan $5. 000 .........................................................................

$5,000-$9,999 ............................................................................

$lo#ooo.$14.999 .........................................................................

$15,000-$19,999

$2O,OOO-$24,999::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

$25,000 or more .........................................................................

Unknown ....................................................................................

Mean

score

8.7

10.5

11.2

8.2

7.3

7.7

6.4

5.7

5.5

*8.7

*12.5

9.3

7.9

7.1

6.3

5.5

9.7

score

o

0

0

0

0

0

0

0

0

3

c1

o

0

0

0

0

0

Largest

score

60

49

60

56

4!5

41

60

25

32

26

60

50

60

49

56

31

43

Standard

deviation

8.4

9.3

9.5

7.9

7.4

8.5

6.8

5.7

6.1

5.9

9.8

8.3

7.9

7.5

6.9

6.3

8,4

Standard

error of

mean

0.18

0.62

0.53

0.30

0.61

0.61

0.88

0.47

0.56

5.77

0.58

0.34

0.36

0.25

0.36

0.40

0.97

Percent

distribution of

population

1100.0

18.9

?6,5

35.5

5.9

6.1

1.9

::

0.4

17.6

24.1

23.7

14.2

8.9

8.1

3.2

1106,956,216 adults 25-74 years of age.

13
Table7. CES-DDeDression Scale scores, standard deviations, i$tandarderrors of means, andpercent distribution ofadults 2&74yearsof

age by geographic region and siza and urbanization of place of residence: Unitad States, 1974-75

Socioaconomic characterist ic

Total population aged 25-74 years ..............................

Geographic region2

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

South ...................................................................................0......

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

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

Size and urbanization of date of residenca

Inside SMSA3 ................................t............................................

Urbanized area .......................................................................

Insida central city ................................,,............................

3 million or more .....................................................!. .0

1-3 million ....................................................................

250,000-1 million .........................................................

Lassthan 250,000 ........................................................

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

3 million or more .........................................................

1-3 million ....................................0............................0.0

250,000-1 million .........................................................

Lassthan 250.000 ........................................................

Urban place ............................................................................

Rural area...............................................................................

Farm .................................................................................

Nonfarm ...........................................................................

Outside SMSA3 ..........................................................................

Urban4 ...................................................................................

Rural ......................................................................................

Farm .................................................................................

Nonfarm ............................................................................

Mean

acora

8.7

8.3

9.1

8.8

8.5

8.6

8.7

9.4

10.3

8.4

9.3

*8,1

:::

8.1

7.7

*7.6

*10,9

7.2

6.7

;:

9.0

8.7

9.5

8.5

score

o

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

Largest

scora

60

60

56

49

60

60

60

48

48

::

38

60

::

45

29

48

56

15

56

60

43

60

34

60

Standard

deviation

8.4

8,2

8.8

8.4

8.2

8.4

8.4

8.6

8.8

7.7

8.5

8.8

8.1

8.5

8.2

7.9

6.9

11.6

7.7

4.0

8.0

8.4

8.8

8.1

7.0

8.4

Standard

error of

mean

0.18

0.49

0.53

0,32

0.36

0.20

0.23

0.38

0.70

0,78

0.80

3.21

0.27

::

0.79

2.50

2,77

0.40

1.30

0.46

0.44

0.42

0.73

0.83

0.72

Percent

distribu.

tion of

population

1100.0

~

22,8

24,6

24.3

28.4

66.4

55,7

28.5

9.3

3,6

12.2

3.4

27,2

8,0

6,2

10.8

2.2

1,5

9.2

0,7,

8.5

33,6

12.1

21.5

4.4

17.1

1106-956.216 ~d~lt~2$74 y~er~of age.

2see ‘app&&~ IIfor ~ Com-plete li~t~g of the compositionof each region. Regional composition essentially followed the standard

U.S. Bureau of the Census classification except for 6 States: Texas and Oklahoma were reclassified from the South intc~the West; and

Kansas, Nebraska, South Dakota, and North Dakota from the North Central Region into the West, leaving what has been renamed the

Midwest.

3SMSA = standard metropolitan statistical area.

41ncludea some urbanized areas and urban Pke.$.
Table 8. CES-D Depression Scale scores, standard deviations, standard errors of means, and percent distribution of adults 25-74 Years of

age by classof worker. usuaI activity, and sex: United States, 1974-75

Classof worker, usual activity, and sax

Total population aged 25-74 years ............................

Classof worker

Government sector.....................................................................

Federal .................................................................................d

State and local.......................................................................

Private sector..............................................................................

Paid .......................................................................................

Self-employed .......................................................................

Unpaid .................................................................................m

Never worked .............................................................................

Unknown ...................................................................................

Usual activity

8oth ~xes ..................................................................

Working ......................................................................................

Keeping houw ............................................................................

Unemployed ...............................................................................

Unable to work ..........................................................................

Attending school ........................................................................

Other ..........................................................................................

Unknown ....................................................................................

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

Working ............... ........... .. ........ ............ ...... .................... ........ ...

Keeping houw ............................................................. ................

Unemployed .......... ..................................... .......... .............. .........

Unable to work ...........................................................................

Attending school ........................................................................4

Other ...........................................................................................

Unknown ....................................................................................

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

Working .......................................................................................

Keeping house .............................................................................

Unemployed ................................................................................

Unable to work ...........................................................................

Attending school .........................................................................

Other ...........................................................................................

Unknown ....................................................................................

1106,956,216 adults 25-74 years Of age.

Mean

score

8.7

6.8

7.6

6.6

8.1

8.3

6.9

11.1

●15.9

10.1

8.7.

7.6

10.0

11.7

13.7

11.1

7.8

●12.0

7.1

:

6.5

*6.4

11.7

13.2

8.6

7.3

. . .

10.0

9.6

10.0

*12.8

15,3

13.9

●13.5

●12.O

Smallest

score

o

0

0

0

0

0

0

0

6

0

0

0

0

:

0

0

12

0

0

1

0

0

0

0

...

0

0

0

11

0

0

0

12

Largasi

score

60

36

33

36

60

60

35

32

28

60

60

60

48

35

49

36

43

12

60

60

19

35

48

36

43

-..

56

56

48

18

49

32

41

12

Standard

deviation

8.4

6.5

7.3

6.3

7.9

8.1

6.3

8.0

9.2

9.4

8.4

7.5

9.1

9.0

12.0

8.8

8.0

7.2

6.3

6.8

9.2

12.2

7.3

7.4

. . .

9.1

9.0

9.1

3.1

11.5

9.5

11.6

Standero

error of

mean

0.18

0.59

1,44

0.60

0.21

0.23

0.49

2.55

8.70

0.39

0.18

0.20

0.33

1.70

1.29

1.54

0.61

8.49

o.m

0.22

4.84

1.77

1.34

2.02

0.56

. . .

0.25

0.40

0.33

6.97

3.12

2.92

4.59

8.49

Percent

distribution of

population

1100.0

12.8

3.0

9.8

52.0

44.2

7.4

0.3

0.1

35.1

100.0

56.9

31.0

1.4

3.2

1.1

6.4

0.0

47.5

37.3

0.1

1.3

2.3

0.6

5.9

. . .

52.5

19.5

30.9

0.1

0.9

0.5

0.5

0.0

15
Table 9. CES-D Depression Scele scores, stendard deviations, standard errors of means, and percent distribution of adults 25-74 years of

aga by age and usual activity: United States, 1974-75

Age and usual activity 1Smallest Standard

deviation

8.4

Standard

error of

mean

Maan

score

Percent

distribution of

population

Largast

score

60 0.18

0.20

0.33

1.70

1.29

1.59

0.61

8.46

0.27

0.33

0.67

2.65

7.93

2,26

13.79

8,49

0.33

All ages 25-74 years ............................................................... 1100.0

Working ........................ .........................................................................

Kaaping houw ........................................................................................

,Unemployed ..........................................................................................

Unable to work ......................................................................................

Attending school ....................................................................................

Other .....................................................................................................

Unknown ....................................................................................... .... ....

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

Working ....................................................................................... .........

Keeping house .......................................................................................

Unemployed ..........................................................................................

Unabla to work ......................................................................................

Attending school ....................................................................................

Other .....................................................................................................

Unknown ...............................................................................................

35-44 years ...................................c..............................................

Working .................................................................................................

Keeping housa ........................................................................................

Unemployed ..........................................................................................

Unabla to work ......................................................................................

Attending school ....................................................................................

Other ........................ .............................................................................

Unknown ..............................................................................................

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

Working .................................................................................................

Keeping house...: ....................................................................................

Unemployed ..........................................................................................

Unable to work .......................................................... ............................

Attending school ...........................................................................,..,.,.,.,

Other .....................................................................................................

Unknown ...............................................................................................

55-64 years ..................................................................................

Working ................................. ................................................................

Keeping house ........................................................................................

Unemployed ..........................................................................................

Unable to work ......................................................................................

Attending school ...................................................................................

Other .....................................................................................................

Unknown .............................................................. .................................

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

Working .................................................................................................

Keeping housa........................................................................................

Unemployed ................... .......................................................................

Unable to work ......................................................................................

Attending school ....................................................................................

Other .....................................................................................................

Unknown ....................................................... ........................................

8.7

7.6

10.0

11.7

13,7

11.1

7.8

*12.O

8.5

0

56.9

31.0

1.4

3.2

1.1

6.4

0.0

0

0

0

0

0

0

12

0

60

48

35

49

36

43

12

48

7.6

9,1

9.0

12.0

8.8

8.0

8.3

6.9

9.8

10.1

15.8

7.1

16.6

8.8

27.3

7.4

10.3

12.4

*1 9.3

9.8

●13.1

●12.O

8.8

0

0

0

2

0

3

12

0

43

48

35

48

32

41

12

60

18.1

7.3

0.8

0.3

0.8

0.1

0.0

20.6

0.38

0.79

2.66

5.55

7,37

4.25

. . .

0.32

13.7

5.7

0.3

0,5

0.1

0.3

7.9

10,2

●8.2

*16.9

*I 2.0

‘11.6

. . .

8,7

7.5

10.4

“1 1.3

12.0

●16.5

●12.O

. . .

8.8

0

0

0

0

0

2

. . .

0

60

40

17

45

28

26

. . .

41

38

39

22

41

22

34

. . .

60

8.3

9.0

5.6

13.1

10.6

8.1

. . .

8.0

. . .

21.7

7.0

9.0

9.4

9.9

8.5

9.7

. . .

9.0

8.1

9.2

3.1

12.2

15.9

7.4

. . .

7.7

0.34

0.49

7.86

2.40

10.06

4,32

. . .

0.46

0.50

0.81

5.95

1.76

14.26

1.73

. . .

0.40

14.0

6.1

0.1

1.1

0.1

0.3

. . .

0

0

2

0

1

3

. . .

0 18.1

7,6

10.0

*1 7.3

13.4

916.3

7.3

. . .

8.4

7.8

9.1

●7.O

*12.8

. . .

7,3

. . .

0

0

13

0

3

0

. . .

0

60

38

21

49

36

43

. . .

41

9.3

6.7

0.1

1.2

0.1

1.6

. . .

12.3

0

0

7

2

. . .

0

. . .

29

41

7

33

. . .

38

. . .

6.5

8.0

9.8

.-.

7.5

. . .

1.03

0.86

4.95

3.66

. . .

0.46

. . .

1.8

6.2

0.0

0.2

. . .

4.0

. . .

1106,956,216 adults 2$74 years Of age.

16
Table 10. CES-D Depression Scale scores, standard deviations, standard errors of means, and parcent distribution of adults 25-74 years

of age by race and usual activity: United Statas, 1974-75

Largest

score

Standard

deviation

Standard

error of

mean

Percent

distribution of

population

Maan

score

Smallast

score

Race and usual activity

Al I races...................................................................... 8.7 0 60 8.4

7.5

9.1

9.0

12.0

8,8

8.0

8.3

0.18 1100.0

56.9

31.0

1.4

3.2

1.1

6.4

0.0

89.1

Worting .......................................................................................

Keeping houw .............................................................................

Unemployed ................................................................................

Unable to work ...........................................................................

Attanding school .........................................................................

Othar ...........................................................................................

Unknown ....................................................................................

7.6

10.0

11.7

13.7

11.1

7.8

*I 2.0

8.4

7.4

9.7

12.8

14.2

10.0

7.6

●I 2.0

11.1

0

0

0

0

0

0

12

0

60

48

35

49

36

43

12

60

0.20

0.33

1.70

1.29

1.54

0,61

8.49

White ................................................................................ 0.18

Worting ...........o...........................................................................

Keaping houw .............................................................................

Unamployad ................................................................................

Unabla to work ...........................................................................

Attending school .........................................................................

o

0

0

0

0

0

12

0

60

48

35

49

36

43

12

36

7.4

8.9

9.4

12.4

9.0

7.9

8.7

0.21

0.34

3.18

1.49

1,69

0.53

8.49

0,57

50.3

28.3

1.1

2.7

, 0.9

5.8

0,0

9.5

Unknown ....................................................................................

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

Worting .......................................................................................

Kaeping house.............................................................................

Unemployed ................................................................................

Unable to work ...........................................................................

Attending school .........................................................................

Other ...........................................................................................

Unknown ....................................................................................

9.9

13.8

*12.1

*I 1.3

*1 6.9

*10,2

. . .

7.9

0

0

3

0

10

0

. . .

0

36

36

21

33

21

34

. . .

25

7.9

9.8

6.8

9.7

4.8

8.4

. . .

6.9

0.67

1.27

6.66

4,00

6.39

2.69

. . .

1.71

5.6

2.4

0,2

0.5

0.1

0.6

. . .

Othar ................................................................................ 1.4

Working .......................................................................................

Keeping houx .............................................................................

Unemployed ................................................................................

Unable to work ...........................................................................

Attanding school .........................................................................

Other ...........................................................................................

Unknown ....................................................................................

●7.6

●I 0.4

+4. 1

. . .

●16.O

. . .

. . .

0

0

3

. . .

16

. . .

. . .

25

25

5

. . .

16

. . .

. . .

6.5

8.8

1.0

. . .

. . .

. . .

2.41

4.56

2.80

. . .

11.31

. . .

. . .

1,0

0.3

0.2

. . .

0.0

. . .

. . .

1106,9S6,216 adults 25-74 Years of age.

17
Table 11. CES-D Depression Scale scores, standard deviations, standard errors of means, and percent distribution of adults 25-74 years

of age by sex and business or industry: United States, 1974-75

Sex and business or industry I

Mean

score

8.0

“11.5

8.8

6.7

6.9

6.4

6.7

6.5

6.7

●7.6

6.5

7.3

6.2

6.7

6.3

“6.2

● 8.6

5.6

8.5

20.6

“11.6

“1.0

“9.8

11.8

12.8

10.8

“7.2

“6.5

8.1

●7.2

10.3

4.5

11.4

10.5

10.5

10.6

“ 10.8

8.1

10.3

11.4

=!= Smallest Largest

score score

o 60

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

3

0

0

5

35

33

60

50

50

41

30

23

18

30

49

38

49

41

23

33

26

56

60

35

T

o 60

0 29

0 33

0 60

0 31

0 31

0 24

0 30

0 22

0 16

0 30

0 36

0 36

0 23

0 41

0 20

0 17

3 11

0 30

0 60

5 35

-4-J

o 35

1 1

1 23

0 50

0 50

0 41

0 23

0 23

1 18

1 12

0 49

0 16

0 49

0 34

1 23

0 33

3 26

0 56

0 49

11 12

Standard

deviation

6.4

6.5

9,5

7.8

7.6

7.8

7,3

6.1

6.1

5.2

6,a

8.5

7.4

8.7

8.a

6.4

8.2

5.7

7.a

9.1

13.0

7.2

5.a

9.5

7.7

5.9

5.9

5.7

5.a

5.8

5.2

6.a

6.6

8.3

5.6

8.9

5.5

5.6

23

5.a

8.7

15.0

a.1

9.a

0.0

8.9

9.9

10.8

8.8

7.0

8.4

5.0

5.5

9.a

4.3

10.3

8.0

7.1

a.a

a.o

6.4

9.2

0.5

Standard

error of

mean

o.la

1.04

6.75

0.81

0.47

0.48

0.s6

0.44

0.61

1.03

1.85

0.41

0.72

0.54

0.75

o.7a

0.86

I .5a

0.43

0.94

0.40

0.20

0.93

7.35

o.7a

0.35

o.4a

0.71

o.4a

0.67

1.13

2.00

0.46

0.85

0.65

1.07

0.s4

1.87

2.al

0.92

1.13

0.70

0.25

2.aa

0.71

8.00

1.14

1.30

1.67

1.23

2.50

1.74

5.33

0.70

0.73

o.7a

I .3a

1.44

1.13

4.03

0.54

1 .oa

0.41

Percent

distribution of

population

1100.0

2.4

0.2

4.5

15.8

9.5

6.2

4.8

3.3

0.8

0.8

I o.a

2.a

8.1

2.9

1.9

2.8

0.4

13.3

39a

0.3

47.5

2.1

0.2

4.4

11.2

7.3

3.9

4.3

3.0

0.6

0.7

6.0

1.9

4.0

1.8

1.2

0.9

0.2

3.9

11.2

0.2

52.5

0.3

0.0

0.1

4.6

2.3

2.3

0.6

0.3

0.2

0.0

4.9

0.8

4.1

1.2

0.6

1.9

0.2

a.3

28.6

0.1

1106,9s6,2 16 adults 25-74 years Of we.

18
Table 12. CES-D Depression Scale scores, standerd deviations, standard errors of means, and ~rcent distribution of adults 25-74 years

of age by sex and occupation: United States, 1974-75

Sex and occupation

Both sexes...................................................................

Professional, technical, and kindred workers ..............................

Managers and administrators, except farm ...................................

Salesworkers.........................................................,,,.,..,,,,,...,,,, .,, ,

Clerical and kindrad workers .......................................................

Craftsmen and kindred workars ...................................................

Operatives, except transport ........................................................

Transport equipment operatives ..................................................

Laborers, except farm .................................................................

Farmers and farm managers,...,,.,.,.,,.,.,., ......................................

Ferm Iaborars end farm foremen .................................................

Service workers, axcapt private household ..................................

Private household workers ...........................................................

Not applicable .............................................................................

Mele ..................................................................................

Professional, technical, and kindrad workers ...............................

Menagers and administrators, excapt farm ...................................

Salesworkers................................................................................

Clerical end kindred workers .......................................................

Craftsmen end kindred workers ...................................................

Operatives, except transport ........................................................

Transport equipment operatives ..................................................

Laborers, except farm .................................................................

Farmars and farm man~ers .........................................................

Farm laborers and farm foremen .................................................

Service workars, excapt privete household ..................................

Private housahold workars ...........................................................

Not applicable .............................................................................

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

Professional, tachnical, and kindrad workers ...............................

Managers and administrators, axcapt farm ....................... ...........

Salesworkers ................................................................................

Clerical and kindred workers .......................................................

Creftsmen and kindrad workers ...................................................

Operatives, except transport ........................................................

Transport equipment operatives ..................................................

Laborers, axcept farm .................................................................

Fermars and farm managers.........................................................

Farm Ieborers and farm foremen .................................................

Service workers, excapt private household ..................................

Priveta household workers ...........................................................

Not applicable .............................................................................

Mean

score

8.7

5.8

5.9

G

U

8.3

7.8

8.0

11.7

9.9

10,1

14.0

7.1

5.3

5,4

5.1

6.2

7,3

8,0

8.5

7.2

7.5

11.9

7.7

●9.1

● 17.6

10.0

6.4

7.7

10.9

9.2

*13.5

12.0

*5.1

*14.5

*13.2

●11.3

11.5

10,4

8.1

Smalles

score

(

(

c

c

c

c

c

c

c

c

c

c

c

i

a

o

0

0

0

a

o

0

0

:

0

0

5

0

0

0

0

0

1

0

0

3

0

7

0

0

2

LargaS

score

6C

41

4~

34

M

6C

3e

29

41

35

H

60

35

60

24

38

24

30

60

33

29

41

29

17

28

60

35

56

41

45

34

56

50

38

14

21

35

17

48

49

12

Standarc

deviatior

8.k

5.$

6,i

8,:

8.:

7.7

8.;

7.C

z

4,1

8.4

9.3

12,E

7.2

5.2

E

5.7

7.2

6.1

7.1

7.3

5.7

3.8

6.6

9.6

14.8

9.1

6.7

9.7

9.4

8.8

15.4

9.4

5.2

5.9

12.1

4.5

9.2

9.2

4.5

Standerc

error of

mean

0.1[

0.46

0,47

0,72

(-j4~

0.5E

0.64

0.94

1!01

1,19

2.07

0,49

0.40

2,61

0.20

0,45

0.49

1.21

0,82

0.50

0.57

0.98

0.85

N

0.71

0.70

1.41

0.25

0.65

1.65

1.27

0.54

5.64

1.15

2.25

3.96

5.79

4.63

0.70

0.42

2.54

Percent

distribution of

population

1100.0

10,5

8.1

3.5

11.0

9.4

7.0

2.6

2.3

:;

7.5

35,6

0,4

47.5

6.3

6.5

1.9

3.0

9,1

3.6

2.5

2.1

Y2

3.1

7.6

0.2

52.5

4.3

1.6

1.6

8.1

0.3

3.4

0.1

0.2

0.2

0.1

4.5

28,0

0.1

1106,956,216 adults 25-74 years of age.

19
APPENDIXES

CONTENTS

I. Statistical Notes ...................................... ........................ ........................ ........................ ...... .........

The Suwey Desi~ ................................................ ...... ..............................................................

Mksing Data .... ..........................................................................................................................

Sampling and Measurement Error ........ .....................................................................................

Tests of Si@ificance ...... ........................ ...... ............... ............................................................ .

II. Definitions of Demogmphic and Socioeconomic Terms ... ................ ........ ......................................

III. HANESIData Tape Summmy Catalog Numl>er 4171:Generd Well-Being and CES-DScdes ........

IV. Description of the CES-D Scale ....... ........................ ........................ .............................. .................

Instructions for Scale Scoring of the CES-D ............................................................ ..................

Rules for Mksing Data ...................... ...... .......... ........................................................................

Interpretation of Scale Scares ...................................................................................................

Generaf Well-Being Questiormaire ............... ...... .......... .............. ................................................

21

21

22

22

24

25

29

APPENDIX FIGURE

I. Schematic (or Venn) diagram of the relationships among the terms used to describe urbanization

of place of residence .............................................. ...... ................................................................... 27

LIST OF /\ PPENDIX TABLES

I. Estimated number in U.S. population for HANES I examination locations 66-100 by sex, race,

and age .................................. .............................. ...................................................... ...... ...... ......... 22

II. Number in sample and estimated number in U.S. population by selected sociodemographic characteristics for alf HANES I survey examinecs in stands 66-100 and number and percent for those

with unusable depression data ..................... ......................... .......................................................... 23

20
APPENDIX I

STATISTICAL NOTES

The Survey Design

The design of the Health and Nutrition

Examination Survey (HANES I) Augmentation

of adults 25-74 years of age is basically a

three-stage stratified probability sample of persons representative of the civilian noninstitutionalized population of the coterminous United

States. The Augmentation Survey design had

two basic constraints: (1) The sample had to

constitute in itself a national probabilityy sample

of the target population; and (2) When considered jointly with persons 25-74 years of age who

had already received the detailed examination in

HANES I locations 1-65, the Augmentation

Sample in locations 66-100 had to complete a

larger (100-primary sampling unit) national

probabiIit y sample and, thereby, would reduce

the sampling error attendant to population

estimates deriving from the smaller (stands 1-65

only) probability sample’s size.

Twelve primary sampling units (PSU’S) were

included in both the Augmentation Survey

sample and the initial 65-PSU design; thus there

were only 88 distinct sample PSU’S. The sample

design specifications, selection procedures, and

data collection procedures have been described

in detail elsewhere.2J3

The HANES I sample design divided the

coterminous United States into 1,900 geographic areas or PSU’S. A PSU consisted of a

county, a small group of contiguous counties, or

a standard metropolitan statistical area. These

1,900 PSU’S were collapsed into 40 superstrata.

Of the 40 superstrata, 15 were composed of

only one very large metropolitan area of more

than 2 million people and were drawn into the

NOTE: A list of references follows the text.

HANES 65-PSU design with certainty. However,

in the Augmentation Survey, only five superstrata were drawn into the sample with certainty. The other 10 superstrata that were drawn

into the 65-PSU design with certainty were

collapsed into five groups of two each, only one

of which was chosen for the Augmentation

Survey with a probability of 0.5. In each of the

25 remaining non certainty strata, defined as

they were for the HANES I 65-PSU design, a

PSU selection was made with probability proportional to size, according to a controlled selection

procedure independent of the PSU’S selection

status in the 65-PSU design. Only two PSU’S in

the noncertainty strata were included in the

sampling frames of both parts of the HANES.

Enumeration districts (ED’s, subdivisions of

a PSU used by the U.S. Bureau of the Census for

administrative purposes, usually averaging 800

people or 250 housing units) were divided into

segments of eight housing units each. In urban

areas for which listing units were well defined in

1970, this division was quite accurate, since

listings resulting from the 1970 Census comprised the sampling frame. For ED’s not covered

by the 1970 listing, area sampling was employed. Consequently, some variation in segment size occurred. To make the sample representative of the current population of the

United States, the Iisted segments were supplemented by a sample of housing units that had

been constructed since 1970. Then a systematic

sample of segments in each PSU was selected.

Randomly selected reserve segments were drawn

to provide a minimum of 105 sample persons

per PSU.

After the sampIe segments and current addresses within the segment boundaries were

selected, household interviews were conducted

21
to determine age and other demographic and

socioeconomic information for each household

member. This information was used to identify

individuals fitting the age, sex, and race sampling

criteria. From this group, a systematic sample of

1 out of every 2 persons was selected for

participation in the survey.

Since HANES I had a complex multistage

probability design, it was necessary to use a.

three-stage procedure to derive accurate population estimates. The following operations were

involved:

Inflation by the reciprocal of the probability

of selection, —The probability of selection was

the product of the probabilities of selection

from each step of selection in the design (PSU,

segment, and sample person).

Nonresponse adjustment. —The estimate:;

were inflated by a multiplication factor calculated within each PSU for each of five selected

income groups. The numerator of these factors

consisted of the sum of the weights for sample

persons, the weights derived from the reciprocal

of the probability of selection. The denominator

consisted of the sum of the weights for examined persons, also derived from the reciprocal of

the probability of selection. The nonresponse

adjustment corrected for the failure to exarnirw

all sample persons.

Poststratification by age-sex-race,–The estimates were ratio-adjusted within each of six

age-sex-race cells to independent estimates, prclvided by the U.S. Bureau of the Census, of the

population of each cell as of the midpoint of the

survey (table I). The effect of the ratio-estimating process was to make the population estimates derived from the sample approximate

more closely the total U.S. civilian noninstitutionalized population.

Missing Data

Appendix IV describes the rules for classifying survey respondents with missing depression

data into two categories: those whose CES-D

questionnaires were unusabIe (N = 36 or 1.2

percent of the 3,059 persons examined) and

those whose total CES-D scores were usable with

imputation for missing items (N = ,209 or 5.4

percent of examiners). Appendix IV also describes the method of imputation. Table II gives

sample counts and population estimates for all

survey respondents and for those with unusable

CES-D data, by sex, age, race, and geographic

region,

Demographic or socioeconomic data may

have been missing because of the fa,ilure to

obtain and record all items of information for

examined persons. Where a sociodemographic

characteristic was missing from a respondent’s

record, population estimates deriving from that

person’s record were classified in an “unknown”

category in the corresponding detailed table,

Sampling and Measurement Error

The probability design of the survey makes

possible the calculation of sampling errors.

Traditionally, the role of the sampling error has

been the determination of how imprecise the

survey results may be because they come from a

sample rather than from the measurem~nt of all

elements in the universe.

Table 1. Estimated number in U.S. population for HANES I examination locations 66-100 by sex, race, and age

Male Female

Age Both sexes

Al I races:L White Black All racesl White Black

All ages 25-74 years..... 108,494,134 51,439,961 46,015,835 4,613,378 57,054,173 50,390,062 5,981,727

25-34 years.................................. 29,523,998 14,236,258 12,614,365 1,168,091 15,287,740 13,253,794 1,597,207

35-44 years, ................................ 22,410,843 10,874,445 9,660,072 987,334 11,536,398

45-54 years......l ...........................

9,982,989 1,384,481

23,539,806 11,214,167 10,126,341 1,042,364 12,325,639 10,956,949 1,281,973

55-64 years.................................. 19,550,025 9,263,545 8,325,090 854,010 10,286,480 9,280,774 1,005,706

65-74 years..., .............................. 13,469,462 5,851,546 5,289,967 561,579 7,617,916 6,915,556 ~ 702,360

llncludes races which are not shown SePi3raklY.

NOTE: Estimates closely approximate the U.S. population estimated by the U.S. Bureau of the Census March 1, 1975.

22
Table 11. Number in sample and estimated number in U.S. population by selected sociodemographic characteristics for all HANES I

suwey examinees in stands 66-100 and number and percent for those with unusable depression data

Characteristic

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

—Sex

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

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

Age —

25.34 yaars ..............................................................

35-44 years ..............................................................

45-54 years ..............................................................

55-64 yaars ..............................................................

65-74 yaars ..............................................................

Race

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

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

Other .......................................................................

Geographic region

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

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

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

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

All survev examinaes

Number

in

sample

3,059

1,332

1,727

839

618

682

541

379

2,760

261

38

769

726

791

773

Us.

population

in thousandsl

108,494

51,440

578054

29,524

22,411

23,540

19,550

13,469

96,406

10,595

1,493

24,681

26,801

26,201

30,610

Examinees with unusable depression data

Number

in

sample

36

13

23

:

6

5

10

25

11

10

14

6

6

Percent

of total

sample

1,2

1.0

1,3

0.8

1.3

0.9

0,9

2.6

0.9

4.2

1.3

1.9

0.8

0.8

U.S.

population

in thousandsl

1,537,9

603.5

934.5

281.9

391.6

298,0

212,4

354.0

1,058,7

479.2

522.4

541.4

218.0

256.1

Percent

of total

population

1,4

1.2

1.6

1.0

1.7

1.3

1.1

2.6

1.1

4.5

2.1

2.0

0.8

0.8

The estimation of sampling errors for a

study such as the Health and Nutrition Examination Survey is difficult for at least three reasons:

(1) Measurement error and “pure” sampling

error are confounded in the data. It is not easy

to find a procedure that will completely include

both or treat one or the other separately. (2)

The survey design and estimation procedures are

complex and, accordingly, require computationally involved techniques for the calculation of

variances. (3) Many statistics are presented in

the tables in this report, some of which are for

subclasses of the population with only a small

number of sample cases. Estimates ,of sampling

error are obtained from the sample data and are

themselves subject to sampling error when the

number of cases in a cell is small or, occasionally, when the number of cases is substantial.

Estimates of the standard errors for selected

lEstimates cl~~ely ~ppro~imat~ the U.S. population estimated by the U.S. B~rea~ of the c~ns~s f&rch 1, 19750

statistics used here are presented in the tables.

These estimates were prepared by the balanced

repeated half-sample replication technique,

which yields overall variability through observation of variability among random subsamples

of the total sample.1o~l1 The standard error is

primarily a measure of sampling variability, that

is, the variations that might occur by chance

because only a sample of the population is

surveyed. As calculated for this report, the

standard error also reflects part of the variation

that arises in the measurement process. It does

not encompass estimates of any biases that

might be included in the data. The chances are

about 68 out of 100 that an estimate from the

sample would differ from a complete census by

less than the standard error. The chances are

about 95 out of 100 that the difference would

be less than twice the standard error and about

23
99 out of 100 that it would be less than 2Y2

times as large.

Tests of Significance

The procedure used for testing the significance of the difference between any two selected means (x and y) consisted of dividing the

difference between the two means, d = x - y, by

the standard error of the difference; that is, a

z statistic was computed. An approximation of

the standard error of the difference between the

two means was obtained using the formula

Sd = (s,2 + SY2)+$, where SXZ and SY2 represented samplmg errors for x and y, respectively.

An example may be helpful. The test between

males and females in this study would be performed as follows:

(10.0- 7.1)

~= = 9.06.

(0.2 X 0.2+ 0.25 X 0.25)%

When this z statistic exceeds 1.96, as it does in

our example, the probability of finding a difference is 5 percent or less. The sampling covariance for x and y was conservatively assumed to

be greater than or equal to zero. The sampling

distribution of the difference between the two

means was assumed to be asymptotically normal

for large sample sizes, with the mean of this distribution being taken as zero to test the null

hypothesis.

If more than one test is implied (such as

marital status differences—three tests), the Bonferroni test 1z was used to test for significance.

In the Bonferroni test the z statistic is also computed; however, for the difference between two

means to be considered significant at the 95 percent confidence level, the z statistic must be

greater than or equal to 2.40 when three tests

are performed. The interested reader can find

more details in the reference given for the Bonferroni test.

000

24
APPENDIX II

DEFINITIONS OF DEMOGRAPHIC AND SOCIOECONOMIC

The demographic and socioeconomic characteristics of the population sample are defined as

follows:

Age. –The age tabulated for each examinee

was the age at last birthday as of the date of

examination. The age criterion for inclusion in

the survey sample, however, was age as of the

date of the household interview. In this sample,

there were four examinees who were 74 years of

age at the time of interview and 75 years of age

at examination. In the adjustment and weighting

procedures used to produce national estimates,

these persons were included in the 65-74 year

age group.

Race. –Observed race was recorded as

“white, “ “black,” or “other.” “White” included

Hispanics. “Blacks” included persons of mixed

black and other parentage. “Other” included all

OrientaI, American Indian, and other racial

groups besides white and black. Mexicans were

classified as “white” unless definitely known to

be of a nonwhite race. When a person of mixed

racial background was uncertain about his race,

the race of the father was recorded.

Man”tal status. –The five categories of marital

status on the household questionnaire were

“married,” “widowed,” “never married,” “divorced,” and “separated.” A person whose

marriage was annulled was included among the

“never married.” The remaining classifications in

the questionnaire constituted the “ever-married”

group. Those classified as “currently married” in

the tables in this report included persons who

reported that they were presently married and

not living apart due to marital discord and

persons having common-law marriages. The subgroup “formerly married” included persons who

were divorced, widowed, or separated. “Separated” referred only to married persons who

were legally separated or who had parted because of marital discord. Thus persons separated

because of circumstances of employment, service in the Armed Forces, or similar reasons were

classified as “currently married” rather than

“separated.”

Number of household members. –The count

of individual residing within a household included all members, regardless of whether they

were related to the head of the household.

Persons who were in active military service or

who indicated that they had another residence

were excluded from the count unless they were

listed as the head of the household.

Relation to head of household. –One person

in each household (and in each family) was

designated as the “head.” The number of heads,

therefore, was equal to the number of households (or families). The head was usually the

person regarded as the head by the members of

the household. Married women were not classified as head of household if their husbands were

living in the same household at the time of the

survey.

Years of education completed. –The highest

grade of formal education completed in a graded

public or private school, day or night, with

fulltime or parttime attendance. Only those

grades completed in a school that advances a

person toward an elementary or high school

diploma or a college, university, or professional

school de~ee were counted. Education received

in vocational, trade, and business schools outside

the regukir school system was not counted in

determining the highest grade of school completed. If a person attended school in a foreign

country or an ungraded school, studied under a

25
tutor, or had other special circumstances, the

nearest equivalent of the highest grade attended

was assigned.

Total annual family income. –Tlhe income

recorded was the total income received during

the 12 months prior to the interview by the

head of the household and all other household

members related to the head, This income was

the gross cash income (excluding pay in kind),

except in the case of a family with its own farm

or business. In that case, net’ income was

recorded. Also included was the income of a

member of the Armed Forces who was living at

home with his family (even though he might not

be considered a household member). If he did

not live at home, allotments and other money

received from him by the family were included

in the family income figure.

Geographic region. –The 48 contiguous

States and the District of Columbia were stratified into four broad geographic regions, each of

about the same population size. The composition of the regions was as follows:

Region

Northeast ...

South .........

Midwest .....

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

It should

States included

Maine, New Hampshire, Vermont, Massachusetts, Connecticut,

Rhode Island, New York, New

Jersey, Pennsylvania

Delaware, Maryland, Virginia, West

Virginia, Kentucky, Arkansas,

Tennessee, North Carolina, South

Carolina, Georgia, Florida, Ala,-

bama, Mississippi, Louisiana, District of Columbia

Ohio, Michigan, Indiana, Illinois,

Wisconsin, Minnesota, IowaL,

Missouri

Washington, Oregon, Idaho, Montana, Wyoming, North Dakota,

South Dakota, California, Nevada,

Utah, Colorado, Nebraska, Arizona, New Mexico, Oklahoma,

Kansas, Texas

be noted that in a few cases the

actual boundaries of the regions do not follow

State lines. Some PSU’S located in Midwestern

26

and southern States have been included, in the

West region. Similarly, some PSU’S locited in

western States have been allocated to the Midwest and South Regions.

The regional composition essentially followed the standard U.S. Bureau of the Census

classification,G except for six states: Texas and

Oklahoma were HANES-reclassified from the

South into the West Region; and Kansas, Nebraska, South Dakota, and North Dakota from

the North Central into the West Region,, leaving

what has been renamed the Midwest Region,

Size and urbanization of place. –Five terms

used by the U.S. Bureau of the Censu# were

employed to categorize the area of resic[ence of

HANES respondents: (1) standard metropolitan

statistical area (SMSA), (2) central city, (3)

urbanized area, (4) urban place, and (5) urban

or rural. According to the 1960 Census, those

areas considered urban were:

1.

2.

3.

4.

5.

Places of 2,500 inhabitants or more that

were incorporated as cities, bl~roughs,

villages, and towns (except towns in New

England, New York, and Wisconsin);

The densely settled urban fringe,

whether incorporated or unincorporated,

of urbanized areas;

Towns in New England and townships in

New Jersey and Pennsylvania that contained no incorporated municipalities as

subdivisions and had either 25,,000 or

more population, or a population of

2,500-25,000 with a density of 1,500

persons or more per square mile;,

Counties in States other than the New

England States, New Jersey, and Pennsylvania that had no incorporated municipalities within their boundaries and

had a population density of 1,500 persons or more per square mile;

Unincorporated places of 2,500 inhabitants or- more th& were not included in

any urban fringe.

The remaining population was classified as rural.

An SMSA consisted of a county or I@oup of

contiguous counties (except in New England)
that contained at least one central city of

50,000 people or more, or twin cities with a

combined population of at least 50,000 people.

In addition, other contiguous counties were

included in an SMSA if, according to certain

criteria, they were socially and economically

integrated with the central city. Definitions of

SMSA’S, including the composition and structure of each, may be found eIsewhere.13 Thus

persons “in the central city“ of an SMSA were

defined as those whose residency was in the city

or cities of the specified standard metropolitan

statistical area. Persons who resided in an SMSA

but outside the city mentioned in the SMSA

title were considered “not in central city.”

These definitions made it possible for “ruralfarrn” and “rural-nonfarrn” to be coded as “in

SMSA.”

An “urbanized area” contained a central city

or twin cities meeting the same criteria as those

used for defining an SMSA, plus the surrounding

closely settled urban fringe of incorporated and

unincorporated areas that met the following

population size or density criteria:

1.

2.

3.

4.

Places of 2,500 or more inhabitants;

Incorporated places with less than 2,500

inhabitants, provided each had a closely

settled area of 100 dwelling units or

more;

Adjacent unincorporated areas with a

population density of 1,000 or more inhabitants per square mile; or

Other adjacent areas with lower population density that served to smooth the

boundary line or to link densely popuIated contiguous areas.

An “urban place” (shown in table 7 both as

inside SMSA’S and as part of “Urban” outside

SMSA’S) was:

1. An incorporated place

2. An unincorporated place of 2,500 inhabitants or more

3. An urban

In summary,

tained within an

town, township, or county.

a central city was always conSMSA and an urbanized area.

An urbanized area was usualIy contained in an

SMSA, wholly or at least in part, and in a centraI city. An urban place might have been contained within an SMSA and/or within an urbanized area, or it might have existed separately

from the two (see fi&re I).

Key

UA = urbanizedarea

UP= urban place

CC= central city

SMSA = standardmetropolitan

statist”wl area

Figure

M1. Schematic (or Venn) diagramFilm

of the relationships

among the terms used to describe urbanization of place of

residence

‘Usual activity. –This item on the household

questionnaire was defined as that function or

major social role (working, keeping house, unemployed, etc.) in which the person” had been

engaged for most of the time between the date

of interview and the same date 3 months earlier.

“Working” incIuded paid work as an employee

of someone else for wages, salary, commission,

or “pay-in-kind” (meals, living quarters, or

supplies provided in the place of cash wages).

Also included was work ‘in the person’s own

business, professional practice, or farm, and

work without pay in a business or farm run by a

relative. Work done around a person’s own

house and volunteer, unpaid work for a church

or charity were not included in the “working”

classification. Unemployed persons included

those “looking for work” and “Iaid off.” The

“unable to work” classification included persons

who were ill or disabled. The “other” category

included those persons who had “retired” or

were “staying at home .“

27
Business or industry. –The business or industry in which a person reported that he was

working was classified according to the major

activity of the establishment. The only exceptions to this were for those few establishments classified according to the major activity

of the parent organization (such as research

laboratories, warehouses, repair shops, and storage garages), where the establishment existed

primarily to serve the parent organization, rather

than other organizations or the public. The

business or industry groupings were those used

by the U.S. Bureau of the Census for the 1970

Census.7 The industry “public administration”

was limited to the postal service and other Federal, State, and local public administrations; this

category included only uniquely government

functions and excluded those activities which

might also be carried out by private enterprise.

For example, teachers in public education facilities and nurses engaged in medical services of

governmental agencies were included in the

“professional and related services” group.

Occupation.–The principal or only kind of

work the person reported doing during the 2

weeks preceding the interview was considered to

be his occupation. If the person worked at or

held more than one job, the question refdrred to

the job at which he spent the most time, If equal

time was spent at each job, the question referred to the job the respondent consickred to

be the most important or the one he had held

longer. A person who had not yet begun work at

a new job, was looking for work, or was on layoff from a job was questioned about his last

fulltime civilian job or business. The occupation

groupings shown are the same as those used by

the U.S. Bureau of the Census for th~e1970

Census.7

-—ooo —

28
APPENDIX Ill

HANES I DATA TAPE SUMMARY CATALOG NUMBER 4171: GENERAL

WELL-BEING AND CES-D SCALES

Tape

Positions

CATALOG NUMBER -4171 .......................................................................................................................................................... 201

GENERAL WELL-BEING ADJUSTMENT INDICATORS

Have you ever been bothered by an illness, body disorder, pains, or fears about your health? (DURING THE PAST MONTH) ....... 209

How concerned or worried about your HEALTH have you bean? (DURING THE PAST MONTH) ................................................. 210

Have you felt tired, worn out, used-up, or exhausted? (DURING THE PAST MONTH) ................................................................... 212

Have you been waking up fresh and rested? (DURING THE PAST MONTH) ................................................................................... 213

How much ENERGY, PEP, VITALITY have you felt? (DURING THE PAST MONTH) .................................................................. 214

How happy, satisfied, or pleased have you been with your personel life? (DURING THE PAST MONTH) ....................................... 216

Has your daily life been full of things that were interesting to you? (DURING THE PAST MONTH) .............................................. 217

Have you felt down-hearted and blue? (DURING THE PAST MONTH) .......................................................................................... 218

How have you been feeling in general? (DURING THE PAST MONTH) ........................................................................................... 219

Have you felt so sad, discouraged, hopeless, or had so many problams that you wondered if anything was worthwhile? (DURING

THE PAST MONTH) ................................................................................................................................................................... 220

How DEPRESSED or CHEERFUL have you bean? (DURING THE PAST MONTH) ....................................................................... 221

Have you baen anxious, worried, or upset? (DURING THE PAST MONTH) .................................................................................... 223

Have you been under or felt you were under any strain, stress, or pressura? (DURING THE PAST MONTH) 224

Heve you been bothered by nervousnessor your “nerves?” (D’LJRING THE PAST MONTH) ........................................................... 225

..................................

How RELAXED or TENSE have you been? (DURING THE PAST MONTH) .................................................................................. 226

Have you been in firm control of your behevior, thoughts, emotions OR feelings? (DURING THE PAST MONTH) ........................ 228

Have you been fealing emotionally stable and sure of yoursalf? (DURING THE PAST MONTH) ..................................................... 229

Have you had any reason to wonder if you were losing your mind, or losing control over the way you act, talk, think, feel, or of

your memory? (DURING THE PAST MONTH ) .......................................................................................................................... 230

ADJUSTMENT FACTORS (SUB-SCALE SCORES)

Freedom from Health Worry, Concern .............................................................................................................................................. 231

Energy Level ................................................................................................................................ ................................ ..................... 233

Satisfying, Interesting Life ................................................................................................................................................................ 235

Cheerful w. Depressed Mood ............................................................................................................................................................ 237

Ralaxed vs. Tense, Anxious ............................................................................................................................................................... 239

Emotional-Behavioral Control ........................................................................................................................................................... 241

Total Ganeral Well-Baing Scale Score ................................................................................................................................................ 243

THE GWB CRITERIAL SECTION

Have you had severe enough parsonal, emotional, behavior, or mental problems that you felt you needad help DURING THE

PAST YEAR? .............................................................................................................................................................................. 246

Have you ever fait that you were going to have, or were close to having, a nervous braakdown? ...................................................... 247

Have you ever had a nervous braakdown? ......................................................................................................................................... 248

Have you ever been a patient (or outpatient) at a mental hospital, a mental health ward of a hospital, or a mental health clinic,

for any personal, emotional, behavior, or mental problem? ......................................................................................................... 249

Hava you ever seen a psychiatrist, psychologist, or psychoanalyst about any personal, emotional, behavior, or mental problem

concerning yourself? .................................................................................................................................................................... 250

29
Have you talked with or had any connection with any of the following about some personal, emotional, behavior, mental l~robIem, worries, or “nerves” CONCERNING YOURSELF DURING THE PAST YEAR? ...

Regular medical doctor (except for definite physical conditions or routine checkups) ................................................................

Brain or nerve specialist ....................................... ................ ................................... ..................................... ...............................

Nurse (except for routine medical conditions) .................... ........................................... ...................... .................................~......

Lawyer (except for routine legal services) ............................ .... .. .................................... .............................. ............................ ....

Police (except for simple traffic violations) ........ ................ ................................................ ................................................ ......<..

Clergyman, minister, priest, rabbi, etc. .............................. .. .................... ....................................................................................

Marriage Counselor .................. ........................................... ..... ....................... .............................................................................

Social Worker .... ....... ..... ..................................................... ..................... ....................................................................................

Other formal assistance (If yes, what kind?) ............. ............................. ............................ ..........................................................

Number of “yes” options checked for positions 251-259 ........ ................ ....................................................................................

251

252

253

254

255

256

257

258

259

Do you discuss your problems with any member of your family or friends? ..................................................................................... 261

GWB filled out by . . .? .......................................................... .............................. .............. ............................... ................ .......,!........ 262

NIMH’S CES-D DEPRESSION SCALE

DURING THE PAST WEEK, . . .

I was bothered by things that usually don’t bother me —. ... ................................................................................................... 279

I did not feel like eating; my appetite was poor — ................. .................... .. .................................................. ........................... 280

I felt that i could not shake off the blues even with help from my family or friends— ......................... ........................ ...~....... 281

I felt that I was just as good as other people — ...... .........t...................................................... ............... ........................ ........... ~~

I had trouble keeping my mind on what I was doing — ........ .................................. .. ...............................................................

I felt depressed — ............................................................!.... . .......................... ............................................4........................ ....

I felt that everything I did was an effort — ................’* ... ............................................................................... .........................

I felt hopeful about the future_ ... ................................ ...... ....................................................................................... ............

I thought my life had been a failure— ... ................ ......... .................. .............................. .........................................................

I felt fearful— .............................................. .................. .........................................................................................................

My sleep was restless_ .................... .................................... ............ ........ ................................................................................

I was happy— ................................................................................................ .........................................................................

I talked less than usual — .................................................................................. .............................................. ................ .........

I felt lonely— ....................................................... .................... ...............................................................................................

People were unfriendly— ............................ ...................... .. .................................................... ........................................ ........

284

285

286

287

288

289

290

291

292

293

I enjoyed life — ............... ......................................................................... .............. .............. .. .......... .............................,.1. ....... 294

I had crying spells_ ................................... ................ ............................................ ...... ..................................................~........ 295

I felt sad — ................................................................ .......................................... ...................... ................................ .............. 296

I felt that people disliked me_ ........................... .................................... ...................... ............................ .............................. 297

I could not get “going”_ ........................................................ ......................................................... ....................................... 298

Total CES-D Depression Scale Score ....................................................................................... ...... .................4. ..... ...................... 299

000

30
APPENDIX IV

DESCRIPTION OF THE CES-D SCALE

The depression questions used in the

HANES I survey were the 20-item set of the

CES-D developed and validated by the Center

for Epidemiologic Studies, National Institute of

Mental Health (NIMH) .*Y5 The questions were

asked in the context of psychometric testing at

the time of the physical examination, at the end

of the General Well-Being Questionnaire. Responses to the CES-D correlated 0.71 with the

Depressed Mood Subscale of the General WellBeing Scale.

The CES-D scale was designed as a short

self-report instrument useful for measuring the

endorsement of depressive symptomatology in

epidemiologic studies of the general population

and clinical patients. Its items were taken from

previously validated longer scales concerning

symptoms associated with depression. The

CES-D was tested in household interview surveys

and in psychiatric settings and Was found to

have very high internal consistency and adequate

test-retest repeatability. It could also detect

changes in clinical status over time. The objective validity of the CES-D was established by

obtaining good correlations with other selfreport measures and cliniczd ratings of depression. Its construct validity was supported by

demonstrating the expected associations with

measures of related constructs. The factor structure of the CES-D and its reliability and validity

were found to hold across a variety of demographic characteristics in samples of the general

population tested.

Instructions for Scale Scoring

of the CES-D

Each item had a range of four response options which indicated how often the survey examinee had felt that way during the past week:

Code Response option

o................. Rarely or none of the time (less

than 1 day)

1................. Some or a little of the time (l-2

days)

2 ................. Occasionally or a moderate

amount of the time (3-4 days)

3................. Most or all of the time (5-7 days)

Questionnaire items 4, 8, 12, and 16 were

worded in a positive (i.e., nondepressed) direction. The other 16 scale items were worded in a

negative direction to elicit depressive symptomatology directly. To score the CES-D, the sense

of the four positive questionnaire items was reversed by subtracting their coded vzdue (indicating the response option selected) from 3.

Then the coded wdues for all 20 items were

summed into a totrd score. The range of possible scores was 0-60.

Rules for Missing Data

If more than five items on the scale were

missing, the whole scale was considered missing.

If one to five items were missing, the values of

the nonmissing items were totaled (after reversal

of the codes on the positively worded items),

the total value was divided by the total number

of (nonmissing) items, and this average vahe

was then multiplied by 20. The computed total

CES-1) score for each Detailed Component survey examinee, including imputation for missing

items, may be found on public-use data tape file

number 4171, tape positions 299-300 (see

appendix HI).

31
Interpretation of Scale Scores tional Institute of Mental Health.5 )14 A lower

Total CES-D scores of 16-60 were inter- cutoff point of 16 was chosen, rather than the

preted to mean high levels of endorsement of de- score of 17 recommended for a ruizl community,l 5 because the former value is preferred pressivc symptomatology bccausc they repre- for a predominantly urban population such as sented roughly the upper quintile of test scores

for patient populations on which the CES-13 that represented by the national probability

instrument was previously validated by the Na- sample of this report.

32
General Well-Being Questionnaire

HRA.11.7 (Formwly HSM.411-7) Form Approved

1.74 O.M.B. No. 68.R I I 84

DEPARTMENT OF HEALTH, EOUCATION, AND wELFARE ASSURANCE OF CONFIDENTIALITY

PUBLIC HEALTH SERVICE

HEALTH RESC)URCESADMINISTRATION

All informatim which W&Jld permit

NATIONAL CENTER FOR HEALTH sTATISTICS

identification of the indivklual will

HEALTH EXAMINATION SURVEY be held strictly confidential, WIII be

used only by persons enxa;ed in

and for the purposes of the survey,

GENERAL WELL-BEING and WIII not be disclosed or released

to others for any other purposes

(22 FR 1687).

o. Name (Lost, first, middle) b. Deck No. c. Sample No. d. Sex . . Age

! ❑ Male

171 _.. –. z ❑ Female ——

READ - This section of th* cxaminotion contoins questions obout how you feal and how things hovo been

going with you. For ●ach question, mark (X) the answer which b*st applies to-you.

I

1. How havo yau boon fcding in goncral? (DURING 1. 1 @ 1 ❑ In excellent spirits

THE PAST MONTH)

:

2 ❑ In very good spirits

a ❑ In good spirits mostly I

4 ❑ I have been up and down in spirits a lot I

I 50 In 10w Spirits mostly

6 ❑ In very low spirits 1

2. Havo you boon botharcd by nervousness or your 2. [ @ I n Extremely so -- to the point where I

“rmrves”? (DURING THE PAST MONTH) could not work or take care of things I

I 2 ❑ Very much so

sn Quite a bit

;

4 ❑ Some -- enough to bother me

sn A little

6n Notat all

I

3. Havo you boon in firm control af your bohaviar, 3. \ @ 1 ❑ Yes, definitely so

thoughts, emotions OR feelings? (DURING THE I

PAST MONTH) 2 ❑ yes, for the most part I

3 ❑ Generally so

I

4 ❑ Not too well

1

s ❑ No* and I am somewhat d isturbed

: 6 ❑ No, and I am very disturbed

4. Havo you felt so sad, discouraged, hopeless, or 1 n Extremely so -- to the point that 1 have

had so mony problems that you wondered if I just about g[ven up

anything was worthwhile? (DURING THE PAST 1

MONTH) /

2 ❑ Very much so

I

sn Quite a bit

I

I

4D Some-- enough to bother me

snA little bit I

6nNot at all I

I

5. Havo you been under or felt you wero under any 5./@ln Yes-- almost more than I could bear

strain, stress, or prossurs? (DURING THE PAST ~

MONTH)

or stand

I

2n Yes -- quite a bit of pressure

I

3 ❑ Yes . . some . more than usual

I

4 ❑ Yes -- some - but about usual

5nYes -a little

6 ❑ Not at all

I

33
6. How hoppy, soti sfied, or pleased have you 6. ~ @ I ❑ Extremely happy –could not have been

been with your personal life? (DURING THE

PAST MONTH)

more satisfied or pleased

~.

I 2 ❑ Very happy

I 3 ❑ Fairly happy

I

4 ❑ Satisfied -- pleased

I

5 ❑ Somewhat dissatisfied

I G ❑ Very dissatisfied

-

7. Have you had any reoson to wonder if you 7.:0~Wt❑ Not at all

were losing your mind, or losing control ovar

the way you act, talk, think, feel, or of your

2U Only a little

memory? (DURING THE PAST MONTH)

I

I 31_J Some -- but not enough to be concerned

I or worried about

I

I

4 ❑ Some and I have been a little concerned

I

s ❑ some and I am quite concerned

I G ❑ Yes. very much so and I am very concerned

—

8. Have you been onxious, worried, or upset? 8. \ @ I ❑ Extremely so -- to the point of being sick

(DURING THE PAST MONTH) I or almost sick

I

2 ❑ Very much so

3U Quite a bit

4m Some-- enough to bather me

I

snA little bit

I

6a Not at all

I

—

9. Have you been waking up fresh ond rested?

(DuRING THE PAST MONTH)

9. \ @ I ❑ Every day

2 I_J Mast every day

3 ❑ Fairly often

4 ❑ Less th~ half the time

5 ❑ Rarely

6 ❑ None of the time

10. Have you been bothered by any il Iness, bodily 10. ~ @) I ❑ AI I the time

disorder, poins, or fears about yaur health? I

(DURING THE PAST MONTH)

2 ❑ Most of the time I

3 I_J A good bit of the time I

I

4 ❑ Some of the time I

I

5 I_J A little of the time

I

I

6 n None of the timt!

11. Has your daily life been full of things that were 11. ~ @ 1 ❑ AI I the time

interesting ta YOU? (DURING THE PAST MONTH) \

2 ❑ Most of tie time

1

I

3 ❑ A good bit of the time

I 4 ❑ Some of the time

,

I so A little of the time

I 6 ❑ None of the time

-

—

12. Have you felt down-hearted and blue? (DURING 12. \ @ I O All of the time

THE PAST MONTH) I

2 ❑ Most of the time

I

,3 ❑ A good bit of the time

I

4 ❑ Some of the time I

I

s ❑ A little of the time

I 6 ❑ None of the time

1

34
13. Have you boon fooling ●motionally stable 13. ~ @la Allaf the time

and suro of yaursslf? (DURING THE PAST

MONTH)

I 2 ❑ Most of the time

/ 3 ❑ A good bit of the time

i 4 ❑ Same of the time

I

I s n A little of the time

I

6 D None of the time

14. Have you felt tired, worn out, used-up, or I ❑ All of the time

exhaust-d? (DURING THE PAST MONTH) I 2 D Most of the time

I 3 ❑ A good bit of the time

I 4 ❑ Some of the time

I 5 ❑ A little of the time

i 6 ❑ None of the time

For ●ach of the four scales below, note that tfr[

wards at each end of thq O to 10 scale describ(

apposite f~clings. Circle any number along the

bar which seems closest to how you have gmr-

●rally felt DURING THE PAST MONTH. 1

I

15. How concerned or worried about your HEALTH 15. ~@01234, ,,, g,(

have you been? (DURING THE PASTMONTH)

I

[ Not Very

I concerned concerned

at all

I

16. Haw RELAXED or TENSE have you been? 16. @ O 1 2 3 4 5 6 7 8 9 II

(DURING THE PAST MONTH) 1

!

I I

I Very Very

I

relaxed tense

17. How much ENERGY, PEP, VITALITY have 17. \@ O 12345678910

you felt? (DURING THE PAST MONTH)

!

I I I

I

No energy Very

AT ALL,

/

ENERGETIC,

listless dynamic

I

18. How DEPRESSED os CHEERFUL have

have you been? (DURING THE PAST MONTH)

1+O1234567891O

I

I

I

I Very Very

I depressed cheerful

19. Have you had severe ●naugh personal, 19.,0~019 I ❑ Yes, and I did seek professional help

emotional, behavior, or mental problems

that you felt yau needed help DURING

2 ❑ Yes, but I did not seek professional

I

THE PAST YEAR?

help

I

I 3 ❑ I have had (or have now) severe

personal problems, but have not felt

[

I needed professional help

4 ❑ I have had ve~ few personal problems 1

I of any serious concern

I

I s I_J I have not been bathered at al I by

personal problems during the past year !

35
0. Have you ● vor felt that yau wora going ta I ❑ Yes .- during the past year

hov~, or woro CIOSO to having, a nervous I z ❑ yes . . more ** a year ago’

breakdown? I SONO

I -

!1. Have you cvor had a nervous 21. { @ 1 ❑ Yes -- during the past year

breakdown? I 2 ❑ Yes . . mare than a year ago

I 30N0

I

U. Have you ● ver baen a patient (or outpatient) 22. I @ I •l Yes -- during the past year

at a mental haspital, a mental health ward of I 2D Yes .- more than a year ago

a haspital, or a mental health clinic, for any

personal, ●motional, behavior, ar mental prablem; [

30N0

?3. Have you ever seen a psychiatrist, psychologist, 23. l@l UYes -- during the past year

ar psychoanalyst abaut any personal, ~ ❑ Yes . . more than a year ago

emotianal, behovior, or mental problem

I

concerning yourself? I 30N0

24. Have you talked with or had any connection I

I

with any af th~ following about some persanal, I

emotional, behavior, mental prablom, worrios,

or “nerves” CONCERNING YOURSELF DURING j

THE PAST YEAR?

o. Regular medical doctor 24a. ~

(except far definite physical

conditions ar routine check-ups) . . . . . . . . . \,0024 I ❑ Yes 20N0

b. Brain or nerve specialist . . . . . . . . . . . . .

b.l@l DYes 2DN0

c. Nurse (except for routine c.~@tDYes medical condition s)...... . . . . . . . . . . .

20N0

d. Lawyer (except for routine

Iegal services) . . . . . . . . . . . . . . . . . . . .

do! @lo Yes ZI_JNO I

e. Police ( ●xcept for simple

I

traffic violation s) o . . . . . . . . . . . . . . . . . ●.[ 2DN0

f. Clergyman, minister, priest,

rabbi, etc...... . . . . . . . . . . . . . . . . . .

fm~@lnYes 2DN0

‘o[ 030 1 ❑ Yes

g. Marrioge Counselor . . . . . . . . . . . . . . . . . g.l 2DN0

h. Social Worker . . . . . . . . . . . . . . . . . . . . .

h.! @l aYes 20N0

I

i. Other formal assistance:. . . . . . . . . . . . . .

i.! 0032 ln Yes- What kind?

I -

I

2nNa

1

25. Da you discuss your prablems with any members 25. \ @ I ❑ Yes - and it helps a lot

of your family or friends? I 20 Yes- and it helps some.

3 ❑ Yes - but it does not help at all

4 ❑ No - I do not have anyone I can talk

with about my problems

s ❑ No - no one cares to hear about my

I problems

I 6nNO- 1 do not care to talk about my

I

problems with anyone

7 ❑ No - I do not have any problems I

36
Circle the number for each statement which best describes how often You felt

26.

27.

28.

29.

30.

31.

32.

33.

34.

35.

36.

37.

38.

39.

40.

41.

42.

43.

44.

45.

or behaved this way-DURING THE PAST WEEK. -

Occasionally

DURING THE PAST WEEK:

I was bothered by things that usually don’t

bother me . . . . . . . . . . . . . .

I did not feel like eating; my appetite was

poor . . . . . . . . . . . . . . . . .

I felt that I could not shake off the blues even

with help from my family or friends . . . .

I felt that I was just as good as other people .

I had trouble keeping my mind on what I

was doing . . . . . . . . . . . . . .

I felt depressed. . . . . . . . . . . . .

I felt that everything 1 did was an effort . . .

I felt hopeful about the future . . . . . .

I thought my life had been a failure . . .

i felt fearful . . . . .

My sleep was restless .

I was happy. . . . .

I tal Ked less than usual

I felt lonely . . . . .

People were unfriendly

I enjoyed life . . . .

I had crying spells . .

Ifeltsad. . . . . .

. . . . . . . . .

. . . . . . . . .

. . . . . . . . .

. . . . . . . . .

. . . . . . . . .

. . . . . . . . .

. . . . . . . . .

. . . . . . . . .

. . . . . . . . .

1 felt that people disliked me . . . . . . .

I could not get “going” . . . . . . . . .

Rarely or

None of

the Time

(1.py

o

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

Some or a

Little of

the Time

(l-2 Days)

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

ora -

Moderate

Amount of

Time

(3-4 Days)

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

Most or

All of

the Time

(5-7 Days)

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

i

46. Filled out by: ~ 1 •l Examinee 2 ❑ Interviewer 30 Mixed

*U.S. GOVERNMENT PRINTING OFFICE: 1980 311-240/15 1-3 37
VITAL AND HEALTH STATISTICS Series

Series 1. Programs and Collection Procedures. –Reports which describe the general programs of the National

Center for Health Statistics and its offices and divisions and data collection methods used and include

definitions and other material necessary for understanding the data.

Series 2. Data Evaluation and Methods Research. –Studies of new statistical methodology including experimental tests of new survey methods, studies of vital statistics collection methods, new analytical

techniques, objective evaluations of reliability of collected data, and contributions to statistical theory.

Series 3. Analytical Studies. –Reports presenting analytical or interpretive studies based on vital and health

statistics, carrying the analysis further than the expository types of reports in the other series.

Series 4. Documents and Committee Reports. –Final reports of major committees concerned with vital and

health statistics and documents such as recommended model vital registration laws and revised birth

and death certificates.

Series 10. Data From the Health Interview Survey. –Statistics on illness, accidental injuries, disability, use of

hospital, medical, dental, and other services, and other health-related topics, all based on data collected

in a continuing national household interview survey.

Series 11. Data From the Health Examination Survey and the Health and Nutrition Examination Survey. –Data

from direct examination, testing, and measurement of national samples of the civilian noninstitutionalized population provide the basis for two types of reports: (1) estimates of the medically defined

prevalence of specific diseases in the United States and the distributions of the population with respect

to physical, physiological, and psychological characteristics and (2) analysis of relationships among the

various measurements without reference to an explicit finite universe of persons.

Series 12, Data From the Institutionalized Population Surveys. –Discontinued effective 1975. Future reports from

these surveys will be in Series 13.

Series 13. Data on Health Resources Utilization. –Statistics on the utilization of health manpower and facilities

providing long-term care, ambulatory care, hospital care, and family planning services.

Series 14. Data on Health Resources: Manpower and Facilities. –Statistics on the numbers, geographic distribution, and characteristics of health resources including physicians, dentists, nurses, other health

occupations, hospitals, nursing homes, and outpatient facilities.

Series 20. Data on Mortality. –Various statistics on mortality other than as included in regular annual or monthly

reports, Special analyses by cause of death, age, and other demographic variables; geographic and time

series analyses; and statistics on characteristics of deaths not available from the vital records based on

sample surveys of those records.

Series 21. Data on Natality, Marriage, and Divorce. –Various statistics on natality, marriage, and divorce other

than as included in regular annual or monthly reports. Special analyses by demographic variables;

geographic and time series analyses; studies of fertility; and statistics on characteristics of births not

available from the vital records based on sample surveys of those records.

Series 22. Data From the National Mortality and Natality Surveys. –Discontinued effective 1975. Future reports

from these sample surveys based on vital records will be included in Series 20 and 21, respectively.

Series 23. Data From the National Survey of Family Growth. –Statistics on fertility, family formation and dissolution, family planning, and related maternal and infant health topics derived from a biennial survey

of a nationwide probability sample of ever-married women 1544 years of age.

For a list of titles of reports published in these series, write to: Scientific and Technical Information Branch

National Center for Health Statistics

Public Health Service

Hyattsville, Md. 20782
NCHS US. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE POSTAGE AND FEES PAIO

Publ+c Health %wce

Otf,ce of Health Pmemh, Slat(stm and Technology U.S DEPARTMENT OF I+E.W

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